Benjamin J. Makamson, D.O.
Lee C. Ferguson, D.O.
Michael B. Hogan, M.D.
Ralph B. Pfeiffer, Jr., M.D.

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Tips for vascular health


Kenley Sweet
Kenley Sweet
Kenley Sweet's Blog
Behaviors That May Reduce Your Chances of a Stroke.png

You’re waking up from a great night out with family or friends.  Food, drinks, dancing, and most importantly, laughter were the menu of the evening.  You stretch as you rise and think to yourself, “didn’t Bill tell some funny stories at the dinner table…” Suddenly, things get a little fuzzy, wobbly, out of focus.  Your head is pounding.  You reach out for the wall to steady yourself, but your legs feel weak, your face numb and tingly.  You want to call out for help, but the words won’t come.  Panic sets in, and the harder you try, the more difficult the simplest tasks become.  

 

Just then, someone nearby hears a noise and comes to check and see if you are feeling the after-effects of all that dancing when they see you and know something is terribly wrong…

 

If you’re lucky, you won’t be one of the nearly 800,000 people in the United States that suffers a stroke every year.  You won’t be one of those that has a stroke in the U.S. about every 40 seconds.  If you did experience one, you’ll be lucky if your stroke is not one of the approximately 87% that blocks blood flow to the brain, often causing permanent damage or disability. 

 

Does the scenario just described or the stroke statistics sound like something out of a scary movie?  It may be the season for it, but these frightening figures and effects of a stroke are real. Very, very real.

 

Consider This

 

Not including the current pandemic, strokes are the fourth leading cause of death among adults in the U.S. and are a major contributor to disability.  However, we are a rugged bunch, an independent, pull yourself up by the bootstraps kind of folks, so we often discount symptoms (like mini-strokes, which are a temporary lack of blood to the brain).  And though all indications point to a stroke, we often won’t head for the nearest treatment facility. However, that poor decision could very well change the course of your life.  

 

There Is A Way

 

So, now that we’ve covered some terrifying information and possibilities, let’s talk about how we can reduce the chance for a stroke while at the same time improving our quality of life.  After all, any age is much too young to have a stroke.

 

Walking.  A walk – pace quickened a little, will do wonders for reducing the chances for a stroke by reducing body fat, blood pressure and cholesterol.  Leading health organizations recommend about 30 minutes of light to vigorous aerobic exercise a day for 5 days a week for adults. Not only will you feel better, but you’ll also look better, and your opportunity for being a stroke statistic nosedive.

 

In addition to walking or other forms of exercise, you can lower your heart rate by changing your eating habits.  Lower the salt, eat healthier, and drink plenty of water, and suddenly your feeling 16 again! Okay, maybe not 16, but you will notice a pep in your step, and again, with exercise, you’re becoming a beacon of health and working to keep a stroke at bay.

 

Cut the smoking! Talk to your doctor about smoking cessation techniques.  The sooner you stop, the faster your body will start to heal itself.  Not only will you reduce the chance of stroke, but you reduce the risk of heart attacks, peripheral vascular disease (discussed in a previous blog), and even premature death.

 

Limit the amount and frequency of alcohol consumption.  Not to mention heavy binge drinking, frequent drinking or alcohol abuse, even a consistent amount of moderate drinking can adversely affect your health.  Increased blood pressure and weight, as well as the higher risk of diabetes or liver damage, can contribute to the possibility of a stroke.  

 

Vascular Associates of South Alabama 

 

Now that we’ve outlined what you can do to help yourself, let’s talk briefly about what the caring team at Vascular Associates of South Alabama can do for you.  Our highly trained and experienced specialists partner with our patients to help identify those at risk and may order a specific ultrasound exam to get a better look at their carotid arteries and then develop a plan of action based on the results of the ultrasound.  We may discuss changes in the habits mentioned above, prescribe medications to help reduce some stroke indicators or explore the option of surgery to help with blood flow.

 

You can trust that our caring staff at any of our convenient locations will make you and your health our utmost priority.  We welcome new patients and accept almost every major medical insurance plan.  

 

Come see us at Vascular Associates of South Alabama, and let’s work together to get you back on the road to better health!

 

Different Treatments for Varicose Veins.png

Did you know you can hear the blood in your veins? You just have to listen varicosely.

Okay, so this is about the only time we’ll chuckle together regarding the issue of varicose veins. Those ugly, often bulging and twisting veins are no joke. But to treat them, we have to better understand them – what are the causes, how serious are they, and can they ever go away, are just some of the things that go through our collective thoughts when we see one beginning to develop.

