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Q- Can they be treated by oral medication ?
At the moment there is
no oral therapy that will make varicose veins go away. Although some
medication and other herbal preparations claim to reinforce the vein walls,
there is no scientific data to support this
Q- How much does it cost ?
It is very difficult
and at times not very proper to project a cost estimate without seeing the
condition of the legs. The amount and type of varicose veins greatly differs
from patient to patient. The physical condition, age, social status, profession
(ex: models) and many factors play role in designing a custom
form of treatment for each patient.
Rough estimates (even though may be
misleading) are as follows:
Physical examination is 100 USD
Sclerotherapy and Laser usually costs 500-1000 USD
Surgery usually costs around 3000 - 4000 USD all inclusive
Q- Do they recur ?
For varicose veins of 2
mm and larger surgical removal is the most radical form of treatment. When
performed by (true) specialists in this field, the recurrence rate is very
low (% 5- 2) Practically there is no recurrence if the patients comply with
the post-op recommendations.
Q- What are post-op
recommendations ?
Post-op recommendations are
very simple. We require you to elevate your leg WHENEVER YOU CAN; Wear very
low pressure below the knee compression stockings WHENEVER YOU CAN; do not skip control visits every 6 months until your doctor tells you
that they are no longer necessary.
Q- How long does it take ?
Again the amount of
varicose veins is the main determinant. The surgery generally takes about
30-45 minutes, and the patients are sent home after 3-4 hrs Sclerotherapy
takes about 30 minutes for each session and the patients can go straight to
work right after the sessions
Q-
Can surgery be done under local anesthesia ?
In cases where varicose
veins are confined to a small area, local anesthesia may suffice. Normally
in varicose veins surgery we need complete pain blockade it the whole leg.
This would require a high number of painful injections with unacceptable
(toxic) amounts of local anesthetic.
Regional anesthesia techniques (Spinal or epidural) work, but they
necessitate overnight hospital stay.
We prefer a light general anesthesia for safety and comfort. The patients
may leave for home 3-4 hours after this type of anesthesia with no unwanted
effects.
Q- Which type of varicose veins are suitable for
sclerotherapy ?
Sclerotherapy is most
effective in veins of 2 mm or less in diameter. Very small volumes of
medical solutions are effective on the inner linings of these small veins. (
In large veins injected solutions are quickly diluted by the amount of blood
already present in the vein. High flow rates in these larger veins also
quickly washes away the injected medication, considerably diminishing its
effects).
Varicose veins treated by sclerotherapy are slowly dissolved by leukocytes
over a period of time (usually between 2-12 weeks). Naturally larger
varicose veins are much harder for resorption
Q- Is it possible to "pull" varicose veins with
needles ?
No, this is a
misconception ( also supported by some doctors ). What actually done is
injecting
sclerosing
solutions into the
varicose veins. As the clear solutions fills up the vessel, replacing the
darker colored blood, the veins seem to disappear instantly. Some treated
veins stay closed and thus appear to have vanished. In fact, even though we
cannot see them, the same dissolving process takes place over a period of
2-4 weeks, only this time with instant cosmetic benefits. ( You are lucky in
30-50 % of the cases)
Q- Effects of pregnancy ?
Extra hormones,
increased blood volume, increased intra-abdominal pressure, all have
negative effects on the veins of the lover extremity.
As the pregnancy progresses, expectant mothers should avoid standing or
sitting for long periods of time. Walking is always welcome, also swimming
is good for the leg veins.
If there are signs of enlargement in the leg veins, medical advice of a
competent vascular specialist should prove beneficiary.
Q- Is this a hereditary condition ?
Yes, there is a great
hereditary prevalence in those who have parents with varicose veins. This
does not mean that you WILL have varicose veins if your parents were
affected
Q- Which compression stockings ?
Compression stockings
are devices for preventive measures. Best stockings are those that you feel
great in them. (truly, a good pair of CS makes you feel fresh at the end of
the day ).
Usually prescribed CS are too tight, or wrong color or too tight to put on.
In most cases, light pressure CS, with proper color and appearance will do
the job perfectly. ("Perfect stockings" that you do not wear for
one reason or another are totally useless) In other words best CS are those that you will like
and want
to wear.
On the other hand, prescribed CS are the most effective an in most cases the
only form of therapy for Chronic Venous Insufficiency.
Q- What can I do to prevent varicose veins ?
Excess weight
(pregnancy), prolonged standing and sitting, are factors that place
additional strain on the leg veins. Preventive measures such as compression
stockings, elevation of legs for 5-10 minutes every 2-3 hours are effective
if these conditions are present. You should be extra careful if your parents
have varicose veins.
Q- Does my insurance cover expenses?
This depends on the kind of policy you
have purchased. You should contact reimbursement division of your insurance
company to learn if varicose vein treatment is included in your policy.
  
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