Eddy Edson
Well-Known Member
- Relationship to Diabetes
- In remission from Type 2
So just before Christmas my claudication - ie leg cramping on walking, due to a blocked artery as a result of peripheral artery disease - suddenly got a lot worse, after ~2 years of getting a lot better. Overnight I went from being able to walk more than 2km usually & sometimes as much as 6km without a break, to cramping after less than 500m. Back to how it was in early 2018.
Just really annoying and discouraging, particularly given all the work to get my "risk factors" under control. Gave up smoking, got BG and BP down to normal levels, cholesterol super low, lost 20kg and now certifiably skinny, walking on average 9km+ per day - all the stuff you're supposed to do. In October this effort had gotten my ABI (BP at ankle vs upper arm) up to 0.95, borderline normal, from a not-good 0.70 at the start. At the time, my vascular guy said he expected I'd be pretty much free of claudication symptoms in a couple of years, if I continued doing as I was doing.
So anyway I had my first angiogram and then met with the vascular guy again yesterday to discuss, hoping to get some insight into why things suddenly changed, whether it was liklely to happen again & what I could do about it.
It wasn't very satisfactory. He's pretty focused on whether or not to do surgery; not indicated for me, so case dealt with and call him in 6 months if I want to. Trying to get answers to my questions didn't really get me very much beyond generic claudication/PAD info which I don't need to pay him for.
There was nothing from the angiogram imaging to suggest to him why things changed. I've got a long blocked segment of artery and a "wonderful" network of lots of collateral vessels bypassing the block. It was nice to see the angiogram pics, but we knew all this already from previous ultrasound studies.
Anyway, he agreed with my guess that some of the collaterals themselves might have gotten blocked. No real insight into why this might have happened, and the only suggestion for behavious change was to quite vaping. Nicotine can damage endothelial linings of arteries contributing to atherosclerosis, understood, and he didn't really want to think about things beyond that.
But it leaves me with lots of questions. First, I vape a pretty small amount of nicotine. In ~2 years of vaping I've used less than 200mg of nicotine. Apparently, you get about 1mg on average from smoking a cigarette. So my vaping has been the nicotine-equaivalent of something less than 200 ciggies in ~2 years. That's really enough to have a significant impact? In the absence of elevated BG, BP, LDL/trigs, and with lots of exercise and a CRP <1? Maybe, I guess.
Second, is the impact the same on collaterals as it is on "real" arteries?
Third, how about the effects of the vape juice, apart from the nicotine? He didn't have any opinion on that - nicotine, case closed - but I have to wonder what that stuff actually does & there doesn't seem to be much data out there yet.
Anyway, I'm going to stop vaping. And keep walking: the one real piece of info he gave me is that you can always develop more collaterals, and in the weeks since Christmas walking has definitely started to deliver improvements.
Just really annoying and discouraging, particularly given all the work to get my "risk factors" under control. Gave up smoking, got BG and BP down to normal levels, cholesterol super low, lost 20kg and now certifiably skinny, walking on average 9km+ per day - all the stuff you're supposed to do. In October this effort had gotten my ABI (BP at ankle vs upper arm) up to 0.95, borderline normal, from a not-good 0.70 at the start. At the time, my vascular guy said he expected I'd be pretty much free of claudication symptoms in a couple of years, if I continued doing as I was doing.
So anyway I had my first angiogram and then met with the vascular guy again yesterday to discuss, hoping to get some insight into why things suddenly changed, whether it was liklely to happen again & what I could do about it.
It wasn't very satisfactory. He's pretty focused on whether or not to do surgery; not indicated for me, so case dealt with and call him in 6 months if I want to. Trying to get answers to my questions didn't really get me very much beyond generic claudication/PAD info which I don't need to pay him for.
There was nothing from the angiogram imaging to suggest to him why things changed. I've got a long blocked segment of artery and a "wonderful" network of lots of collateral vessels bypassing the block. It was nice to see the angiogram pics, but we knew all this already from previous ultrasound studies.
Anyway, he agreed with my guess that some of the collaterals themselves might have gotten blocked. No real insight into why this might have happened, and the only suggestion for behavious change was to quite vaping. Nicotine can damage endothelial linings of arteries contributing to atherosclerosis, understood, and he didn't really want to think about things beyond that.
But it leaves me with lots of questions. First, I vape a pretty small amount of nicotine. In ~2 years of vaping I've used less than 200mg of nicotine. Apparently, you get about 1mg on average from smoking a cigarette. So my vaping has been the nicotine-equaivalent of something less than 200 ciggies in ~2 years. That's really enough to have a significant impact? In the absence of elevated BG, BP, LDL/trigs, and with lots of exercise and a CRP <1? Maybe, I guess.
Second, is the impact the same on collaterals as it is on "real" arteries?
Third, how about the effects of the vape juice, apart from the nicotine? He didn't have any opinion on that - nicotine, case closed - but I have to wonder what that stuff actually does & there doesn't seem to be much data out there yet.
Anyway, I'm going to stop vaping. And keep walking: the one real piece of info he gave me is that you can always develop more collaterals, and in the weeks since Christmas walking has definitely started to deliver improvements.
