Surgery can ease poor leg circulation
Dear Dr. Donohue: I am having a problem with lack of circulation in my legs and feet. My doctor did an arteriogram that showed blood-vessel narrowing from my knees to my feet. He said that the only remedy is surgery, which he does not recommend. Is there any other remedy? — W.W.
Answer: The problem is peripheral (legs are considered the body’s periphery) vascular (or arterial) disease. It’s a most prevalent problem. Close to 20 percent of those over 50 have the makings of it, and by age 70, many have the full-blown condition.
Buildup of cholesterol in leg arteries blocks blood flow. When a person with peripheral vascular disease walks any distance, the calves hurt. Pain can also be felt in the buttocks, the thighs or the feet. It depends on where the blockage is. Taking a rest alleviates the pain in a short time.
You had the ultimate test for peripheral vascular disease — an arteriogram, in which dye is injected into leg arteries and X-ray pictures show the blockage. A less-invasive test is comparing the blood pressure at the ankles with the blood pressure in the arms. They should be about the same. A low ankle blood pressure is a strong indication that there is a blockage in the leg arteries.
• Walking is an important treatment for you. Start out modestly, with a block or two. When pain strikes, stop until it goes away, and then resume walking. Increase the distance and time until you are walking at least 30 minutes on as many days of the week as you can.
• Medicines such as Pletal, Plavix and Trental can improve leg circulation.
• Surgery can be the answer for many. It’s much like the bypass surgery for blocked heart arteries.
• And the same angioplasty that is used for clogged heart arteries can be used for clogged leg arteries. A catheter with a balloon tip is inched to the point of obstruction and then inflated to squash the buildup.
The booklet on this disorder explains how it happens and what can be done for it. 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./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
Dear Dr. Donohue: Can you tell me what a PA is? My wife could not see our regular doctor, so they made an appointment for her with a PA. It turned out really well, as she was efficient and nice. My wife is going to see her again so the PA can tell her the results of her tests. — W.C.
Answer: A PA is a physician’s assistant. It’s a college-awarded degree, and the training is quite rigorous. PAs work under a doctor, but they are quite independent in their role of diagnosing and treating illnesses. They have become valuable members of the health profession.