Frequently Asked Questions
What are varicose veins?
Varicose veins are enlarged, swollen, tortuous veins commonly found on the legs and feet, although they may occur anywhere. It is estimated that 17% of men and over 30% of women are affected.
What are spider veins?
Spider veins are tiny blood vessels just beneath the skin commonly seen on the face and legs. In most cases, they are of cosmetic concern although some patients do experience discomfort, aching, burning, itching and swelling. Nearly 50% of adults aged over 50, have some form of spider veins or varicose veins.
What are the causes of varicose and spider veins?
Increasing age: when veins in the elderly lose elasticity causing them to stretch. Valves within the veins weaken, allowing blood to flow backwards and stagnate in the vein. Women are more prone to develop varicose veins. Multiple pregnancies increase your chances of varicose veins. Family history: If others in your family had varicose veins, there is a greater chance you could be affected. Obesity increases the incidence as does standing or sitting for prolonged periods.
What are the signs and symptoms of varicose veins?
-veins appear twisted, bulging and enlarged beneath the skin
- tired, aching, heavy legs especially towards the end of the day
- swelling particularly at the ankle
- skin discoloration
-dry, itchy skin
- leg cramps
- restless legs
How do varicose veins occur?
In healthy veins, the valves within them allow blood to flow in one direction. If the valves are weakened, blood flows backwards and accumulates within the vein. This stagnant blood causes the vein to enlarge, dilate and get varicose.
Is the treatment covered by my Medical Services Plan (MSP)?
MSP covers the consultation with the surgeon. At this visit, you will be explained what your medical plan does cover for your particular venous disorder. Cosmetic procedures are not covered by MSP.
Will a doctor be performing the procedure?
Your entire treatment will be performed by an experienced surgeon who has dedicated his career towards the treatment of varicose veins and related disorders. He will perform and be responsible for every treatment.
How many treatments will I need?
The number of treatments will vary with the extent of varicose and spider veins that need to be treated. The average is between two to four sessions. At the initial consultation you will be told how many treatments you will require. Follow up treatments may also be required.
How long does the procedure take?
Each procedure takes between 20-30 minutes usually.
Are the treatments painful?
There is virtually no discomfort at all. Sclerotherapy is not performed with a normal gauge needle but is usually performed with a 27 or 30 gauge needle, similar to those used in acupuncture. Some patients experience a mild stinging sensation during the procedure. After treatment, most patients experience no discomfort. It is very rare for a patient to require any Tylenol.
Will I need time off work?
Every patient is encouraged to be as active as possible and walk at least 40 minutes a day. There is no interference with normal activities. Very vigorous exercise and swimming may need to be curtailed for two to four days in some patients. Running, jogging and moderate weightlifting can usually be undertaken on the day of treatment.
What should I expect on my first visit?
You will be asked to complete a questionnaire about your problems and general health. Following this, you will have a consultation with the surgical specialist who will review your history and exam both legs from groin to toe. Your blood flow will then be checked with a Doppler. A duplex ultrasound assessment may be required and if so, will be discussed with you. Next, a diagnosis of your problem will be explained to you. You will be provided with a detailed individualized treatment plan, keeping in mind your expectations and symptoms.
Will varicose and spider veins recur after treatment?
Yes, they can arise at different or perhaps the same location. No treatment is a guarantee of cure and no claim is made to cure your condition. Treatment results are subjective and vary from patient to patient. Most patients will achieve significant benefit, both cosmetic and functional. Please note the results of treatment may take time to manifest.
WHAT TREATMENT OPTIONS ARE AVAILABLE?
Sclerotherapy: The doctor injects a solution into small and medium sized veins. This results in scarring and sealing off the vein. Blood is then rerouted into a healthier vein. No anesthesia is required for this pain free procedure. No time off work is necessary for this safe and effective treatment. As with any other drug, adverse effects may rarely occur although serious adverse effects are extremely rare.
Foam Sclerotherapy: Normally, the solution is injected directly into the vein that needs to be treated. Foam sclerotherapy involves making small volume of the solution into a foam, by mixing and agitating the solution with air. Foam is used to treat larger varicose veins which may not be well treated with conventional sclerotherapy.
Ultrasound guided foam sclerotherapy: A safer, more effective alternative, where the medication is injected directly into the varicose vein using ultrasound technology.
Laser treatment: Laser treatment sends strong bursts of light into the smaller veins to make them fade. No injections, needles or anesthesia are required. After treatment, blood vessels fade over several months.
MINIMALLY INVASIVE PROCEDURES FOR VARICOSE VEINS:
Ambulatory Phlebectomy: This is a technique in which multiple, small incisions are made through which the diseased vein is stripped.
Laser Therapy: This therapy uses the heat of laser energy to scar and seal off a varicose vein.
How will blood circulate if the blood vessel is sealed off?
Blood returns to the heart through the deep venous system which is never treated. It is only the surface veins which get varicosed and need treatment.
PREPARING FOR YOUR APPOINTMENT:
Write down all the complaints/problems you are experiencing related to your varicose veins
Write down your personal and family history of all medical issues including a list of your medication.
Consider writing a list of questions to ask the doctor.
HELPFUL HINTS FOR SCLEROTHERAPY:
Avoid aspirin for a week if possible (consult your doctor) to decrease bruising.
Do not schedule treatments prior to vacation or travel.
Do not apply any cream, lotion or moisturizer on your legs on the day of treatment.
Please bring a pair of shorts with you.
Tape, bandages or a stocking may be required to be worn for between one to three days depending on your treatment. You will be explained how to keep them covered during a shower.
You will require to be active / walk at least 40 minutes a day.
Avoid very hot baths and hot yoga for two to three days after treatment.
There is never need to rest, immobilize yourself, elevate your legs or wear bandages/stockings for a prolonged period.
You will possibly require a follow up six to nine months after your prescribed treatment is complete. You will have personal access to your doctor at all times.