From Physician Associate to Amputee Advocate: An Inspiring Odyssey featuring Tina Hurley
In this podcast episode, we sit down with Tina Hurley, a board-certified physician associate with extensive experience in vascular surgery, acute care medicine, and wound care. Tina’s medical career involved treating diabetic patients and performing amputations, until she herself became an amputee.
This exciting interview reveals Tina’s journey from medical professional to amputee, and eventually into advocacy. She discusses the challenges and barriers faced by amputees in navigating the healthcare system and the lack of support for their unique needs. Tina emphasizes the importance of education, mental health support, and community in the recovery and rehabilitation of amputees.
Tina is the founder and CEO of «Less Leg More Heart,” a nonprofit organization that provides education, mentorship, advocacy, and funding to help amputees physically, emotionally, and financially. She explains the significance of understanding, connecting, and funding as the primary needs of amputees. The conversation sheds light on the mental health challenges amputees face, the importance of psychotherapy, and the role of community and support in their recovery.
Transcript
Host
Tina is a board-certified physician associate with 10 years in vascular surgery, acute care, medicine, uh, sorry. Tina is a board certified physician associate with 10 years in vascular surgery, acute care, medicine, and wound care experience. She's the founder and CEO of the 501c3 nonprofit, Less Leg More Heart. They provide support, supplies, and services to United States amputees. She's a New Hampshire native, a toddler mother, public speaker, adaptive athlete, and passionate disability advocate. Tina Hurley, welcome to the Patient Advocacy Now podcast. Thank you so much for being here.
Tina Hurley
Thanks so much, John, for having me. I'm excited to connect and I'm just such a fan of GNA and it's such a pleasure to have these conversations and hopefully have some folks in the community learn vital information and some resources that will help them out.
Host
Yeah, we're excited to have you. We haven't had an amputee kind of focused advocate or someone in that space yet. And I'm curious to hear your story, how you got started and what drew you to that cause.
Tina Hurley
Yeah, it's, you know, folks joke that it's divinely intervened on or universally nudged, but my circumstances, I sort of saw things from the bedside as a clinician and also from the bed itself as a patient at the same chapter in my life. So one of these...
Things is a physician associate degree and I worked in a practice where I amputated legs for a living and I rounded on all of the patients and took care of all of the adverse outcomes and watched them struggle with the barriers that they had to navigating the system understanding the system and The other barriers that made their ability to comply with the medical plan Unsuccessful and as a clinician, you know, your hands are bound by FDA regulations, which
Host
No.
Tina Hurley
govern the things you can provide, needles, narcotics, surgeries, and some other things sprinkled in, but it wasn't often the most successful and people needed more education and more, just navigation and more social work to fill the holes in care, to really fix the problems that were occurring. In medicine we...
measure secondary outcomes like infection and depression and suicidality and opioid overuse and readmission and etc. But we oftentimes don't have the capacity, time, affordability in the system to really govern and fix the problems that lead to those outcomes. And it's a systems issue. It's not anyone's fault, but
because of the way that insurance is and the governance that it has over the direction of care for patients, the clinicians are sort of stuck, you know, in the middle of this tier that makes everybody in it struggle at times. And so when I became an amputee seven years ago, I then felt what it was like on the other side of the bed to suffer the outcomes that...
Host
to suffer the outcomes that are resulted from fully efficient training providers. That is where we stand.
Tina Hurley
resulted from poor communication between providers, lack of understanding of my insurance, medication that rendered me unable to execute or follow up or, you know, just direct my care in the most logical way because I'm also processing a significant amount of grief and trying to go through stages of grieving while I'm in incredible pain and medicated and doing everything as a new
Host
dedication that Senator Cammie wants you to execute upon.
Tina Hurley
um skill as a new amputee um it's just it's so overwhelming it's like you just got dumped off of a tidal wave and you're kicking ferociously trying to swim when you don't know which way's up and um so anyway i realized that i despite still being board certified as a pa i just wanted to take a stab at creating something that could fill in some of those holes for this specific demographic amputees and
Host
Yeah.
Tina Hurley
and get that going and then return back to practice, knowing that the amputees that I'm creating by my hand are also ones that won't suffer from the same, lacking collaboration and knowledge and care. And so that's sort of what Red lost like more heart five years ago.
Host
And have you returned to being a PA and working in that capacity as well?
Tina Hurley
no, I've still maintained all of my accreditations and my son is two and a half years old. Running the household and growing this human and running this business is definitely hands full. My dream is that when he gets into preschool or first grade, that things are operational enough and large enough from a funding source. Our internal operations are...
Host
Okay.
