DEAR DR. DONOHUE: Please discuss peripheral artery disease. I think I have it. I get calf pain when I walk. I have seen the ads on TV where a woman and her grandson discuss this. The boy asks her if she has it. She says she doesn’t know. That’s where I am. I don’t know, but I think I might. — N.O.
ANSWER: Peripheral artery disease, PAD, also called peripheral vascular disease, means that arteries in the legs — the periphery — are clogged and leg muscles aren’t getting enough blood. The proof comes from walking. People with PAD get leg pain when they walk a certain distance, and they can tell you almost to the inch when the pain will start. The pain leaves when they take a rest, but returns after they have resumed walking
The site of pain depends on where the blockage occurs. Pain in the buttock or thigh indicates a blockage high in the leg arteries. Pain in the calf comes from a block from midthigh to knee, and pain in the foot comes from a lower blockage.
PAD is a common malady. Five percent of men and 2.5 percent of women over 60 have it, even though some have no symptoms.
A doctor can make the diagnosis in the office. If there’s an obstruction to blood flow in the leg arteries, the pulses at the ankle and on the top of the foot will be weak. Many doctors are equipped to take the ankle blood pressure. The blood pressure at the ankle should be the same as the blood pressure in the arm. If it’s much less, that indicates an obstruction to blood flow in the leg artery.
People with PAD often have CAD, coronary artery disease. The same process that clogs leg arteries also clogs heart arteries. You must see your doctor. He can check the status of your leg arteries, and he can check the status of your heart arteries. There are medicines for both conditions, as well as recommendations for diet changes and exercise.
The booklet on peripheral vascular disease treats this topic in great depth. Readers can obtain a copy by writing: Dr. Donohue — No. 109W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My husband is on blood pressure and cholesterol-lowering medicine. He is now trying herbal medicines ordered from a catalog. I understand that when you are on medicines, you should consult your doctor before making changes or discontinuing them.
My husband says that he is going to stop all medicines. He is 57. I always thought blood-pressure medicine was for life. What is the truth? — P.
ANSWER: The truth is that stopping medicines without consulting the doctor is foolhardy. Some people can get off blood-pressure medicine by adhering to a strict, low-salt diet, losing weight and exercising. And some people can get off cholesterol medicine by adopting a low-fat — especially low-saturated-fat — diet. Giving up medicines blindly is asking for trouble, as is substituting unproven remedies.
Paul G. Donohue, M.D. regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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