DEAR DR. DONOHUE: Please discuss peripheral artery disease. I think I have it. I get calf pain when I walk. I have seen the ads on TV where a woman and her grandson discuss this. The boy asks her if she has it. She says she doesn’t know. That’s where I am. I don’t know, but I think I might. – N.O.

ANSWER:
Peripheral artery disease, PAD, also called peripheral vascular disease, means that arteries in the legs – the periphery – are clogged and leg muscles aren’t getting enough blood. The proof comes from walking. People with PAD get leg pain when they walk a certain distance, and they can tell you almost to the inch when the pain will start. The pain leaves when they take a rest, but returns after they have resumed walking

The site of pain depends on where the blockage occurs. Pain in the buttock or thigh indicates a blockage high in the leg arteries. Pain in the calf comes from a block from midthigh to knee, and pain in the foot comes from a lower blockage.

PAD is a common malady. Five percent of men and 2.5 percent of women over 60 have it, even though some have no symptoms.

A doctor can make the diagnosis in the office. If there’s an obstruction to blood flow in the leg arteries, the pulses at the ankle and on the top of the foot will be weak. Many doctors are equipped to take the ankle blood pressure. The blood pressure at the ankle should be the same as the blood pressure in the arm. If it’s much less, that indicates an obstruction to blood flow in the leg artery.

People with PAD often have CAD, coronary artery disease. The same process that clogs leg arteries also clogs heart arteries. You must see your doctor. He can check the status of your leg arteries, and he can check the status of your heart arteries. There are medicines for both conditions, as well as recommendations for diet changes and exercise.

The booklet on peripheral vascular disease treats this topic in great depth. Readers can obtain a copy by writing: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am 85 years old. My platelet count has been high for at least five years. I take one aspirin daily. What can be done to lower the count? – S.S.

ANSWER:
Platelets are the smallest blood cells, whose job is forming a clot to plug the leak when a blood vessel breaks. Platelets also are called thromobocytes. Your condition is thrombocytosis, an overproduction of platelets without a detectable cause. Quite frequently, it’s accidentally discovered in a person who has no symptoms and who has a blood test done for some unrelated reason. A glut of platelets can lead to bleeding problems. How? Because many of those platelets function poorly. It also can lead to unwanted clots.

In this condition the doctor considers the patient and not the lab test. For people with thrombocytosis and no symptoms, as in your case, the best treatment is often no treatment. When treatment is called for, hydroxyurea and anagrelide can lower the count.

DEAR DR. DONOHUE: I am distressed to read you have begun to use “stomach” for “abdomen.” Please don’t. The door for misunderstanding is wide open if you do. Thank you. – N.B.

ANSWER: I have begun to substitute “stomach” for “abdomen” because it seems to me that the general public does so without loss of clarity. People say that their stomach aches or they have stomach pain when they really should say “abdomen.” They also say their stomach sticks out – clearly wrong.

Maybe I should go back to using “abdomen.” Tell you what. I’ll take a poll. Whatever readers want, I’ll do. I have a gut feeling it will be to use “stomach.”

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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