Learning the Hard Way

A Daughter's Story of Peripheral Artery Disease

Three things qualified me to help my mother deal with the health challenges of her later years. One was that I loved her and wanted to have her around as long as possible. The second was that I lived just a five-minute drive from the home she shared with my father. The third was that I was fairly knowledgeable about the medical issues affecting Mom — or so I thought.

PAD, the Missing Piece

As it turned out, there was an important gap in my knowledge. I knew nothing about peripheral artery disease (PAD), a condition that played a major role in Mom’s decline.

PAD showed up close to the end of a long progression of problems that began decades earlier when Mom was diagnosed with a leaky heart valve. Her defective mitral valve didn’t threaten her health at the time, but as years passed, it led to atrial fibrillation (AFib), an irregular heartbeat that my mother referred to as her heart dancing a conga. We laughed about how our family tended to march to the beat of a very different drum.

Behind the laughter, there lurked a serious danger. AFib is associated with a fivefold increase in the risk for stroke. As a precaution, her cardiologist prescribed a blood thinner. She also underwent cardioversion, a procedure that shocks the heart to restore regular rhythm. Unfortunately, Mom’s heart insisted on continuing its erratic dance.

The First Stroke

Poppy Sundeen with her mother, Anna Beck, circa 1990

Poppy Sundeen with her mother, Anna Beck, circa 1990

One day a few years later, I answered an urgent call from my father. He said that Mom had fallen, and they were at the ER waiting to see the doctor. I hung up and rushed to join them.

When I walked into my mother’s room at the ER, I knew immediately that she’d had a stroke. One side of her beautiful face sagged. She gave me a weak, lopsided smile. Dad told me that as they were shopping at our neighborhood supermarket, she slumped to the floor. A concerned store employee called 911.

Then the doctor came into Mom’s room to assess her condition. He asked her if she knew where she was. She replied that she was at the supermarket medical center, adding that she never realized there was a hospital attached to our grocery store. Clearly, she was confused.

The whole family breathed a collective sigh of relief when Mom bounced back from that stroke. Her smile returned to its usual symmetry, and life got back to normal — at least for a while.

Over the next couple of years, Mom had a number of small strokes. Little by little, she grew more unsteady on her feet and less mentally sure. Her quirky sense of humor revealed itself all too rarely. She said she felt as if there were cobwebs in her brain. The strokes were taking their toll.

A Sore that Wouldn’t Heal

The first time Mom mentioned the sore on her leg, I had a hard time seeing it. It looked like nothing more than a tiny scratch. If I had known then what I know now, I would have suspected PAD and called the doctor immediately.

Apparently, I’m not alone in missing PAD’s often subtle signs. Many people overlook symptoms, such as leg or foot wounds that fail to heal, cramping in one leg during exercise and a lower skin temperature in one leg than the other — symptoms that could indicate a lack of blood flow.

A week or two after first learning about Mom’s leg sore, I became concerned. Why wasn’t it healing?

Her primary care physician referred Mom to a wound specialist. He treated the stubborn sore. But despite regular treatments for more than a month, it continued to get worse.

That’s when the wound specialist and Mom’s primary care physician referred her to a vascular surgeon.

Our office visit to the vascular surgeon took an unexpected turn. After examining Mom’s wound, he told us he wanted to admit her to the hospital immediately. As it turned out, the blockages in her peripheral arteries couldn’t be cleared or stented, so the surgeon did his best to remove the dead tissue around the wound. He told me there was a chance that gangrene might necessitate amputation. We’d just have to wait and see.

The Last Days

My mother never returned home from the hospital. After a few days of acute care, she was transferred to a nursing unit in the same medical center. I knew we were in trouble when my mother — a lifelong dog lover — showed no interest in a visiting therapy dog. It took considerable coaxing to get her to eat anything. Even daily visits from her beloved grandson elicited nothing more than a weak smile.

Her leg ceased to be the major concern after she suffered another stroke. This one was massive. She lingered for a few days, barely moving and unable to speak. I don’t know if she was aware of much, but I feel a certain satisfaction that I was with her when she died.

A Lesson Learned

I realize that my mother’s story would most likely have turned out the same way, even if I’d rushed her to the doctor when her leg sore first appeared. The convergence of her health issues was already well underway, and their momentum was unstoppable.

But while awareness of PAD might not have saved her life, it might make a big difference in yours — or in the life of someone you love. That is why I’m happy to share my mother’s story.

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