Before busting the myths related to Varicose Veins, first, let us discuss what are Varicose Veins?

You know that there are 2 types of blood vessels: artery and vein. Arteries carry out the blood from the heart and the Veins carry the blood back  to the heart

The veins have a series of one-way valves, which ensure that the blood goes back in a single direction, towards the heart.

If the valves in the veins of the legs do not work, then the blood will flow back towards the ankles due to gravity. This will enlarge the veins of the legs, and these veins become large and visible. These enlarged veins are called varicose veins.

What are the symptoms of Varicose veins, and when should you consult your doctor?

·  If there is swelling in your feet, ankles, or your whole leg

·  If you have a feeling of heaviness or discomfort in your legs

·  If you feel itching in or around your veins or ankle areas

·  If your skin color in your leg is changing or your skin is hardening

·  If you feel throbbing for burning in your legs

These are the symptoms that warn you of the disease of Varicose veins.

Myth #1:  You need not worry about Varicose Veins until it pains or the condition becomes severe, or Varicose Veins are not a problem until they make you feel uneasy.

Often, the patients who have varicose veins think that the problem is not of concern until it starts to cause trouble. However, when you see varicose veins, that’s the sign your leg veins are already in distress, and you should not ignore the fact that not looking into the condition will only make things more severe.

Varicose veins increase in size over some time. Not only that the increased pressure in these veins gives rise to other serious issues, like ankle swelling, pigmentation of the skin, and discomfort and pain in the legs. This discomfort decreases the patients’ activity, leading to weight gain, and further pressure on the already dilated veins. So it is a vicious circle. And we all know that being overweight leads to many more diseases.

Apart from this, large varicose veins allow blood to be stagnant in them for long periods, which can lead to blood clot formation. Such a blood clot can sometimes break off, and travel to the deep veins of the legs, causing Deep Vein Thrombosis. Occasionally the clot can even travel to the lungs, causing a very serious condition called Pulmonary Embolism.

Myth #2:  Varicose Veins only occur in women, and men are safe from this problem.

It is a fact that women are more vulnerable to Varicose Veins, but that doesn’t mean that men are safe from this. About 1/3rd of the adults suffer from this disease, and it is not sex-biased.

Whether it is a man or a woman, one should not ignore the symptoms because the problems will gradually increase, just as discussed in myth #1, regardless of the sex.

Myth #3: Only the elderly get Varicose veins

While it is true that the majority of patients who develop severe varicose veins are beyond the age of 40, this disease can also affect the young. If the vein valves are weak from birth, Varicose veins can be seen after the age of 15 years. Furthermore, if they develop in younger patients, they are usually under increased pressure due to the strenuous activities usually performed by youngsters. So, they should not be neglected.

Myth #4: Varicose Veins are just a cosmetic problem

Small Varicose veins may be a cosmetic problem. However, many patients with small Spider Veins can have significant pain and burn in the thighs and legs.

In many patients with Large varicose veins, there is no pain or discomfort. However, this does not mean that they are harmless. Over some time, these will cause various symptoms in the legs, such as tiredness, pain, and discomfort. They may also cause ankle swelling and dark skin pigmentation around the ankles with wounds called ulcers. Rarely, blood clots that form in varicose veins can travel to the lungs, and cause a life-threatening condition called Pulmonary Embolism.

It is important to consult a Vein Specialist to confirm what precautions and treatment you need to do if you have varicose veins.

Myth #5: Nothing can treat Varicose veins

Nowadays, there are many treatment options for Varicose veins, which range from changing your lifestyle habits, some oral medications to surgery. The latest options such as Laser will not require you to undergo open surgery at all.

Remember, with advances in technology, treatment options for Varicose Veins have also evolved. Most of the techniques available nowadays require no cuts or stitches, and usually performed under local anesthesia.  Furthermore, most patients can return to their daily routine within 24 hours.

It is always better to get treated earlier in the disease, rather than later when more symptoms have occurred and some permanent changes such as ankle swelling, skin pigmentation, and ulcers have developed. The treatment protocol will remain the same, but you will be left with some permanent problems. Therefore, the earlier the treatment, the better for you.

