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EXCLUSIVELY DEVOTED & FOCUSED ON VENOUS DISEASE

Month: December 2017

Your veins work hard everyday, fighting against gravity to return blood to the heart. But with age, weight gain, a sedentary lifestyle, genetic factors, and prolonged sitting and standing, the veins in your legs can expand, making the valves ineffective in preventing backflow. Let’s discuss the different types of venous diseases.

Types of Venous Diseases

Blood flow in the veins depends on muscle contraction to open the valves so blood can flow forward. When the muscles expand, the valves shut preventing blood from flowing backwards. But when some valves fail to close properly, blood begins to flow backwards – a condition known as reflux.

Types of Venous Diseases

This may in turn cause blood to pool in some veins, resulting in a number of venous diseases with varying symptoms and treatment options. Common vascular diseases include:

1. Varicose Veins and Spider Veins

When blood begins to pool in the main valves, it is redirected to smaller veins that sit closer to the surface of the skin to maintain blood flow. With the increased blood supply, these veins dilate and swell to appear like blue-purple, ropy bulges under the skin – referred to as varicose veins. They usually appear on your legs.

Smaller blood vessels – capillaries – can also be affected, appearing like small red-purple bursts on your thighs, knees, or calves. These are known as spider veins.

Varicose and spider veins are unattractive to look at, but are seldom painful. You may choose to get them removed for aesthetic purposes, or when they begin to cause pain and discomfort.

2. Blood Clots

Expanded veins and damaged valves often cause blood to flow slowly, causing it to pool, stick to the inner walls of the veins, and form clots. The clots in your veins are referred to as venous thromboembolisms, and are usually caused by:

  • Any condition that reduces the blood flow rate or thickens blood, like some tumors or congestive heart failure
  • Damaged veins due to infection or injury
  • Damaged endothelium – vein lining
  • Damaged valves inside the vein
  • Some hormones, including estrogen due to the use of birth control pills or pregnancy
  • Immobility, like due to prolonged bed rest
  • Genetic disorders that make your blood clot
  • Insufficient blood-thinning proteins (anticoagulant)
  • Surgical procedures on your legs and hips

If the clot develops in a vein near the surface of the skin, it is referred to as phlebitis or superficial venous thrombosis.

If the clot forms in a large vein inside the thigh, lower leg, or pelvis, it is referred to as deep vein thrombosis (DVT).

If the clot breaks away from the vein wall and reaches your lungs, it is referred to as pulmonary embolism.

3. Chronic Venous Insufficiency

If no intervention is made to correct deep vein thrombosis (DVT), the prolonged blood pooling can cause your legs to swell and experience pain or pressure. This condition is referred to as chronic venous insufficiency.

You should visit a vein specialist immediately before internal fluids begin to leak into your feet and ankle tissues, which may break down your skin and cause it to wear away and darken.

4. Ulcers

These are the open sores or wounds caused by static blood flow that refuse to heal completely or keep returning. They usually manifest as venous stasis ulcers, which are found deep inside the leg, above the ankle.

When to See a Vein Specialist

Unfortunately, defective veins or venous valves that cause any of these diseases cannot be fixed or replaced. The only fix is removal through minimally invasive procedures, or valve repair for post-thrombotic syndrome.

Please visit the Center for Vein Wellness or schedule a consultation with Dr. Shah to discuss your case and venous disease treatment options.

Compression therapy involves the use of compression socks or stockings to promote healthy blood circulation in your legs and feet. The elastic hosiery is designed so it’s tightest at the ankle and loosens gradually higher on the leg. They work by compressing surface veins, which helps to maintain steady blood flow back to the heart.

Compression Therapy for Varicose Veins

Compression stockings are a form of self-care therapy for varicose veins, spider veins, and chronic venous insufficiency. Your physician may recommend them during the day to help relieve serious symptoms of varicose veins, including:

  • Fatigue and pain
  • Aching or heavy legs
  • Restless legs
  • Swollen ankles
  • Night cramps

Mild symptoms of swelling and aching can be successfully managed using regular, cost-effective thigh-high, knee-high, or panty hose compression stockings.

How Compression Therapy Works

Your veins function best when lying in a horizontal position as opposed to when standing or sitting, especially when your valves are damaged. In the mornings, your calves and ankles usually feel fine, and only get heavy and swollen later in the day.

If you wear your compression socks in the morning before lowering your legs to get out of bed, you can maintain the proper function of the valves, promoting healthy blood flow in your legs all day.

