Avoiding Leg Amputations Due to Peripheral Arterial Disease | Q&A
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- เผยแพร่เมื่อ 12 มิ.ย. 2024
- Johns Hopkins Medicine Vascular Surgeon Dr. Thomas Reifsnyder discusses symptoms, diagnosis and treatment of severe peripheral arterial disease (PAD). He also shares insight on how to avoid limb amputations, including leg and foot removal.
The Johns Hopkins Heart and Vascular Institute www.hopkinsmedicine.org/heart_...
Questions answered:
1. Describe what you do. (0:11)
2. Why see a vascular surgeon for PAD? (0:18)
3. What advice would you give to a patient who is in danger of losing a limb to PAD? (0:39)
4. What is PAD and how does it present? (1:54)
5. What are the risk factors for PAD? (3:28)
6. How is PAD diagnosed? (3:50)
7. Which patients are the most challenging to treat? (5:03)
8. Describe when an open surgery or minimally invasive procedure might be recommended. (7:25)
9. Describe the surgery. (8:43)
10. What can patients expect after surgery? (9:24)
11. Why should someone seek treatment at Johns Hopkins? (10:29) - วิทยาศาสตร์และเทคโนโลยี
Thank you Dr Reifsnyder, you are the Superman that saved my mother’s leg in Pittsburgh in 1993. Along with your sidekicks, Mike and Ike. You are awesome!
I had blood clots in my foot 2 different times and had angioplasty 5 or 6 times and a stent put in. I had lost part of my big toe. I started having severe pain in my thigh so I went to the ER and found out the stent had failed. The Dr came in and told me I was going to lose my leg at the knee and they were going to do it the next day. Hearing that news was devastating but what choice did I have. Anyway the next day the Dr came to see me before the surgery and gave me the best news ever. He couldn't explain it but I wasn't going to lose my leg. They did bypass surgery and I ended up losing the tip of my second toe. Way better than my leg. I'm 15 months post op and still have discomfort in my thigh but everyday I thank God for saving my leg. The Drs too.
Just had my femoral to femoral bypass. Instant results. Forget my feet could be pink and warm. I can walk again 🤩
Diagnoses led to 4 Stents(No Episode)...Drinking and Smoking for 30 yrs...QUIT COLD TURKEY ...Changed diet 180 and Exercising again! Walking 2 miles a day and Working out again.
I am 47.
dan skroko wow!
So happy for u! God bless!
dan skroko what did u change ur diet to? What do u eat presently?
@@eugenierunner7988 I eat mostly Fruit in the Morning....Whole Foods. Not the Store but a Mindset Rather. No/Little Processed Foods. Think Shopping the Perimeter of the Supermarket...Fruits/Veg....Dairy....Meats....Bakery and Deli are a No -No. i quit Eating White Carbs. Whole Wheat Bread is better. Also what People do not Realize is the Benefits of Soup made with Bones and Chicken feet for Collagen. Beef Shank Soup. Cabbage Soup with V-8. Nose to Tail Eating would be Ideal but i get Powdered Beef Organs in a Pill.(online) Hope this Helps. I am Eating Forementioned Chicken Soup Right Now. But the Bad News is that now i have stage 4 Throat Cancer from all the Smoking. 6 Weeks of Rad and Chemo were a Breeze. Feeding Tube is Pissing me Off though. But I am doing Great. Have a Good Day Bud.
