second opinion

It’s Okay to Ask for a Second Opinion

Peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.) has many treatment options, including long-term lifestyle changes and medications.

However, if you have advanced PAD, these treatments might not be enough. Your doctor may recommend bypass surgery(Arterial bypass surgery) Your doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery. or amputationTo surgically remove all or part of a limb (leg, foot or toe), a common treatment for the most severe stage of PAD.³

This is an important decision. There are more than 160,000 PAD-related amputations annually performed in the U.S.,³ and having an amputation can put your life at risk.³

So how do you know if other treatment options are available for you?

Get a second opinion. Talk with a doctor who is a PAD specialist or is a part of a limb salvage programA hospital-based, physician-led, comprehensive program in which health care providers coordinate your care among the multiple specialties involved with the goal of saving your legs, feet or toes from amputation..

It’s OK to think about whether another doctor may suggest different treatment options. As with any big decision, you want to make sure you’ve gathered as much information as possible in order to make the best decisions about your health.

Keep in mind, not all health care professionals are PAD specialists — and not all PAD specialists use the same treatment techniques. Treatment options for PAD are constantly advancing, and today’s options are very different than they were just five years ago.²⁰

Some questions you might want to consider asking your doctor:

Does your clinic/hospital have a limb salvage program?
What treatment options do I have other than amputation?
What benefits do these options offer compared to amputation?

It’s up to you to take control of your health. If amputation has been recommended for you, get a second opinion that could help guide your decisions. Medical treatments to help restore blood flow to your legs may be able to help save legs and feet. In many patients, these treatments have been shown to offer advantages when compared to amputation.¹⁷

Only a doctor can determine the most appropriate treatment options for your condition, but it’s important to explore your options. Find a PAD specialist near you and ask for a second opinion about your treatment.

How to Get a Second Opinion

How To Get a Second Opinion: Important Steps Before Agreeing to an AmputationTo surgically remove all or part of a limb (leg, foot or toe)

Many people fear that seeing a doctor will lead to bad news. With peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.), early detection is important. Getting appropriate screening and treatment could help stop the disease from getting worse – possibly saving a toe or leg from amputation,

However, there sometimes is a recommendation for amputation. If that happens to you or a loved one, remember that you do have the right to seek a second opinion. Getting a second opinion helps you know all your options and provides peace of mind about your decision.

Advanced PAD Symptoms and Treatment Options

It’s important to first understand the signs your body is telling you. If you feel leg pain during the night, experience wounds that aren’t healing, or have numb, cold toes or feet, schedule an appointment with your doctor as soon as possible.

Amputation also can be an outcome for PAD as people with diabetes and PAD have a 5-10 times greater risk of amputation than people without diabetes(Diabetes mellitus) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both..¹²

There are many treatment options for PAD, such as diet changes, exercise, medication, minimally invasiveIn minimally invasive surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. procedures and arterial bypass surgeryYour doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery.. Before agreeing to an amputation, talk to another health care professional. Many other health factors can contribute to your life being at risk after amputation, including advanced age, heart failure, kidney diseaseA disease that impairs the kidneys’ ability to filter waste products and extra water from the blood. and cancer.²⁵

How to Get a Second Opinion

As you look for a second opinion, here are a few thing to remember:

For advanced PAD often called critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. or chronic limb threatening ischemiaAlso referred to as critical limb ischemia (CLI), the most severe and deadly form of peripheral artery disease., it’s very important that you are treated by a vascular specialist. Unfortunately, not all physicians who treat PAD are skilled in treating the most advanced cases.
If your current doctor says that you need an amputation, it’s often in your best interest to seek a second opinion before undergoing a life-changing procedure like amputation.
You don’t need your current doctor’s permission to find another doctor. You can use CSI’s Find a Doctor tool as a resource to find nearby PAD specialists.
Check your insurance plan to understand your coverage with any new physicians.
As you research other practices, ask front-office staff if they have a limb salvage

As part of your ongoing care, make sure you have an angiogram before agreeing to an amputation. An angiogram test uses X-rays to take a series of images of your blood vessels. The results will show the extent of blockages and how to restore blood flow.

“Never agree to an amputation without an angiogram,” says Dr. Jihad Mustapha, Associate Professor of Medicine at Michigan State University. “An angiogram alone increases your chances of not having an amputation by approximately 90%.⁵

For More Information

Get additional information from more healthcare professionals will help you make treatment decisions. Learn more about second opinions on Stand Against Amputation website.

Be an Advocate for Your Health — Get a Second Opinion About Amputation

Advocate for Your Health and Ask for a Second Opinion Regarding PAD-related amputations

Be an Advocate for Your Health — Get a Second Opinion About AmputationTo surgically remove all or part of a limb (leg, foot or toe)

Is your doctor recommending amputating your leg or foot as treatment for peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.)? It’s important to know that you don’t have to accept that prognosis before doing more research. You can — and should — advocate for yourself by getting a second opinion.

Many people take a doctor’s recommendation at face value and without question. However, not all healthcare providers are PAD experts.

PAD is a complex condition that requires years of specific expertise to treat each unique case. Some doctors don’t use optimal imaging techniques and equipment that show the severity of a patient’s PAD.

If your doctor isn’t using updated techniques and technology, you might not be getting the best recommendation. Don’t be afraid to speak up and find out more information.

Why should amputation be the last treatment option?

Losing a toe, foot or leg can impact your quality of life, it puts you at risk for surgical complications, infection and further amputations. Several other health factors including advanced age, heart failure, kidney diseaseA disease that impairs the kidneys’ ability to filter waste products and extra water from the blood. and cancer can also contribute to your life being at risk after amputation.²⁵

Even with severe PAD, don’t give up hope if your initial prognosis is bad. There may be other options to try. According to the University of Michigan’s Frankel Cardiovascular Center, “in many cases even when gangreneGangrene is dead tissue, caused by poor blood flow to part of your body. Gangrene can occur on the skin or in muscles or organs. Peripheral artery disease is a known cause of gangrene. is present, amputation can be avoided.”

Efforts to save your legs and feet have been shown to have advantages compared to amputation. If you can avoid an amputation, you not only have lower healthcare costs, but you may live longer with a better quality of life.³

With this information in hand, how do you get a second opinion that helps you decide the best treatment plan?

Do your research

Research trusted online resources. While remembering that each case is unique, you can talk to other doctors about PAD. To get a second opinion, ask your doctor for PAD specialist recommendations or use our Find a Doctor tool.

The bottom line — don’t be afraid to ask lots of questions and be a partner in your healthcare. You have the power to prevent a life-altering amputation.