NATIONWIDE, SEPTEMBER 23, 2017)—Leading global dance fitness company, Jazzercise, Inc. will celebrate the 2017 GirlForce initiative with a Day of GirlForce event on Saturday, September 23. Launched at the beginning of 2017, the GirlForceinitiative aims to empower teens and college-aged women by offering them a free place to get fit, learn healthy habits, and experience a positive sense of community through fun workout routines with like-minded women. The Global Dance Party Celebration will take place at participating Jazzercise facilities across the country and around the world and will be offered, like the rest of the initiative, at no charge.

The “Day of GirlForce” Celebration classes will consist of a special workout routine, with music and dance moves curated specifically for this class and youthful age group. The celebration playlist will feature hits from Lady Gaga, Ariana Grande, Shawn Mendes, Meghan Trainor, and Drake, among others, and studios will be lively decorated in gold, purple, and pink. Participants will also have the opportunity to use branded SnapChat filters and will be encourages to share the Day of GirlForce event via social media channels.

In business for almost 50 years, Jazzercise created the global GirlForce initiative to offer young women, ages 16-21, a safe place to workout, stay active and introduce them to a healthy and fun way to experience the endorphins of the workout “high.” The classes are being offered through the end of 2017 and are free of charge. Currently, approximately 2,000 monthly participants have taken advantage of the GirlForce program. Jazzercise classes integrate top-40 hit songs and the latest workout trends such as HIIT, also known as high intensity interval training, Pilates and cardio dance moves.

International participating Jazzercise locations will join the “Day of GirlForce” Celebration classes to inspire teens and college-aged women to be confident and to learn to dance their own path through fitness. “Our company culture has always been to give back, and this year our focus is on supporting young women in creating the healthy habits we’ve come to rely upon,” says CEO and Founder of Jazzercise, Inc., Judi Shepherd Missett.

While Jazzercise, Inc. and its franchisees have raised over $28MM for charities over their 48-year history, this the first time the company has developed a free corporate initiative. Young women who are interested in joining the GirlForce can find more information at jazzercise.com/GirlForce or follow the @jazzerciseinc Instagram page.

About Jazzercise

Jazzercise believes you can create a stronger, happier, healthier life through fitness. The company draws on the passion to motivate and inspire customers, instructors and employees to live healthier, fitter lives.  Jazzercise develops fun and effective fitness routines and products that enhance the well-being of people of all ages.  You can learn more about Jazzercise at www.jazzercise.com

Five Ways PCOS May Impact Your Fertility

by Dr. Fiona McCulloch

Polycystic ovary syndrome or PCOS is the most common hormonal disorder in women of reproductive age, affecting 10-15% of women and upward of 7 million women in the US alone. Although the name PCOS implies that the syndrome  centers around ovarian cysts, cysts are not even required for its diagnosis. PCOS is a syndrome that affects a woman’s entire body - in particular her hormonal and metabolic systems. It is lifelong, begins in childhood and lasts past menopause causing a constellation of symptoms such as weight gain, irregular periods, infertility, acne, hair growth on the face (hirsutism), and hair loss. PCOS also steps-up a woman’s risks for type-two diabetes and cardiovascular disease as she gets older.

When it comes to the reproductive years, PCOS ranks as the leading cause of ovulatory infertility. Many women who have trouble conceiving are shocked to learn that they have PCOS, never having known as up to 50% of women with PCOS don’t know they have it.

The type of infertility women with PCOS experience is, in fact, quite different from other types of infertility – so, if you have this common condition there are a few facts you might like to know.

1. Women with PCOS Have an Abundance of Follicles in their Ovaries

Women with PCOS tend to have an abundance of follicles in their ovaries. Follicles are structures in the ovaries that house the eggs which secrete hormones like estrogen, and testosterone. After ovulation, they transform into the corpus luteum which secretes the important female hormone, progesterone. In PCOS, the follicles often secrete much more testosterone than they typically do, causing the follicles to develop more slowly, in some cases blocking ovulation entirely. In some women with PCOS, multiple stalled follicles create a cystic appearance within the ovaries on ultrasound.

