Eddy Edson
Well-Known Member
- Relationship to Diabetes
- Type 2
I should add that walking is great for the earlier stages of PAD but I'm not sure what the situation is when things have progressed to resting pain, and I don't think the guidelines are as clear. Your vascular consultant really should give you some guidance.I don't think a blockage in one leg would effect the other? But it's common to have problems with both legs, one worse than the other. Eg: I have a completely blocked left femoral artery, most of the way from groin to knee, and 50%+ narrowing (but not actual blockage) in the right. On CT angiogram imaging, I have a big twisty snaking bundle of collaterals bypassing the long, long left blockage and a couple of little collaterals doing a short bypass of the narrowing in the right. Without the blockage in the left leg I'd still feel the effects of the narrowing in the right, but as it is the bigger problem kind of masks the smaller one.
"Walking a lot": I've always enjoyed walking & so reaching the point where I could only do a couple of hundred metres before stopping was a big deal. Having worked out that walking is the best therapy for PAD, I started to really push things. By 12 months after diagnosis I was averaging around 8,000 steps per day; 11,000 by year 2.
At that point I'd achieved a lot of the collateral development & my vascular surgeon lost interest; no opportunity for him to wield a scalpel, I'd dealt with things as far as he was concerned.
The last two years I've averaged 14K steps per day and so far this year I'm averaging around 16K. Walking speed has also increased progressively: from < 100 steps/minute to 115-125 now.
I think maybe I grow collaterals more easily than lots of other people, or at least that's the sense I get from reading studies. In practical terms, it hurt like hell starting out, but I could see meaningful improvements in walking distance reasonably quickly, so the pain/gain picture was kind of favourable. But it seems to vary a lot from person to person.
Anyway, finding some activity you can build up, even if not walking, would I think give you more comfort that you have a level of control over things, in addition to just being generally good for your health and outlook.
Talking at you and not explaining things is nothing like the standard of care & in your position I'd really push for them to do a better job. They should be giving you a detailed explanation of the disease, what your situation is, why they are stenting, and what kind of risk factor modifications you should be lstriving for, and they should be giving you time and space to consider and ask questions. They should definitely be giving you advice about exercise, ideally referring to you a structured exercise program if available in your area.
But unfortunately inadequate care for PAD seems to be a general problem in lots of places, including here in Oz. It's seen as less serious than CAD, incorrectly, and not as sexy.
I found that educating myself about the disease was more useful than any advice I was getting from HCP's. You've probably been to the NHS site: https://www.nhs.uk/conditions/peripheral-arterial-disease-pad/treatment/ Being in Oz I get to pick & choose and I actually find that US guidance is usually more thorough and informative. This from the American Heart Association is a good starting reference: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000470
Best of luck! Let us know how you get on.
And another refererence - European Cardiology Society PAD Guidelines: https://academic.oup.com/eurheartj/article/39/9/763/4095038