What Is Peripheral Artery Disease, or PAD?
It’s a disease that few people may know by name, but peripheral artery disease (PAD) is estimated to impact the lives of more than 20 million Americans. If left unrecognized and untreated, PAD can lead to a heart attack, stroke or an amputation.
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. 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. 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. It may feel like stiff muscles, or just tired legs. As minor as these symptoms appear, they should never be ignored.
Knowing The Symptoms of PAD
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 with PAD. He lived with leg cramping and increasing pains in his legs and feet for 10 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 and devastating--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 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.” 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.
Common PAD symptoms include the following:
- 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
PAD has the same risk factors as heart disease. These include high blood pressure, high cholesterol, diabetes, family history and smoking. Tomas had been smoking almost his entire life: “I smoked for a long time. I started when I was a child.”
If one suspects they have PAD, it’s important to seek a diagnosis as soon as possible. Diagnosing PAD is easy with a test called an ankle brachial index, where blood pressure around the ankles is compared to blood pressure of the arms. If the blood pressure in the ankle is lower, then that means there could be 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.
“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,” said Dr. Walker.
Why a Second Opinion is Important
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. 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.”
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. Advanced treatments allow patients to avoid amputation, as well as prolonged hospitalization and recovery times.
The Triumphant Path for Tomas
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 bunch of times thinking he could never drive again. But he can drive now, and he can use that right leg again.”
She reflected on how they felt when he was initially told his legs would both need to be amputated. “We just kept praying. He told the doctors he didn’t want an amputation. All the other doctors from that point said they couldn’t do anything for him. We found out about Dr. Walker…to us he was God sent. He literally saved his legs. Both of them!”
It’s important to realize that early diagnosis is critical in order to treat PAD and keep the condition from getting worse. 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.
“Nowadays, I feel wonderful. You don’t really realize some things that you have until you don’t have them anymore. It feels good to be able to walk," said Tomas. Dr. Walker is pretty happy and satisfied too.
“ I love what I do because when we can help a patient, we really become a part of their family.”
If you think you may have PAD and would like to see a CIS physician, click below to request an appointment at a CIS location near you.