Amputation Nation Show Outline
CHAPTER 1: The Problem • Patient Story #1 (African American who got amputated too early) • CLI is deadlier than many cancers • Too many amputations performed as a first-line treatment • Many patients don’t receive proper PAD Screening before amputation • Many providers aren’t aware of the latest treatments • Not enough qualified specialists • Amputations come at great cost to patient, family, health systems, & society • Amputations & CLI affect socioeconomically disadvantaged at a higher rate
CHAPTER 2: History & Disease • Patient Story #2 (follow Native American patient diagnosis through treatment) • First amputations • What is PAD vs CLI and how does diabetes play a role • How has it been treated historically • Latest & Greatest Treatments
CHAPTER 3: The Roadblocks • Who are Radiologists, Cardiologists, & Vascular Surgeons • Patient Story #3 (patient caught up in turf war) • History of Turf Wars (DeBakey vs Cooley Story & Early days of balloons/stents) • Today’s Landscape - New Frontier of CLI - Who’s going to treat these patients and how? - OBLs vs Hospitals - Surgeons vs Endovascular Specialists - Insurance coverage - Costs of amputation vs therapies - Should CLI be its own specialty?
CHAPTER 4: When is the Right Time to Amputate? • Most Patients die within 5 years of Amputation • Patient Story #4 (Patient who died within 5 years) • Patient Story #5 (Patient who continues to thrive after 5 years) • Do new technologies work or are we just delaying the inevitable? • Should we amputate before patients are too sick to handle prosthetic? • Advancements in prosthetics • Should we intervene to save legs endlessly until there is no alternative? • On-going treatment vs Cure. How do you define success? • CLI Therapy is a program not a treatment • They do if for cancer patients, why not CLI?
CHAPTER 5: Where Do We Go from Here? • Patient Story #6 (Patient who has gained years of quality life with legs) • Work together among all specialties (even podiatrist) • Training more CLI Specialists • Healthy legs aren’t attached to unhealthy bodies • New EARLY Diagnostic Tests - CT Fractional Flow Reserve • Patient and Referring Physician Education is key • What should a patient do when faced with CLI and amputation? • Amputation should not be a frontline therapy without proper screening, education, and treatment options explored • The right time for an amputation is when an educated patient makes an educated decision themselves
CHAPTER 2: History & Disease • Patient Story #2 (follow Native American patient diagnosis through treatment) • First amputations • What is PAD vs CLI and how does diabetes play a role • How has it been treated historically • Latest & Greatest Treatments
CHAPTER 3: The Roadblocks • Who are Radiologists, Cardiologists, & Vascular Surgeons • Patient Story #3 (patient caught up in turf war) • History of Turf Wars (DeBakey vs Cooley Story & Early days of balloons/stents) • Today’s Landscape - New Frontier of CLI - Who’s going to treat these patients and how? - OBLs vs Hospitals - Surgeons vs Endovascular Specialists - Insurance coverage - Costs of amputation vs therapies - Should CLI be its own specialty?
CHAPTER 4: When is the Right Time to Amputate? • Most Patients die within 5 years of Amputation • Patient Story #4 (Patient who died within 5 years) • Patient Story #5 (Patient who continues to thrive after 5 years) • Do new technologies work or are we just delaying the inevitable? • Should we amputate before patients are too sick to handle prosthetic? • Advancements in prosthetics • Should we intervene to save legs endlessly until there is no alternative? • On-going treatment vs Cure. How do you define success? • CLI Therapy is a program not a treatment • They do if for cancer patients, why not CLI?
CHAPTER 5: Where Do We Go from Here? • Patient Story #6 (Patient who has gained years of quality life with legs) • Work together among all specialties (even podiatrist) • Training more CLI Specialists • Healthy legs aren’t attached to unhealthy bodies • New EARLY Diagnostic Tests - CT Fractional Flow Reserve • Patient and Referring Physician Education is key • What should a patient do when faced with CLI and amputation? • Amputation should not be a frontline therapy without proper screening, education, and treatment options explored • The right time for an amputation is when an educated patient makes an educated decision themselves