@@danskroko3537 Thank you for sharing your story. I just got done with my second round of stents in a years time a month ago. If that makes since, in a year I have had 2 surgery’s. The first surgery I built up scare tissue around the stent so this surgery they had to remove that which caused me to have nerve damage in my leg. After a Month I still haven’t had any feeling in my leg but I still have severe sharp pains. So tried of all of this because I am at old at all. So sorry to hear of your cancer. I will be praying for your speedy recovery 🙏🏼❤️🙏🏼
As a non-smoker non-drinker non-diabetic active 83 yr old man had tingling toes told arthritis of the toes....Pain got worse in the Calves went to family physician told to ice-pack and take Advil for pain....Finally calve pain got worse went to ER was admitted fast had angioplasty, the artery burst clots escaped so same day another operation stent...waited 2 weeks for blood flow back to toes but told not enough pulse going to the toes so 2 weeks later had to have my 5 toes and part of right foot amputated....So I would say some doctors just are not qualified enough to diagnose this disease as I had complained to my Doctor for over nearly 3 yrs but he never once examined me for a pulse on my foot till it was too late. Wish I seen your video a few years ago, then I would not have waited so long.....but we believed our family doctor just arthritis of the toes.....and never once questioned him so we just took it as old age like most of us Seniors get from most Doctors......
Going through this right now, hence the youtube search. Dr. Reifsnyder has such a calming voice and manner, he has put me instantly more at ease!!!!!. Thank you Dr. R. : )
Some one give me advice or help me i dont wanna die young please someone help me
Im only 18
@@deshawnreding9575 have you seen vascular dr yet? N what r the problems you having now ? I'm not a nurse but some who lived with this four yrs. What I can tell you this never goes away. It can get worse. . Find a vascular dr asap n see what are the idea for you. Good luck . I'm. I Texas if you wanted to know
This is an excellent and very informative video. Thank you so much, Dr. Reifsnyder.
Wow ... what a story to live with! Happy for you!
Thank you Dr. Reifsnyder, for the very informative video on this condition. My husband suffers from P.A.D., as well as diabetes and has already had several procedures to help the P.A.D., but your clear and concise video has helped us better understand his condition, along with his options, so thank you so much.
I have the same. I'm diabetic and 5 years I got quintuple bypass. All my toes on both feet are amputated, plus I had 2 bypass on both legs, and my eye doctor is trying to get my vision back because I lost 90 percent of my vision in my left eye. Speedy recovery to all of us 🙏🙏🙏
God bless you Dr for helping patients.Really appreciate.thanks.
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Brilliant and eloquently explained 🙏🏻
Wow. Thank you for this video. My son ask me to take a look because of his diagnosis. This is eye opening and now we can ask better questions.
Very important explanation of PAD
This Gets Attention. Thanks Doc.
THANKYOU! for posting. this helped me with my search for a doctor who does venious surgery.....the rest wanted to amputate my Dads leg. Dr Izzo and AlKiere in Tampa are the Greatest!!! and did a bypass in my dads leg at Tampa general. goes to show you there are some shoemakers out there mascarading as doctors and others that are Medical geniouses. Im forever graetful to Dr Izzo and the team he put together to take care of my 79 year old father..
Nothing better than free bees!
main office is on the property of tampa general hosp .
Just read your message in its entirty. just punch his name up and youll find him. unfortunatly the update is my Dad had passed his leg had become infected by the shitass doings of another doctor and he got sepsis God rest his soul he was a good man. however Izzo did the best he could and his operation worked out. he has several offices and he is also a thorasic surgeon as well. they had all said for my dad to get his leg amputated and thats what we were trying to avoid and it was his wishes as well to fight on to save his leg. he was 79 when he passed. good luck to you.
Nicely explained Doctor 👍
As a person who lived with pad for yrs n have had a few op. During this time I can say this never gets better. You will have problems from time to time. But with the right vascular dr you should be OK. Me I've got a generic history totals n heart problems . Solar heart doing we'll
Is there a possibility for revasculazation if the blockage or microvascular disease is in the foot? I'm trying very hard to avoid amputation but they seem to think there's absolutely no other way to fix this issue
I’m 64, had claudication in both my legs and also in the arches of my feet. Had testing, then the “roto-drill” procedure in each leg, weeks apart. Additionally, the artery to my left kidney was blocked. The pulse of my left foot wasn’t strong, & was still having pain in the left foot. So I then had a balloon angioplasty in the left leg the same day a stent was put in near my kidney. I’m not diabetic, though somewhat sedentary (Ok, I’m a potato…). Intend to start a walking program soon though in order to be a better potato…maybe a French fry!