2. Women with PCOS Ovulate late, or not at all.

Many women with PCOS ovulate 7 days or more later than the typical day 14 of the cycle due to excessive androgens. This causes the menstrual cycle to arrive late as well, often resulting in cycles lasting at least 35 days, or in some cases, much longer.Some women with PCOS don’t ovulate at all, or if they do it occurs rarely. The best way to determine ovulation in PCOS is to track cervical mucous or to use fertility awareness method (FAM), a time-tested method to understand ovulatory patterns.

3. Ovulation test kits often don’t work in women with PCOS.

Ovulation tests that you can buy at the drugstore often don’t work for women with PCOS. That’s because they measure a hormone called luteinizing hormone (LH), which is often already unusually high in PCOS. This hormone typically surges middle of a woman’s cycle, triggering ovulation. In PCOS, many women find that their ovulation tests are positive at unusual times that don’t’ correspond with ovulation, and can even be positive every day! This happens because LH tends to be higher across the whole cycle in PCOS.

4. Women with PCOS hit their reproductive peak later and go through menopause later.

Here’s some good news – women with PCOS tend to hit their peak fertility around 2 years later than other women. The abundance of follicles and androgens that stall ovulation in PCOS naturally decline with age, and therefore women’s ovaries start to become more active as they become older. Women with PCOS also have an estimated two years longer before they go through menopause, adding extra years onto their reproductive lifespan. One study found that across the age range of 22–41 years, egg count and live birth rates remained stable in women with PCOS. Whereas in the non-PCOS comparison group, these parameters decreased significantly with age.

5. PCOS typically causes Subfertility rather than Infertility and Most Women Will Eventually Conceive

The word “infertility” doesn’t quite fit in PCOS, as the vast majority of women will be able to conceive in time. In fact, one study found that over a lifetime, women with PCOS had the same chances of having children and bore the same number of children on average as women without the condition. Again, this relates to improved ovulatory function as women with PCOS get older. Numerous studies have also found that fertility rates increase significantly in women with PCOS by making nutritional and lifestyle interventions, as insulin resistance is one of its key aggravating factors.

Overall, the news is very good when it comes to fertility in this common condition.  Chances of conception tend to improve with age and with enough time. As PCOS is one of the conditions that responds the best to nutritional and lifestyle changes, there is a great deal of hope for women to achieve reproductive success.

Tehrani FR, Solaymani-Dodaran M,Hedayati M, Aziz F. Is polycystic ovary syndrome an exception to reproductive aging? Human Reproduction, Vol.25, No.7 pp. 1775–1781, 2010

Legro, R. S., Dodson, W. C., Kunselman, A. R., Stetter, C. M., Kris-Etherton, P. M., Williams, N. I., … Dokras, A. (2016). Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. The Journal of Clinical Endocrinology & Metabolism, 101(7), 2658–2666. http://doi.org/10.1210/jc.2016-1659

Marca, A La; Sighinolfi, G.; Radi, D., et al. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010; 16:113–130.

Mellembakken, J. R., Berga, S. L., Kilen, M., Tanbo, T. G., Abyholm, T., & Fedorcsak, P. (2011). Sustained fertility from 22 to 41 years of age in women with polycystic ovarian syndrome. Human Reproduction, 26(9), 2499–2504. http://doi.org/10.1093/humrep/der214

Hudecova, M., Holte, J., Olovsson, M., & Sundstrom Poromaa, I. (2009). Long-term follow-up of patients with polycystic ovary syndrome: reproductive outcome and ovarian reserve. Human Reproduction, 24(5), 1176–1183. http://doi.org/10.1093/humrep/den482

Fiona McCulloch, N.D., founder and owner of White Lotus Integrated Medicine, is a naturopath practitioner having worked with thousands of people seeking better health over the past fifteen years. She is a data-junkie who specializes in evidence-based therapies for PCOS, thyroid health, autoimmunity, weight management and infertility among other unique conditions that can all benefit from a system reboot.

