DEAR DR. DONOHUE: I am a 74-year-old male and have been diagnosed with peripheral artery disease, PAD. I have a complete occlusion of the main artery just above the knee. What, in your opinion, are the chances of getting through the blockage with angioplasty? There is constant soreness in my calf, even at rest. Is that caused by the blockage? Will cilostazol (Pletal) and Crestor possibly dissolve some of the blockage? — J.C.
ANSWER: Peripheral artery disease, PAD, is also called peripheral vascular disease. It’s an obstruction to the flow of blood through a leg artery. The obstruction is a buildup of cholesterol, fats and various other blood elements. Between the ages of 60 and 65, 4 percent of adults have it, and by the time people reach 80, 20 percent or more are victims of it.
Its chief sign is intermittent claudication, which is pain in leg muscles, quite often the calf muscles, when a person is active. Many can predict almost to a specified number of steps when the pain will arise. Once the person rests, pain usually lasts minutes, but it can take 20 or more minutes to leave. It returns when the person begins to walk again. I can’t say definitely if your constant calf pain is due to PAD; it might be.
Ankle blood pressure is a valuable test for detecting PAD. Normally, the ankle pressure should be close to the arm blood pressure. A lower ankle pressure indicates an obstruction in a leg artery.
Your medicines cilostazol and Crestor won’t completely dissolve the buildup in your leg artery, but they’ll keep it from growing larger. Crestor might reduce the size somewhat. You can help matters by watching your cholesterol; eating a diet that emphasizes grains, fruits and vegetables; controlling your blood pressure; and controlling your blood sugar if you have diabetes. Walking is an exercise that is most helpful.
Angioplasty is one option for you. It will get through the buildup. It’s the same procedure used to open heart arteries with a balloon-equipped catheter that is threaded to the blockage through a surface artery. The balloon is opened at the obstruction, and often a stent is left in the artery. A stent is a wire device that keeps the artery opened. Surgical replacement of the clogged segment of artery with a graft is another option. The location and extent of disease determine which is the better choice.
The booklet on PAD explains this common condition in detail. To obtain a copy, write: 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 boyfriend’s feet sweat terribly. His socks are wringing wet when he takes his shoes off after running. I have told him to wear cotton socks, and he made the change. I don’t see any improvement. Would a different kind of sock be better? — H.M.
ANSWER: Acrylic is a better material. It wicks moisture away from the feet. Dusting powders and a change of socks will improve the situation. Have him carry an extra pair with him when he runs. Damp feet invite fungal infections.
Dr. Donohue 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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