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When Helms started his therapy, he could walk for only 90 seconds before the pain was too much.
Approximately 8.5 million people in the United States have peripheral arterial disease (PAD), a narrowing of arteries that don’t involve the heart, particularly those in the legs. One of those people is Jeff Helms, 64, of East Stroudsburg.
Helms suffers from classic PAD symptoms: cramping and leg pain when walking or climbing stairs, signs that his leg muscles are not getting enough oxygen. As a result, people with PAD typically walk less and less. That amounts to less exercise, which allows PAD to get worse.
Helms had this in mind when his primary care physician sent him to Lehigh Valley Health Network (LVHN) for testing. Helms soon learned that the blood flow in his right leg was only about 60 percent of what it should have been, and it was just 70 percent of what it should have been in the left leg.
Helms was referred to vascular surgeon Eric Wilson, MD, with LVPG Vascular Surgery.
Rehab for PAD
Helms became the first patient at Lehigh Valley Hospital (LVH)–Pocono’s new PAD rehabilitation program. The program, led by Wilson, launched in September 2018 and is part of the cardiac rehabilitation offering at LVH– Pocono. “Ideally, this is for patients who have not had surgery and can avoid surgery or balloon angioplasty,” Wilson says. “The goal is to get patients involved in their treatment and in caring for themselves,” he says.
Walking away from leg pain
PAD has long been treated with medication and/or medical procedures. Blocked arteries are opened with balloon angioplasty. Stents can be placed in arteries to keep them open after angioplasty. Vascular surgeons can perform bypass surgery to circumvent blocked arteries. Various medications can be prescribed to keep blood thin and help open the arteries. But the latest treatment is the simplest: a walking regimen.
Typically, the pain of PAD comes when you are walking and goes away when you stop and rest. Start walking again, and it soon returns. Yet, through carefully planned and supervised walking, patients can push past the limits of their PAD and improve the health of their arteries.
Treatment involves three sessions per week for 12 weeks. Patients start by walking 2 miles per hour on a treadmill. When their pain reaches 3 on a scale of 1 to 5, they stop and rest until they are able to start again. Over time, speed and duration increase. An incline is added too. If back pain or some other issue makes walking difficult, a stationary bike can be substituted for the treadmill.
Building endurance
When Helms started his therapy, he could walk for only 90 seconds before the pain was too much. By two and a half weeks, he had progressed to eight minutes of uninterrupted walking. Things continued to improve over the course of his treatment.
“At the end of 12 weeks, I could walk more than 30 minutes without stopping,” Helms says. “It seemed like someone just opened a door, and I could keep on continually improving.” Helms’ progress in rehab made a real difference for him in his daily life too.
“I couldn’t walk up hills or a flight of stairs without extreme pain,” he says, “but recently, I ran up a flight of stairs. I went hunting this year too. I can hike the trails again.” Helms also lost 10 pounds – and his doctor is no longer talking about surgery.
Although Wilson’s specialty is vascular surgery, he’s happy to add rehab to the list of options for treating PAD patients. “This makes us full service as vascular specialists,” he says.
While those services continue to include bypass surgery, balloon angioplasty and medicine, he’s glad to have this additional option. “Just because we have a few hammers doesn’t mean everything is a nail.” Wilson says.
–Laurie Harrington