Oral medications usually work only in the very early stages of varicose veins. The same is true of Compression stockings. They will probably slightly slow the advancement of the disease, but cannot halt it.

Myth #6:  If blood clots occur, they will remain in the legs and not travel anywhere else in the body.

Most blood clots that form in the Varicose veins will remain there. However, in some patients, a clot will break off and travel to the lungs, and block an artery of the lung. This condition is called Pulmonary embolism (PE).  This is a dangerous condition. Pulmonary Embolism is life-threatening in more than 50% of the patients.

Myth #7:  Other than looking bad, there is no issue with Varicose Veins.

When a person is suffering from Varicose veins, the veins start to bulge out of the skin if the condition is severe. These prominent veins can sometimes have a very thin wall,  and even a slight scratch or a simple bump from the side of your table can cause severe bleeding. The bleeding is usually quite painless and can occur at night due to sleep when one tends to scratch the affected area. In such cases, significant blood loss can occur, before the problem is detected.

Apart from this, if left untreated, Varicose veins can cause wounds around the ankle called Venous Ulcers. These may take a long time to heal unless the varicose veins are treated properly immediately.

The most common cause of dark skin around the ankles is underlying varicose veins. It is important to realize that many times, varicose veins are not visible, and maybe below the surface. Therefore in all patients with skin changes in the lower legs, a venous ultrasound test should be carried out to diagnose varicose veins.

Myth #8: The treatment for Varicose Veins is very painful.

There several types of treatments that a person chooses for Varicose veins, whether surgical or non-surgical.

In the past traditional open surgery was performed, which usually involved general or spinal anesthesia, and multiple cuts and stitches. Recovery could be painful.

However, the newer methods of treating Varicose veins require no cuts or stitches. Most of these treatments are done under local anesthesia, and the patients are fully conscious during the treatment and talking to their doctors. Post-treatment, there is no rest involved, and the vast majority of patients can resume their normal duties within 24 hours.

Pain is not a significant problem with the newer methods of treatment.

Myth #9: Varicose veins are harmful to pregnant women

Varicose Veins are common during pregnancy. During pregnancy, the enlarged uterus in the abdomen presses on the veins in the abdomen, and as a result, the pressure in the veins in the legs rises. If the vein valves are weak, they start leaking due to the increased pressure, and the blood starts pooling in the legs, causing dilated, enlarged varicose veins. If a person already has varicose veins, the veins will increase in size.

The varicose veins may disappear after the baby is born. However, in many ladies, the veins persist. Also, repeated pregnancies lead to more severity of varicose veins.

Myth #10:  Women should wait until they have children to start the treatment for Varicose veins.

If a lady suffers from Varicose veins and becomes pregnant, there is a good chance that the severity of varicose veins will increase. Not only that, the varicose veins can be quite painful during pregnancy. Sometimes, blood clots can form inside the dilated varicose veins, and these clots can dislodge and travel to the lungs, causing a very serious condition called Pulmonary embolism, which can be harmful, even fatal to the patient.

Therefore if you have significant varicose veins, and are planning a pregnancy, do consult your vein doctor, and get the right advice.

Myth #11:  Medicines can’t cause varicose veins

The increased use of hormone medications in women, prescribed to help with the Menopause symptoms, or Birth control pills, can cause a condition called Deep Vein Thrombosis.  DVT is the formation of blood clots in the Deep Veins of the legs. It is known that one of the long term complications of DVT is Secondary Varicose veins.

Some blood pressure medications, medicines for Diabetes, and Steroids can cause significant weight gain. In patients who have weak vein valves, this weight gain combined with the decrease in physical activity will lead to the formation of varicose veins.

Myth #12:  Whatever job I do won’t affect my chances of getting varicose veins.

Varicose veins are more commonly seen in some occupations, usually those which require prolonged standing.   If you work in the restaurant or hotel industry, are a teacher, policeman, flight attendant, then long-standing hours will cause increased pressure on the veins of your legs. If your vein valves are weak, then these valves will start leaking, and you will develop varicose veins. You must have weak vein valves for developing varicose veins, only prolonged standing is not the only cause ( Otherwise the entire army will have varicose veins.)

