Originally created 09/12/99

Leg pain may indicate serious problem



WASHINGTON -- Do your lower legs hurt after you walk a few blocks? Are they sometimes numb, tingly or cold?

If the answer is yes, doctors say you need a checkup -- you may have a problem that could threaten not just your ability to walk, but your life.

It's called peripheral vascular disease, a long name that simply means arteries in your legs are blocked, preventing proper blood circulation.

It can be extremely painful -- some patients can't even walk through their house without stopping to rest. Left untreated, parts of the leg or foot can become gangrenous and have to be amputated.

Worse, if your leg arteries are clogged, arteries around the heart and brain are likely to be clogged, too, putting you at risk for a heart attack or stroke.

The good news: There are ways to control peripheral vascular disease, or PVD, and the earlier it's diagnosed, the easier the treatment.

Yet few of the 8 million Americans believed to have PVD know that painful legs are something to worry about. Many assume they're just out of shape or getting older, so they don't even mention symptoms to their doctors, said Dr. Rodney Raabe, a PVD specialist of Spokane, Wash.

"We have a massive public education problem," he said.

So Raabe is spearheading a nationwide program next week that aims to test -- for free -- up to 75,000 people for PVD.

Organized by the Society of Cardiovascular and Interventional Radiology, the "Legs for Life" screenings will be offered at over 500 hospitals and clinics. The campaign isn't aimed just at leg pain sufferers, but also at people at risk who don't yet have symptoms.

Who's at risk? Anyone can get PVD, which is why doctors want to examine people with lower leg pain during walking or exercise that -- unlike pain from arthritis or injury -- subsides after a few minutes of rest. Other symptoms: numbness, tingling or coldness in the lower legs or feet, or sores there that don't heal.

But PVD occurs most often in people over 50 and smokers. Other risk factors include diabetes; high blood pressure, high cholesterol or other heart disease; obesity; and relatives with PVD.

It's a quick, painless test -- doctors just measure your blood pressure at the ankle and the arm. Farther from the heart, leg pressure is supposed to be higher or at least equal to arm pressure. If it's not, you're developing PVD, Raabe explained.

Don't put off getting tested, advises a patient who ignored his own symptoms long enough that he ultimately had a toe amputated.

Dr. Zhad Korduba is a New York anesthesiologist who admits, with all his medical training, he should have known he had a problem.

"If a patient had come up to me and told me these symptoms, I would have jumped all over it," said Korduba, 59. Instead, "I kind of chucked it off to getting older and being out of shape."

Korduba enjoyed hiking, but a few years ago noticed his legs got unusually tired while walking uphill. Later, he had severe leg cramps after tennis.

He knew a change in health like that should prompt a doctor visit, but ignored the symptoms until they suddenly worsened a few months ago. He'd walk a mere 1« blocks before having to stop from sharp pain.

When PVD is diagnosed early, the preferred treatment is walking. It may hurt at first -- you may have to rest while pain fades and then walk a little more. But many people gradually walk farther and farther pain-free, as new blood vessels grow around their blocked arteries, Raabe said.

"The ideal is to walk about 3 miles a day, five days a week, if you really want good vascular health," he said.

Doctors also may prescribe aspirin or other blood thinners.

For worse cases, an angioplasty -- threading a balloon into the blocked leg artery -- can clear the clog. The most severe patients get a leg bypass -- just like with heart bypass surgery, doctors sew a new artery around the clogged one.

Korduba's PVD was so bad he had to have a toe amputated and a leg angioplasty, but he now walks pain-free.

The radiological society has opened an Internet site -- http://www.legsforlife.org -- with a questionnaire to alert people to their risk of PVD. It also lists sites offering the free tests next week. Or, call 1-877-357-2847 to request a brochure on PVD.