Bob’s legs hurt. The pain was bad. So bad it made Bob do something he thought he’d do only in his worst nightmare. Give up golf. As he hauled his clubs up to the attic, he wondered about the pain in his calves and thighs. How come when he walked or climbed the stairs his legs hurt, but when he stopped or sat down, the pain went away?
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To vascular specialists at the Cleveland Clinic Miller Family Heart & Vascular Institute, Bob’s on-and-off pain wasn’t a mystery. It’s frequently the first symptom of a serious condition known as peripheral arterial disease, or PAD. One in five people over 70 may have it. PAD is a blockage of the arteries in the legs or less often, the arms. Bob had the classic symptoms of PAD: pain in the calves, thighs or buttocks that comes on with exertion and resolves within a few minutes of rest.
But PAD can have other symptoms. Half the people who have it report fatigue, numbness, tightness or heaviness in the limb. Forty percent don’t mention leg problems at all (although they may have a mobility problem that prevents them from using their legs very much). Like coronary artery disease, you can have a severe case without serious symptoms.
Risk factors for PAD include smoking, poor diet, and lack of exercise. Treatments begin with lifestyle changes, and may include blood thinning medications. Severe PAD may call for angioplasty or stenting. Even bypass surgery. Sadly, in some 2 percent of cases, it is necessary to amputate the limb.
Our golfer? He discussed his options, including angioplasty and surgery, in detail with his physician. He chose conservative therapy – medication and exercise. His physician prescribed a cholesterol-lowering medication and a daily aspirin, and had a serious talk with him about smoking.
Six months later, spring was in the air and Bob was happy to take his golf clubs out of the attic. He could play a full 18 holes with only the mildest of symptoms. Quit smoking? Sure, if he had to. But quit golf? Not on your life.