Elizabeth Beard – Exercise Coverage for PAD
“THERE IS A DEADLY DISEASE ATTACKING NORTH AMERICANS AND THREE OUT OF FOUR PEOPLE WON’T KNOW THEY HAVE IT UNTIL THEY SUFFER A STROKE OR DIE……” (The Wall Street Journal)
Maybe that should be the headline scrolling across our television screens at night, because it is the truth. The late Dr. Alan Hirsch of the former Vascular Disease Foundation in Colorado said that “PAD is the most common and deadly cardiovascular disease that the public has never heard of.”
As a survivor and PAD patient, I think the biggest challenge we face is that most people (like me) don’t realize that they have it, so they never even mention it to their physicians. The symptoms are usually chalked up to getting older, being out of shape or overweight. Even with my heavy family history of heart disease and stroke - and knowing that I was a 35 year smoker - it never entered my mind that something was wrong with the arteries in my legs and my abdominal aorta.
Thinking back on it now, I see how slowly over the years before I was actually diagnosed that it had become increasingly difficult for me to push mow my yard and to do certain types of house work. At that point, I didn’t really have what I would call pain associated with doing these things it was more like a fatigued feeling or my heart would beat harder, or I would feel dizzy. So I just hired somebody to mow my lawn.
Truthfully, for a long time I never walked far enough to even experience the symptom of intermittent claudication or leg cramps. I wasn’t exercising at all. I would finish my work day (which was sitting at a desk for 8-12 hours) grab a glass of tea and my cigarettes and after an unhealthy dinner sit on the couch, watch TV and go to bed. I think there are more people that live this way than would like to admit it.
This is why 50% of people with PAD do not know they have it, and many physicians are not as vigilant as they should be in the diagnosis and treatment of this disease. This is resulting in millions of unnecessary limb amputations and deaths. Currently it is estimated that 8-12 million Americans have PAD, especially people over 50 years old.
Limb amputation is the sixth most expensive surgery in the United States. With our aging population, Medicare will bear the largest brunt of that cost as they are now. In addition, statistics show that 50% of amputees whose limbs have not been removed to due trauma over 65 years old will die within one-two years of amputation.
When you have Peripheral Artery Disease (PAD) the first symptom most people are aware of is called “intermittent claudication.” When a person walks, her calves will cramp, seize up or ache until they cease moving. When they rest the pain stops. Then, as the disease progresses, walking becomes so painful that patients usually just stop walking. They will either avoid situations where a lot of walking or climbing stairs is involved, or in many cases they will begin to ride on a scooter. The result is always the same, eventually the disease will progress to a drastically worse quality of life or even the loss of your life if you do not seek treatment.
I think that is very important as a layperson that I share with you something that I learned along the way about the importance of my calves and feet as they relate to my cardiovascular system.
You may not know that you have a system in your body that is commonly referred to as “the second heart.” It is a system of muscles, veins and valves in the calf and foot that work together to push the blood that now has no oxygen back up to the heart and lungs to get oxygen in it again.
Your calf muscles squeeze your veins when you walk in a pumping fashion much like your heart does. In a patient that has PAD, this pumping-squeezing action is what causes the pain in legs that have blocked arteries. So imagine what happens to the body if your legs have to be amputated.
There is a simple non-invasive test called an ABI test that can be done to confirm whether or not you have PAD. If you do there is now more hope than ever for you.
The CMS (Centers for Medicare and Medicaid Services) has just now approved payment for a supervised exercise therapy (SET) for patients with Symptomatic Peripheral Vascular Disease (PAD). This is going to be a game changer for people with PAD.
This life-saving program will enable patients to learn to walk longer and farther, and to educate them on making the lifestyle changes that must be made in order to have a chance at better life with PAD.
My greatest hope is that all insurers will approve this therapy and that rehabilitation will also be offered post-surgery for patients like me.
Go for a walk around the block if you haven’t been active in a while. If you experience the symptoms of PAD….please make an appointment today with your doctor. Don’t wait. Your life depends on it.
And thank you, from the bottom of my heart, to CMS and the American Heart Association for all your efforts related to this disease, and the approval of exercise therapy for PAD patients.