November 2007
Understand this: Stumbling through your day utterly exhausted is anything but normal. And if after a full night of sleep you’re quick to blame that lingering tiredness on the extra cup of Maxwell House or the chocolate bar that you ate before bedtime, well, STOP.
Truth is, you can consider yourself lucky if your less-than-stellar sleep can be solved by some tweaks to your diet.
That’s because foggy days stacked end to end are among the most telling signs of a deadly condition that can increase your risks of a heart attack, a stroke, high blood pressure, and for a few––even sudden death due to respiratory failure. It’s called sleep apnea. And if you’re one of the estimated 10 million folks in this country who have unrecognized sleep apnea, you’re going to need more than just an ounce of luck to get it diagnosed.
Why a sleep-disorder diagnosis is so elusive
And therein lies the problem, as most time-constricted doctors take a narrow view of sleep. They figure that either you’re sleeping or you’re not. And if you’re not, they’re sure you’ll ask for a pill to help you along—just like the commercials tell you to do. (Somewhere along the way, some docs seem to have given up their capacity to prescribe and are leaving it up to the drug companies.) They can then write you a script and wash their hands of it.
I’ve written before about “complicated” medical conditions being given short shrift because it’s just too time-consuming for mainstream doctors to try to figure them out. You can count sleep disorders as being among those mainstream quagmires.
Consider this: Most doctors aren’t going to ask you any questions that have the potential of opening the medical equivalent of a can of worms. They fear getting bogged down in something that won’t fit in the seven-minute-per-patient paradigm the insurance companies have foisted on them.
In my practice, I’ve been on more difficult “fishing” expeditions than sleep apnea. In fact, one of the first things I ask my patients is “How have you been sleeping, and do you feel rested when you wake up?” You’d be surprised by how many of them say, “Oh, yes, I forgot to mention that.” Please, mention it.
And you need to know the facts—because the longer you go untreated, the more serious your problem becomes. When you aren’t breathing, your brain is being deprived of oxygen—and that’s where the damage begins.
Navigating a swamp of symptoms
The clock shows you slept eight hours, but you feel like you’ve been run over by a truck. And that’s just one clue that can signal sleep apnea. In my practice, scarcely a week goes by that I don’t see at least one new patient with previously undiagnosed obstructive sleep apnea (OSA for short, sometimes called obstructive sleep apnea/hypopnea syndrome, or OSAHS).
The stories I hear are remarkably similar. One of my patients recently came in to have his blood pressure checked. During the exam, I asked him how he felt, and he said: “Fine, though a little worn out every day.” I dug a little deeper and asked how he was sleeping, and his reply was: “I just don’t feel really rested when I wake up in the morning.” I pushed a little more before he confided a little sheepishly, “My wife says I snore loudly, and to tell you the truth, sometimes it wakes me up, it’s so loud!”
Does that sound like you? If so, there’s a 20 percent chance that you suffer from this energy-draining disorder. And your snoring is nothing to be embarrassed about—it’s a clue. With sleep apnea, your snores indicate you’re literally gasping for breath—and for precious oxygen to feed your body.
OSA is defined as pauses during sleep that last a minimum of 10 seconds and are repeated at least five times an hour. Often, this cycle will repeat up to 400 times in a night. There are physiological markers of sleep apnea, such as brain changes measurable by EEG and temporary drops in oxygen uptake through the lungs and into your blood, called “desaturations.”
This is the most common form of sleep apnea, due to a physical blockage of air caused by a temporary collapse of the soft tissue at the back of your throat, despite the physical effort to breathe your body is making. A rarer form is called central sleep apnea, which is an absence of that normal breathing effort as a result of brain changes. You can also experience sleep apnea due to your having an advanced disease state like congestive heart failure or any of a small number of rare genetic disorders.
