469720?1388149949
Lee Kirksey, MD  
Male
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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PAD Awareness Month

Oct 05, 2008 - 5 comments
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I encourage everyone to make sure that you observe PAD awareness Month by encouraging those around you over the age of 50 to have their ABI (Ankle Brachial Index) checked. The Ankle Brachial Index is a comparison of the blood pressure at the ankle to the blood pressure at the elbow. Its very simple and anyone that is capable of measuring a regular blood pressure can perform the test, it does not necessarily require a medical professional. Lets do a sample calculation:

Mrs Smith has an ankle blood pressure of 60/20. Her brachial (elbow) pressure measures 120/80.
60 divided by 120 = .50 . Mrs Smith's ABI is .50. The Normal ABI is>1.0, mild decrease .9-.75, moderate decrease .74-.50, severe decrease <.49

At least one in fifteen people over the age of 55 have PAD which can lead to stroke, limb loss and heart attack.
Importantly more than have the people that are affected have no symptoms for various reasons including the presence of diabetes and limited activity.

Early diagnosis can permit effective treatment.

For more information, visit www.beatpad.org

Comments
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by alagirl, Oct 10, 2008
How important are diabetes and obesity in terms of the risk factors for PAD?  I have a friend with horrible leg and foot pain and she DOES have recently diagnosed neuropathy, but in spite of her diabetes and obesity nobody has checked for PAD.  I have read studies saying that both atherosclerosis and pad are thought to be worsened by diabetes.  What type of .doctor is best at evaluating for PAD?  I am wanting to help her get set up to see someone to have this evaluated.

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by booluvschoco, Oct 12, 2008
Hi Doc, can I ask a question about my brain avm,I had radiation for it this past january,gamma knife, my avm is on my left parietal lobe and is 33mm in size, Ive never had a bleed or the mri says I never have,this past month ive been seeing what looks like sparks  while im looking or watching tv,,on the corner of my eye,it comes and goes,the doc sent me in for an mra and ill have to wait till the 23 rd of this month for the results,can I still get a bleed ,even after radiation is done,plus,one more thing,,sounds crazy but I always hear a heartbeat sound in my head,,all the time,,seems when im straining or have a headache or even just waking up from sleep,theres that sound I hear in my head,,whats up with that? is it shunting of the vessels making that sound,,my mra still shows many very large vessels ,not all gone,,could that be causeing the sounds,it worries me,not to mention the sharp pains I get on top and on the side where the avm is,sometimes it lasts all day..its hard to get answers and im just worried,,what do you make of all of this? thank you for your time and sorry for so many questions,im just not getting answers. Caroline

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by Lee Kirksey, MDBlank, Oct 14, 2008
diabetes and obesity are two of the most important risk factors. At the very least, a person with these medical conditions should have an ABI to determine if the also have arterial blockages. Neuropathy and arterial blockages frequently occur together

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by stenosis_31, Oct 20, 2008
I've been having trouble when walking-my ankles and my calves just ache after walking about 15 min.  It goes away quite soon after I stop walking but, I could bearly finish my walk if I didn't stop.  I had my abi index checked and my right side was 120 arm 124 ankle and left side 110 arm, 110 ankle.  Is this ok or do I have the beginning of this?  I wouldn't even wonder but, I have mod/sev aortic sten, mild regurg and my aorta is dialated.

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by ZeeIn, Aug 30, 2009
I'm confused.  My ankle blood pressures seem rather high, not low as you stated Mrs Smith's is, yet she has problems.  Based on your algorithm, my legs are just fine - 1.69 and 1.48.

Systolic/Diastolic - Pulse
186/129 - 80  = Left Ankle
163/116 - 83  = Right Ankle
110/81 - 87    = Left Arm

I also read how to get Pulse Pressure regarding what is normal and not. Apparently the more spread out the Systolic and Diastolic readings are, the greater the Pulse Pressure and the higher risk of problems.  So yesterday I measured my BP and Pulse and according to that algorithm, once again it is fine.  

108/91 - 106
105/87 - 121

Since I know I have Heart disease and several other health related issues, I'm just wondering if these algorithms are really all that accurate for the general public.  Just curious.  

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