What is intermittent claudication?

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- What are the first signals of intermittent claudication?

On the shin and foot for a short time and without cause suddenly there are numbness and chilliness. After a long walk, the calf muscles ache. Alas, as soon as these symptoms have appeared, most patients do not consult a doctor, writing off everything on the natural beginning of old age. It is very important to visit a vascular surgeon as soon as possible. Two analyzes are irreplaceable. Dopplerography (this is a kind of ultrasound) in order to see the narrowing of the lumen of blood vessels and measure the speed of blood flow in them. And a blood test to determine the ratio of "bad" and "good" cholesterol. If atherosclerosis has begun, the blood flow rate will decrease, and the ratio of "bad" and "good" cholesterol will increase beyond the norm in the direction of "bad".

- How to be treated from limping?

First, are prescribed drugs called statins. They reduce the production of "bad cholesterol" by the liver. Secondly, you need to take medicine disaggregants. They reduce the risk of blood clots. You will have to use them during whole life.

- I heard that smoking for those who suffer from this disease is tantamount to "self-amputation" of the limbs? Is smoking can lead to "self-amputation" of the limbs?

At the most inveterate smokers this term can be even shorter. In a word, smoking for such patients is strictly prohibited because it causes a sharp spasm of blood vessels. Such patients need daily walking 3-4 times a day for 30-40 minutes or until the appearance of the first pain in the muscles. To watch feet with atherosclerosis as the apple of the eye! Even with minor injuries and rubbing, ulcers can start. Football and all "foot" sports are excluded. When the feet and shins are cold, do not wrap them with thick socks, and do not wear hard heavy shoes! Do a 15-minute massage of the shins and feet not less than 4 times a day. With two hands, forming a ring with thumb and forefinger, make them smooth stroking movements up and down to improve blood flow.

- What is intermittent claudication?

Intermittent claudication is not a disease in the broadest sense, but rather a symptom of certain diseases. It arises due to certain pathological conditions in the human body and requires obligatory attention to itself.  On the change of the initial stage of the development of the disease comes neglected form. Usually only then we begin the therapy. There may come a time when the tissues of the limbs no longer have enough oxygen and nutrients. Intermittent claudication will begin: pains cause the patient to stop when walking at short intervals. Further worse legs hurt even when a person lies. In more severe cases, the skin becomes brown, hair falls out. The limbs become cold, the nails are brittle. The pulsation of the arteries will disappear. However, the most serious violations are now trophic ulcers. Medications at this stage are already helping badly. Treatment of intermittent claudication is possible only with the use of vascular operations. Unfortunately, with completely neglected atherosclerosis, one must resort to amputation of the extremities affected by gangrene. Its first signs are cyanosis and coldness of the toes or her calcaneus. The main test for intermittent claudication aimed at measuring the distance that the patient is able to overcome painlessly.

- But is it possible for local treatment of trophic ulcers, where instead of vascular surgery, for example, ointments would act? 

This way rather is the external treatment of the ulcer. If to believe the doctors’ experience: the healing of an ulcer will hardly give even the most expensive ointment. After all, this requires normal blood flow, but it is impossible to adjust it without surgery. But to protect tissues affected by the ulcer, from microbes, it is necessary. All patients with intermittent claudication should control the blood glucose level (decrease in the level of glycosylated hemoglobin up to 7%), and in the presence of diabetes mellitus intensive therapy with antihyperglycemic drugs or insulin, as well as careful skin care of the feet and shins.

Antiaggregant (antiplatelet) therapy in the form of Aspirin at a dosage of 75-325 mg day or clopidogrel 75 mg day is indicated in patients with atherosclerosis of the arteries of the lower extremities to reduce the risk of cardiovascular events. It is advisable to prescribe patients with Pletal with a vasodilating, metabolic and disaggregant effect. Pentoxifylline at a dose of 1200 mg per day can be considered as one of the main drugs to increase the maximum passable distance. This is not the entire list of medications for intermittent claudication but as time shows it is the most effective of all known. Prevention of this disease is all measures that are used to prevent systemic atherosclerosis. Victory over bad habits, proper nutrition, and active pastime cannot only help restore the body, but also prevent the emergence and development of diseases. Especially necessary preventive measures are for patients at risk. These include the elderly, hypertensive people, diabetics, smokers, people with overweight, and with a metabolic disorder.

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