Friday, September 13, 2013

Active again: persevering with PAD

HEALTHY AND HAPPY: Parsons, left, with Drachman


“All of a sudden I was having more pain in my right leg than I could bear. I couldn’t exercise for more than five minutes.”

That was the predicament of Peter VK Parsons in 2011, six months after the now 69-year-old had started an intensive weight loss and workout routine. Parsons, who had battled obesity and diabetes for 20 years, knew the condition of his health could affect circulation throughout his body, but he was unaware that another problem might be lurking.

Douglas Drachman, MD, director of the Cardiology Fellowship Program in the MGH Institute for Heart, Vascular and Stroke Care, diagnosed Parsons with peripheral arterial disease (PAD), which attacks the arteries of the extremities and reduces blood flow to the limbs. A hallmark symptom of PAD is cramping in the legs with exertion, which may result in the inability to walk more than a short distance.

PAD affects more than 9 million people in the United States, but the disease is often underrecognized by both patients and physicians. Drachman encourages patients to know the symptoms of PAD and the link to life-threatening problems. “Many people feel as though exertional cramping in the leg represents something benign like a muscle ache,” Drachman says. “They don’t recognize it as a sign of a major systemic disease. If you have cholesterol plaque build-up in your leg, you may also have plaque build-up in other parts of your body, like in your heart or carotid arteries, which could raise your risk for heart attack or stroke.”

Once recognized, these risks may be dramatically lowered with lifestyle modification – particularly smoking cessation – and with medications. The symptoms of PAD also may be improved through exercise, medication, or some situations including Parsons’ case – with a minimally-invasive surgical procedure designed to restore blood flow to the affected limb.

For Parsons, this was done with endovascular therapy, in which a catheter was advanced through a small tube in his right leg, which enabled an angioplasty to be performed using a balloon to stretch the plaque blocking blood flow in his leg and to deploy a metal mesh stent to keep the artery open. Following the procedure, Parsons was able to walk and, later, to exercise vigorously without limitation.

Thanks to medical treatment and lifestyle modifications, Parsons says he is the healthiest he
has ever been. He has lost more than 60 pounds and eliminated 80 percent of his medications. “I’m thinking of trying water skiing next summer. I remember trying to do it as an overweight teenager, but now I’m excited to do it with my ‘new self.’ ”  

Parsons’ efforts have not gone unnoticed by his medical team at the MGH. “Peter represents the best that we can hope for in this situation,” Drachman says. “He took the opportunity, through a medical advance, to improve his quality of life, to reduce his risk factors associated with this systemic illness and to become a spokesman for the recognition and treatment of PAD.”  


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