Frequently Asked Questions
What is venous insufficiency?
Venous insufficiency is an abnormal circulatory condition with decreased return of blood from the leg veins up to the heart, with pooling of blood in the veins. Normally, stop valves in the vein close to keep blood form flowing downward with gravity. When the valves in the vein become weak and don't close properly, they allow blood to flow backward, or reflux.
What are varicose veins?
Varicose veins are prominent veins that have lost their valve effectiveness and, as a result of dilation under pressure, become elongated, rope-like, bulged and thickened.
What are the sypmtoms of varicose veins or venous insufficiency?
Symptoms caused by venous insufficiency and varicose veins include aching pain, easy leg fatigue, and leg heaviness, all of which worsen as the day progresses. Many people find they need to sit down in the afternoon and elevate their legs to relieve these symptoms. In more severe cases, venous insufficiency and reflux can cause skin discoloration and ulceration which may be very difficult to treat. One percent of adults over age 60 have chronic ulceration.
How common is venous disease and varicose veins?
Chronic venous disease of the legs is one of the most common conditions affecting people. Approximately half of the U.S. population has venous disease--50 to 55% of women and 40 to 45 % of men. Of these, 20 to 25% of the women and 10 to 15% of men will have visible varicose veins. Varicose veins affect 1 out of 2 people age 50 and older, and 15-25% of all adults.
What causes varicose veins?
Contrary to popular belief, crossing the legs has absolutely nothing to do with the appearance of varicose or spider veins. In most persons, the tendency to develop these abnormal veins is largely hereditary. Vein problems are aggravated by pregnancy and estrogen levels, so they are usually worse in women, but men are not immune! It can affect people of all ages, from teenagers to patients in their 90's.
I've had vein stripping before and the veins came back. How is your treatment different?
The key to modern, effective treatment of varicose veins is using duplex ultrasound, done in the standing position, to completely map out the size and location of all diseased veins, many of which are underneath the skin and not visible. By utilizing ultrasound to 'see' these hidden diseased veins, we can eliminate the root cause of most recurrences. Unless you had a complete 'vein mapping' ultrasound in the standing position prior to your surgery, chances are the surgeon left behind some diseased veins, and that is why your problem came back. In addition, vein strippings were done in the hospital under general anesthesia and required prolonged and painful recovery times away from work. Our microsurgical procedures are done under local anesthesia right in our office. You are up and around immediately after the procedure and can return to work the very next day. And because our incisions are so small, there are no scars!
I've told my doctor about my veins many times, but he told me not to worry about them, that they were just 'cosmetic.' What do you think?
Large bulging varicose veins cause symptoms in the vast majority of people who have them. In most cases, these veins are not just cosmetic but are considered to be a serious medical problem that can lead to significant complications if not treated. In years past, when the surgery to remove varicose veins was so barbaric and disfiguring (e.g., vein stripping), many physicians discouraged their patients from having anything done. The new surgical and non-surgical techniques are so much easier and less painful that there is no reason to live with varicose veins anymore. Unfortunately, your physician may not be aware of all the newest techniques available for varicose vein treatment (But YOU are!)
Do men get varicose veins?
Yes, but varicose veins routinely occur 7-10 times more often in women. Pregnancy and hormones can worsen varicose veins and this is why they occur more often in women.
My legs hurt all the time, but I just have spider veins. Is this normal?
Spider veins can very often be symptomatic. Spider veins are unhealthy veins where blood pools and this can often cause pain and inflammation.
What is a DVT?
How do I begin treatment for my vein problem?
During your initial consultation, the physician will evaluate your symptoms and examine your legs. A portable ultrasound may be used to check for diseased internal veins. Any questions you may have will be answered. You may also discuss your expectations and anticipated results. The doctor will give you an estimate of the number and type of treatments you may need and the affiliated costs, which will vary depending upon the size and extent of your problem. In some cases, a more detailed ultrasound test may be needed to assess the extent of your vein problem. After final treatment recommendations have been made by the physician, you should then be able to schedule an appointment for treatment.
I was told that if you take out my vein, then I would not have any for a heart bypass.
This is not true. Bulging varicose veins are useless to a heart surgeon. He needs a normal-sized, straight, and healthy vein to bypass an obstructed coronary artery. Likewise, any internal veins that we treat are already diseased, and as such, cannot be used for coronary bypass. If your leg veins are so diseased that they cannot be used, there are plenty of other options available to the heart surgeon.
What will happen if my varicose veins are NOT treated?
Over time, varicose veins always enlarge and become more symptomatic, forcing many people to alter their daily activities to try to decrease the pain and swelling. In severe cases, varicose veins can cause skin damage, ulcerations, and blood clots. These complications can be prevented by treating the varicose veins early. No matter how severe the vein problem, and no matter how long it has gone on, effective treatment can be given in most cases.
My Mother has varicose veins, will I get them too?
