PAD. Peripheral artery disease.

[himmel]

Hi, I've been suffering from this for the last 18 months without any real problems, just aching calf's and numbness in the feet, I've just been taking one aspirin  a day for blood thinning,

but now the symptom's have escalated to swelling of my left foot and ankle with pain in my Achilles heel, with a little difficulty walking, I've been doing leg and foot exercises 3/4 times a day

while lying on the sofa for over a year, I've also started using my treadmill  again after a layoff for a few months, (tedious) now using twice a day for 15 minute's, painful for the first 5, then eases up. Now I'm seeking advice as to treatment for this (I know its not curable) could there be a doctor at Buriram  Gov Hospital that treats Vascular problems. Thanks.

0

[carlyai]

Some of the first things you should check are: do you have diabetes and do you have lumbar back troubles.

They can also do scans to see if your muscles around your lumbar are dying or been replaced with fatty tissue.

Sometimes your nerves die from the feet up.

[Sheryl]

Who made this diagnosis? As it is not something you can self diagnose, and what you describe (initial leg pain that eases up as you walk) does not sound like it.

 

Buriram hospital (min government hospital in Buriram town) is a Regional level hospital so has specialists, may or may not include a vascular surgeon (which may or may not be what you need). Worth a try.

 

If you have not had a recent test for diabetes (fasting blood sugar or HB1Ac), you certainly should. 

[dinsdale]

1 hour ago, Sheryl said:

Who made this diagnosis? As it is not something you can self diagnose, and what you describe (initial leg pain that eases up as you walk) does not sound like it.

 

Buriram hospital (min government hospital in Buriram town) is a Regional level hospital so has specialists, may or may not include a vascular surgeon (which may or may not be what you need). Worth a try.

 

If you have not had a recent test for diabetes (fasting blood sugar or HB1Ac), you certainly should. 

It's not difficult to self diagnose. Symptoms described are in line with PAD. Seems the OP suffers from intermittent claudication which is the main and initial symptom of PAD in it's early symptomatic stage. Only pharmaceuticals are statins. Other than that it's vascular or arterial surgery and possibly amputation depending on how bad things are. Amputation stage feet will be turning blue. I have PAD. Didn't go to a doctor. Don't need to. I gave up cigarettes, modified my diet and take baby aspirin daily and although the intermittent claudication is still there I can walk about 500 metres pretty much pain free now. Before it was 50m and the pain would start, by a 100m the pain was bad and by 500m the pain was excruciating. Sit down and the pain is gone within a couple of minutes. This is how intermittent claudication presents. I suggest the OP researches this online and starts drinking 2 or 3 teaspoons of cold pressed extra virgin olive oil every morning and eats sardines/mackerel a few times a week. Continue to exercise your legs. This is a must and exercise to the point where there is pain. Continue with the baby aspirin. If a smoker stop immediately. If the swelling continues for more than a few days or increases seek medical advice.

Note PAD is very serious and can be fatal. If it advances to the stage where amputation is required the average life expectancy after amputation is 2-5 years. 

OP is correct as in there is no cure. Lifestyle modification will be recommended by any doctor the OP sees as it seems it's still mild. There is a chance (probably a good one TIT) that the doc will also prescribe statins for pharmaceutical intervention. Taking them is a personal decision. I won't. Don't need pharmaceutical intervention.

[Sheryl]

1 hour ago, dinsdale said:

It's not difficult to self diagnose. Symptoms described are in line with PAD. Seems the OP suffers from intermittent claudication which is the main and initial symptom of PAD

 

OP describes pain that eases with exercise ("I've also started using my treadmill  again after a layoff for a few months, (tedious) now using twice a day for 15 minute's, painful for the first 5, then eases up.")

 

Intermittent claudication is exactly the opposite, progressively  worsens with exercise and eases with rest.

 

He also mentions foot swelling and heel pain.

 

There are several possible differentials for this  and he does need to have it diagnosed by a doctor.

 

 

 

 

[himmel]

Thanks for the replies, we will go to Buriram Private Hospital tomorrow, ask for blood tests for diabetes, get the ankle x-rayed and 

any other tests that are done for PAD.

[Sheryl]

1 hour ago, himmel said:

Thanks for the replies, we will go to Buriram Private Hospital tomorrow, ask for blood tests for diabetes, get the ankle x-rayed and 

any other tests that are done for PAD.

