Friday, July 15, 2016

Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease…sounds important huh?  Well it kind of is.  This condition is most commonly found in aging individuals.  Peripheral arterial disease affects the blood vessels that carry blood away from the heart, the arteries.  This disease is caused by hardening of the arteries that usually occurs in the arteries of the legs, it is characterized by an inadequate flow of blood.  Raynaud’s disease or Buerger’s disease are conditions that you may be more familiar with or have possibly heard of, and they are examples of peripheral arterial disease.

The hardening of the arteries occurs gradually, which ultimately results in narrowing of them also.  As the vessels harden, plaques may form on their walls which cause them to be more fragile than normal too.  The gradual stiffening and narrowing of the arteries causes a decreased blood supply to the surrounding tissues.  Plus, the changes of the arteries also make it much more difficult for blood to flow throughout the vessels as it once did.  You will see that your provider will either classify your peripheral arterial disease as inflow or outflow depending upon where it is located.  Also, the severity of peripheral arterial disease may range from mild to severe.  The damage to the tissues will occur and be apparent below where the obstruction is taking place.

We all like to know how likely it is for us to come down with health conditions and being aware of risk factors may provide more of an insight for this.  Following are risk factors in developing peripheral arterial disease.

ü  Increased blood pressure
ü  Increased fat in the blood
ü  Diabetes
ü  Smoking
ü  Obesity
ü  Leading a rather inactive lifestyle
ü  Family history
ü  Advancing age
o   Older adult individuals have a higher incidence of peripheral arterial disease and also a higher mortality rate from complications than younger individuals do.

In addition to all the risk factors you may begin to experience noticeable signs and symptoms that could be indicate peripheral arterial disease is occurring.  The following list describes these possible signs and symptoms.

ü  Burning, cramping, and pain in the legs during exercise or activity.
ü  Numbness or burning pain primarily in the feet when lying in bed.
ü  Pain is relieved by placing legs at rest in a dependent position (allowing legs to hang over side of bed, or always being below heart level).

From the view of a health care professional there may be a decrease or lack of pulses in the feet, loss of hair areas of the lower leg, dry and scaly skin, thick toenails, cool and bluish/purple lower leg, leg will appear pale if it is elevated or appear red if it is below the heart level, and there could be ulcer areas or gangrene of the toes.  Some of the signs will be fairly obvious to health care professionals, but any of them may be apparent depending on the severity of your disease.  Diagnosis and possibly treatment of your disease can occur via several different procedures including an arteriography, exercise tolerance testing, plethysmography, or segmental systolic blood pressure measurements as described below.

ü  Arteriography.  An imaging study of the network of arteries in your legs.  The study involves an arterial injection of contrast medium in order to more clearly visualize the areas of inadequate blood flow on the x-ray image. 
ü  Exercise tolerance testing.  A stress test that is done either on or off of a treadmill.  Your pulse volumes and blood pressures will be checked before and following the start of your symptoms or within 5 minutes of exercise.  Delays in return to normal pressures and pulses will indicate the disease.
ü  Plethysmography.  This is used to determine variations of blood that is passing through an artery.  Blood pressure cuffs will be placed on your arm and leg and attached to a plethysmograph machine to measure variations in peripheral pulses between the arm and leg.  A decrease in pulse pressure of the leg may indicate a possible blockage.
ü  Segmental systolic blood pressure (BP) monitoring.  A Doppler probe is used to take various BP measurements for comparison.  Pressures in the thigh, calf, and ankle will be lower with arterial disease.

This condition can be a nuisance and interfere with how you perform your daily activities, it could interfere with sleeping, and so much more.  Total Home Health has a program that is right for you.  Our professionals completely understand peripheral arterial disease and will implement nursing measures to make you feel as comfortable and independent as possible, while also keeping you safe.  We will encourage you to remain active, however with this disease we will advise you to exercise gradually and increase slowly.  We will advise you to walk until you reach the point of pain, then stop and rest, and then continue to walk a little farther in order to get the most out of what remains of your blood circulation process.  There are a wide array of other tips and tricks Total Home Health professionals will educate you on to make the most out of your condition, while remaining as functional as possible.  Enroll with us today because we always understand, and always put you first!

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