Vascular information from Dr. Bunke

Vein & Vascular News, Tips, Treatments and More!

Osteoarthritis 101

Osteoarthritis is the most common arthritis form that affects millions of people across the globe. While OA can affect any joint, it often damages the knees, hands, spine, and hips. Also known as wear and tear arthritis, the condition develops when the protective cartilage cushioning the ends of the bone in a joint wears away over time. Joints are parts of the body where two or more bones meet. These parts include your knee, hip, hands, backbone (any part of the body that you can bend has a joint).

The ends of the bones in a joint have a smooth, slippery surface referred to as the cartilage. This protective covering allows the bones to rub against each other without friction. Osteoarthritis causes the wear and tear of the cartilage between the bones, making the joint rough. The increased resistance at the joint causes stiffness, pain, swelling, and decreased ability to move.

While various treatments help in managing the OA symptoms, damaged joints are not reversible. Maintaining a healthy weight and staying active c will also help in slowing the disease progression. Although OA can affect both men and women at any age, individuals aged over 45 years are at an increased risk. Based on the research done by the Arthritis Foundation, osteoarthritis affects more than 27 million people in the USA alone, with the knee being the most susceptible part. Research also shows that women are at an increased risk of developing OA than men.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 



Osteoarthritis 1012023-01-14T13:20:58-08:00

Uterine Fibroids 101

Millions of women around the world are affected by the development of uterine fibroids each year. While it is not a life-threatening condition in itself, the symptoms and potential complications that come with it make it such a pressing medical concern for affected individuals.

As only women will usually possess a uterus, it follows that only women are afflicted by this ailment, which is why gynecologists will often be the first ones to make a definite diagnosis. As with so many medical emergencies, knowing the problem early will greatly increase the chances of beating it, which is why the professionals at La Jolla Vein & Vascular are dedicated to administering reliable, accurate, and entirely effective diagnostics, therapies, and treatments to all clients coming through our doors.

Let’s take a closer look at what exactly we will be dealing with should uterine fibroids turn out to be the issue at hand.

What are uterine fibroids? 

To understand what uterine fibroids are, the first thing one should do is separate the two terms making up the condition. A fibroid is a term to refer to a type of tumor that has ‘muscular’ characteristics. They are also referred to as a leiomyoma and can appear singularly or in formations or in lumps. 

They are known as uterine fibroids since they will appear in the patient’s uterus. Although they are not cancerous in almost all instances, they will range in size from patient to patient, from as small as an apple seed to as large as a grapefruit and beyond, in some unusual instances. 

It is important for all women to be aware of the dangers presented by uterine fibroids, not only owing to the potential harm that the condition might bring about but due to the high rate of prevalence among the female population affected in some way. By the time they are 50 years old, it is estimated between 20 to 80 percent of women will have developed uterine fibroids, with most cases affecting the 40’s to early 50’s. 

Symptoms to look out for: 

Fibroids go undiscovered in most patients due to the lack of symptoms accompanying them, but some patients will experience some symptoms, including:

  • Frequent urination due to pressure being exerted on the patient’s bladder
  • Lower back pain
  • Pain during sexual intercourse
  • Enlargement of the lower abdomen, with severe and extremely rare instances causing the appearance of apparent pregnancy in the patient where none exists
  • Heavy bleeding and/or painful bleeding during periods sometimes resulting in a medically significant depletion of blood in the patient (anemia)
  • Greatly increased risks of complication during pregnancy and delivery, with uterine fibroid patients requiring cesarean sections at six times the average rate.
  • Reproductive health problems such as infertility are very rare outcomes.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Uterine Fibroids 1012023-01-14T13:17:33-08:00

Peripheral Arterial Disease Signs

Peripheral Arterial Disease – Symptoms

The most common symptom of Peripheral arterial disease is claudication. The fat and cholesterol build up on the artery walls cause a lack of blood flow, causing a condition referred to as ischemia. Ischemia is a condition that results when there is a greater demand for oxygen than the supply.

Claudication is a condition that causes cramping in the legs and buttocks. As mentioned, the pain and clamping flares up when you start to walk and subsides when you rest. Intermittent claudication affects about 50 percent of individuals suffering from peripheral artery disease. Some of the other common symptoms include loss of hair around the ankles, numbness or coldness in your feet.

Pain and cramping while walking may lead to a more sedentary lifestyle, meaning that the individual will burn few calories and add weight. An increase in weight also increases cholesterol, blood pressure, and other heart disease risk factors. The claudication severity often varies from mild discomfort to debilitating pain, making it hard for you to walk or perform other types of physical activities. 

