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.