I'd avoid leg amputation by death if need be. Honestly, death is preferable to amputation for me. That might not apply to everyone, but for my character/personality it applies 100%
100%. Quality over quantity.
Do not resuscitate. Do not amputate.
Yeah sure , Pray and appropriate the blood of Lord Jesus Christ 🙏 and Be healed , He really heals.
@@goldagraceline6633 I'm not interested in your cult. Keep your religion to yourself.
Admittedly my father was already 86 y.o. when he had the leg bypass. It didn't take and as a result he started to develop gangrene. They gave us a few days to decide what we wanted to do. As for myself, I suggested to my father to let his life go in a hospital so they could make it as painless as possible. Besides being diabetic for about 25 years, he was already showing signs of dementia (not alzheimer's). My mother voted against me and later explained she couldn't have it on her conscience. Well my father had to have his leg above the knee amputated. I thought doing this to such an old man was immoral. He lived 3 more years, barely able to get around, watching daytime television with my mother. Consider well before having a bypass.
I Chose Stents and NO By-pass ...at the Recommendation of my Doctor. Through Intense Walking and Pushing my Leg...I Developed Angio-genesis (Arteries/Veins that Grow back like a Freakin Lizard can Regenerate. My Doctor said that He Read about but Never Seen until ME!
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thank you I have pad and at 73 worried about what might happen only sugestion so far is amputation
Can John Hopkins treat severe toe gangrene caused by prolonged frostbite in the absence of both diabetes and PAD and without amputations?
I just had femoral endarterectomy and iliac bilateral stents done 2 weeks ago. I couldn't walk far at all before the pain in my hip and thigh would cause me to limp and stop walking.
Wishing you well 😍
@@blang8127 thank you so much
I e have had 3 different op with my pad n almost lost my left leg due to my toes lacking blood flow . I'm happy to say still have both legs check each year .. so far so good. This will never go away . Have a vascular dr to due with this. Oh I'm pre diabetic also n now retired
Help. My father is suffering from pain in the calves. He kept screaming saying that he could not take the pain any longer. I feel helpless because here in the Philippines, the cost of laboratories and checkup are expensive and we could not afford it. :(
simple question to you as a person with pad myself why did you wait so long to have anything done? ive have had 2 different bypass done on me first one didn't hold up. by this past july had a artiobiefermoral bypass done. and now I can walk and most importantly I still have my right foot and I get 2 go back to work.
How do you feel now that it is 7 years since your post? Thanks for any info
@@dwood2342 well back. In 2019 had another op due to my left toes turning black m red due to lost blood flow. My Dr told me if the op didn't work than the next question would have been how high of a leg lost? Thankfully the op worked n still have both legs working ok . I have a yearly check up on my legs m so far so good. ... I happy. To say.
Thank you for. Asking
@@angelathompson2171 I am glad you are doing well
when your 92 yrold what are the possible approaches. my father is 92. bed ridden for 3 years develope left foot wound in the heel and on top of the foot. wound doctor is working on him for 2 months this time it got infected. they wounds are bad he is under anti biotic . I am upset with the doctor and taking him for ER hospital, I will not be surprise the eR doctors will be shock to see his large open wound the questions I have are there any treatment that can save him his left foot mind you he has been bedriden because he has joint dieseas he is 100 immobility what are his treatment, can he sustain an operation ect ect at 92?
Sometimes I cannot get warmth to my feet all my legs receive ..is surging pain and icey coldness ..and my toes are so stiff they feel ready to snap off.
Other times ...especially if walking for half an hour and I have socks and trainers on..
I will struggle to breathe due to my usual COPD ... Then my limbs follow suit by cramping up with shooting pain in the feet, the shins and reaching the thighs ..
They begin to burn with heat and swell at the ankles ..
I stop walking ...and continue after just a few yards each time ..consistently.
And once home again the pain , no matter if I'm resting stays with me. More so in bed and hang my legs down over the bed .
It takes approx three days for the pain to subside a little.
