I have apressure reading of 183/105 in arms 50/30 in legs,

ken,

Thanks for your question.  Sorry to hear you are having so many problems. 

With your prior history and problems, you should also be taking a statin medication which is used in the treatment of high cholesterol.  You should be taking this medication even if your cholesterol is normal.  Many studies have shown a slow down, and even some regression, in blockages that occur in blood vessels.  Small arteries can be a problem, but small arteries with blockages are a bigger problem which can be addressed, and the earlier the better. 

The difference in the blood pressures is due to your vascular disease and the poor circulation to your legs, despite the stents in your lower back.  The pressure in your arms is still too high and needs attention to get it down.  Elevated blood pressure is a major risk factor in the development of atherosclerosis - the fatty deposits in blood vessels that cause blockages.

As for your doctor's statement about what more can be done?  You need a comprehensive evaluation of your whole situation.  You need better treatment of your medical situation in order to minimize your risks and help prevent (or at least slow down) your vascular disease.  If your primary care physician is not capable of doing this, find another physician.  From a surgical viewpoint, find a major referral center for vascular surgery and make an appointment for an evaluation.  Be sure you have your old records with you, especially your X-rays.  This is a field where new techniques are being used all of the time.  These techniques are used first at referral centers before being adopted by other surgeons.  Consider major university medical school hospital centers, or centers known for their expertise in vascular surgery, such as the Cleveland Clinic. 

And a major consideration:  what are you doing to help this situation?  I hope that you are not smoking - another major risk factor for atherosclerosis.  You should be following a healthy, low fat diet, as well as exercising regularly.  Explore this websites area for high blood pressure, Cholesterol, and Heart, for more information and tips to help you live a better lifestyle as well as minimize your risks for further problems.

As for disability, this depends on your job and what your capabilities are.  Your doctor should work with you on filling out the paperwork.  It can sometimes take several applications before approval is given. 

It's time to take better control of your life.  Find the right physicians and do your part in taking care of yourself.  Best wishes.

Martin Cane, M.D.