Avid fisherman discovers real reason behind leg pain

About eight years ago, Bob Burruss’s left foot started hurting. He’d had problems with his arches before, but this time, none of the costly orthotic appliances prescribed by his podiatrist seemed to do the trick.

Then a few years later, his right leg started bothering him. The 74-year-old chalked it up to aging and some underlying heart problems. But it kept getting worse. Over time, Bob — a former football coach, fly fisherman and river guide — found he could no longer walk to his mailbox without severe pain.

Bob is one of an estimated 10 million Americans with Peripheral Artery Disease (PAD), a dangerous circulatory condition marked by narrowed or clogged arteries in the legs or arms. Leg pain is the most common sign, although about half of those with the disease show no symptoms.

PAD is easy to diagnose — but only if you know to look for it. Thankfully, Bob's former cardiologist at the Oregon Heart & Vascular Institute (OHVI) at PeaceHealth Sacred Heart Medical Center at RiverBend suspected he might have PAD. A blood pressure comparison between his arm and legs — known as an ankle-brachial index measure (ABI) — revealed clogged arteries in both legs; the right leg was completely blocked.

“When they take your blood pressure, you hear the rushing sound of the blood flowing, but with my right leg it was perfectly silent. It was completely occluded," Bob recalled.

The disease had been advancing for years, eroding Bob's quality of life and posing a serious health threat. PAD raises the risk for heart attack and stroke, and if left untreated can result in open sores, gangrene or even amputation.

“It affected my whole life,” said Bob, who lives with his wife on acreage east of Roseburg. “I’m not a depressed person by nature, but it was a real downer. A big bummer.”

15-minute screening changed everything

Last year, Manju Raju, MD, a cardiologist at OHVI who specializes in the diagnosis and treatment of PAD, performed an angioplasty — a minimally invasive procedure that uses a balloon to widen narrowed or obstructed arteries— on Bob’s left leg. He also inserted stents to keep the passageway open. Six months later — this past June — Dr. Raju performed essentially the same procedures on the right leg.

“Within 48 hours there was a tremendous difference,” Bob said. “It’s big bang for the buck. It was practically instantaneous relief.”

Because of Bob’s history of heart disease — which includes a heart attack and two heart bypass surgeries, the first when he was just 33 — Bob spent one night in the hospital after the first procedure. But most patients go home the same day.

If caught early enough, PAD can often be managed by lifestyle changes, such as exercising more, eating better and quitting smoking, sometimes in tandem with medications to lower blood pressure or cholesterol, control blood sugar or prevent blood clots.

“The key is early diagnosis,” Dr. Raju said. “Some patients blame these symptoms on age or frailty — they don’t understand that they are suffering from a serious disease. Unfortunately, PAD often goes undiagnosed by healthcare professionals.”

What are the risk factors

Bob urges those with any of the risk factors to seize the opportunity for a potentially limb- and life-saving screening.

If you're older than 50 with one or more of the following conditions, consider getting screened for PAD:

• Current or recent smoker
• Diabetic
• Family history of abdominal aortic aneurysm
• Experiencing pain or numbness in legs, especially when walking
• Not currently under the care of a vascular physician

Additional risk factors include high blood pressure, high cholesterol and obesity.

“Honestly, my feet and my legs did more to compromise my health than my heart,” Bob said. “I’m regaining my strength now and walking every day. I feel good.”

If you have risk factors for PAD or are experiencing symptoms described above, talk to your primary care or cardiovascular provider.