Questions about Varicose veins and Spider Veins treatment

Last week, I receive a list of questions from a journalist working for a local healthcare magazine. Since her questions are very relevant and will probably be asked by a lot of people who has veins problems, I shall post my answers here.

1. What is vericose vein (typo from source)? Please explain. Varicose veins are abnormally swollen or enlarged blood vessels in the leg caused by the weakening in the vein’s wall. Apart from being cosmetically unpleasant, varicose veins in their advance stages can be harmful to a patient’s health, because they may be associated with the development of one or more of the following conditions: inflamed tender vein, blood clot in the vein, and skin ulcers.The reason varicose veins developed is not fully understood. The basic problem appeared to be that of damaged valves. Normally, the veins transport blood from the leg to the heart. In order for this to be possible, it has one-way valves to allow blood to travel in only one direction. In varicose vein, these valves have failed. Without the proper valve function, the blood tends to flow down (leaky), giving rise to blood pooling in the leg, thus causing the vein to bulge.
  People who have varicose veins often have an inherited weakness of this valve. They may also give history of prolonged standing at work or multiple pregnancies, situations that will cause significant stress on the veins in the leg. These ultimately cause the veins to stretch and the valves to fail.
  
  SYMPTOMS OF VARICOSE VEINS
  
  These can be grouped into
  * Asymptomatic-some patients has no symptoms at all apart from the veins being unsightly. They are usually very active physically and their active leg muscles compensate for the weakness of the vein function.
  
  * Mild symptoms-aching and cramps in the leg, itchiness near the area of the veins and swollen ankle. All these are worse with prolonged standing.
  
  * Severe symptoms and complications –leg ulcers, bleeding and thrombophlebitis

1. High heels is sometimes accused to be the culprit of this condition. Is it true? Is there other cause? High heels can contribute to the formation of varicose veins but they are usually not the only factors. The 3 main factors are inherited weakness of the veins, pregnancies and prolonged standinga. Inherited weakness of the veins-patients whose parents have varicose veins may have inherited sets of veins. These get damaged when subjected to stressess like pregnancies and prolonged standing.
  b. Pregnancies stressess the veins in many ways. Pregnancy causes an elevation of many hormones. Estrogen relaxes the smooth muscle and collagen fibres in general, which may contribute to the vein wall expanding. In addition, the amount of blood in the systems increases by up to 40% thus exerting additional stress on the leg veins. The large uterus in the pelvis can also impede return flow of blood in the veins thus causing congestion in the leg veins.
  
  c. Prolonged standing. This explained why people who stands a lot at work have a tendencies to get varicose veins. Like hawkers

1. Who can get varicose vein? Does age worsen this condition? As above. Varicose veins get more common and more severe as a person ages as the additional years mean more stress on the veins anad more damaged valves

1. Can varicose vein endanger you health in general? Varicose veins is not merely a cosmetic problem. At a later stages, varicose veins can cause thickening and eczematous changes in the skin around the ankle area. Left untreated, the patient can developed large ulcers that is very difficult to treat.Other complications of varicose veins includes profuse bleeding, infection and thrombosis of the veins. Patient with varicose veins are also at risk of developing Deep Vein Throbosis, a potentially life threatening conditions.

1. What can we do to prevent varicose vein?This may not always be possible; however some simple measures and changes in our lifestyle can potentially delay the onset of varicose veins.* Regular exercise will improve circulation and strengthen the veins. Focus on exercises that work your legs, like walking or running.
  * Watch your weight. Obesity can put a lot of pressure on the legs and is known to cause spider veins.
  
  * Do not cross your legs when sitting.
  
  * Elevate your legs when resting or sleeping. To achieve this, the ankle should be place above the level of the heart. Try sleeping with 2 pillows under the feet, or lean on a couch and elevate the leg while watching TV
  
  * Try not to sit or stand for long periods of time. When you have to sit for a long time, get up and take a walk every now and then. If you must stand for a long time, shift your weight from one leg to the other or do tip toeing exercises to improve circulation in the leg.
  
  * Wear elastic support stockings as much as you can.
  
  * Avoid wearing tight clothing and high heel shoes. They can constrict your waist and legs and impede circulation.
  
  * Eat a well balanced diet with sufficient fibers and cut down on salt intake.

1. If you already have varicose veins, is there any treatment that you can go through?Is it invasive? For the last 40 years, the only treatment available for varicose veins is an invasive surgery called stripping of varicose veins. Under general anesthesia, a few large incisions are made in the leg and the disease veins are completely stripped off. Post surgery, the patient ususally have to rest in the hospital for a few days. The pain is intense and patient usually cannot walk for a few days. Patients are left with very unsightly scars. Furthermore, many studies have shown that about 25-30% of the varicose veins recurred after this surgery.It is not surprising that it is extremely unpopular and most patients prefer to leave theis varicose veins than to go through this surgery.
  Since 2002, THE VEIN CLINIC, Singapore has been treating varicose veins using an advance technique called ENDOVENOUS LASER TREATMENT. Endovenous Laser is a minimally invasive, clinically proven alternative to surgical vein stripping that treats varicose veins by using a laser fiber to deliver energy inside the vein, directly into the vein wall. The precise laser energy achieves optimal therapeutic effect while limiting collateral damage.
  
  The procedure is performed under local anesthesia. A tiny laser fiber is first inserted into the diseased vein through a tiny opening in the skin. Laser energy is then delivered through the fiber, which causes the vein to close as the fiber is gradually removed.
  
  With over 70,000 procedures performed worldwide, and over 60 clinical articles documenting its efficacy out to five years, EVLT is the proven alternative.
  
  Benefits of EVLT include:
  1. Treatment in less than an hour
  2. Can be performed in the doctor’s office
  3. Minimal post procedure pain
  4. Immediate return to activity
  5. NO general anesthesia or hospitalization
  6. NO scar

1. Where can you get this EVLT treatment? THE VEIN CLINIC Singapore
  290 Orchard Road, #12-01 Paragon
  Singapore (238859)Tel: (65) 9889 0288
  Fax: (65) 6238 8566
  www.theveinclinic.com.sg
  email drjohntan@gmail.com

1. How long will the treatment last? Is it save? about 30 minutes. Dr. John Tan has many cases with no significant complications.

1. I’ve read about EVLT in your clinic, what are the benefits of this treatment? as above

What are the consumer’s opinion about this treatment? This technique has completely change the way we treat varicose veins. Patients are also more receptive to treatment because they know the treatment is safe and leave no scars.My patients are very happy with the procedure. They come to the clinic at 9am in the morning, have the vein treated with minimal pain and walk out of my clinic on their own about 2 hours later. They are even more thrilled with the beautiful legs they get after the treatment. The needle marks are so small they healed without leaving any scars. With all the varicose veins gone and no visible scars, they can confidently go out in skirts again.