Knowing P.A.D. risk factors can save many lives

Editor's note: Healthy Tuesdays is a weekly feature in The Sentinel. The commentary, which will be written by those affiliated with Lewistown Hospital, will focus on a different theme each week and highlight health care in the Juniata Valley.

LEWISTOWN - Peripheral Arterial Disease affects millions of Americans. Among adults 65 years old and older, 15 percent may have P.A.D.

"P.A.D. occurs when blood vessels outside the heart are narrowed due to fat and cholesterol buildup," said Dolcy Jones, Lewistown Hospital registered vascular technologist.

Lewistown Hospital provides dedicated testing and treatment for patients with P.A.D. Testing is offered in the area's only IAC-accredited Vascular Laboratory.

Signs and symptoms of P.A.D. include: pain when walking, numbness, and heaviness in legs; cramping in the feet, legs, thighs, and hips; absent pulses; poor healing; skin color changes; cold feet; nail dryness and cracking; hair loss on legs and feet; and erectile dysfunction.

Proven P.A.D. risk factors include: smoking, diabetes, high blood pressure, family history of stroke, medical conditions such as kidney disease, high cholesterol, heart disease and high blood pressure, and men older than 50 years and women older than 55 years.

"P.A.D. is a serious condition that can lead to limb loss. P.A.D. is associated with an increase in death from heart attack and stroke. This is why your doctor feels and listens for pulses in the neck, legs, and abdomen. When abnormalities are found, appropriate testing can be ordered," Philip Rice, MD, said.

Simple testing in the Lewistown Hospital Vascular Laboratory can easily diagnose P.A.D. A physician's order is needed for performance of studies.

The vascular lab also is able to help diagnose abdominal aortic aneurysm, or swelling of the main blood vessel in the abdomen. An AAA may not cause symptoms. Each year, 200,000 new aneurysms are diagnosed, and 15,000 of these are large enough to rupture, and possibly cause death. AAA is most common after age 60. Males are five times more likely than females to be affected. This means men older than 60 years are at highest risk to develop an abdominal aortic aneurysm, and approximately 5 percent of men older than 60 years develop the condition. Your doctor can order a test for AAA. If you have an AAA, treatment is offered at Lewistown Hospital using the latest minimally invasive stents or open surgery.

Many patients also are at risk of stroke from narrowing of the carotid arteries. These arteries supply the brain with blood and oxygen. When blood flow is limited, a stroke can occur. This can cause loss of speech, loss of arm and leg function, and death. The narrowing can be seen on a Doppler study in the vascular lab, and can be treated when diagnosed.

Treatment of P.A.D., AAA, and stroke disease can include exercise, diet change, medications, minimally invasive surgery with balloons and stents, and sometimes open surgery. All of these are offered at Lewistown Hospital. All patients should avoid tobacco, maintain normal weight and eating habits, exercise, and see their physician for continued care of vascular disease.

"Take action. Ask your health care providers about your risk for vascular disease and if you need testing," Rice said.

For further information, visit www.lewistownhospital.org.

Philip Rice, MD, is a cardiovascular surgeon, Vascular Laboratory medical director and registered physician vascular interpreter at Lewistown Hospital. He can be reached by calling 242-7940.