Diane Treat-Jacobson, PhD, RN, FAHA - Take control of PAD with treatment, management of risk factors
Diane Treat-Jacobson, PhD, RN, FAHA, is a professor and associate dean for research at the University of Minnesota School of Nursing and an American Heart Association volunteer. She writes in recognition of PAD Awareness Month.
Talking with patients, I’m often struck by the fact that many don’t recognize how big an impact peripheral artery disease (PAD) has on their lives.
For many patients, the condition becomes isolating, keeping them from the activities they enjoy or daily routines. They plan their routes to avoid walking or take routes that have plenty of places to rest, anticipating the pain that come with walking. Many say they avoid walking altogether to avoid the leg pain that can be common with PAD.
What they don’t realize is that avoiding walking can actually make PAD condition worse.
PAD, a life-threatening condition that affects more than 8.5 million Americans, occurs when fatty deposits build up in the arteries that supply blood to the legs and feet. Without proper circulation and oxygen, your limbs may suffer damage, placing you at risk for amputation if left untreated.
Early detection and treatment are key to preventing PAD and living a longer, healthier life, but the condition can be challenging to diagnose.
Many people who have symptoms, which can include leg pain, fatigue or discomfort during exercise, assume they’re simply a sign of aging, rather than a symptom of a serious vascular condition and don’t seek treatment.
No pain, no gain
Often, we’re told when it comes to medical conditions that if something hurts, we should stop doing it. But in the case of PAD, avoiding exercise can cause the condition to get worse.
PAD restricts oxygen to the muscles, so one of the most effective treatment therapies is exercise, which helps muscles learn how to work more efficiently.
Start with intermittent exercise — walking until the pain begins, resting until the pain stops, then repeat the walking/rest cycle until you’ve accumulated at least 30 minutes of aerobic exercise. The key is to keep pushing yourself. Once you can walk 10 minutes without pain, increase the pace or grade if you are using a treadmill.
By doing this, many patients find they are able to walk longer without pain and continue walking longer until the pain causes them to stop.
If you are living with PAD, your medical insurance may cover up to 36 supervised exercise therapy sessions that encourage you to get active and walk on a treadmill at your own pace with a supervised mentor by your side. A second set of 36 sessions may be covered if symptoms persist.
Medicare and many private insurers now pay for SilverSneakers, a program offering access to gyms and fitness centers and classes and online resources designed for seniors.
Don’t live near a gym or fitness center? Set up lawn chairs outside and walk back and forth.
Patients unable to walk steadily may get aerobic benefit by using a recumbent stepping machine or arm ergometer.
For some patients, revascularization therapy that uses stents to reopen arteries may be recommended. Sometimes one blockage is reopened, but there are others that can cause symptoms, or the stents can close after period of time.
Patients who undergo revascularization, participating in supervised or other aerobic exercise programs can help strengthen the arteries, enabling the stents to keep them open, longer.
Manage your risk factors
Reducing and managing risk factors for PAD is another critical part of treatment, because PAD significantly increases your risk for heart attack and stroke.
Undergoing a smoking cessation program is critically important because frequent tobacco smoking puts you at high-risk for developing PAD and for worsening of the disease.
Other risk factors include diabetes, high blood pressure, excessive weight and high cholesterol.
Be sure to stay on cholesterol-lowering medications, also known as statins, and make sure blood pressure and diabetes are under control.
Talk to your doctor about whether anti-platelet medication to prevent clots from forming is appropriate.
Don’t let PAD stop you from living your life. Treatment can improve symptoms and help reduce your risks. Maybe it’s about doing the things you love or keeping up with the grandkids. You have the power to get better and get active and do the things that allow you to have a high quality of life.