Why should I get my varicose veins treated?

Answer: This is a question that even your primary care doctor may not be able to answer.

Many of our patients tell me that their doctor advises “if they don’t bother you, don’t bother them.” They tell them that it’s a natural process of aging and cannot be treated. If the patient has edema, they often send their patient to get an ultrasound scan in the
hospital or imaging center. These centers are great for ruling out deep blood clots, but they seldom perform an adequate study to demonstrate venous disease.

The fact is that even the appearance of your legs is not always a reliable guide to the extent of venous disease. Swelling (edema) is one sign that has many causes, but if this problem persists after treating other causes, chances are that the venous or the lymphatic
system is not functioning properly.

Now we understand that venous disease, a chronic condition that gets worse with time, can damage the tiny lymph channels. This causes swelling and is then called veno- lymphatic syndrome. This condition is often confused with lymphedema, which is a
genetic defect.

I have seen patients who were misdiagnosed and mistreated for years without improvement. The diagnosis can only be determined by having an ultrasound of the superficial and deep veins of the legs while standing, not lying down. If you have been
treated with compression for leg swelling and never had an ultrasound evaluation, you
may be one of those patients.

Also, the size of varicose veins is not a reliable indicator of the extent of venous disease. Research has shown that even the common symptoms of leg pain, leg cramps, restless legs, and itching occur years before doctors think to order ultrasound testing. The absence of bulging veins does not rule out chronic venous insufficiency. Venous disease is progressive and will never improve without treatment. The slow progress of venous disease and the aging process increases the risk of blood clots and significant skin
changes, leading to ulceration. The eventual outcome without treatment is stasis ulceration (an open sore on the ankle). So why get your varicose veins treated? You will look and feel better as you reduce chances of future complications.

Startling statistics about venous disease

Question: My doctor told me not to worry about my leg pain and edema. He said there is no
treatment except vein stripping. What should I do?

Answer: Most doctors are not aware of the risks involved with venous problems. As we age, leg
veins can increase the risk of blood clots that can have serious health consequences. The stats
don’t lie: Leg problems affect more Americans than any other condition.

A recent study shows that up to 60 percent of the U.S. population will eventually have serious
issues with leg veins. Look at your legs and you may see changes that seem to get worse every
year. In advanced cases, you may see actual varicose veins, but often the symptoms are subtle.

If your legs are swollen and/or discolored, this may indicate you have an abnormal venous
condition. Purple discoloration around the ankles indicates that you may have had venous
problems for many years. The skin may also become dry and red with inflammation.

Left untreated, these areas may progress to ulceration. Although vein and leg problems tend to
run in families, venous problems are under-recognized, under-diagnosed, and therefore under-
treated. Most physicians do not focus on this problem and in many cases are not aware of the
latest in-office treatments that are rapidly becoming the treatment of choice.

Also, I have noticed many physicians are placing patients with edema in knee-high stockings. If
you are wearing knee-highs, you may be making the condition worse. Often the stocking will
create a tourniquet effect, thus restricting venous return.

Varicose veins may seem like just of cosmetic concern, but they do carry some significant health
risks if not treated. Among the conditions that may occur: swelling; leg heaviness; skin
breakdown; itching; bleeding; blood clots; leg ulcers. As the disease progresses, leg ulcers
become more difficult to heal.

You can get a lot of information by visiting AshtonVeinCenter.com. You can view before/after
photos, get answers to frequently asked questions and download my free book “How to Stop
Painful Ugly Legs.” When you’re ready, call us at 561-630-6800 to schedule a FREE evaluation.
You deserve a great pair of legs!

There’s nothing like a great pair of legs

Question: I used to dance. Now my legs are swollen, itchy, discolored, and heavy. My doctor says its just part of the aging process. I don’t have varicose veins, so what can I do?

Answer: Believe it or not, venous disease is the most common medical condition on the planet. Some studies demonstrate that up to 60% of the US population will experience venous problems at some point… That means there may be as many as 210,000,000 people that may or may not be aware that unsightly painful legs are not to be ignored or accepted as normal. That means venous disease of the legs is grossly under-recognized, under-diagnosed, and therefore, under-treated.

Since your doctor is not focused on your legs, he/she may be missing a significant, yet correctable condition. In this case, you may be your own best physician by seeking answers to the common question: “Why do my legs look and feel bad.?” The answer to that question can be easily discovered. Look at your legs. Do you see swelling, skin changes, discoloration, or even visible bulging veins? Do you have leg cramps, or restless legs, or itching? Did anyone in your family have venous disease? If you say yes to any of these questions, you will benefit from a full venous evaluation.

