UPDATE!!!!!Peripheral arterial disease testing HELP

[highlander317]

Hi All
A little background into my situation first.
Type 1 diagnosed in July 2022 at the age of 47 after a weekend in the hospital with DKA, 3 stone weightloss in 6 weeks, all the signs of diabetes now that I know, my bad.
The diabetes is well managed, no issues from the diabetes team at the docs, still no experience of lows or highs, ( didn't feel ill when admitted to hospital either, just tired ).

Just before Christmas 2024, I had a regular pulled muscle feeling usually in the left calf, but over time has happened in both calves. Went to the doctors in Jan 2025 after researching what it could be and ruling out simple things like footware and it just being a pulled muscle, but the problem just kept coming back. I said to the doctors I thought it was Peripheral Arterial Disease, and after some feeling of my calves agreed to refer me to hospital. Since then, the left calf has the pulled muscle feeling all the time when I'm on my feet, the advice is to walk til it hurts, walk a bit more then rest, but it's there all the time, less often in the right calf, with the sensation of throbbing or a spasm sometimes whilst resting. I regularly walk at least 1 mile a day more at he weekends, some days I really struggle with half a mile, but the pain does not really go away, even with rest, it's back straight away after a few steps/ metres.

So the appointment came 3 weeks ago, to my amazement the expected test for PAD, what I had researched was an ABPI test, that didn't happen. The consultant merely felt with her hands for a pulse in both feet, then added some gel and added a doplar to prove I had a pulse there and that there was nothing her department could do, bye. No blood pressure anywhere on the body, just the magical fingers of the consultant, when I questioned her, she said as you have a pulse in your foot, it's not PAD. I was left waiting for over 35 minutes
In the 3 weeks since the appoinment, i've been eager to see what she reports to the doctor, sadly the outpatients needed a kick up the backside and only sent the results yesterday after me complaining about the wait, (how strange), so I can get the problem sorted.

I'm hoping someone here can report on their experience of having a test for PAD, what was done during their appointment, did that involve an ABPI test, or was my consultant negligent or just had magical fingers.

Many thanks
Lee

Update- managed to get an appointment this afternoon, docs seemed puzzled that a finger pulse check was all that was done and agreed to get diabetes team at docs to do an ABPI test next Wednesday.​

 

[Eddy Edson]

ABPI is "gold standard" for diagnosing PAD and consultants' magic fingers are not. I was diagnosed by a vascular specialist on the basis of an ABPI ~ 0.70.

You can certainly have mild/moderate PAD, enough to cause pain on walking, and detectable pulses. With chronic severe pad, collateralisation can lead to pulses being detectable. Etc etc, Pulses are just not a good diagnostic for PAD.

My situation: I have a fully occluded left SFA and popliteal, but with lots of collaterals developing over time, and my podiatrist can now just detect a pulse in my left foot (manually, without doppler).

Your symptoms don't sound like typical PAD (pain at rest but able to walk a mile, with enough flow to generate pulses). But then again "atypical" PAD synptoms are very common, so in yr position I'd keep pushing for an ABPI, while keeping in mind you might well have some other condition causing the symptoms.

 

[Deb_l]

Believe me, I'm no expert but I have spent several hundred hours with my mum at vascular clinics so I do know a little bit. If you have a pulse in your foot that can be felt just by touch alone, then you don't have PAD. No, the consultant hasn't got magic fingers but they will have laid their hands on enough feet in their career to say without contradiction that a good pulse is just that, a good pulse.

Just an example of bad PAD (my mum). Absolutely no pulse in either foot through touch alone. Still no recordable pulse using the doplar machine. Further tests via the APBI cuff thingy and still no recordable pulse in her right foot but a slight pulse in her left. She's very lucky she's still got her lower limbs but they are constantly ulcerated and need bandaging 24/7/365.

Your consultant wasn't being negligent, she was just doing her job..................thoroughly.

 

[Ieva DUK]

Hi Lee,
Thanks for sharing your experience, that all sounds incredibly frustrating, especially after doing your own research and preparing to advocate for yourself. It’s no small thing to show up to an appointment expecting a thorough assessment and then leave feeling dismissed, particularly when you're dealing with ongoing pain that’s affecting your day-to-day life.
You're right that an ABPI test is a standard diagnostic tool for Peripheral Arterial Disease. It’s sometimes done alongside Doppler ultrasound imaging. While feeling for pulses can be part of an assessment, it doesn’t really tell the full story - especially in the early stages of PAD or if there’s intermittent claudication, as you're describing. The symptoms you’ve laid out (pain on walking, tightness or spasms, relief with rest that’s only temporary) definitely sound like something that needs proper follow-up, and you were absolutely right to push for answers.
Have you been referred for any vascular follow-up or imaging, or is that something you’re still trying to pursue through your GP? If it’s helpful, you might consider asking your GP directly for an ABPI test or referral to a vascular specialist who will take a more thorough approach. It’s also okay to ask for a second opinion if you feel your concerns haven’t been properly heard - you know your body better than anyone.
Please do keep us posted, and I really hope you get some clearer answers and support soon.

 

[highlander317]

Hi thanks for all the replies so far.
The consultant was from the vascular surgery team at the hospital.
Due to the hospital / consultant / secretary taking 3 weeks to send the results to the doctors, I can only now try to get somewhere, again.
I've requested an appointment with the docs again, to try and get somewhere, and will keep the post updated.
Cheers
Lee

 

[Eddy Edson]

Hi thanks for all the replies so far.
The consultant was from the vascular surgery team at the hospital.
Due to the hospital / consultant / secretary taking 3 weeks to send the results to the doctors, I can only now try to get somewhere, again.
I've requested an appointment with the docs again, to try and get somewhere, and will keep the post updated.
Cheers
Lee

Good luck - be interested to know how you get on.

 

[everydayupsanddowns]

Hope you are able to get an appointment without too much of a wait @highlander317