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Varicose veins with their associated symptoms
and complications constitutes the most common of all vascular disorders
of the legs. Varicose veins are estimated
to affect up to 80% of the US adult population and increase in frequency
with increasing age. As the average age of the US population increases,
the number of patients affected will increase sharply. Women are
afflicted much more frequently than men at a ratio of 8 to 1.
In the US, six million workdays per year are lost due to the complications
of varicose veins.
With today's emphasis on being healthy, youthful and active, it
is understandable why many people are seeking out physicians that
can control the complications of age. Many people feel that if treatment
exits that will make them better will not be painful or cost them
"an arm or a leg", and then they will go for it. “Life
waits for no one.” What I hope to achieve with this website
is to give you a clear informative narrative on the latest and best
treatments for varicose veins.
What are Varicose Veins?
Varicose veins are enlarged and elongated veins at or close
to the surface of your skin. They often appear twisted and are sometimes
painful or discolored. They may be large and rope-like or fine and
spider-like. Their color may vary from dark blue to red. They can
be found not only on your legs but also on your abdomen, breasts,
face, arms, and hands.
What are the Symptoms?
If you are suffering from leg pains, swelling of your legs after
a long day on your feet, leg cramps at night, restless legs, itchiness
of your legs, a heavy feeling in your legs made worse during your
menstrual period, discoloration of the skin, burning, or skin ulcers;
then you may be experiencing symptoms of venous insufficiency caused
by your varicose veins. Venous insufficiency is a condition whereby
your veins are not functioning properly. Treatment can alleviate
these symptoms.
What Causes Them?
In the majority of patients the cause is a hereditary weakness of
the vein wall. Spider veins may develop with hormonal changes as
a result of fluctuations in estrogen-progesterone levels that occur
during pregnancy and irregular menses, the use of birth control
pills, or estrogen supplements. Injury to a leg either from a broken
bone or a bad contusion may lead to the development of varicose
veins. Sunburns to your legs are known to be followed by the development
of spider veins. Standing and sedentary occupations are definitely
aggravating factors. Varicose veins tend to get worse with age.
Anyone may develop them including men, pregnant young women, attractive
adults, and even athletes in peak condition.
How Should My Veins Correctly Function?
See diagram (right) >
Your veins are a part of your circulatory system, the vast network
of blood vessels throughout your body. Your arteries bring fresh
blood from your heart to your organs and your legs. Your veins carry
this blood back to your heart and lungs to be replenished. When
we sleep flat in bed, there is enough energy in the venous system
to move the blood back to our hearts. However, when we sit up, the
effect of gravity is introduced. The veins in your legs have an
especially difficult job to do. They must carry blood uphill against
gravity when you are standing or sitting. To do this, they require
our conscious effort, and our leg muscles. Our leg muscles, veins,
their one-way valves and the fascia or ligaments of our legs comprise
what is commonly called the venous pump. Blood is always entering
our legs as long as our heart is beating. This blood nourishes our
leg muscles, provides the energy to our muscles so that we can walk,
and also nourishes our skin fat areas, hair and nails. After our
blood accomplishes this it collects on the venous side of our circulation.
Our veins were designed to accommodate most of this venous blood.
When we move the muscles of our legs, (the venous pump) is activated
and blood returns to the heart. If we stand on our feet all day
without moving our muscles well, our veins distend, their valve
cusps become incompetent, and blood is not able to leave the leg
well. When this happens, blood accumulates, causing the larger veins
to bulge and the smaller ones to show up as discolored patterns
we call spider veins. An inherited tendency leads to poor structural
integrity of your veins, compounded by poor conscious control of
our venous pump, sets the stage for the development of varicose
veins. Compare this to the balloons that are used for making
decorative items such as animals and symbols. These balloons are
thin and narrow when new. When these balloons are inflated and then
deflated, they never return to their original size. They are distended
and irregular, similar to a varicose vein. A high quality balloon
made of pure rubber does return to its original size when deflated.
Surgical balloons that we use to dilate coronary arteries or leg
arteries are of this high quality. Our genes determine what quality
of material is used to form our veins. When we were born, someone
forgot to give us a manual on operating our venous pump. Nature
assumed we would always be walking; never thinking that our modern
society would require us to be on our feet for long periods working
in factories, as hairdressers, waitresses, or waiters, nurses, clerks,
etc.
Other causes of varicose veins are trauma to your legs. This causes
phlebitis or inflammation of your veins. This inflammation destroys
the delicate vein valves leading to high venous pressures, and this
causes the veins to distend. This will lead to venous insufficiency
with its attendant complications.
What Happens If I Don't Have My Varicose Veins Treated?
You run the risk of much more serious problems, including tenderness
and inflammation along the veins (phlebitis), blood clots (thrombosis),permanent
changes in the color and texture of your skin, ulcers that don't
heal, spontaneous bleeding from the varicose vein, a blood clot
that migrates to your lungs (pulmonary embolism), loss of a limb,
and even death. While the possibility of the more serious of these
is very small, it is none-the-less very real. Varicose disease usually
gets progressively worse, and each stage has more serious consequences.
At some point when swelling develops you may notice your calf muscles
getting larger. This muscle enlargement is the body's response to
significant venous valvular leaking. These leaks force your leg
muscles to work harder, as a consequence, your muscles get larger
is the same way a weight lifter makes his muscles get larger. If
you have any of these conditions, you should seek treatment.
Will Exercising Help?
If you have venous reflux or leaks of your venous valves, exercise
will only accelerate the size of your veins. Once the leaky valves
have been corrected, then exercising will lead to healthier legs.
What Can I Do For Varicose and Spider Veins?
Aside from seeking treatment, there are a few things you can do
to take better care of your veins. You can try to avoid long periods
of standing or sitting. Elevate your legs to give your veins a "rest".
Adjust your chair at work not to be too high, if you cannot, then
put a few books under your feet. This will lessen the pressure on
your thighs and thus the pressure on your veins. Try to keep your
legs cool. You may consider wearing support stockings. Many women
ask if crossing their legs cause varicose or spider veins. The answer
is generally no. Yet, crossing ones legs in some situations may
injure the underlying veins leading to the development of varicose
veins. None of these suggestions will cure varicose veins though;
but they will slow their development.
Do I Have To Go Through Surgery In Order To Cure My Varicose Veins?
In most cases, no! Surgical stripping is one way varicose veins
can be treated and this method was used extensively in the past.
This treatment of varicose veins was to remove the diseased vein.
Today correcting the valve leaks and preserving the normal veins
(fixing the veins) can treat vein disease. These veins can later
be used for bypass procedures e.g. (coronary). There are other less
painful, less costly, less debilitating methods that are more effective.
What Are These New Methods?
The most effective technique today is injection-compressive sclerotherapy.
This technique is augmented in certain situations by combining it
with ultrasonography (Echosclerotherapy), which allows treatment
of non-visible vein disease. Occasionally, if a valve leak occurs
in the groin or behind the knee where there is a large flow of blood,
surgical ligation is the safest, most cost-effective treatment available.
This procedure is done painlessly in our office.
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