A few years ago, Dale Smith was unable to walk more than 10 or 15 paces at work before leg and toe pain forced her to sit and rest. As assistant manager of a grocery store in Beebe, AR, that was a big problem. “I have to constantly be on the floor walking,” says Smith, now 61.
Following a visit to her cardiologist, after she had a heart attack a year earlier, Smith learned she had peripheral artery disease (PAD), a narrowing of the arteries that mainly occurs in the legs. She had an angioplasty procedure done in a leg artery and began taking medication for pain and cholesterol.
Recently, Smith’s smartwatch told her she walked 15,000 steps pain-free, and she has kept a job she loves.
“I’m thankful I have a really great boss who understood fully and told me to take as many rest breaks as I needed,” she says. “But I did worry before if I could keep working.”
If you are diagnosed with PAD, your doctor hits you with a lot of information about exercise plans, diet, and medication. Making PAD treatment fit with your job may get less discussion. Even though PAD usually affects people in their 50s or older, that can leave a decade or more of working years to consider for people like Dale Smith.
“PAD is all about lifestyle adjustments, and work is a major part of everyone’s life,” says Damon Pierce, MD, a vascular surgeon for Virginia Mason Franciscan Health in greater Seattle.
Pierce had a PAD patient, an auto mechanic, who worked for 20 years in a shop with bonuses based on job speed. Over time, competing against younger mechanics in physically strenuous work that required him to get into and out tight spaces under cars, the mechanic’s PAD-related leg cramps worsened. But he was able to negotiate a workload that was less physically intense. Still, continuing job stress eventually led him to quit for a supervisory role in a new shop with a less demanding pace.
Typical PAD symptoms — pain or cramps in the legs, hips, or buttocks; trouble walking; sores or ulcers on the legs or feet that don’t heal — are not always severe enough to require a change of job. But discomfort can affect productivity. It’s smart to initiate adjustments that help keep you comfortable and pain-free.
Make sure that your work life fits with the treatment plan your doctor provides. You may need to ask your employer to make accommodations.
To help you manage your PAD on the job, here are several doctors’ recommendations:
Make time for exercise. A 10-minute walk isn’t the kind of exercise that helps manage your PAD. Instead, combine part of your lunch hour with other break time that allows an hourlong, vigorous and beneficial walk, Pierce suggests.
Take mental health breaks. Job-related stress raises the risk of hospitalization for PAD, one study found. Also, “when you’re stressed, you feel more tired and are less likely to do the exercise that improves blood flow through your legs,” says Amy Pollak, MD, a cardiologist with the Mayo Clinic Florida in Jacksonville and a volunteer advocate for the American Heart Association.
That’s why Pierce recommends taking mental breaks during the workday to relieve stress. Use that time to meditate or just walk around the building. Even a couple of minutes away from the job helps.
Stay warm. Colder temperatures interfere with blood flow to your legs and arms. Dress to stay warm at work, outdoors or indoors. And don’t be shy about asking to bump up the office thermostat.
Pay attention to your diet. If you eat lunch out, look for low-fat, low-salt choices on restaurant menus. If your building’s cafeteria is short on heart-healthy foods, ask if they could add some.
Think about air quality. Avoid areas where co-workers gather for smoke breaks. And avoid prolonged exposure to work environments where the air quality is poor.
Invest in good footwear. If your job requires a lot of walking or driving, you should buy comfortable, durable shoes with sturdy soles.
You may not want to change jobs just because you are managing PAD. But that doesn’t mean you should keep quiet and pretend nothing has changed.
“You want to be honest with your employer about what is going on, that you are following a prescribed treatment plan,” Pierce says.
He often writes a letter for his patients with PAD to give to their supervisors that explains what treatment involves and how they can stay productive with the company’s help.
You may need to ask for flexibility to balance your job with your PAD treatment. Here are a few possible scenarios:
Request a change of duties if your job involves bursts of strenuous physical activity or requires heavy lifting. Sitting at a desk for hours at a time usually doesn’t increase risk unless your PAD is advanced, according to Pierce.Work additional hours or request deadline extensions if PAD is tiring you. “You need to be honest if it will take you longer to get a task done,” Pollak saysRequest time off for doctor’s appointments at varying times.
You may be nervous about asking your boss for flexibility. But remember you may have a legal right to ask for reasonable accommodations if your doctor certifies your PAD has become a disability. The federal Americans with Disabilities Act provides that right if your company employs 15 or more people and PAD “substantially limits” your ability to perform your duties in the current setting.
Despite your best efforts, it’s possible PAD symptoms could force you to take time away from work. Using your paid vacation and authorized sick days will be your first option.
But what if you have already burned through those days for this year?
Remember that under the federal Family and Medical Leave Act (FMLA), you can request up to 12 weeks a year of unpaid leave. You need to have worked for at least a year at a business that employs 50 or more people to qualify.
You can’t be fired or denied your old job for taking unpaid medical leave. And the company can’t stop paying its share of your health insurance. Even so, it’s recommended that you give your employer at least 30 days’ notice if you can and explain exactly why you need leave. You will have to provide a letter from your doctor if your employer requests one.
It is possible for PAD-related leg pain to get so bad that you are unable to keep working. In its online Blue Book manual, the Social Security Administration recognizes PAD as a “cardiovascular impairment” and potential disability. This means you may qualify for disability benefits to help cover your living expenses.
But just saying you deal with pain or labored walking from PAD will not be enough to get these benefits. You will need to see a doctor to get imaging tests on your blood vessels and blood pressure readings from your ankles or toes and then provide the results. You may want to hire an attorney who specializes in disability requests.
Pain and discomfort from PAD can create challenges for your work life. But there are approaches that help you enjoy a rewarding career as you manage PAD. Be assertive about making improvements to your job conditions, and don’t be shy about asking for help. You deserve to feel rewarded by your work life.
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