Peripheral Arterial Disease, PAD for short, is a narrowing of the peripheral arteries. The peripheral arteries are the blood vessels that carry blood away from the heart to the abdomen, legs, arms and neck/head. PAD is typically found in the legs and is caused by the accumulation of plaque. This accumulation of plaque and the hardening of the vessels is called atherosclerosis. Basically, the arteries become blocked preventing blood flow. Most people know the blood vessels of the heart can become blocked resulting in a heart attack, but many have never heard of this in their legs until it is too late. The danger of PAD is it often has no symptoms. It is the leading cause of minor and major lower limb amputations. Once you have a leg amputation from PAD your five-year mortality rate increases to 50%. That means you have a 50% chance of dying in the following five years. Should you survive, you have a 50% chance of having the other leg amputated. The news gets worse before it gets better. If you have type II diabetes or smoke you are at greater risk of developing PAD. While there is no cure for PAD, you can certainly fight it and keep it in check.
PAD By The Numbers
According to the Centers for Disease Control, CDC, there are at least 12 million people in the US who are affected by PAD. 95% of people with PAD have at least one co-morbidity (a related disease) such as heart disease and diabetes. Only about 50% of those with PAD will experience any symptoms before the severe stage. Diabetics and smokers have four times higher risk of developing severe PAD and five times greater risk of amputation. 65% of PAD sufferers also have high blood pressure. What does this mean for you as a black woman? You have at high risk of developing PAD and progressing quickly to severe. Black women suffer in high numbers from obesity, type II diabetes, and heart disease, precursors to PAD.
Symptoms Of PAD Are Often Ignored
Even though PAD is fairly silent during most of its progression there are some signs and symptoms. Unfortunately, given the vague nature of the symptoms, they often go ignored or discounted as old age. An annual exam that includes checking specifically for PAD will catch this condition early. These are signs of severe PAD that people are most likely to experience in the late stages of progression.
- Leg pain that doesn’t go away after exercise (resting leg pain)
- Foot wounds that won’t heal (diabetics, check your feet once a week every week!)
- Cold-to-the-touch legs
- Lack of hair on legs and toes
All of these symptoms are associated with the lack of blood flow to the legs. Blood carries oxygen to the muscles. Pain in the legs after physical exertion is basically because your leg muscles are suffocating. They aren’t getting the oxygen and other nutrients needed to recover. This is the same reasons why legs would feel cold. Hair is unnecessary for the body so when it isn’t getting what it needs, it will discard it for survival. Wounds need blood flow to heal. The body’s healing and defense mechanisms are found in the blood. It isn’t the lack of blood flow to the foot that causes a wound. The lack of blood flow prevents even a minor wound from healing and then it will begin to decay. I will spare you the pictures, but your foot will literally begin to rot off.
Diagnosing PAD Early Is Your Best Defense
Knowing your numbers is key! If you are a type II diabetic and/or a smoker you should begin looking for signs and symptoms of PAD as early as 40 years of age. The best diagnostic tool for PAD is the ankle-brachial index (ABI). It’s easy, cheap and should be a standard part of your annual exam. The test involves putting a blood pressure cuff on each ankle and taking a reading. It’s the same process for taking blood pressure on your arm. It will indicate how much blood is getting down to your feet. A reading of 0.9 to 1.3 is normal. Below 0.9 is considered PAD. It can also be diagnosed by Doppler and duplex ultrasound imaging, CT, MRA and angiography which are all methods of seeing the actual blood flow. These methods are typically used once symptoms are present.
The bad news is everyone develops some amount of plaque in the arteries as they age. Research shows even the mummies of ancient Egyptians had atherosclerosis to some degree. Once you have PAD there is essentially no cure. The great news is we can control its progression through lifestyle changes. A diet rich in omega 3, antioxidants, vitamins and minerals will prevent the formation of plaque by keeping cholesterol low and the body’s defenses strong. Of course, regular exercise will keep the heart pumping and blood rushing through the arteries.
Treating Severe PAD Can Be A Costly Band-Aid Or Life-Changing
Unfortunately, there is no cure for PAD. Dr. Dean Ornish, however, believes that PAD, Coronary Artery Disease (CAD), and type II diabetes, can be reversed through diet and lifestyle changes. It’s worth checking out his work. Once PAD advances to a more severe state, critical limb ischemia (CLI), surgical intervention will be required. The severity will dictate how invasive the intervention will be. There is minimally invasive intervention using an angioplasty balloon to clear the blockage and potentially place a stent to hold the vessel open. In more severe cases a bypass may be required to send blood around the blockage. In the most severe cases, a partial limb amputation may be required. Sometimes it’s a toe and other times it’s a complete below the knee amputation. PAD costs the health care system millions of dollars per year.
Some doctors feel it’s not worth the “trouble” of intervening and will go straight to amputation. In fact, a study revealed that 60% of people who undergo any type of amputation for PAD did so without any imaging to see the actual blood flow. Your best defense is a strong offense. Know your options. If you have a doctor that wants to go straight to amputation without any medical management or minimally invasive intervention first, get a second opinion. There are limb salvage centers whose primary mission is to save the limbs by any means necessary. Amputation is a last resort. You must also make the necessary lifestyle changes in order for the intervention to work.
To learn more about PAD visit the American Heart Association and the Save a Limb Save a Life Foundation. I urge you to get checked and share this information with the people you love and within your communities. Follow us on Twitter, Facebook, Instagram, and Pinterest. We know you’re looking for more great content like this. Drop us your email and we’ll make sure you continue to receive original and informative content for health and wealth creation for divine black women.