Sleep is a no no, I don't grow hair on my legs any more and they are extremely shiny ..and cracked dry skin.
I'm going to see a vascular consultant very soon.. as my own doctor suggested it was P.A.D
This has been with me for over several years ..I'm 58 ..but it's only when it got so bad even in rest that I decided to visit my doctor..
I do get scared than my limbs might go gangrene .
Already I've got sores that don't heal ..and if they do .they leave behind sensitive red scarring..
Dealing with breathing problems and this .. helped me to give up smoking 🚭 once and for all..but so far it hasn't helped .
I have weakness in both my arms n cramps throughout my whole body n parts that cramp severly n hurt badly... I am severly weak in whole all body parts
I have chronic leg ischemia, I went into Kaiser emergency on 09/27/2020 spent 1 1/2 weeks in Kaiser, they did 3 surgeries without removing the blockage, they have me on Lipitor, 2 blood thinners and gabapentin, the Dr. thinks that if the pain doesn't get better they may have to amputate, I am looking for a second opinion
Always get another dr idea especially a vascular dr . I've had have 3 opsince 2013 n still have both legs.dont wait
Thank you Im 27 but the other day was so cold that now one of my legs is feeling numb and tingly even tho I work out but anyways just hope is nothing serious I made me an appoinment for monday at a local hospital since my leg keeps feeling cold
I have a leg ulcer and have all the symptoms of P.A.D. I've had the ulcer for 20 years and they can't use a pressure bandage because it cuts off the circulation. I then broke my toe on the same leg and I can't wiggle my toes anymore. I've started to get achs in the buttocks and groin on the bad leg I'm now finding it to be like running a marathon just walking a few hundred meters. My GP said to have an x ray on my upper leg i think I should just go to the hospital and take it from there.
Can you please tell me if you can recover from this after having my lower leg removed?
Why won't they do angioplasty?
@@gregorymalchuk272 Im going to ask for one....
What is the cost of this procedure?
My mother has a blockage at the top of the left leg and 2 further down in the calf.
She has a left heel ulcer which has not repaired in the last 5 months after a fall..we had the leg scanned a month ago.She is 82 years of age.
Thankyou
Hi, for specific questions please call 855-695-4872. Please note, many of our offices are reaching out to patients to reschedule appointments as video visits; this will depend on visit type and currently, these are only available for existing patients. Please call the above number to learn more about what options may be available for your specific situation. You can see more on our patient and visitor guidelines at www.hopkinsmedicine.org/coronavirus/index.html#patient-visitor-alerts
Would giving them a artificial heart in the region of the blockage cure this from pushing blood better then one heart did
I assume a artificial heart can be put anywhere there is a artery and a vein
p sure that's not how that works
I need urgent help! Is it possible to avoid amputation if the leg has gotten numb and blue and the scan shows almost a complete arterial occlusion. The doctor suggested amputation at the femur ( it’s still just a suggestion not smth certain ). The patient is my grandmother who is 82 years old and is very sick and weak having a lot of other severe conditions such as high blood pressure, very bad blood vessels, and atrial fibrillation. She is bedridden, hardly eats anything, complains of extreme weakness and pain everywhere especially her legs. We are afraid she simply won’t survive the general anaesthesia and if she does she won’t ever heal and will die suffering. But if not this surgery then what else, we cannot watch her slowly die from sepsis and gangrene. She has been admitted to the hospital and is currently receiving blood thinners, glucose and pain meds iv, since we live in a small town there is really no other hospital with this type of specialisation. We don’t understand what to do and if it’s possible to find an alternative to this operation considering her many health issues, age and the current degree of thrombosis.
Hi. I am so sorry to hear about your grandmother. Creator Almighty guide this family to the right direction. Don't let them suffer. Amen
If I was her I would do the surgery. She could regain most or all of the function of her legs after angioplasty. Any update on her condition?
MY
DAD has arterial ulcer, what can i do for him, i'm upset, it's not healing properly and they're saying they will have to amputate it later on? which is 50/50 % chance risk factor
Hi, thank you for reaching out to us. We’re very sorry to hear about what you’re going through. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication.
