Lee Kirksey, MD  
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Early Diagnosis of Peripheral Arterial Disease (PAD) Decreases Heart Attack Risk

Aug 31, 2008 - 9 comments





Peripheral Arterial Disease












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New Jersey




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Heart Disease


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Lee Kirksey

My non profit organization The PAD Coalition (www.beatpad.org) kicked off the season with a visit to a local church recently. After several years of campaigning to increase public awareness about Cardiovascular disease, I am always surprised at the number of people who have a poor understanding of the process. As a healthcare system, we clearly do a very poor job of educating people about identifying the symptoms of disease. We are stuck in a "Medical Treatment Model" instead of a disease prevention model

Peripheral Arterial Disease or PAD is a subset of Cardiovascular disease. PAD is the term for blockages that occur outside of the  heart including the blood vessels of the neck (carotid) responsible for strokes; the blood vessels of the legs that are responsible for pain with ambulation (claudication) , gangrene and amputations; the blood vessels of the kidneys responsible for hypertension and kidney failure just to name a few

Of these groups, the legs are by far the most easily diagnosed by patient's complaints, physician examination and very easily performed tests like the ABI (Ankle Brachial Index). This is important for several reasons. One, if we identify developing blood vessel blockages in the legs, we can become more aggressive in treating the medical factors of blood pressure, lipids and diabetes as well as smoking cessation. If these fail to improve the symptoms, then many procedures are available to improve the situation

More importantly, if a patient has abnormal circulation in the arteries of the legs, there is an 80% chance that they will have significant blockages in the blood vessels of the heart. By identifying this process by a patient complaints of pain in the legs with ambulation or more sever symptoms of ulceration; we are alerted to be very aggressive in treating the identical risk factors for heart disease. If patients and primary care doctors were aware of this very simple premise and applied it every day, we would make a significant impact on the prevention, identification and treatment of heart disease.

The problem is that although vascular specialists are familiar with this 5-10 minute evaluation,  the familiarity of non specialist is much less. That's why it is just as important to improve awareness among PCP's, nurses, NP's as it is for patients. In fact, if one can measure their blood pressure, you can measure your ABI

photo source www.cardiovascularsystemsinc.com

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Avatar universal
by Jesse1188, Sep 02, 2008
My GP has never mentioned ABI. I'll ask her about it when I see her in a couple of months to renew my BP prescription. I think it is very important for patients to educate themselves and to do everything they can do reduce their risk of cardiovascular disease. It is not difficult. Since being diagnosed with hypertension, I have overhauled my diet and exercise routine, but have only seen very modest results - not enough to get off medication yet. I am now looking into other lifestyle changes - meditation, relaxation techniques, etc. Somewhere, I will reach the tipping point and become medication free. I appreciate your holistic approach. Most doctors concentrate on medicine tot treat disease and mention lifestyle changes as something additional a patient can do. It should be the other way around.

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by Bornsickie, Sep 02, 2008
Is PAD and Atherosclerosis similar? I was diagnosed with Athero. 18 years ago and my neck has never been checked since. I did have deep vein thrombosis at the time as well. Emboli to the left lung (collapsed). I also suffer from RLS. Is this a symptom?
4 years ago... maybe 3...  I was informed I had a 60% blockage in the left ventricle. Is this PAD? I have high cholesterol as well.

Avatar universal
by Beattyann, Sep 06, 2008
I was diagnosed with mild PAD 2 years ago at the age of 63.  However, a recent heart catherization did not show any blockages to the heart.  Carotid arteries also checked out okay.  I do have high blood pressure and cholesterol, but have been unable to tolerate any of the cholesterol lowering drugs even after consulting with  an endocrinologist.  Is there anything I can do to minimize this condition?  Thank you.

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by brainavmagain, Sep 10, 2008
AVM (Steal Phenomenon)
by brainavmagain

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Female, 40 years
Martinsburg - WV
Member since Feb 2007  

, Sep 03, 2008 08:31PM
Tags: phenomenon, cyst, brain, cysts, symptom, kidney, headaches, gallbladder, symptoms, kidneys
I have a 5 cm temperal/parietal AVM, I had it Embolized 2 times and the AVM is 90% closed but I was told that the 10% that is left is to deep to touch. I have speach and memory problems from my last Embolization My answer is that I keep getting severe pressure in my right temple that feels like it is going to rupture but, my AVM is in my left side of my brain. I have had a severe earache in my right ear that starts when the pressure builds in my temple. I also have severe headaches everyday, right at the spot of my AVM. My face, arm and leg stays numb and sometimes tingles. For the past few day's I have a metallic taste in my mouth and I keep feeling like I am going to pass out. I have read about the Steal Phenomenon that some people get from the AVM, could all of these symptoms be from that? If so does it mean the AVM could rupture more easily because of the Steal? I have an appointment on the 15th of Sept to see an AVM HHT specialist in Philladelphia because my mother also had a giant cerebral AVM. I also have Cyst in my kidneys and gallbladder issues.  I thank you for your time Brenda Dinch

549614 tn?1315213113
by Bornsickie, Sep 15, 2008
I guess the Dr. does not answer questions in this forum.

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by cat1203, Sep 16, 2008
they don't in any of them.  you have to do it yourself

Avatar universal
by stacymarie20, Sep 18, 2008
I just happened to stumble across this board and realized I had something to add.  I used to work for a company called FoxHollow Technologies, who created medical devices that treated PAD.  They ended up merging with ev3 - http://www.ev3.net/ - who has taken on the products.  We had a very cool device called the SilverHawk that excised plaque buildup, rather than just pushing it against your artery walls with balloons or stents.  There are doctors around the county that were trained on the devices and I think you can check it out on the ev3 website.  I recall that they really only treated legs at the time I was laid off - I'm not sure if the've made it to the heart yet.

Hope this helps someone's life!!

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by tupperdee, Sep 25, 2008
any  infro will help that will tell me how does ones overy get attached to one colon

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by lisa_777, Oct 14, 2011
The CHIP program is the only way to treat all of the above in a reliable way, with diet changes - but you can eat as much as you want. Your arteries will self-repair, and you will lose weight without even trying. It reverses so many diseases. Google it.

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