 

Varicose or Spider?

 

Approximately 50 percent of our older population will begin to notice either varicose veins or spider veins in various spots on their bodies.  Even though they look very similar and are essentially related, their look, cause, severity and location can vary immensely.  

 

Certain lifestyle factors may contribute to what may seem like a sudden appearance of varicose or spider veins.  Overall weight, medicines with hormones in them, or if you have a job where you sit or stand for long periods of time can all contribute.  

 

But some reasons for varicose or spider veins are unavoidable.  Both can be considered hereditary, women are statistically more likely to develop them, and age is also a factor, as mentioned earlier.

 

Varicose veins are identified as those veins that are bulging, purplish in appearance and can look very twisted. They are more frequently found in women and usually show in the legs.  Pain is occasionally associated with varicose veins, as is a feeling of the limbs being heavy and tired. The most severe instances of varicose veins can result in further circulatory problems.

 

Spider veins are smaller, are most likely tiny blue or red lines, can appear nearly anywhere on our body (including the face), and are hardly ever painful or a precursor to other health-related issues.  They are mainly a sightly nuisance.

Finally, while not all varicose veins are considered serious, it is nevertheless better to speak to your physician or our highly knowledgeable staff here at Vascular Associates when you begin to see them so we can diagnose the veins and give you peace of mind that there are no underlying conditions, or develop a game plan as to how we’ll work together to combat their existence.

 

What Can Be Done?

So, you’ve come to terms with having varicose veins, but want to know if there are even any treatments for them.  The short, and highly positive answer, is YES! Here at Vascular Associates, we can discuss several treatment plans: 

 

Compression socks are not just for diabetes.  Designed to aid in pushing blood from your legs back toward your heart, compression socks also work very well in the treatment of varicose veins, thus reducing the opportunity for your veins to become swollen. 

 

Sclerotherapy injections: Using special chemical formulations to close off the damaged vein and causing them to then shrink in time (typically a very short period), the vein will fade away and no longer be visible.  Upon your initial visit, we will discuss whether you are a candidate for this procedure, and discuss possible side effects (most are minor).

 

Varithena: Administered by using either a catheter or by direct injection, Varithena is a foam that will fill the section of the vein to be treated, causing it to eventually collapse (results may be nearly immediate or require 1 or 2 more visits).  It is minimally invasive, and the best part? You can walk out and resume normal activities (with some minor restrictions) the same day!

 

VenaSeal (Closure Treatment): Using a small catheter, a specially formulated vein glue is administered to the affected area, and once it adheres to the vein, closes it off and reroutes the blood flow to nearby healthy veins.  It is nearly painless and is an outpatient procedure.  

 

Endovenous Laser Treatment (EVLT): Uses very thin fibers to transmit laser energy (heat) to the interior walls of the damaged vein, resulting in vein closure and then the flow of blood is redirected to neighboring veins.  It is nearly painless, most patients go home the same day, and the vein fades from view.

Phlebectomy or micro phlebectomy (sometimes called ambulatory phlebectomy): a procedure designed to remove the damaged vein through tiny openings in the skin.  This procedure is considered one of the best for those veins that are particularly bulging.  But unlike other procedures that merely close off the vein, a phlebectomy completely removes the bulging vein, so the aesthetic appeal is almost immediate. 

 

Let’s Partner

 

While there are alternatives available, we want to emphasize your comfort is of the utmost importance to us, so we will thoroughly go over treatment plans from which to choose as well as offer to manage associated pain medicinally to minimize any pain and reduce risks for nerve injury when using thermal ablation.

If you have questions about these or other procedures to remove varicose veins, please make an appointment today, and our caring staff at Vascular Associates of South Alabama will be glad to discuss available options with you and talk about lifestyle changes to give you relief and better health.  The best you is possible!

Is It Neuropathy or Peripheral Artery Disease (PAD).png

The Signs

You’re just sitting down with a good book or to catch the six o’clock news, when the shooting or stabbing pain in your feet you’ve overlooked before, is now undeniable. Unsure of the cause, you go into doctor mode and look for answers by Google.

Out for a nice walk, suddenly and without any real rhyme or reason, your legs feel like they’re cramping up, especially in your calves. You decide to sit on the nearest chair or bench, and the pain begins to disappear.  What’s going on here?