During our free evaluation, we can discover the truth about your leg discomfort. In this situation, it is important to make an accurate diagnosis, and to design a treatment plan that is not only effective, but convenient. You may even qualify for the VenaSeal treatment, that is immediately effective, and does not always require the use of gradient compression stockings. Here is some fantastic news: once your venous problem is corrected, you are no longer at increased risk of blood clots. This is a risk factor reduction that can only happen when you take responsibility for your legs.

There’s nothing like a great pair of legs. I have written a book for you. “How to stop painful ugly legs”. You can get a free copy here or you can get a free download from our web site: Ashtonveincenter.com. Sometimes transportation to the Center is a problem. If you need a ride, we can arrange that for you. See you soon, lets get started on your “great pair of legs”.

Dr. Thomas Ashton is Board Certified in venous treatments and, as a general surgeon, has vast experience in the latest laser techniques available. He has performed more than 4,000 laser and combined vein procedures.

Risk factors for venous disease

Question: My father has bad veins. Am I going to get that as well?

Answer: A recent article in The Journal of Venous Disease discussed this very topic. Venous disease ranges in severity from minor cosmetic concerns to the very severe blood flow changes that result in ulceration or blood clots. In part the article reads:

“The cause of the disease is probably multifactorial. Genetic predisposition, older age, female sex, obesity, number of pregnancies, oral contraceptive use, hormonal replacement therapy, prolonged sitting or standing, low level of physical activity, smoking, prior episodes of blood clots, leg trauma, flat feet, hernia surgery, history of cardiovascular disease, diet, and bowel habits have all been investigated.”

These investigations, however, can be confusing. In our experience with thousands of patients, it is evident that these factors can be present in any combination or not.

And the real question may be, is there anyone on the planet that does not have one or more of these risk factors?

We have no control over our genetics, but certainly we can modify our risks by taking action. The proper action is to seek evaluation as soon as possible. We are currently offering free screening for leg discomfort problems. “Captain Obvious” says that free is better than not free; and that now is better than later.

Recurrence of varicose veins

Question: I had vein-stripping many years ago. Why do I my veins look worse than ever?

Answer: In the past, vein-stripping was the universally accepted treatment procedure for varicose veins. This required general anesthesia, a groin incision, and multiple large incisions. Research has demonstrated that the groin incision and dissection actually stimulates the growth of additional abnormal veins (neovascularization). This practically ensures recurrence in the years to follow.

Additionally, most surgeons are not providing adequate follow-up exams and treatment. Post-op ultrasound scan often demonstrates additional abnormal veins that contribute to recurrences. These veins are often not evident until several months after the initial procedure.

Once they are identified, they can easily be treated with special sclerotherapy procedures. At our clinic, we use endovenous laser techniques instead of vein-stripping. We have seen about a 1% recurrence rate (compared to 85% with stripping). In each case, we follow up our procedures with ultrasound scanning to identify and treat any residual veins that may be present.

The final step is to treat spider veins with compression sclerotherapy. We encourage yearly scans, to detect any changes that could lead to future problems. Depending on the individual situation, some patients may need touch-up sclerotherapy to maintain an excellent cosmetic result.

The many misconceptions of vein disease

Question: I have very severe bulging veins in both of my legs. My doctor told me to just wear support stockings because there is no treatment, and no reason to try treating this condition. Is this correct?

Answer: There are many misconceptions about vein disease, and unfortunately many of these bad ideas are coming from physicians. Many think varicose vein disease is a normal aspect of aging. Or that varicose vein disease is only of cosmetic concern.

I think that aching, heaviness, tiredness, itching, burning swelling, skin disruption and ulcers – that is, all the symptoms that accompany varicose veins – are not cosmetic. These are dangerous signs that constitute a medical condition that should be corrected.

Others will advise the use of support stockings. This is also incorrect. Support stockings and TED anti-embolic stockings are useless in the care of varicose vein disease. The stockings must be properly fit to order, and be gradient compression. This requires a written prescription.

Some doctors think that because vein disease is “cosmetic,” insurance will not cover treatment. Treatments are medically necessary and are covered by most plans. Another misconception passed on by some doctors is that no treatment really works. We have performed more than 4,000 in-office procedures with excellent results that have withstood the test of time.

Some good advice about vein problems

Question: Why should I get my varicose veins treated?

Answer: This is a question that even your primary care doctor may not be able to answer. Many of our patients tell me that their doctor advises “if they don’t bother you, don’t bother them.” The fact is that even the appearance of your legs is not always a reliable guide to the extent of venous disease.

