Maggie McKay (Host): If you have unusual leg symptoms, there are some you should not ignore. Today, we'll discuss peripheral artery disease with vascular surgeon, Dr. Amy Reed. Welcome to the Better Health Podcast from Tidelands Health. I'm your host, Maggie McKay. Thank you so much for being here today, Dr. Reed.

Amy Reed, MD (Guest): Thank you, Maggie.

Host: Let's just start with what is peripheral artery disease?

Amy Reed, MD (Guest): Peripheral artery disease is very similar to heart disease, except it involves the arteries that give blood flow to the legs. So the same type of blockages that occur in the arteries in the heart where people get stents for those, the same problems exist in the arteries giving blood to the legs and can result in amputation or bad infections, if not treated.

Oftentimes treatment for peripheral artery disease is outpatient based and not involving a surgery where you have a general anesthetic. It, just like heart disease where stents and balloons are used through a small puncture, the same can be true for treatment of peripheral artery disease.

Host: And how can you prevent peripheral artery disease?

Amy Reed, MD (Guest): Prevention for peripheral artery disease is very similar, again, to managing what patients might do for heart disease, which includes not smoking, managing your blood sugars if you're a diabetic, walking and using exercise to help promote better blood return and blood flow to your legs, and also taking prescribed medications that might help lower cholesterol.

Host: Okay. And if someone has persistent leg pain, what other symptoms should they look out for and what does it mean?

Amy Reed, MD (Guest): There's some confusion with leg pain, and obviously some of us will get leg cramps at night or cramps in our toes. Those aren't the things we're talking about. We're talking about pain when you walk a certain distance. Let's say you walk a block and after you walk a block, you start getting a cramp in your calf or it gets tired or tight and you stop and rest and it comes back after you walk a block again.

So we're not talking about arthritis or pain when you stand up. Well, you have to typically be moving to generate this aching or pain that comes about. So pain with walking, which goes away when you stop walking. Other things that can be extreme ends of peripheral artery disease are when you start noticing sores on your feet that aren't healing.

Maybe you had a blister with wearing a new shoe or suddenly you see what looks like scab on your toe and it's not going away or you don't know where it came from. Those can all be signs of peripheral artery disease.

Host: What's the danger of leaving leg pain untreated or unaddressed?

Amy Reed, MD (Guest): So, the most extreme problem can be amputation, um, if the leg circulation is not addressed. And again, this is the artery, the red blood, not the veins or where people get a blood clot in the vein, but we're talking about the arteries. And if left untreated and people don't recognize the problems going on; the worst case scenario can actually be a need for amputation and inability to actually get better blood flow to the legs. So hopefully most of our patients don't get to that point, but it can get so severe that that may need to have an amputation may be necessary.

Host: Wow. And is there anything else you'd like to add in closing that we should know about it?

Amy Reed, MD (Guest): I think the most important thing, just like again, like heart disease that took quite a while to be recognized in women and how it presents in women, the same type of thing is true for peripheral artery disease. When I was training in vascular surgery in the 1990s, we always thought this was a problem of men.

And what we've learned over time is that women present with peripheral artery disease in the same numbers as men. And in fact, like heart disease presenting different in women, in vascular disease or peripheral artery disease, women might be told, oh, it's your varicose veins or, oh, it's neuropathy or, oh, it's your back.

It's so important, I think, for men and women to ask their primary care doctor about peripheral artery disease. And ask, do I have this? It's very easy to check just with blood pressure cuff measurements at the ankle and the arm. You don't need fancy CAT scans or fancy, you don't need dye or things like that.

So it's very easy to check. I think it's just taking advantage of the opportunities with your primary care provider and asking, do I have this problem in my legs? And it's very easy to check.

Host: Well, that's good to know. And so once it's treated, are you done with it forever or is it always with you? Can it come back? How does that work?

Well,

Amy Reed, MD (Guest): So for treating peripheral artery disease, if we are managing patients, if it's early on and they just need medications, we follow you generally every six months to a year just checking on the circulation. And I would say as a vascular surgeon, patients really see us often for life, at least once a year to check on the circulation. If we've done a balloon or stent or something like that, we want to check up on that.

But we just keep in mind that the circulation can sometimes develop other areas of blockage, so it's always important to just check in with the patient and follow and make sure that the blood flow is adequate to the legs.

Host: Thank you so much for sharing your expertise. We really appreciate your time. And it's good to know about this.

Amy Reed, MD (Guest): Thank you so much.

Host: Again, that's Dr. Amy Reed. Go to tidelandshealth.org for more information or call 1-866-tidelands. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.

I'm Maggie McKay. Thank you for listening to the Better Health Podcast from Tidelands Health.