In my first column for this month, I’ll discuss general comments regarding peripheral vascular disease, commonly referred to as PAD. This topic will encompass several blog columns over the next few weeks and months.
Throughout the last several decades, heart disease has gained widespread attention and focus. Meanwhile, PAD has gone largely unnoticed and continues to be both under-diagnosed and under-treated in the United States. Many of the therapies currently utilized actually had their principal effects in modulating the heart circulation, only having secondary gains in the peripheral vessels.
PAD describes problems that focus on the lower extremities (although, infrequently the upper extremities can be involved). There are a number of symptoms that patients may complain about, which may include leg pain with walking and inability to complete daily chores (getting the mail, shopping, yard work, etc.). Pain in the feet may develop, awakening patients at night and causing them to dangle their feet over the bed for relief. Or, it may have deteriorated to the point of developing wounds on the feet and ankles that won’t heal. All of these situations point to the possibility of PAD as an underlying cause of their symptoms and require an evaluation and treatment plan to improve.
Remember, just like all things, all leg pain isn’t necessarily PAD. There are a number of other possibilities that exist, including diabetic neuropathy, venous insufficiency, spinal stenosis and musculoskeletal problems. These problems can usually be quickly and easily differentiated by your health care provider. There are also various tests that can be performed to clarify the situation.
Assuming that PAD is the actual reason behind the problem, let’s envision a very typical scenario. A patient is being evaluated for a PAD-related problem, whether it’s leg pain, difficulty walking and completing daily tasks, a wound on their foot that won’t heal, etc. During that evaluation, the patient usually asks, ‘What can I do to help my situation?’ This is a great starting point! This discussion focuses on the concept of risk factor awareness and risk factor modification. I like to break things down into things we can change and things we cannot. In general terms, there might be a component of hereditary factors that you cannot change. However, other life choices, such as diet, exercise, smoking, weight control, cholesterol/lipid management and blood glucose control are very much within our grasp to identify and modify. In the next series of blog articles, we’ll take a look at these factors one at a time and discover that sometimes small adjustments can have significant benefits.
Vascular Surgeon Brad Sweda, M.D., is dedicated to the diagnosis and treatment of disorders of the circulatory system, including the arteries and veins. His passion for vascular surgery goes beyond treating an ailment, but rather treating the individual. He sees each of his patients as unique, each requiring their own personalized treatment and attention. Dr. Sweda sees patients in Midland and Alpena. To make an appointment, contact his office at (989) 794-5240.