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Treating PAD: Free Flowing Arteries Benefit More than Your Heart

Treating PAD: Free Flowing Arteries Benefit More than Your Heart

It’s a disease that few people may know by name, but Peripheral Artery Disease (PAD) is estimated to impact the lives of one out of five Americans over the age of 60 and almost a third of people over 70. Younger people too are at risk, especially if they smoke or are diabetic. The risks are high because left unrecognized and untreated, PAD can lead to not only mobility problems, but a stroke or heart attack.

What Is Peripheral Artery Disease, or PAD?
Simply put, PAD is a serious condition where fatty plaque builds up in the arteries over time and impedes or blocks blood flow. Peripheral Artery Disease is similar to Coronary Artery Disease because both involve plaque building in the arteries. But while CAD involves the heart, PAD affects the legs. Unfortunately, many people with early stages of PAD might not even recognize they have a problem because the changes they feel are often subtle and easy to ignore. Sometimes it feels like stiff muscles, or just tired legs. However minor they might seem to be, these are symptoms that should never be ignored. Eventually as the arteries become increasingly clogged, discomfort or pain may affect the legs, ankles and feet. If left untreated, PAD can result in amputation or increase the risk of heart attack or stroke.

The Importance of Seeing Your Doctor if You Have Leg Pain
Early diagnosis of PAD, treatment, and attention to lifestyle changes are providing many patients with positive outcomes. Of course, there are many reasons why a patient might experience pain or discomfort in the legs and feet, and it is important to see a physician to determine the exact cause. Many people find it easy to ignore small changes in the comfort of their legs, often dismissing minor aches and pains as just having tired legs or too much exercise. Sometimes even more pronounced symptoms like cramping and pain might be disregarded as nothing more serious than issues related to getting older.
Doctors warn that ignoring symptoms like these could be a very costly decision.
Take the case of Tomas Tillman, a retired 70-year old master welder in Louisiana and a typical PAD patient. He lived with leg cramping and increasing pains in his legs and feet for ten years before finding out he had Peripheral Artery Disease. It was only when he developed a sore on his shin that wouldn’t heal that he sought a doctor’s attention.
By that time, the blood flow in his arteries had become so compromised that he had to have bypass surgery on his legs in an attempt to improve his circulation. The surgery resulted in limited improvement. Tomas and his wife were deeply disappointed and talked to the doctor to see what else could be done. They were hoping for another bypass surgery. The answer they got was shocking. 
It was at this time they were given the devastating news that the arteries in Tomas’s legs were not going to get better, and his health was in danger. He was told he would need to have both legs amputated.
Tomas and his family prayed for a miracle, and their prayers were answered by Dr. Craig Walker, an Interventional Cardiologist and Founder and President of the Cardiovascular Institute of the South

Dr. Walker says it is common for people with PAD to not realize they have it.
“Many people feel no symptoms at all or they adjust their lifestyles to where they just don’t feel symptoms. Yet it’s crucial we make the diagnosis because of the link between peripheral artery disease and death. A patient who has been diagnosed with peripheral artery disease is more likely to die of a heart attack than a heart attack survivor.”

Common PAD Symptoms:

  • Leg pain (persistent or intermittent) and/or cramping when walking
  • Hair loss on affected areas such as legs and toes
  • Numbness in affected areas
  • Foot pain when resting
  • Sores that heal slowly or not at all
  • Legs are different from one another in terms of color and warmth

Like heart disease, Peripheral Artery Disease (PAD) is a common condition in which arteries outside the heart become narrowed or blocked due to the buildup of plaque. 
PAD is different from heart disease, though, because the blockages refer to arteries that appear in the abdomen, pelvis, and legs instead of the heart. However, PAD has the same risk factors as heart disease. These include: as high blood pressure, high cholesterol, diabetes, family history and cigarette smoking.

Smoking is a Major Risk Factor in Developing PAD
Tomas had been smoking almost his entire life:
“I smoked for a long time. I started when I was a little child.”

Other Names Related to PAD 
PAD is also called peripheral vascular disease (PVD) or peripheral vascular occlusive disease (PVOD). It is estimated that there are 8-12 million Americans suffering from PAD, and again, many don’t realize it. 
Dr. Walker believes more people would question their symptoms and see the doctor if they understood how important it is to get a diagnosis as soon as possible.
“The problem with a diagnosis of PAD is that it is simply not on the radar. Many people just have unusual symptoms, a little bit of cramping, things that they don’t recognize. So we cannot say if someone’s not complaining of symptoms that they don’t have PAD. Some just adjust their lifestyle and walk slower. That way they don’t feel the pain.”

