The Doc Replies
Our expert answers your medical questions
My 31-year-old diabetic nephew has been diagnosed with peripheral vascular disease. I am worried for him. Can you please tell me a bit more about it?
Peripheral vascular disease (PVD) is a narrowing of the arteries, usually to the legs. This is caused by atheroma, which are fatty plaques in the artery wall. In most cases it starts to cause problems in middle age, and is more common in people with diabetes and smokers. The usual symptom is pain, most commonly in the calf on walking. PVD most commonly affects the femoral artery, the main artery in the leg. If it is chronic, the feet will feel cool. On clinical examination the pulses in the foot and perhaps further up the leg too will be weak or absent. In more severe cases sufferers can experience pain when at rest. Ulcers can occur and ultimately gangrene – where the tissue dies – although we would certainly aim to prevent that. The first thing to do, if a smoker, is to stop smoking; regular exercise helps, and losing weight is beneficial. Medication can also be helpful.
I am over 75 and my cholesterol is borderline. My doctor wants to prescribe 20mg of statin. But, having read about the side-effects, it is not advisable for someone my age. What should I do?
This is a matter of patient preference and the decision is yours following discussion with your doctor. As you get older your risk of heart attack and stroke increases, but if you have survived well enough to age 75, by taking statins you may be trying to prevent a heart attack that might never happen. You have to weigh-up the risks and benefits. If you are on lots of medication you may feel less inclined to take them.
I have a shooting pain from my lower back right down my left leg. It seems to be worse after activity. What could it be?
This may be sciatica, which is the irritation of a nerve root coming from the spinal cord. It is usually caused by a prolapsed disc and can cause pain along the length of the nerve – including the leg. Try to work through the pain with medication like pain killers and muscle relaxants.
The Doc Replies
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