Vein treatment has changed dramatically in the past 20 years, he says Danielle Bajakian, MDvascular surgeon in Columbia, but many patients are still delayed in receiving treatment.
“Because vein disease is mostly inherited, many patients delay treatment because their mom or grandma had a procedure that required a long hospital stay or was painful afterward, and they remember those things,” Bajakian says. , assistant professor of surgery at Vagelos College of Physicians and Surgeons and director of the Columbia Vein Program.
“But most of the treatments I offer for vein patients are office procedures that don’t require an operating room, don’t require anything other than local anesthesia, and most don’t even require an incision.” Most of the time, Bajakian can treat patients with laser therapy, radiofrequency therapy, or sclerotherapy, which injects foam or another solution into the veins to shrink the small veins.
“Knowing that you can have the procedures done in 20 minutes and really only need to block time for a few office visits makes it that much more appealing.”
Here are five things to know about vein disease and treatment options in 2021:
Symptoms can be subtle at times.
“For some patients, it’s obvious, and the things to look for are large leg veins, varicose veins and leg swelling or ankle swelling that’s worse at the end of the day. Dark pigmentation and many spider veins around the ankles are easy ways to tell if you have vein disease.
“However, some more subtle symptoms are leg heaviness or leg fatigue. It is usually worse at the end of the day or after standing for a long time, sometimes accompanied by a little swelling in the ankle. Restless legs at night can be an early diagnosis of this type of problem. Some people also experience itchy dry skin around their ankles. These are all vague signs and symptoms that are often ignored.
“Think of people who stand for long shifts without moving around much: doctors, nurses, pharmacists, retailers, cashiers, chefs. He is the one who tends to have these symptoms and often ignores them thinking that heavy legs are normal after a long day.”
Prolonged standing can lead to venous problems.
“The most common problem is superficial venous insufficiency and I describe it as leaking valves in the veins. Since the veins are what bring blood from the legs back to the heart, they must work against gravity. So the calf muscles pump the blood into these one-way valves that are supposed to close so the blood doesn’t flow back down.
“When your valves are leaking, there’s a lot of increased pressure, which is one of the things that causes heavy, sore, tired legs.
“Additionally, the fluid begins to leak and people experience swelling in the ankle. And sometimes tiny branches of the vein begin to serve as outflow valves, and that’s where the varicose veins come from.”
Exercises and compression stockings can help.
“For good vein health, I always tell my patients to keep exercising. And it doesn’t have to be anything complicated. Walking a few times a day is really helpful. Walking or exercising helps your veins bring blood from your legs back to your heart.
“Trying not to stand or sit for a long time without moving is really helpful. Elevating your feet at the end of the day, which helps gravity drain all that fluid from your feet, greatly relieves symptoms.
“Finally, compression socks! The ones they make today are not the ugly ones our grandparents wore. More breathable, easier to wear, better fabrics and technology.”
The pandemic has led to the emergence of venous symptoms.
“Exercising, walking and being active counteracts vein problems, whether we know it or not. I often see patients in the office who have significant vein problems but are asymptomatic because they are so active.
“In the pandemic, because the gyms are closed, because people are working from home, they are not as active. And many people have gained weight.
“I’m seeing more and more patients who have had these types of vein problems for a very long time who are just now symptomatic. They are confused as to why they have had varicose veins for 10 years but only now have problems. I’ve been treating a lot more venous disease in the last three or four months than I used to.”
Venous disease often needs long-term care.
“It’s a common misconception that when you treat a vein, you end a life. Venous disease is an ongoing chronic condition. I see many of my patients for years and years because it can be a progressive disease.
“The advantage of seeing a surgeon like me is that we treat a thorough variety of vein problems and assess whether the patient has other underlying conditions. A lot of my patients come in to have their veins treated, but I’ll find spinal problems, neurological problems, sometimes even arterial problems.”