With patients who come to me complaining of excessive tiredness despite reporting they sleep a full eight hours, I always take a second look at them—literally. One of the first clues can be how a patient is built. It’s one of those factors I was telling you about that—at least in part—you have very little control over. These particular patients are often overweight, but even more important, they usually have a large neck and a stocky torso. Also, I’ll look for larger-than-normal tonsils and adenoids that are visible in the back of their mouth (called “oral crowding”). Other risk factors I’ll consider include family history, smo- king and whether or not the patient is keeping irregular sleep hours.
These are all just possible symptoms and clues for sleep apnea, because not everyone with OSA is overweight and has what would be considered a large neck. But as a doctor, I insist on taking the time to look for these things.
(I only wish more mainstream doctors would stage an inner-office revolt against “the system” and do the same.) In any event, these physical characteristics are also mechanical—which leads to the increased risk of airway blockage.
If you’re a man, you’re generally more at risk for sleep apnea. And ladies, your risk becomes equal once you hit menopause. Remember how I mentioned your sex life being disrupted? A study was just released last year about this. Researchers evaluated the sexual function of 25 women with sleep apnea, and the results showed that the more severe a woman’s sleep apnea was the greater her decrease in sexual function became. Previous studies had already shown this same link for men. This is as healthy a reason as any to have your sleep apnea diagnosed and treated.
Your sleep apnea could also be just a temporary condition, brought on by an excess amount of alcohol, nasal congestion, or even throat swelling due to mononucleosis brought on by the Epstein-Barr virus. Sometimes all it takes to cure sleep apnea is simply drying out, which reminds me of another patient I recently saw—a 50-year-old guy with chronic allergy-related nasal stuffiness. (And I see plenty of women with the same symptoms, too.) He’s five feet eight inches tall, weighs 210 pounds, and has been told by his wife that he snores and stops breathing at night. He’s getting a home evaluation for sleep apnea (more about that later), but I’m also working on clearing up his stuffy nose once and for all.
That covers the more obvious symptoms, but there are a slew of others that mimic a wide range of other conditions. These can include morning headaches, forgetfulness, mood changes, irritability, anxiety, and heavy night sweats—and that’s just for starters. These could be red flags for anything from depression to a sluggish thyroid or even another sleep disorder, such as insomnia. Does this give you an idea as to why most doctors don’t want to touch these with a 10-foot pole?
And here’s a kicker for you: Folks who suffer from sleep apnea generally suffer from low mood. The sleep apnea goes undiagnosed, but I’ll be a monkey’s uncle if they aren’t slapped with an antidepressant! That’s what I call a misdiagnosis if ever there was one. But unfortunately, depression pills are now being handed out like Pez candy. This only serves to mask the fact that in a lot of cases depression is truly a symptom of something else entirely, such as, you guessed it—sleep apnea.
So let’s get you properly diagnosed and better yet, treated.
It’s a sleep disorder—not a life sentence
Various surgeries to remove tissue and open up the airway are sometimes reported, but these have mediocre track records and are seldom performed. Another treatment option that mild to moderate sleep apnea sometimes responds to is a mandibular advancement splint (MAS). It’s similar to a sports mouth guard, holding your lower jaw slightly down and forward. If you recall my stance on surgeries, it should come as no surprise that I have never used surgery, nor have I used the MAS mouth guard (a cumbersome apparatus that reportedly doesn’t even work that well), with patients.
A less-invasive, commonly used diagnostic tool that measures your level of daytime sleepiness is the Epworth Sleepiness Scale. It ranks your likelihood of dozing off in a few situations, such as sitting and reading, watching TV, and lying down in the afternoon. The lowest chance of your dozing off is rated a 0 and ranges up to a 3 to indicate a very likely chance of your doing so. If your score on this diagnostic scale totals a 9 or more, you need to have a more in-depth evaluation, and I would recommend a sleep study. (See www.umm.edu/sleep/epworth_sleep.html.)
