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Explore the Blogs category of CSI’s Stand Against Amputation site to find out medical information, symptoms and treatments for PAD.

What to Expect from Your PAD Medical Team

PAD Medical Team

What to Expect from Your PAD Medical Team

Have you noticed new or increased symptoms such as poor circulation, leg pain, cold legs and sores recently?

Too many people dismiss these important signs as mild irritations. Some also worry that physicians won’t take their concerns seriously or, worse, will recommend amputation. It feels easier to not schedule a doctor appointment.

Early detection is important if you have peripheral artery disease (PAD). Through tests such as an ankle-brachial index (ABI) and getting the right treatment, you can help stop the disease from getting worse. You might also save a toe or leg from amputation.17

Learning how a team of medical providers will work with you will also make you feel more comfortable going to appointments.

Keep your PAD medical appointments

 If you’re experiencing new symptoms, your first step is to meet with your primary care physician (PCP). According to the Society for Vascular Surgery, “If you are older than 50, have diabetes, are a smoker or overweight and have leg pain when you walk, it is a good sign to talk to your doctor.” Your PCP’s evaluation will help determine if you need to see a specialist.

Your PAD medical team probably will involve several providers. “Nurse practitioners or physicians will function as a navigator for patients to ensure they go to every appointment,” says Dr. Jason Mendivil, a podiatrist for Pulse Amputation Prevention Centers in El Paso, TX. “It’s important to see every healthcare professional that is recommended to you — from interventional radiologists to podiatrists to vascular surgeons.”

What to expect from a PAD specialist

During your checkup with a PCP, they will determine if you’re at risk for PAD by asking questions about your medical history. They may also perform or request an ABI test. With this test, your doctors can compare the blood pressure in an artery of the ankle to the blood pressure in an artery of the arm.

If you need to see a PAD specialist, you may work with a team of clinical care coordinators, podiatrists and wound care specialists, vascular specialists and other healthcare professionals.

  • Podiatrist will perform a general physical examination of your feet, especially with diabetic patients. They will also treat and track the healing of open wounds.
  • Vascular specialists will examine the blood flow through your entire leg. “Once I get an entire good picture of the entire arteries and circulation of both legs, then we make a decision of what is the best way to treat a patient,” says Dr. M. Laiq Raja, a cardiologist at Pulse Amputation Prevention Centers in El Paso, TX. Minimally invasive endovascular procedures include angioplasty, stenting and/or atherectomy. For more serious forms of PAD, doctors may recommend arterial bypass surgery.

Schedule an initial evaluation and keep ongoing medical appointments with your PAD medical team. That way you can have more treatment options and avoid amputation of a toe, foot or leg due to advanced PAD.

For more information

 If you or a loved one needs help finding a doctor or getting a second opinion, use CSI’s Find a Doctor tool to help find a PAD expert near you.

What is Peripheral Neuropathy?

Peripheral neuropathy can cause burning or pain in the feet and legs

Is Peripheral Neuropathy the Same as PAD?

When you talk with your doctor about diabetes, you may hear a variety of medical terms, including peripheral artery disease (PAD) and peripheral neuropathy.

It’s easy to confuse these “peripheral conditions” because both cause burning or painful discomfort in the feet or legs. As you advocate for your or a loved one’s health, you want to know the correct diagnosis and term. That way you can do additional research and know the right type of doctor for a second opinion.

So what is the difference between these two serious conditions?

What is peripheral neuropathy?

Your peripheral nervous system is the critical connection between your central nervous system and the rest of your body. Peripheral nerves tell you how you feel — cold, hot, tingly, prickly, numb or weak. But what happens if these nerves are damaged or destroyed?

Peripheral neuropathy is a disease that results from diminished or malfunctioning peripheral nerves. According to Johns Hopkins, “Some people inherit the disorder from their parents. Others develop it because of an injury or another disorder,” which can include chemotherapy, infections, traumatic injuries and more. However, diabetes is one of the most common causes.45

Peripheral neuropathy can mask PAD symptoms and delay diagnosis, according to Harvard Health Pubhlishing. Women are particularly at risk as they are less likely to report pain.

Know the symptoms  

Estimates show that neuropathy will affect about 25% to 30% of Americans. The condition affects people of all ages; however, older people are at increased risk. About 8% of adults over 65 years of age report some degree of neuropathy, according to the Cleveland Clinic.

