Vascular information from Dr. Bunke

Vein & Vascular News, Tips, Treatments and More!

What is an Angioplasty

Angioplasty

At La Jolla Vein & vascular, we are dedicated to offering our patients various procedures and treatment options. One of those options is called an Angioplasty. It is also called percutaneous transluminal Angioplasty (PTA), Angioplasty is a medical procedure performed using a catheter. A catheter is usually a thin, flexible tube inserted through an artery and guided by imaging to the narrowed section of the artery. Once the tip of the catheter reaches the narrowed section, the small balloon at the end inflates for a short period. The pressure created by the inflated balloon usually presses the plaque against the artery wall. This procedure will help to widen the arteries, restoring normal blood flow.

angioplasty

What to expect with an angioplasty:

After Angioplasty, the doctor usually applies pressure to the area where the procedure was done. The doctor uses bandages or a compression device, which helps prevent bleeding. The nurse will also check on your blood pressure, heart rate, and ensure that the area is not bleeding. The procedure also requires you to lie still while keeping you rleg straight for three to six hours. Sometimes, the nurse may also put a weighted bag on the leg to prevent movement. The procedure may require you to spend the night in our facility. Similar to other invasive surgeries, recovery does not take long. 

 

Why is it done?

Angioplasty is done to widen narrowed arteries and ensure optimal blood flow. The procedure is common in restoring blood flow for the individual’s suffering from peripheral arterial disease. 

How well does it work? 

Angioplasty procedure helps in restoring blood flow and relieves intermittent claudication. The procedure will eliminate the symptoms associated with PAD. Our experienced doctor has vast experience in this field and uses advanced tools to ensure the best results for your condition.

 

What is an Angioplasty2022-05-23T13:30:46-07:00

Causes of Osteoarthritis

Causes Of Osteoarthritis (OA)

 

Although Knee Osteoarthritis affects as many as 45 percent of people in their lifetime, the exact cause is unknown. However, medical practitioners have discovered several risks that increase the chances of developing knee osteoarthritis. These include:

Advanced Age

Obesity

Joint Trauma

Family History

Congenital Disabilities or Illnesses

Chronic Injury and Joint Stress

Lack of Exercise

Poor Muscle Tone

Female Sex

 

Advanced Age

Your susceptibility to developing osteoarthritis increases with age. As you grow old, the cartilage in the knee joint wears down, making it prone to damage and thinning. According to research done by the Arthritis Foundation, about 19 percent of people over 45 years have knee OA. The research further indicates that 37 percent of people over 60 years have the condition, although not all will have the symptoms.

 

Obesity

The knees support the weight from the thighs upwards. Obese people are at two times more risk of developing knee arthritis than individuals who are not.

 

Joint Trauma

Surgery, a broken bone, or severe injuries that affect the knee joint can also lead to knee osteoarthritis. These symptoms may not be present immediately after the injuries but may reveal years later.

 

Family History

Hereditary genes also play a crucial role in the susceptibility of knee arthritis. For instance, if your mother had knee OA, you are more likely to develop the condition than people with no family history of the condition are.

 

Congenital Disabilities or Illnesses

Septic arthritis, gout, poor bone alignment, congenital conditions, and metabolic disorder can also increase your susceptibility to contracting knee arthritis.

 

Chronic Injury and Joint Stress

Individuals whose daily activities involve heavy lifting while standing, crawling, or squatting tend to experience mini-traumas. These mini traumas can lead to knee osteoarthritis over time—bodybuilders and other athletes who participate in high-impact sports are prone to knee osteoarthritis development.

 

Lack of Exercise

Although putting too much stress on your knee joint can lead to arthritis, lack of exercise can also cause OA. Exercise helps in boosting the cartilage’s health and repair. Additionally, the knee joints contain fluid-rich nutrients that need to be circulated in the knee joint capsule. Regular exercise promotes proper circulation of the joint fluid.

 

Poor Muscle Tone

Poor hamstring, calf, and quadriceps muscle development can put more stress on the knee’s bones and cartilage, causing knee osteoarthritis.

 

Female Sex

Research shows that women are about 40 percent more likely to develop knee arthritis than men are.

 

 So, if this is you and you’ve been experiencing pain, please give our office a call at 858-550-0330. 

 

For more information please check out our Youtube Channel at this link. 

 

Causes of Osteoarthritis2022-05-13T17:16:22-07:00

How is Osteoarthritis of the knee diagnosed and treated?

How is Osteoarthritis of the Knee Diagnosed?

osteoarthritis

At La Jolla Vein & Vascular we diagnose and treat patients with Osteoarthritis.

Besides collecting the information and performing a physical examination, your doctor may also request additional testing such as x-rays and MRI scans. The X-ray imaging shows the extent of the cartilage damage and any presence of bone spurs. Magnetic resonance imaging (MRI) scans are more precise and detailed and help the doctor see the bones, cartilage, and other joint tissue damage. The doctor may also request blood tests that will help him to rule out other conditions that may be causing the knee pain.