Sleep studies have evolved—and for the better. For example, consider my neck of the woods. Patients previously had to spend the night in our local sleep lab for a study that cost over $3,000, usually paid for by insurance. Recently, our local respiratory-care company started using an evaluation tool called Apnea Link.
They’ll come into your home and set it up for you, saving you the time and trouble (and the possibility that insurance won’t cover the cost) of an overnight sleep study. Even better, it’s just as accurate.
The chief treatment in the vast majority of cases is, I’m happy to say, not a drug. It’s actually a machine, designed for home use, that supplies a continuous flow of air. This helps hold open your airway while you sleep. The treatment is called positive airway pressure (PAP), and the most common form that is used is continuous positive airway pressure (CPAP). It’s usually administered through a small nasal mask at night.
Now, I can hear you saying, “A mask? Not for me!” But hear me out. Sure, there are a few people who never get used to the mask. But in my experience with hundreds of patients, I’ve found that almost everybody quickly adjusts to it and usually finds the gentle whooshing sound to be pleasantly soothing. More to the point, when folks notice how much better they feel in the morning—after their first good night of sleep in years—they’re absolutely sold.
While a CPAP is usually all that’s needed, it’s sometimes necessary to have a machine that varies the pressure, BIPAP and APAP, providing more when the patient inhales and less when he exhales.
Besides having a sleep study done, there are other things you can do to reduce the severity of your sleep apnea. If you smoke, stop now—for this reason and a hundred other good ones. Also, cut back on or avoid entirely alcohol, opiates, tranquilizers, muscle relaxants, and sleeping pills. You heard me correctly—those pills aren’t going to help resolve your sleep apnea. And losing body weight helps as well. Folks who are considered morbidly obese that lose 50 to 100 pounds or more have been known to cure the problem entirely. A good, all-around resource is the American Sleep Apnea Association, www.sleepapnea.org.
There’s also a breathing technique that is used to treat sleep apnea. Called the Buteyko method, it’s named for the Russian doctor who devised it: Konstantin Buteyko. It’s a series of breathing exercises that focus on breathing through the nose, relaxation, and holding one’s breath. The idea is to retrain the breath to the point that it’s again considered normal. Originally intended to treat asthma, it has become a risk-free, time-honored therapy for all kinds of breathing problems. This naturally makes it a target for mainstream doctors, who dismiss the method, saying there are no large conclusive studies proving its efficacy. Also, because they don’t understand how it works, they don’t want anything to do with it. If this isn’t a case of hypocritical resetting of the goal posts to suit a prejudice, I don’t know what is. I can’t justify their ignorance as being a valid reason to dismiss a safe, cheap, side-effect-free remedy in favor of a drug-fiesta-jamboree mentality that still characterizes too much of mainstream medicine.
You can learn more about the Buteyko method at www.buteyko.com. The great thing about developing a daily breathing practice is the general health benefits it confers for everyone (with sleep disorders or not). It’s especially beneficial for stress reduction, which in turn will help lower your risk of a long list of common, chronic diseases.
At any given point in time, 70 to 80 percent of all people are affected by lower back pain (LBP). It’s one of the most common problems I encounter in my practice and can be quite a challenge to treat. It also comes with a hefty price tag: Annual treatment is $60 billion. Complementary and alternative medicine (CAM) is used for LBP more than for any other problem.
LBP is classified as acute (less than six weeks in duration), subacute (six to 12 weeks) and chronic (more than 12 weeks). If your back pain is new, you need to find out if your pain is caused by an underlying medical problem. I don’t mean to scare you, but the new onset of sudden back pain can potentially indicate a spinal tumor, infection, a fracture, nerve damage, osteoporosis or kidney disease. Hence, my sense of urgency. See your doctor.
Also, if your pain is worse while sitting but better when leaning forward, if it’s accompanied by bowel or bladder incontinence, or if you’re experiencing new leg, ankle or foot weakness or difficulty walking, have a doctor evaluate you. The same applies for any recent weight loss, a fever or swollen lymph glands along with that back pain.