The most common peripheral neuropathy symptoms include:

  • Gradual onset of numbness and weakness in legs
  • Constant or shooting/stabbing pain
  • Changes in sensation — from an inability to feel pain, pressure, temperature or touch to extreme sensitivity to touch and severe pain, especially at night
  • Pain during casual activities
  • Tripping, stumbling, lack of coordination and balance problems
  • Muscle weakness and atrophy

What is PAD?

While peripheral neuropathy is a nervous system condition, PAD is a condition of the arteries. It’s characterized by narrowed, hardened arteries in the legs, limiting blood flow to the legs and feet.

Common risk factors for PAD are increasing age, diabetes, kidney disease and smoking. PAD has a range of general symptoms:

  • Cold toes or feet
  • Dry, discolored skin
  • Pain while walking
  • Nighttime leg pain
  • Painful, heavy legs
  • Numbness or burning sensations
  • Wounds that won’t heal
  • Gangrene or black tissue

Peripheral neuropathy can mask PAD symptoms and delay diagnosis, according to Harvard Health Publishing. Talk to your primary care physician (PCP) if you’re having recurring pain. Describe the pain in detail to help get a proper diagnosis.

You want to diagnose PAD or peripheral artery disease as soon as possible. Early detection gives your doctor more treatment options and prevent the conditions from getting worse.

Use Take a Stand Against Amputation’s Symptom Quiz and Find a Doctor tool if you’re experiencing symptoms that may be related to PAD.

What Doctors Diagnose and Treat Peripheral Artery Disease

When you should see a PAD specialist

What Doctors Diagnose and Treat Peripheral Artery Disease?

Are you worried that pain in your leg is getting worse? Or are you experiencing cold toes or feet? Sometimes you may even have numbness or burning sensations in your legs.

You may be experiencing symptoms of peripheral artery disease (PAD).

It’s important to not assume these symptoms as part of the normal aging process because if not detected early, PAD could lead to amputation. But what type of doctor or PAD specialist should you see for help?

Start with your primary care physician

See your primary care physician (PCP) if you’re experiencing any leg pain, wounds that won’t heal or dry, discolored skin. Before arriving at a PAD diagnosis, your PCP will initially consider your:

  • Medical history. Expect questions about your history of coronary heart disease, cardiovascular and cerebrovascular disease, diabetes, hypertension, cholesterol levels, previous surgical and interventional radiological procedures, chronic kidney disease and more. Your PCP also will ask you about your smoking history.
  • Family’s medical history. Do you have one or more members of your immediate family who have undergone surgical procedures on arteries in the legs like balloon angioplasty, stent or surgical bypass before the age of 65? Do you have a relative who has had a non-traumatic foot or lower leg amputation?
  • Clinical examination. Your doctor may assess you for weak or absent artery pulses, measure blood pressure with the ankle-brachial index (ABI) test, take blood, and check your skin and nails for poor wound healing and changes in color.

When to see a PAD specialist

For early-stage PAD, your doctor may recommend long-lasting lifestyle changes.34 “You often can successfully treat peripheral artery disease by quitting tobacco, exercising and eating a healthy diet,” according to the Mayo Clinic. PCPs can also treat moderate cases with medication.

However, for more advanced cases of PAD, your PCP may recommend seeing a PAD specialist, such as:

  • Interventional cardiologists or radiologists who perform minimally invasive procedures like angioplasty, atherectomy or stenting to restore blood flow.
  • Vascular specialists who treat blood vessel diseases and can perform lower extremity bypass surgery to treat PAD. This bypass graft surgery in the leg removes a healthy blood vessel in the leg and grafts it above and below the blockage.
  • Cardiologists who may be consulted in case of heart problems, such as congenital heart disease (CHD), chest pains and a heart attack, associated with PAD.

Don’t wait to talk to a doctor about your symptoms. Seeing a PCP and getting an early diagnosis can make a big difference in your health — and possibly save you from amputation.

For more information

Take CSI’s interactive Symptom Quiz if you’re concerned about PAD. The quiz offers a list of questions to help you talk with your PCP. You can also use our Find a Doctor tool to locate a PAD specialist near you.

