Let’s Keep Your Legs Looking Great

EnlargedVeinAndDamagedVein

Chronic Venous Insufficiency (CVI) is one of the leading causes of swollen feet, ankles, and legs. There are several things that can cause CVI. In CVI the butterfly valves which help blood move from the lower extremity back to the heart are damaged (incompetent) and do not close properly. Ultimately long-term blood pressure in the leg veins that is higher than normal causes CVI. Prolonged sitting or standing can stretch the superficial vein walls and damage the valves. Compression stockings and compression socks help the veins to close by applying a specific amount of pressure to the leg (this is the compression which your physician recommends). The compression stockings and compression socks also work with the muscles of the lower extremity to act as a secondary heart pump to move the blood out of the lower extremity and back to the heart.

  • Ankle swelling
  • Tight feeling calves
  • Heavy, tired, restless or achy legs
  • Pain while walking or shortly after stopping

At the end of the day, someone with CVI may experience only slight swelling and their legs may be tired and heavy. Now is the time to visit your physician and get some compression socks or compression stockings to keep the CVI from becoming worse.

  • Family history of varicose veins
  • Being overweight
  • Not exercising enough
  • Being pregnant
  • Smoking
  • Sitting or standing for long periods of time

If you have a parent who has had varicose veins, if you are overweight, or if you sit or stand for long periods of time, again now is the time to visit your physician and get some compression socks or compression stockings to keep the CVI from becoming worse.

CVI can be diagnosed by your physician by reviewing your patient history and a physical exam. The physician may also measure the blood pressure in your legs and examine any varicose veins you may have. To confirm a diagnosis of CVI, the physician will usually order a duplex ultrasound or a venogram. A duplex ultrasound uses sound waves to measure the speed of blood flow and visualizes the structure of the leg veins. A venogram is an x-ray that uses a dye (contrast) which enables the physician to see the veins.

Chronic venous insufficiency is usually not considered a health risk; your physician will try to decrease your pain and disability. In mild cases of CVI, compression stockings or compression socks may alleviate the discomfort and swelling. Physicians usually use a 20-30mmHg compression stocking or a 20-30mmHg compression sock for this. The stockings will not make the varicosities go away, but is the least invasive treatment.

Chronic Venous Insufficiency

More serious cases of Chronic Venous Insufficiency require sclerotherapy, ablation, or surgical intervention such as stripping to correct the problematic vein. This is usually done by a vascular specialist or vascular surgeon. During sclerotherapy a chemical is injected in the affected vein or veins and a scar will form from the inside of the vein. During ablation a thin, flexible tube (catheter) with an electrode at the tip will heat the vein walls at the appropriate location to seal the vein. When a vein stripping is done one of the saphenous veins is removed. The physician will make a small incision in the groin area and usually another in the calf below the knee. The veins associated with the saphenous vein will be disconnected and tied off and the vein removed. There are other surgical procedures which are done to improve your leg health. After one of the above procedures 20-30mmHg compression stockings are usually put on and you are told to wear them for a certain length of time. Some physicians will tell their patients on their follow-up visit that it is no longer necessary to wear the compression garments. For me, this is where I have some concerns. If the real underlining cause of CVI (such as family history of varicose veins, being overweight, not exercising enough, smoking or sitting or standing for long periods of time) has not been corrected why would you not continue to wear compression stockings to keep from developing CVI again.

Compression stockings and socks have come a long way in the last few years. They no longer look like the garments our grandparents wore. They look like ordinary stockings and socks and can improve the quality of life. The stigma of wearing compression garments is in the past.

Let’s wear our compression stockings and socks to keep our legs looking great!

Vanda

http://www.supporthoseplus.com

Defy Gravity

The condition of men’s legs are not something that they are concerned with; they don’t sit around and talk about varicose veins while drinking a beer and watching a game for the FIFA World Cup or their favorite sports program. Perhaps the condition of their legs is at least something they should think about and talk to their physician. About 10-15% of younger men have varicose veins whereas about 20-25%of the young women experience the problem. As I wrote about last week, it’s the women who will seek a physician’s advice about varicose veins and not the men. Most men think varicose veins are no big deal…a woman’s problem. Think again. By the time men are in their sixties between 50 and 60% have varicose veins.

Exercise regularly...It's important to involve your calves. It is the calves that act as a secondary pump to return the blood to the heart.

