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My mother,


(64, diabetic type 2, height: approx. 5'0, weight: 53 kilos, medication: metformin 2000 mg and pravastatin 10 mg per day, HbA1c is 6,8% and cholesterol is within normal range, location: Germany)


has been diagnosed with POAD recently and apparently she also has diabetic neuropathy.


Her doppler pressure index/ ankle-brachial index is at: 1,0 and 0,8. She is being referred to an angiologist for further testing (color duplex sonography). At the moment we don't know where we stand and what to do, so here are my questions:


- I know you can't heal POAD, but can we prevent it from getting worse? Will it progress to the last stage? Or can we improve her test results?


- Does my mother have advanced POAD?


- I have read on google that people with POAD have their life expectancy cut short by 10 years, is this true?


- Aside from being gentle on her feet (no hot water, sharp items) is there anything else we can so? Will massages or taking gingko help?


To be honest I'm just very worried and really don't know what to do. Her doctor didn't explain much and only referred us. The doppler pressure test was done three months ago and we weren't notified of anything worrisome, only today she told this (same doctor).


Any answer is appreciated.

Lain,
Just so you know, we are glad to have a member from Germany.
There are members and posters here on Aging Care from all over the world.
You have a challenge caring for your Mother and Grandmother!

Keep us updated!
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Lain129 Feb 15, 2020
Thank you so much :)
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It seems ur Mom is pretty active and tries to watch what she eats. You have to allow for some cheating. The neuropathy is caused by the diabetes. It involves the nerves and from what I understand is not reversible. It happens because diabetes effects circulation. If Mom still drives, she may not be able to eventually. She has to be careful about falling. There is numbness involved. I was told after a fall Mom had, she went down like a sack of potatoes. The same people who witnesses that fall, allowed my Mom to go out a door with a deep step and no railings. Again, she fell. Mom was told not to pivot when she turned around.
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Lain129 Feb 15, 2020
Thanks for your reply. We are working on finding ways to improve her diet. It's a working progress I guess. My mum doesn't have a driver's license so that's not a worry. I'm sorry for what happened to your mum.
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Type 2 Diabetes MAY respond dramatically to dietary modifications if your mother is willing to give changing her eating a try.

Is she obese? Willing to eat fewer prepared foods, fewer refined carbs like bread, cookies, candy? Increase veggies, whole fruit, protein? Willing to move- walking, stationary bike, “dancing” just for fun?

If she IS obese, a loss of 5% of her current body weight can help her overall well being, and also her blood scores.

Will she work with a physical therapist, on a prescription from her doctor for a movement program intended to maximize however much circulation there still is in her legs and feet?

Some, or all of these suggestions can change her diabetes scores, if she’s motivated and understands the consequences of improving her condition vs. not improving it.
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Lain129 Feb 13, 2020
Thank you for your reply. My mother is in not obese (height 5'0 weight 106 pounds). She also moves a lot (but there is potential for improvement here). She tries to watch what she wants but does get weak for sweets often. So I will have to monitor that.
She does gymnastics every morning for 30 minutes and once a week in a group. I will ask for a prescription for leg specific gymnastics.

Thanks again :)
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I would wait until all her testing is completed before you seek another opinion.
Otherwise it’s a watch and wait diagnosis. If her Doppler studies show arterial occlusion and it is affecting her legs a stent to the artery may be a solution. They also may treat her with Plavix to prevent clotting.
Peripheral neuropathy complicates things. Inspect her feet often to look for any unhealing cuts and schedule regular podiatry appts.
Compression hose may be prescribed as well.
As far as the rest of your questions perhaps someone else can offer suggestions.
Treatment is pretty standard though.
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Lain129 Feb 13, 2020
Thank you for your reply. I will take your advice and wait until the results angiologist. Podiatry appointment is already booked.
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Thank you for your replies.

@countrymouse: my mum is fairly active. And we thought everything was ok with her diabetes. She had her feet examined in November 2019 and they told her everything was fine. We went in yesterday to get blood drawn and the doctor told us that she has POAD and neuropathy without a new examination.
I asked to get the results and it says:
Feet: 11/19 pnp (neuropathy), Doppler 11/19.

I'm thinking about getting an second opinion.
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How active is your mother?
Do you also live in Germany, near her, or are you trying to support her from overseas?
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Lain129 Feb 13, 2020
Thank your for your reply. I do live with my mum in Germany. I'm using agingcare because I got good information and support for another family member and there isn't a forum like that in German.
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https://my.clevelandclinic.org/health/diseases/17357-peripheral-artery-disease-pad/management-and-treatment
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I dont know much about POAD , but the brachial number seems to be in the first tier of "not within expected limits".

Most if our posters are in the US, so it's the middle of the night for them. I'm sure you'll get some answers in a few hours.

I think you and mom are going to need to be patient and wait for further testing. Make a list of questions to ask the Vascular doctor.

I would not take any supplements without speaking to a doctor. Have compression socks been recommended?
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Lain129 Feb 13, 2020
Thank you for your reply. I will try to get an second opinion because the doctor notified us three months late and didn't explain much. Thank your for links also I will read them after work. My mum doesn't wear compressions socks as there never was the need. Thanks again.
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https://en.m.wikipedia.org/wiki/Ankle%E2%80%93brachial_pressure_index
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