5 Things About Peripheral Arterial Disease (PAD)
1: PAD May Result In Limb Loss and Death
We’ll start at the end and work our way forward. PAD may result in limb loss and death. Once PAD starts becoming painful a vascular procedure or amputation are often the only things that will reduce the pain. Even opiates have been shown to poorly control pain from PAD. This is because the pain in PAD is due to tissues that have no blood flow, and are literally being starved to death. The chance that you will be dead at 5 years (5 year mortality) with PAD is over 60%, this is worse than many types of cancer.
2: PAD Can Be Very Painful … or Not.
In the later stages as more and more vessels are occluded, an entire toe or finger may begin dying. This will be heralded by the area turning red, then blue, then white. Then black. The black means that the tissue is dead. This is an emergency, and can happen shockingly fast. Over the course of two to three days, you can go through all of the colors above. This will be noticed if you are doing a daily foot exam (hint hint diabetics), but if you are not then you will probably only notice when you see a black toe. Or your toe falls off in the shower.* Or it may not be painful, in earlier stages 75% of those with PAD will not have any symptoms.
3: Stop Smoking Or Die Horribly
Your old friend nicotine it turns out is not much of a friend. Smoking increases the rate of vascular plaque formation up to 10 times. Those are not good odds. If you used to smoke, but quit right before reading this you are still at much higher risk. The longer you smoked, and the more you smoked while you were smoking, the more damage you have done. If you’re still smoking now, please quit. It’s not easy, but then again worthwhile things rarely are.
4: Nobody Escapes, Yes This Includes You
We all experience PAD to a certain extent. A child has little to none, as they have not had time to form any plaques, or pick up any bad habits. As we age the buildup of materials increases faster and faster, certain medical conditions accelerate this process: high blood pressure (Hypertension), high cholesterol (hypercholesterolemia), and let’s not forget old faithful – Diabetes.
5: September is PAD Awareness Month
Peripheral arterial disease (PAD) is a slowdown in bloodflow in your arterial system. This causes a delay in delivery of blood to the tissues. The delay may be due to accumulation of detritus in your arteries, cholesterol forming plaques, and narrowing of the vessels overall.
September is peripheral arterial disease awareness month. We’re not all clamoring to get you to recognize other people’s PAD, we’re trying to get you to recognize it in yourself. If you experience pain when climbing stairs, or can’t walk as far as you used to (say one year ago, not back when you were 20), let your doctor know and have the conversation early. In general, walk more, eat less, quit smoking and you won’t have to meet the vascular surgery department at 3AM.
*Bonus macabre tip – if you do have an area of necrosis (black tissue), don’t let your pets near it. Dogs can smell the dead tissue, and they will eat it right off of you. They are trying to help. I’m not kidding, I’ve had several patients who reported that their black toe is no longer with us because their dog ate it. So keep those black areas covered up, or let someone else watch the pets for a while.