What is Peripheral arterial disease and how it can lead to limb loss in the lower extremities

PHILADELPHIA (WPVI) -- We're all familiar with fat and cholesterol buildups in heart arteries.

But it can happen in the extremities, especially the legs.

John Bilkins, a retired firefighter from East Falls, calls it his "lucky" injury.

"I stubbed my toe. And I went to - waited too long," he recalls.

By the time John saw a foot doctor, he had a diabetic ulcer that needed wound care.

At the wound center, "They took tests, and they say - By the way, you have low blood flow," Bilkins says.

He never realized the occasional cramps in his left leg were a sign of peripheral arterial disease or PAD.

Vascular surgeon Andrea Lubitz of Temple Health compares it to plumbing trouble.

"Temple Health vascular surgeon. You get kind of a thick buildup of hardening on the inside of the arteries, essentially clogging off the pipes," Dr. Lubitz says.

"The most common causes are things like smoking, diabetes, high blood pressure, and high cholesterol," she explains.

Dr Lubitz says leg cramps while walking is a pretty universal symptom.

"The patient will typically come in and say I can walk, I walk 2 blocks, and I get it every time. When I sit still, it goes away," she says.

Those with pain at rest or leg sores or wounds are in danger of losing a limb.

Dr. Lubitz says usually. when leg vessels clog, so do smaller ones in the heart, neck, or brain.

So patients go on aspirin and statins.

"It's not going to stop the process, but it can help it from really kind of getting worse," she notes.

Walking 30 minutes a day, with pauses to let the pain ease, helps blood find new routes around blockages.

"What your body is really good at doing is finding new ways for blood to go," says Dr. Lubitz.

"Your body knows it needs more blood flow to an area, and it's trying to get it there," she says,

"The more you walk, the more your body is able to do that," she adds.

Severe cases might need a bypass to restore blood flow. The procedure is similar to the bypass heart patients undergo.

For Bilkins, a balloon angioplasty was enough to open the artery so the ulcer could heal.

"I can walk, I can exercise. There's no restrictions," he says happily. "The stupid accident probably saved my foot."

PAD was long thought to be affecting mostly men.

But slowly, doctors are recognizing women get it too, though they're less likely to have symptoms or severe enough symptoms to be classified as PAD.