“I would have never dreamed that I would lose my limb.”
Larry “Shorty” Coleman delivered those words to lawmakers during the bipartisan relaunch of the Congressional Peripheral Artery Disease (PAD) Caucus.
A Harlem Globetrotter who has played basketball since he was eleven, Shorty built his life around movement. Conditioning. Endurance. The instinct to push through pain. When his leg began to hurt, he treated it like an athlete treats a cramp. Something temporary. Something manageable.
He was one of the patients who spoke on Capitol Hill at the caucus relaunch, alongside physicians, industry leaders, and another PAD patient, Dawn-Marie.
Both Shorty and Dawn-Marie rolled in.
Neither walked in.
They were not there for sympathy. They were there to explain how a disease more prevalent and deadlier than most cancers combined was allowed to progress unchecked until amputation became the outcome.
And how that progression did not have to happen.
Peripheral Artery Disease is not rare. It is poor circulation in the legs that increases cardiovascular morbidity and mortality. In high-risk patients such as those with diabetes, hypertension, hyperlipidemia, clotting disorders, or autoimmune disease, early testing can identify disease before it advances to tissue loss. In many cases, progression can be slowed with medication, risk-factor control, and coordinated vascular care.
That is what the physicians and patients who stood before Congress made clear. And that is what they discussed in depth on this week’s episode of The Heart of Innovation.
Dr. John Phillips and I invited Shorty, Dawn-Marie, vascular surgeon Dr. Bob Tahara, and interventional cardiologist Dr. Andrew Klein to share what was said during the relaunch of the PAD Caucus and why it matters now. The focus was direct: expand coverage for early PAD testing, require documented vascular evaluation before non-traumatic amputation, and address insurance delays and denials that stall limb-saving care while amputations move forward with far less resistance.
The relaunch centers on reviving the Amputation Reduction and Compassion Act, legislation that lost traction after Congressman Donald Payne Jr., who had PAD and championed the bill, passed away. The ARC Act would expand coverage for early PAD testing among high-risk patients and require documented vascular evaluation before any non-traumatic amputation proceeds.
For clinicians, those provisions address two persistent gaps. Too many high-risk patients are not screened early. Too many amputations proceed without comprehensive vascular assessment.
Shorty’s story underscores the first gap.
“Don’t take for granted it’s just a cramp,” he told lawmakers.
He described escalating leg pain and the assumption that it was muscular. He spoke about diabetes in his family. About going to the emergency room when the pain intensified. Looking back, he believes earlier specialist evaluation might have changed his trajectory.
Dawn-Marie followed him at the caucus relaunch.
She began with questions.
When you leave this building and walk to your car in the snow, she asked lawmakers, what does that require? When your child runs ahead of you at the park and you step onto wood chips to push them on a swing, what does that require? When you go to the beach and your children run toward the ocean, can you reach them?
She cannot.
But her message to lawmakers did not stop at life after amputation.
Before the amputation, the leg pain was severe enough that she would sit on the floor in public because she could not keep walking. She sought medical care and described worsening symptoms.
Doctors dismissed it.
She then had a heart attack.
She underwent two heart catheterizations.
The leg pain continued to intensify.
Still, she said, no vascular evaluation was performed. No PAD diagnosis was made. No coordinated assessment connected her cardiac disease with her limb ischemia.
That sequence is not isolated. It is why the ARC Act is back on the table.
Early testing for high-risk patients. Documented vascular evaluation before non-traumatic amputation. Connecting cardiac disease and limb ischemia instead of treating them as separate silos.
During the broadcast, I shared what we see through the Global PAD Association hotline. Patients are told it is neuropathy. Or diabetes. Or aging. They are reassured. When they finally get proper testing, the diagnosis is PAD.
When we actually get them tested, it is PAD.
And once they reach a physician willing to pursue true limb salvage, major amputation is often mitigated or prevented altogether.
Dr. Bob Tahara addressed what that work requires. Disease below the knee. Malleolar reconstructions. Time-intensive procedures that not everyone is trained or willing to perform.
“You have to be willing to go below the knee,” he said. “Not everybody’s capable of doing that.”
He also made a point that resonated in the room. Amputation has existed for as long as surgery has existed. Revascularization is comparatively recent.
“Amputation’s been around for a long time,” he said. “Revascularization is really a recent technology.”
Yet reimbursement systems often treat them as though the older solution is the default.
The conversation turned to insurance pre-authorization. I asked how it is possible that amputations receive approval so readily, while revascularization procedures are delayed, scrutinized, or denied.
Patients call the Global PAD Association’s Leg saver Hotline in the middle of the night.
“I need hope. I need help,” they say. “Walk me through dangling my legs. Pacing. Trying to get blood back into my feet.”
They wait. Tissue deteriorates. Two weeks later, a denial.
Meanwhile, a major amputation moves forward.
Dawn-Marie added another layer.
“There are a lot of doctors that think you’re going to get a prosthetic, like no big deal,” she said. “You’re going to get a prosthetic the moment you have the amputation. Within a year, you’ll be walking like no problem.”
Then she addressed physicians directly.
“Stop promising,” she said. “If you’re a physician or a surgeon, stop giving the false hopes of walking within the first year. I’m almost five years out, and I still don’t walk.”
The human cost does not end in the operating room.
Dr. Tahara noted that once patients reach a major level amputation, rehabilitation is difficult and outcomes are often limited. And PAD rarely affects only one limb.
“Disease burden is always bilateral,” he said.
Dawn-Marie knows that reality. Her remaining leg is still diseased. Physicians are cautious after what happened with the first.
“I still have young children,” she said. “I still have to go to the supermarket. I have to keep going. I can’t afford to stop and lose my other leg.”
The relaunch of the Congressional PAD Caucus brings these stories back into the room where policy is shaped.
Shorty assumed a cramp would pass.
Dawn-Marie sat on the floor in public because the pain was overwhelming, survived a heart attack and two cardiac catheterizations, and still was not evaluated for PAD until amputation was unavoidable.
The physicians who stood beside them are not asking for sympathy. They are asking for standardization. Early testing in high-risk patients. Documented vascular evaluation before amputation. Reimbursement structures that do not delay limb salvage while accelerating limb loss.
We already know how to detect PAD.
The question is whether we will do it consistently.
Recognition is not optional. It is the difference between intervention and regret.
About the PAD Pulse Alliance and Get a Pulse on PAD Campaign
The relaunch of the Congressional Peripheral Artery Disease Caucus was supported by the PAD Pulse Alliance, a coalition of leading cardiovascular and vascular organizations working to improve PAD awareness, screening, and treatment standards.
Founding members include the Association of Black Cardiologists (ABC), the Society for Cardiovascular Angiography and Interventions (SCAI), the Society of Interventional Radiology (SIR), and the Society for Vascular Surgery (SVS). Supporting partners include the American Podiatric Medical Association, the CardioVascular Coalition, the CLI Global Society, Corazon, the Global PAD Association, the Outpatient Endovascular and Interventional Society, the Preventive Cardiovascular Nurses Association, and the Society for Vascular Medicine.
The initiative is driven in part through SCAI’s Get a Pulse on PAD campaign, which aims to educate clinicians and the public about PAD risk factors, symptom recognition, and the importance of early testing. The campaign is supported by industry partners including BD, Biomedix, and others committed to improving early detection and limb preservation.
Together, the coalition is focused on advancing policy solutions that expand high-risk PAD screening, require vascular evaluation before non-traumatic amputation, and reduce preventable limb loss nationwide.
