Varicose Veins | How To Deal With Them
Definitions: 1. Permanent dilation & tortuosity of veins, most commonly seen in the legs, probably as a result of congenitally incomplete valves. (mediLexicon)
Varicose Veins | How To Deal With Them
How Do Veins Become Varicosed?
Of all those who’ve experienced varicose veins, 70% are women.
What's the cause? Usually incompetent valves at the top of the Great Saphenous Vein.
What do Incompetent valves mean?
Veins return blood to the heart. Between heartbeats, the leaflets of the valve (within a vein) catch & hold the "backflow" of blood until the next heartbeat. If the valves are incompetent, they no longer meet & thus can no longer catch the “backflow".
Trouble runs downhill! Due to gravity, this “backflow” of blood pools & eventually causes damage in a superficial vein in the lower half of the leg.
That poor vein! To accommodate the increased volume of blood, the vein wall stretches & stretches until it's weakened & it’s valve leaflets no longer meet. The vein becomes bulbous & tortuous - in other words, varicosed. The vein is ruined!
However, treatment is only recommended (& covered by Medical) if there are symptoms or complications such as pain, leg swelling, skin discolouration, eczema, venous ulcers or varicose vein rupture.
Do you have one, or more, varicose vein(s) that you want to get rid of?
Are You Plagued With a Varicose Vein or Two?
Many women get varicose veins during pregnancy or weight gain due to the pressure placed on the Great Saphenous Vein.
However, after the baby is delivered or if the weight is lost, the valves in the Great Saphenous vein usually recover & become functional once more.
Unfortunately, the varicosed superficial vein (usually in the lower leg) is ruined permanently.
What is Sclerotherapy?
Definitions: 1. Treatment involving the injection of a sclerosing solution into vessels or tissues
Synonyms: Sclerosing Therapy
Ask your General Practitioner for a referral to a Vascular Surgeon. If this is your first venture with a Vascular Surgeon, Sclerotherapy is the perfect non-invasive option.
If another varicose vein develops in 5 - 10 years, then you know that your Great Saphenous vein never recovered & is incompetent. Continue Sclerotherapy for as long as you’re allowed. There will come a time when the Vascular Surgeon says, “No more!”
Then you’ll need the superior portion of Great Saphenous Vein ultra-sounded to confirm that it is indeed, incompetent. If it is incompetent & your varicose veins are symptomatic, then you’re a candidate for a surgery called, a Saphenectomy.
Women should be finished having children before this surgery.
A Saphenectomy is the surgical removal of the Great Saphenous Vein & therefore with it, the entire superficial venous system in the leg. It's a simple, non-surgical procedure used to take smaller, superficial, varicose veins out of commission. There’s almost nothing to it. It’s a quick 5-minute job!
1. You lie on a tilted table
2. The vascular surgeon injects the bottom & the top of the vein with saline solution (which renders the vein unusable)
3. Your leg is wrapped in a tensor bandage (the medical office will sell you tensor bandages or you can supply your own).
4. You’re done!
There’s NO recovery time! Over several months the dark brown line fades as the body reabsorbs the unusable vein.
Will the removal of your leg's superficial venous system become a problem?
Apparently not. The deep venous system returns 99.99% of your blood back to your heart. The superficial system returns 0.01% of your blood. The deep venous system has no trouble whatsoever taking up that extra 0.01%.
Definitions: 1. Excision of a Saphenous vein. (mediLexicon)
My Venous Past
I was only 23 years old when my first blue, bulbous vein crept up over my knee. When I figured out what it was, I was mortified!
Such was the beginning of my venous experience. The research, the tensor bandages & the assortment of vascular surgeons. Dr. Fry was awesome. He had white hair, the bluest eyes & told me to never stop running.
Ongoing, my vanity reigned! I had four superficial veins removed from my lower legs by Sclerotherapy on four different occasions. Once a vein appeared, I’d never dream of waiting long enough for it to get bulbous – I’d run off to the vascular surgeon immediately!
On my fifth try, Dr. Fry told me that I couldn’t have any more veins removed. Instead I was sent to Vancouver General Hospital to have the superior portion of my Great Saphenous vein in each leg ultra-sounded to verify that the valves were indeed incompetent.
And so they were.
What happened to the valves in my two Great Saphenous Veins? Unknown. I’ve never been overweight or pregnant & I do not have a family history of venous difficulties. My health & fitness has always been far above average. It doesn’t make any sense.
It was recommended that I have the Great Saphenous vein (& thereby the entire superficial venous system) removed in both legs. This is called a Saphenectomy. Once the Great Saphenous vein has been removed, it’s gone & along with it, your entire superficial venous system. This is a big deal because it is full-on surgery.
I waited years. It didn't seem right to remove a system that naturally should be in place.
Finally, I'd had enough. I went to Dr. Hunter & he confirmed that I was a candidate for a double Saphenectomy. My name was placed on the elective surgery list.
I convinced him to schedule me for both legs at once by telling him I was self-employed. I asked him if it would be months & months before I was called. He said yes.
Spider-burst (Spider veins)
Definitions: 1. Radiating dull red capillary lines on the skin of the leg, usually without any visible or palpable varicose veins, but nevertheless due to deep-seated venous dilation. (MediLexicon)
So I underwent a surgical double Saphenectomy (removal of the Great Saphenous vein from both legs).
