DEAR DR. DONOHUE: While watching TV with my grandson, I saw an ad featuring a grandmother and grandson in a store. The youngster read a sign about peripheral artery disease and asked his grandmother if she had it. My grandson looked at me and asked the same question. I told him I didn’t think so. Actually, I’m not sure. How do I know if I have it? Is surgery the only answer? — C.C.

ANSWER: Peripheral artery disease, also called peripheral vascular disease, is a clogging of leg arteries, the same process that happens to heart arteries. Cholesterol and other materials form a buildup on the artery lining and block the flow of blood to leg muscles. When the buildup reaches a certain size, blood flow to the leg muscles is insufficient to meet their demands when a person walks. Pain occurs. Rest relieves it.

The calf muscles are the ones most often involved in exhibiting the pain of PAD. But pain can arise in other places — the buttocks, the thighs or the feet. It all depends where the obstruction is located in the artery.

 Signs of PAD are an absence of pulses in the feet and at the ankles, coolness of the affected leg when compared with the other and a loss of hair on the involved leg. The doctor can make a definite diagnosis by comparing ankle blood pressure to blood pressure in the arm. The two pressures should be the same. If the ankle pressure is lower than the arm pressure, something is obstructing blood flow in that leg.

 The causes of PAD are the same as the causes of heart disease: cigarette smoking, high blood cholesterol, diabetes, inactivity, heredity and aging.

 Surgery is not the only answer: Medicines to lower cholesterol and to inhibit clot formation (aspirin, Plavix) are the first treatment. A low-fat, low-cholesterol diet is important. Eliminating smoking is mandatory. An exercise program tailored to the individual’s capability is another factor. Balloon dilation of the clogged artery is a less-invasive procedure than surgery.

 The booklet on peripheral artery disease discusses the ailment in greater detail. To order a copy, write: 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: What’s the scoop on giardia? I had it. How did I pick it up? I had diarrhea so bad that I practically lived in the bathroom. I am better now. I’ll be even better if you can tell me how I got it and how I can avoid it. — J.A.

 ANSWER: Giardia (gee-ARE-dee-uh) is a one-celled organism like the ameba you might have studied in high-school biology. People mostly contract it through contaminated water. Campers who drink water from a stream that appears crystal-clear are potential victims. The cyst form of this organism can live for long periods in such environments. About one or two weeks after ingesting the giardia organism, the prominent symptom of this illness appears — diarrhea. Think about where you were and where you ate one to two weeks before you became symptomatic, and you can get an idea of where and how you caught this bug. If you were camping, from now on, boil drinking water for 10 minutes. That will get rid of all organisms.

 Metronidazole (Flagyl) and tinidazole (Tindamax) are two reliable treatments for giardia.

 DEAR DR. DONOHUE: After removal of an appendix, how long does it take before a person can resume full activity? My son had his appendix removed at the end of February. Will he be able to play baseball in April? — T.D.

 ANSWER: Most often, a person is fully active six weeks after an appendectomy. Your son should be able to play baseball in April. The umpire who makes the decision is his surgeon.

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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