Leg Pain: The Lull before The Fatal Storm

“Have you ever heard of Matthew’s Law?” I asked a journalism student who recently interviewed me. Her assignment was to find out what young people could do to prevent health problems. The timing of the interview was good because at the time I was writing a column about peripheral arterial disease (PAD), a prime example of Matthew’s Law. And did she, or readers, know about the ABI test?

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A report from the Mayo Clinic says that 10 million Americans have PAD. Another study from Duke University in Durham, North Carolina, claims that five percent of men and two percent of women over the age of 50 have PAD. This increases the risk of heart attack six times. The Mayo Clinic states that 80 percent are unaware that this is a serious problem even though for some it’s a walking time bomb. So it should be a wakeup call to improve one’s habits to prevent heart attack or in extreme cases, gangrene and amputation of legs. What happens is that coronary artery disease, the number one killer, always gets prime coverage, for good reason. A sudden severe pain in the chest may be the last pain you ever have on this planet. Half of its victims die before reaching a hospital emergency. But leg pain, compared to this, doesn’t excite many people. Patients initially pass it off as a simple leg cramp. But when it keeps recurring while walking, this symptom should get higher priority. PAD is the result of atherosclerosis (hardening of arteries) and its ever-thickening presence is established early in life by faulty lifestyle. The major cause is childhood obesity and diabetes. But how are heart attack and pain in the legs related? A heart attack occurs when coronary arteries are blocked and shut off blood supply. But atherosclerosis isn’t a localized disease so if coronary arteries are compromised, there’s a good chance the leg’s arteries are also obstructed. Today, physicians are often so busy that they may ask if you’re having headaches or chest pain, but fail to question if you’ve noticed leg pain. But even if PAD is not severe enough to cause warning cramps, there’s a non-invasive test to diagnose this condition, the anti-brachial index (ABI) test. Blood pressure is tested at the usual place in the arm, but also at the ankle. If there is a blockage in either leg the blood pressure will be lower at the ankle. If PAD is diagnosed, treatment is the same as for early heart disease. Patients must lose weight, control diabetes and hypertension, stop smoking, lower blood cholesterol and exercise their legs. And Aspirin may be prescribed to decrease the risk of a blood clot cutting off circulation. Vitamin E can also be helpful in treating PAD. A 75 year old patient had to stop playing tennis due severe pain in his legs. I suggested taking 1,200 units of natural E daily and three months later he returned to the tennis court. Vitamin E increases the amount of oxygen delivered to leg muscles. Doctors, at the moment, are not seeing young people with PAD. But don’t hold your breath. It may not be too long before this happens all because of Matthew’s Law. Matthew’s Law states that it’s the sum of all your bad habits that eventually causes trouble. One medical problem such as obesity leads to diabetes. That leads to atherosclerosis (hardening of arteries). That results in PAD and heart attack along with a multitude of other obese related diseases. And we know that 90 percent of obese children usually become obese adults. How quickly things change! Fifty years ago only 10 percent of diabetes was due to obesity. Now it has sky rocketed to 90 percent. Today, it’s appalling that every 45 seconds a new case of diabetes is diagnosed in North America. It’s equally catastrophic that, in Manitoba, 90 percent of leg amputations are done on aboriginal people! And now more often these troubles are striking children. So I hope this student won’t forget Matthew’s Law. That it’s all the bad habits started early in life that bring so many people to their knees. Or as Pogo remarked, “We have identified the enemy and the enemy is us.”