Dr. McCulloch is also a medical advisor for IVF.ca: Canada’s premier fertility community and is on the medical advisory committee for the PCOS Awareness Association. As a woman with PCOS herself, she is dedicated to increasing both awareness and research of this important condition that has far reaching effects on the lives of so many women. When she was a young girl, Dr. McCulloch would spend hours “compounding” mixtures made from plants and trees in the woods near her house.  Today, Dr. McCulloch is a graduate of the Canadian College of Naturopathic Medicine (2001) and the University of Guelph (biological science).  She is married and the mother of three boys.  She can be reached on Facebook, LinkedIn, and Twitter.

Dr. McCulloch’s new book, 8 Steps to Reverse Your PCOS, is available on Amazon and all fine booksellers.

“Talent is never enough. With few exceptions the best players are the hardest workers.”

– Magic Johnson

Ever since Carol Dweck’s seminal research on success in 2006, the conversation has opened up about how to transform the fixed mindsets that many of us grew up with into growth mindsets that lead to resilience and achievement.

In Growth Mindset for Athletes, Coaches and Trainers Jennifer Purdie takes Dweck’s academic research and translates her theories into comprehensive, actionable plans for athletes and coaches to improve their training and performance. By teaching new ways to approach failures, successes and setbacks, trainers and athletes can hone in on the right mindset to push towards greater success.

Purdie examines real life examples from successful coaches and athletes, to mine lessons in how to set goals that are SMART (Specific, Measurable, Attainable, Realistic and Timely), improve communication, and break through training plateaus.

Title:Growth Mindset for Athletes, Coaches and Trainers: Harness the Revolutionary New Psychology for Achieving Peak Performance

Author: Jennifer Purdie

Publisher: Ulysses Press

ISBN: 9781612437231

Price: $15.95

October 2017

Jennifer Purdie is a freelance writer, endurance athlete and personal trainer. She has written for publications such as The Los Angeles Times, the Washington Post, U.S. News and World Report, Triathlete, Running Times, Competitor and Salon. She has been featured in magazines and on television, including Woman’s Day, Redbook, Reader’s Digest, Shape, Dr. Oz The Good Life, Success and Fox Sports. She is also an Ironman finisher and has completed marathons on every continent. She holds a personal training certification with the National Academy of Sports Medicine and is a Fitness and Nutrition Specialist with the American Council on Exercise. She lives in Los Angeles, CA.

Inspired by Ainsley's amazing story, Montreal's business community comes together to raise $657,885 at the Montreal Children's Hospital Foundation Golf Tournament

Proceeds will go to the new McGill-MCH chair in pediatric surgery.

MONTREAL, Sept. 12, 2017 /CNW Telbec/ - Inspired by young Ainsley, who had part of her brain removed to save her life, Montreal's business community showed their support once again for excellence in care at the Children's by raising $657,885 at the 21^st edition of the Montreal Children's Hospital Foundation Golf Tournament at the Royal Montreal Golf Club.

This year's edition paid tribute to the late Bruce Williams, surgeon, researcher and outstanding teacher, who was at the forefront of revolutionary changes in children's healthcare throughout his long and distinguished career at the Children's. Proceeds will go toward the creation of a $ 4-million endowed chair in pediatric surgery.

Mark Pathy, chair of the organizing committee, explains the goal of the tournament: "This annual event aims to raise funds to attract and retain talented healthcare professionals at the Children's, a vision shared by the tournament's founders, Dr. Bruce Williams and Hugh Hallward, who chose to invest in talent in a time when event organizers were raising funds to buy equipment. We're grateful to Dr. Williams for his incredible leadership, demonstrated by McGill's outstanding national reputation in pediatric surgery."

The Chair in pediatric surgery will allow the Children's to remain a leader in its field by offering quality patient and family-centered pediatric surgical care while remaining at the cutting edge of all levels of surgical training and in retaining top talent.

Ainsley: a story that touches us all

The golfers were touched when they learned about Ainsley, who was a patient of the Children's surgeon-in-chief, Dr. Jean-Pierre Farmer. Ainsley and her mother Jocelyn were present to talk about the expert care their received. Jocelyn explains: "We were presented with the painful option of removing half of Ainsley's brain to stop her from having the epileptic seizures that were slowly killing her. The surgery would leave one side of her body paralyzed, with no guarantee she'd ever regain mobility. It was the hardest decision we've ever had to make. We gave the green light because we knew that we could count on the exceptional doctors, who were all in favour of the procedure, and that the surgery would be performed by a top surgeon. Our child was suffering, and we had an opportunity to do something about it. Now, our 9-year-old girl goes to school, can walk, and is happy."

