Unless you are in critical limb ischemia, the most advanced stage of PAD where your leg is acutely threatened…and/or your life, you need to have a candid conversation with your vascular specialist about why you have PAD BEFORE any intervention or surgery.

Knowing why you have PAD can help you mitigate the risk factors and possibly avoid a procedure altogether.

If it’s a genetic clotting disorder, a doctor may put you on anticoagulant therapy.

If it’s diabetes, a doctor may refer you to a dietitian and/or provide appropriate glucose control medicine.

If it’s caused by smoking, your doctor may offer prescription gum or patches as well as cessation programs to help you quit.

If it’s caused by a sedentary lifestyle, your doctor can put you on a regimented walking program.

And if you still need a procedure because symptoms don’t improve and they’re lifestyle limiting despite conservative approaches, mitigating these risk factors soonest can help prevent a revolving door of interventional and surgical treatments.

But, unfortunately not all doctors have the memo on this approach.

A 33 year old patient presented to our Leg Saver Hotline after her vascular specialist told her she needed an intervention to clear out blockages in her leg.

Her insurance denied coverage for the procedure initially, so she reached out to our organization for options.

After talking with her, I don’t blame the insurance company in this case for raising a red flag.

She’s 33 years old!

No wounds.

No frontline medical therapy or lifestyle modification programs for weigh loss and walking discussed.

No advanced blood work or imaging to determine the cause of this early PAD onset (and she’s not diabetic!).

Might she have an autoimmune condition?

Might she have a genetic clotting disorder?

We don’t know.

So, why are you going to do a procedure without an acute leg scenario when we have no idea what or why?

I just had a patient come to me after a doctor went in blind, not realizing she was filled with clots. He poked the beehive and a shower of clots trashed her foot! Amputation. So, she NOW seeks a second opinion to keep her other leg.

So my spidey sense is triggered with these types of cases.

I messaged the vascular doctor to ask for additional imaging and bloodwork as well as to get approval for the 33 year old to join our walking program.

No response.

I told the 33 year old that she needed to get a consult with her primary care physician for further exploration and potential referrals to hematology, rheumatology, and a general cardiologist.

That was today.

We worked together on critical questions and concerns to address during this appointment, urging her PCP for support in getting to the bottom of what’s leading to clots in both legs below-the-knee….

Her PCP refused all referrals including a hematology referral as “your ultrasound did not show clots, only that your blood was struggling.”

She hesitantly ordered some basic blood panels, but assured the patient they would be normal, blaming the sluggish flow on simply “Bad genetics.”

I love that after talking to our organization that our patient was advocating for additional imaging and testing that could help with potential medicine and supplement selection to mitigate risk factors, as well as for support with lifestyle modifications.

It’s too bad that neither the PCP nor the vascular specialist would listen and only urging her to have an intervention.

Thank goodness this patient is taking her health into her own hands and already signed up for our walking program a month ago and has been watching her diet after reading our diet book…

Shocker… symptoms have improved.

We still have BIG concerns about what’s causing her blockages…

So, it’s time for another opinion.

It’s a good lesson for all patients to be the best advocate for their health!

If you have PAD, bring this form into your doctor for the next appointment and have a candid discussion with them about what may be causing your arteries to back-up.