The Lion's Gate Hospital provided:
- A nightgown open a the back
- a housecoat placed over top & tied around the waist
- long kelly-green stockings with pointy toes
- pale blue booties – you know, the kind you put on when looking at real estate open houses.
Then I had to remove all my jewelry.
Over the next two hours I was asked the same questions over & over, each staff member dutifully initialing in the rightful column on the forms.
I swallowed a pill that allegedly helped with nausea. Then a blanket was draped over my shoulders & I was set free to wander around the elective surgery waiting-room steering my IV stand with my needled hand.
Nothing had been done to me, nothing was wrong with me & yet suddenly I felt ill & vulnerable, like an invalid on a day pass from Palliative care.
The operating room was bright, sterile & LARGE - probably over half the size of my condo! Four nurses milled about. They helped me up onto the operating table, covered me in blankets & set about gossiping amongst themselves. It was the anesthesiologist who engaged me – tried to set me at ease by chatting with me about books.
Finally, Dr. Hunter came in & I had to get out from under the blankets & off the table with my open-backed nightgown flapping, so he could mark up my legs with a black felt pen. I reminded him that he said he’d remove that aqua-blue, bulbous vein from the back of my right calf. He just seemed in a hurry.
While he was drawing I was clenching my teeth, trying not to shiver. Then I exclaimed that I didn’t understand why I was so cold. The anesthesiologist said, “Uh, yeah, because it’s freezing in here!” I wondered if I had just detected hospital politics.
I got back on the operating table. My arms were placed out spread eagle on planks & blankets were piled on top of me. The anesthesiologist let me know that he was going to put me under & I was glad because I was so tired of feeling afraid.
One Day Post-Op
One Day Post-Op
I awoke what seemed like seconds later.
“BREATHE!” I looked up into the concerned face of a nurse. I took a deep breath & looked around. I was in a rolling hospital bed parked in a hallway. My legs were wrapped in tensor bandages with splotches of blood intermittently down the insides from thigh to ankle.
“BREATHE!” I was surprised to find that she was right - I kept forgetting to breathe! Breathing is supposed to be involuntary – you’re not supposed to have to think about it. But when my thoughts wandered to the ache in my legs, the nurse again reminded me to breathe.
Suddenly, the anesthesiologist was looming over me & asking, “ARE YOU ALL RIGHT?!?”
“Yeah,” I said. “Except I keep forgetting to breathe.”
“Well no doubt,” he said. “You stopped breathing on the table. We had to shove a tube down your throat!”
“Oh! That’s why my throat hurts so much.”
The weird thing was that I didn’t feel particularly cold. But I had started to shiver… violently. It was uncomfortable & magnified the pain in my legs. The nurse piled blankets on top of me - to no avail. Finally she got this reverse vacuum thingy & shoved the hose under the blankets near my feet. It blew hot air underneath. Oh bliss! I was in Mexico
Finally my hospital bed was wheeled into a cosy space surrounded by hospital green curtains. It was warm, comfortable, restful & welcome. I was so tired.
The last thing I wanted to do was get out of the bed, get dressed, climb into the wheelchair to be wheeled down to the car. But the nurse said it was time.
When I was finally in my own bed, I propped my legs up on pillows & fell asleep for several hours.
Chillin' in My Recovery Room
Three Days Post-Op
18 Days Post-Op
Recovering From a Saphenectomy
Two good two weeks mostly propped up in bed with my legs up on pillows & I recovered fully.
- The incisions down the inside of the legs take at least 10 days to heal.
- There is a lot of blood under the skin & it causes painful pressure whle standing.
- Walking with proper strides – “outside walking” - is very painful.
- Shorter strides – “indoor walking” - is bearable & recommended (walk around the inside your home every 30 minutes).
I was sent home with a prescription for Tylenol with Codeine & 6 Demerol tablets. After my anaesthetic experience in the hospital, I wouldn’t even dream of taking any of these. But I did look up the street value of Demerol – $25 bucks a tablet! They’re still sitting in my bathroom drawer.
- A few days later, at our local pub, I sat with my legs up on a chair but had to leave because I felt dizzy & sick.
- 8 days post op I went to my clinic & saw 3 clients. I was exhausted!
- 10 days post op I saw 1 client.
- 12 days post op I did a full day at the clinic & was really tired by the end of it.
- Otherwise I stayed in bed.
My Unveined Outcome
I feel it’s important to note that the thoroughness, attentiveness & kindness of the hospital staff was impressive.
And I must mention that of all the treatments I’ve received above, I did not have to pay for anything. I’m Canadian, eh! And I’m so proud of it!
Have you undergone treatment for your varicose veins?
The only complaint I may have is that I found patient education either simple or not forthcoming.
Having said that, I’m not complaining at all because I believe that people should be accountable for their health & should educate themselves. The Internet has rendered ignorance into a mere symptom of laziness.
The information written in this article is only a small portion of what is medically known. I’ve only included that which I’ve experienced. For those who are affected, I recommend reading all the evidence-based information you can get your hands on.
Wikipedia, as always, is a wonderful overview & a great place to start.
If you like this article, please share it!
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- Sylvia Leong RMT CPT ARS
- LEONG Orthopaedic Health
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© 2012 Sylvia Leong