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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Vascular Associates of South Alabama

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Tips for vascular health

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If you’re monitoring your vascular health, you’ve probably been told to keep a watch on your cholesterol. This sticky villain is a known health risk, responsible for clogged arteries, heart attacks, strokes, and a variety of other life-threatening problems.

But cholesterol is a natural substance that has both good and bad qualities - when it’s consumed appropriately. So how did this once-beneficial substance turn into the big bad wolf of vascular health? Let’s get back to the basics.

What is cholesterol?

Cholesterol is an organic substance found in the walls of every human cell. It’s necessary for the production of hormones, Vitamin D, and substances that aid in proper digestion.

Your body produces all the cholesterol it needs, but cholesterol can also be found in foods that come from other animals such as eggs, milk, meat, and cheese. As these are common staples in every human diet, many people consume much more cholesterol than their body needs.

When your doctor runs a cholesterol test, they’re looking at two main types of cholesterol:

High-Density Lipoprotein (HDL)

Also known as “good cholesterol”, HDLs act as scavengers that carry cholesterol through the bloodstream to the liver, where it’s expelled from the body. High levels of HDL can actually lower your risk of heart disease and stroke.

Low-Density Lipoprotein (LDL)

The majority of cholesterol in your body is LDL or “bad cholesterol”. LDL can build up in your arteries as plaque, a condition known as atherosclerosis. High levels of LDL increase your risk of heart disease and stroke.

Why is High Cholesterol Dangerous?

Because it has a waxy, fat-like texture, consuming too much cholesterol can cause it to build up in the blood and arteries as plaque. Eventually, the arteries can narrow and harden, leading to a range of serious health problems such as vascular diseases (like coronary artery disease or peripheral artery disease), stroke, or heart attack.

What causes High Cholesterol?

Most cases of high cholesterol are caused by an unhealthy lifestyle, though genetics, age, and race can also put you at higher risk. The most common causes of high cholesterol include:

  • Smoking
  • A high-fat diet
  • Lack of physical activity

How Can I Lower My Cholesterol?

Ideally, your total cholesterol level should be less than 200, with at least 60 HDL and less than 130 LDL. If your blood test shows high levels, your doctor may prescribe a combination of lifestyle changes and medications to lower and control your cholesterol.

Helpful lifestyle changes can include:

  • Eating a healthy diet. Heart-healthy diets are low in trans and saturated fats and high in vegetables, fruits, lean meats, and whole grains.
  • Weight management. Maintaining a healthy weight through proper diet and regular exercise can lower your LDL levels.
  • Quitting smoking. Tobacco lowers your HDL levels. The sooner you stop smoking, the faster your body can build helpful HDL to carry cholesterol to the liver.

If lifestyle changes alone can’t control your cholesterol, your doctor may also prescribe medication. Common medications for cholesterol management can include statins, bile acid sequestrants, cholesterol absorption inhibitors, and others. Your doctor will work with you to decide the best type of medication for you.

If you’re struggling with high cholesterol or other vascular health problems, the expert physicians at Vascular Associates of South Alabama can help. We work closely with our patients to develop treatment plans to treat and manage your condition and keep you in optimal health. Contact us today for an appointment.

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Most people alive today know someone who has experienced a stroke. This common but devastating medical condition occurs when blood flow to the brain is restricted, resulting in cell death and potentially permanent brain damage.

A stroke is a serious medical emergency, and they’re all too common. In the United States, a person experiences a stroke every 40 seconds; of those, one in 20 will die. That’s why it’s so important to recognize the symptoms of a stroke - when timing is crucial, knowing how to identify the condition and call for help can save yours or someone else’s life. Here’s what you should know about identifying and reacting to common symptoms of a stroke.

Common Symptoms of a Stroke: Act FAST

One of the most recognized acronyms in the world, F-A-S-T is also a mnemonic that can help you remember the signs and symptoms of a stroke. If you suspect someone is having a stroke, follow these steps:

F - FACE. Ask them to smile. Does one side of their face droop or seem hard to move?

Facial drooping is one of the most commonly recognized symptoms of a stroke. It occurs when the muscles that control the face are damaged in the brain, causing facial paralysis and the characteristic ‘drooping’ appearance. Depending on the type of stroke, this can be due to a lack of oxygen or excess pressure caused by bleeding in the brain.

A - ARMS. Ask them to raise both arms. Do they have trouble lifting them to the same height? Does one arm drift downward?