When sitting or standing for prolonged periods of time, blood pools in the lower extremity expanding the vein walls. Over time the veins loose their elasticity and do not return to their taut state. Some people (both men and women) have a genetic preponderance to varicose veins. If one of your parents has vein disease (venous insufficiency), you have about a 33% chance of developing it. If both of your parents have venous insufficiency, your chance jumps up to 90%.

  • Exercise regularly…It’s important to involve your calves. It is the calves that act as a secondary pump to return the blood to the heart.
  • Wear compression hose… Some physicians recommend everyone wear knee-length compression stockings—even if they don’t have signs of varicose veins. The compression of the stockings assists the calf muscle in pumping the blood from the ankle back to the heart. Usually a 15-20mmHg or 20-30mmHg compression is adequate.
  • Watch your diet… Foods high in sodium may cause your body to retain more fluids and swell.

Some people experience no symptoms with varicose veins, for others, the varicose veins hurt (throbbing, aching or burning). Other people experience itching or the vein feels hot, and many experience swelling in their legs. Symptoms are usually less severe in the early morning and worse at the end of the day (after standing or sitting for prolonged periods of time). The cause of the pain may be nerve irritation. As varicose veins dilate, they can begin to press against adjacent nerves.

Some athletes relate that their legs feel fine when training, but a short time later the legs that have varicose veins begin to ache, throb and feel heavy. If they lie down and elevate their legs, they feel better. While an athlete is exercising, their muscles required more oxygen. So the oxygen rich blood is transported through the arteries and the muscles helped the veins return the oxygen poor blood to the heart. When the exercise is completed, there is no calf pump action to help the veins return blood to the heart resulting in pooling of blood in the lower extremity. Elevating the leg helps the body defy gravity and return the blood to the heart (just as compression stockings and socks do).

Sports which add more weight to the legs such as weightlifting, skiing, backpacking and repetitive motion sports such as running, cycling and tennis put a lot of stress on the veins in the legs. These activities can damage the delicate valves of the venous system and exacerbate the venous insufficiency. There are positive and negative reasons to exercise or not, but they cancel each other out. So stay active and defy gravity by wearing compression socks!

Visit your primary care physician so he can make arrangements to have them checked out and defy gravity by wearing compression socks.

If your legs ache and swell, it could be a bigger problem than simply overdoing it at last week’s soccer game. And even if your legs aren’t in pain, if you’re seeing weird vein patterns, chances are there could be something wrong. Visit your primary care physician so he can make arrangements to have them checked out and defy gravity by wearing compression socks.

Vanda

March Is DVT Awareness Month

Federal Awareness Campaign

In September of 2008, Dr. Steven Galston, the acting Surgeon General, issued a Call to Action to urge all Americans to learn about and prevent DVT (deep vein thrombosis) and PE (pulmonary embolism) which are both treatable conditions. Deep vein thrombosis affects up to 600,000 people yearly and results in death of 100,000 Americans from pulmonary embolism. Dr. Galson, in his “call to action” states “I don’t think most people understand that this is a serious medical problem or what can be done to prevent it,”

The people, who are at a greater risk for a DVT, even though they are healthy, include those who are:

  • Obese
  • Pregnant
  • On contraceptive or hormone therapy
  • Recovering from a recent surgery or trauma
  • Have chronic heart disease
  • Have varicose veins
  • Have a history of blood clots
  • Travel on long trips by airplane or by other means where movement is restricted for a long period of time

So what is a Deep Vein Thrombosis and how is a DVT formed?

A DVT is a blood clot that forms in the deep veins of the legs. The DVT, although serious, can be treated by your physician. DVT’s are most common in sedentary situations such as being bed ridden for long periods of time. To begin with, the human body has three types of blood veins. The blood flow leaving the heart travels in the deep vein system within the body. The blood then flows through the perforating veins (veins which connect the deep vein system to the superficial vein system). The perforating veins contain one way valves which force the blood back to the heart and keep it from flowing backwards. If these valves are damaged or the blood flow impeded, a DVT can form in the lower leg or thigh. When a blood clot is formed, it can caused permanent damage to the vein walls and the one way valves. The blood clot, left untreated, can be life threatening. A piece of the clot can break loose and cause a pulmonary embolism (obstruction of the pulmonary artery causing stoppage of blood flow to the lungs) sometimes resulting in death. Please remember, a DVT can be treated. If you are experiencing pain, redness, heat, or skin discoloration in your leg consult a physician for treatment immediately. Also, seek professional advice on preventable measures, including the amount of compression to wear in support stockings.

