Vein Treatment Varicose Veins Laser Lipo & Vein Care Center Ask the Doctor

Q: How do vein doctors help with problem veins?

A: Our veins can cause trouble in many areas of the body, but by far the most common reason people visit vein doctors is for problems with the veins in their legs.  The reason is simple: The veins in our legs do a tremendous amount of the work circulating blood.  They have to fight gravity constantly to keep pumping blood back up to our hearts.  They use an ingenious system of valves to keep blood from flowing back down into our legs—where gravity keeps pulling it.  And sometimes, as your vein doctor will explain, the valves can wear out, slow down, or even stop working entirely.
Weak or faulty valves can be an inherited trait, and are more common in women than in men.  The government reports that up to 55% of American women and 45% of American men will suffer with vein problems in their lifetime, and varicose veins affect one out of every two people over 50. Today’s vein doctors are treating a growing percentage of those afflicted.

Vein doctors — phlebologists — have powerful technology-guided diagnostic tools like ultrasound to discover underlying causes of vein problems, which often announce themselves either via a heavy, aching feeling, restless legs, or by the appearance of varicose veins.  And your vein specialist will be skilled in a number of minimally invasive procedures that can dramatically improve not only your comfort but often the appearance of problem leg veins as well.  And today’s treatments don’t require taking off work, result in only minimal discomfort, and quickly improve how you feel. Diagnosis and minimally invasive treatment to offer relief of symptoms are what you can expect from your phlebologist. If you are experiencing symptoms, you ought to seek medical attention for this often-overlooked issue.

- Dr. Wright

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Q: How do I choose a vein doctor?

A: When you’ve decided to do something as personal as having your varicose veins fixed, you want to be sure you’re choosing just the right vein doctor.  Remember to ask yourself this:  How do you feel now that you’ve interviewed the vein doctor?  Here are some important questions to help you work through the decision process of selecting an appropriate vein specialist:
1. Do you feel at ease when you visit the vein clinic or center where the vein doctor practices?  Do the facilities look clean and professional?  This is an important occasion for you and, even though you’re not going into a hospital, you should feel the same level of confidence about the place where you’ll have this work done.
2. Are you satisfied with the vein doctor’s credentials?  Be aware that many doctors may claim to be able to fix veins even though they may not be specially trained in vein treatment techniques.  Not everyone who claims to be an expert in these procedures has the kind of medical training or expertise you would expect a vein doctor to have.  You deserve the best attention to your medical needs.
3. Most importantly, are you comfortable talking to the vein doctor? You don’t want to be in a position of having this important work done to your body without feeling comfortable that you can ask as many questions as you like–and be completely satisfied with the answers you receive. Your trust in your doctor is key, and your doctor ought to be someone with whom you feel comfortable discussing your symptoms, your concerns, your expected outcome, your apprehensions, your billing and insurance situations, and your thoughts.

In short, seek a qualified specialist whose background and credentials are solid and whose judgement you trust, and whose care of you is up to your expectations.

- Dr. Wright

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Q: Why go to a vein clinic instead of a hospital for varicose vein treatment?

A: Hospitals have come a long way since the 1600s when the print below was made, but the answer is simple. Today all modern vein treatments are done mainly in vein clinics (sometimes called vein centers).  Not only is it less complicated to go there than to a hospital–you don’t have to be “admitted” and you won’t have to pay hospital overhead charges–but you’ll still have a fully qualified physician performing or overseeing your procedure with all the latest equipment and instruments.

You’ll be covered by insurance the same as if you were in a hospital.  And often it’s easier to get to a vein clinic than to a hospital. Why go to a vein clinic instead of a hospital for varicose vein treatment?  Hospitals have come a long way since the 1600s when this print was made, but the answer is simple. Today all modern vein treatments are done mainly in vein clinics (sometimes called vein centers).  Not only is it less complicated to go there than to a hospital–you don’t have to be “admitted” and you won’t have to pay hospital overhead charges–but you’ll still have a fully qualified physician performing or overseeing your procedure with all the latest equipment and instruments.  You’ll be covered by insurance the same as if you were in a hospital.  And often it’s easier to get to a vein clinic than to a hospital.

When you have varicose veins you don’t need to go to a hospital to get the most advanced diagnosis and treatment options.  Vein specialists generally do all their diagnostic work and perform all their procedures right in their vein clinics.  Treatment options at reputable vein clinics may include sclerotherapy, endovenous radiofrequency [VNUS] or laser closure, ambulatory phlebectomy, and vein stripping (rarely done today).

Worried about your varicose veins?  When you go to a vein doctor who is certified specifically in vein treatments, you’ll have the same–and sometimes more–treatment options and the same protection against any potential risk for complications.  Find a reputable vein clinic in your area and get some answers.  Why continue to live with a life-long problem when you might find relief?

- Dr. Wright

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Q: I had laser light therapy for facial redness and veins showing on my face due to Rosacea. The veins now appear darker and more visible than they were before. Is this normal if this procedure was done 2 days ago? if so when will the redness go away for the desired result?

A: Yes, exaggerated coloration may take up to a week to 10 days to disappear, depending on how severe your rosacea was. It almost always looks worse before it looks better. Discuss your concerns with your doctor, but know that in general, you will have some differences in coloration shortly after your treatment which should dissipate and leave behind a better result.

- Dr. Wright

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Q: How long after Sclerotherapy can you get in the sun?

