Tired Legs may be a sign or symptom of something more serious...
Article by Ruck Davids, CNMT, NCT

Those tired legs may not be just because of a long day. That tight aching or squeezing pain in your thighs or calf may be a sign or peripheral arterial disease. Peripheral arterial disease or (PAD) is a common circulatory problem in which narrowed arteries reduce the blood flow to your limbs and that squeezing pain known as intermittent claudication is one of the first signs of PAD. Other signs and symptoms of PAD are weak or tired legs, difficulty walking or balancing, cold and numb feet and toes, and sores that are slow to heal. Foot pain when you are at rest means that PAD is getting worse, Individuals with PAD are at increased risk for heart attack or stroke. The American Heart Association encourages patients with symptoms of PAD to discuss them with their Cardiologist to ensure early diagnosis and treatment.

Diagnosis of PAD begins with a physical examination. Your doctor will check for weak pulses in the leg or may compare the blood pressure in your feet to the blood pressure in your arms. This will give your physician an idea whether further testing is indicated or not. One of the more common tests for PAD is performed in our Madison Office. The Doppler ultrasound is a non-invasive method of looking at the blood vessels in your extremities (arms and legs) and can measure the blood flow in the artery to indicate the presence of any narrowing or blockages. Additional testing such as CAT scanning or Angiography can further look at the blood flow into your limbs.

Your treatment for peripheral arterial disease may focus on healthy lifestyle changes first. You may need to take medicines to ease pain or to help you manage other health problems. It's important to do what you can to improve your health and possibly reverse the buildup of plaque in your arteries because of the increased risk of heart attack or stroke. Making healthy changes can reduce this risk. One of these changes is to stop smoking. If your doctor says it's safe get regular exercise, try to walk at least 30 minutes a day. Eat healthy foods and try to lose weight. Your cardiologist may also prescribe medications to help ease the associated leg pain or to decrease the risk of blood clots and lower blood pressure and cholesterol. Other more invasive treatment for PAD may involve surgery that either bypasses the narrowed vessel or uses a stent to reopen them. These are normally used in more severe cases of peripheral arterial disease.

"Why do I have to take my socks and shoes off? I am here to have my heart checked."
Article by Chris Rose, RVT

This is a question that is frequently encountered by our staff. The fact of the matter is your healthcare provider is able to gain very useful information regarding your cardiovascular health based on an evaluation of your feet and legs. During your office visit, your health care provider will feel for pulses, check to see if there is any swelling present, look for skin changes, and assess varicose veins. An abnormal exam may signify a potential health issue depending on the findings ranging from a heart problem, a circulation problem, a kidney problem, a liver problem or an infection. If necessary, your healthcare provider will order additional testing to further evaluate any findings. If you feel you may have an issue with your legs or feet that may be related to a cardiovascular problem, please mention this to your healthcare provider at your next appointment.
Do you know the warning signs of a stroke? Remember the word "F-A-S-T" to identify the symptoms of a person who may be having a stroke:
F - Facial drooping. A section of the face, usually only one side that is drooping or hard to move.
A - Arm weakness. The inability to raise one's arm fully.
S - Speech difficulties. An inability or difficulty to understand or produce speech.
T - Time. If any of the symptoms above are showing, time is of the essence; call 911 or go straight to the hospital.

Top 10 Ways to Make the Most of Your Cardiology Appointment:
Diane Marolda, MSN, APN-C - Clinical Director

  • Need a referral? Take care of that 1 week before the appointment.
  • Don't wait until the last minute. We cannot see you if your insurance requires a referral and we do not have one at the time of your appointment. We cannot obtain the referral for you; that is your responsibility.
  • Make sure you have your insurance cards, referrals, personal ID and co-pay in your possession, ready to go before you leave the house!
  • If you have an early appointment, set your alarm so you have enough time to take your meds, eat breakfast and arrive on time. If you arrive late you may miss your appointment time and may be advised to reschedule.
  • If you have an appointment at the end of the day, give yourself enough travel time. If you arrive late you may miss your appointment time and may be advised to reschedule.
  • Bring your medication list or bottles with you to every appointment, even if we just saw you recently
  • If you bring a list, be sure it includes the medication name, dose, and frequency of each
  • Bring a list of questions or concerns you may have
  • It is so hard to remember everything during the appointment. Providers appreciate your organization and interest!
  • Bring any outside test results you think we need to have
    If you had recent labs or tests ordered by an outside provider, bring a copy of them with you. We will not be able to obtain them for you during the office visit.
  • Bring a loved one with you
  • Did you know that most patients only "hear" about 60% of what is discussed during the office visit? This may be due to stress and anxiety about the information being discussed, or results being reviewed. If you have a loved one with you, they can provide support and companionship as well as another set of ears!
  • Know what to expect! In the office be prepared to:
    • Review your demographics, past medical, social, and family history
    • Remove your shoes and socks in the exam room
    • Have an ECG done if necessary. If so, we will need access to the skin on your arms, legs, and your chest area. (If you are a male patient it may be necessary to shave any area where there is hair in order to obtain a good tracing.)

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Accuracy Of Blood Pressure Self-Measurement Devices Questioned.
Reuters (9/6, Crist) reports that a new study published in Hypertension suggests that “people with high blood pressure who monitor it regularly at home may be getting incorrect readings with devices that take measurements on the wrist.” Researchers “found that self-measurement at home with wrist devices often led to false reports of elevated blood pressure when compared to measurements in a doctor’s office.” The device’s accuracy “often depended on correct positioning of the wrist, which patients either didn’t understand or didn’t remember how to do.”