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Many cardiac patients’ disease has spread beyond the arteries supplying blood to the heart. Atherosclerotic blockage can also occur in the arteries of the legs. When physical exertion results in an oxygen deficit to the legs, the cramping pain that ensues is termed intermittent claudication. It’s typically enough to literally stop someone in his or her tracks until the oxygen deficit can be repaid. The similarity to angina is obvious.

One form of treatment for this condition, also known as peripheral vascular disease, is surgery whereby a bypass is made across the blocked artery. Either saphenous vein from the leg or an artificial vessel can be implanted.

Dr William Hiatt of Denver discussed treatment of peripheral vascular disease at the 1990 meeting of the American Heart Association. He pointed out that this condition afflicts 12 per cent of the entire population, both men and women, and 20 per cent of all those past age 70. He said that recovery is no better with surgery than with a vigorous program of rehabilitation. Again, it’s in your hands.

The first thing to realise is that claudication pain signals no impending disaster. Unlike angina, the patient is not imperiled when claudication strikes, and there’s no reason to become frightened. The treatment for claudication becomes a matter of “pushing the episodes back” further and further, thus allowing ever-increasing periods of pain-free exercise.

Let’s say, for example, that you develop leg pains after a one-block walk. The pain is enough to make you stop. Fine. Rest for whatever time it takes for the pain to pass, then walk a bit more. Today you’ll do just a little, tomorrow you’ll do more.

A treadmill makes overcoming claudication more convenient and efficient. With a treadmill you can set the speed at a constant 3 kilo-metres-per-hour rate, and increase the grade from flat to eventually 3.5 per cent, moving it up at just 0.5 per cent at a time.

As the pain strikes, you can step off the treadmill, sit down, and rest until the discomfort passes. Then get back on and do a bit more. Day by day, week by week, month by month, the progress will amaze you. It’s important to maintain an exercise log, noting the time and distance you’re able to achieve each day. As you read back through the pages from a few weeks or months earlier, you’ll be pleasantly surprised.

This is about the only time in rehabilitation when one can actually say “no pain, no gain”. As the pain hits, take a few steps more, walking into the pain. You can’t do any harm. You’re in no danger. Don’t be a stoic martyr; just a few more steps will do before coming to a rest.

As you continue this rehabilitation process, the same phenomena occur in your legs as were described for your heart’s muscle in our discussion of angina. Exercise will increase blood flow to your leg muscles, oxygen will be more efficiently removed from the red cell’s haemoglobin, and a degree of collateral circulation will form. Some researchers believe, based on their own observations, that the blockage in the legs’ vessels can also be reversed through a program of low-fat diet and exercise.

Some patients have pain in their feet at rest. Often, at night, they have to swing their legs over the side of the bed to get relief by changing position. This type of patient should not be exercising, and should work closely with physicians to determine the cause of the problem and best approaches to treatment.

While one can achieve claudication recovery on one’s own,, it’s more efficient to do so in a formal, structured program. Talk with your doctor about the availability of such programs in your area. You’ll work with a trained specialist on a treadmill, doing specified increases in effort at each session. The two principal advantages are that a structured program provides additional confidence and reduction of the fear element, and progress will be faster since the patient will be pushed along a bit mote rapidly than he or she would if working alone.

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Cardio & Blood/ Cholesterol

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