Seeing your doctor? Take off your socks!

Diabetics know that every time they see their doctor they need
to have their feet checked, but everyone else should do that, as well. Not only should a doctor look for any discoloration or unusual nail growth, they should also take a pulse — yes, a pulse — in your foot.

What are they looking for? Signs of peripheral artery disease (PAD), a narrowing of the arteries to your limbs. While most people have heard of coronary artery disease (CAD), which is caused by a narrowing of the major blood vessels to the heart, they may not have heard of PAD. However, the two go hand-in-hand. If someone has CAD, they probably have PAD, and vice versa. If your blood vessels are narrowed in one part of the body, they’re probably narrowed in other parts as well.

Approximately half of people with PAD, especially at the early stages, have no symptoms. Or, more precisely, they think they have no symptoms. They may have leg pain when walking, but write it off as a normal feature of aging. If it is not normal aging, but undetected PAD, it puts the person at greater risk of cardiac events like a heart attack or a stroke.

Symptoms

Not everyone with PAD has symptoms, but, if they do, the following symptoms are the most common:

• Cramping, fatigue, or sense of heaviness in the lower body during exertion. This pain or sensation of heaviness usually occurs in the calves, but may also occur in one or both hips
  or thighs. It may or may not go away after a few minutes of rest. This is called claudication,
  and is the most common symptom of PAD.
• A sensation of numbness or weakness in one or both legs
• Decreased temperature of one lower leg or foot, as compared to the rest of the body or the other leg or foot
• Change in the color of the legs, feet, or toes
• Shiny leg skin
• Slow toenail growth
• Decreased hair growth on legs, feet, or toes
• Dead tissue (gangrene)
• Sores or wounds on the leg, foot, or toe that either don’t heal or heal very slowly

Risk Factors

If the symptoms listed above bring diabetes to mind, it is no coincidence. One of the greatest risk factors for PAD is diabetes, and more than 25% of diabetics have PAD. Smoking is the other greatest risk factor.

Other risk factors for PAD include:

• Being over 65 years old
• Being over 50 years old, with:
  a history of diabetes or smoking,
  high cholesterol,
  a family history of PAD,
  high blood pressure, or
  obesity
• Being under 50 years old, with diabetes and any of the risk factors listed above
• Having been diagnosed with atherosclerosis, at any age

Complications

Complications from PAD put a person at risk of

• Critical limb ischemia, in which decreased blood flow to the legs cause chronic sores or infections. Left untreated, these can cause gangrene, and may require amputation of the affected part of the leg
• Heart attack or If the blood vessels in your legs are narrowed, the blood vessels to your heart and brain are probably narrowed as well.

Treatment

Most people with PAD can be treated with therapeutic life changes (TLC), such as a structured exercise program. They may also be put on a statin and aspirin. Of course, if they are diabetic, it is imperative that they keep their blood sugar under control in order to prevent PAD from progressing.

Patients with advanced PAD may require a stent. Even if they undergo this procedure, they will need to institute TLC in order to prevent further progression of the disease.

PAD is a serious condition, but with appropriate lifestyle changes, it can be stopped in its tracks.