Why Didn’t We Know More?”: One Family’s Experience with PAD

After both her mother and her aunt were diagnosed with peripheral artery disease (PAD), Mariam was left wondering why her family had known so little about a disease with such serious consequences.

Mary loved to walk. She and her husband, Bill, traveled throughout California and the West, spent time outdoors, and volunteered together as campground hosts. She raised four children, remained deeply connected to her family, and lived to be 98.

So when peripheral artery disease eventually took away her mobility, and ultimately her leg, the loss was especially profound.

For Mary’s daughter, Mariam, PAD is not an abstract medical condition. She watched both her mother and her aunt live with the disease. Both women underwent multiple procedures to restore blood flow to their legs. Their experiences were different, but together they left Mariam with a lasting awareness of just how serious PAD can become and how difficult it can be for patients and families to understand what is happening before the disease has progressed.

Mary’s problems began with something extraordinarily ordinary: a toenail clipping. She had significant vision loss from macular degeneration, and during routine nail care her toe was accidentally cut. The injury did not heal but became worse; Mary’s vision loss meant that she did not see how the wound was getting worse. It eventually developed into an ulcer.

Mariam and her family urged her to see a doctor. When she was evaluated, they learned that the problem was far more serious than the wound itself: there was inadequate blood flow to her leg.

A vascular surgeon performed a procedure to restore circulation, and the result was dramatic. “It worked fabulously,” Mariam remembers. Her mother was up and walking with her walker the next day.

But PAD is a chronic disease. Restoring blood flow does not make the underlying vascular disease disappear, and continued monitoring and care remain important. Life also intervened. Mary’s husband of nearly eight decades fell ill, and she became his caregiver. Like many people caring for someone they love, her focus shifted toward his needs and away from her own.

Meanwhile, the PAD had not gone away. Problems later developed in Mary’s other foot. What followed would eventually consist of a series of vascular procedures, worsening circulation, and ultimately above-the-knee amputation. 

The loss itself was devastating. So was what came after. Rehabilitation after a major amputation is grueling, even for a fit, strong, determined woman like Mary. Mariam remembers her mother sobbing when the family tried to encourage physical therapy. Mary eventually required residential care and developed additional complications. She died later that year.

Mary’s sister, Mariam’s aunt, also had PAD. She, too, underwent multiple vascular procedures, although her interventions were more successful. She ultimately died after a stroke.

For Mariam, having two women in the same family affected by vascular disease

raises an important question: Why didn’t we know more?

If someone has a heart attack, families immediately understand that something serious has happened. They know the heart is involved. They know the condition can be life-threatening. They know it needs urgent attention.

PAD does not always carry that same sense of danger. A sore foot can look like a foot problem. Leg pain can seem like aging. A wound that heals slowly may not immediately suggest vascular disease.

PAD affects the arteries that carry blood to the legs and feet. Because it is generally caused by the same atherosclerotic process that affects arteries supplying the heart and brain, PAD is not simply a “leg problem.” People with PAD are also at increased risk of heart attack and stroke.

Yet PAD can be surprisingly difficult to recognize.

Some people experience leg pain while walking. Others may notice numbness, weakness, changes in the skin or toenails, or wounds on the feet or toes that are slow to heal. Some people have few noticeable symptoms at all.

A minor cut on a healthy foot may heal without a second thought. In someone with severely reduced circulation, that same injury can become a non-healing wound and, in advanced disease, threaten a limb.

That is why awareness and prevention matter.

Knowing the risk factors for PAD, recognizing symptoms and foot problems early, and talking with a healthcare provider about vascular health can lead to earlier diagnosis and treatment. For people already living with PAD, continued medical care and careful attention to foot health are especially important, along with managing cardiovascular risk factors such as diabetes, high blood pressure, high cholesterol, and smoking.

Mariam cannot know whether greater awareness would have changed what happened to her mother or her aunt. But she does know that her family understood far too little about PAD while they were living through it. Because sometimes vascular disease begins quietly, with pain someone dismisses, a wound that will not heal, or even a tiny cut from a toenail clipping. Knowing what those signs can mean may make all the difference.

By sharing their story, she hopes another family might recognize the warning signs sooner.