Here I try to explain in detail every week the questions asked by patients in my practice.

Dr. Homan Riazi

Specialist in vascular surgery

1.About intermittent claudication or - known as peripheral arterial occlusive disease (PAOD)

What is intermittent claudication / circulatory disorder / PAOD?

Intermittent claudication, also known as peripheral artery disease (PAD), is a condition in which the blood vessels in the legs become narrowed or blocked. This results in poor blood flow and can lead to pain, damage and ulceration of the skin, and impairment of the ability to walk.

It is important to look for early signs of PAD, including pain or weakness in the legs when walking, tired or heavy legs, pain in the calves, cold feet, or changes in skin color.

A variety of approaches can be used to treat PAD, including drug therapy, surgery, and lifestyle changes. It is important to have close control and regular monitoring by a doctor to prevent disease progression and avoid complications.

If you have signs of PAD, contact your doctor. Early diagnosis and treatment can help improve your blood flow and physical function and reduce the risk of complications.

What are the main symptoms(signs) of PAD?

Here are some of the main symptoms of PAD:

1. Intermittent claudication: Pain or weakness in the legs when walking that subsides after a short rest.
2. Tired or heavy legs: A feeling of heaviness or fatigue in the legs, especially when standing or walking for long periods.
3. Calf pain: Pain or stabbing in the calves, especially during movements such as walking or climbing stairs.
4. Cold feet: A feeling of coldness in the feet, which may indicate a lack of circulation.
5. Changes in skin color: Changes in skin color, especially on the legs, which may indicate a lack of blood circulation.

It is important to note that these symptoms can also occur in other health conditions. If you notice one or more of these symptoms, it is important to see a doctor for proper diagnosis and treatment.

How can I be treated if I am diagnosed with PAD?

Treatment for peripheral artery disease (PAD) depends on several factors, such as the stage of the disease and the patient's general health. Here are some of the treatment options for PAD:

1. Drug therapy: A variety of medications can be used to improve blood flow and slow the progression of PAD, such as cholesterol-lowering drugs, blood thinners and blood pressure lowering drugs.
2. Surgical procedures: In some cases, surgical treatment may be necessary to widen or replace blocked or stenosed arteries (e.g. bypass).
3. Lifestyle changes: Lifestyle changes may also be helpful in treating PAD, such as weight loss, regular exercise, quitting smoking, and eating a healthy diet.

It is important to note that none of these treatment methods are suitable for all patients. Your doctor will work with you to develop a treatment plan tailored to your individual needs and conditions.

If you have PAD, it is important to have close control and regular monitoring by a doctor to prevent the disease from progressing and avoid complications.

How should I change my diet if I am diagnosed with PAD?

A healthy diet can play an important role in the treatment and prevention of peripheral artery disease (PAD). Here are some recommendations to consider when designing a healthy diet for PAD:

1. Avoid high intake of saturated fatty acids: These can raise cholesterol levels and increase the risk of arteriosclerosis.
2. Increase your intake of fruits, vegetables and whole grains: These foods are rich in nutrients and fiber that can help prevent hardening of the arteries.
3. Avoid high salt intake: High salt intake can increase blood pressure and increase the risk of cardiovascular disease.
4. Avoid alcohol: Alcohol can raise blood pressure and increase the risk of cardiovascular disease.

It is important to note that a healthy diet alone may not be enough to treat or prevent PAD. A balanced diet should be used in combination with other treatment methods, such as regular exercise and quitting smoking.

If you have PAD or are at risk of developing PAD, you should consult your doctor for personalized nutritional advice.

What are the risk factors for PAD?

Peripheral artery disease (PAD) is a common condition that can affect blood supply to the legs and feet. Here are some of the known risk factors for PAD:

1. Age: Age is an important risk factor for PAD. As we get older, the risk of developing arteriosclerosis and thus PAD increases.
2. Smoking: Smoking increases the risk of developing atherosclerosis and PAD.
3. High blood pressure: Prolonged high blood pressure can increase the risk of PAD.
4. Diabetes: Diabetics have an increased risk of developing PAD.
5. Obesity: Overweight and obesity can increase the risk of PAD.
6. Family history: A family history can increase the risk of PAD.

It is important to note that not all people with these risk factors will develop PAD and that people without these risk factors can also develop PAD.

If you have one or more of these risk factors, it is important to be examined by your doctor to enable early diagnosis and treatment of PAD.

How can smoking cause PAD, does smoking really play a big role here?

Yes! Smoking is one of the most important risk factors for developing peripheral artery disease (PAD). Here is how smoking affects the development of PAD:

1. Atherosclerosis: Smoking leads to a faster development of atherosclerosis, which is the main cause of PAD.
2. Nicotine: The nicotine contained in cigarettes causes blood vessels to constrict, which can impair blood supply to the legs and feet.
3. Carbon monoxide: Carbon monoxide released when smoking reduces the blood's ability to absorb oxygen, thereby increasing the risk of PAD.
4. Inflammation: Smoking can cause inflammation in the body, which can contribute to the development of PAD.

If you have PAD or any of the risk factors for PAD, it is especially important that you stop smoking. Quitting smoking can slow the progression of the disease and reduce the risk of further deterioration of blood flow. Your doctor can help you to stop smoking.

2. About smoking

There are a variety of harmful chemicals in tobacco smoke, including carcinogens that can cause cancer, as well as toxins that can affect the cardiovascular system and lung function. The risk of health problems from tobacco smoke depends on many factors, including the amount and duration of smoking, as well as individual genetic predisposition and other factors.