Other common symptoms of the peripheral arterial disease include;

  • In extreme cases, an open wound or ulcer occurs on your toes or feet. These extreme cases lead to non-healing ulcers. The ulcer can progress to gangrene, making it hard for you to walk. In such a scenario, immediate medical attention is necessary.
  • Weakness or numbness in your legs
  • Coldness in your lower feet, especially when you find one foot is colder than the other one.
  • Experiencing pain in your feet or toes while you are resting
  • Sores on the legs, feet, and toes that do not heal
  • Slower toenails growth
  • Change in the color of your feet
  • Erectile dysfunction in men can be treated by prostate arterial embolization (PAE), which also treats benign prostatic hyperplasia (BPH)
  • Weak pulse in your feet or legs
  • Developing shiny skin on your legs
  • Having pain in your arms, especially when writing, knitting, or performing manual tasks

As the peripheral disease progresses, you may start to experience pain even when you are lying down. In extreme cases, the pain becomes intense enough to distract your sleep. Resting your legs by hanging them at your bed edge or walking around the room helps stimulate blood flow, relieving the pain temporarily.

 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Peripheral Arterial Disease Signs2023-02-20T18:07:22-08:00

Peripheral Arterial Disease 101

Peripheral arterial disease is a subset of vascular disease,also referred to as peripheral arterial disease (PAD), which develops when excessive plaque buildup on the artery walls causes the narrowing of the arteries.

The arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it usually restricts the flow of blood, oxygen, and glucose. The obstruction causes pain in the leg as the muscles and tissues are starved for oxygen and other nutrients from the blood. While the pain usually occurs in your legs primarily, it can also be felt in other parts of the body, including your arms, stomach, hip, head, and kidneys.

Are You at Risk for Peripheral Arterial Disease (PAD)?

In most cases, the PAD symptoms are on the lower extremities. You may experience some pain, craping, or tiredness in your hip or leg muscles when climbing stairs or walking. However, the pain usually goes away with rest, only to resurface when you start walking again. Individuals suffering from peripheral arterial disease are at a high risk of coronary artery disease, stroke, or heart attack. Even worse, if left untreated, the condition can lead to gangrene and amputation.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 




Peripheral Arterial Disease 1012023-01-14T13:13:58-08:00

Patient Transformations with venous disease:spider veins

What are spider veins?

Spider veins (venous disease) are the fine, thread-like reddish veins at the surface of the skin. Spider veins are not healthy. Spider veins are often considered a cosmetic issue, but they can be associated with underlying feeder veins, not visible to the naked eye.  Feeder veins are the ‘blue veins’ also known as ‘reticular veins,’ that give rise to spider veins. Spider veins may also be a sign of underlying venous insufficiency. For example, spider veins located in the inner ankles and inner thighs can indicate an underlying problem with the saphenous vein. As a result, an ultrasound examination may be recommended to identify and effectively treat the underlying source of the spider veins.

What are the symptoms of spider veins?

Venous conditions affect people differently. For some, spider veins can be a painless cosmetic concern, and for others they may cause symptoms. The most common symptoms of spider veins are burning, throbbing, and localized pain. They can also feel hot and itchy and bleed.

What causes spider veins?

Spider veins (venous disease) in the legs are caused by the same condition that causes varicose veins. Leaky vein valves allow blood to pool within the veins causing them to stretch and become enlarged. Spider veins on other areas of the body, such as the face, and chest can be caused by sun damage, hormone changes or liver disease. Hormones, such as with pregnancy, birth control or hormone replacement therapy can weaken the vein wall.

Below are patient transformations with Sclerotherapy treatment for spider veins. 

venous 2 BA SV Spider NOR2151 3 BA SV spider 1after fotor 4 BA SV spider 2before fotor 1

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Patient Transformations with venous disease:spider veins2023-01-14T13:11:03-08:00

Patient Transformation from venous disease: varicose veins

What are varicose veins?

Varicose veins are the twisted, bulging veins just beneath the surface of the skin. Varicose veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body. Varicose veins are a common condition.

What causes varicose veins?

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. Varicose veins can be an isolated finding, but the majority of the time, they are caused by underlying venous reflux disease. Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Reflux may occur in the deep and/or superficial leg veins.

In our study, led by Dr. Nisha Bunke and published in the Journal of Vascular Ultrasound in 2018, we studied over 1,000 legs with varicose veins. Over 90% of the time, the source of the varicose veins were the great and small saphenous veins. The Great Saphenous Vein (GSV) courses up the middle of the thigh and calf and the small saphenous vein (SSV), which courses along the back of the calf. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

La Jolla Vein & Vascular Before and After Transformations:

venous 2 BA VV NOR2187 3 BA VV varicose NOR2149 4 BA VV NOR2155

At La Jolla Vein & Vascular, we are here for our patients from beginning to the end. We love seeing the transformations that take place. Below are a few cases from our patient transformations from before varicose vein treatment to after varicose vein treatment. 

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Patient Transformation from venous disease: varicose veins2023-01-14T13:10:34-08:00

Patient Reviews and Testimonials

La Jolla Vein & Vascular is a state-of-the-art medical center dedicated exclusively to the diagnosis and treatment of venous conditions and arterial conditions.