Host
Oh, OK. Enough said, right? Yeah.
Tina Hurley
really well greased. It's just a matter of as an organization really solidifying the financial landscape of the nonprofit and making sure that you can hire employees and solidify a few years of salary for them so that I can hand it over because I'm a great medical professional. But here I am a business person and even though I'm doing pretty good at it, there are probably better suited folks to step into those executive roles to help guide the business side of the organization while the beneficiary side.
is handled by us clinicians.
Host
Yeah, absolutely. And I mean, look, it's such a, it's such a fascinating story. I mean, you're sitting there amputating limbs and then you wake up one day and find out that you're going to be on the table. How did that happen? How, you know, what, what exactly led to, and was it a total shock? Was it something you knew that was coming?
Tina Hurley
Yeah, so the timeline was I was, I felt fine until I was about 25 and I had graduated from schools and I was doing CrossFit and I had always been an athlete and my legs just started to feel heavy and they got more and more debilitating in terms of their capacity over the following
Um, you know, I went through all the specialists and all the tests and exhaustively, you know, misdiagnosed and then just in and out of the washing machine of diagnostics to get a diagnosis that eventually was made. And concomitantly, I was working in acute care medicine as a hospitalist for a large, um, trauma center. And I realized that I didn't know as much as I should know about the diagnosis and the
you know the topic of vascular and Knowing that I was going to be in that field as a patient for the rest of my life and that my mother also Is a vascular patient. I just felt the calling to Transition over and learn more and help people in that field So I got my diagnosis before I transitioned into vascular surgery But before I also knew that I was going to lose my limb and then 13 surgeries later and three You know amputation revisions later
I got out of the practice to run the nonprofit, but the process of, you know, taking limbs off for a living was not part of what I thought going into vascular surgery would be. I thought it was largely a clinic job and I loved surgery. But when I found out that after the 10 surgeries had failed, all the debulkings and the vascular
Host
Mm-hmm.
Tina Hurley
For me, the best solution was gonna be losing my limb to regain quality of life. So essentially it was a semi-elective amputation. My options were to live on chronic narcotics and be unable to really do my job or live life at all as at this time in my early thirties or lose my limb. I mean, that's, it's a no brainer in terms of which direction you need to go, but knowing what I saw on the medical side.
was scary because the folks that I was largely turning into amputees were, you know, chronically comorbid vascular aging diabetics. And I didn't identify at all with that demographic. And I didn't know anybody else in the amputee space. And so for six months, I was trying to find the right surgeon to do an URDL amputation, which is a specialized kind that was, you know, strategized to be more successful for my circumstance. And I was...
working Monday through Friday, you know, still in the OR and had to really dissociate from my identity and my future and my struggling and my suffering because in order to execute my profession and really empathetically care for people and make the money that I needed to pay the upcoming medical bills, I had to not acknowledge that was my fate in a very, very short period of time. And that was tough because I also...
Host
Thank you.
Tina Hurley
became very far from my center. And I was at that time newly married. And we didn't know at the time we were married that I'd be losing my leg or that my graft would fail. We had hope still, we were told we were gonna get fixed. And so while I'm lining up waiting for the surgery, I'm medicated outside of my shifts, I'm in pain all day, every day. My interactions with my husband are limited and very much focused on my needs because there were so many at the time that it...
deprive me of my life and my hope and my joy and my happiness and I had to go numb because feeling was too overwhelming and In retrospect, I didn't get the help I likely needed during that time Psychotherapy wise I absolutely had clinical depression and anxiety and probably even panic syndromes and Was self-medicating sometimes with wine, you know if I had to do an amputation that day I'd come home and it was so much
Host
Thank you.
Tina Hurley
I couldn't ignore the fear. And I would find myself at the bottom of a bottle of wine that evening, which for me is a lot. And I'd feel bad the next day. And it was just, it was a cycle of just terror. And there wasn't really hope at the end of the tunnel except for losing my foot. So I did what I felt was right, which is like prepare the best I could. I took my foot for a lot of last ventures. I...
Host
Thank you.
Host
It's crazy.
Tina Hurley
I was implying to my shoe off and I crushed 20 pounds of grapes in a bucket and I got a henna tattoo because I didn't have any other tattoos at the time. I felt beach sand and walked on grass and I just did everything that I could do to feel at peace with the decision. I faked a lot of that to everybody around me because I didn't want the people that loved me and cared about me or my coworkers to give me pity, treat me broken, or worse be...
Host
I see it.
Host
Thank you. No problem.
Tina Hurley
scared themselves. And so the stronger that I felt like I was showing them I was, the less suffering they went through. And that imposter situation really depleted me. It's really tiring on in an already exhausted person to be so fake. And the only person that got the real terrorized person was my husband. And
Host
helps.
