Well, here goes—PAD stands for Peripheral Arterial Disease. You may hear it called PVD or peripheral vascular disease. Whatever you want to call it, PAD is a narrowing of the arteries that carry blood to your brain, organs, legs, arms, and other areas outside of your heart. The narrowing is caused by the same process that causes coronary artery disease.
Ten million people in the United States have PAD, which can lead to mortality rates similar to breast cancer and colon cancer. Risk factors include diabetes, high cholesterol, smoking, family history of heart disease, obesity, high blood pressure, and age over 50.
Symptoms to watch for include discomfort or aching in the calves, thighs, hips, or buttocks; rest pain in the toes and feet (especially at night) that is usually relieved by standing; changes in skin color or temperature; impotence; painful foot sores that don’t heal; ulcers; gangrene. Quite often, people who have this disease cannot walk more than a block or two and their calves or hips begin to hurt. After they rest for a few minutes, the pain disappears.
Now don’t run to make a doctor’s appointment right this second. Remember, ambiguous symptoms include arthritis, back problems, poor physical conditioning, or electrolyte imbalances, to name a few. If necessary, diagnosing the problem can be done with a simple, noninvasive test called an ABI (oops, another acronym). ABI stands for ankle /brachial index. Simply, does your blood flow get all the way from your heart down to your toes without anything stopping it? Other noninvasive tests include pressures and ultrasound Doppler. Invasive testing would be a peripheral arteriogram.
The good news… PAD can be fixed! The earlier that PAD is found, the easier the treatment and the better the outcome. Treatment options include lifestyle changes, medication, angioplasty, laser angioplasty, peripheral stenting, and, if necessary, bypass surgery.
With this is mind, we would like to introduce you to JoAnn Arden, a 49-year-old, white female. She is a mother of three who lives with her husband Steve in Denton, Texas. On Valentine’s Day 2001, instead of going to a romantic dinner, she found herself admitted to the hospital with a blackened right toe and heel in excruciating pain.
A known diabetic (non-insulin dependent, diagnosed at age 40) and prior smoker, her problem had begun six months earlier with numbness in her right foot. She was told that this was due to diabetes. In January, the problem escalated. She developed significant pain in her right foot. At this point, she was told that she had an infection in her toe and was given antibiotics.
Subsequently, her situation deteriorated to the point of the emergency visit to the hospital, where she was diagnosed with gangrene and faced the possibility of amputation. Multiple doctor visits and numerous diagnoses, but all along, the problem was PAD. She changed physicians, and an angiogram was then done, confirming that she had severe peripheral arterial disease (PAD) causing loss of blood flow to her foot.
A laser angioplasty was done on February 19, 2001. The procedure was a success and blood flow had returned to JoAnn’s foot and toes. JoAnn remains under the supervision of her cardiac specialist, who has performed subsequent procedures. He has also placed peripheral stents in the affected arteries. At her last checkup, JoAnn had recently walked the entire Grapevine Mills Mall. As a result of her ordeal, Jo Ann advises: “If you smoke, quit. If you have diabetes, control it. Diabetics, please take care of your feet. Get another opinion. Do not have an amputation.”
Hopefully, no one reading this finds him/herself where JoAnn did. With early diagnosis and proper treatment, people with PAD can look forward to increased activity and improved health. It all depends on early diagnosis. If you are at risk, ask about a screening test today.
Written by PeggySue Carroll, R.C.S., R.V.S., and Kathy Fleischmann, R.D.C.S., R.V.T.