 

The Causes

Peripheral Neuropathy, or peripheral neuritis, is the result of damage or disease to your nervous system. Diabetes is generally considered the main cause, but exposure to toxins, injuries or infections can also be what causes the damage.  Neuropathy symptoms range from numbness, weakness, to a pins-and-needles sensation that is painful.  Left unattended, the pain can become acute.

Peripheral Artery Disease, or PAD, is a disease brought on by the narrowing of arteries that carry blood and affects the extremities of your body, such as legs and feet.  Being overweight, smoking or lack of exercise are all contributing factors to PAD.  To add to your frustration, when you move, pain begins and can grow worse and only seems to get better when you are at rest.  But this is a tell-tale sign of PAD. Left untreated, you may also see changes in skin color, or form noticeable sores. And plaque buildup can cause clots, which will further reduce the flow of blood, or may even block it altogether, which may result in a damaging infection or possible amputation.  

First Things First

Nearly all of us at some point or another will experience some sort of discomfort or minor aches and pains. Whether it’s muscle soreness, cramps, or a slight twinge, we usually pass these off with excuses, like, “I haven’t used those muscles in a while”, or, “I stepped wrong”, and so on.  We also attempt to reason it away with thoughts such as a lack of exercise, miscalculating the weight of a particular object and even age. 

However, when the pain can no longer be ignored, when it doesn’t completely go away on its own or with simple pain meds, it’s time to get serious about the root cause, because doing so will make the path taken to find relief become clearer.    

Begin making mental or written notes of such things as, when the pain occurs, what you are doing, does it go away, etc. And remember to be specific about what areas hurt.  

 

The Way Ahead

Share these notes with your doctor, or with us and we’ll go over your symptoms together. We’ll discuss things like your current lifestyle or any recent changes to your daily routine, and from that, forge a way forward to get you back to better health. 

With either neuropathy or PAD, a better, healthier you, is possible. Our staff has the experience, knowledge and expertise to get you there. Schedule an appointment with us, today!

Predicting Amputation Due to Diabetes and PAD.png

 

If you have type 2 diabetes, you’ve likely thought about limb amputation. Diabetic patients are at increased risk of amputation, accounting for up to 85% of daily limb amputations worldwide. This increased threat is due to a variety of factors, making it difficult - if not impossible - to reduce the risk completely. 

 

Luckily, researchers continue to study the connection between diabetes and amputation in an effort to more accurately predict and prevent the threat. One recent study suggests that doctors should be paying special attention to a subgroup of diabetic patients: those with Peripheral Artery Disease (PAD).

 

How Diabetes and PAD affect amputation risk

 

There is no doubt a connection between diabetes and Peripheral Artery Disease (PAD). Patients with diabetes are more likely to develop PAD, as high levels of blood sugar cause changes in the blood chemistry and artery walls that contribute to plaque buildup. Not only are diabetic patients more likely to develop PAD, but diabetes is also known to increase the progression and severity of the disease.

 

Diabetes and PAD each carry an independent risk of limb amputation, and that risk increases significantly when the conditions co-exist. In fact, the risks are directly related: diabetes causes slow-healing sores and PAD, which blocks the blood flow needed to heal the open wounds from reaching the extremities. As blood flow is restricted, tissue damage occurs and sores may develop gangrene, a dangerous and deadly infection. Diabetic patients may also develop nerve damage that decreases pain, causing dangerous foot ulcers to go untreated until amputation is the only answer.

 

Unfortunately, the burden of amputations is severe, causing a significant rise in five-year mortality rates. For this reason, experts have begun conducting studies to determine variable risk factors that increase the threat of amputation in diabetic patients. One such study recently published in Diabetic Medicine developed a new risk score model that could help physicians better treat patients that present with major adverse limb events (MALEs). 

 

Predicting Diabetic Limb Amputation with Risk Scores

 

There are many factors that put you at an increased risk for amputation, including:

 

  • Certain demographic factors (age, gender, ethnicity)

  • Smoking

  • Underlying conditions, especially diabetes or vascular diseases

  • A history of foot ulcers or prior amputations

  • Neuropathy status

 

In this new study, 14,752 patients with type 2 diabetes were assessed for major adverse limb amputations, including amputations, revascularization, and gangrene. By reviewing the data, experts were able to create a variable risk score model that ranges from 6 (low risk) to 96 (high risk).

