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Guest Post by:
Jean Marie Ruddy, M.D.
MUSC Health

We live in a beautiful city and the Lowcountry offers a multitude of opportunities to explore and enjoy the outdoors, whether your preference is boating, golfing or strolling through historic downtown Charleston. To feel your best every day and have the energy to enjoy an active lifestyle, all parts of your body need to be nourished with oxygen and nutrients. These vital elements are carried throughout your body by a vast network of arteries.

Peripheral Arterial Disease (PAD) represents accumulation of plaque in these blood vessels, particularly in the neck, arms, legs, and abdomen. Similar to build-up in the arteries of the heart, plaque causes narrowing in other parts of your body which blocks blood flow and causes damage—plaque in the neck can cause stroke and plaque in the legs can cause pain with walking, or in some cases, severely reduce the blood flow to the foot and toes.

PAD in Women

While once considered more common in men, recent nationwide studies have noted equal percentage of women suffering from leg PAD, but unfortunately this frequently may not be recognized until the disease is advanced. Understanding risk factors, signs and symptoms of PAD in the legs can help women inform their doctors about potential concerns and provide opportunities to maximize vascular health, and in turn, their quality of life.

To aid in this effort, the American Heart Association is focusing on better education about PAD, and particularly PAD in women, as a primary goal in 2016. MUSC Health will be a pilot institution for a web-based training program aimed at identifying and treating those at risk.

Risk Factors for PAD are similar to heart disease:

  • Smoking
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Obesity
  • Age
  • Family history of heart disease

Symptoms of PAD

Typical symptoms of PAD in the legs include cramping pain or fatigue in the calf when walking, but greater than 50% of women with PAD may not have symptoms.

Behavioral changes should be considered, for instance loss of interest in hobbies or changes in job activities may be due to chronic discomfort and represent subconscious lifestyle modifications to minimize the pain.

Diagnosing PAD —ABI Test

If you or your doctor has raised concerns about PAD, a quick non-invasive test can be completed. The ankle-brachial index (ABI) compares the blood pressure in the arm to the blood pressure at the ankle. If outside the normal value, this simple ratio can indicate that further evaluation with a vascular surgeon would be beneficial.

Medical Management of PAD

Ask your doctor what medications can help control your PAD:

  • Aspirin
  • Statin medications
  • Oral anti-claudication medications

Lifestyle changes that can decrease your risk:

  • Walking
  • Smoking Cessation
  • Good Blood Glucose Control

A Life Returned

In conjunction with the American Heart Association, MUSC Health’s vascular surgeons are committed to increasing awareness, diagnosis, and treatment of PAD in all patients in the greater Charleston area, and our team offers multidisciplinary, technologically-advanced care to promote vascular health in women.

Mable Benton grew up in Surfside, SC, and works in health care in the Conway area. She and her husband Keith have raised two daughters and enjoyed the addition of three grandchildren.

When she has free time, you can find Mable gardening or fishing, but last year she found these beloved hobbies to be out of her reach.

Mable began noticing leg heaviness and fatigue when walking in the late 1990s, but only at long distances, so she took Tylenol for the pain. By the spring of 2014, however, the pain was starting at shorter distances, and it felt like she “had just run 5 miles.” The following September she noted that she couldn’t walk 50 feet without severe back and leg pain with “burning and cramping.” She began using a wheelchair at work, expecting that it was a back problem.

Finally a friend and colleague who is a general surgeon recognized her symptoms. He was concerned that she had no pulses in her groins and suggested she talk to her doctor, who ordered an ankle-brachial index (ABI) test. Mable was aware that smoking cigarettes can worsen PAD and dropped that habit as soon as she was diagnosed. By this time her PAD was so advanced that it showed less than 50% blood flow at the ankles. A follow-up CT scan confirmed blockage at the end of her aorta and into the pelvic blood vessels. She was referred to MUSC Health.

At the MUSC Health Aortic Center, our team specializes in care of patients with aneurysms or blockages of the aorta. This collaboration among physicians specializing in Vascular Surgery, Cardiothoracic Surgery, Cardiology and Interventional Radiology enables comprehensive care and provides access to state-of-the-art technology for minimally invasive interventions.

When Mable came for her visit, it was clear that this leg pain had ruined her quality of life. She was using an electric scooter at the grocery store and could no longer cut her grass or play with her grandson.

Although surgery through an open incision on the abdomen is a well-established and effective way to fix this problem, she was a great candidate for a newer method of treatment that would break through the blockage and use stents to keep the vessels open. Our team discussed the risks and benefits of this new therapy and she was excited to proceed. She left the office that day with renewed hope for a long and active life.

