Thursday, October 17, 2013
Don't ignore leg pain symptoms

By Dr. Anthony Policastro
Everyone knows that if the blood supply to the heart is inadequate, chest pain occurs. The heart is a muscle. That is how muscle reacts to decreased blood supply. The heart is not the only muscle affected in this way. If the blood supply to the legs is inadequate, pain in those muscles will also occur. The pain usually will occur in the calf muscles. The term for this pain is intermittent claudication. Claudication occurs during walking. More blood is needed by the leg muscles when walking occurs. If there is a problem with the blood supply, the muscles will develop pain. The degree of blockage to blood flow will affect the type of pain. For example, significant blood flow problems will quickly cause pain. The individual will not even be able to walk an entire block without pain. This is referred to as one-block claudication. If an individual can walk for three blocks before there is pain, then it becomes three-block claudication. Once the individual stops walking, the muscles need less blood. The pain goes away. The individual can then walk again until the pain recurs. Most people recognize chest pain being related to poor blood flow to the heart muscle. However, claudication is less common. People who have this symptom might just think it is a muscle cramp when they walk. Therefore, they do not get it properly evaluated. There are two possible locations for the cause of claudication. One of them is a narrowing in the lower aorta. This will decrease the blood flow to both legs. It will cause pain in both calves. The other is a narrowing of the artery in the leg itself. This will cause pain in that particular leg. While the arteries of both legs are often affected, this type of narrowing tends to cause the pain in one leg to be worse than the other. Again the individual may just think it is muscle cramping. When I was a third year medical student, my first clinical rotation was on vascular surgery. We evaluated people with claudication. In those days, we had to inject dye into the legs to evaluate them. If there was a problem, we would have to put in an artificial graft. That might need to go into the aorta or the leg. Treatment is more advanced now. We have better imaging techniques to tell us where the problem is. We have stents that can be placed into the artery to open it up more. The problem that we have is more in the area of diagnosis than it is in the area of treatment. People will develop claudication. They will not recognize it as a blood flow problem. They will think it is only a muscle cramp. If the artery blockage gets bad enough, it will block the blood flow to the leg entirely. The result will be gangrene followed by a leg amputation. It is a lot better to get early treatment and prevent that. The heart is not the only muscle that tells us when it does not receive enough blood.

Seasonal flu shots offered at Mears Health Campus Nanticoke Memorial Hospital will offer seasonal flu shots to individuals 18 and older at Nanticoke Memorial Hospital's Mears Health Campus (300 Rawlins Dr., Seaford, Rehabilitation Services Building) on the following dates: Thursday, Oct. 17 - 8 a.m. to noon Thursday, Oct. 24 - 4 to 8 p.m. Thursday, Oct. 31 - 10 a.m. to 2 p.m. There is no charge for this year's flu shots. A donation of $10 per vaccination is appreciated. Pre-registration is not required.

Free balance screenings offered Suffering from dizziness or loss of balance? In honor of National PT Month, Seaford Physical Therapy of Aquacare will offer free screenings during the month of October to see if you would benefit from physical therapy. Licensed physical therapists will provide an assessment of your balance and give tips on strategies to improve your balance. Vertigo is the sensation of spinning. Even when being still, you may feel like you are moving, or that the room is moving around you. You may also experience nausea, vomiting, sweating, and abnormal eye movements. Physical therapy for balance, vertigo, or dizziness is covered by most insurances. For more information or to schedule a free screening, call 536-1774.

Diabetes education program offered Nanticoke Memorial Hospital, Seaford, will hold a four-session diabetes education program on Oct. 30, Nov. 6, 13 and 20, from 5 to 7 p.m., at the hospital. Registration is required. The cost of the program may be reimbursable by insurance. This four-session program includes weekly education sessions and individualized meal planning for diabetes self-management. Family members/significant others are welcome to attend the weekly sessions. Pre-registration is required. For more information and to register, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.

Parkinson support group The Nanticoke Parkinson Education and Support Group will hold its regularly scheduled meeting from 10 to 11:30 a.m. on Monday, Oct. 21, at the Nanticoke Senior Center, 1001 West Locust St., Seaford. The agenda will be a presentation by a local physical therapist. Contact Dennis Leebel, 302-644-3465, for more information. CPR classes offered Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR on Tuesday, Oct. 22, at the Nanticoke Training Center on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children and infants and how to help an adult, child or infant who is choking and use of the AED. This classroom-based, video, and instructor-led CPR course offers families, friends, and community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements.

