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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.

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.

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.   

Telehealth — A Way to Stay on Top of Appointments

telehealth

Telehealth — The Modern Way to Make House Calls

People with peripheral arterial disease (PAD) symptoms need to stay on top of appointments — even during a pandemic. While doctors and patients used telehealth appointments as a way to meet for years, COVID-19 accelerated its increased use. There are a variety of ways that telehealth can benefit PAD patients now and well into the future.

The Benefits of Telehealth

With the recent removal of regulatory hurdles, telehealth appointments are now more easily available. By talking with your physician on a phone, tablet or laptop, potential benefits include:

  • More time with your doctor. In many ways, telehealth is the modern form of doctors making house calls. Easy access to your physician helps improve connections and build relationships. Patients gain one-on-one time without the hassle and unpredictability of keeping in-person appointments.
  • Increased connectivity. Telehealth facilitates organization and communication. Patients receive calls before and after procedures to ensure they’re taking their medication and to follow up about symptoms. Both the doctor and the patient save time and money while increasing satisfaction because of the streamlined process.
  • Easier second opinions. Are you uncertain about a doctor’s diagnosis — especially if they’re advising you to get an amputation? With telehealth, patients can access world-leading second opinions without the worry of travel and expense.

Telehealth Helps Patients with PAD

Not all healthcare professionals are PAD specialists. “There is never a reason to deny yourself exposure to increased levels of expertise,” says Dr. Craig Walker, interventional cardiologist and founder of the Cardiovascular Institute of the South. “That doesn’t ever negatively impact your diagnosis and it may indeed save your limb.”

“I really honestly believe no patient — short of someone who has very active infection and need for urgent, on-the-spot amputation like a crush injury or something like that — should have a major amputation without at least a major vascular assessment,” he continues.

PAD specialists can assess your symptoms via telehealth as thoroughly as in-person visits. Telehealth is applicable for seeing wounds on a leg or foot and evaluating:

  • Wounds that aren’t healing
  • Signs of infection
  • Color of limbs

However, before making a telehealth appointment, remember that insurance coverage does vary state by state and regulations can change. Check with your provider and insurance plan to verify your coverage.

For more information

Telehealth is going to become more common in the years ahead. Don’t hesitate to take advantage of this innovative method to talk with your doctor about your PAD symptoms.

CSI’s Find a Doctor can help connect you with experts across the country who offer unique insights and second opinions through telehealth appointments.

 

Stop Smoking and Improve Your PAD Outlook

Stop smoking - By breaking the cigarette habit, you can improve your PAD outlook

Stop Smoking and Improve Your PAD Outlook

You’ve likely heard it many times: Smoking is bad for your health. But if you have peripheral artery disease (PAD), smoking cigarettes could have a stronger effect on your health than you realize.

Smoking is a significant risk factor for PAD.37 The lives of patients with PAD who also have cardiovascular problems could be at greater risk.28

People who smoke are also at risk for developing plaque in their arteries (atherosclerosis)19 — a leading cause of PAD, heart attack and stroke.21 PAD results from narrowed arteries in the legs, limiting blood flow to the legs and feet. PAD can lead to a range of symptoms including aches, numbness and burning sensations in your legs and/or feet.

Without early detection and treatment, PAD can advance. The worst form of PAD is, critical limb ischemia (CLI). People with CLI commonly have pain while walking. They may have open wounds on their feet or legs that won’t heal. Many people with CLI are at significant risk for amputation if they don’t seek treatment. Things can even get worse from there — CLI has been linked to putting a person’s life at risk.4

Smoking and aging are risk factors

Plus, aging plays a role in raising a smoker’s risk of PAD. The older a smoker is, the higher the risk for PAD.13

There is good news: There are treatment options for PAD. If you are a smoker, talk to your health care professional about your risk level for PAD. You can talk about options to help you stop smoking. If the doctor does diagnose PAD, you can discuss treatment options.

Don’t delay — talk to your doctor now. Use our Find a Doctor tool to locate a PAD specialist near you who is experienced using Cardiovascular Systems, Inc., devices to treat PAD.

Reducing Health Disparities: Black Americans and PAD

Health Disparities

Reducing Health Disparities: Black Americans and PAD

Peripheral arterial disease (PAD) is more common in Black Americans than any other racial or ethnic group.63 Black Americans are also twice as likely to get an amputation than White Americans due to PAD.47

Why do these health disparities exist? And what can be done to reduce the possibility of amputations for Black Americans who have PAD?   