If you would like to request an appointment at one of our hospitals, please call 888-872-1408. Our specially trained medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins USA can also provide language interpretation, financial counseling, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.
Did they do surgery to reopen the arteries?
Is there anyway to contact him, my grandfather is suffering from a really bad case of it. His foot is literally rotting. Someone please tell me how to contact him
Google his name
My feet become cold l m using trental tablet and petaal tab is it cure for pad no pain in legs ect
My father having PVD and the legs are blacked so doctors says ambute the leg. Plz reply sir have any other treatment to avoid ambutation
Why wait so long with pvd? Me I've almost lost a leg to lack of blood flow but got very luckie .. just saw this
How he doing now? Me history of genetic vascular and heart. .. me understanding that
learned a lot I have a partialy blocked artery in my left leg had a lot of pain and scan revealed a boccked artery shortly there after ulcers developed say a vascular dr who scanned and said your still gettting blood has his nurse dress ulcers which I still have but mostly healed say orthopedic dr when I asked what happens if artery gets completely blocked he responded we amputate your leg
Can an injury to ankles cause it?Glass hit my artery and cut it.They perform surgery . .It healed now standing to long at work after 3 hours feet start to hurt.
what can i do dr? i'm so upset
I live in Quebec CANADA
I have the best and top notch Vascular Surgeon in all CANADA
Why would I get a second option when I have the Best of THE BEST
I had a stent and a by-pass in one leg
I had a triple heart by-pass
I have a (shockbox) defibrillator installed in my chest
I am a diabetic
just had the bottom of my heel removed I am on a VAC-therapy
I cannot use my right leg at all cannot place my foot on the floor at all ( such fun )
I have a fracture on the same foot that cannot be fixed - I have to wait for the VAC to be removed
and only then they can screw my fracture together.
The pain is just bloody amazing
And on top of this all
I am unemployed
I am a single father raising a young special needs child *alone*
I need Gods help so much
May Abba Father Bless you with health in Jesus's Name
God is faithful, he will help you just continue to trust him, there is nothing he can not fix. I pray for his mercy and divine visitation upon your life and child in Jesus name amen
Dr i even get severe cramos in my fingers n stomache n neck also
Hi, thank you for reaching out to us. We’re very sorry to hear about what you’re going through. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication.
If you would like to request an appointment at one of our hospitals, please call 888-872-1408. Our specially trained medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins USA can also provide language interpretation, financial counseling, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.
calves and feet and small vessel disease extreme pain and my doctors dont treat me with anything im in extreme pain all the time and they just stopped giving me my tramadol which will cause life to be unbearable .
My mom has the same issue, but they do give her opiods for pain. Her foot loss function and the ankle and calf are painful.
See a vascular surgeon...
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I'm Australian and have been suffering from PAD for about 5 years and continue getting worse. Severe numbness and cramping however Drs here just don't make an effort to fix the problem they would wait until amputation. In the state of NSW over 5000 amputations every year. Seems as though the Drs here would rather take the legs that fix the problem.. I take 4000 mg of magnesium and 2400 mg vitamin D daily which does give me a little bit of relief but I do still suffer chronic cramping and severe pain so without a doubt my legs will be gone within 2 years. Drs here in Australia need to get their heads out of the sand and have USA Drs educate our surgeons and help sufferers of PAD I'm 58 years old with diabetes.
@CosmicDamian Some one give me advice or help me i dont wanna die young please someone help me
@CosmicDamianim only 18
older be great for a update
Sir my father having PVD am totally upset. Doctors says ambute the leg
I was told the same thing But, when they went in they saved my leg. Thank God !! I had no warning I thought my leg fell asleep an ended up in .emergency surgery with in 2 hours. I watched my leg turn white an the underside blue. Going into the ER I was very fortunate I had an amazingly skilled vascular surgeon on call,I was very fortunate I pray your father has all the right people at the right place at the right time..
