We have to get blood to the ankle before the midfoot and the midfoot before the toes etc. With topical O2 we may prevent tissue loss while this revascularization process proceeds. The arteriogram showed us where contrast was able to go but gave no data on its speed , pressure or benefit. The anxiety of the patient was magnified daily with the realization that the cost of his treatment was of more concern to his HMO than his outcome. Doctors frequently are not paid for their efforts by HMO's.
Cerebral work costs the doctor time.
Boot treatment may cost the doctor time in supervising the care but it also costs money for technicians, compression bags, electrodes, treatment tables, compressors etc. As HMO's reduce the reimbursement they pay for such services and minimize the profit margin of such services, free care to those in need becomes impossible. This man might have lost his leg eventually someday anyhow. He lost it at the time he did because of a deadline of mankind and not an act of God. And those enforcing the decisions of the HMO still have not authorized the payment of the funds they agreed to pay.