The same paralysis that causes one-sided facial drooping leads to arm weakness during a stroke. A person suffering a stroke will be unable to hold both arms to the same height. They may also struggle to squeeze your hand or a ball on one side of their body.

S - SPEECH. Ask them to repeat a simple sentence. Is their speech slurred or strange? Do they have trouble repeating the phrase?

Lack of oxygen to the brain can cause a stroke victim to become extremely confused and disoriented. This often results in slurred or strange speech patterns. They may not know they are speaking abnormally, or they may not be able to speak at all. At this stage, it’s crucial to keep them calm and reassure them that you’re seeking medical attention.

T - TIME. If the person is experiencing any of these symptoms, call 9-1-1.

Any symptom of a stroke means it’s time to call 9-1-1 immediately. The best treatments are only effective if administered in the first 3 hours of the first stroke symptoms. This means that seeking prompt treatment is crucial in preventing long-term brain damage from a stroke.

If possible, note the time the first stroke symptom appears. This will help medical professionals decide on the best course of treatment for the stroke patient.

Even if the symptom(s) appears to resolve, don’t delay - call 9-1-1 immediately. This could be a sign of a transient ischemic attack (TIA), an early warning sign of a stroke that needs immediate medical attention.

Other Stroke Symptoms

The F-A-S-T mnemonic is a good way to spot the most common and obvious signs of a stroke, but there are other symptoms you should watch out for. Those include:

Trouble seeing in one or both eyes.

Trouble walking, dizziness, or loss of balance or coordination.

Sudden severe headache with no known cause.

Sudden numbness or weakness of the face or limbs, especially on one side of the body

If you or someone you know is at risk of stroke, the expert physicians at Vascular Associates of South Alabama can help. We offer detailed stroke prevention and management treatments that can analyze and reduce your risk of future strokes. Contact us today!

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A stroke is one of the most widely known - and feared - medical conditions in the world today. You probably know the F-A-S-T pneumonic to identify a stroke, aptly named for the importance of quick medical intervention. But you may not know much about carotid artery disease, the silent killer that contributes to nearly 20% of the 700,000 strokes that will occur this year.

So you can be prepared, here are 5 things to know about carotid artery disease (CAD).

Carotid artery disease restricts blood flow to the brain

When your doctor places a hand on the side of your neck to feel for a pulse, they’re feeling your carotid artery. These major arteries are located on either side of your neck and feed blood to your head and brain. Carotid artery disease occurs when a build-up of fatty deposits known as plaque causes a blockage in your carotid artery, restricting blood flow to the brain.

The first sign of carotid artery disease may be a transient ischemic attack (TIA)

Carotid artery disease develops slowly and may show no noticeable symptoms until you experience a transient ischemic attack (TIA) or stroke. A TIA is a temporary restriction of blood flow to the brain.

Symptoms of a TIA include:

  • Numbness or weakness, especially on one side of the body
  • Difficulty speaking or slurred speech
  • Trouble seeing in one or both eyes
  • Dizziness
  • Trouble walking or loss of balance

The symptoms of a TIA closely resemble that of a stroke but do not last as long. If you experience any sign of a TIA or stroke, seek medical attention immediately even if you begin to feel better.

Carotid artery disease increases your risk of stroke

Because carotid artery disease restricts blood flow to the brain, it significantly increases your risk of stroke. A stroke deprives your brain of oxygen and can result in permanent brain damage or death in minutes; it is the leading cause of both in the United States.

Carotid artery disease can cause a stroke in two ways. A piece of plaque can break off and become lodged in the brain’s blood vessels, causing an embolism. Less commonly, CAD can become so severe that the carotid artery is blocked completely.

You may be at risk of carotid artery disease

There are risk factors that contribute to a patient’s risk of carotid artery disease. Some are hereditary and health-related, while others are attributed to specific lifestyle choices.

The risk factors for CAD include:

  • Smoking increases your blood pressure and heart rate and can irritate the lining of your arteries, causing damage that leads to plaque.
  • High Blood Pressure causes increased pressure on your artery walls, causing weakness and damage that contribute to CAD.
  • High cholesterol is a major risk factor for carotid artery disease.
  • Diabetes affects your body’s ability to process blood sugar and fats, putting you at a higher risk for high blood pressure and plaque build-up.
  • Obesity increases your risk of diabetes, carotid artery disease, and high blood pressure.
  • Older age causes your arteries to stiffen and become more susceptible to damage.
  • Family history. If someone in your family has had carotid artery disease you may be at higher risk yourself.

