Dr Darren’s surgery

The Advanced Clinicals(TM) Spider Vein Relief system is fortified with Marine Matrix(TM), an ocean-based ingredient clinically tested and proven to diminish the appearance of spider veins up to 26% after the first 30 days of directed use. (PRNewsFoto/Advanced Clinicals) zenaide, health, legs, varicose veins, veins,

The Advanced Clinicals(TM) Spider Vein Relief system is fortified with Marine Matrix(TM), an ocean-based ingredient clinically tested and proven to diminish the appearance of spider veins up to 26% after the first 30 days of directed use. (PRNewsFoto/Advanced Clinicals) zenaide, health, legs, varicose veins, veins,

Published Sep 4, 2014

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QUESTION: I am a 36-year-old female with no previous medical illnesses or serious chronic conditions. I am active and despite working a high-paced corporate job I manage to train about three times a week.

Recently, I’ve become self-conscious about my physical appearance. My legs have conspicuous veins that attract unfavourable attention. There seems to be an abundance of wrinkly, swollen blood vessels on my legs, especially behind the knees and calf areas.

Occasionally these vessels stand out and are sometimes so painful I can’t touch them.

After really strenuous days, they throb intermittently when I lie down. I have tried various skin preparations and topical oils, but to no avail.

Along with the pain, it looks bad and makes me feel undesirable. What can I do to get this fixed and is it risky? Is this kind of procedure covered by medical aid and how long does it take?

ANSWER: Varicose veins have been a topical issue for many decades and new therapies are constantly being tried to minimise surgical intervention. It affects one out of two people over the age of 50 and are more common in women than men. Haemorrhoids are a type of varicose vein, while spider veins are like varicose veins, but smaller.

What are varicose veins?

They are enlarged veins that are swollen and raised above the surface of the skin. They vary in colour from dark purple to blue, and often appear to be twisted and bulging.

How do they present?

As painful, swollen areas mostly on the lower leg, with brown discolouration at the level of the ankle (in severe cases) and skin ulcers in severe cases.

Where are they commonly found?

At the backs of the calves or on the inside of the leg.

How and why do they occur?

Defective valves in the veins that facilitate blood flow towards the heart lead to blood pooling and cause them to enlarge.

Tips to prevent complications

* Exercise.

* Lose weight.

* Elevate your legs when resting.

* Do not cross legs when sitting.

* Wear loose clothing.

* Avoid long periods of standing.

* Act on painful varicose veins.

* Wear support stockings or socks.

Most patients ask me if there is a significant risk of developing complications if left untreated – the answer is yes. If there are recurrent episodes of thrombophlebitis (inflammation of the superficial venous system), the risk of developing deep venous thromboses increases.

The inflammatory response adds to a process that makes blood sticky and possibly thicker – thus facilitating clot formation.

Main causes

Three main causes are defective venous valves, pregnancy and thrombophlebitis. Most common complications are blood clots and venous ulcers.

Best treatment for thrombophlebitis?

Anti-inflammatories, heparin topical gel and a broad spectrum antibiotic.

How is diagnosis made?

Clinical evaluation is of paramount importance while you are standing or sitting with your legs dangling. A duplex ultrasound exam assists in investigating blood flow in the veins and to rule out other problems such as a blood clot.

Treatment

Vein stripping is surgery to remove varicose veins usually only done in patients who are in a lot of pain or who have skin sores. Less invasive treatments are laser ablation, radiofrequency ablation and sclerotherapy which are used with varying results.

Endovenous Thermal Ablation (endovenous laser treatment or radiofrequency ablation), and foam sclerotherapy are not as well studied.

When is surgery indicated?

* Leg pain.

* Skin sores because of poor blood flow.

* Appearance gets worse.

* Thickening and hardening of the skin in the legs and ankles.

Alternative natural remedies

The compound aescin, derived from horse chestnut, has been shown to be as effective as support stockings to strengthen the vein walls reducing the risk of further damage. You might try a supplement called V-nal to aid blood flow.

Stiletto cost

Avoid wearing high-heeled shoes every day, they are not fashionable for your veins.

If you wear a heel that is more than 3.81cm every day, your calf muscle will not effectively pump blood out of the leg.

Try this at home: walk in lower heels and then high heels, and feel how the calf contracts. The foot simply moves forward in high heels and you won’t feel your calf contracting as you walk.

High-heeled shoes make you use the muscles in your buttocks, rather than calf muscles, to walk.

Walking in high heels does not promote blood flow in the legs, while low-heeled or athletic shoes help strengthen calf muscles and improve circulation. – www.ehealthmd.com

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