Making Strides
Walking in spite of heart and leg artery blockages

"When I started my supervised exercise program for claudication, I could only walk for 4 minutes," lamented Tom Brungardt. "And then I would have to stop for 4 minutes until the pain went away." Now, after 9 weeks, and half-way through his walking exercise program, Tom has seen great progress. He now is able to walk continuously 13 minutes and rest for only 1 or 2.

Like many people, Tom began his walking rehab program following a heart attack. His doctors told him his arteries were blocked and he needed to reduce the risk factors that contributed to the blockages. This included medications for keeping his blood pressure and cholesterol in normal ranges, and to make his blood platelets less sticky. Then his doctor said he should walk. Walking would help his heart and improve his health by being more active. Yet, it was not easy. It's not that he did not want to. He didn't want another heart attack, but his calves hurt when he walked, even a short time. He learned that this was because he had peripheral arterial disease (PAD) as well as coronary artery disease (CAD). The blocked arteries cause pain with exertion in both the heart and leg muscles, because oxygenated blood can't get to the muscles fast enough.

Some people with peripheral arterial disease, or PAD, learn ways to compensate for and ease this symptom of pain over time. One common practice is to shuffle when walking. This requires less action of the calf muscle, and thus less demand for blood. This can also allow someone to walk farther before experiencing pain. Another common technique is to take routes with lots of places to sit and rest, or to avoid stairs. Sadly, these give only minor relief and many end up just foregoing activities they used to enjoy because it takes too much effort or too much walking. However there is a way to obtain much greater relief through a progressive exercise program, in which one repeatedly walks to the point of pain and then stops. This helps improve both the heart pain (angina) and the leg pain (claudication). This is what Tom did.

Now that he's able to walk farther, it's getting easier. In fact, he tries to walk in-between sessions now. Tom now philosophically says, "Exercise after a heart attack is good." He also knows that the exercise program helped him get started. And although he could do the same thing on his own, it's often hard to really do it. Plus, at the rehab center, they monitored him throughout each session. They would take a blood pressure before beginning, a couple of times during the exercise and then when he finished. Plus, he said, "they could show me how much I've improved." Tom discovered another advantage to walking. He lost 26 pounds in the 9 weeks since he started. At a young 69, Tom is active and wants to stay active.

Obviously, discussing these problems with your health care provider is important. If walking is difficult, or you have made some of the adaptations mentioned above, you should find out why. Your doctor may run some tests. He or she may prescribe some medications to reduce your risk factors, or some dietary changes, or exercise. Prevention of a heart attack or stroke would be the best result. Walking farther improves your quality of life and independence. The earlier you find out you are at risk for a heart attack or stroke, the earlier you can begin to take the necessary measures to prevent one.