Black Americans at Higher Risk for PAD

The risk of PAD varies between races, sexes, ages, smokers and people with diabetes. The risk of PAD is about 30% for Black men and 28% for Black women, according to a recent study. In comparison, White Americans and Hispanics have a 20% chance to develop PAD.63

The higher risk for PAD may be due to the prevalence of a number of conditions. For example, Black Americans are more likely to have anemia, high blood pressure and diabetes than White Americans.47 Diabetes is especially a problem for Black Americans due to biological risk factors including a combination of body mass index, waist measurement, fasting glucose levels, lipids, blood pressure and lung function, says the National Institutes of Health.

Let’s Not Accept PAD-related Amputations as Inevitable

Unfortunately, amputations as a treatment for PAD have been too normalized within the Black American community:

  • Black Americans are approximately twice as like to be amputated as White Americans47
  • Black Americans have a far greater number of annual amputations48

This data suggests that Black Americans have less access to care, are admitted to the hospital when sicker and are more likely to be treated at an Emergency Department.47 Additionally, many patients and family members accept amputation as a treatment option from doctors who may not be PAD specialists and/or do not have limb salvage programs.

Amputation should be a last treatment option after exploring other minimally invasive approaches and arterial bypass surgery. Early diagnosis is also important so that PAD can be treated before it even becomes limb and life-threatening. Most physicians will diagnose PAD with a simple non-invasive  ankle-brachial index (ABI). This screening test is one of the best ways to determine if a person has PAD and its level of severity.23 Not surprisingly due to the higher risk of PAD, African Americans are two times more likely to screen positive for PAD than non-Hispanic whites based on data from the American Heart Association.

Because so many PAD and diabetes-related amputations are believed to be preventable, the American Diabetes Association is working to address this disparity in care and has included The Right to Avoid Preventable Amputations in their Health Equity Bill of Rights campaign that launched in 2020.

For More Information

It’s important for patients and loved ones to question if there are alternatives to amputation. Do your research! Don’t put your mobility and potentially your life at risk. Get a second opinion from a PAD specialist before agreeing to an amputation.

Learn about the treatment options available by using CSI’s Find a Doctor tool. Let’s all work together to reduce the PAD health disparities for Black Americans and the number of unnecessary amputations. 

 

Racial Disparities in Amputation

improve racial disparities in PAD-related amputation rates

Racial Disparities in Amputation

African Americans are twice as likely to get an amputation than Caucasians. Hispanics are 50% more likely to be amputated compared to Caucasians.47

These numbers are disappointing and unacceptable. Our goal at Take A Stand Against Amputation is to reduce the number of unnecessary amputations. Amputation can be a life-changing procedure with long-term, difficult consequences and a higher risk of death.

How to reduce the number of amputations

We need a multifaceted approach to reduce amputations, according to Interventional Cardiologist Aaron Horne, MD of HeartCare Specialists in Fort Worth, Texas. That effort needs to involve patient advocacy, physician education and policy making.

Amputations have been normalized. The upswing in diabetes has made amputations feel common, especially in the African American community. Instead of questioning whether there are other treatment options, patients and their family accept the recommendation without getting a second opinion. Click here to learn more about how to get a second opinion and why that’s important.

People need to advocate for themselves. Patients often show a deference to their health care provider, according to Dr. Horne.

“It’s ‘Whatever you say, doc’ or ‘You’re the doctor, I don’t know,’ ” he says. “It’s important to ask questions. Advocate for yourself. Be comfortable with talking to your healthcare provider.”

In addition, not all doctors are PAD specialists. If you want to find another doctor to consult, you can use our Find a Doctor locator tool.

Health care providers need to be aware of the disparities. Dr. Horne believes that the medical community needs to do a better job of educating their peers about PAD, technology and treatment. “53%5,16 of patients in this country have amputations without getting diagnostic tests to see if something can be done to get it fixed,” he says. “That needs to change.”

Learn, use and support the American Diabetes Equity Bill of Rights. It’s 60% more likely that African Americans will get diagnosed with diabetes and every 4 minutes a limb is amputated due to diabetes that could be avoided, according to the American Diabetes Association. That’s why the organization is trying to remedy the health inequities facing people of color. It’s 10-point Health Equity Bill of Rights seeks equal access to health care for everyone. Learn about the Bill of Rights here.

How to schedule a PAD appointment

Only a health care professional can determine if you have PAD and what stage you have. Learn more about the symptoms of PAD and how the disease progresses on our website. If you don’t have a PAD specialist, use our Find a Doctor tool to locate one.

Partner With Your Doctor for PAD Treatment Options

PAD Treatment Spectrum

Partner With Your Doctor for PAD Treatment Options

You’ve suspected for a while that your pain is more than just getting older. Wounds won’t heal. Your skin’s discolored. Maybe you’re experiencing numbness or even burning in your legs and feet.