Sore Leg Muscles
Tomas lived with PAD for 10 years before it was finally diagnosed after an ulcer on his shin wouldn’t heal, a sign of advanced disease. In hindsight, Tomas recognized some early symptoms and now knows their cause:
“My muscles in my legs, my calves would get tense, it would tighten up, it would just get stiff. And it would hurt. Not terrible but it would hurt. And that was a sign that blood wasn’t getting to my legs. It doesn’t take a nuclear physicist to figure that out.”

Diagnosing PAD 
If one suspects they have PAD, it’s important to seek a diagnosis as soon as possible. Diagnosing PAD is easy. A doctor or nurse will take a person’s blood pressure around their ankles and then compare it to their blood pressure when taken on their arms. 
If the blood pressure in the ankle is lower, then that means there is an issue with blood flow in the legs. 
This information is typically followed up with a request for an ultrasound and a CT scan for a more detailed diagnosis. This is what happened with Tomas after he went under Dr. Walker’s care.

What the Patient Learns from the Endovascular Specialist

My whole system was blocked up. Worse than I ever would have ever thought,” Tomas said.
Tomas’s previous doctors felt they had done all they could do to help him and that the only procedure left was to amputate his legs. He had been expecting a phone call to schedule some bypass surgery in his legs to attempt to increase the blood flow. He was shocked with the call he got instead.
“I received a phone call saying, ‘Forget the bypass surgery in your leg. Come in we’re going to amputate.’ I was praying for my leg.”
Tomas’ wife, Sharleen, explains what they did next:
“We just kept praying. When Tommy told the doctors no, he didn’t want an amputation. All the other doctors from that point said they couldn’t do anything for him. He was too bad off, too blocked off. We found out about Dr. Walker… To us he was God sent. He literally saved his legs. Both of them!”

Preventing Limb Amputation
It’s crucial for patients to realize that in order to help prevent limb amputation and slow the progression of PAD, they need to seek medical care by a trained endovascular specialist such as an Interventional Cardiologist like Dr. Walker, or an Interventional Radiologist or Vascular Surgeon.
Tomas took comfort in Dr. Walker’s immediate optimism and positivity.
“He didn’t say ‘maybe I can help you,’ or ‘hopefully I can help you,’ he said, ‘I believe I can help you.’”
Dr. Walker treated Tomas with some of the latest endovascular treatments:
“He had some of the most advanced treatments you can possibly get. Once we restored blood flow, very rapidly the wounds healed.”

Treatments for PAD 
Advanced treatments, especially with minimally invasive endovascular procedures, allow patients to avoid amputation, as well as prolonged hospitalization and recovery times. Dr. Walker explains:
“Historically the management of peripheral artery disease, was surgical. It was either going in and cutting out the blockage and repairing the artery, or bypassing around the area of blockage.” 

Using Balloons and Stents to Open Arteries
Today innovative surgeons are using balloons and stents to open up arteries, as well as tools that they can insert into arteries that can remove and grind through plaque as hard as bone. They are even using laser light at a frequency that doesn’t cause heat but that can still ablate plaque. 
Dr. Walker feels it is just a normal extension of scientific advances being translated into practical treatments:
“I think it’s like almost everything we’ve seen in medicine. Scientific progress is really booming and sometimes the practice of medicine takes a while to catch up to that.”

The Triumphant Path for Thomas
Under Dr. Walker’s care and treatment, Tomas initially spent a year-and-a-half in a wheelchair while his legs became stronger. He transitioned to a walker, then a cane, and now he is walking well and even driving again four years later. His wife Sharleen is both thrilled and amazed:
“He can even drive a car now! He almost sold his car a whole bunch of times thinking he could never drive again. But he can drive, he can use that right leg again.”

The Key: Early Diagnosis and Prevention
Even with the advances in PAD it’s important to realize that early diagnosis is critical in order to treat it right away and keep the condition from getting worse
“By identifying PAD in its early stages and making sure that we take appropriate, preventive measures, we can clearly improve life expectancy and quality of life,” says Dr. Walker
Better yet, people can work at preventing PAD  through lifestyle changes that include regular exercise, a proper diet, not smoking and keeping cholesterol under control. 
Tomas says he has stopped smoking, is eating better, exercising, taking aspirin, keeping his blood sugar at a good level and doing routine follow up visits with Dr. Walker. It all seems to be working for him

It Feels Good to Be Able to Walk

“Nowadays, I feel wonderful and I guess like a lot of situations you don’t really realize some things that you may have until you don’t have them anymore. It feels good to be able to walk.”
Tomas’ wife Sharleen is ecstatic:
“Life is awesome now! It’s amazing what Dr. Walker has been able to do. And Tommy is just getting better and better and better.”
Dr. Walker is pretty happy and satisfied too:
“I love what I do. I love what I do because when we can help a patient we really become a part of their family.”

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