The best way to reduce your risk of health problems from tobacco smoke is to quit smoking or never start.

I find it difficult to quit smoking, how do I do it?

There are different approaches to quitting smoking. Here are some methods based on medical guidelines and scientific literature:

1. Cold turkey: Quitting without any support or substitute products.
2. Nicotine replacement therapy (NRT): This involves using a replacement product, such as nicotine patches or gum, to relieve withdrawal symptoms.
3. Drug therapy: Prescription drugs
4. Psychotherapeutic support: Behavioral therapy and/or motivational interviewing can help you quit smoking.
5. Combination of different methods: Many people find it helpful to use a combination of several methods to quit smoking.

It is important to note that everyone responds differently to different methods. It may take several attempts to successfully quit smoking. However, it is worth continuing and trying again and again, as quitting smoking leads to better health in the long term. Talk to your doctor to find the method that is best for you.

I have spoken to several patients who have quit smoking. Most of them managed to do it overnight and without any support or substitute products.

Are cigars healthier than cigarettes?

No! Cigars are not healthier than cigarettes; quite the opposite: cigars contain more toxic and carcinogenic substances than cigarettes. Fermentation of the tobacco contained in cigars produces more carcinogenic nitrosamines. In addition, the tar content per gram of tobacco consumed is higher.

Is there a certain amount of tobacco smoke that can be consumed without increasing the risk of health problems?

No, there is no safe amount of tobacco smoke that can be consumed without increasing the risk of health problems. Any amount of tobacco smoke, whether from active or passive smoking, can be harmful to health.

There are a variety of harmful chemicals in tobacco smoke, including carcinogens that can cause cancer, as well as toxins that can affect the cardiovascular system and lung function. The risk of health problems from tobacco smoke depends on many factors, including the amount and duration of smoking, as well as individual genetic predisposition and other factors.

The best way to reduce your risk of health problems from tobacco smoke is to quit smoking or never start.

Are e-cigarettes generally healthier than regular cigarettes?

E-cigarettes can generally be considered less harmful than traditional cigarettes because they do not produce combustion products such as tar, carbon monoxide, and other harmful chemicals that are produced by traditional cigarettes. Instead, e-cigarettes vaporize a liquid (e-liquid) through a heating coil to create an aerosol-like vapor that is inhaled.

Although e-cigarettes may be less harmful than traditional cigarettes, there are still some health risks associated with e-cigarette use. E-cigarettes typically contain nicotine, an addictive substance that can have many negative health effects, including increased risk of cardiovascular disease and respiratory disease. In addition, some of the flavorings and chemicals in e-liquids can be potentially harmful.

It is important to note that e-cigarettes should also not be considered an effective way to quit smoking. However, there is evidence that e-cigarettes may pose health risks, especially with long-term and frequent use.

E-cigarettes typically contain nicotine, which is an addictive substance and has many negative health effects, including increased risk of cardiovascular disease and respiratory disease. In addition, some of the flavorings and chemicals in e-liquids can be potentially harmful.

There is also evidence that e-cigarettes can cause damage to the lungs with prolonged and frequent use, including increasing the risk of chronic obstructive pulmonary disease (COPD). In addition, there is still the potential for unwanted side effects with e-cigarettes, such as eye and respiratory irritation and skin rashes.

Overall, research on the long-term effects of e-cigarettes is still limited, and it is difficult to make definitive statements about their health risks. However, it is important to note that e-cigarettes should not be viewed as a harmless alternative to traditional cigarettes. If you smoke and want to try to quit, there are several options available to you, including smoking cessation programs, medications, and counseling from health professionals.

3. About varicose veins

What are varicose veins, when and how can they be treated?

Varicose veins, also known as varicose veins, are swollen and enlarged veins that often appear on the legs. Although varicose veins are not usually a serious health problem, they can cause uncomfortable symptoms such as pain, itching and swelling. In some cases, they can also lead to more serious complications such as blood clots.

Varicose veins develop when the valves in the veins that regulate blood flow back to the heart do not work properly. This causes blood to flow backwards and pool in the veins, which can lead to swelling and enlargement of the veins.

People who have to stand or sit for long periods of time are particularly susceptible to varicose veins. In addition, factors such as age, pregnancy, obesity and a family history can also play a role in the development of varicose veins.

Treatment for varicose veins can vary depending on the severity of the condition. In mild cases, compression stockings or lifestyle changes such as regular exercise and a healthy diet can help relieve symptoms and slow the progression of the condition. In more severe cases, medical treatment such as sclerotherapy, laser treatment or surgery may be necessary.

If you think you have varicose veins, you should see a doctor or specialist/vascular surgeon for an accurate diagnosis and appropriate treatment. Early treatment can help prevent complications and improve your quality of life. Our practice offers a wide range of diagnostic and treatment options for varicose veins and is available to help you improve your health and quality of life.

What are spider veins, when and how can they be treated?

Spider veins are small, bluish or reddish veins that often appear on the legs. They are usually harmless, but can be perceived as a cosmetic problem.

Spider veins occur when small veins in the skin expand and become visible. This can be caused by factors such as heredity, hormones, excess weight, standing or sitting for long periods of time, and sun exposure.

Although spider veins do not usually pose a health risk, they can cause discomfort, especially when they are located on the legs. Symptoms include heaviness, itching, pain and cramping.

There are various treatment options for spider veins. In mild cases, lifestyle changes such as regular exercise and weight loss can help slow the progression of spider veins. Various procedures are available for targeted treatment of spider veins, such as laser therapy, sclerotherapy or a combination of both.