Dr.Joseph Borreggine, local podiatric physician and the currrent President of the Illinois Podiatric Medical Association (IPMA) recently was trained and certified to provide testing for Peripheral vascular disease (PAD) for the lower extermity.

The purpose of the vascular screening exam is to help evaluate potential poor circulation issues that may be currently undetected. Based on the test results, Dr. Borreggine will provide a referral along with a thorough report to the patient's primary physician, vascular specialist, or cardiovascular surgeon at their community hospital. Therefore, further treatment can be provided to prevent any further complication like stroke of heart attack.

Borreggine is also a member of the American Podiatric Medical Association (APMA). The APMA is a founding member of the PAD Coalition which is non-for-profit entity working to improve the health and care of patients with or at risk for PAD.

When is arterial leg pain a problem

If you engage in excessive amounts of exercise, your legs will hurt. That's normal. But if you regularly have leg pain after moderate or small amounts of exercise, or feel it lying down or sitting in a chair, that's not normal. That's when leg pain can be a problem.

The symptoms of leg pain are more common than you think. Particularly for people over age 50, and especially for those who smoke or have diabetes. About 30% of adults in this category have some form of peripheral arterial disease, which is often the underlying cause of leg pain.
Leg pain feels different to different people. Some people feel it as a sharp, crampy, or "Charlie-horse" type pain they get after walking, climbing stairs or some other kind of leg exercise. This type is called "intermittent claudication." In more severe cases, people will complain of pain in their toes or feet when lying down, and this pain can even disturb sleep. This type of leg pain is called "rest pain."

What causes P.A.D.?

Peripheral arterial disease (PAD) is caused by a narrowing or blockage of arteries that results in restricted blood flow to your arms and legs. When you walk or exercise, your leg muscles do not get enough blood and you can get painful cramps.

Leg arteries get clogged with fatty deposits, or plaque (pronounced as 'plak'). Plaque is made of extra cholesterol, calcium, and other material in your blood. Over time, plaque builds up along the inner walls of the arteries, including those that supply blood to your legs. When plaque builds up, there is less room for blood to flow. Every part of your body needs blood that is rich in oxygen. But plaque buildup prevents that blood from flowing freely and starves the muscles and other tissues in the lower body.

This process of plaque buildup usually happens at the same time throughout the body. It is called atherosclerosis or hardening of the arteries.

Is P.A.D. serious?

P.A.D. affects millions of Americans over age 50. The hardened arteries found in people with P.A.D. are a sign that they are likely to have hardened and narrowed arteries to the heart and the brain. That is why people with P.A.D. have a two to six time's greater chance of death from a heart attack or a stroke.

What happens when I see my doctor?
Your doctor will ask lots of questions. What does your leg pain feel like? Where is it isolated? How did it start? How bad does it get? Is it constant or does it come in attacks? What seems to bring it on? What makes it better? What makes it worse? What other symptoms go along with it?

If you are seeing a doctor for the first time, you will also be asked about other or current health problems, about health problems in your immediate family, and about your lifestyle.

Some doctors prefer to ask these questions face-to-face. Others prefer to have you fill out a questionnaire in the waiting room and then go over the answers with you. You should be aware that certain information is helpful and other information is not. Your doctor knows what information is helpful, so it's best to let him (or her) ask the questions.

You will be examined. Your height, weight, heart rate, and blood pressure will be taken. The doctor will listen to your heart and lungs and examine various parts of your body, especially looking for evidence of sores or ulcers on your feet, legs and toes. He will feel your pulses, particularly in the legs to feel for the strength of blood flow to these areas.

What can my doctor do about my leg pain?
Some disorders that cause leg pain don't require treatment. They go away by themselves. Fortunately, most arterial disorders can be treated with medication, surgery, diet, a change in lifestyle, or some combination of these.

After his examination, if your doctor thinks you may have P.A.D., he (or she) may order a test called PADnet. PADnet is a 15-20 minute test of segmental blood pressures in your arms and legs, called the ABI, or ankle brachial index (pronounced as 'an´ kel-bra´ ke-el in´dex'). It also measures blood volume in the legs using pressure cuffs (Pulse Volume Recordings or PVR's) and blood pressures in the toe (toe brachial index or TBI). For more information on PADnet and BioMedix go on the web at www.biomedix.com or contact Dr. Joseph Borreggine, podiatric physician at 1-800-366-8397



Click here to view the Walk Healthy Brochure

Some, but not all of you have recently been introduced to a simplified approach to the Walk Healthy 3-Step Program. We are now calling our systematic program for patient care the Walk Healthy 3-Step ''A-HA'' Program. Many of you have told us that you find ''A-HA'' a useful acronym which quickly reminds you and your staff of all 3-Steps in the Program, specifically:

1. Ailment-Relief
2. Hygiene
3. Alignment

If you apply these 3-Steps to each patient visit, you will quickly discover that the Walk Healthy 3-Step ''A-HA'' Program is applicable to EVERY patient you see. The attached Walk Healthy brochure explains our 3-Step Program in more detail.

Some Walk Healthy practitioners by habit, are still stopping their treatment at Step 1 and never getting to the Hygiene and Alignment Steps, and therefore not offering their patients the benefits of basic Hygiene, or biomechanical, customizable Alignment. By remembering and teaching the ''A-HA'' acronym to your professional staff, you will provide a fuller range of health services to all patients, and you will also find yourself dispensing much more product.

Consider a typical patient who comes in with an aching bunion, which they do not wish to have you operate on. The application of Step 1, Ailment-Relief, will trigger the prescription of our new Bunion-Sesamoid Pad, a unique product which is superior to anything else now available. The application of Step 2, Hygiene, will trigger the dispensing of the Shoe & Insole Hygienic Refresher Spray and the Bath & Shower Cleansing Spray, without which their environment will stay perpetually dirty. And the application of Step 3, Alignment, should put them in one of our patented Customizable Everyday Orthotic Insoles to control their feet and to reduce impact shock. By following the Walk Healthy 3-Step ''A-HA'' Program, this patient will receive a minimum of 4 products, as many as 6 if their feet are wet (add the Deodorizing Drying Spray and Foot & Shoe Powder), and 7 if their Customizable Everyday Orthotic Insole needs customizing (a heel lift or arch support). If the patient is reluctant to take all the products in one visit, that's fine, just enter all the products on the Walk Healthy Dispensing Log, placing a DL next to those you will need to Dispense Later on their next visit.

If you follow the Walk Healthy 3-Step ''A-HA'' Program, you and your patients will derive the fullest benefit from our Program. So have yourself an ''A-HA'' moment, and start using all 3-Steps. You will see a big difference is patient satisfaction and in your practice's bottom line.