Lifestyle changes can prevent carotid artery disease

Good news! There are lifestyle changes you can make to lower your risk and even manage carotid artery disease. They include:

  • Don’t smoke. If you use tobacco, it’s best to quit now. If you’re not a smoker, don’t pick up the habit.
  • Exercise regularly. Physical inactivity contributes to obesity and carotid artery disease. Get the recommended amount of exercise each week.
  • Eat a balanced diet. A diet rich in fruit and vegetables helps you maintain a healthy weight and gives you essential vitamins and nutrients that may prevent strokes and TIAs.
  • Limit fat and cholesterol. This will reduce your risk of atherosclerosis.
  • Reduce alcohol consumption.
  • Manage health conditions such as diabetes and high cholesterol.

If you’re at high risk for carotid artery disease or have experienced a stroke (or stroke-like symptoms) in the past, it’s important to see a vascular specialist like those at Vascular Associates of South Alabama. A vascular physician can help you control the disease through lifestyle changes, medical management, and surgical treatments to keep you in optimal health. If you need to speak to someone about carotid artery disease, contact us today!

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Deep vein thrombosis (DVT) is a serious medical condition in which a blood clot forms in one of your body’s deep veins. A blood clot (thrombus) is when a clump of blood changes from a liquid to a semi-solid or gel-like state. DVT occurs most commonly in the legs, though it can occur elsewhere in the body.

Your arms and legs have both superficial and deep veins. When a clot forms in a deep vein, it's a serious medical condition. That’s because a piece of the clot may break off and travel to the lungs, causing a medical emergency.

What are the signs and symptoms of deep vein thrombosis (DVT)?

DVT can occur without noticeable symptoms. Those that do experience symptoms may experience:

  • Pain or cramping in the leg, usually starting at the calf
  • Swelling in the leg
  • Warmth in the affected area
  • Red or blue skin discoloration

Many people are unaware they have a DVT until it breaks off and reaches the lungs. This is known as a Pulmonary Embolism (PE), and it’s a life-threatening emergency. Signs of a PE can include shortness of breath, chest pain that gets worse with deep breathing, coughing up blood, and rapid heart rate. If you suffer from any of those symptoms, seek emergency medical treatment immediately.

What Causes DVT?

DVT can be caused by anything that prevents your blood from circulating or clotting correctly. The most common causes include:

  • Immobility. Long periods of sitting or immobility are one of the main causes of DVT. This can include bed rest due to illness or surgery, long trips in a car or airplane, or injury to the leg that keeps it immobile.
  • Medication. Certain medications like birth control, estrogen supplements, and hormone replacement therapy can cause DVT.
  • Injury to a vein. Veins can be injured through trauma (such as a broken bone) or surgery.
  • Inherited blood disorders. Some families are predisposed to blood disorders that cause the blood to clot easily or frequently, a condition known as hypercoagulation.

Some individuals are more likely to suffer from deep vein thrombosis than others. Common risk factors include:

  • Pregnancy
  • Smoking
  • Obesity
  • Certain cancers
  • Irritable Bowel Syndrome (IBS)
  • Family history or genetic predisposition to blood clots
  • Heart disease

How is Deep Vein Thrombosis Treated?

To diagnose DVT, your doctor will take a family history, do a physical exam, and conduct one or more diagnostic tests. Those may include an ultrasound, D-dimer blood test, or venography.

If you are diagnosed with DVT, your doctor will work with you to determine the best course of treatment. Common treatment options include:

Blood thinners. The most common treatment for DVT is oral or intravenous blood thinners. They cannot dissolve an existing clot, but they can keep it from growing or breaking as well as keep new clots from forming.

Clot Busters. If blood thinners don’t work, or your clot is dangerously large, your doctor may choose a more aggressive medication known as a clot-buster, or thrombolytic. These medications are inserted intravenously or through a catheter directly into the clot. They carry a severe risk of stroke and bleeding and are often reserved for more serious cases of DVT.

A Vena Cava Filter. If your clot doesn’t respond well to medication, a filter may be surgically placed into the large vena cava vein in your abdomen. This filter prevents clots that break off from reaching the lungs and causing a pulmonary embolism.

Thrombectomy. In rare cases, your doctor may need to surgically remove the clot in a procedure known as a thrombectomy.

Once your DVT is under control, there are lifestyle changes that will help prevent a future clot. Those include exercise, maintaining a healthy weight, stop smoking, and avoiding periods of prolonged immobility.