You might have peripheral arterial disease (PAD). This serious condition can lead to amputation or worse, if left untreated. Fortunately, there are a variety of treatment options available for PAD — from less invasive to more invasive. It’s important to have your doctor or specialist provide a diagnosis early.

Don’t hesitate and suffer with the symptoms in silence. Talk to and partner with your doctor to explore all available treatment options.

The PAD Spectrum of Care

Your doctor or PAD specialist will consider your symptoms comprehensively, evaluate your ankle-brachial index (ABI) results and your overall health. Then they will determine possible treatment strategies. If you receive a PAD diagnosis, your treatment plan may include one or more of the following approaches:

Non-surgical Treatments

  • The least-invasive method for treating PAD is through lifestyle modifications.34 These include stopping smoking, managing your diet and exercising regularly.
  • In addition, your doctor may prescribe a supervised exercise therapy plan with a healthcare provider before considering medical procedures.
  • Your doctor may also prescribe medications to supplement lifestyle changes.8 Medicine can help lower high cholesterol and high blood pressure, prevent formation of blood clots and increase mobility while decreasing pain during walks.

Minimally Invasive Treatments

For more advance cases of PAD, your healthcare provider may recommend minimally invasive treatment options20 that are less complicated and safer than open surgery.

  • Angioplasty, stenting and atherectomy are endovascular procedures where small catheters are inserted into an artery and maneuvered to the area of blockage where treatment then occurs. Doctors now perform these procedures more commonly than bypass surgery for PAD.32
    • In angioplasties, doctors insert a small balloon that inflates to reopen an artery.
    • During an atherectomy, a physician removes plaque buildup in arteries using a catheter.
    • Both procedures may be followed by placement of stents to keep the artery open.

Invasive Procedures 

  • Arterial bypass surgery is a technique in which the surgeon uses a blood vessel or synthetic vessel to create a new path around a blocked artery. As with minimally invasive treatments, doctors can perform an arterial bypass even if your PAD has developed into critical limb ischemia (CLI)16 — the worst form of PAD.5
  • Amputation — the removal of a leg, foot or toe — should be the last option after all other forms of treatment are considered.

See the entire treatment spectrum below. You can use it as a reference when discussing treatment options with your doctor.

PAD Treatment Options

For More Information

 Discuss your symptoms with your doctor or PAD specialist to determine if you have peripheral artery disease. Then determine the best treatment plan for you. There is hope!

To get a second opinion on your PAD diagnosis, please use CSI’s Find a Doctor tool to locate a PAD specialist near you.

PAD Treatment Options

You can find PAD options that will help.

PAD Treatment Options

More than 20 million Americans have peripheral artery disease (PAD).1 However, while so many Americans are affected by PAD, too few are receiving treatment.

PAD is a complex disease. Early detection and getting treatment could help stop the disease from getting worse – and potentially save a toe or leg from amputation.17

The good news is that there are more treatment options available now for PAD, according to Dr. Chris Boyes, vascular surgeon at Coastal Vein and Vascular Specialists in Palm Beach Gardens, FL.

“Previously, if people had severe disease in the small arteries below the knee, we typically took X-rays and said, ‘okay, we’re done,’ ” says Dr. Boyes. “Then we sent them to the wound care center, crossed our fingers and hoped that the wound healed. If the wound didn’t heal, then we would do an amputation.”

Current PAD treatment options

While patients 5 to 10 years ago didn’t have many options for therapy, now there’s a range of possible treatments that avoid amputation, according to Dr. Boyes.

  • Lifestyle modifications: Managing diabetes, quitting smoking, eating healthier, being more physically active, and managing cholesterol and high blood pressure may help treat early-stage PAD.
  • Minimally invasive procedures: These procedures are safer and provide faster recovery and healing with less pain and scarring. Your doctor may discuss angioplasty or atherectomy procedures to help open blocked arteries.
  • Arterial bypass surgery: While physicians approve minimally invasive procedures now more often32 for PAD treatment, they sometimes recommend bypass surgery to treat critical limb ischemia (CLI) ― the worst form of PAD.5

The effects of PAD can lead to other severe health problems. If you’re concerned about new symptoms or ones that aren’t getting better, don’t wait to explore your treatment options. There is hope!

For more information

Are you experiencing nighttime leg pain, pain while walking, numbness or burning sensations, or wounds that won’t heal? Talk to your doctor about your symptoms so you can get help as soon as possible. To find a doctor or get a second opinion, use CSI’s Find a Doctor tool to help explore the variety of PAD treatment options available.

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