Similarly,  if you have a sedentary job, which requires you to sit at your desk for long hours, with your legs handing down, it will also contribute to your chances of getting Varicose veins.

When you stand or sit for prolonged periods, there is a pooling of blood in the veins of the legs. However, if you walk every once in a while, the muscle of the calf helps to push the blood upwards towards the heart, emptying the veins of the legs.  Therefore it is very important to take a short walk every hour or so, even for 5 minutes.

Myth #13:  Varicose veins and Spider veins are the same.

While Varicose veins are bulging blood vessels that are seen and felt on the surface of the skin, Spider veins are tiny red or blue lines that look like branches of a spider on the surface of your skin.

Varicose veins cause heaviness, swelling, and a lot of discomfort in your legs and can lead to severe health conditions, like blood clots, whereas spider veins are mostly painless and do not cause swelling health-related problems. However, in some patients, spider veins can be the reason for a lot of burning, pain, or pins and needles like sensation.

Spider veins can be treated by a process called Sclerotherapy, a non-surgical method.

Myth #14: One can’t go back to regular life, even after the treatment of varicose veins.

Most patients can go back to doing what they enjoyed after the treatment of their varicose veins.

Many patients have restricted activities because their varicose veins cause heaviness, swelling, and pain in the legs. These problems are taken care of by proper and timely treatment. The legs feel so much lighter after treatment, that patients enjoy walking and running activities.

Almost all gym activities are allowed after treatment. Walking, treadmill exercise, cycling, and swimming are the best activities. Weight lifting is to be avoided, as this may cause a lot of pressure on the legs, and may cause new varicose veins to develop.

If Varicose veins are not treated in time, the condition may lead to chronic pain and discomfort. However, there are many treatment options and lifestyle choices that can help you control your symptoms. You can even exercise with varicose veins, says Dr Shoaib Padaria, the pioneer of laser treatment of Varicose veins in India.

How to Manage Varicose Veins

1. Compression stockings

2. Proper shoes

3. Avoid prolonged sitting or standing

4. Exercise

5. Stop smoking

6. Elevate feet

7. Losing weight and healthy eating

8. Varicose veins treatment

1. Compression Stockings

Veins have valves that keep your blood flowing in one direction. When these valves do not work properly, blood can pool in the legs, causing dilated veins called Varicose Veins. Compression stockings are tight-fitting socks that put mild pressure on your legs and prevent the veins from enlarging and encourage proper blood flow from the legs towards the heart. Compression stockings may also help prevent blood clots.

2. Proper Shoes

There are genetic risk factors that predispose you to varicose veins—and age play a role—but certain lifestyle choices also substantially increase your odds of developing this potentially painful vein issue. Studies have found that wearing high-heeled shoes may increase your risk of developing varicose veins. If you already suffer from varicose veins, high heels can worsen these veins. Try a shoe with good arch support, a nursing shoe, or a stylish flat.

3. Avoid Prolonged Sitting or Standing

If you have a job that requires several hours of standing or sitting daily (e.g. nurses, teachers, retail sales executives, computer operators), it is important to move the legs and walk at intervals of one to two hours. When you stand or sit for prolonged periods, you are putting undue stress on your leg veins. When you sit for several hours like truck drivers and office workers do, you are compromising blood flow. Stagnation of blood in the legs not only may be responsible for Varicose veins but may also lead to blood clots in the veins (Deep Vein Thrombosis)

4. Exercise

Exercising with varicose veins may be painful, but certain activities like walking, biking, and swimming can help improve blood flow through the leg veins. Ideally, you want to move your calf muscles, which get the blood flowing through your legs. It is important to warm up before exercising with varicose veins, and it is generally important to avoid exercising after certain vein treatments. If you have varicose veins, consult at our centre with Dr Shoaib Padaria before beginning an exercise routine.

5. Stop Smoking

Smoking affects many organs in the body and can damage blood vessels as well. Smoking restricts circulation and narrows blood vessels, leading to poor circulation and may contribute to the development of varicose veins.

6. Elevate Feet

As part of varicose veins management, you can elevate your feet to help blood flow more freely into and back from your legs, which improves circulation. Elevating your feet can help with pain and leg swelling. Reducing swelling may also help in the healing of the painful varicose ulcers associated with vein disease.