 

 

We’re Here to Stand Against Amputation with You

The Best Care for PAD

We’re Here to Stand Against Amputation with You

A lesser known health condition is making a big impact in the U.S. Every year, about 160,000 Americans undergo an amputation due to peripheral artery disease (PAD).3

That is a significant number for one health condition, and it’s staggering considering that it represents more amputations than all U.S. war-related amputations since the Civil War.

PAD is a common and often underdiagnosed circulatory disease where blood flow to the legs and feet is restricted by the narrowing of blood vessels due to plaque buildup. Left untreated, PAD can lead to amputation and put you or a loved one’s quality of life and long-term health at serious risk.

Amputations result from a variety of factors, including underlying conditions, late-stage diagnosis and healthcare disparities.

  • 73,000 amputations per year are patients with diabetes3
  • The risk for amputation is 10 times greater in patients who have both PAD and diabetes versus those who have PAD alone12
  • Critical limb ischemia (CLI) — the advanced form of PAD — carries a high risk of lower limb amputation estimated in 10% to 40% of patients60
  • African Americans are up to 4 times more likely to have an amputation than Caucasian Americans61

How to get the best care for PAD

Many people dismiss early PAD symptoms, like pain while walking or cold feet. Instead of talking with a health care professional, they may think these changes are just a normal part of getting older.

But it’s crucial to take these symptoms seriously and to schedule regular medical appointments and have open discussions with your doctor, according to Dr. Jihad Mustapha, Assistant Professor for Medicine at Michigan State University.

“If you have critical limb ischemia (the most severe form of PAD), your chance of dying is higher than colon, breast or prostate cancer,” he says. “Tell your doctor exactly what you’re feeling. With early detection of PAD, there are more treatment options available. Your physician may be able to recommend lifestyle changes or a minimally invasive procedure.”

Are you at risk for PAD?

  • Over 50 years old
  • A current or former smoker
  • Have diabetes
  • Struggle with high blood pressure or cholesterol
  • Suffer from kidney disease

Reduce the risk of amputation

There are ways to reduce the possibility of amputation in addition to making lifestyle changes.

  1. If you exhibit risk factors, talk to your doctor about PAD.
  2. If you have received a PAD diagnosis, keep in-office or telehealth appointments to avoid more serious surgical interventions.
  3. If a doctor recommends amputation, you can ask for a second opinion. Use our Find a Doctor tool to locate a PAD specialist.

For More Information

There are treatment options available for PAD. Using the Find a Doctor tool to locate a specialist today and talk to them about your options.

We Stand with the ADA for Health Equity

Stand Against Ampuation supports the American Diabetes Association's Health Equity Bill of Rights

Know Your Rights to Get the Healthcare You Deserve

Too many minority and low-income Americans do not have access to the health care they need. The COVID-19 pandemic increased awareness of these inequities, and the American Diabetes Association (ADA) has a Health Equity Bill of Rights to balance the injustices.

Healthcare disparities have many effects, including:

  • Uneven access to medical services
  • Gaps in in health insurance coverage
  • Worse health outcomes — especially when it comes to the diagnosis and treatment of diabetes

At Stand Against Amputation, we support the association’s goal in combatting systemic racism in healthcare. Education and empowerment are the first steps toward equal healthcare for all.

Not Enough Doctors Take Black People’s Pain Seriously

122 million Americans live with diabetes and prediabetes and Black Americans are 60% more likely to be diagnosed with diabetes than other races, according to the ADA. The association reports that Black men are also twice as likely to die from diabetes.

There are many factors that contribute to this healthcare imbalance. Access to insurance is critical. The ADA reports that people of color account for over 75% of low-income Americans.

“Some healthcare providers also approach Black patients with a bias,” says Dr. Robert Gabbay, the ADA’s Chief Medical Officer. “Not enough doctors take Black people’s pain seriously. They may not prescribe the medication, diet or exercise regimen in the same way for a white patient. Untreated diabetes can then lead to worse health problems and other serious illnesses.

Diabetes is also a powerful risk factor for peripheral artery disease (PAD). Amputation is a common treatment for advanced stages of PAD, and Black people are twice as likely to get an amputation than Caucasians.47 Amputation should be avoided, as it can put your life at risk.25

Inaction on health inequities is not an option.