Host
questions.
Host
Thank you.
Thank you.
Tina Hurley
I lost my leg and I remember waking up with the sheet flat where my foot had used to be and despite all the preparation and knowing for six months, it was really tough. And I had always identified with my physicality and who am I now and how am I going to do these things? And I suffered a lot of secondary issues in the hospital. I had these neurogenic cramps that were absolutely horrific and they had me on.
just really strong cocktails of medications and you know, an overnight hospitalization was 10 days long and when you're on these heavy duty medications at one point they had manketamine drip to mitigate some things and reset my pain signals and it causes psychosis in people like medication-induced delirium, which is transient and common and my husband didn't know that. You know, he goes through these hardships for three years and...
Host
and create the end.
Tina Hurley
And this person is almost like an Alzheimer's patient that is not maintaining. It's like you just lose reality for a short period of time until the medication's tapered off. And thankfully, when it tapered off, you resume your normal cognition. And I had fallen in the hospital. I had this huge wound. It required eight months of debridement and wound management. It was like I had to have a revision surgically. And then I came home on the one year anniversary of my, or the day after the one year anniversary of my leg amputation. And just all of that.
Host
Mm.
Tina Hurley
just chaos resulted in my husband unknowingly, like distancing himself emotionally and not knowing what else to do but leave because he was so unhappy. And why wouldn't he be? You know, he went from gas mask, jump roping in a cross-fit gym with this woman to a couple of years later, dealing with someone that wasn't even maintaining normally in the hospital. And it's like, it's just a really, everybody had such a hard time. And I found myself in the wake of those losses, the loss of my foot.
Host
Thank you.
Tina Hurley
the loss of my marriage and then, you know, resultingly having to sell my home and rehome my dogs and really starting from scratch in my life, having to figure out what my purpose was and why this is all happening and what I can make with it and who I am now. And that rebirth in a sense was where all the beauty sort of came in and when I realized things might be happening for me if and changing my perspective and practicing gratitude and realizing that.
Host
Thank you.
Host
of it.
Host
Thanks.
Tina Hurley
Community and connection and advocacy is such a vital part of success in life. And that I'd been missing the mark my whole life. I was so obsessed with success because I came from a very, you know, blue collar, struggling to get by family, and didn't want to have the same challenges. And I managed to accomplish that, but that is all removable.
And what I had neglected to do the entire time I was expending energy outward to climb the ladder to be more successful and stable was I actually never really spent time to build a home inside of myself and figure out who I was and take a pause intentionally to heal from some of the prior traumas in my life until when you're completely stagnant post-operatively, it catches you. And that was some hard work.
Host
in your eyes.
Host
Yeah.
Tina Hurley
That was a few years of just real, real hard intentional work. And it spit me out in a beautiful place. And I think service and advocacy were the things that really saved me.
Host
What was your, you know, real big realization right away being a patient versus being on the other side of the, of the surgical table where you're like, Oh, this is missing from what we were doing for people. What was the first thing that kind of hit you?
Tina Hurley
There were two things in the same 24-hour timeframe. I was in the hospital after one of the revision surgeries and one of the medical folks for the clinical team had come in.
Nobody had talked to me about the intricacies of the procedure or gone over any of the risks of the procedure, you know, the consent form classically. And anesthesia came in and bolus me with the medication to get me into the OR, which makes you sedated and starts to impair your ability to think and have memory. And I was asked to sign a consent form after I was given those medications. And only after I woke up and like healed many days later.
Did I, after I requested my medical records, because I always do that, and it's very, very good practice to do, I realized I never remembered signing that form. And that's horrifying. And on the same 24-hour schedule, the next morning I had a drain in place for some of the bleeding post-operatively. The next morning I had a medical resident come into my room and not wake me up.
I was still sleeping when they ripped the drain out of my leg. Yeah, because it wasn't supposed to hurt. Um, that was when I started to become the difficult patient. No, the one that, um, specifies you're going to wake me up 30 minutes before I see anybody and have to think, and you're gonna, you know, X, Y, Z and.
Host
Wow.
Host
Hahaha
Tina Hurley
Then realizing after becoming that difficult patient that it creates, in a sense, a barrier to your own care and then that's hard to navigate when you're in the bed and you're vulnerable and you're medicated. Those were really the standout moments. But you won't have enough time for me to explain all of the personal and also the folks that I've cared for now, hundreds of amputees over the last five years, just the horror stories.
