Spider Veins at the Beach

Article by: Jennifer Clark, PA-C, MPAS

There is no arguing that the state of Florida is one of the premiere vacation destinations in the United States, with over 80 million tourists visiting our sunshine state in 2010 and the numbers of tourists for 2011 are ever increasing! We are fortunate enough to live on one of the most beautiful coasts in the world, and while most of us can’t wait to get to the beach and enjoy our beautiful waters, others are not so eager to throw on the swimsuit, fearing embarrassment due to unsightly spider veins! Interestingly, while 80 million people visited our state in 2010, the same amount of people in the United States have problems with their veins! Often times this can impact our quality of life and detour us from enjoying the things we normally like to do, whether it is due to symptoms of venous disease or the appearance of spider and varicose veins.

                This then raises many questions: What are the symptoms of venous disease? How can I prevent spider veins and varicose veins from forming? How can I get them to go away? To understand the answers to these questions let us first discuss what exactly veins do and what happens when they stop working correctly. Veins are the vessels that return blood to the heart once it has circulated through the body. They are a tube with one-way valves that open and close to help move the blood in the proper direction. If these valves stop functioning correctly, the blood can flow backwards and pool in the vein, a condition called venous insufficiency. This causes the veins to enlarge and people can develop symptoms of heavy, tired, achy legs with numbness, itching, cramping, swelling and burning.  These enlarged veins fall into three groups: spider veins, reticular veins and varicose veins. Spider veins are visible on the surface of the skin as red, blue or purple lines. Reticular veins are visible as well and have a bluish discoloration and are larger than the spider veins.  Varicose veins are even larger and deeper and often look like bluish bumps under the skin, and sometimes become large and ropey.

                There are many methods that can prevent these veins from forming. Exercise is of the upmost importance, as it helps increase circulation. Along the same lines, maintaining your ideal body weight helps prevent the formation of varicose and spider veins by reducing the amount of pressure on the valves in the veins. Avoiding prolonged standing or sitting for extended periods of time helps as well. This is much easier said than done in many cases since most jobs require us to stand or sit for many hours during the day. If you are required to stand for several hours then make an effort to shift your body weight frequently and invest in a pair of knee-high compression hose, they not only help prevent development of varicose veins, but they also make your legs feel good. Shoes can also make a difference. Try to avoid wearing high heels which can constrict venous blood flow, a lower heeled shoe can actually tone the calf muscle which in turn helps improve blood flow. If you sit most of the day, then get up and walk around frequently. Elevation while you are sitting or lying down helps the blood travel back up to the heart. Lastly, to help prevent spider veins on the face from excessive sun exposure, wear sunscreen while outdoors. If you try these methods and still develop signs and symptoms of venous disease, there are treatments available for venous insufficiency as well as for the cosmetically displeasing spider veins which are listed on our website www.arteryandveins.com.  Now grab your beach gear and head out to those beautiful beaches on our Emerald Coast!

When is it okay to be Stationary?

Article by: Clark Stream, PA-C

As we age we tend to accept a more stationary way of life.  Immobility and inactivity can lead to serious health problems.  Fortunately, there is a simple and easy to use solution for those with mobility issues…A little invention called the Stationary Bike.

 

Stationary exercise bikes are a fun and safe way to get regular exercise.  There are many styles of exercise bikes.  For those who cannot sit on an exercise bike, a floor bike, often called a pedal exerciser can be used.  These small mini cycles allow the patient to sit in a comfortable chair with arms, or even in a wheelchair while exercising.  They are often used in rehabilitative and medical centers.  The pedal exerciser serves as a useful tool for decreasing the amount of time you sit sedentary. 

The pedal exerciser consists of a small metal frame and two pedals.  It is a light device, usually weighing less than 15 lbs.  Most units have straps on the pedals to secure your feet or hands so they do not slip during exercise.  Some pedal exercisers are basic pedaling machines with no electronic components.  Other pedal exercisers include an electronic monitor that provides feedback about your workout, such as time, distance, calories burned and speed.  Pedal exercisers can be used on a table top as an arm exerciser or on the floor to exercise the legs.  Convenient tension control knob allows a broad range of pedal resistance for a progressive exercise program.