7. Losing Weight and Healthy Eating

Carrying extra pounds puts pressure on your veins which may worsen the blood pooling caused by poorly functioning vein valves. When you lose weight, you are also lessening the pressure that is put on your leg veins. Losing weight cannot reverse varicose veins presence but may prevent any existing varicose veins from worsening in appearance. Eating a balanced diet is an important factor in maintaining a healthy weight. It is also important to watch your salt intake, leading to water retention, general heaviness, and added pressure on your legs.

8. Varicose Veins Treatment

There are many varicose vein treatments available for those who want to rid themselves of varicose veins under a vascular specialist’s care. Varicose veins can return after treatment in some patients, so it’s important to make healthy lifestyle changes to support medical interventions. Generally, the more proactive you are with your health, the better the outcome.

Sclerotherapy is one treatment option for varicose veins. During this procedure, a vascular specialist will make injections into the varicose veins to reroute blood flow to healthier veins. Alternatively, endovenous thermal ablation like Laser Treatment or RFA relies on laser heat or high-frequency radio waves to reroute blood to healthier veins and shut down problematic veins.

Rarely, surgery for varicose veins is warranted. Still, when you are taking proactive steps—making healthy choices with your diet, quitting smoking, elevating your feet, and exercising—you stand a much better chance of avoiding surgery. You can also lower your risk of potentially dangerous complications like venous ulcers and blood clots.

If you have questions about varicose vein management, call 022 23525001/ 022 23526001 and schedule an appointment with Vascular Specialist Dr Shoaib Padaria.

 

WHY ARE COMPRESSION STOCKINGS IMPORTANT?

Compression stockings are snug-fitting pieces of clothing for the legs. They look similar to other socks or stockings, but their unique design puts gentle pressure on your ankles and legs. Compression therapy is likely to be recommended if you have varicose veins or another type of venous insufficiency.

How Compression Stockings Help Veins

Healthy veins have a series of valves that help push blood upwards to the heart. This promotes good circulation in the feet and legs. When someone has a vein disorder, however, leg valves don’t always work correctly. Without the needed pressure, blood can start to pool in the feet, triggering the pain, discomfort, and aesthetic issues related to varicose veins.

Compression stockings assist with blood flow. They can reduce the size of your veins, which increases upward pressure and improves circulation. Compression stockings can help with vein disease symptoms but do not stop the progression of the disease. Here are some of the ways this type of vein treatment can help:

• Heavy or aching legs: Compression socks give your legs a rest. That way, they feel lighter and more comfortable throughout the day.
• Swelling: Some people who have varicose veins experience pain, swelling, burning, or itching. By preventing blood from pooling, compression stockings can alleviate these symptoms.
• Poor circulation: If you usually have poor circulation in your toes, feet, ankles, or legs, this type of therapy may improve things significantly.
• Dizziness: With good circulation, your heart doesn’t have to work hard to get blood to your tissues. This can reduce feelings of dizziness or lightheadedness.

In addition to these benefits, compression stockings support your veins and may reduce the appearance of spider veins and varicose veins. They also help prevent serious conditions such as deep vein thrombosis (DVT) and leg ulcers.

Types of Compression Stockings

There are three main categories of compression stockings, along with countless individual styles. Your doctor may prescribe knee-length or thigh-length stockings with the right amount of pressure, depending on your needs.

Graduated compression socks are usually the ideal choice for vein treatments. They start tighter and get looser toward the top of your leg.

Patients who aren’t able to be very mobile may benefit from specialized anti-embolism stockings. This type of compression therapy is usually firmer than other stockings for vein treatments. It provides extra protection against DVT when physical activity is challenging.

Non Medical stockings (also called support hosiery) are general compression garments that focus on giving tired legs a rest. Athletes, pilots, and other people with aching legs may experience some benefits, but these are more for everyday use and prevention than part of the vein treatment process.

Why Are Compression Stockings Important?

As people age, the risk of developing a vein condition becomes more likely. The walls of veins start to weaken, making it harder for them to transport blood correctly. Compression stockings can provide vein support. This is essential following vein treatments, such as endovenous laser ablation or sclerotherapy for varicose veins.