I am sorry to say that varicose veins tend to run in families, so most likely you will get them too. Varicose veins are often hereditary.
Another surgeon wants me to have my veins stripped...is that necessary?
Vein stripping requires a hospital, a general anesthetic and leaves multiple scars. What is even worse is the discomfort which usually mandates a 4-6 weeks recovery. There can also be complications such as nerve damage and wound infections. This procedure is becoming less common as a treatment options. New endovenous ablation procedures require none of the aforementioned problems. The recurrence rate is much lower with the new procedure.
Should I wait until I am finished having children before I have them fixed?
The treatment cannot be performed while pregnant however it can be done between pregnancies. The sooner they are treated the less time it will take to get your legs looking and feeling great again. Pregnancy can still worsen your varicose or spider veins so subsequent pregnancies could cause more requiring further treatment.
What is Endovenous Ablation (VNUS ClosureFAST)?
It is a new procedure that takes about 45 minutes to an hour and is performed in an outpatient setting. During the procedure, the area of the leg affected is locally anesthetized and a thin catheter is inserted into the abnormal vein and delivers the energy which closes the vein. Blood no longer gathers and the varicose vein shrinks and is reabsorbed.
Don't I need these veins for my circulation?
Spider and varicose veins are actually a burden to your circulation. When varicose veins are eliminated, the legs feel lighter and more energetic because the venous circulation is improved, and the body has re-routed the blood flow into stronger, healthier, deeper veins.
What is sclerotherapy? Isn't it painful?
Sclerotherapy involves using a very small needle to inject special medications into diseased veins that cause the veins to shrink and gradually disappear. The needles used are very small and feel like a mosquito bite. Most people find this treatment relatively painless. Sedation and local anesthesia are not required. The solutions we use for these treatments are painless, as opposed to the old-fashioned saline treatments which were not.
How long will my treatment take?
Sclerotherapy treatment sessions are usually 30 minutes each. Every patient is different, and the number of sessions needed varies depending on the severity of your condition. Most cases require three to six treatments; however, this is only a guideline. Your individual case may be different. Your legs may begin to show improvement in as little as a few weeks, but the best results are usually seen after several treatment sessions. After healing has occurred, spider veins and bulging varicose veins will be gone, leaving you with healthy, great-looking legs. Contrary to reports in the media, there is no such thing as a miracle 'one treatment' cure for spider veins.
What do I have to do after Endovenous Ablation?
Wear the hose! Make sure you walk at least 30 minutes each day. Take ibuprofen for pain.
Are there any restrictions to my physical activity after spider vein treatment?
There are usually no restrictions on physical activity after sclerotherapy. In fact, exercise is encouraged. We do discourage direct sun exposure to treated areas for a couple weeks after each treatment (sunscreens are adequate protection during this time).
Do varicose veins come back?
Our micro-surgical procedures remove bulging varicose veins permanently. Sclerotherapy destroys veins so they will not return. Endovenous catheter procedures also permanently destroy the treated vein segments. None of these procedures, however, can prevent new veins from forming in the future. Remember, the tendency for good veins to wear out is hereditary. If you notice new varicose veins forming, see your doctor right away so additional treatment can be given. The earlier bad veins are found, the easier they are to treat.
What can I do to prevent varicose veins?
Regular exercise helps to pump blood up the legs and back to the heart against gravity. Getting enough rest, eating a healthy diet, and keeping your weight down help your overall health, including your veins. Support stockings and herbal supplements have been shown to improve pain and swelling from varicose veins but have never been proven to heal bad veins or prevent healthy ones from deteriorating. Unfortunately, time and gravity cause veins in susceptible people to wear out. Once a vein has become a varicose vein, it will never function properly and should be eliminated.
Do spider veins come back?
The spider veins treated with sclerotherapy are permanently destroyed and will be reabsorbed by the body, so they can't come back. However, nothing can be done to prevent your body from forming new spider veins. Excessive standing and crossing the legs does not cause them, it is mostly hereditary. But new spider veins can be treated just as effectively as the previous ones with additional sclerotherapy. The best prevention is to keep your legs in shape, weight under control, and seek regular cleanup sclerotherapy of new spider veins.
Will my insurance pay for treatments?
The initial consultation (office visit) is usually covered by insurance. If treatment of your condition is considered medically necessary by your physician, we will make every reasonable effort to seek reimbursement from your insurance company. Unfortunately, we cannot guarantee that they will provide payment. Treatment of spider veins, regardless of symptoms, is always considered cosmetic by insurance companies and is not covered. Support hose are not covered by insurance however we do provide them at a low cost for our patients.
Can I make payment arrangements?
We realize that medical cost can really add up, so we try to keep our prices affordable. We are willing to work with you to make payment arrangements when insurance is not available or if the procedure is not covered. We accept cash, personal checks, MasterCard, Visa, and FlexCard.