Following surgery, Mabel had no pain and just 2 small incisions in her groins. She was home the next day, quickly resuming activities and returned to work…without a wheelchair! She professes, “I can walk as far as I want without pain. I have been given my life back.”

Show you care this Valentine’s Day. Get your loved one screened for PAD. Visit MUSChealth.org/PADscreening or call 843-792-1616 to schedule a special PAD Screening.

Guest Post by:

Brittney Lang, MS ATC
Athletic Trainer
MUSC Health Sports Medicine

We are gearing up for spring season athletes to be starting games and practices in the coming weeks. With more sports come more athletes with potential for musculoskeletal injuries. We of course will see many of the common injuries such as ankle sprains, strained muscles, overall soreness and more but injuries that are not really prepared for the most are dental and oral injuries. For every sport, there is some form of protective equipment that is required to be worn from helmets, to pads, to goggles and face masks to help to prevent possible injuries. But there is one small piece of protective equipment that is over looked by most athletes and can help decrease the amount of oral injuries seen is a mouth guard. There are only a few sports that require mouth guards to be worn during participation at all times, such as football, lacrosse and ice hockey. However, though it is highly recommended for all physical activity and sports to use a mouth guard during participation many do not.  Studies have shown that athletes have a 1 in 10 chance of receiving a facial or oral injury during their season. If we take just a few extra precautions by either providing mouth guards or highly suggesting that mouth guards be used during play we can help minimize dental and other oral injuries in the future.

Types of Mouth Guards

There are different kinds of mouth guards out there but they are for the most part broken into two kinds, one being the boil and bite or stock mouth guards that you can get from most sport stores or the fabricated ones that require a dentist to make specifically for the individual. The boil and bite mouth guards are most often used since they are cheaper and easily accessible. But they are usually a one size fits all kind of item so many will have issues with them fitting properly and causing athletes discomfort thereby causing them to not want to wear one. The athlete will place the mouth guard into boiling water making it pliable. Then placed into the mouth while waiting for the plastic to cool down and form to the mouth and teeth as best it can. The other type of mouth guard is one that is fabricated by a dentist specifically for the athlete using a plaster mold of the athlete’s mouth and teeth. These mouth guards are the best way to go but can be expensive therefore only seen with athletes who need a well fitted mouth guard such as though with braces or with athletes who need to be able to talk freely but require using one in their sports like quarterbacks.

Treatment for Dental Injuries

When it comes to oral and dental injuries, the athlete should be sent to a dentist or dental specialist for proper care. Depending on severity of the dental or oral injury, it will determine if the injury will need to seek emergency dental treatment or not. The earlier the athlete can be treated the overall care and outcome of the injury will be beneficial.

Preventing Dental Injuries

The first step in preventing oral injuries is to educate the community, both the athletes and health care professionals, on the benefits of using a mouth guard during all sport related activity; and dispelling myths that athletes might have about wearing mouth guards such as it restricting them to breath freely. Showing that mouth guards can decrease the amount of oral injuries during sports due to contact from other athletes or equipment used in the activity. Also, whether an athlete or health care professional, helping to promote that mouth guards be required to be worn by all sports during participation and to enforce the requirements that are already out there.

Guest Post by:

Katie Bracken, ATC, PES
MUSC Health Sports Medicine

It’s that time of year where New Year Resolutions are going strong! It is the perfect time to step outside of your comfort zone and try weight training. Even if you are more interested in cardio (cardio is great for all types of athletes to increase lung capacity and aerobic endurance), weight training has many benefits short-term and long term. 

Whole body exercise:

Many people think of squats as a “leg” dominant exercise. However, squats actively engage several other areas of the body. In order to prevent injury, one must “activate” the low, mid and upper-back to properly keep the spine in line. At the same time, to not over work your back you must also engage your core to keep a balance in the mid section of the body.  Not only do you have to use your nervous system to engage the proper muscles, but also while doing that you are building muscle. A strong back and a strong core are essential to any weight training program.

Increase in muscle mass:

As we all know, an increase in weight training in turn increases muscle mass. Research has shown that adding squats into a weight-training program has shown to increase muscle mass in an area other than just the lower body. Squats are a full body exercise that includes: quadriceps, hamstrings, glutes, back and core.  A continuous addition of squats to a weight-training program will increase muscle mass in these certain areas of the body.

