DEAR DR. DONOHUE: My wife has a problem. About a year ago, she saw a doctor about her legs. The doctor couldn’t find a pulse in her legs. She is not active. She sits on the couch or in bed all day. When she walks, she has a lot of pain. She has to stop and rest. She is a heavy smoker. She is only 53. What’s the story? – H.S.
ANSWER: The story is a potential tragedy unless your wife makes some big changes.
The cause of her pulseless legs and her leg pain when walking is most likely blockage of her leg arteries with cholesterol and fat. That’s atherosclerosis – artery hardening – and she is quite young to have it. If her leg arteries are clogged, the chances are great that her heart and brain arteries are clogged also. She’s inviting a heart attack or a stroke if she lets matters ride.
She needs a careful examination of her arteries. Determining the blood pressure at her ankles and comparing it with the blood pressure in her arms provides evidence of artery blockage. The two pressures should be about equal. If the leg pressure is lower than the arm pressure, there’s an obstruction in leg arteries. An ultrasound of the arteries is also most helpful.
She has to stop smoking. Smoking is a major cause of artery obstruction. She must become more active. Physical activity keeps arteries free of buildup. She should lose weight if that applies to her. She should be checked for diabetes and high blood pressure.
I don’t mean to scare your wife, but she must understand that if she doesn’t make significant changes, she is in danger of losing her leg or legs to gangrene.
She might also need some psychological counseling. Her inactivity could be due to depression.
The booklet on peripheral vascular disease, as artery hardening is called, explains this widespread illness and its treatment more thoroughly. Readers can obtain a copy by writing: Dr. Donohue – No. 109W, Box 536475, Orlando, FL32853- 6475. Enclose a check or money order for $4.75 U.S./$6.75 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have heard pros and cons on the subject I present to you. Is it better to exercise before or after eating? By exercise, I mean walking. – L.M.
ANSWER: That depends on the size of the meal and your walking pace. If you walk at a moderate pace, you can walk either before or after a meal. Some say exercise decreases the appetite, but I don’t know about that.
If you walk fast or eat a very large meal, it would be better not to walk right after eating. Blood gets diverted from the digestive tract to the exercising muscles, and that impedes digestion.
I answered this same question previously about swimming, and many were horrified when I said you can swim after eating. I didn’t mean that you could swim after eating a Thanksgiving-size meal, but you can swim after eating a light meal.
+++ Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475.
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