Finding the Right Compression Level

As effective as compression therapy may be for managing varicose veins symptoms, you should avoid wearing the socks unless your doctor recommends them and helps you find the right fit for you. If you choose the wrong size, the socks can restrict blood flow, making the symptoms worse.

The different levels of compression include:

  • Mild compression – for mild cases of chronic venous insufficiency
  • Moderate compression – help to manage common symptoms of varicose or spider veins
  • Firm or extra firm compression – recommended for serious venous diseases like leg ulcers, deep vein thrombosis, and lymphatic edema

Choosing the right compression level is vital for successful compression therapy and optimal comfort. Your physician can help you find the best size for your case.

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Leg veins have a difficult task propelling blood against gravity and resistance from your bodyweight, back to your heart. They rely on muscle contraction and expansion to push the blood, while the valves prevent the backflow of blood. Varicose veins symptoms may start to appear with age.

The valves can weaken and stop functioning properly. This may in turn cause the blood to flow backwards, pool in the superficial veins – those closer to the surface of the skin – and make those blood vessels bigger.

Varicose Veins Symptoms

Varicose Veins Symptoms

If the affected veins do not cause any pain or discomfort, you can tell that they’re varicose veins if:

  • They appear dark blue or purple in color
  • They are bulging and twisted – appear like cords running on the surface of your legs

In some cases, varicose veins may cause discomfort in the form of:

  • Itching around the veins
  • Swelling and throbbing, burning, muscle cramping in the lower legs
  • Heavy feeling in the legs – achy
  • Increased pain after prolonged sitting or standing
  • Red skin discoloration with a throbbing cord inside the vein
  • Minor bleeding from the varicose veins – when they burst
  • Vein hardening, color changes, and skin inflammation or ulcers around the ankle, all of which indicate a more serious vascular disease

Varicose veins can also cause complications. Though very rare, you can experience:

  • Blood clots – In very rare cases, the veins deep inside your legs can also become enlarged, causing blood clots that make the leg swell significantly. This condition is medically referred to as deep venous thrombosis and needs immediate medical attention.
  • Ulcers – Prolonged fluid buildup in the tissues near varicose veins around the ankles, due to the increased blood pressure within affected veins, can cause very painful ulcers to form. Ulcers are usually preceded by a discolored spot on your skin, at which point you should seek immediate attention.

When to Seek Medical Attention

Although you cannot completely keep varicose veins from forming, those at high risk – due to family history, age, obesity, or jobs that involve extended sitting or standing – can reduce the risk by improving circulation through exercising, adjusting your sitting and standing position regularly, elevating your legs when sitting, and wearing compression stockings. If self-care doesn’t help, you should see a doctor.

First, it is important to note that board certification in any medical specialty in the US is a voluntary process. Medical licensure is primarily used to indicate the minimum requirements for competency in order to diagnose and treat patients in a specific specialty.

Board Certification

Board Certification vs. Medical License

A physician must have a medical license to lawfully practice medicine. This requires the doctor to fulfill the certain requirements including:

  • Successfully completing a certified program in a recognized medical school
  • Fulfilling residency requirements
  • Passing the exams indicated by your state to practice medicine
  • Approval by your state’s medical board

If a medical practitioner is board-certified, he or she has exceptional expertise in a specific specialty and/or subspecialty in the field of medicine.

Prior to certification, the physician has to go through a rigorous process of tests and peer evaluations designed and administered by other specialists in the same field of medicine, in addition to fulfilling the requirements of licensure.

The American Board of Medical Specialties (ABMS) was established in 1933, and has 24 member boards comprising multiple medicine specialties and subspecialties.

Although board certification is voluntary, it is vital because it keeps the specialty/subspecialty current through:

  • Participation in continuing education to remain current with the newest advances in the medical field of specialty
  • Participation in ongoing training to keep current on best practices in providing quality health care, patient safety, and establishing a patient-oriented and responsive environment

Dr. Shah is Triple Board Cerified

Dr. Shah is a diplomate of the American Board of Venous and Lymphatic Medicine, formerly the American Board of Phlebology. He is one of the few physicians nationwide who is certified by the American Board of Venous and Lymphatic Medicine, demonstrating expertise in the understanding and treatment of venous conditions. In 2005, the American Medical Association (AMA) recognized Phlebology as a separate self-designated specialty. The American Board of Venous and Lymphatic Medicine was established in 2007 to improve the standards of medical practitioners and the quality of care related to the treatment of venous disease. He is a Registered Physician in Vascular Interpretation (RPVI), certified by American Registry for Diagnostic Medical Sonography.

You can trust that Dr. Shah is dedicated to his field and will provide the best possible care through lifelong learning.