Peripheral Arterial Disease (PAD)

In today's day and age, vascular disease is becoming increasingly more common and people are more frequently receiving vascular testing. What is vascular disease? Vascular disease occurs when the arteries and veins in the body are either blocked or damaged. There are several contributing factors to vascular disease and they include: aging, smoking, high cholesterol, and diabetes just to name a few. If left untreated, vascular disease can ultimately lead to serious health issues, possible limb amputation, stroke, or even death. This is why it is important to have vascular testing done if you might be at risk.

More and more often we are seeing patients with peripheral arterial disease or PAD, as it is commonly called. PAD affects the blood flow in the arteries of the legs. As a result, the legs begin to hurt due to the blockage and possible blood clots may even occur. If serious enough, surgery or angioplasty may be performed to remove the blockage in order to restore normal blood flow.

So how do you know if you may be at risk for PAD? The first signs or symptoms of PAD include cramping, fatigue, numbness, and pain in the leg muscles that typically go away when you stop and rest, and then reoccur when you begin to walk again. However, there are some other specific risk factors for your health that may be present if you have PAD. If you are found to have PAD through screening or formal testing, you are at risk of heart attack, stroke, or aortic aneurysm and should be evaluated by your physician for these vascular problems as well. The most common test for PAD is an ABI test, or ankle-brachial index, which measures the blood pressure at your ankles compared to an arm pressure that is then taken.

What can you do to prevent PAD and increase your chances of living a better and healthier life? For starters, quit smoking, watch what you eat, and try to exercise. Just a simple walk around the block can help to avoid PAD. From there, ask your doctor about certain medications that can help you avoid heart attack and stroke and be sure to take necessary medications to regulate high blood pressure, cholesterol, and diabetes.

Care of the Feet and Legs for the Person with a Peripheral Problem
CLEANLINESS:
1. Wash feet at least once daily.
2. Use warm water and bland soap.
3. Dry feet thoroughly, especially between the toes. Blot and pat with a towel, do not rub.

WARMTH:
1. Wear cotton hose, since they are comfortable and absorb moisture.
2. Prevent feet from getting cold; this reduces blood supply.
3. Avoid applying heat to the feet or legs unless approved by a physician or nurse.

SAFETY:
1. Protect feet by performing exercises on level ground.
2. Avoid walking in crowds.
3. Use care in cutting toenails a. First soak feet for 10 minutes in warm water to soften nails. b. Cut nails straight across, avoid cutting nails close to flesh.

COMFORT MEASURES:
1. Wear shoes that provide adequate toe room, have a good arch, and feel comfortable.
2. Apply powder if feet tend to become moist.
3. Apply a thin coating of lanolin if feet are dry and scaly.

PREVENTING CONSTRICTION OF BLOOD VESSELS:
1. Avoid circular garters that cut off blood supply to legs and feet.
2. Do not cross legs at knees.
3. Place a pillow at foot end of bed under covers to prevent top bedding from exerting pressure on toes.
4. Apply lamb's wool between toes if they rub each other.

EXERCISE:
1. Walking stimulates circulation and promotes tissue repair.

MEDICAL ATTENTION:
1. Report redness, blistering, swelling, or pain.
2. Report athelet's foot, peeling, and itching between toes.
3. Do not use any medication on feet or legs unless prescribed by the physician.

SMOKING:
1. Avoid tobacco in any form, since it aggravates peripheral vascular conditions.