All too often patients with LBP end up with a surgeon who recommends surgery. There are plenty of responsible, conservative surgeons, but also too many of the other kind. I am strongly opposed to the overuse of surgery by irresponsible, knife-happy back-surgery cowboys. They’ve been the source of suffering, dashed hopes and explosive costs to the health-care system. Forget about providing true benefits to patients! There’s even a common pain syndrome called “failed back syndrome.” Can you guess who gets it? Patients who had surgery—and still have back pain. Believe me, I’ve seen plenty of such cases, and it’s an outrage. Surgery is the method of last resort, such as when there’s dangerous pressure on the nerves that must be relieved.
Doctors will tell you that up to 90 percent of LBP cases will resolve on their own in three to four weeks —and they’re right. It’s the rate of recurrence that’s the problem—up to 75 percent of cases. Even when you work to resolve the underlying issue, whether it’s structural imbalance, weak trunk muscles, poor posture, emotional stress, or a combination of these, you still run the risk of more pain.
If you’re a smoker, I encourage you to quit. Smokers suffer more back pain. No surprise there, since smoking has a general pro-inflammatory effect. Thanks to reduced blood flow, it reduces nutrition to the spinal discs.
Although I don’t list it below, massage can almost always help to relieve back pain. It may be just the thing you need to calm an acute muscle strain. If you get massages on a more frequent basis and combine the therapy with oral or topical anti-inflammatories, you can help reeducate muscles back to a pain-free state.
An essential part of any back-health program is to start with weight loss and strengthen your core trunk muscles. Yoga, the Pilates Method, the MacKenzie exercises (see below), Gyrotonics and the Egoscue Method offer excellent strengthening moves. I used the Egoscue Method myself with notable success. But let me warn you, it’s a lot of work—20 minutes per day for a minimum of six months. Go to www.Egoscue.com to see if you’re fortunate enough to have a clinic near you.
Anti-inflammatory double play
Here’s a one-two punch for back pain: High-dose fish oil and Zyflamend, a very effective botanical anti-inflammatory that includes ginger, green tea, rosemary and curcumin. Sounds like a treatment cooked up in the kitchen—which is why it’s so effective. Dr. Joseph Maroon, team doctor for the Pittsburgh Steelers and a highly respected neurosurgeon, has treated hundreds of patients with back pain. He uses doses of fish oil ranging from 2 grams up to 5 grams of total EPA and DHA. For most cases of LBP I encounter, I add Zyflamend. The beauty of this approach is that it confers powerful, general health benefits that transcend the back pain itself, including mood support and decreased arthritis pain. Add to that protection against cancer, heart disease and dementia—and you’ve got yourself a winner.
A needle in the haystack of options
Using acupuncture for LBP is well supported by current medical evidence. The practice has only been around for a few thousand years––enough time to get it right. It may work best when combined with the whole system of Traditional Chinese Medicine, including herbs and dietary changes. Acupuncture is safe and involves minimal discomfort, if any. And infections caused by the needles are virtually nonexistent. Acupuncture has been the bulwark of treatment for quite a few of my patients with more severe, chronic LBP and sciatica. The key here is to not give up after just one or two treatments. You may have to continue weekly treatments for two to six months. Insurance may not cover it, but my patients find it worth the money—usually about $60 per session. Go to http://medicalacupuncture.org/findadoc/index.html to locate a doctor.
I have to hand it to them—it works for me
Good evidence supports the use of chiropractic spinal manipulation in both acute and chronic LBP. I do a lot of rowing and strength training for exercise, and use it myself a few times per year and have been happy with the results. Many athletes swear by it. I do feel a few comments are in order. First, it’s estimated that up to 29 percent of chiropractic care is unnecessary, with chiropractors continuing to provide unneeded care—and to collect insurance reimbursement. I’ve observed this myself. So if you’re getting nowhere after three or four sessions, consider finding a different treatment. To be fair, there’s at least as much unnecessary drug prescribing in mainstream medicine—also covered by insurance. A second point is that chiropractic doesn’t tend to directly address soft-tissue issues like muscle tightness, balance and strength. Good chiropractors will acknowledge this and will prescribe exercises as well.