The Health Equity Bill of Rights

The American Diabetes Association has created the Health Equity Bill of Rights to help spread awareness about how inequity systemically harms people of color. The ADA envisions a future without unjust health disparities. That dream starts with knowing your rights:

  1. The right to access insulin and other drugs affordably – People with diabetes should be able to get the medication they need.
  2. The right to healthy food – Diabetes rates are inversely related to income level. Nutrition is critical to diabetes prevention and management.
  3. The right to insurance that covers diabetes management and future cures – It’s essential that all people with or at risk of diabetes are covered by robust health insurance.
  4. The right not to face stigma or discrimination – Every American with diabetes should be able to live and work free of discrimination and stigma.
  5. The right to avoid preventable amputations – Every American with diabetes should have access to the care necessary to prevent diabetes-related amputations.
  6. The right to participate in clinical trials without fear – Medical research has a troubling history of mistreatment of minorities. Every effort must be made to protect a diverse range of participants in drug trials.
  7. The right to stop prediabetes from becoming diabetes – Every American should have access to culturally and linguistically appropriate diabetes testing, care, counseling and other resources necessary to prevent diabetes onset.
  8. The right to a built environment that does not put you at greater risk for getting diabetes – All Americans are entitled to access to an environment that allows for a healthy lifestyle.
  9. The right to the latest medical advances – The latest advances in diabetes management should be accessible for all.
  10. The right to have your voice heard – Every community should have a say in how their needs can best be addressed.

Download the Health Equity Bill of Rights to learn more about #HealthyEquityNow. We can have a future where everyone has equal access to healthcare – regardless of race, income, zip code, age, education or gender.

For More Information

Education and empowerment are also important for PAD. Don’t accept amputation before getting a second opinion. Learn more about how PAD progresses and use our Find a Doctor tool to locate a PAD specialist.

The Symptoms and Risks Factors of PAD

PAD Symptoms and Risk Factors

The Symptoms and Risks Factors of PAD

Would you recognize the symptoms of peripheral arterial disease (PAD) even if you were experiencing them? Sometimes the signs of pain in your legs and feet are so gradual they’re easy to ignore.

But PAD can lead to amputation if left untreated! Dr. Kirk Minkus, Vascular & Interventional Radiologist at Southwest Cardiovascular Associates in Phoenix, Arizona, warns about the consequences of missing the signs of PAD.

Watch Dr. Minkus in the video “Peripheral Artery Disease Symptoms and Risk Factors,” brought to you by Take A Stand Against Amputation® and The Way To My Heart to learn more about this deadly disease.

Signs of Serious Health Problems

According to Dr. Minkus, “PAD is an affliction that affects the legs and can seriously restrict the amount of arterial blood flow that moves from your heart down to your toes and mainly, by way of the arterial vessels of your pelvis, your legs and your feet.”

PAD presents in a range of general symptoms, including:

  • Pain while walking
  • Limitation to how far you can walk
  • Pain and cramping in the calves or the legs
  • Discoloration of the feet and toes
  • Numbness in your feet or toes
  • Tingling in the legs or feet
  • Hair loss on the legs
  • Wounds that won’t heal
  • Gangrene

Unfortunately, many people do not realize they have a more serious health problem and dismiss the symptoms as the effects of getting older or as part of another condition.

For More Information

Do you want to discuss what you’ve learned about PAD with a healthcare professional? Use CSI’s Find a Doctor tool to talk to a PAD specialist today and prevent even the possibility of amputation.   

The Importance of Angiograms

Angiograms can diagnose PAD and determine the best course of medical treatment

The Importance of Angiograms for Treating PAD

Too many people with peripheral artery disease (PAD) have a toe, foot or leg amputated as their first-line treatment. “53% of the people in this country get amputations without getting diagnostic tests taken to see whether or not you can increase the blood supply to the leg,”5,16 says Dr. Aaron Horne, an interventional cardiologist with HeartCare Specialists in Fort Worth, Texas.

It’s important that you research all possibilities before agreeing to an amputation. An angiogram can determine the viability of alternatives to an amputation like lifestyle changes, medical management, supervised exercise therapy or revascularization (including minimally invasive procedures) for successful treatment. With the information provided by an angiogram, you and your doctor can make a more informed health care choice.

What is an angiogram?