Muscle mass increases metabolism:

If your main focus is weight loss, which it is common this time of year, then add weight training! Research has shown that the more muscle you put on, the more your metabolism continues to work. Even after your workout is complete, muscle continues to work for you throughout the day! Exercise is used for weight loss…weight-training burns fat…. muscle burns fat…. more muscle burns fat!! One rule of thumb is for every pound of muscle gained, 50-70 extra kilocalories are burned for the day.  And NO, women, lifting weights will not make you bulky. There are so many other added benefits that come with weight training.

A boost of sports performance:

Whether you run tough mudders or go for a walk during the evening hours, squats will over all help your athletic performance. As mentioned, weight training and squats increase muscle mass. With more muscle mass present, there becomes an increase in power output. It is not that you gain more muscle fibers within a muscle, but you increase the size of the muscle fibers you already have. SO… the bigger the muscle fibers you produce in a muscle, the more power you are able to generate. I.e. you can walk faster, jump higher and finish the tough mudders quicker. Who wouldn’t want that?

Injury Prevention:

With the above information in mind, please consider the following tip. When first beginning to add squats to your routine, do not jump right into them without educating yourself on proper technique or consulting with a professional. In order to avoid injury, mobility must occur in two places, the ankles and hips. If proper mobility is achieved then squats can in turn improve range of motion, flexibility and create stronger ligaments and joints, which can help prevent injuries.  As we get older, we need stronger ligaments, joints, muscles and a better center of balance. The earlier you can start adding squats to your routine, the better!

Overall, try something new! Begin light and reach for your goals, its never to late!

Need some inspiration for living well?  Check out MUSC News Center’s Oldie Goldies series. Oldie Goldies features people 60 and up who are embracing aging, serving as role models who maintain good health and vitality.

Meet Jeanne Nelson, 90, who still loves to dance, cleans her own home and mows her lawn.  She offers suggestions for healthy aging.  One of her suggestions, not surprisingly, is about physical activity. “Stay active, no matter what you do. If you take walks or even just vacuum and do housework, that's activity. A lot of people hire others to come in to do that for them.”  Read more of Jeanne's advice here.

Then, meet the “Diva”, Delores Sanders, 60, a Hollings Cancer patient whose style is undeniable.  Her advice includes being herself and  she says: “Oh, yes, girlfriend. I want to be an inspiration and let people know that all things are possible. You can’t give up. You have to be positive. With all that I’ve been through and where I am now, I’ve learned that you just have to focus on the good.” Find the full story on the "Diva" here.

 

 

 

 

Guest Post by:
Brittany Darling, MS, ATC

As we enter the New Year, the busy schedule is not the only thing getting in the way of staying active. Around this time of year we also see the weather changing and getting colder everyday, with daylight becoming less and less. This time of year, in my opinion, is the absolute worst for staying in shape. I have come up with some tips that may be helpful to not let yourself fall into hibernation mode this year.

Get on a schedule. Creating a schedule that flows with your normal routine can make it easier to stick to work out plans. Write it down, or sign up for classes ahead of time based on what the upcoming work schedule looks like. I have found that getting up a half hour earlier and doing something active really helps to get the day started. Getting your blood flowing and adrenaline pumping first thing in the morning will have a direct effect on the rest of your day. I think morning workouts are especially effective this time of the year because it is dark by 5pm, so it allows you to relax when you get out of work knowing you have already done your exercising for the day.

Try something new. If you are getting bored with the same old gym scene, and it’s obviously too cold to run outside, and then try a new class somewhere else. You may even be able to put your current gym membership on hold for a month.   I would highly recommend a yoga class, especially one that has a warm and/or hot class that they offer. It’s great to walk in from the cold to a heated room this time of year. This may also introduce your body, as well as your mind, to something new. A great way to stay committed is to sign up and pay for the class ahead of time, this way you are motivated to not waste the money you spent.

Start a home exercise plan. Depending on what level of activity you are looking for, it is very possible to accomplish your fitness goals right from home. Again, it will be beneficial to think of a time that works best for your schedule, whether it is in the morning or at night in order to stay consistent. There is a variety of phone apps out there right now that outline a basic body weight routine for you and track your progress. You can also implement your own, for example: body squats, push-ups, plank hold, jump rope and max out every other day. These are basic exercises that take no more than 10 minutes to complete, but you can easily track gradual improvements as your max becomes higher each week.

Overall the hardest part always seems to be getting started and beginning the exercise. Find your own personal motivation and use it to keep you going. Just keep reminding yourself that spring is right around the corner!

 

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