If you have further questions or are at risk for developing DVT, Vascular Associates of South Alabama can help! Our team of board-certified vascular surgeons will work with you to develop a treatment plan that takes control of your DVT and vascular health. Contact us today!

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For most of us, diseases are diagnosed because we experience common symptoms. Chest pain? It’s likely Coronary Disease. Kidney dysfunction? Let’s test for Renal Disease. Some diseases, like Peripheral Artery Disease, are much harder to diagnose because their symptoms are mild or nonexistent.

Almost half of those with Peripheral Artery Disease have no symptoms at all, especially in the early stages. Of those who do, symptoms can be so mild that they are attributed to natural aging or are easily ignored. Because of this, many patients have Peripheral Artery Disease for years before being diagnosed. Since P.A.D. causes fatty blockage in the arteries that can restrict blood flow, it’s important to catch it early to prevent serious or even life-threatening consequences.

There are a few common signs to watch for that may indicate a vascular disease like P.A.D. If you suffer from any of the below conditions or are at high-risk for the disease, it’s important to speak with your doctor.

Intermittent Claudication

The most common sign of P.A.D. is also one of the most confusing. Intermittent Claudication refers to pain or cramping in the arms or legs that comes with exercise or activity and disappears with rest. Because most of us have experienced occasional discomfort when exercising, it’s one of the most quickly written-off symptoms. The key is that intermittent claudication pain can reach intolerable levels during movement but is relieved very quickly when you stop.

Weakness or numbness in the legs

 If your legs are unusually weak, numb, or prone to “falling asleep”, you may have a blood flow issue that could be due to P.A.D.

Changes in color or temperature in the legs

If one leg is much cooler than the other, or if you notice a change in skin color such as blueness or paleness, it may be due to P.A.D.

Sores on your toes, feet, or legs that won’t heal

Your body needs blood and oxygen to heal wounds. When your blood flow is restricted, even small wounds like a heel blister will be hard to overcome. This opens the door to infection and even gangrene, which can result in leg or foot amputation.

Loss of leg hair

As blood flow is restricted to the skin, it loses its ability to grow or hold body hair. Sparse or missing leg hair can indicate P.A.D.

Poor toenail growth

If you haven’t had to reach for the clippers in a while, it could be due to a vascular problem like P.A.D.

Erectile Dysfunction

In men, P.A.D. can manifest as erectile dysfunction due to decreased blood flow to the genital area.

Pain or cramping in the legs when at rest

If P.A.D is severe, you may experience pain or cramping in your legs or feet even when you’re resting. This occurs when your artery blockage is so severe that blood and oxygen are restricted, and it requires prompt treatment. It’s most commonly experienced as intense pain in the feet while resting at night.

If you think you may have Peripheral Artery Disease, we can help! Our expert vascular specialists can help you devise a treatment plan to take control of the disease and improve your vascular health. Contact us today to schedule your appointment!

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Millions of men and women across the United States are affected by Peripheral Artery Disease (PAD). PAD occurs when plaque builds up in the arteries that carry blood away from the heart, causing them to narrow and restricting blood flow. If you’ve been diagnosed with PAD or think you may be experiencing symptoms, there are a few things you should know about this common condition.

One in every 20 Americans over 50 has P.A.D.

In all, there are between 8-12 million cases of Peripheral Artery Disease in the United States, most of those over the age of 50. P.A.D. can affect anyone but is found most common in older patients, African-Americans and those with chronic health conditions like diabetes or hypertension.

It occurs most commonly in the limbs

Though any peripheral artery can become blocked by plaque, it occurs most commonly in the legs and feet.

It’s most commonly caused by Atherosclerosis

The most common cause of Peripheral Artery Disease is atherosclerosis, a condition in which plaque builds up in the arteries. Plaque is a sticky substance made up of cholesterol, fat, calcium, fibrous tissue and other substances in the blood.

Having PAD puts you at risk of other health problems

People with Peripheral Artery Disease are at significantly higher risk of stroke, ischemic heart attacks, and coronary heart disease. If left untreated, P.A.D. can also lead to gangrene and amputation.

You may not know you have P.A.D.

Weakness in the limbs, aching or cramping legs, poor toenail growth - these could be simple signs of aging, but they could also indicate P.A.D. The symptoms of Peripheral Artery Disease can range from mild to severe and are often vague enough to be easily mistaken for other conditions or written off completely. To add to the confusion, symptoms may become worse with activity but vanish completely with rest.

