It is always important to keep on top of your mental health, especially when you have a chronic disease like Peripheral Arterial Disease (PAD). When we are afflicted with health concerns like PAD, it can be too easy to become discouraged or depressed. A positive mindset is crucial toward regaining your quality of life and improving your health. Just remember that it is never too late to start new and healthy habits. There is no point beating yourself up about past mistakes or bad habits. The key is to live in the “now.” What can you change today to contribute to becoming your best self? If you have struggled with PAD or diabetes, you know how crucial exercise, food choices, and stress management are to a self-improvement plan. As the adage goes, “Rome was not built in a day.” Making the choice to embrace a healthful lifestyle is the first step toward a better you!

Exercise will be the focus for the 1st part of this 3-part series. According to HelpGuide.org, “Exercise works to boost your mood by promoting neural growth, reduced inflammation, and new activity patterns that promote feelings of calm and well-being. It also releases endorphins, powerful chemicals in your brain that energize your spirits and make you feel good. A recent study done by the Harvard T.H. Chan School of Public Health found that running for 15 minutes a day or walking for an hour reduces the risk of major depression by 26%! In addition to relieving symptoms of depression, research shows that maintaining an exercise schedule can also prevent you from relapsing.”

Of course, when you are beginning a new exercise program, you need to get guidance from your doctor on what exercises they recommend and duration (how long). Walking or swimming in general are great options. Start small and take “baby steps,” if you will. If you have not exercised in a long time, try starting out with 10 minutes a day. 

Listening to music or having an exercise buddy can be especially motivating. An exercise buddy not only allows for accountability, but who doesn’t love chatting it up while walking? Sometimes you will even walk longer than you thought you could.

Pay attention to how you feel during and after the walk and write it down in an activity journal. It is important to stop and rest for approximately 5 minutes during your walk when you feel pain; only resume your walk if you can tolerate it safely. Ask yourself if the walk duration was too hard or too easy for you. Did you feel winded, or were you able to carry on a conversation with no problem? Track how long your walk lasted with the date and the start and stop times. If you have PAD, pay attention to your pain and comfort level. Ask yourself if you felt leg pain. If so, how bad was the pain on a scale of 1 to 10, with 1 being no pain at all and 10 being the worst pain imaginable? Also note if the walk made the pain better or worse. Did walking improve cramping or claudication? Observe your mood at the beginning of your exercise regimen and afterward. Write all these observations in your activity journal so you can keep track of the goals you’ve met and your progress.

Of course, if you experience excruciating pain at any time or more pain than normal that doesn’t go away with rest, please stop your activity — and call your doctor right away!

According to Emile R. Mohler, III, MD, the late Director of Vascular Medicine at Penn Medicine, walking is one of the best exercises a patient with PAD could do.

The late Dr. Mohler had these walking program recommendations, but please consult your vascular doctor for what is appropriate for you:

• Get a good upper and lower leg stretch before you start.

• Walk as briskly as you comfortably can for about 5 minutes. Mild discomfort may be experienced.

• Take a 5-minute break and assess how you feel. If mild pain goes away in five minutes, repeat a brisk walk for another 5 minutes, then stop, reassess for 5 minutes, and continue as tolerated. 

• Repeat the “walk-and-stop routine” as often as you safely can. 

• Ideally, for the first two months of your walking program, your goal will be to work up to a 35-minute session, not counting the 5-minute rest breaks toward your time. Keep adding a few minutes until you’re at the goal of walking 50 minutes.

• Cool down by slowly walking for 5 minutes, and finish with your calf and thigh stretches.

Although Dr. Mohler had an end goal of walking for 50 minutes 3 to 5 times a week, each person’s tolerance and ability will vary. It is important to take an individual approach while under the direction of your physician. Some patients will reach a goal of “30-minutes of moderate exercise 5 times a week (which can even be broken down into two 15-minute or even three 10-minute exercise sessions).”

Some patients may meet or even exceed Dr. Mohler’s 50-minute walking goal of 3 to 5 times a week. The important thing is to set goals that are tailored to you by your health professional. And don’t compare yourself to other people! Stay focused on your individual journey.

Stretching your legs and calves is also a great way to relax and improve PAD symptoms. In a study using an “ankle dorsiflexion splint to induce passive calf muscle stretching, there showed evidence that it enhanced vascular endothelial function and improve walking function in some PAD patients.”

There are many tools to help us with mental and vascular health from doctors, mental health professionals, nutritionists, and physical therapists. It is important to get help when you need it. Ensure that you have a great vascular surgeon who can answer questions on how to improve and treat PAD and other vascular diseases to help you live your best life. For more information, contact Dr. David Nabi at NewportVascular.com.