Because You Know I’m All About The Veins…Spider Veins? No Trouble!, Winter 2015 Newsletter

If you have ears and own a radio…certainly if you also own a teenager…you probably caught the reference to “All about that Bass” by Meghan Trainor. As a musician, it’s a cute & clever song. As a parent of 2 young girls, it’s a wonderfully iconoclastic, empowering anthem affirming that external beauty is self-determined and founded on an internally healthy self-esteem.

This concept also applies to the realm of diagnosing and managing chronic vein disease: it’s oftentimes more about the health of the system beneath the surface rather than the spidery superficial manifestations.

During every 1 hour consultation appointment with a new patient, I spend a great deal of time explaining venous physiology (how things are supposed to work) and pathophysiology (how things go wrong). Aside from the fact that I love to teach, I feel strongly about the concept that the patient-doctor alliance is a team effort. You are the “President” of your body and I’m here to be an advisor and advocate. In order for me to help you make the best decision for yourself, we have to make sure that you have as much info as you need.

During the consultation appointment, patients learn that the varicose veins that have been progressively worsening over the years may also be related to symptoms that have plagued them over time. Symptoms including lower extremity “heaviness”, tiredness, cramping, swelling and even restless legs at night. Such symptoms may be traced to malfunctioning valves in segments of their superficial venous system beneath the surface. To determine if this is the case, an ultrasound examination is performed in the office. The ultrasound is a painless, fascinating study that allows us to map the form and flow of a patient’s venous system. Malfunctioning valves may lead to wrong-way flow that in turn leads to chronic stretching of veins due to excess pressure.

The beauty about this field of medicine is that no matter what we find, there is always good news to give to patients! If we find that the valves and flow are normal, patients have peace of mind; we only need to focus on treating (with a safe, simple and comfortable technique known as sclerotherapy) the surface spider/varicose veins. If we find wrong-way flow (called reflux) in certain vein segments, the good news is that technology has finally caught up to the problem!

Unlike the invasive, surgical options of yesteryear, the past decade has ushered in a new era of minimally invasive, maximally comfortable techniques to treat chronic vein disease. Using ultrasound guidance, flow can be improved by treating problematic veins from the inside, rather than stripping them out of the body. These techniques, Endovenous Laser Ablation (EVLA) and mechanical occlusion with chemical assist (MOCA, or ClariVein^®) are performed in the office, using only local anesthesia and take about an hour. There is no downtime: patients can resume most normal activities immediately after their procedures. In fact, activities such as walking are strongly encouraged! Discomfort is minimal both during and after the procedures.

In addition, patients are surprised to learn that their consultation visit and many treatments may be covered by commercial insurance & Medicare. Coverage may vary based on an individual’s policy and can often take weeks to months for approval. No worries, we handle all of the insurance submissions for our patients.

The cold winter months (aka “pants season”) are the perfect time to address these nagging issues. The “silver lining” about our seemingly interminable winters is that we have time to start dealing with your venous issues before “shorts season” is here. I look forward to meeting you and helping you be “All about the happy legs!”