Everyone knows of the condition Cardiovascular Disease, also known as Heart Disease, which is plaque
build-up in the arteries around the heart. In the legs, plaque build-up in the arteries
is known as Peripheral Artery Disease (P.A.D.). It can also impact the arms and
sometimes the small arteries in the brain. But it's mainly the legs. Three-in-five
heart attack sufferers, one-in-five over age 60, and one-in-three diabetics
over age 50 have it. Globally, it is estimated that more than 200 million
people have P.A.D. Most don't know it until it reaches advanced stages and
heart attack, stroke, and amputation are imminent. Doctors may misdiagnose textbook
symptoms of leg pain and leg cramps as diabetic neuropathy, diabetic foot,
fibromyalgia, old age, arthritis, or even spinal/sciatic problems. But it’s
easy to diagnose or rule out with even two fingers and two seconds with a
doctor feeling a patient’s leg pulses.
Douglas, a P.A.D.Patient from Texas, calls in to ask about walking as medicine for P.A.D. A
brisk 30-minute walk a few times a week can help your body create a ‘natural
bypass’ around blockages by triggering the body’s collateral network of vessels.
Pushing through some of the pain and cramping caused by that restricted blood
flow tells your body, “Hey, we have demand for additional blood flow that we
aren’t meeting so let’s calling in for some back-up!” The back-is our collateral
network of vessels which lay dormant until they’re needed to re-route flow
around blockages to feed oxygen and other nutrients to the lower extremities. Dr.
John Phillips, co-host of The Heart of Innovation, explains to Douglas how to
walk effectively to kick that collateral network into gear to improve
circulation naturally.
Dr. Yazan Khatib, Interventional Cardiologist with First Coast Cardiovascular Institute in
Jacksonville, Florida calls in to drive home the importance of not only
diagnosing P.A.D. early but then finding the right doctor who has advanced
skills in treating P.A.D. Vascular Surgeons, Interventional Cardiologists, Interventional
Radiologists, and Vascular Medicine doctors may be treated in treating P.A.D.
If they do treat P.A.D. patients, it’s likely they’ll offer a set of treatment
options which may differ from another P.A.D. specialist, but that their options
are the best and only ones available. Dr. Khatib contends it’s very important
to always seek a second and even third opinion prior to any procedure to
understand all available treatment options which may include medical therapy,
walking program, angiogram (using wires, catheters, balloons, stents, etc through a small puncture in the leg), bypass, or amputation.
Tammie Caves, Clinical Program Director for wound care organization Healogics, Inc. calls in to share
why it’s perfect timing to discuss P.A.D. It’s Wound Care Awareness Month in
June. If a patient is not diagnosed with P.A.D. in its early stages, the first
indication that triggers a physician to take action might be a non-healing
wound on the foot and/or toes. She explains that restricted blood flow hinders
the healing process because oxygen is a critical component. She urges patients
who are most at-risk for restricted blood flow, diabetics, to get regular foot
check-ups because diabetic neuropathy can prevent someone from feeling a wound,
and infection might set-in before seeking treatment. Diabetics are more
susceptible to P.A.D. because sugar molecules tend to scratch the artery walls
triggering an inflammatory response in the body which causes plaque to build-up
in those damaged areas. A lot of plaque building up restricts blood flow. Restricted
blood flow can lead to non-healing wounds. Tammie expresses disbelief about how
many patients come to Healogics with wounds, who have not been assessed for
P.A.D. She drives home the importance of these patients ensuring they have a proper
vascular assessment prior to any extensive wound work by a podiatrist or wound
care specialist.
Nurse Practitioner KaySmith is featured in our “Save My Piggies” segment, to share her story about
spending 19 months in the most advanced stages of P.A.D. known as Critical Limb
Ischemia (CLI) and how she persevered. P.A.D. can be separated into two buckets:
Intermittent Claudication (you walk, get pain, stop for a few minutes, pain
goes away, walk again) and CLI (rest pain at night and non-healing wounds).
Only 10% of patients with P.A.D. end up in CLI and its typically only because
they were not diagnosed early and treated appropriately in earlier stages
because symptoms were not recognized, or risk factors not properly assessed. NP
Kay was told her debilitating pain was due to back problems and prescribed her
a wheelchair until her toes turned blue. Her vascular surgeon performed an
angiogram to assess the blockages, and without even sending in a wire to try
and push through the blockage, he said she couldn’t be treated and marked her
as palliative (terminal). She found The Way To My Heart which helped her to
find hope again. She was able to learn all available options and the right
questions to ask to find the most advanced P.A.D. specialist. She also enrolled
in The Way To My Heart’s walking program which helped her to start building her
collateral network, with some additional help of her virtual reality headset. A
second opinion from an advanced skilled vascular specialist led to a proper angiogram
where blockages were cleared, getting NP Kay back on her feet again. Months later she danced with her husband forthe first time in five years, clocking a record 9,000 steps in one day. Now NP Kay
pays it forward by supporting The Way To My Heart’s network of more than 11,000
patients as a Nurse Practitioner, Board Certified in Wound Care.
Listen to the show at this link to hear life and limb saving information about Peripheral Artery Disease.
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