Stationary pedal exerciser workouts are low impact and ideal for individuals with bone or back problems.  If you have osteoporosis, working out on a stationary bike can help reduce pain and delay bone degeneration long term.  Pedal exercisers are a great alternative for patients who have numbness in their feet, balance issues or who are prone to falls.

The stationary pedal exerciser provides a good cardiovascular workout.  It also strengthens muscle in the thighs and legs.  It improves flexibility and promotes good balance and posture.  These are physical benefits that can help patients stay strong, healthy and mobile.

Several senior studies show that working out on a stationary bike or pedal exerciser can enhance mood, promote better sleep and increase energy levels.  Burning calories on a pedal exerciser can help patients lose weight or avoid gaining unhealthy extra pounds.

How difficult is it to start a regular exercise program?  Not at all, just place the pedal exerciser on the floor, place your feet into the pedal straps and begin rotating the pedals forward.  You can get a great workout watching TV, reading the Lynn Haven Ledger or listening to music. 

Pedal exercisers can be found locally at medical supply stores, several pharmacies and online.  They start at around thirty dollars.  They are an affordable way to get your exercise program started.  And remember, being stationary does not mean you have to give up your quality of life.

Treating Leg Veins; Everything you Need to Know

Article by: Jennifer Clark, PA-C, MPAS

Approximately 60% of American citizens suffer from venous disease. These Americans often complain of heavy, tired, achy legs with possible swelling, numbness, restless leg syndrome, muscle cramps, and burning. Many will develop large, ropey varicose veins and some people even develop skin changes and ulcers.  Often times these symptoms can be improved with conservative management such as compression hose, exercise, weight loss, and elevation, however the underlying problem remains, and that is venous insufficiency.

                We treat this condition now by closing down the problematic vein with a minimally invasive procedure called endovenous ablation. During this procedure, heat produced by a laser or radiofrequency causes the vein to shrink down on itself and it eventually be reabsorbed by the body. By eliminating the vein that is not working correctly, the symptoms go away. This procedure has an excellent result with over 97% efficacy after one year.  While this procedure is minimally invasive, there are some potential risks which are important to be knowledgeable of when deciding to pursue treatment.

                When closing the veins with ablation it is required to insert a catheter into the vein that is heated to provide treatment. There is a risk of penetrating the wall of the vessel by doing this. This can cause a collection of blood underneath the skin called a hematoma which will resolve over time. By using ultrasound to ensure proper positioning of the catheter this can easily be avoided. There are nerves that run in close proximity to the veins in the leg, one of which becomes very superficial towards the ankle, another becomes very close to the vein at the back of the knee. These nerves can be damaged if the ablation is performed too far down the leg or too close to the one behind the knee, which is why these areas are avoided. When the vein closes down after ablation, often the nerves can become irritated and patients may experience numbness to the inner thigh or the back of the calf that usually resolves in one to two months. 

                                During the ablation, numbing medicine is injected around the veins to provide anesthesia. After the procedure patients may develop bruising from this that will resolve in one to two weeks. Sometimes the treated vein can become inflamed, a condition known as phlebitis. The skin may become red and tender to the touch with what feels like a knot directly under the surface. This often resolves with warm compresses, anti-inflammatory medications, and elevation.  And, with any procedure there is a risk for developing an infection. We use sterile technique which makes this risk very low.

One very serious complication is the formation of a clot in the deep veins of the leg, also known as a DVT or Deep Vein Thrombosis. The national risk for DVTs after ablation is about 3%. Hormone replacement therapy and oral birth control pills can increase this risk, therefore by following recommendations to discontinue these medications 4-5 days prior to treatment can help reduce likelihood of clot formation.  We also recommend avoiding physical inactivity after treatment. The development of a DVT is very uncommon, yet a very real concern which is why we recommend a DVT ultrasound several days after ablation treatment to ensure a clot has not formed, and if one has formed then we can initiate treatment promptly. 

  In medicine it is vitally important that our patients have a full understanding of not only their medical condition, but the treatment options and potential complications associated with the recommended treatment. Our goal is to ensure we do everything possible to help our patients make an educated decision about whether or not to pursue endovenous ablation for treatment of venous insufficiency.