Tina Hurley
with maybe not as much bedside training is needed and also not the personal experience that a lot of clinicians would benefit from having in treating people. I think the best education I ever received in eight years of college and a medical degree was being a patient because until you understand the effect of your verbal and non-verbal communication on a person's life and spirit and energy and vigor and family life,
until you experience that, you don't have the same caution, every patient, every day. And I can understand that side of it. You know, you open up 15 to 30 doors a day to find a new person and you objectify because that's what helps you cope with the things that you're managing, which are traumatic every day. But inherently that pace and that objectification leads to sort of a slippery slope and a lot of folks fall into it.
Host
What do you find is the most common thing that the amputees who come into your fold need help with?
Tina Hurley
Understanding and connecting, you know, understanding, connecting and funding is the most common sort of triad. You know, they don't even know what to ask sometimes. You know, we'll get our workflow management software and our sort of system as folks will submit their information on our contact page.
on our website and it goes into, you know, our workflow management system and our beneficiary team takes over and there's a little comment section and it says like, how can we help you? And we're very clear about the pillars of our assistance, which is mentorship, advocacy, funding for holistic care, which is intentionally vague and funding for home services. And I can tell you, and you know, statistics, a little rough here, but at least a quarter of those people as an average write something to the effect of, I'm not even sure.
what I need, I just need to know what I need and how to do this and like where to go and how this works because understanding living with a limb loss physically and emotionally in addition to the complex insurance and medical landscape is profound to have to digest, study and become a master of while you're actively just becoming a new patient in it.
Host
Mm-hmm.
Tina Hurley
And so I think that's the biggest thing is they just want to figure out what they need to know and how to get through it physically, emotionally and financially.
Host
Did you find you mentioned psychotherapy as something that you perhaps should have gotten into when you got your diagnosis? I'm curious, is there a type of therapy or a type? I mean, obviously the support group must be incredibly helpful because you're kind of identifying and connecting with peers, but is there a type of therapy that you have found that is more successful or more impactful for people who, um,
have become amputees.
Tina Hurley
Yeah, the significant piece that we see in terms of like DSM criteria diagnoses are depression, anxiety, and PTSD. Those are like the three most common things that the folks that come to us report as diagnoses.
Um, the depression and anxiety we see, cause we have a very sophisticated intake where we know everybody's socioeconomic situations and their psychosocial situations and all of their medications. And like, we really are thorough with the information that we harvest because we have to have that information to truly guide and govern, um, the, the resources and education that we give to them. And what we see typically is.
folks are just sort of managed by their PCP and slapped with lower SSRI is most commonly prescribed and it's ineffective and they're still struggling and they've never been told about EMDR and they've, you know, not seen an actual psychiatrist that has the depth of knowledge of all the psychoactive options. And that's, I think what we're.
Host
Thank you.
Tina Hurley
seeing most. There's a lot of trauma. There's a lot of loss. And so people that focus in trauma therapy, grief, and post-traumatic recovery are oftentimes the most helpful to this demographic.
Host
Yeah. I've in my own, in my own world, I've seen EMDR as an example with, with trauma and PTSD be incredibly helpful. And you're right. A lot of people don't even know what to look for or how to look for it. Or even in your case, how it affects the family, right? And how it affects your spouse or if you have children, how it affects them. And so there's a lot. Right.
Tina Hurley
And it's until it's too late. And the only difference between that social system collapsing and it staying erect is education. And I mean, my husband didn't know about the stages of grieving. Why is she angry? This must be a character trait. When in fact, it's just like me.
Host
It's dangerous.
Tina Hurley
processing my trauma. And so we try to help the person understand what's going on and why it's happening and take some of the shame away so that they're more inclined and enthusiastic to get assistance because a lot of folks just will not receive it. We're seeing that a lot of folks don't actively pursue it because it makes them feel more shameful to admit that they need the help.
And that's a lot of what we focus on is just finding the tremendous strength and vulnerability and allowing yourself to be helped and recognizing that it's not weakness and it's, you know, it's not all these things that there's such a stigma around, um, because that's, that's still the opinion of a lot of folks coming through.
Host
And you said you've worked with hundreds. How do people find less leg, more heart? And are you national? Is it something where you can really only operate locally? Tell us more about the actual organization.