Age is not a limiting factor in DVT and PE

DVT and PE can strike men and women of all ages and walks of life with relative little warning. So keep a friend or loved one healthy tell them about DVT and how to prevent it by wearing compression stockings and compression hose and following our tips…

Compression support stockings help prevent blood from pooling in the lower extremities and can minimize the risk of a DVT. Other things you can do to help prevent a DVT include:

  • Exercise your legs regularly when sitting or laying for a long period of time. This can be a simple as making figure 8’s with your feet, or walking for just a few minutes.
  • When sitting, stretch your legs and change position frequently
  • Breathe deeply frequently.
  • Elevate your legs whenever possible.
  • Be careful about leg rest that compress the calf or behind the knee.
  • Avoid excessive alcohol intake (it dehydrates the body).
  • Drink plenty of water.
  • Wear loose, non-binding clothes when traveling

Above all wear compression stockings or support socks especially when traveling,

Vanda

www.supporthoseplus.com

Chronic Venous Insufficiency

Early intervention could prevent future complications

Up to 13 million people in the U.S. suffer from chronic venous insufficiency (CVI). If not treated, CVI can result in a venous stasis ulcer.

Risk Factors

  • Increased age
  • Prior deep vein thrombosis (DVT)
  • Family history of DVT
  • Sedentary life style
  • Obesity
  • History of leg trauma
  • Cardiac Disease
  • Multiple pregnancies

Venous Stasis Ulcer

Clinical Manifestations

  • Varicose veins
  • Leg pain
  • Distal leg edema
  • Inflammation
  • Induration (The process of becoming extremely firm or hard)
  • Skin pigmentation
  • Stasis dermatitis
  • Ulceration

Gradient compression hose can help control venous insufficiency and prevent venous ulcerations. When venous ulcerations do occur, they can take a very active role in the healing of the venous ulceration.

Noninvasive Treatment of Varicose Veins and Venous Insuffeciency

By JON SENKOWSKY, MD FACS

Venous disease is a health problem that affects almost everyone. Despite the fact venous disease has been acknowledged since the time of Hippocrates, hundreds of years B.C., innovative technology and significant diagnostic advances in treating venous disease are only now emerging in the field of vascular surgery.

Venous disease occurs for the simple reason that veins are always working against gravity. Veins in the legs carry blood from the leg to the heart. In order to cover this long distance efficiently, veins contain valves that allow blood to move up the leg, and not down. If these valves become destroyed, blood pools in the lower portion of the leg causing leg swelling, varicose veins and other venous problems. Typical symptoms include heaviness in the legs, swelling, development of varicose veins, and even skin damage, dry skin, and brownish pigmentation at the ankle level leading to ulcers.

Another more serious symptom includes blood clots in the legs. Indeed, recent reports indicate people who frequently fly in airplanes are at risk of developing blood clots, which can break free and cause pulmonary emboli. This situation appears to be minimized by the use of hose (see the Travel Socks section of the Support Hose Store web site).

The majority of people with venous disease have chronic problems with their legs. The most effective treatment can be found by making an accurate diagnosis; determining if blood clotting is present; and identifying whether any venous valve disorders are present. Valve disorders often indicate venous reflux, or pooling of the blood located in the deep veins of the muscle or on the surface veins underneath the skin. (The surface veins, when enlarged, are actually varicose veins.) By utilizing a machine called a Duplex Scan, a noninvasive and painless diagnostic test, all these questions can be answered.

Perhaps the simplest and most well known treatment for venous disease is the compression garment. Compression garments can be used to prevent the complications of venous disease. These are essentially tight hose or wraps that control the swelling in the leg by forcing the blood into the deeper veins. It is important to use gradient compression hose, obtained from a reputable manufacturer, such as Jobst, in order to get the right fit and avoid problems. The compression garments force the same amount of blood into a smaller volume of veins, resulting in more efficient removal of the blood from the lower extremities. A variety of different hose products, both knee high, thigh high, and waist high, and a variety of different strengths and colors, are now available from Jobst at Support Hose Plus. Other techniques, such as lymphedema wraps and pumps can be used in order to decrease the swelling associated with venous disease (see the lymphedema section of The Support Hose Plus web site).

New techniques in the treatment of varicose veins are emerging. An accurate diagnosis with ultrasound and physical examination are essential for the correct care of varicose veins. Hose are the mainstay of treatment, and are available at www.supporthoseplus.com, or by calling 1-844-472-8807 to speak to a certified fitter.

Dr. Senkowsky is a Board Certified vascular surgeon in private practice in Arlington, Texas. He is a Fellow of the American College of Surgeons, and a member of the American Society of Vascular Surgeons.