This hands-on therapy beats off pain
Of all the possible hands-on therapies, I personally believe this one may be potentially the most useful. Yet, I find that most people have little idea what osteopathy is or where to obtain care. Doctors of Osteopathy (D.O.s) receive training similar in rigor and extent to that of conventional MDs. There’s greater emphasis placed on the interrelatedness of body functions and treating the whole person. Some of the best doctors I have worked with are D.O.s. They also receive training in various forms of soft-tissue manipulation, including two known as muscle energy and strain-counterstrain. When an osteopath evaluates back pain, he considers up to a dozen possible causes, while a conventional M.D. may have in mind no more than a handful. The result tends to be a more accurate diagnosis and targeted, successful treatment providing longer-lasting results. See if any of your friends or family have used one and can refer you. Otherwise, go to www.osteopathic.org. Look for the link that says “Local and Community Resources.”
Just a spoonful of sugar makes the pain go down
This involves an injection of a safe substance into a joint—usually sugar water or dextrose—that provokes a natural, short-term inflammatory reaction that is very healing. The back is supported by a fine network of ligaments that are easily injured. Prolotherapy helps strengthen, heal and stabilize injured ligaments and tendons, which helps to reduce or even banish pain. The practice has been around for over 50 years, and I can tell you from personal experience, it works.
Former U.S. Surgeon General Everett Koop, M.D., swears by it, having had his chronic, severe back pain cured by it years ago. It made him a believer, so he learned how to do prolotherapy himself and treated his family, friends and patients with it. I highly recommend it for difficult to treat, persistent cases. See www.getprolo.com for a list of practicing physicians.
Mr. MacKenzie offers relief
Robin MacKenzie, a noted physiotherapist from New Zealand, developed a highly evolved treatment that involves frequent exercise (two to three minutes every two hours). He believes the most common cause of back pain is poor posture, especially when sitting. His exercises have proved beneficial for both acute and chronic LBP. Many thousands of people around the world have benefited from his simple, elegant methods. In my experience, the main obstacle has been the unwillingness on the part of some folks to actually perform the exercises. Makes little sense to me if you’re looking for relief—as these exercises will provide it.
Call (800) 635-8380 to locate a trained practitioner near you. I also recommend his book, 7 Steps to a Pain-free Life.
Calming catalyst
There are certain enzymes that are catalysts for breaking down proteins in the body. They include bromelain, papain, trypsin and chemotrypsin. They can be helpful in calming back pain because of their anti-inflammatory activity. The best-known and studied product is a high-quality German one called Wobenzym (literally “good enzyme”). I have found it more useful as part of an overall treatment plan for chronic, recurrent back pain than as a sole treatment for acute back pain.
Running hot and cold
You can’t go wrong with ice—it’s one of nature’s best topical anti-inflammatories. Get an ice pack and apply it for 10 to 20 minutes, two to four times per day. (A pack of frozen peas or corn will work just as well.) You can also experiment with heat therapy—in the form of a heating pad or hot-water bottle, for example. Heat is especially good for calming muscle spasms, which are the body’s normal protective reaction against injured ligaments. There is some debate about whether or not heat actually provokes inflammation. I usually instruct people to experiment, and I find that most prefer either ice alone or alternating ice and heat.
