Silent Epidemic Needlessly Costing Life and Limb

LISTEN TO THE HEART OF INNOVATION HERE: EPISODE 2

Everyone knows of the condition Cardiovascular Disease, also known as Heart Disease, which is plaque build-up in the arteries around the heart. In the legs, plaque build-up in the arteries is known as Peripheral Artery Disease (P.A.D.). It can also impact the arms and sometimes the small arteries in the brain. But it's mainly the legs. Three-in-five heart attack sufferers, one-in-five over age 60, and one-in-three diabetics over age 50 have it. Globally, it is estimated that more than 200 million people have P.A.D. Most don't know it until it reaches advanced stages and heart attack, stroke, and amputation are imminent. Doctors may misdiagnose textbook symptoms of leg pain and leg cramps as diabetic neuropathy, diabetic foot, fibromyalgia, old age, arthritis, or even spinal/sciatic problems. But it’s easy to diagnose or rule out with even two fingers and two seconds with a doctor feeling a patient’s leg pulses. In this episode of The Heart of Innovation , hosts Emmy Award-winning journalist Kym McNicholas and Interventional Cardiologist Dr. John Phillips discuss the basics of what patients need to know about P.A.D. and the importance of early diagnosis and early appropriate treatment.

Douglas, a P.A.D. Patient from Texas, calls in to ask about walking as medicine for P.A.D. A brisk 30-minute walk a few times a week can help your body create a ‘natural bypass’ around blockages by triggering the body’s collateral network of vessels. Pushing through some of the pain and cramping caused by that restricted blood flow tells your body, “Hey, we have demand for additional blood flow that we aren’t meeting so let’s calling in for some back-up!” The back-is our collateral network of vessels which lay dormant until they’re needed to re-route flow around blockages to feed oxygen and other nutrients to the lower extremities. Dr. John Phillips, co-host of The Heart of Innovation, explains to Douglas how to walk effectively to kick that collateral network into gear to improve circulation naturally.

Dr. Yazan Khatib, Interventional Cardiologist with First Coast Cardiovascular Institute in Jacksonville, Florida calls in to drive home the importance of not only diagnosing P.A.D. early but then finding the right doctor who has advanced skills in treating P.A.D. Vascular Surgeons, Interventional Cardiologists, Interventional Radiologists, and Vascular Medicine doctors may be treated in treating P.A.D. If they do treat P.A.D. patients, it’s likely they’ll offer a set of treatment options which may differ from another P.A.D. specialist, but that their options are the best and only ones available. Dr. Khatib contends it’s very important to always seek a second and even third opinion prior to any procedure to understand all available treatment options which may include medical therapy, walking program, angiogram (using wires, catheters, balloons, stents, etc through a small puncture in the leg), bypass, or amputation.

Tammie Caves, Clinical Program Director for wound care organization Healogics, Inc. calls in to share why it’s perfect timing to discuss P.A.D. It’s Wound Care Awareness Month in June. If a patient is not diagnosed with P.A.D. in its early stages, the first indication that triggers a physician to take action might be a non-healing wound on the foot and/or toes. She explains that restricted blood flow hinders the healing process because oxygen is a critical component. She urges patients who are most at-risk for restricted blood flow, diabetics, to get regular foot check-ups because diabetic neuropathy can prevent someone from feeling a wound, and infection might set-in before seeking treatment. Diabetics are more susceptible to P.A.D. because sugar molecules tend to scratch the artery walls triggering an inflammatory response in the body which causes plaque to build-up in those damaged areas. A lot of plaque building up restricts blood flow. Restricted blood flow can lead to non-healing wounds. Tammie expresses disbelief about how many patients come to Healogics with wounds, who have not been assessed for P.A.D. She drives home the importance of these patients ensuring they have a proper vascular assessment prior to any extensive wound work by a podiatrist or wound care specialist.

Nurse Practitioner Kay Smith is featured in our “Save My Piggies” segment, to share her story about spending 19 months in the most advanced stages of P.A.D. known as Critical Limb Ischemia (CLI) and how she persevered. P.A.D. can be separated into two buckets: Intermittent Claudication (you walk, get pain, stop for a few minutes, pain goes away, walk again) and CLI (rest pain at night and non-healing wounds). Only 10% of patients with P.A.D. end up in CLI and its typically only because they were not diagnosed early and treated appropriately in earlier stages because symptoms were not recognized, or risk factors not properly assessed. NP Kay was told her debilitating pain was due to back problems and prescribed her a wheelchair until her toes turned blue. Her vascular surgeon performed an angiogram to assess the blockages, and without even sending in a wire to try and push through the blockage, he said she couldn’t be treated and marked her as palliative (terminal). She found The Way To My Heart which helped her to find hope again. She was able to learn all available options and the right questions to ask to find the most advanced P.A.D. specialist. She also enrolled in The Way To My Heart’s walking program which helped her to start building her collateral network, with some additional help of her virtual reality headset. A second opinion from an advanced skilled vascular specialist led to a proper angiogram where blockages were cleared, getting NP Kay back on her feet again.?Months later she danced with her husband for the first time in five years, clocking a record 9,000 steps in one day. Now NP Kay pays it forward by supporting The Way To My Heart’s network of more than 11,000 patients as a Nurse Practitioner, Board Certified in Wound Care.

Listen to the show at this link to hear life and limb saving information about Peripheral Artery Disease.

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