The Montreal Children's Hospital Foundation's Interim President, Katrin Nakashima, would like to thank Dr. William's family, Golf Tournament organizing committee president Mark Pathy, along with the employees and volunteers who make up the organizing committee, for their continued efforts. She also thanks the business community for their commitment over the past 21 years, most notably RBC, the Golf Tournament's lead partner. "Year after year, these people come together and demonstrate their support and commitment. Since the first edition in 1997, countless projects have materialized thanks to the efforts of the committee, volunteers, golfers, sponsors, donors and raffle participants, who continue to support our noble cause," she explains.

ABOUT THE MONTREAL CHILDREN'S HOSPITAL FOUNDATION
The mission of the Montreal Children's Hospital Foundation is to support excellence in patient care, teaching, and research at the Montreal Children's Hospital, the pediatric teaching hospital for McGill University's Faculty of Medicine. Since its inception in 1973, the Foundation has raised almost $340 million, which has been used to transform the lives of sick children through cutting-edge research and teaching projects, and quality care. The Foundation's Best Care for Children campaign raised $105 million to help build the new Montreal Children's Hospital on the Glen site. For more information, please visit childrenfoundation.com.

SOURCE The Montreal Children's Hospital Foundation

Statement by Rita Notarandrea, CEO, on Recovery Month

OTTAWA, Sept. 12, 2017 /CNW/ - The Canadian Centre on Substance Use and Addiction (CCSA) is pleased to add its voice in support of Recovery Month in order to build awareness, challenge stigma and celebrate the fact that people can and do recover from addiction.

CCSA's mission is to address issues of substance use in Canada by providing national leadership and harnessing the power of evidence to generate coordinated action.

CCSA applauds the coordinated action on recovery, which will happen throughout the month of September when communities across Canada will host recovery events and shine the spotlight on problematic substance use and addiction. These events will draw attention to the stories of individuals who found a pathway to recovery, and the needs of those who are still charting their path to recovery and an improved quality of life.

For this Recovery Month, Canada's opioid crisis, and the unprecedented number of overdoses and deaths, looms large. The health and social impacts of this crisis on individuals, families and communities are devastating, and the healthcare system is struggling to cope. The opioid crisis requires involvement by the people and organizations who lead education, prevention, treatment and long-term recovery initiatives, working in close coordination with the decision makers who set the course for action.

To this end, CCSA looks forward to working collaboratively with Canada's new Minister of Health, the Hon. Ginette Petitpas Taylor, and her provincial and territorial colleagues in reforming the system of care to ensure access to much-needed services and support for opioid misuse, problematic substance use and addiction. We know that impactful reform requires cross-disciplinary collaboration using evidence-based best practices and tools to address comprehensively the needs of each individual, and CCSA is working to do its part.

We know recovery is possible, achievable and sustainable with access to the right evidence-based treatments, supports and quality services. That is why CCSA is leading a number of activities (please see the attached Backgrounder) that are contributing to increasing understanding of an often misunderstood issue, and providing policy makers and experts in the field with the evidence and the resources to inform their approaches.

A trusted counsel, CCSA will continue to provide national guidance by harnessing the power of research, curating knowledge and bringing together diverse perspectives to inspire collective action. Our efforts, like so many others, will continue beyond Recovery Month as we work to achieve our vision of a healthier Canadian society where evidence transforms approaches to substance use.

Across the country, Canadians are engaging in conversations and storytelling about recovery and reinforcing what is possible. Without question, recovery from addiction is possible. This month, and every one that follows, let us remember that a person who is ready to embrace recovery and improve their quality of life is a person with a health condition who is asking for help; asking for nothing more than the care they need and deserve. Their voice and the voices of so many others who are at different points in their journey deserve to be heard and their needs addressed.

To help share these important messages and findings about recovery, CCSA has created a communications toolkit designed to facilitate public discussions on the survey findings. The toolkit, which includes posters, infographics, social media images and other content, is available on the CCSA website and can be used throughout September, and beyond, to facilitate discussion on recovery.