Angiogram tests use X-rays to take a series of images of your blood vessels. A physician may use these imaging techniques:

  • Magnetic resonance angiography (MRA). A non-invasive type of MRI (magnetic resonance image) that looks specifically at the body’s blood vessels.
  • Computed Tomography angiography (CTA). This is another non-invasive test that combines a CT scan with the injection of a dye to create pictures of the blood vessels in the legs.
  • Catheter angiography. This minimally invasive procedure involves guiding a catheter through an artery in your groin or wrist to the affected area and using X-rays to see how an injected dye flows through your arteries.

The importance of angiograms in determining a PAD treatment plan

Knowing the results of an angiogram can allow physicians more treatment options when they know the extent of blockages and how to restore blood flow. A health care provider may recommend lifestyle changes, such as quitting smoking, eating a healthy diet and exercising regularly. Medical therapies such as cholesterol and blood pressure medications may also be prescribed.

“Early detection is extremely helpful to prevent patients from having the worst outcomes,” says Dr. Jihad Mustapha, Associate Professor of Medicine at Michigan State University. “With early detection, you can potentially avoid advanced or end-stage PAD such as critical limb ischemia (CLI), which usually presents like an ulcer on the foot or gangrene on the foot.”

If a medical procedure is necessary, angiograms provide necessary data about the location and severity of the narrowed area of a blood vessel. Based on that information, a treatment plan for revascularization can then be developed.

For more information

“Never agree to an amputation without an angiogram,” says Dr. Mustapha. “An angiogram alone increases your chances of not having an amputation by approximately 90%.”5

If you’ve been told you need an amputation, don’t be afraid to get a second opinion. Use CSI’s Find a Doctor tool to help explore the variety of PAD treatment options available.

The Importance of ABI Tests

ABI tests are important for PAD diagnosis and treatment

Why ABI Tests Are Important for PAD Diagnosis and Treatment

Are you concerned that you’re at risk for peripheral artery disease (PAD)? There are steps you can take to protect your health. You can maintain healthy lifestyle habits that may prevent the disease. You can also prevent the more serious complications of PAD through early detection and treatment.

PAD symptoms include:

  • Cold toes or feet
  • Pain while walking
  • Nighttime leg pain
  • Painful heavy legs
  • Numbness or burning sensations
  • Wounds that won’t heal
  • Dry, discolored skin
  • Gangrene or black tissue

Unfortunately, PAD frequently flies under the radar — as it’s the biggest disease that most people have never heard about. However, there’s a relatively simple diagnostic tool for PAD. The noninvasive ankle-brachial index (ABI) helps healthcare professionals identify the level of risk for PAD and determine the most effective treatment.

PAD Detection and Treatment

An ABI takes as little as ten minutes. By using a blood pressure cuff, healthcare providers can compare the blood pressure in your ankles with the pressure in your arms. If it’s lower in an ankle than an arm, you may have PAD.

Your physician can determine next steps based on the ABI test results. Nonsurgical treatment options may include lifestyle changes, such as exercise, dietary changes and quitting smoking as well as medical management. Minimally invasive endovascular procedures20 — such as angioplasty, atherectomy or stents — or arterial bypass surgery may be necessary in more severe cases of PAD. 

ABI tests are important because they can lead to treatment that can stop PAD from getting worse. Ignoring symptoms and putting off medical appointments could result in more serious forms of the disease. This form, called critical limb ischemia, can result in amputation of a toe, foot or leg.

ABI tests are covered by most insurance plans for patients with PAD symptoms. Congressman Donald M. Payne, Jr. recently introduced the Amputation Reduction and Compassion (ARC) Act. The bipartisan bill would expand coverage for ABI tests and require Medicare, Medicaid and group health insurance plans to fully cover costs for PAD screening tests for at-risk beneficiaries.

For more information

An ABI test is the best first step toward detecting and treating PAD. If you are worried about your or a loved one’s symptoms, insist that your doctor take an ABI.

Early detection of PAD can help relieve symptoms, avoid amputation, save your feet and legs and lead to a better quality of life. Use CSI’s Find a Doctor tool to find a PAD specialist to talk to today.   

The Connection between CAD and PAD

What You Should Know about the CAD-PAD Connection

The Connection between CAD and PAD

It’s tempting to focus only on one thing at a time, especially when it comes to a medical issue. However, there are many interrelated conditions that are important to pay attention to for your long-term health — such as the connection between coronary artery disease (CAD) and peripheral artery disease (PAD).