Uber-painkiller
Phenylalanine is an amino acid and a building block of dopa-mine, an important brain chemical responsible for motivation, the ability to experience reward and general brain function. A synthetic form of it, DL-phenylalanine, may be especially useful for people suffering from both back pain and depression. This isn’t surprising, as the two conditions often go together—although it’s not always clear which is causing the other. DLPA may slow the breakdown of endorphins, the body’s own anti-pain “feel-good” chemicals. The Chicago Medical School did a study with mice and found that it blocked pain in 70 percent of them—and the painkilling effect grew stronger over time. Use 1,500 to 2,500 mg daily in divided doses on an empty stomach.
It may be in your head
Research shows that one of the primary underlying causes of back pain is psychological or emotional stress. Stress certainly worsens pain. I’ve observed this often in my own practice, especially when it comes to chronic back pain. Some folks’ lives are an unhappy emotional and social mess. These underlying psychosocial problems must be addressed in order to alleviate back pain. John Sarno, M.D., at New York University Medical School has developed a successful program that shifts attention to psychological pain. I recommend his book, Healing Back Pain: The Mind-Body Connection.
This is one honey of a remedy
Honey has been used by humans for food and as a healing remedy for thousands of years. According to the Bible, John the Baptist reportedly lived on wild honey and locusts. The Egyptians used it too—Cleopatra could have conceivably dressed the battle wounds of Mark Antony with this healing salve. It was also used to embalm the dead of the Syrians and Babylonians.
As you can see, honey is a whole lot more than a tea sweetener and a sore-throat soother. It can help heal your stomach ulcers. (Just think of a stomach ulcer as being a skin wound on the inside.) What a pleasant way to wean you off any of those acid-blocking drugs (such as Nexium, Prilosec and Prevacid) your doctor is so fond of prescribing.
The healing properties of honey extend beyond just flesh wounds and ulcers, however. It will also reduce allergy and hay fever symptoms. And if you combine it with another of my favorite remedies—apple cider vinegar—you’ll have a handy cold and respiratory-infection fighter.
Honey can even reduce pain from arthritis. A study was done with 200 patients at Copenhagen University to see if it could make a difference in the level of pain experienced by sufferers. They were given one tablespoon of honey mixed with half a teaspoon of cinnamon every morning. After one week, 73 of those arthritis sufferers experienced complete pain relief. After one month of this regimen, almost all of the 200 patients could move around without the pain that had restricted them so much in the past.
Honey owes much of its healing power to hydrogen peroxide, an antiviral and antibacterial agent that’s released immediately on contact with tissue. Honey also draws moisture from the air, which reduces scarring, enhances tissue regrowth and helps keep bandages from sticking.
I recommend unpasteurized, organic raw honey. Pasteurization diminishes the nutritional and healing powers of honey. But nothing surpasses Manuka honey when it comes to healing. Manuka honey is derived from honeybees in New Zealand that have been fed exclusively from the manuka bush. It has been extensively researched at the Honey Research Unit at New Zealand’s University of Waikato.
The phytochemicals found in Manuka honey place it a class above ordinary honey. It contains “unique manuka factor (UMF),” which is non-hydrogen-peroxide antibacterial activity. (It’s not understood exactly why, but not all Manuka honey has it.) Manuka honey is rated for its UMF content from zero to 16, with 16 found to confer the most benefits.
Manuka honey is exceptionally active in fighting many bacteria such as Staph aureus, a common skin bacterium implicated in most skin wounds, and E. coli, a gut bug. Another gut bacterium it fights is H. pylori, which has been linked to peptic ulcer disease (PUD).
Beyond fighting bacteria, Manuka honey is just as useful for combating sore throats, diarrhea, and last but not least, skin wounds. My wife, who is a vet, claims it works better than anything else for wounds on dogs, cats and horses. The only problem (especially with the dogs) is that they want to lick it off, so they’re constantly worrying the dressing! As to horses they have a healing component in their saliva, so putting honey on their wounds encourages them to lick the area.
Just to prepare you, Manuka honey costs about $34 per jar. But it’s so effective I’ll gladly overlook the price in exchange for the health benefits it provides me. Learn more about it and order a bottle for yourself. Go to www.manukahoneyusa.com, the U.S. site, or www.manukahoney.com, the New Zealand site.
