PAD can be pain-free

Seventy-year-old Paul Ambrosino can finally rest at night. But getting him to this point took determination — from him and his team of specialists at the Institute of Cardiovascular Excellence (ICE).

Paul’s all-too-familiar story started in 2011 with excruciating leg pain. But to refer to the pain Paul experienced while walking and at night as ‘cramping’ would be an understatement. Worried and committed to finding a solution, he sought out comprehensive and convenient testing that would save him pain and time.

ICE performed all of Paul’s diagnostic testing, including a lower extremity arterial ultrasound (LEAD) and a computed tomography angiography (CTA). He was diagnosed with peripheral arterial disease (PAD). PAD is caused when a sticky

Yours,

Asad U. Qamar, MD

FACC, FCCP, FSGC, FACP, FSCAI Cardiologist

plaque made up of cholesterol, calcium, and fibrous tissue prevents blood from travelling freely through the arteries and blood vessels in the extremities. What is concerning is when arteries are not supplying our legs, calves, and feet with the rich blood they need, people with PAD are at risk for strokes, high blood pressure, kidney problems, and even limb amputation.

Paul did not take this news sitting down. At ICE, Paul was able to discuss treatment options with Dr. Qamar and set out on a path to comfort. He received an angioplasty on his lower extremities with stenting, which showed promise as it relieved some of his pain. Over the past two years, Paul received help in managing and treating his PAD under careful and continuous care at ICE. The ultimate goal was to improve his quality of life and keep him moving, walking, and resting peacefully.

Recently, Paul’s PAD seemed to get the best of him. His leg felt heavy and cold and simply walking from his bedroom to his living room required frequent stops for rest. He used canes, a walker, and even a scooter to move around and standing more than 15 minutes was nearly impossible.

Seeking answers, he returned to the team at ICE and again received comprehensive testing on his lower extremities. It was discovered that Paul’s condition had worsened, and he was soon scheduled for an angioplasty in ICE’s catheterization lab. Finally, Paul felt a sense of relief he had not experienced in years. His legs now feel remarkably better, he sleeps pain-free, and he can walk further than before without any assistance.

Paul knows he must do his part to manage his illness at home, but he can also rest knowing that Dr. Qamar and his team at ICE can treat him. And without using the widely exercised, invasive surgical bypass option, Dr. Qamar has been able to help Paul return to the active life he deserves.

Is your skin in the clear?

A patient came to us with multiple, non-healing, venous ulcers that he had tried to heal with other physicians for more than five years. He presented with skin color changes, swelling in his legs, and large bulging varicosities.

To diagnose the severity of his problems, we ran a venous reflux ultrasound.

We look at the size of the deep veins and superficial veins to see how much blood is pooling in them. We also look at the different perforated veins and structures that normal ultrasounds don’t treat.

His great saphenous vein was enlarged with a lot of blood pooling. The great saphenous vein is the underlying vein that causes all the symptoms that appear on the outside of the leg, such as wounds, ulcers, and swelling.

We proceeded with radio frequency ablation, a new procedure out to treat vein disease. The procedure is done through one little needle hole so there is no cutting, no suture, and no down-time. We use a new process of spraying the leg with cold anesthetic, which differentiates our vein center from others, so patients feel little to no pain.

Since his procedure, the patient’s ulcers have not returned and his veins continue to be closed. He has been able to resume activities without any pain, discomfort, or leg swelling.

Why weight?

For many aging adults, many simple, everyday tasks such as reaching up to pull spices from your kitchen cabinet or bending down to retrieve a heavy pot out of the cupboard takes some planning. This lack of flexibility, stability, and strength combined with a few extra pounds around the waist is easy to accept as a typical result of the aging process.

But the good news is people should not feel defeated. Besides, doing so can negatively impact your physical health and the body’s ability to fight disease.

There is no one weight management plan that works for everyone, as many people have restrictions based on pre-existing illness or physical disability. Therefore, how do you know what physical activities and nutrition plans will work best for you?

The best answer is to ask a primary care physician for help in removing the guesswork. Skilled physicians like Dr. Julio Ugarte, M.D., and his team at the Institute of Medical Excellence create tailored plans based on their patients’ health profile and help them navigate their weight management plans along the way. Aging adults do not have to go it alone to get moving.