If a person has blockage in the heart arteries, there may be blockages in the legs as well, according to Dr. John Phillips, an interventional cardiologist in Columbus, Ohio. If you have CAD, there is a 15 to 20% likelihood that you also have PAD.

If you’ve experienced a heart attack or have CAD while experiencing PAD symptoms, ask your doctor to check for PAD.

How to Assess for Additional Blockages

You can see if you’re at risk for PAD by taking our Stand Against Amputation Symptom quiz. Then share the results with your cardiologist at your next appointment. After discussing risk factors and potential symptoms, your doctor can assess for PAD. This is done by a simple, noninvasive test is called an ankle-brachial index (ABI) and it’s covered by most insurance plans. This is one of the best methods to determine if you have PAD and the severity of the condition.

Don’t Delay — Advocate for Your Health

If you have CAD, it may feel difficult to face the fact that you could have other artery blockages. However, getting an ABI test and the appropriate follow-up care can make a major difference in your life. Early detection can help stop PAD from getting worse — and potentially save a toe or leg from amputation.17

“Heart attacks scare people,” says Dr. Phillips. “There isn’t enough awareness of PAD. But early detection is so important. It’s not curable yet, but we can help patients live more active lives with the appropriate medical therapy.”

For more information

Learn more about PAD on our Take a Stand Against Amputation® website. If you need help finding a doctor or getting a second opinion, use the Find a Doctor tool to help explore the PAD treatment options available to you.

 

Telehealth: Another Option for Medical Treatment

Telehealth appointments are a good option for ongoing PAD appointments

Telehealth: Another Option for Medical Treatment

Early detection and ongoing medical care are crucial to maintaining good health – especially if you have a chronic condition, such as kidney disease, diabetes or peripheral artery disease. Due to the COVID-19 pandemic, you may feel hesitant about visiting a doctor, but you can’t let that stop you. While healthcare providers in many states can offer in-person visits again, you also have another option: Telehealth visits.

You may have heard of Telehealth but have a number of questions. Are people really using it? How do the appointments work? And are they effective?

Telehealth by the numbers

Telehealth usage was on the rise, even before the COVID-19 pandemic. Doctors and patients have turned to telehealth visits even more to limit exposure to the coronavirus.

Annual Growth in Telehealth Visits from 2005–201457

Increase in Telehealth Visits in March 202058

Potential Virtual Health Care Interactions in 202058

 

How it works

Telehealth service helps ensure you receive the right care, in the right place, at the right time. If you are elderly, have a compromised immune system or live with people who do, you can meet with a doctor from the comfort of your own home – to safely continue receiving medical care.

Seeing patients in their homes is an important advantage of telemedicine, according to Dr. Imraan Ansaarie of Ansaarie Cardiac & Endovascular Center of Excellence, East Palatka St. Augustine, Fla. “They get a lot more time to speak. We’re in their world — looking at them. It’s a huge advantage for the patients and for us,” he says.

With today’s technology, doctors can also perform detailed physical examinations as they inspect patients’ feet for ulcer, wounds, swelling or color changes.

Ongoing care is important for early diagnoses and early intervention. Many people living with peripheral artery disease (PAD) don’t show any symptoms or know it is progressing. Some people may dismiss PAD’s early symptoms — like pain while walking or cold feet — as normal signs of aging.

If you or a loved one cannot walk 15 minutes without a problem, Dr. Ansaarie recommends scheduling an appointment immediately. With an earlier diagnosis, doctors can provide less-invasive treatment methods for milder forms of PAD that may include:

  • Lifestyle changes (smoking cessation, healthier diet)
  • Supervised exercise therapy
  • Medical management

Keeping regular appointments is also key to managing the disease

“The spectrum of time gives us the best knowledge. We can make a history of you. We can make a timeline,” says Dr. Ansaarie. “If you skip appointments — or data points — it’s hard for us and for you to predict what’s going to happen next.”

Most importantly in cases of advanced peripheral artery disease, there are treatment options that can help you avoid amputation.

By making and keeping telehealth appointments with your doctor, it may be possible to avoid more serious surgical interventions. If you don’t have a PAD specialist, use our Find a Doctor tool to locate one.

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