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Father-in-law Leg Arteries Closed PAD please help

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Old 11-10-2004, 02:49 PM   #1
Join Date: Feb 2003
Location: Lincoln, Illinois, USA
Posts: 4
Madbkseller HB User
Father-in-law Leg Arteries Closed PAD please help

Oh, please help. My father-in-law, age 79 had a heart attack and 4 bypass surgery in June 2003, it included a stent in his right carotid artery. He has had high blood pressure for many (30+) years. Then he had the left carotid stented. He has been having trouble walking for more than 15 feet for a long time. They discovered that he had very little pulse, even with a doppler into his feet, so they started surgery to hopefully open up the arteries. There are NO ARTERIES below his knees. Only collateral blood supply which is minimal. So, then they checked his kidneys. One is completely closed and the other was 90% closed, so they stented it and now it's working at 50%. Does anyone have any idea what we should expect next. Someone told me that this condition makes his feet similar to the problems of diabetes. Please help. It's very hard when the doctor says, "There is nothing else I can do to help."
Thanks so much,

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Old 11-10-2004, 10:43 PM   #2
Join Date: Aug 2004
Posts: 434
Jack51 HB User
Re: Father-in-law Leg Arteries Closed PAD please help

Your father-in-law should feel better with the increase in kidney function. I have never heard of this condition where there are no major, native arteries below the knees. I say this not trying to be smug or act like I should have heard about it. It's just that I have done so much research on poor circulation in the legs, because mine is bad also, due to small vessel disease.

The collaterial arteries have kept the tissue of his legs supplied to some degree, because he would have developed gangrene. I would suspect that it is going to be painful for him to walk for any distances, but if he is otherwise able, he should get as much exercise for his legs as he can stand. A stationary bike would be really good exercise for this condition, as long as someone is always with him while he exercises. This will help to promote new collateral artery growth.

His age will limit his rehabilitation to some extent, as you know. He needs to make sure that he stays on a strict diet to help his kidneys. Limiting the sodium and protein would seem to be right, but check with his doctors on this, and any planned exercise program. He needs the best nutrition that he can get. Is there a rehabilitation program that he can start? His attitude and/or outlook needs to be at it's best. He needs a lot of encouragement and support from his family and friends.

As far as what this loss of blood circulation feels like, or causes, I can relate with that. His pain and sensations are probably a lot worse than I have felt. The calf muscles just more or less "lock up" in a constant type of cramp (claudication), whenever he pushes it, or tries to walk uphill. The loss of proper blood flow and circulation has more than likely damaged the nerves, or the nerve endings, of the muscles in his legs. This can cause peripheral neuropathy, which I have. It causes these wierd pains that constantly change, sometimes in a cyclical rhythm. Burning, numb, and tingling sensations can go up and down the chin, calves, ankles and feet. His feet can become numb and he can injure them without being aware of it. Many diabetics have to constantly check their feet. Ulcers can form and lead to infection and subsequent amputation. He should never wear any tight or uncomfortable shoes.

There is a medicine that I take that has helped myself and many with the symptoms of peripheral neuropathy. It is neurontin. It was originally developed as an anti-seizure drug, but has since been prescribed for PN and other ailments.

He should see a neurologist, if he has the symptoms of PN. Not that they can really help him, but that is their area of expertise.

I assume it was a vascular surgeon that said there was nothing more that they could do to help him. Do you really believe the doctor? If not, get him to see another doctor for a second opinion.

I really hope that he can recover and enjoy the rest of his time

Old 11-11-2004, 02:28 PM   #3
Join Date: Feb 2003
Location: Lincoln, Illinois, USA
Posts: 4
Madbkseller HB User
Re: Father-in-law Leg Arteries Closed PAD please help

Jack 51:
First of all, thanks so much for your reply. I have somehow become the main caregiver for my father-in-law, even with his daughter and two sons (one of them being my husband) are still alive and well. Anyway...I'm just getting more and more loss in all this mess.

First of all, you are correct about the kidney function helping. He takes 4 different blood pressure medicines. Since his surgery his bp has leveled off, so that's great news.

You are also correct about the pain with walking. He can only walk about 15 feet without having to sit down for a few minutes, only to begin again. There is absolutely no way to ever get him to do a treadmill or anything else comparable. He still lives at home alone, 79 years old. Widower for over 25 years. Still quite independent. He virtually walks from his Lazyboy to the kitchen for a quick food fix, to the bathroom and to his bed. That's it!! We have urged him to do more, but to no avail. And the food situation?? We live one hour away from him so that doesn't help much. We tried Meals on Wheels and he only tried it two days and refused it.

He does have many of the symptoms you describe in his feet and toes. He is currently under the care of a neurologist as well as his cardiologist, who is the one that said there is nothing else to be done. I'm thinking that when he had his heart attack and they harvested arteries from his legs, which makes no sense to me when someone has poor circulation, that they believed with exercise his circulation to lower legs would return. That didn't happen. They could only find a pulse in one foot on the top, other foot on the side...but only with a Doppler.

So, you can see it is a very bad situation. I was hoping that someone else had gone through this so we have some idea of what to expect? I know that since he has PAD that he is like five times more likely to have another heart attack or stroke...but I'm also curious what will happen with his legs and feet with little to no circulation in some areas.

Thanks again for your help....if you have any more insight I would truly appreciate it. Also, anyone else who has been through this HELP!!!

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