Cost is $45. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required. St. Jude Motorcycle Ride rescheduled Due to inclement weather, the 4th Annual Cat Country Cares for St. Jude Kids Motorcycle Ride, presented by Custom Mechanical and Geico will now take place on Sunday, Oct. 27, starting at the White Marlin Mall in Ocean City. Registration begins at 10 a.m., and the ride goes "kickstands up" at 11:30. After a scenic ride from Ocean City to Rehoboth Beach, the festivities continue at Delaware Distilling Company on Route 1 in Rehoboth Beach. All proceeds benefit St. Jude Children's Research Hospital in Memphis, Tenn., the world's leading facility in dealing with childhood cancer. The hospital turns no child away, regardless of a family's ability to pay. Currently, St. Jude Children's Research Hospital spends more than $1.4 million dollars per day to operate the facility. Registration is $25 per bike, and $5 per additional rider. To pre-register, visit For details contact Dixie Kelly at 410-219-3500.

Mini-Walk for Alzheimer's The 4th Annual Mini-Walk for the Alzheimer's Association along with a yard sale will take place on Saturday, Nov. 2. The yard sale will run from 8 a.m. to noon and the mini-walk begins at 10:30 a.m. at Lofland Park Center at Genesis in Seaford. All proceeds benefit the Alzheimer's Association. For details call 628-3000.

DBCC plans Monster Miles event The Delaware Breast Cancer Coalition (DBCC) will hold their Fourth Annual "Monster Miles for a Cause" Walk at Dover International Speedway on Saturday, Oct. 19. The event is a unique opportunity for supporters of local charities to walk on the NASCAR track. Attendees are encouraged to walk in honor or memory of someone in their life that has been impacted by breast cancer. The DBCC walk begins at noon with registration opening at 10 am. The event will have vendors, food and team prizes. Visit to register or to learn more about sponsorship opportunities. The event is rain or shine and costs $25 per person or $30 on event day. Children 10 and under can walk for free with an adult. Those who cannot attend but would still like to support DBCC can register online as "Sleepwalkers." The 2012 event raised over $16,000 for DBCC's local programs. For more information, contact Michelle Marshall, event coordinator, at 302-593-9924 or

E-Racing the Blues Walk/Run Christa Scalies, suicide prevention and mental health advocate and founder of Giggle On, will lead a pre-race 10-minute laughter warm-up session of 5K participants in the 11th Annual E-Racing the Blues 5K/10K Walk/Run hosted by the Mental Health Association in Delaware on Sunday, Oct. 27. Using various laughter-based, lung-strengthening and muscle-stretching exercises that she developed, Scalies will motivate and invigorate the walk/run participants by helping them reduce stress, boost endorphins, stimulate deep breathing, and boost their immune systems. For more information about Scalies and Giggle On, visit For more information about the walk/run, visit

Free flu vaccine on Oct. 24 The Delaware Division of Public Health (DPH) will prepare for the 2013-2014 flu season by offering free influenza vaccines to the public in Sussex County at the Georgetown Presbyterian Church from 9 a.m. to 3 p.m. The flu clinic is being run as a timed drill so DPH staff can practice their readiness in the event of a large-scale health emergency. Public Health nurses will administer flu vaccine to Delawareans age 6 months and above. They will offer the intramuscular flu vaccine for ages 6 months and above, and the nasal FluMist for ages 9 years to 49 years. Clients who sign a media consent form may be photographed.

BIAD plans annual fundraiser To help promote greater public awareness of the Brain Injury Association of Delaware's (BIAD) advocacy, support, and prevention programs, the organization has set Nov. 2, as the date for its annual "Embellish Your Melon" fundraiser. The event will be capped by a fun-filled, hat-contest-themed dinner-dance, grand prize awards, sponsor acknowledgements and silent auction. The event will take place from 6:30 to 9:30 p.m. at Harry's Savoy Ballroom, 2020 Naamans Rd., Wilmington. Advance registration at is $49 per person ($59 at the door) and includes the dinner-dance, contest entry and silent auction admission. Businesses and individuals who wish to participate in the event are encouraged to contact BIAD (by leaving a return-call phone message at 800-411-0505) to reserve sponsorship package rates and arrangements.

Alzheimer's Caregiver Workshop Cadia at Renaissance in Millsboro will host an Alzheimer's Association Caregiver Workshop on Wednesday, Oct. 23, from 8:30 a.m. to 4:30 p.m. The free workshop will include: "The Basics" presented by Dr. Lawrence Kemp, "Legal and Financial Issues" presented by Amber B. Woodland, Esq., "Behaviors and Communication" presented by Ruth Pryor, geriatric social worker, and the Delaware Hospice Transitions Program presented by Al Morris. Lunch will be provided by Renaissance and pre-registration is required by Oct. 17. For more information, or to register, call Jamie Magee, Sussex County program coordinator, at 854-9788 or 800-272-3900.