Because of this, many patients have P.A.D. for years before a diagnosis is made. If you are 70 years or older or have a history of high-risk factors, you should be screened for Peripheral Artery Disease.

Diagnosis is Easy and Painless

Good news! If you’re at risk of Peripheral Artery Disease or are experiencing symptoms, getting to the right diagnosis is often easy and painless. Your doctor will conduct a physical exam, review your family and medical history, and use test results to determine if you have P.A.D.

A common diagnostic tool is the Ankle-Brachial Index (ABI). This painless 10-minute test compares the blood pressure in your feet to the blood pressure in your hands to look for blockages. Your ankle pressure should be within 90% of your arms, but if the blockage is severe it may be less than 50%.

If your ABI result is concerning, your doctor may use a vascular ultrasound or other imaging studies to test further.

You can take control of your PAD

In most cases, managing PAD is as simple as lifestyle changes and medication to prevent clots. Like so many other health issues, PAD can be reduced with exercise, a proper diet, and smoking cessation. Managing chronic conditions like diabetes or high cholesterol also helps reduce PAD.

In severe cases, surgery or injections may be needed to remove blockages or bypass the damaged artery. Speak with your doctor about what treatment plan is best for you.

We can help!

The specialists at Vascular Associates of South Alabama can help you diagnose and manage your Peripheral Artery Disease. Our expert staff uses state-of-the-art equipment and a range of treatment options to help you take control of your PAD - and your life. Call to schedule your appointment today.

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Some of us have more prominent veins than others. But when your veins appear swollen, twisted, or darkly colored, you may be suffering from varicose veins. Varicose veins affect 1 in 4 adults and can range from merely unsightly to downright dangerous. But what exactly are varicose veins, and what can be done about them?

What Causes Varicose Veins?

In the simplest terms, varicose veins are veins that are swollen with blood. Your veins have valves that keep your blood flowing toward your heart. When those veins become damaged or weakened, blood can back-up behind them and pool in your veins, causing them to swell. When this happens, they protrude from the skin and appear twisted, enlarged, and bluish in color. They are often called “spider veins” when they are mild thanks to their webbed appearance.

Varicose veins are most common in the legs, ankles and feet. That’s because the pressure in the veins of your lower body is increased when you stand or walk. Any vein can become varicose. For example, hemorrhoids are a form of varicose veins that form in the rectum. They can also occur in the stomach, esophagus, liver or testicles.

What are the symptoms of varicose veins?

The most common sign of varicose veins is their dark, bulging appearance. Many varicose veins cause no other symptoms. If left untreated, varicose veins can cause:

  • Itching
  • Burning
  • Pain
  • Dull aching
  • Feelings of heaviness or tiredness in the limbs
  • Changes in skin color
  • Nighttime skin cramps or restlessness

Symptoms can range from mild to severe. Your symptoms may get worse when you sit or stand for long periods. 

Am I at risk for varicose veins?

Varicose veins are very common, affecting over 23% of adults. They occur more often in women than in men. Experts are not sure what causes varicose veins, but some potential risk factors include menopause, pregnancy, obesity, family history, and being over 50. You may also be at increased risk of varicose veins if you are taking certain medications, are inactive for long periods, or smoke.

How do you treat varicose veins?

Many varicose veins need no treatment for health reasons, but they may indicate an underlying condition so they should always be evaluated by a medical professional. Your physician will diagnose varicose veins by doing a physical examination and reviewing your lifestyle, family history, and symptoms. They may also use imaging like an ultrasound to determine the health of your veins.

Treatment for varicose veins can range from lifestyle changes to surgery. Being more active, maintaining a healthy weight, and not smoking are common ways to combat varicose veins. Your physician may also suggest compression therapy, which improves circulation.

If your varicose veins are severe, you may need surgical treatment. Most procedures involve closing off the vein to prevent blood flow. Once the vein is closed, blood will re-route to healthy veins nearby. For a look at the most common surgical treatments, visit our services page.

Each patient is different. The physicians at Vascular Associates of South Alabama will work with you to determine the most appropriate course of treatment for your needs.

If you think you may be suffering from varicose veins, give us a call at 251-410-8272. Our expert vascular physicians can diagnose and treat your varicose veins to make you comfortable and keep you in optimal health. Plus, most of our procedures are minimally invasive and can be done right on-site in our Mobile, AL facility. Contact us today!

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