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Peripheral arterial disease: recommended by experts


Can you walk more? This may be the last question you want to hear if you have a vascular condition peripheral arterial disease, or PAD. Even walking short distances, as you probably know, can cause your legs cramp on.

But doctors say that if you push yourself to move more often and walk further, you will actually feel better. John Osborne, MD, PhD, a cardiologist in Dallas, says the inclusion of supervised rehab therapy will give you the best results – and the ache will be worth the profit.

Rehab focuses on “continuing to push your gait up until it hurts,” he says. “But if you continue to do that, it will actually tend to build in additional collateral. [blood] vessels or bridging vessels around the blocked vessels. “

PAD occurs when plaque builds up in your peripheral arteries. The butcher wear blood away from you heart to other areas of your body, such as the arms and legs.

The most common form of PAD affects your legs and feet. You may not have felt any symptoms – about 1 in 4 people have not. If you do, you may have felt pain in your muscles or weakness when walking or trying something else. type of exercise.

Your doctor may recommend a procedure to open one of those blocked veins or to remove accumulated plaque. But you can take other steps to boost how you feel with PAD, say cardiologists. Treatment of high blood pressure and high cholesterol, eat healthier food – and definitely kick any tobacco habit – will help protect those smaller vessels in your arms or legs. The purpose: to guard against ulcers or the death of nearby tissue, which can lead to amputation.

You may also have plaque that can cause problems in you. heart and elsewhere, says Sahil Parikh, MD, an associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons in New York City.

“Everything we do is designed to improve the symptoms. [of PAD], but also to make people live longer, ”he says.

Here are the experts’ top tips.

Limit your risk factors

Many people with PAD probably used tobacco at one time or another. “I do not ask them if they smoked,” says Osborne. “I ask them: ‘Are you still smoke? ‘”

Tobacco is a major risk factor because nicotine encourages plaque to form in blood vessels. “I tell people, ‘I don’t care if you smoke it, snore it, chew it,'” Osborne says.

Quitting tobacco is a good start, even if you may not know where to start. The American Heart Association offers some tips on how to quit, start setting up a “Stop Day””(Preferably one within the next 7 days) when you will completely stop using tobacco.

Keep up to date blood pressure, so it does not drift too high, says Parikh. Exercise, lower tension, and other lifestyle changes may be enough, he says. If not, your doctor may prescribe medication.

If you have diabetes, you have to look at your blood sugar levels now, says Parikh. In addition, keep your cholesterol within the healthy range, whether required diet changes alone or medication.

To improve your diet, the American Heart Association recommends reducing salt, saturated and saturated foods as much as possible. trans fat, sugars and red meat. Rather, load your plate with vegetables, fruits, low-fat dairy, fish, chicken, nuts and other healthy foods.

Print your activity

Because PAD often does not have symptoms at the beginning, you have probably had the disease for some time without realizing it. Over time, less blood flowed through the veins in your legs, Osborne says. Without so much blood to supply your muscles, walking can be uncomfortable or even painful. Often it is the calves which hurts, but it could also be the thighs or other areas, he says.

“What typically happens is that people start walking, their legs cramp up, becomes stiff, sore and sore, ”says Osborne. “They stop. The blood flow catches up. They feel better. And they walk again. And then that cycle repeats itself. ”

This is not surprising, it can sometimes be difficult to embrace exercise. But research has shown that if you exercise under someone’s supervision, such as a physical therapist, you will be more likely to push yourself. As your pain eases, you can exercise even more.

Medicare covers this approach, called supervised exercise therapy, for patients with PAD. Evidence shows that it works better to slow down the aggravation of PAD than to try to pump up exercise on your own.

Your medication options

You may already be taking medication to treat risk factors, such as high blood pressure, says Marc Bonaca, MD, a cardiologist and director of vascular research at the University of Colorado School of Medicine in Aurora. Your doctor may also prescribe other drugs to lower your risk of getting a lump, he says.

One option is aspirin. Recently, the FDA has another drug, rivaroxaban (Xarelto), specifically for people with PAD. Federal officials recommend prescribing rivaroxaban and aspirin to people who have already had a procedure to remove a blockage in their legs. The two drugs together help increase your chances of a heart attack of a stroke more than taking aspirin alone.

Monitor and advocate for your health

Stay up to date on your medication, and watch out for any sores or other changes in the areas where you have PAD, Bonaca says. If the condition affects your feet, keep your toenails well trimmed and your feet clean – and check your feet daily for any signs of skin damage, he says.

A small stone in your shoe or a toenail problem can grow into a serious problem, Bonaca says. With less blood flow, the body has more trouble fighting infection. “Then the wound grows, and the surrounding tissue runs the risk of dying, and that may require amputation,” he says.

Other suggestions: Avoid bare feet and wear comfortable shoes. And do not treat corn, calluses, and ingrown nails themselves.

While living with PAD, plead for yourself to get the best possible care, Parikh says. “PAD is an important life-changing diagnosis. Not just because of the bones, but because of its implications for the rest of the body.”

But he says that if people “get on the right medicine, and you get them on a walking program, they feel much better and are probably better at it.”



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