Swelling (edema) is one sign that has many causes, but if this problem persists after treating other causes, chances are high that the venous or the lymphatic system is not functioning properly. The diagnosis can only be determined by having an ultrasound of the superficial and deep veins of the legs.

Also, the size of your varicose veins is not a reliable indicator of the extent of venous disease. Research has shown that even the common symptoms of leg pain, leg cramps, restless legs, and itching occur years after venous insufficiency is demonstrated on ultrasound testing.

Venous disease is progressive and will never improve without treatment. The slow progress of venous disease and the aging process increases the risk of blood clots and significant skin changes leading to ulceration. The eventual outcome without treatment is stasis ulceration (an open sore on the ankle).

So why get your varicose veins treated? Because you will look and feel better as you reduce chances of future complications.

The many misconceptions of vein disease

Question: I have very severe bulging veins in both of my legs. My doctor told me to just wear support stockings because there is no treatment, and no reason to try treating this condition. Is this correct?

Answer: There are many misconceptions about vein disease, and unfortunately many of these bad ideas are coming from physicians. Many think varicose vein disease is a normal aspect of aging. Or that varicose vein disease is only of cosmetic concern.

I think that aching, heaviness, tiredness, itching, burning swelling, skin disruption and ulcers – that is, all the symptoms that accompany varicose veins – are not cosmetic. These are dangerous signs that constitute a medical condition that should be corrected.

Others will advise the use of support stockings. This is also incorrect. Support stockings and TED anti-embolic stockings are useless in the care of varicose vein disease. The stockings must be properly fit to order, and be gradient compression. This requires a written prescription.

Some doctors think that because vein disease is “cosmetic,” insurance will not cover treatment. Treatments are medically necessary and are covered by most plans. Another misconception passed on by some doctors is that no treatment really works. We have performed more than 4,000 in-office procedures with excellent results that have withstood the test of time.

How vein treatment feels depends on severity

Question: How will I feel after vein treatment?

Answer: Venous disease presents in many different forms and many degrees of severity. No two patients are exactly alike. In the case of cosmetic spider veins, you may experience some bruising for several days after treatment. Over about a month, you will notice the gradual disappearance of the spider veins. Your legs will also feel better. We use cosmetic sclerotherapy for these veins. Laser technology is not indicated for spider veins. 

If you have a more advanced vein problem, the laser procedure may be indicated. This procedure is done in the office. The patient walks in has the procedure, walks out and in most cases, resumes normal activity the very next day. No longer is vein stripping required, thus there is no blood loss, and no bed rest required.

Our patients report a rapid decline in symptoms and problems related to their legs. In many the leg cramps, pain, tenderness, and heaviness is gone within the first week. If swelling is a problem, that usually takes longer to resolve. Follow-up treatment is a must. Although the problem is related to the long saphenous vein, many patients have branch veins that can contribute to recurrence. These veins are usually treated with sclerotherapy.

Ultrasound guided sclerotherapy as done for follow-up after laser treatment is very effective in clearing off residual veins. This in office procedure is essential to providing the comprehensive care of venous disease.

Many of our athletic patients report increase performance, stamina, and comfort as they compete in their respective sports.

Treatment options for varicose veins

Question: What are the treatment options in varicose veins?

Answer: Vein disease of the legs is a common disorder that looks bad, feels bad, and can result in dangerous medical conditions (stasis ulcers and blood clots). The appearance of your legs however is not a reliable guide to the extent of venous disease.

Swelling, for example, has many causes and a proper diagnosis must be established by Duplex Ultrasound mapping before any therapy is started. Also the size of the visible veins is not a reliable indicator of the severity of the condition. Symptoms are experienced and venous tests are abnormal long before any abnormal veins are visible. Some of the early symptoms that are associated with vein disease include night cramps, tired heavy legs, restless leg syndrome and skin changes (as in redness, burning and itching). The unsightly appearance of bulging veins is a late finding, and indicates that immediate evaluation is important. The sooner this process is reversed, the better. Never wait until there is an ulcer, phlebitis, or blood clots.

Recently, the treatment options for diseased veins has evolved from radical vein stripping (requiring hospital stay, general anesthesia and prolonged bed rest), to simple in office procedures that require essentially no down time, and have been remarkably effective.

At the Ashton Vein Center, you will meet the most experienced staff of professionals that are highly skilled in the diagnosis and comprehensive treatment of all vein conditions of the legs. Dr. Thomas Ashton, MD, FACPh, has performed more than 5,000 venous laser cases, and has taught these procedures to hundreds of physicians. Our team is dedicated to achieving superior results in today’s most advanced methods of effective treatments.