Speak up. Speak often. We're listening.

Rita Notarandrea, M.H.Sc., C.H.E.
Chief Executive Officer

Contact: media@ccsa.ca | Twitter: @CCSACanada

Visit RecoveryDayCanada.com for more information on events and activities throughout Canada.

Rita Notarandrea will be speaking at this year's Recovery Capital Conference of Canada event (Vancouver, September 7–8) and the Recovery Day Ottawa event (September 23).

Backgrounder on CCSA's Initiatives In Relation To Recovery

Changing the Conversation: Life in Recovery from Addiction In Canada

In 2015, CCSA hosted the first-ever National Summit on Addiction Recovery to put forth a common vision and overarching principles to guide a strength-based recovery approach to the treatment and care of substance use disorders in Canada, now known as A National Commitment to Recovery from the Disease of Addiction in Canada.

As its next step, CCSA established the National Recovery Advisory Committee (NRAC), made up of individuals with lived experience to inform and guide recovery related activities. To that end, CCSA and NRAC undertook the first national survey of people in recovery from alcohol and other drugs. The Life in Recovery from Addiction in Canada survey was conducted in 2016 and the full technical report was released in May 2017.

The survey gathered information and stories from 855 people across Canada who generously shared information on their experiences with addiction and the barriers they faced. More importantly, it describes their journey of recovery: what encouraged them to seek recovery, the supports that helped and the quality of life they have experienced since attaining recovery.

For the first time in Canada, we have a detailed picture of the lives and experiences of people in recovery and it is a good news story. The results showed that recovery is linked to a return to positive citizenship: engagement with family, friends, the community and the workforce. A remarkable 91% of participants in the survey reported their quality of life was either excellent, very good or good after recovery had been initiated.

These findings provide hope for individuals and families affected by addiction and give much-needed evidence to service providers and policy makers to enable informed decisions that reflect lived experience. Results from the Life in Recovery from Addiction in Canada survey will be used to increase understanding and address the stigma associated with addiction and recovery, drive investment in treatment and recovery support services, and improve overall access, thereby removing barriers to recovery.

Moving Towards a Recovery Oriented System of Care: A Resource for Service Providers and Decision Makers
As part of its efforts to increase understanding and reduce barriers to recovery, later this month, CCSA will be releasing Moving Towards a Recovery Oriented System of Care: A Resource for Service Providers and Decision Makers. This resource will provide actionable examples of policies and practices that service providers can implement to support the principles of recovery that are outlined in the National Commitment to Recovery from the Disease of Addiction. This resource highlights the six principles of recovery:

There are many pathways in recovery: A variety of interventions and approaches can lead to successful long-term recovery. There is no one pathway in recovery that works for all those struggling with addiction and as a result, a successful journey can be different for each person.

Recovery requires collaboration: A recovery-focused system of care includes collaboration between service providers and community support systems, as well as between professionals across health care and social service sectors.

Recovery is a personal journey toward wellbeing: Recovery is unique to the individual with optimal services tailored to strengths, needs, perceptions and experiences, including trauma and mental health issues.

Recovery extends beyond the individual: The recovery process includes not only the individual, but the individual's family, friends, workplace and community. Everybody can play a role in supporting an individual's recovery.

Recovery is multidimensional: Recovery involves addressing the multiple dimensions of a person's health in addition to their substance use.

Recovery involves everyone: Everyone can contribute to creating a culture and society that is compassionate, understanding and supportive of people in recovery and those struggling with addiction. This begins with overcoming stigma and dispelling the common myths that are associated with both having a substance use disorder and being in recovery.

Selected findings from the Life in Recovery from Addiction in Canada survey are also included in this resource to highlight the experiences and journeys of people in recovery, and illustrate the relevance of these principles. This resource is a living document. CCSA will continue to update it to reflect the perspective and feedback from service providers and decision makers, as well as the latest evidence and emerging research.

SOURCE Canadian Centre on Substance Use and Addiction

THE FAMOUS CANADIAN BEER RUN & FESTIVAL @ ONTARIO PLACE THIS SUNDAY

WHAT:

• The Famous Canadian Beer Run & Festival - a 5-kilometre fun run/walk followed by a craft beer and food festival.

