Painful cramps that start at the hip could be sign of peripheral arterial disease

As I write this column, the country’s senators are still deliberating on the passage of the sin tax bill, which is expected to provide additional funds for the effective and meaningful implementation of the universal health care law. The senators have until June 3 to decide, and pass their approved version to the House.

If rejected by the Senate, it reverts back to square one for the next batch of senators to tackle. That will certainly be a legislative tragedy of sorts, but we’re confident it doesn’t have to go that route, especially with President Duterte’s endorsement of the bill as an urgent one.

I think the senators would vote more convincingly this time, in contrast to the hair-raising narrow victory in 2012, when they voted 10-9. Surprisingly, then Sen. Lito Lapid provided the swing vote that clinched the passage of the sin tax law of 2012.

Let’s keep our fingers crossed that the senators fulfill their promise to keep health care paramount in their priorities.

Appreciation

I thank the Philippine Heart Association-Philippine College of Cardiology (PHA-PCC) for honoring me with a Lifetime Achievement in Cardiology award at the opening ceremonies of the annual convention last week.

I believe my more senior colleagues are more deserving of the award, but I truly appreciate the PHA-PCC board’s recognition of whatever little I have contributed in the field of cardiology, locally and internationally. I shall continue doing my humble share in the association’s undertakings.

I’m sure the award is not a courteous urging from the board, that those of us who have received it may retire and leave it to our young colleagues to continue whatever work still needs to be done.

The zest for contributing our humble share remains, and it gives us the energy to wake up early in the morning and go to work to do our researches, prepare for our lectures, and see how the health programs we’re involved in are doing.

Top scientist

Recently, one of our senior colleagues, Dr. Rody Sy, was hailed as one of the top scientists in the Asia-Pacific region, and was elected as an academician of the National Academy of Science and Technology.

He is an emeritus professor at the University of the Philippines-College of Medicine, but his enthusiasm for the science and art of cardiology has never waned. It’s still like the first several years when he was just starting his clinical practice and stint in the academe.

Congrats and wishing you more successes, Rody.

Actually, many of the more senior members of our 67-year-old association have remained active, but are just too happy to support the undertakings of our young colleagues who have just started to make their mark in the field.

In fact, sometimes, when we’re invited to lecture, we love to do the “front act” for our younger colleagues who would give their scholarly discussion on the more important topics of the conference.

We’re truly proud of our young cardiologists and cardiovascular surgeons who have been gaining recognition abroad for their expertise in specific areas in cardiovascular medicine.

Vascular medicine

Recently, for instance, Dr. Tess Abola was recognized by the International Society of Vascular Medicine with the conferment of the title, Master in Vascular Medicine, meaning, expertise-wise, she is at par with any other renowned expert in this subspecialty worldwide.

If I’m not mistaken, she pioneered this subspecialty in the Philippines at a time when so little was known about it, and she helped stimulate local interests and researches on this field.

Now we have several training programs on vascular medicine, and our local experts have grown in number already. Dr. Abola, at a young age, is rightfully called the “Mother of Vascular Medicine” in the country.

Specialists in vascular medicine deal with all problems related to the peripheral arteries. These patients present with signs and symptoms of occlusion of their peripheral arteries especially in diabetics and smokers. Buerger’s disease, which President Duterte says he has a history of, also falls under this specialty.

Through various nondrug and drug interventions, many limbs could be spared from developing gangrene that leads to amputation.

Patients with peripheral arterial disease (PAD) may complain of painful cramps which may start from one or both hips, thighs or calf muscles while walking or climbing stairs. This is called claudication. Other symptoms include:

Weakness or numbness of one or both legs;

Coldness usually in one lower leg or foot, when compared to the other extremity;

Nonhealing wounds or sores on the toes, feet or legs;

Color changes in the legs, particularly darkening discoloration;

Loss of hair on the legs and feet;

Slow growth of toenails;

Shiny skin on the legs;

Absent or weak pulse in the legs and feet.

Diabetics, smokers, and those with other risk factors for heart disease and stroke are also prone to develop PAD, so they need to see specialists in vascular medicine for evaluation even if they don’t have the bothersome symptoms yet. When severe symptoms appear, it might be a prelude to amputation. Better to do early intervention than be sorry.

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