Compression stocking can help with the symptoms of vein disease before treatment. We encourage patients to use them before treatment and one to two weeks after endovenous laser ablation treatment. One of the most important roles of compression socks is to prevent blood clots from forming. People who have chronic venous insufficiency (CVI) are at risk of DVT and pulmonary embolism, which are life-threatening. Because compression stockings promote healthy blood flow in the feet and legs, they can significantly reduce DVT risk. Wearing them may literally save your life.

FAQs for Compression Stockings

Here are the answers to several common questions about compression stockings. This information is general. It’s always a good idea to ask your doctor for more specific recommendations.

• DO YOU HAVE TO WEAR COMPRESSION STOCKINGS ALL THE TIME?

· Compression stockings are designed to be worn during the day. It would help if you took them off before going to bed at night. When you get out of bed in the morning, put them on again.

• WHY DO COMPRESSION STOCKINGS REQUIRE PROFESSIONAL FITTING?

· Each pair of compression stockings needs to fit your legs perfectly. Such a complex measuring process always requires the expertise of a vein specialist.

· The stockings have to apply just the right amount of pressure to work properly, not too much or too little. In fact, the pressure varies in different parts of the garment. The bottom part near your ankles needs to squeeze your legs more firmly than the area closer to your calves.

• WHO SHOULD WEAR COMPRESSION STOCKINGS?

· Individuals with varicose veins or CVI should wear compression stockings. People who are at risk for DVT, such as someone recovering from surgery, also need them. If your job requires you to spend extended periods of time standing or sitting, you may want compression socks for extra support.

Learn More About Professional Compression Treatments

If you have varicose veins or another type of circulatory issue, there are many vein treatments available that can help at Doctor House Cardio Vascular Center; we have caring professionals who want to help you find relief. Please find out more about high-quality compression stockings and other options that really work by contacting us right away. You can also reach us by calling 022 23525001/23526001

Varicose veins are enlarged blood vessels, which develop due to vein valves weakness and the pooling of blood in the legs veins. They may cause itchiness, discomfort, and swelling around the ankles, and if neglected, may lead to even more severe conditions. Varicose veins are mostly seen after 40 years, although severe varicose veins are not uncommon in young persons.

They are also commonly seen in obese people, those with standing or sitting jobs, and those with a sedentary lifestyle. The problem of Varicose veins left untreated is not how it looks in those areas.

What happens if the Varicose veins are left alone. In some patients, they can lead to significant medical complications. Dr. Shoaib Padaria, the Pioneer of Laser treatment in India, offers some insights on this.

1- Swelling of the legs, especially the ankles:

Swelling of the leg is one of the most common complaints of patients suffering from Varicose veins. Due to increased pressure of leaking blood in the veins, the ankles swelling is usually noticed, usually towards the evening, when the patient has been standing or sitting for a long period.

This swelling usually decreases or completely subsides on elevating the legs or when the patient sleeps at night. However, later on, this swelling becomes more permanent and will not reduce even with leg elevation or by wearing compression stockings.

Patients should not wait until this occurs, and consult your Vein Specialist as soon as ankle swelling is noticed, says Dr. Padaria.

2- Skin Infections:

Skin infections of the legs is a risk that accompanies Varicose veins. Due to increased pressure of the blood in the enlarged veins, some amount of fluid and proteins leak out into the lower limbs' tissues. This is accompanied by swelling. The leg is now very much prone to bacterial infections, which do not heal quickly. The commonest infection which occurs is known as cellulitis, causing redness and warmth in the infected area.

The patient may even develop a high fever and have raised blood cell counts. The cellulitis can sometimes be very severe, involving the entire limb, and may even spread to the other leg. It may occasionally require hospitalization and treatment with intravenous antibiotics.

Even after the cellulitis is treated and recovers, many patients are left with some swelling and darkening of the affected skin, which may persist lifelong.

3- Skin Ulcers:

The skin of the patients with varicose veins around the ankles is usually prone to swelling and infection. Furthermore, there is a reduced capacity for healing. Therefore, even small legs small wounds do not heal easily or take a long time to heal. These wounds around the ankles are called Venous Ulcers.