@@lollieb9284 thank u sir for your prayer
Can you please help my Mother before it’s too late
I have very bad pain inside my groin area and it’s been 3 years . I’m 28 year old women . I need help because I’ve been mentioning that to my dr. And they just don’t know what’s causing it and I think it’s PAD !! I don’t smoke .
Have you seen a vascular surgeon? I'm in my 30s and have had bad leg pains for 3 months. I dont smoke, not overweight.
I was just diagnosed with PAD. I have had blood clots in my leg in the past but now they want to do a bypass. How long would I be down if the do a bypass?
I had two bypasses in my legs. Fem-pop grafts. 3 days in hospital, about two weeks before I could work at all. Progress every few days leading up to working full time in about 4 weeks, maybe shorter. Still numbness after 2 months. 3 -4 months till fullest recovery possible. If neurapathy is in leg or foot, you may not get back to full normal. I have been biking up to 15 miles at a time and walking up to 3 miles. It is a pleasure to be able to walk again without leg pain.
@@BobHagel I just got my bypass done they harvested a vein from my right leg and used it to by pass blockages on my left. I'm still in the hospital recovering but I dont think it will be as smooth as yours. I've been in the hospital now for 12 days.
@@workaholic2022 Hi Terry. I hope you are doing well. Both my bypass surgeries were performed with artificial grafts as I had quadruple heart bypass last year and they used my entire right leg vein. My surgeon did not want to take my left leg vein as I might need it in the future. My second leg bypass (right leg) was suppose to be easier then the first as the left leg done first had the most nerve damage. However, it did not go that way. My right leg had bleeding issues and it took 3 trips to the surgeon afterwards to remove all the staples and stitches. I found walking around the house after about 4 or 5 days (without over doing it) helped recovery a lot. It might only be 10 or 20 steps at a time but it keeps the blood flowing. Just focus on the moment and take one day at a time. Life is much better now and it was worth the down time. Get well!
Bone marrow concentrate can re-grow collateral vessels
My father in law is been told to cut the leg due to blocked arteries. Please suggest. He is having diabetes and BP. He is 79 years old. Can this be cured?
Hi, Please reach out to inquire about a new appointment by calling 855-695-4872. Please note, many of our offices are reaching out to patients to reschedule appointments as video visits; this will depend on visit type and currently, these are only available for existing patients. Please call the above number to learn more about what options may be available for your specific situation. You can see more on our patient and visitor guidelines at www.hopkinsmedicine.org/coronavirus/index.html#patient-visitor-alerts
Does he have a vascular dr which deal with this?? I've come near of losing a leg back in 2019 but got very luckie. Still have both n doing ok... been dealing with pad or pvd for yrs now.
Oh im in .but still alive with both legs to mydr here
@@angelathompson2171 How did you hack it ? My dad's leg is to be amputated but family against it
Dr tell gangrene toe treatment plz..
Amputation is so old school we in 2023 surely pigs veins will do. Ok most ppl make bad choices but medical advancements should be better. What if a stent gets blocked? Down road 10 yrs Curious
DRAPPER FRAPPER ROULER TANBOU WOUAT POU GRANDPERE WE NEED MASSACTES
Im only 18 with this im goin To die early i didnt even get to do everything i wanted to 😔
How are you doing now
Wow you're very young to have this. How are you doing?
Hi @deshawnreding9575 how are you now? I am 28 years old experiencing extreme pain in my left leg up till my lower back, when I move or lie down it pains a lot, I want to know how are you and everything? Please reply
I’m only 14😔
It would be nice if you actually practiced what you’re sharing here.
WHAT WE NEED = NOUS BESOIN NASAR FORMATION
My husband has this... and I don't care... I need him up and working at any cost really because I'm a bitch....
nice attempt at trolling you stupid airhead with your fake account
we need a stationary bike with a motor on the bike so the motor exercises the leg in the place of the person before they say amputation , this amputating is barbaric , they are not doing medical services, they are doing experiments on people, we should be allowed to sue