By AMERICAN HEART ASSOCIATION NEWS
Larry Sadwin’s legs hurt whenever he exercises, a symptom of restricted blood vessels. But he’s finding a way to manage his condition.
Sadwin, a retired businessman and philanthropist from Warren, Rhode Island, is one of 8.5 million Americans with peripheral artery disease, a condition that causes a narrowing of the peripheral arteries to the legs, stomach, arms and head.
Between 12 percent and 20 percent of Americans age 60 and older are affected by PAD.
When Sadwin’s legs began aching while golfing or walking on the treadmill more than four years ago, he figured it was due to aging or being out of shape.
His calf and thigh muscles ached like he’d overexerted himself. Yet, unlike overtaxed muscles that ache for a day or so, Sadwin’s stopped hurting whenever he stopped walking or rested, a classic symptom of PAD.
The symptoms were intermittent at first, but worsened over the course of a year.
He complained about it to his primary care physician and cardiologist, and was referred to a vascular surgeon. In 2013, he was diagnosed with PAD.
Sadwin had already spent more than 30 years managing coronary heart disease, so it was a relief to finally have a diagnosis and a plan for how to treat it. While the last few years have had its share of ups and downs in terms of managing his condition, Sadwin is staying optimistic and encourages others to learn more about PAD.
“It isn’t life-threatening, but it definitely affects quality of life,” he said.
PAD can limit a person’s ability to walk but often goes unnoticed or undiagnosed. One survey found that 75 percent of the public is unaware of the condition, with medical practitioners often blaming leg pain on age or arthritis.
While up to 40 percent of PAD patients don’t feel any pain, symptoms of pain, aches or cramping while walking can occur throughout the leg. Other signs include muscle atrophy, hair loss, smooth shiny skin, skin that feels cool, decreased pulse in the feet, sores on the legs or feet that don’t heal, and cold or numb toes.
Tobacco use, Type 2 diabetes and high blood pressure and cholesterol all increase the risk of PAD.
Mark Creager, M.D., professor of medicine at Harvard Medical School and director of Vascular Medicine at Brigham and Women’s Hospital in Boston, said greater awareness is needed to preserve vascular health and efforts must begin earlier in life. He also advocates better research and education on treatments to build on current approaches to management of the condition.
“We still have a long way to go in awareness, treatment and prevention to preserve vascular health, and so we must continually seek new and creative solutions,” said Creager.
Heart disease has been part of Sadwin’s life since childhood. He remembers seeing his father survive his first heart attack when he was only 8 and his dad was 30. His father would have two more heart attacks, including a fatal one at age 42. His grandfather also died from heart disease.
Sadwin was diagnosed with coronary artery disease and ischemia at age 38. His doctor ordered a stress test after complaints about indigestion, combined with his family history of heart disease. He also learned he had experienced a silent heart attack.
The news was an emotional blow to Sadwin, whose son was 8, the same age he was when his father had his first heart attack.
“I was 38 and master of my universe,” he said. “It wasn’t going to happen to me.”
Back then, Sadwin stayed active and maintained a healthy weight, although his diet was dominated by fried, fatty foods and red meat. He smoked three packs of cigarettes a day.
After receiving his diagnosis, he immediately quit smoking and overhauled his diet. He struggled with angina for two years, then underwent a triple bypass in 1984.
He spent the next three decades managing his heart disease with medication and regular exercise. He volunteered with the American Heart Association, grateful for the advancements in medical treatment not available when his father was alive.
“My dad never got to meet his grandchildren. I do,” he said.
Sadwin, who served as AHA’s chairman of the board in 2001, now chairs AHA’s Research Network Expert Panel and the subcommittee for Emotional Support for Patients and their families.
His PAD diagnosis adds another layer to his motivation, as he navigates how to manage his condition and heart health.
He underwent surgery in 2013 to improve circulation in his legs. He experienced a month pain-free before a stent collapsed and the pain returned. He will undergo testing again in October to evaluate whether he needs a second surgery.
For Sadwin, now 73, quality of life issues are the most difficult part of PAD.
“I feel great, I just can’t walk without my legs aching,” he said. “I want to get the most out of life, but when you realize the trip you want to go on or hike you want to take isn’t possible, it’s hard.”
Sadwin encourages others to advocate for themselves and talk to their doctors about their symptoms and to find support from others who share the condition.
“Doctors are focused on the mechanical part, but realize that you aren’t alone and others may have experiences to share about quality of life and the emotional side,” he said.