Venous conditions include varicose veins, spider veins, and venous leg ulcers, chronic venous insufficiency, edema, lymphedema, and deep vein thrombosis.  Arterial conditions and treatments such as peripheral arterial disease (PAD), atherectomy, angioplasty, stenting.  We also offer prostate artery embolization (PAE) to treat BPH, varicocele embolization for men and uterine fibroid embolization (UFE), pelvic venous congestion (PVCS), pelvic and labial varicose veins for women.  Osteoarthritis treatment includes genicular artery embolization (GAE) to alleviate knee pain due to arthritis.

Below are some patient reviews and testimonials. 

vein 6 1 7 1 8 1

“Bringing Experts Together for Unparalleled Venous and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled venous and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into venous and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Patient Reviews and Testimonials2023-01-14T13:09:42-08:00

Understanding Vein Disease

What is Venous Reflux Disease?

Venous reflux disease of the veins is also known as venous stasis, venous insufficiency or venous incompetence. Venous reflux disease refers to ‘leaky valves’ in the legs. 

Reflux may occur in the deep and/or superficial leg veins. Those located in the deep are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. Those located in the superficial area outside the muscle and under the skin. The main superficial veins are the Great Saphenous that courses up the middle of the thigh and calf and small saphenous vein. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

Symptoms of Venous Reflux Disease:

Symptoms of venous reflux disease include; leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins), restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as venous stasis skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer. All of which are possible symptoms of venous reflux disease to look out for. 

What influences the development of Venous Reflux Disease?

A patient is more likely to develop venous reflux disease if they are:

  • Overweight
  • Pregnant
  • Have a family history of vein disease
  • Have damage to the leg due to injury, surgery, or previous blood clots
  • High blood pressure
  • Lack of exercise
  • Smoking
  • A blood clot in a deep vein (calf or thigh) “deep vein thrombosis” 
  • Swelling and inflammation of a vein close to the skin, known as “phlebitis”

How is Venous Reflux Disease Diagnosed? 

In addition to physical exam findings and medical history, an ultrasound examination is an important tool in the assessment of venous disease. Not all venous disease is visible to the naked eye, and it usually arises beneath the surface of the skin, only visible by ultrasound technology. 

The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages for example from blood clots or scars within the veins from previous clots. The ultrasound will determine exactly which veins are “bad” or incompetent. Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and /or branches of the saphenous veins. This will help determine the treatment plan. 

“Bringing Experts Together for Unparalleled Venous and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled venous and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into venous and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Understanding Vein Disease2023-01-14T13:09:15-08:00

Leg Pain: What can be causing it?

Concerned about Leg Pain?

We evaluate and treat leg pain that is related to poor circulation, varicose veins and blood clots. These are all vascular conditions. However, there are numerous causes of non-vascular leg pain including injuries in the joints, bones, muscles or ligaments. Arthritis can also cause leg pain. Low back pain can radiate to the legs and also cause pain. It is always important to have a thorough evaluation by your doctor to determine the correct cause.

Causes of Leg Pain

  • Injuries in the joints, bones, muscles, or ligaments
  • Arthritis
  • Low back pain radiating to the legs

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Leg Pain: What can be causing it?2023-01-14T13:07:18-08:00

Venous Insufficiency and Leg Ulcers

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is an inflammatory condition caused by long standing, untreated venous reflux disease.  Commonly, venous reflux disease causes a collection of symptoms such as leg swelling, heaviness, fatigue and varicose veins. But, over time, when blood is no longer circulating properly in the leg veins, skin changes can also appear. When skin changes appear, this is termed, chronic venous insufficiency (CVI). Venous stasis is another term used for this condition.   Chronic inflammation from CVI causes the skin around the ankles to darken, become dry, itchy, and firm. In severe cases, the skin can start to break down and ulcerate. The ulcer (wound) occurs in the inner or outer ankle and is also referred to as a stasis ulcer or venous ulcer.

Venous stasis skin changes associated with venous insufficiency include:

  • Darkening of the skin along the ankles
  • Itching and dry skin around the ankles (venous eczema)
  • Development of wounds around the ankles, called venous leg ulcers

HOW IS CVI TREATED?

The treatment of CVI cannot reverse the skin changes but it can prevent it from worsening and ulceration. In our experience, treatment of underlying venous reflux reduces the inflammatory changes and the skin may become less itchy and dry, but the permanent skin discoloration does not disappear. Treatment involves correction of the underlying venous reflux.

HOW ARE LEG ULCERS TREATED?

Venous leg ulcers, depending on the severity, can be healed with a combination of correction of the underlying venous reflux, wound care clinic referral, and compression therapy. A detailed ultrasound will determine what specific treatment is needed depending on where the underlying reflux lies (for example, in the saphenous veins, perforator veins and tributaries). Deep vein reflux is also present in many individuals with ulcers.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information on treatments and to book a consultation, please give our office a call at 858-550-0330. 

For a deeper dive into vein and vascular care, please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Please follow our social media Instagram Profile and Tik Tok Profile for more fun videos and educational information. 

Venous Insufficiency and Leg Ulcers2023-01-14T13:06:34-08:00
Go to Top