Treatments for Osteoarthritis (OA)

Like most other diseases, addressing the symptoms of knee OA from early stages helps prevent the condition from worsening. Various treatments are available for knee arthritis. As mentioned, this treatment’s primary aim is to stop the condition’s progression since damaged joints are not reversible. The main types of knee osteoarthritis include medications, non-surgical treatments, surgeries, and injections.

Your doctor will choose the right approach depending on your general wellbeing and the condition progression level. Like other arthritic conditions, lifestyle modifications can help protect your knee health and slow the progression of knee arthritis. Your physician may recommend following the following lifestyle changes.

  1. Minimizing the activities that aggravate the condition. Avoiding activities such as heavy lifting or climbing stairs can help in slowing OA progression.
  2. Losing weight. Maintaining the proper weight will reduce the stress on your knee joint.
  3. Switch from intense activities such as tennis or jogging to low-impact activities like cycling or swimming. Low impact activities will help you stay in shape while protecting your knees

Options for Osteoarthritis include: 

-Medications and Injections

-Physical Therapy

-Surgery

So, if this is you and you’ve been experiencing pain, please give our office a call at 858-550-0330.

For more information please check out our Youtube Channel at this link.

 

How is Osteoarthritis of the knee diagnosed and treated?2022-05-30T13:30:35-07:00

Signs of Osteoarthritis

For most people, the knee osteoarthritis symptoms come and go, worsening over time. While it is easy to dismiss early knee OA signs and symptoms, the symptoms become worse if left untreated, causing mobility issues. 

 

Some of the common OA signs and symptoms include:

 

Knee Pain: Knee pain is the most reported OA symptom. The pain description often varies from one person to the other depending on their condition and situation. Sometimes the pain may come and go, while the person may experience chronic low levels of pain with intermittent intense pain flare-ups. On the other hand, you may experience a dull, aching. Most often, knee OA pain gets worse, especially when doing activities that put a strain on the knee, such as walking upstairs or squatting.

 

Swelling: Damaged cartilage causes the femur and tibia bones to rub together, leading to irritation. The irritation forces the body to produce excess fluid at the joint, making the knee swell.

 

Stiffness: The swelling and friction in the knee make the joint stiff. You may often experience 30 minutes of stiffness after sitting for an extended period or early in the morning. Knee stiffness can also be accompanied by reduced motion range and visible swelling.

 

Redness and Warmth: The irritation develops when the knee joint’s bones rub each other causing the skin over the knee to become warm and red. These signs could also indicate an infection that requires medical attention.

 

Reduced Range of Motion: The swelling in the knee limits your range of motion. Mild to moderate knee OA makes it hard for you to bend or straighten the knee completely.

Worsening Symptoms with Inactivity

Your knees tend to become stiff after long periods of sitting or sleeping. In most cases, you will notice pain and stiffness after waking up in the morning or sitting for long hours.

 

Popping or Crunching: A popping or crunching sound when bending your knee indicates knee joint friction.

 

Buckling or Locking Up: People with moderate to severe knee OA can also cause a sensation of knee-buckling. The sensation develops when there are uneven flaps or grooves, or cartilage breaks off and sticks in the joint.

 

 So, if this is you and you’ve been experiencing  osteoarthritis pain, please give our office a call at 858-550-0330. 

 

For more information please check out our Youtube Channel at this link. 

 

Signs of Osteoarthritis2022-05-30T13:29:11-07:00

What is Osteoarthritis?

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.

Osteoarthritis of the Knee

The most common cause of knee pain is knee osteoarthritis. The pain may come and go, become worse over time, or come accompanied by other symptoms, including knee stiffness. The condition develops due to degeneration of the cartilage. While the cartilage does not contain any nerves, damage or missing cartilage in the knee causes friction between bones and bone tissue changes, leading to pain. For example, damaged cartilage can lead to various bone changes such as:

  • Bone Spurs: Bone spurs, also known as osteophytes, are abnormal bony growth at the knee joints with damaged cartilage. The joint bones produce the bone spurs to compensate for missing or deteriorated cartilage. Bone spurs have an irregular shape that creates more friction in the knee joint, causing discomfort and pain.
  • Subchondral Bone Sclerosis: Due to undistributed weight loads, the tibia and femur surfaces, which lie beneath the cartilage, can change in composition, making it harden.
  • Cysts And Bone Marrow Lesions: Missing or deteriorated knee cartilage can also lead to cysts development and bone marrow lesions (areas of abnormal swelling). These cysts and lesions lead to knee discomfort and pain.