WHO:

• More than 2,000 runners and festival-goers are expected to participate in the event.

WHEN:

• This Sunday, September 17^th. Event waves run every 30 minutes from 10:30 a.m. – 12:30 p.m. The festival is open from 11 a.m. – 5 p.m.

WHERE:

• The start and finish line and festival area are located on the West Island of Ontario Place. The 5-kilometre course runs through both the East and West Islands, including Ontario Place’s new greenspace.

EVENT DETAILS:

• 5 kilometre run/walk course through Ontario Place offering views of city skyline, Lake Ontario and Ontario Place’s new greenspace
• Vibrant post-run festival featuring Canada’s best craft beer vendors, food trucks, beer yoga classes, live music and more

www.RunForBeer.ca

Alzheimer Society Research Program provides $3.4 million boost to dementia research

TORONTO, Sept. 12, 2017 /CNW/ - The Alzheimer Society Research Program (ASRP) is pleased to announce it has awarded $3.4 million to Canadian researchers through this year's research competition to help create a brighter future for Canadians who are impacted by or at risk of Alzheimer's disease and other forms of dementia.

This year's awards and grants support 24 applicants from across the country who are working towards finding new prevention and treatment strategies, enhancing patient care, and finding a cure.

Recipients include:

Jennifer Walker, First Nations University of Canada: Jennifer is collaborating with local researchers to study the increasing rate of dementia among First Nations in Saskatchewan. Her work will help inform and improve dementia care services in Indigenous communities.

Heather Cooke, University of British Columbia: Heather seeks to better understand how incivility and bullying among long-term care workers influences dementia care. The results will help improve staffing practices and policies and enhance the quality of life for both residents and staff.

Jannic Boehm, Université de Montréal: Jannic's goal is to develop a "peptide" that will penetrate the blood-brain barrier and access neurons in the brain. If successful, this tool could be used to help maintain and promote brain function in people with Alzheimer's disease.

Matthew Parsons, Memorial University, St. John's: Matthew's research will investigate when and where toxic proteins in the brain, the hallmarks of Alzheimer's disease, begin to impair brain cells and disrupt the formation of memories. He hopes these findings will ultimately lead to new treatments.

"Research funding is critical for advancing scientific discoveries and producing breakthroughs that enable people with dementia to live well and bring us closer to a cure," says Nalini Sen, Program Director. "We're proud of our Program and to be able to provide opportunities to many of Canada's bright and talented minds."

The Alzheimer Society Research Program (ASRP) is a national leader in dementia research aimed at supporting and developing capacity in the areas of biomedical, clinical and health services research. Funding applications undergo an extensive peer-review process led by respected researchers as well as people with lived experience of dementia. The ASRP is a collaborative initiative of Alzheimer Societies across Canada, key partners and generous individual and corporate donors. Since its inception 30 years ago, the Program has invested $53 million in dementia research.

For an inside look at the ASRP and to hear directly from some of our researchers about their discoveries, watch our video at https://youtu.be/rqfQnFHOZk8. More information is also available at www.alzheimer.ca/research.

SOURCE Alzheimer Society of Canada

YOURE INVITED TO THE Team Trex Training Bootcamp!

Come try something new!

All are welcome to the Team Trex Training Bootcamp on September 24th!

Tons of prizes and giveaways!

***Free Puma Towels to the first 50 attendees!***

You can can sign up for:

******FST SESSIONS WITH ME******

OR

- Conditioning Bootcamp
- Booty Building Seminar
- Muscle Hypertrophy Bootcamp
- Posing (All categories Offered)

Location: Form and Function Fitness Center
1101 Clarckson Rd, Mississauga

To Register in advance to secure your spot email:

info@teamtrextraining.com

PAD | Often misdiagnosed, this illness can be mild or deadly

SEPTEMBER IS PAD AWARENESS MONTH 
Tell the doctor about your symptoms; it could save your leg

CHICAGO, Illinois, September, 2017 – As we age, it is common to be concerned about heart disease or high blood pressure. But many people don’t know that those conditions are also related to another common health issue, peripheral artery disease (PAD). Unfortunately, many patients are not diagnosed until it has progressed.