When I said Buriram might have it, I meant the government hospital, not a private hospital.  The government hospital is a 900 bed regional level facility. Buriram private hospital is quite small and might nto have a vascular specialist.

 

Personally I'd try the after hours clinic of the government regional hospital instead.

 

For PAD -- of doctor suspects that - tests would be Ankle Brachial Indix ( comparison of blood pressure in the arm and at the ankle), Doppler Ultrasound, and sometimes angiogram.

 

Doppler will also identify venous thrombosis which is also a possibility.

 

If a vascular cause is not found, next stop would be an ortho doctor to check for arthritis or spinal issue.

[newbee2022]

19 hours ago, himmel said:

Hi, I've been suffering from this for the last 18 months without any real problems, just aching calf's and numbness in the feet, I've just been taking one aspirin  a day for blood thinning,

but now the symptom's have escalated to swelling of my left foot and ankle with pain in my Achilles heel, with a little difficulty walking, I've been doing leg and foot exercises 3/4 times a day

while lying on the sofa for over a year, I've also started using my treadmill  again after a layoff for a few months, (tedious) now using twice a day for 15 minute's, painful for the first 5, then eases up. Now I'm seeking advice as to treatment for this (I know its not curable) could there be a doctor at Buriram  Gov Hospital that treats Vascular problems. Thanks.

0

Sorry, I don't live in that area. 

Without knowing your symptoms and without a profound anamnesis and without knowing your present (and past) medication it's impossible to give medical advice. However, there are ways to ease your situation (angioplasty, stents aso). 

I reckon in some universities there are specialists.

[newbee2022]

10 hours ago, Sheryl said:

When I said Buriram might have it, I meant the government hospital, not a private hospital.  The government hospital is a 900 bed regional level facility. Buriram private hospital is quite small and might nto have a vascular specialist.

 

Personally I'd try the after hours clinic of the government regional hospital instead.

 

For PAD -- of doctor suspects that - tests would be Ankle Brachial Indix ( comparison of blood pressure in the arm and at the ankle), Doppler Ultrasound, and sometimes angiogram.

 

Doppler will also identify venous thrombosis which is also a possibility.

 

If a vascular cause is not found, next stop would be an ortho doctor to check for arthritis or spinal issue.

If PAD is diagnosed there is always arthritis an issue. 

[newbee2022]

Since I live in Thailand and don't have a work permit I'm not allowed to give diagnosis or treatment or professional advice.

But this here might help you:

https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/diagnosis-treatment/drc-20350563

Look for a vascular specialist near to you.

[Sheryl]

5 hours ago, newbee2022 said:

Since I live in Thailand and don't have a work permit I'm not allowed to give diagnosis or treatment or professional advice.

But this here might help you:

https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/diagnosis-treatment/drc-20350563

Look for a vascular specialist near to you.

Likely location of a vascular specialist  is precisely what OP asked for, and that advice has been provided.

 

[newbee2022]

57 minutes ago, Sheryl said:

Likely location of a vascular specialist  is precisely what OP asked for, and that advice has been provided.

 

Yes, I mentioned the required specialist. Next you might ask your doctor for precise information.

[Ralf001]

20 hours ago, Sheryl said:

 

OP describes pain that eases with exercise ("I've also started using my treadmill  again after a layoff for a few months, (tedious) now using twice a day for 15 minute's, painful for the first 5, then eases up.")

 

Intermittent claudication is exactly the opposite, progressively  worsens with exercise and eases with rest.

 

He also mentions foot swelling and heel pain.

 

There are several possible differentials for this  and he does need to have it diagnosed by a doctor.

 

 

 

 

 

I agree, I have claudication in both legs and the pain increases the longer I walk.

 

First diagnosed in 2017 at Bangkok Pattaya Hospital with the suggestion if it worsens I will need a bypass done on both legs, luckily it has improved some what over the years since then.

[Jaggg88]

On 1/2/2025 at 4:14 PM, dinsdale said:

It's not difficult to self diagnose. Symptoms described are in line with PAD. Seems the OP suffers from intermittent claudication which is the main and initial symptom of PAD in it's early symptomatic stage. Only pharmaceuticals are statins. Other than that it's vascular or arterial surgery and possibly amputation depending on how bad things are. Amputation stage feet will be turning blue. I have PAD. Didn't go to a doctor. Don't need to. I gave up cigarettes, modified my diet and take baby aspirin daily and although the intermittent claudication is still there I can walk about 500 metres pretty much pain free now. Before it was 50m and the pain would start, by a 100m the pain was bad and by 500m the pain was excruciating. Sit down and the pain is gone within a couple of minutes. This is how intermittent claudication presents. I suggest the OP researches this online and starts drinking 2 or 3 teaspoons of cold pressed extra virgin olive oil every morning and eats sardines/mackerel a few times a week. Continue to exercise your legs. This is a must and exercise to the point where there is pain. Continue with the baby aspirin. If a smoker stop immediately. If the swelling continues for more than a few days or increases seek medical advice.