A: The more you wait the better but the minimum is 6 weeks.

You should wait for the acute inflammation to go away, usually in 4-6 weeks, depending on the solution used, the size of the vein treated and you skin complexion. (Olive skin or dark skin color may be more predisposed to darker discoloration than fair skin.)

The main concern here is not to stimulate the melanin (skin pigment) producing skin cells and thus minimize the undesirable skin discoloration that may happen in the treated areas. A compromise may be to venture out with shorts and skirts with sunblock on at most, and certainly no sun tanning. In time, you may resume normal activities with normal sun exposure.

- Dr. Wright

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Q: Will Varicose Veins reappear? Do I have them for life even after treatment?
A: Patients with varicose veins have a predisposition to forming varicose veins. Therefore, despite treatment, you will always be predisposed to having varicose veins. However, once a varicose vein has been removed or ablated by sclerotherapy or laser… it is gone! It can never return.

It is possible for a new vein to go bad and appear, even in the same area as the old vein. I often tell patients that it is like having bad teeth. You can fill a cavity or pull a tooth, but it doesn’t mean another tooth may not go bad years down the road. In practice with over half a million patients over 20 years, we have found that only about 25% of patients have another vein that needs treatment withing half a decade.

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Q: I had veinwave treated for spider veins on my face 2 months ago but my face is worse after the treatment. It looks scarred. Will this go away?

A: I wasn’t aware the Veinwave could cause scars. The company that sells the machine claims it doesn’t scar. I have not seen any scarring. My guess is that you have some hyperpigmentation, which usually fades over a year or so. Consult with your doctor about your results and their cause.

- Dr. Wright

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Q: My compression stockings really hurt the back of my knees I cannot gt my compression stocking to not have wrinkles. These wrinkles gather around the back of my knee and really hurt. How do I overcome that?

A: The keys with compression stockings are that they fit properly and that they are worn. It seems that they do not fit you properly. They could be too long. I would recommend a custom fit stocking or perphaps another brand. Please discuss your results with your doctor to ensure a proper fit.

- Dr. Wright

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Q: How long do sclerotherapy chemicals stay in the bloodstream? I would like to become pregnant, but would like to know what’s safe.

A: I am asked this question many times. You can safely get pregnant immediately after a treatment. But if you do get pregnant in the middle of a series of treatments, you should stop all treatments until 3 months after you deliver. This is a wide safety margin for the prevention of blood clots. The medications that are used by almost all experts, Sodium Tetradecyl Sulfate and Polidocanol, are very safe. They are fatty acid esters similar to lidocaine. They are cleared out of your system in 24 hours or less and present no difficulties.

- Dr. Wright

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Q: I have to wear a compression sock because I had a DVT and the valve in the vein that runs behind my knee is broken. I am still young and would like this fixed so I don’t have to wear the sock. Is there a procedure to fix this?

A: I strongly recommend that you continue to wear the compression stockings per your physicians recommendation since this has been shown to decrease the chance of “post thrombotic syndrome.”

Additionally, you really need to know which “valve is broken.” A complete ultrasound is needed. If you do not have any DVT anymore and you have superficial venous reflux, that could be treated and you could get improvement of your symptoms (assuming you have them).

- Dr. Wright

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Q: Is EVLT recommended for lipodermatosclerosis (LDS)?

A: Lipodermatosclerosis is a form of scarring due to venous insufficiency. It will not go away with the laser procedure but may improve if treamtent gets rid of the cause of your venous insufficiency.

- Dr. Wright

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Q: It is the tool used to pull veins through microincisions. What are these called?

A: Phlebectomy hooks would be the general name for the tool. There are many types including Varaday, Ramelet, and Mueller to name a few.

- Dr. Wright

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Q: Can you please detail some of the restrictions after an Endovenous Laser Ablation?

A: Normal activity should be ok, including walking, standing, and house chores. Activity can essentially be resumed right away. Rigorous exercise and heavy lifting (<20lbs) will need to be delayed by 1 week. Typically showering is ok immediately as well. I advise compression stocking use on the leg for 1 week after the procedure.

- Dr. Wright

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Q: Is it harmful to your leg circulation to sit with them crossed?

A: Leg crossing has by myth been accused of causing all varieties of circulatory problems.

Interestingly, there has not been a scientific article confirming this ingrained and still-propogated rumor. Even more fascinating, there is strong and growing evidence the leg crossing favors circulation, especially the vein system! Many studies well designed have demonstrated that sitting with legs crossed reduces stagnation and pooling of blood.

- Dr. Wright

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Q: Does it matter if I fly after a varicose vein surgery?

A: While there is no specific answer to this important question, the following guidelines should help: First, the question comes up because air travel is a known risk factor for the development of vein thrombosis and phlebitis. The concept is to minimize multiple risks for these complications. The risk of phlebitis is rather low after a vein operation, however the nature and extent of the procedure is the most important aspect to consider. Other pre-existing risks need also be taken into account. These include a previous history of phlebitis, a known hematologic hypercoaguable state, the general activity of the individual, and several co-morbid conditions.

While data suggests that the risk of flying increases over 2 1/2 hours, a planned shorter flight may be extended due to airline schedules, ect. I feel it is safe for a limited phlebectomy to fly after 2-3 days, where an extensive large vein sclerotherapy or endovenous vein ablation in my practice would lean towards 7-14 days.

- Dr. Wright

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