PAD is caused when hardening of the arteries deprives the legs and feet of oxygen-rich blood. This occurs because the arteries become clogged, much like water pipes in an old house that build up with lime. In the body, clogged arteries don’t bring enough oxygen to the toes, feet and legs. (Less commonly, the same thing can happen to arms and hands.)

Older people are more likely to have some level of PAD. Those over 60 have a 5 percent chance; those over 70, 15 percent; and those over 80, 20 percent. Smokers and diabetics are far more likely to have PAD.

If the disease stays mild, it can cause no symptoms at all, or just a little pain in the legs while walking. But if it progresses, it can lead to gangrene, amputation and sometimes even death.

“A lot of time when patients complain of leg pain, it is misdiagnosed as something else, such as back pain,” said vascular surgeon and researcher Dr. Katherine Gallagher of the University of Michigan. “Then they may be referred to other doctors and occasionally have procedures like back surgery that fails to relieve the pain. Only then they are diagnosed with PAD.”

Patients need to know that even if they have PAD, it can be managed conservatively with medications most of the time, she added. “Surgery or endovascular therapy should be reserved for patients who have lifestyle-limiting pain when walking, rest pain and ulcers that don’t heal.”

When someone is diagnosed with or suspected of having PAD, they are typically referred to a vascular surgeon or vascular specialist. Vascular surgeons will often prescribe medications and lifestyle changes for PAD patients. If this fails or if the cases and symptoms are severe, surgery or a minimally invasive procedure may be necessary.

If the patient follows doctor’s orders, he has a 75 percent change that his PAD will not get worse. Exercise, such as walking on a treadmill, has been found to be an effective way to reduce pain, and in fact, supervised exercise has just officially been approved for Medicare and Medicaid reimbursement.

PAD patients may do better with supervised exercise therapy because left on their own, many don’t follow through with consistent exercise, researchers have found.

Patients frequently want to take a pill to make the disease go away, noted vascular surgeon and researcher Dr. Misty Humphries of the University of California Davis Medical Center.

“They become passive observers of their health,” she said. “While medications are essential, medication alone will never be the answer. Patients need to realize that they can change their lives and be in the driver’s seat of their own health care.”

That means you must:

• Tell your primary care doctor if you have fatigue or cramping in the calf, thigh, hip or buttock when walking or at rest.
• Tell the doctor if your feet feel numb.
• Bring notes to your doctor visit to remind yourself of questions to ask.
• Don’t assume the pain is unimportant.

If you don’t tell the doctor, what could happen?

At the least, the pain will continue. Eventually your feet could get sores that don’t heal, or heal very slowly. If the disease progresses, your feet and legs will get so little oxygen that you could develop a severe and painful form of PAD called chronic limb ischemia, which often leads to amputations.

For some patients, open foot sores are painful, but in others, disease has caused their feet to go numb and they may not know they have sores, Dr. Gallagher said.

What can you do to avoid the severe later stages of PAD?

• Don’t smoke; if you do smoke, quit. Nicotine inflames the blood vessels and increases the likelihood of PAD. Ask your doctor to help you find assistance with smoking cessation.
• See your primary care doctor regularly. Checkups are designed to catch things like PAD.
• If you are having pain in your legs, feet or toes, or have sores on your feet that won’t heal, be sure to mention that in your doctor visit.
• Be sure to follow doctor’s advice and take prescribed blood pressure and cholesterol medications as directed.
• Keep walking. Walking 30 minutes a day, three to five times a week can keep PAD at bay. If your legs hurt just a little, keep walking; if the pain is bad, stop for a few minutes till it goes away, then start walking again. Pushing through mild and moderate pain will increase the distance you can walk without pain over time.
• If that’s hard to manage, ask if supervised exercise therapy is covered for you.

  Learn more about PAD.

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The Society for Vascular Surgery® (SVS) is a 5,800-plus member, not-for-profit professional medical society, composed primarily of specialty-trained vascular surgeons, which seeks to advance excellence and innovation in vascular health through education, advocacy, research and public awareness.