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Phylicia Rashad Discusses Peripheral Artery Disease

Many members of Phylicia Rashad’s* family have had peripheral artery disease (P.A.D.), strokes, and heart attacks. In a candid interview with me, she describes how her healthy lifestyle (regular exercise, no smoking, and a Mediterranean diet) has helped her to beat the odds and avoid the disease.

Dr. Val: I’m so sorry to hear that 8 of your relatives have suffered stokes or heart attacks. What was that like for you?

Ms. Rashad: All of these relatives of mine had diabetes. At the time of their deaths, P.A.D. was not a recognized condition. It wasn’t regularly diagnosed until the 1990s. I remember my father complaining of his legs cramping a lot. At the time we chalked it up to him being on his feet all day as a dentist, but I wish we had known that it was a sign of something much more serious. Things were different back then – people just accepted that if you had diabetes, you were going to lose toes or limbs. They accepted that as we age, we’d likely have a stroke or a heart attack. No one thought about preventing that from occurring.

Dr. Val: What do you do differently to help insure that you don’t follow in their footsteps?

Ms. Rashad: I eat differently, and have done so for decades. I also get regular exercise. Unfortunately, my hard working family was in the habit of coming home, having dinner and relaxing on the couch after work. This contributed to their diabetes and P.A.D. issues. Interestingly, my relatives who worked on a farm lived into a ripe old age with no chronic disease. Read more »

Peripheral Artery Disease: What You Need To Know

Peripheral Artery (Arterial) Disease (P.A.D.) is an under-recognized and under-diagnosed condition, yet it serves as an important warning sign for those at high risk for stroke and heart attack. Even though we have an inexpensive and non-invasive test for P.A.D. very few people have the test done. I interviewed Dr. Gary Schaer, Director of the Cardiac Cath Lab at Rush University Medical Center in Chicago, about P.A.D. and also spoke with actor Phylicia Rashad about her family’s trials and tribulations with P.A.D. This post is devoted to Dr. Schaer’s insights on the medical aspects of the disease, and the next post focuses on Ms. Rashad’s personal story. 

Dr. Val: To set the stage for our listeners, Dr. Schaer, can you tell us what is peripheral artery disease exactly?

Dr. Schaer: Peripheral Arterial Disease is a condition where the blood vessels (that deliver blood to the legs) become plugged up with a mixture of fat and cholesterol, also known as plaque. This plaque sticks to the blood vessel walls and causes a decrease in oxygen delivery and blood flow to the leg muscles. Patients sometimes experience a burning, aching or tired feeling in their calf muscles (called “claudication”) when the blood supply is diminished. This discomfort is usually made worse by walking but relieved by rest.  It’s a fairly common problem, particularly in people with risk factors (like smoking, diabetes, and high cholesterol) for P.A.D.  It’s important to recognize when a person has P.A.D. because they could be at higher risk for stroke, heart disease, and even death.

Dr. Val: Why do you think so few people know about P.A.D.?

Dr. Schaer: It’s not as “glamorous or exciting” a disease as heart attack or stroke (as portrayed in Hollywood movies). P.A.D. is a chronic disease that is a marker for atherosclerotic plaque – which can lead to heart attacks and strokes.

Dr. Val: How does the average person know they have P.A.D.?

Dr. Schaer: You can get tested. We have a simple, non-invasive test available to diagnose this disease – it’s called the “Ankle Brachial Index.” The test basically compares the blood pressure in the arm with blood pressures in the thigh and ankle.  If there’s a significant drop in the leg blood pressure, then that suggests a blockage of blood flow or P.A.D.

Dr. Val: Who would be a good candidate for the ABI test?

Dr. Schaer: People who have symptoms of P.A.D. (claudication) should definitely be tested. However, keep in mind that about half the patients who have P.A.D. are asymptomatic, so people with risk factors like long-term smoking, age over 65, diabetes, and high cholesterol should consider having the test too. The reason why we do the test is because there are some excellent treatment options that can reduce the risk of heart attack and stroke for people with P.A.D.

Dr. Val: What are the treatment options?

Dr. Schaer: First of all, people with P.A.D. should be on an anti-platelet drug – either Plavix or aspirin. Studies have shown that these drugs substantially reduce the risk of stroke and heart attack (and heart related death) in patients with P.A.D. However, Plavix is more effective than aspirin, though aspirin is cheaper. Secondly, people with P.A.D. must not smoke. Quitting smoking is a top priority. Thirdly, underlying conditions like diabetes, high blood pressure, and high cholesterol must be aggressively managed. And finally, increasing physical activity can also reduce the risk of dangerous complications from the disease.

Dr. Val: What’s the most important thing for Americans to know about P.A.D.?

Dr. Schaer: The most important thing is for Americans at risk for P.A.D. to get tested for it. Anyone over 65 with claudication symptoms or other risk factors like smoking, diabetes, or high cholesterol should get an ABI test from their doctor. If P.A.D. is diagnosed, there are therapies that clearly reduce the risk of having it progress to heart disease, stroke, and even death. Testing could save your life.

*This post was first published at my new blog site – URL pending*

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Peripheral Artery Disease: Phylicia Rashad’s Story

Many members of Phylicia Rashad’s family have had peripheral artery disease (P.A.D.), strokes, and heart attacks. In a candid interview with me, she describes how her healthy lifestyle (regular exercise, no smoking, and a Mediterranean diet) has helped her to beat the odds and avoid the disease. To listen to our conversation, please click here. Ms. Rashad begins speaking at about minute 10:30 of the podcast.

Dr. Val: I’m so sorry to hear that 8 of your relatives have suffered stokes or heart attacks. What was that like for you?

Read more »

Peripheral Artery Disease: Red Flag For Stroke and Heart Attack Risks

Peripheral Artery (Arterial) Disease (P.A.D.) is an under-recognized and under-diagnosed condition, yet it serves as an important warning sign for those at high risk for stroke and heart attack. Even though we have an inexpensive and non-invasive test for P.A.D. very few people have the test done. I interviewed Dr. Gary Schaer, Director of the Cardiac Cath Lab at Rush University Medical Center in Chicago, about P.A.D. and also spoke with actor Phylicia Rashad about her family’s trials and tribulations with P.A.D. This post is devoted to Dr. Schaer’s insights on the medical aspects of the disease, and the next post focuses on Ms. Rashad’s personal story.  To listen to the entire podcast of our interview, please click here.

Read more »

Employment Ad For Doctors

KevinMD pointed me to this amusing USA Today opinion piece about an imaginary want ad for physicians:

“Idealistic Generation X/Y overachievers with low- to mid-six-figure student loans to work in imploding health care system currently subject to runaway entitlement spending. Future salary to be subject to government whim and guaranteed not to keep up with inflation. Will be subject to unreasonable expectations of patients and held responsible for less-than-perfect outcomes by consumer advocates and trial lawyers. Must be able to work 70-80 hours per week, not including on-call duties, and place family obligations a distant second to career pursuits.”

Read more »

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