PAD= Peripheral Artery Disease

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PAD = Peripheral Artery Disease Part 1 The New Year's weekend from December 29, 2000 to January 2, 2001 was one of my most memorable though I only remember half of it! Somehow I had called 911 and was taken to Broward Hospital (or was it Holy Cross?) where it seems I had congestive heart failure and, as one of the nurses told me a day or 2 later I kept complaining that I couldn't find my flip-flops! From my diary: "December 20, 2000, diagnosed with atrial fibrillation--whatever that was---Doc said I could have a stroke--should, but probably won't, stop smoking (that would happen 8 and a half years later!), change eating habits (I did lose 16 pounds in January), was given Coumadin and Toprol XL to take. My calves are killing me, can't walk without pain--what if I can't work? On December 26 I had an echo-cardiogram and on the 27th I was given a holster heart monitor. In hospital all New Year's Weekend!" By the way, I suppose I should add that early December 29 I had eaten a 5-pound ham, 2 liters of diet cola and half a carrot cake--- mmmm--wonder why I had congestive heart failure? Up until that New Year's weekend, I wasn't really that doctor or hospital oriented. Oh sure I had the childhood diseases but as an adult, I didn't go to doctors regularly and I think the only major operation I had was when I had my appendix taken out sometime in the late 1980s, early 1990s. I do know it was a Thanksgiving week because I was working at the Fisherman's Wharf and I was concerned I wouldn't recover enough to work Thanksgiving Day and weekend and make the money I needed. I did. From January 1, 2001, to this past Monday, I have been seeing all kinds of doctors on a regular basis and on January 1, 2001 I would meet vascular surgeon Ron Arison and it was him I saw on Monday and the reason for this 'report' and PAD! PAD PART 2 I have always loved walking whether it was in New York city strolling from Greenwich Village to Central Park or Miami Beach going from First Street and Ocean Drive to 23rd Street and Collins Avenue. I am bringing this up because my first meeting with Dr. Arison really wasn't a good one as he explained I had claudication in my legs and seeing my puzzled look added that it meant too little blood flow through the arteries in my legs. He went on to tell me what Peripheral Artery Disease, better known as PAD, was which was plaque building up around the arteries in the legs caused, mainly, by smoking and, in addition, high blood pressure and cholesterol caused by foods and lifestyle. He then went into what all this caused including in some cases inability to walk. After that I sort of spaced out until he gave me his card and told me to call his office and make an appointment to talk to him more about what was going on and what could be done. By the time January 31, 2001, came around I had lost 16 pounds, taking 15 medicines from blood thinners to bringing down my cholesterol, blood pressure, inhalers for COPD, pills for prostate, fluid retention, diabetes, potassium replacement, to name just a few and, oh yes, back to Dr. Arison, stents in each of my legs. At my first appointment Dr. Arison explained to me what was going on, what could happen and what he would like to do which was to put me in the hospital in the morning, put stents in both legs and I would be on my way by the afternoon which is exactly what happened. I am not sure how many stents he put in each leg but I know over the next 15 years and, up to today, I have had 6-7 stents total in both legs. Instead of my trying to explain what a stent is, and does, let me quote this from wisegeek.com "A leg stent is used to open blocked blood vessels in the leg. The device is typically placed in the artery after a balloon has been expanded to clear out the blockage. This procedure is called an angioplasty. The stent widens after the balloon is blown up and then the balloon and the wires that guide the process are removed from the blood vessel. The stent will then fit snugly in place and the blood is able to flow through it." After the first operation I felt immediate relief and I could walk to the Gateway Theatre--about a mile--and back without any problem. Without having to look it up, a couple of years after the first stent insertions I remember having it done again. It wasn't until about 3 years ago I started having problems with both legs. PAD--Part 3--the end! I don't remember the first time I had to stop completely walking to the Gateway Theatre as the pain in my calves was just too much! Each time I walked to or from the theatre I had to make stops because of the pain though it lasted very briefly and I could walk again but, eventually, it was taking too much time and pain to walk the mile. Since 2001 I had been going to see Dr. Arison every 6 months and he would make me come back the following week to have a scan taken of my legs and then would call me the following Saturday to say everything looked the same. Every 6 months he would ask me about how far I was walking before I felt pain and he would say that I should just walk through the pain! (I won't say what my reaction to that was!) Little by little, it would be less and less until 5 weeks ago, I decided to actually count how many steps I was taking before the pain hit and I was really surprised that it was only 200 steps! I knew I had an appointment with him on August 10 and decided to wait until then to discuss it. I told him what happened with my counting of steps, my finding it a chore to walk down to Karen Bay, not feeling any pain except when I was walking, even in my apartment, along with panting for breath when I walked, especially walking upstairs. He had a trainee with him and he had her take all the vitals and at times I wasn't sure whether he was talking to me or her but finally after all that was done he started talking directly to me saying that he didn't think it was the aorta valve, which I had brought up, and that when I went to see my primary doctor in September he could check it out. Dr. Arison then said I had 4 choices starting with losing some weight--he had noticed I gained weight since I first started to see him 19 years before though he knew I had lost 16 pounds that January. The second choice was to start walking every day and no matter how bad the pain to just keep walking as soon as I stopped and the pain went away. The third choice was to go into both legs and either replace the stent(s) or move them around to get the blood flowing more freely. The last choice was to do nothing and he said eventually that would mean amputation either of one or both legs. He said that wasn't to scare me but to let me know what was ahead. He added that if either or both legs experienced pain when I was just sitting or when I was sleeping or increased to such a point that I felt I couldn't walk anymore that I should call him immediately. What struck me as odd was that for the first time he said nothing about doing a scan and why I didn't ask him the reason I still don't know! He said that choices number 3 and 4 were ones he didn't want to do and wouldn't do number 3 because of what was going on in the hospitals in South Florida right now and at my age it was even more of a risk. Regarding number 4 it was not an option as far as he was concerned. Obviously that narrowed my choices down to number 1 and/or number 2. I have been walking every day down to Karen Bay and back to my apartment at 2 in the afternoon and sometimes in the late evening. It is not really enough steps but it is a start. I am also aiming to walk back and forth to the Gateway Theatre whether it opens again or not. I have started to lose the extra pounds I have gained aiming for a half to a pound a week with a number in mind that I want to weigh when I go see my primary doctor on September 23. When you look at me doing whatever I do whether walking or not you would never suspect that I have PAD, COPD, diabetes, a valve replacement, Afib, now and then attacks of gout, ED, etc., and take 15 meds a day but thanks to them and the squad of doctors taking care of me at the age of 84 I really don't have a complaint in the world. Okay, so I don't like the color of my legs or all the 'bruise' marks I show on my arms and upper torso due to the blood thinner but that is all ego and I can live with that--more often than not!! All I have to do is get up every morning---well, late morning--and I am a happy guy! A year later there has been no improvement. I saw Dr. Arison on Friday, August 6 and he said right now everything right now is on hold until he gets reports from my cardiologist and pulmonary doctor due to the whole 'pacemaker, AFib and aorta valve replacement uncertainty. He was not thrilled to hear that I can only still walk 200 steps before the calves hurt but, on the other hand, he was glad to a certain point it hasn't gotten worse! I still am not able to walk to the Gateway Theatre---ARGH!!!