Leg pain can indicate artery disease
DEAR DR. DONOHUE: I have tried to stay healthy by walking every day. I was doing two or more miles. Now I can barely get a mile done. After walking a short distance, I have to stop and rest and wait for the calf pain to leave before I can start once again. Could this be a circulation problem? If so, what can I do for it? — S.J.
ANSWER: It sounds like a circulation problem — peripheral artery (vascular) disease, PAD. Here, “periphery” (outer boundary) refers to the legs, and much less often to the arms. “Artery disease” indicates artery clogging, the same kind of artery clogging that leads to heart disease when heart arteries are involved. Although calf pain is the most common manifestation of PAD, the pain can also occur in the buttocks, the hips or the feet. It all depends on which artery is blocked.
Pain occurs because muscles are not getting the blood they need to keep working. You have to rest when you walk to give your muscles a chance to recover from their deprivation of blood.
There’s not a whole lot you can do for this. You have to lose weight if you’re carrying too much. You have to lower blood pressure if it’s high. You have to control your cholesterol if it’s elevated. And you have to continue with your exercise, just as you are now doing. These are the things that keep arteries healthy.
You also have to work with a doctor. First the doctor can confirm the diagnosis of PAD by measuring the blood pressure at your ankle and comparing it with blood pressure in your arm. The two pressures should be the same. If the ankle pressure is lower, that’s evidence of PAD.
You’ll probably have to take medicines to get some of the above goals accomplished, like cholesterol-lowering. Pletal (cilostazol) can improve blood flow to exercising muscles.
Unplugging the leg arteries is another approach to treatment. That can be accomplished with balloon dilation of those arteries, just as it is done with heart arteries, or it can be done surgically, by replacing the clogged section of artery with a graft.
The booklet on peripheral artery disease explains this common malady in detail. Readers can order it 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./$6.00 Can. with the recipient’s printed name and address. Allow four weeks for delivery.
DEAR DR. DONOHUE: I realize this isn’t a serious health problem, but I would like to know what causes dark circles under my eyes. Could it be a sign of something? If it isn’t, what can I do to get rid of them? People are always asking me if I am sleeping well. I do. — D.E.
ANSWER: Those circles are a genetic thing. You have inherited skin that is very thin and transparent. The color of venous blood shows through the skin beneath the eyes. The circles don’t come from a lack of sleep.
Allergies might be related to them in some people. Allergies dilate veins so their color is more pronounced. You should have some other allergy symptoms if this is the case — itching eyes and nose, runny nose, sneezing.
The skillful application of cosmetics can usually hide these circles.
DEAR DR. DONOHUE: What is the purpose of taking aspirin for prevention of heart attacks? My doctor told me to start taking a baby aspirin every day. I don’t think I have a heart problem. — L.B.
ANSWER: Aspirin prevents clots from occurring in arteries. A clot that forms in a heart artery is the basis for a heart attack. Heart disease kills more people than any other illness. Aspirin keeps blood platelets from sticking together. It’s the adherence of platelets to one another that forms the clot leading to a heart attack.
Aspirin also dampens artery inflammation, another factor in clot formation.
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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