These venous ulcers are usually seen around the inner or outer side of the lower ankle area. They are usually reddish and may be mildly painful. If there is severe pain in the ulcer wound, it is usually due to accompanying infection, associated involvement of the area’s arteries, or damage to the surrounding nerves. Some venous ulcers may take years to heal.

Venous ulcers appropriate treatment is to treat the Varicose veins, followed by proper bandaging and compression therapy for the wounds. Venous ulcers occurrence indicates the presence of very severe varicose veins disease and should not be neglected. Dr. Padaria has treated many patients with venous ulcers and is one of the authors of the Guidelines for Venous Ulcer Treatment in India, published on behalf of the Venous Association of India.

4- Lipodermatosclerosis:

Patients with severe varicose veins will develop significant skin changes around the ankles and lower legs, called Lipodermatosclerosis. There is darkening (pigmentation) of the skin, and it also becomes hard. The fat tissue below the skin also decreases so that the ankles become very thin and narrow, and the skin is seen to be directly over the bone.

This damaged skin is very prone to tear and rupture because the underlying fat is absent. Patients who notice darkening of the skin around the ankles, especially those who also have itching in that area, should immediately consult a Vascular Specialist. In most cases, the cause is underlying varicose veins, which can easily be identified by a Venous Doppler sonography test.

Venous Doppler study is routinely performed at Doctor House Cardiovascular Centre by Dr. Padaria and our expert radiology team, who have been doing these tests for the last 30 years.

5- Superficial Thrombophlebitis and Superficial Venous Thrombosis:

Occasionally the dilated Varicose veins in the legs may become very painful, swollen, and hard, with the warmth of the overlying skin.

This condition is called Superficial Thrombophlebitis and is due to irritation and inflammation of the Varicose Veins. It can be quite painful and disturbing. The treatment is with medicines like anti-inflammatory drugs and compression stockings.

On the other hand, there may be the clotting of blood in the dilated Varicose Veins. This condition is diagnosed by sonography and will require special clot-dissolving medicines for 6 to 12 weeks. Sometimes, the clot may extend into the legs deep veins, causing severe Deep Vein Thrombosis.

6- Deep Vein Thrombosis:

One of the most severe complications in a patient with Varicose Veins is Deep Vein Thrombosis. A blood clot that forms in the Varicose Veins may travel into the legs deep veins and block the flow of blood.

Since the legs deep veins are responsible for returning more than 90% of the blood from the legs back to the heart, this blockage causes the entire leg to swell. Along with the swelling, there is pain.

Occasionally the blood clot from the deep veins can travel to the heart and get lodged in the lungs, causing a severe pulmonary embolism condition. Many patients die from Pulmonary Embolism. So it is important to treat Varicose Veins in time before they cause any major complications.

7- Severe Bleeding:

Sometimes, the enlarged Varicose Veins can burst and cause severe bleeding. As we know, varicose veins occur because of leakage in the vein valves, with theblood in the veins flowing in a reverse direction towards the ankles. Over some time, the veins dilate, especially the smaller branches, which are very thin. These thin branches can sometimes break ( rupture ).

They may occur spontaneously ( by themselves) or maybe due to scratching the area or during a bath. Most of the time, this bleeding is painless and occurs as a spurt of blood. If it occurs at night during sleep, the patient may lose a lot of blood before becoming aware of the problem.

Bleeding varicose veins indicate that the veins pressure is very high, and the Varicose veins should be treated immediately. At Doctor House Cardiovascular Center, we evaluate all these patients in great detail and formulate a treatment plan.

Every patient is different and may need a different type of treatment. The various treatment procedures include Laser Therapy, Radiofrequency Ablation, Foam Sclerotherapy, Glue (Venaseal), etc. However, it should be understood that every procedure has its advantage and its disadvantages, and Dr. Padaria will explain to each patient what procedure would be most beneficial to that particular patient, depending on the clinical findings and the results of the investigations.

We suggest you contact your doctor when you feel your varicose veins are bulging out or have started to pain. You can call 022 23525001/ 022 23526001 and schedule an appointment with Vascular Specialist Dr. Shoaib Padaria.

At Doctor House Cardiovascular Center, we have all investigative facilities for Vascular Diseases in-house.