Bee Colony Collapse
Throughout the summer, the mystery of the disappearing bees was breathlessly reported in every news outlet. It’s interesting to note that organic beekeepers across the country are not experiencing these so-called colony collapses. The bees that are dying are the hyperbred varieties whose hives are regularly fumigated with toxic pesticides in order to ward off mites. Other factors may include the use of genetically modified organisms (GMOs) and the common practice of moving conventional beehives over long distances. See www.organicconsumers.org/bees.cfm.
Two arms, two different measurements, same body. What gives?
Q.My husband and I just started seeing a new doctor. He measured my husband’s blood pressure in both arms, and there was a 10-point difference in the top number between one arm and the other. My husband is 58 and healthy, has no complaints, and has never smoked, but his father did die of a heart attack in his 60s. Should we be concerned?
––A. Walters, NYC, NY
A.Your husband probably has nothing to worry about regarding that 10-point difference. Generally speaking, any difference between arm measurements of 10 mm Hg or less falls well within the normal range—and such differences are common. But you raise an interesting question —and also highlight a peculiar behavior on the part of many doctors. I can’t fathom why so many doctors will take measurements and not explain the results to their patients. I consider it to be, well, just plain bad manners. Patients should never leave a doctor’s office with more questions than they came in with.
Let me explain what those results mean and not leave you hanging a second longer. I warn you in advance, there’s some jargon and technical information which I’ve tried to translate into English, so hang in there with me.
Different blood-pressure measure- ments between the arms can signal what we call peripheral vascular disease (PVD), which is a narrowing of the arteries that serve the arms and/or legs.
The mechanism responsible for PVD is similar to the one that’s responsible for heart disease and most cases of stroke. There’s inflammation and injury to the arterial wall followed by the formation of a lesion (or athero-matus plaque), which can crack open. This will cause a sudden blockage, or increase in size until normal circulation is impeded.
The general thinking is that a difference of more than 20 millimeters mercury (Hg) systolic (top number) and 10 millimeters mercury (Hg) diastolic (bottom number)—20/10mmhg—is cause for concern. Studies have shown that 10 to 15 percent of the population may have this rather high difference between arm measurements.
Your doctor can evaluate this further by taking careful foot pulses. Weak or absent pulses in the feet suggest PVD. He can also arrange an ankle-brachial-index (ABI) test, in which blood pressure is measured in the arms and ankles at rest and then again—usually after a five-minute walk on a treadmill. Interestingly, ankle blood pressure is usually higher than arm blood pressure, so a normal ration (or index) is 1.0 to 1.1. Anything less than 1.0 is considered abnormal, and if it’s less than .95 (or 95 percent), it could signal significant narrowing of the circulation to your legs.
Make sure your doctor takes a careful listen to the carotid arteries in your neck for bruits (which is French for “noise”). This can signify possible blockage. He can then order a carotid- artery ultrasound to evaluate the degree of blockage, if any. Other tests your doctor can consider include an EKG and an echocardiogram, which is an ultrasound study of the heart that evaluates how well the valves and heart muscle are working. If PVD is severe enough, it can cause pain—even while you’re at rest. And surgery may be required to undo the blockage.
In most cases, the best approach is risk reduction similar to that used for heart disease and stroke. This means an anti-inflammatory, whole-food diet that’s rich in fruits, vegetables, and whole grains and adequate protein from natural sources. And don’t forget healthy fats, mainly found in nuts and cold-water fish (such as trout, mackerel and salmon).
It’s also important to manage high cholesterol and blood-pressure levels. This can usually be done quite success- fully without drugs in most people. Adequate exercise, sleep and stress reduction all round out the program.
The text contained herein does not constitute medical advice. Health Revelations advises that you consult your own physician before acting on any recommendations contained within this publication.