 

The study found that peripheral artery disease was the leading risk factor for diabetic limb amputation. Negative outcomes were also more likely in patients over 50, males, and those with a history of smoking. Additional high-risk factors included coronary artery disease, unmanaged insulin use and a history of prior foot ulcers or amputations.

 

In the future, this new risk score model could be used to categorize patient risk of amputation based on the presence of certain individual factors, allowing doctors to provide more specialized care that reduces the threat of limb loss. 

 

Reducing Amputation Risk

 

By understanding the most prevalent risk factors, patients and physicians can take a more proactive role in preventing diabetic amputation. Doctors should take special care to closely monitor high-risk patients and manage underlying conditions like diabetes and peripheral artery disease. Patients should be taught to check themselves for dangerous foot ulcerations, make healthy lifestyle choices, and control their blood sugar levels.

 

If you have diabetes, being proactive about peripheral artery disease is one of the best ways to reduce the risk of amputation. Vascular Associates of South Alabama offers a wide range of PAD treatments and procedures to help you manage your condition and improve your overall health. Contact us today to schedule an appointment. 

Can Young Adults Get Peripheral Artery Disease.png

 

Wrinkles. Vision Loss. Dementia. There are some things we don’t expect to combat until we’re older. You probably wouldn’t think to ask about Peripheral Artery Disease at your 35-year check-up - but maybe you should.

 

While this common vascular disease doesn’t typically show up on your patient questionnaire until your late 50s, it can occur much earlier. More young adults than ever are showing early signs of the condition - and they experience an alarmingly poor prognosis. To help you be proactive at your next physical, here’s what you need to know about premature Peripheral Artery Disease.

 

What is Premature Peripheral Arterial Disease?

 

Peripheral Artery Disease (PAD) is caused by plaque buildup in the arteries that carry blood away from the heart. This sticky substance causes the arteries to narrow and restricts blood flow to the extremities, especially the legs and feet. If left untreated, the condition can lead to limited mobility, limb pain and weakness, and even early death. 

 

PAD typically occurs later in life. When symptomatic PAD occurs in patients under the age of 50, it is known as Premature Peripheral Artery Disease. This early onset is rare - it occurs in less than one percent of the U.S. population, but it can also be extremely serious. Studies have shown that premature PAD is associated with a higher risk of rapid progression, limb loss, and death.

 

Signs of Premature Peripheral Artery Disease

 

PAD is easy to overlook, even in high-risk patients. The condition builds gradually and symptoms are often mild, causing many patients to go undiagnosed for several years. You may be suffering from Peripheral Artery Disease if you have:

 

  • Limb pain that lessens or disappears with rest (Intermittent Claudication)

  • Weakness or Numbness in the legs and/or feet

  • Limb sores that are slow to heal

  • Legs that are pale, blue-tinted, or cold to the touch

  • Poor growth of toenails or leg hair

  • Restlessness in the legs and feet, especially at night

 

Because PAD is uncommon in younger adults, it’s important to speak with your doctor if you are experiencing any of the above symptoms or are at increased risk of premature PAD. 

 

Am I at risk of Premature Peripheral Artery Disease?

 

Although rare, premature PAD does occur under the right conditions. Those at risk of Premature Peripheral Artery Disease share many of the same risk factors as those in the condition’s typical onset range. 

 

The most common risk factors include:

 

  • Smoking

  • Family history of Vascular Disease

  • Uncontrolled Diabetes

  • Obesity and Physical Inactivity

  • High Blood Pressure

  • High Cholesterol

  • High levels of Homocysteine, an amino acid that helps break down protein

 

Because PAD is uncommon in younger adults, it’s important to speak with a vascular specialist if you are at increased risk of premature PAD. A quick, non-invasive test known as an Ankle-Brachial Index (ABI) can provide a painless diagnosis by comparing the blood pressure levels in your hands and feet. If your ABI level is below 0.9, you may have a blocked artery that requires medical intervention.

 

How is Premature Peripheral Artery Disease Treated?

 

There are many treatment options available for patients with Peripheral Artery Disease. These can range from simple lifestyle changes such as smoking cessation and exercise to daily medications to control underlying conditions. In severe cases, surgical interventions may be necessary. 

 

Because PAD is progressive, it is extremely important that the condition is managed as quickly as possible, especially in those with early onset. If you are at risk of Premature Peripheral Artery Disease, make an appointment with Vascular Associates of South Alabama. Our expert physicians and specialists will work with you in our state-of-the-art facility to develop a tailored treatment plan that manages your condition and extends your quality of life.  

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