Tina Hurley
Yeah, so we've served amputees, we just did our metrics in 32 states. We operate all remotely because of the way that our rollout sort of process is. So we customize everything that we give to folks. And so when people find us either through largely word of mouth or social media or YouTube or our website or, you know, we have...
around where I live, there's some, you know, I've lived here for a long time. And so, you know, there's a good word of mouth and the chambers are involved and rotaries, but on a national scale, some of the speaking endeavors that I've done and the friends and colleagues that I have around the country just filter folks our way. And so we're not, we have not directly opened at five years even, they're like direct referrals from hospitals or acute rehabs. We still haven't even gone into those places.
to hand our brochures out because we already are managing a high workflow. Already this year, somewhere in the realm of 35, 36 amputees, and we've got like six to eight folks in our pipeline, and we get these waves that there could be eight people in a week, and then maybe there's not for a couple of weeks, or sometimes they're trickling at two a week. It's still so post-pandemically...
Host
is.
Tina Hurley
oscillating in terms of volume, that we want to make sure that is managed well and with excellence. So we're national, we tend to do a lot of like local community projects in terms of accessibility for people's homes in places that some of our volunteers or we live because it's nice to have an on-site representative or we make a new volunteer in a place where someone needs help in that we don't necessarily have a volunteer. So we've got about
Host
Mm-hmm.
Tina Hurley
three dozen, three and a half dozen volunteers from around the country. And we send care packages to every amputee that submits their information through our website. There's a contact form and one is amputees in need. They send their information and then we chat with them for an hour. We get all of their intake, like we talked about, medical, psychological, social, economic circumstances, and then we allocate them an award within three to five days. So they get
something, education, mentorship, advocacy, funding, and then we actually check in with them at one, three, six, and 12 months the first year and every six months after that for as long as they want to remain part of the program. So that system has proven to be really helpful because those that do engage in the frequency that we've set it up have a lot better outcomes than the folks that just want a quick handout. You know, we're trying to do something long-standing and
Host
Thank you.
Host
Okay.
Tina Hurley
We want to promote independence and autonomy and power and confidence in people. And that skill is not a skill that they can acquire in a 30-minute Zoom with me or anybody on my team. And so… Yeah, that's the ultimate goal, right? Rise by lifting others, whether it's with...
Host
Yeah, and I bet that frequency and that cadence also breeds more volunteers and mentors as they kind of come through the program themselves.
Tina Hurley
our organization or with any other philanthropic endeavor, we always encourage folks to just get involved with something that, you know, sets their soul on fire because finding purpose and meaning is a vital part in my mind of any kind of recovery and putting yourself in a community of like individuals, whether that's like physically amputees or like in terms of your passion, the thing that you're supporting. So.
Host
is.
Tina Hurley
Yeah, we love it when our beneficiaries come over to volunteer. And we've got a pretty good turnover because we like to be a little family. So you had mentioned the weekly or the monthly support group meetings. That's really, it's less of like a meet and greet and talk and support group in the traditional way where you make friends, although people do connect with each other after the fact, it's largely taken the form of an educational format. So we have health and wellness experts that
Host
Thank you.
Tina Hurley
we'll come on or I'll run a session on something that's amputee specific for the month. Like in September, we're running one on phantom pain, which is something that's been largely requested and is a pretty multifaceted topic and there's a lot of options. And so we always encourage folks, whether they're part of our program or not part of our program, to jump into Heart to Heart. And we hope that they'll come to our program because there's always things we can find to help people no matter how far along in their journey they are.
But if they want to just pop into the monthly meetings, the ones that resonate with them, that's always an option too.
Host
I think that's great. I should, I should direct people on how they can, uh, you know, register for those and be part of them. You have a couple of interesting things, and I'll post the direct links in the, uh, in the show notes and, and depending on where you're listening to this in the description, if it's on YouTube or wherever, but just, uh, audibly, if you're listening to this in your car, if you want to register for those virtual heart to heart meetings and you go to less leg, more heart.com it's under the about section.
in the menu. So if you click on about or hover over it, you'll see the heart to heart there. You can register and be part of it. You also have a wonderful gala that you, you know, kind of a red carpet gala that's under events. I recommend people that's in December usually, but people kind of, you know, look, look forward to that. It's a great way to contribute and support as well as, you know, something fun to do as well on a night out.
Tina Hurley
Yeah, it's going to be beautiful. We waited five years to really have the event that in the middle of the holidays intentionally, you know, uplifts people and gives them that perspective. And
you know, there's so much stress to be had or stress that's made in folks psychologically during the holidays. I have to do this and I have to do that and I have to and people forget sometimes in that pace to recognize that they get to and that by just changing that word it really makes the process of being busy and having to-dos enjoyable and so I'm hoping that in addition to being a significant fundraiser for our organization that we can provide that perspective that helps the holiday season be a little bit more fun for folks. Thanks so much for having me and I look forward to folks reaching out that may be listening.
Host
Tina Hurley, thank you so much for sharing your story and the amazing work that you're doing with everybody. I wish you the best of luck and come see us again sometime.