Note PAD is very serious and can be fatal. If it advances to the stage where amputation is required the average life expectancy after amputation is 2-5 years. 

OP is correct as in there is no cure. Lifestyle modification will be recommended by any doctor the OP sees as it seems it's still mild. There is a chance (probably a good one TIT) that the doc will also prescribe statins for pharmaceutical intervention. Taking them is a personal decision. I won't. Don't need pharmaceutical intervention.

I have the same symptoms as the OP but I don't have PAD. I was tested 4 years ago. I have peripheral neuropathy. I was also tested for diabetes and sciatica. I am going to Bangkok soon to have my Vit B1 tested as I've read this can cause my symptoms. So self-diagnosis is never a good thing.

[Wullie Mercer]

I have also had PAD, after scan, showed one of the tow arteries just above knee area was clogged up, had a bypass done with vein from other leg, and it solved the problem. Suggest you have a scan.

[Fortean1]

Yes, I've read that about 60% of diabetics will have peripheral neuropathy.  I've had it for 25 years.  Treatment is seemingly not available, only pain medication.  I take Gabapentin which prevents epileptic seizures and helps with the pain.  I've been seen at Veterans Administration hospitals in the U.S. and at two private hospitals in Bangkok.  I would appreciate hearing forum opinions on a plan of treatment either alleviating the pain or possible other treatments.

[Sheryl]

1 hour ago, Fortean1 said:

Yes, I've read that about 60% of diabetics will have peripheral neuropathy.  I've had it for 25 years.  Treatment is seemingly not available, only pain medication.  I take Gabapentin which prevents epileptic seizures and helps with the pain.  I've been seen at Veterans Administration hospitals in the U.S. and at two private hospitals in Bangkok.  I would appreciate hearing forum opinions on a plan of treatment either alleviating the pain or possible other treatments.

To avoid confusion, kindly start a separate thread on that subject as this thread focuses on PAD (which may or may not be OP's actual diagnosis).

[himmel]

Well got the blood test done today,,I'm not diebetic blood over sugar 122, now I'm going to have to decided whether to peruse this further, I'm 80 in three months and I don't want to be sitting around in hospitals for hours, all my symptoms point to PAD so for now I will just do what I've been doing for the last 18 months, I thank you all for time and input, I will update if any change.

On 1/2/2025 at 5:41 PM, Sheryl said:

 

OP describes pain that eases with exercise ("I've also started using my treadmill  again after a layoff for a few months, (tedious) now using twice a day for 15 minute's, painful for the first 5, then eases up.")

 

Intermittent claudication is exactly the opposite, progressively  worsens with exercise and eases with rest.

 

He also mentions foot swelling and heel pain.

 

There are several possible differentials for this  and he does need to have it diagnosed by a doctor.

 

 

Hi Sheryl, when i said pain eases up, I meant the pain in my Achilles heal, I still have pain in my calf's , numbness in feet,feet feeling cold and sometimes a pins and needles sensation, this is all self diagnosed, google, Mayo Clinic,couldn't get the blood test today, forgot and had a cup of tea this morning, the reason for going Private is getting the blood test  results quickly,Rather than wait for hours at Gov hospital, also ask the Doc advise on PAD, ie: do you have  vascular Doc here,can the tests be done here, if not where, my wife has never heard of after hours clinic at Gov Hospital, Plan is to ask Doc tomorrow at Private Hospital.

 

[Fortean1]

I did not review the Internet sources re PAD and neuropathy.  It seems the artery damage is the main cause of PAD and that neuropathy is a dying off of nerve endings. I find this educational.  Himmel, I hope your diagnoses are well established and that the doctors recommend a course of action. 

[Ralf001]

1 hour ago, himmel said:

Well got the blood test done today,,I'm not diebetic blood over sugar 122, 

 

how far over 122 ?

thats Prediabetes.... 

[himmel]

59 minutes ago, Ralf001 said:

how far over 122 ?

thats Prediabetes.... 

Not over, it was as said 122