Total Body Surgical Blog

Varicose Veins....an ugly term for an ugly and troublesome condition.  Almost everyone remembers a relative that had or has hideous looking legs.  When they show them, the kids run for the hills.  Today, I would like to discuss why the problem occurs and what can be done about it.  Also, a little history to show you how things have changed.....they are a whole lot better today!!

Varicose veins are a wastebasket term for chronic venous insufficiency.  Both are big descriptions for a complex problem.  The issue can range in severity from small spider veins, which most people have a smattering of, to the big ropey veins, to swelling in the lower legs, skin color changes and even leg ulcers that won't heal.

  A picture of spider veins.

  Picture of large varicose vein.

To be nice, I won't show an ulcer, they are ugly!!

The cause of these problems are usually hereditary, but can occur from leg injuries, clotting in the legs, and other factors.  They are made worse by working conditions, pregnancy, but usually not caused by them.  Of course, the human vascular system starts with the heart.  It pumps blood rich in oxygen to the rest of the body.  The blood travels around and exchanges oxygen for CO2 (the byproduct of the cells working), it then must get back to the lungs for the exchange of CO2 for new oxygen and the process repeats.  The veins don't have the heart to pump the blood, so, the musculature of the extremities compress the veins and make the blood move towards the chest and lungs.  In the normally functioning vein, there are valves present that allow the blood to only go towards the chest....up....against gravity that wants it to go down.  In the diseased vein, these valves don't work and the blood pools and stays in the leg or arm.  These pictures are a good visual for how this works.

If the valves do not work properly, pressure builds.  This is reflected in the branches of the larger veins and they enlarge over time creating the large varicose veins we have all seen.  These become painful as they stretch the surrounding connective tissue and the pressure, combined with the lack of flow causes the iron from the blood to break down in the skin.  This can lead to rust colored changes in the skin, rashes, and eventually skin breakdown. 

Treating this problem has changed significantly in the last decade or so.  Since the problem is usually the saphenous vein (kind of an intermediate vein in the leg), we used to remove it surgically and called it stripping.  Many have heard horror stories about removing these veins, having general anesthesia and the recovery time required.  With modern ultrasound and laser technology we can now remove this vein from the circulation without stripping, without general anesthesia, and without a long recovery time......great news!!  We do them in the office, patients walk, in then walk out. There is almost no down time...if any.

For the large, tortuous, ugly branches, we remove them through tiny incisions, as small as the end of a pen.  Because we have stopped the flow into this vein by lasering the saphenous vein there is very little blood loss and again, almost no down time.  The little incisions heal nicely and are not noticed after a few months.

Most of the time, if you are having symptoms of pain, swelling, skin color changes and have a visible varicose vein, insurance will pay for the procedure...after jumping through a few hoops.  Spider veins are considered cosmetic and are not covered though we can treat them with injections or laser.

So if you have vein issues, come see us today at Total Body Surgical where we can help.  Our goal is to try to make your legs look and feel as normal as possible. Call 918-786-7780 today!!

Last week the discussion was all about the causes of venous problems that occur in over half the population.  This week the discussion will be about treating the problem and some of the common hurdles faced when attempting to encourage payment from our wonderful insurance carriers.  The good thing is that if criteria are met, insurance will usually pay for treatment.  What are the criteria??  Well, they are somewhat variable.  First, there must be symptoms.  Pain, swelling, skin discoloration, aching, restless legs, and at the worst, ulceration and chronic changes.  Second, there must be ultrasound documentation of the problem.  This includes dilation of the veins or vein, and reflux of blood which demonstrates the absence of proper valve function.  Third, many require failure of conservative therapy with compression stockings for varied lengths of time....in some cases for up to six months.  Of course, treatment of spider veins is NOT covered as it is considered cosmetic.  A great deal of the time, however, these pesky spider veins are caused by an underlying bigger problem with the larger veins and this is covered.  The reason that's good is that after treating the larger veins, getting rid of the spider veins usually is much more permanent and they don't come back!!

The way it works at Total Body Surgical, we see you for a consultation and examine the problem.  If it is obviously a venous issue, I will give you stockings to start your time requirement, if present, and schedule an ultrasound.  At the ultrasound, we will discover what the extent of the problem is and how many veins are involved.  At that point we will figure out the treatment plan.  The important part of the ultrasound is measuring how much and where the reflux is located and document this.  Once all of your insurance criteria are met, your procedure, or procedures are scheduled.  At the procedure we use sedation for your comfort.  We use the cooltouch laser and tumescent local.  The laser fiber is inserted into the vein, the tumescent local is injected around the vein and the fiber is activated and pulled back the length of the vein to heat seal it.  This redirects the flow of venous blood to the deeper system where it is supposed to go anyway.  Sometimes, depending on how many veins are diseased, this may require more than one treatment.

Pictured above is the laser fiber itself and a rendition of what happens inside the vein when it is inserted, activated and retrieved.

Next week we will talk about removing the large varicosities that branch off of the veins that are closed by the laser.  This is known as European microphlebectomy.

We are approaching the final week of the breast augmentation special and don't forget our lap band introductory offer.

New special for fall to be announced next week!!!

Thank you for visiting!

Well.....things have changed!!  Thank God!!  What has changed is advancement in ultrasound and laser technology.  Stripping was done to remove the vein that was causing the problem.  The laser heat seals and closes the vein accomplishing the same result without any of the downside.  The procedure is done in the office under mild sedation, patients walk in and are required to walk 30 minutes after the procedure.  The down time is minimal and I require patients to wear stockings for 2 weeks after avoiding strenuous activity. Large varicosities are removed through very small punctures in the office as well with no stitches and after a short time, essentially no sign of surgery. In most cases, if symptomatic and the ultrasound proves disease, insurance will cover this part of the treatment. Spider veins are then treated with sclerotherapy which usually is not covered by insurance but is very affordable. Afterwards, legs are nearly as good as new and usually none of the pain persists. Best of all you can take advantage of all the summer fashions. The success rate is around 80-90%....very good.

Come see us at INTEGRIS Total Body Surgical and get a great deal on cosmetic sclerotherapy after Laser ablation!!

COOL TOUCH LASER ABLATION

 At INTEGRIS Total Body Surgical, we provide the latest in total vein therapy.  When I first started in surgery many years ago vein stripping was the norm.  It usually required multiple incisions and a fair amount of blood loss.  The procedure was done under general anesthesia and required a prolonged recovery and left unsightly scarring.   The success rate was about 60=70%.  We know that this condition, known as chronic venous insufficiency, is inherited and aggravated by long periods on our feet and pregnancy.  It can also be caused by trauma, deep vein thrombosis and other abnormal clotting states.  The symptoms are caused by malfunctioning of the valves in the venous system.  Because of this, the venous blood pools in the lower leg causing pain, swelling, spider and varicose veins, skin color and texture changes, and possible ulceration.  It can cause restless leg syndrome, and makes them look bad.  Many people no longer wear dresses, skirts, shorts, or any other attire that shows leg because of embarrassment.  Others spend their life in hot and uncomfortable stockings with their legs elevated at night to deal with the discomfort. 

More later in the week on treatments.

  At INTEGRIS Total Body Surgical, Through July, we are offering $150.00 off of one sclerotherapy session if you screen and qualify for laser vein closure. See the link below for sign up and more details!!! Or call 918-786-7780 Today....don't miss out!!

http://www.totalbodysurgical.net/love-your-legsagain/

Video on how it is done.