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Courtesy : Subhadra Nambudiri Foundation
Leg Pain
Most of us experience pain in the legs while walking and
also while resting, but a majority of us ignore the pain or at the most take
some pain killers and get momentary relief. But such repeated occurrence of leg
pain is not to be ignored as it could be due to an underlying Vascular problem.
The Vascular disease is caused due to the blockage of
artery to the leg . It is due to the deposition of fat within the artery wall
narrowing it and thus leading to reduced blood supply to the leg and causing
pain and other problems. Diabetics and heavy smokers have to be extra careful.
The following are the symptoms of Vascular disease.
- Pain on walking relieved by rest
- Pain preventing you from sleeping at night(Rest Pain)
- Pain in the legs, hips ,buttock, while walking relieved
by rest.
- Pain when lying down (or when legs are elevated)
relieved by dangling or lowering legs
- Changes in colour appearance of legs and feet.
- Thin shiny skin on the legs.
- Thickened brittle toe nails.
- No hair on toes, legs and calves.
- Feet turn dark when down,turn pale when up.
- Blue or purple toes.
- Wounds (Ulcers) on the lower legs found between toes or
on the tip of the toe, outside of the ankles anywhere your shoes rub.
According to Dr. Jaisom Chopra Vascular Surgeon with Batra Hospital New Delhi
If the pain prevents you from sleeping at night, one may be
in danger of losing his leg and has to be brought immeadiately under the notice
of a vascular surgeon?.
Dr Chopra further says not everybody needs hospitalisation
if the pain is not interfering with your life style then exercise and complete
abstinence from smoking is required.
The patient suffering from the above symptoms has to
undergo certain tests before it is diagnosed as Vascular. Firstly colour Doppler
Or Ultrasound of the leg arteries to show the site of narrowing or
blockage and seeing if collaterals will be capable of taking the increased blood
flow post ?operatively.
The second test is Angiogram before the surgery. It
is a slightly painful invasive technique showing the inner lining of deceased
arteries along with the extra channels (collaterals ) making the legs survive so
long.
As mentioned earlier, if the patient has pain only while
walking and that is not interfering with his life style, then probably exercise
and complete abstinence from smoking will help. In other cases two kinds of
surgeries are performed depending on the intensity of the problems.
In the case of Minimal Invasive Surgery, a patient needs
hospitalisation for 1-2 days. This technique is basically ballooning of the
arteries (Angioplasty). It is dependent on the site and length of the blockage.
A wire is passed from the groin or the arm to the site of mischief. A Balloon is
passed over this wire to dilate the narrowing or blockage once achieved then a
stainless steel stent is put into the area to prevent narrowing again . If
possible, this is an excellent option with good results and long patency
rate, says Dr Chopra.
The second type is Bypass Surgery where the patient needs
hospitalisation for 7-10 days. It is similar to the heart bypass except here the
leg artery is being bypassed using your own vein or synthetic graft. .In high
flow system like the Aorta these last well over 20 years ,while those below the
groin last anywhere from 10-15 years. Good collaterals develop in the mean
time and give enough blood to the leg.
The last and final option of not performing a surgery is
possible in a critically ?Ischaemic leg?, then Intra-Venous strong
vasodilator drugs may be given over 5 days to try and dilate your vessels
by drugs.
Dr Chopra further says that less than 2%land up with major
amputation if timely advise is taken from the vascular surgeon. Life would
become much better if not absolutely normal.
In US,10% of the people over 70 years have blocked arteries
and those in the age group of 40-69 have 3to 4% blocked arteries . The
statistics for India are not available but presume that they are higher than US.
Sunita Govind, Reporter
Sarkaritel.com
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