 

What is Osteoarthritis?2022-05-13T16:57:54-07:00

What are Pelvic & Labial Varicose Veins

Pelvic & Labial Varicose Veins

labialvaricosities

Labial varicosities are a common vascular condition that is now treated at La Jolla Vein and Vascular. Most people understand that varicose veins can be found in the legs and feet. And while this is mostly true, they can also manifest in the vulva. This is generally why most women who develop from vulva varicosities don’t notice it until the condition begins to worsen.

 

What are Labial Varicosities?

 

Vulvar varicosities, also commonly referred to as labial varicosities, are a condition when the veins in the labia minora or Majora become dilated.

 

Like any other part of the human body, the vulva is interconnected through an extensive reach of large and small blood vessels. During pregnancy, the increase in weight and pressure may reduce blood flow to the lower body and genitals. This will then cascade into the condition known as Labial varicosities.

 

While no one is fully exempt from developing vulvar varicose veins, the condition is more apparent in pregnant women. Moreover, pregnant women are more susceptible to developing pelvic varicosities due to the pressure and weight exerted by the baby.

 

However, in most cases, the condition does go away after giving birth. Ideally, you should start feeling better within six to eight weeks from the delivery time. Unfortunately, in some women, the dilated veins do not recover independently and need medical intervention to help fix the condition and get you back to your normal self from labial varicose veins. 

 

Most people understand that varicose veins can be found in the legs and feet. And while this is mostly true, they can also manifest in the vulva. This is generally why most women who develop from vulva varicosities don’t notice it until the condition begins to worsen.

There are numerous veins supplying blood to and from the vulva. And since they all differ in size, there’s no sure way to tell if you’re developing pelvic varicosities. The impact may leave them moderately swollen from the varying size of the veins, especially in the smaller veins. Larger veins may get twisted and become painful over time. This further goes to assert the importance of consulting a healthcare professional if you’re uncertain.

 

 So, if this is you and you’ve been experiencing pain or any other symptoms, please give our office a call at 858-550-0330. 

 

For more information please check out our Youtube Channel at this link. 

 

What are Pelvic & Labial Varicose Veins2022-05-12T12:46:22-07:00

Uterine Artery Embolization (UFE) vs. Hysterectomy

Benefits of UFE Over Hysterectomy

UFE ( Uterine Artery Embolization ) is a minimally invasive procedure that is effective for treating uterine fibroids and is considered an alternative to uterine fibroid surgery removal. UFE is typically performed as an outpatient procedure, which means that most women go home the same day for recovery.

UFE has several benefits over hysterectomy. Besides involving only a small nick in the groin or wrist for catheter insertion, the uterus is preserved. There is no scar with UFE. For a Uterine Artery Embolization, conscious sedation is used, unlike for a hysterectomy, where the woman receives general anesthesia. The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

Women who have a hysterectomy that remove both the uterus and ovaries usually just get estrogen replacement therapy (ERT) alone. But women who have only the ovaries removed need both estrogen and progestin because estrogen alone can increase the risk of cancer in the uterus.

The recovery time for Uterine Artery Embolization is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

The idea of having your entire uterus removed is psychologically daunting for women as some women may still want the option to carry a child, do not want to undergo a general surgery and/or feel like removing the uterus takes away part of their identity as a female.

 

For more information on vein and vascular treatment please visit our YouTube Channel.

Uterine Artery Embolization (UFE) vs. Hysterectomy2022-04-29T17:33:47-07:00

What is Uterine Fibroid Embolization (UFE)

What is Uterine Fibroid Embolization (UFE)

With modern medication and care, conditions like fibroid tumors have become more treatable and easier to manage. Uterine Fibroid Embolization (UFE), for instance, is a fairly straightforward procedure used in the treatment of fibroid tumors in the uterus.

Sometimes referred to as uterine artery embolization (UAE), the uterine fibroid embolization (UFE) procedure helps countless women plagued by fibroid tumors.

What does the uterine fibroid embolization treatment entail, and how can you prepare for the procedure? Here’s everything you need to know about uterine fibroids treatment.

What is Uterine Fibroid Embolization?

The muscular walls of the uterus can sometimes be invaded by non-cancerous fibroid tumors. These tumors are also known as myomas and are a form of benign tumors. While these fibroid tumors rarely become cancerous, they can lead to other severe conditions such as increased menstrual bleeding, bowel or bladder pressure, and pelvic discomfort. 

Admittedly, while uterine fibroid embolization shows a high success rate, more research is still needed on the subject. For instance, at the moment, the procedure is usually performed on women who no longer desire to get pregnant. The UFE procedure may also be used on women who wish to avoid a hysterectomy procedure. 

When is Uterine Fibroid Embolization Used? 

 

As mentioned above, uterine fibroid treatment is rather straightforward and minimally invasive. As a result, the procedure can be used in a wide variety of cases. Some of the instances where the treatment is necessary or advocated for include;

  • Malignant gynecological tumors
  • Hemorrhage after childbirth
  • General or specific trauma

 

How to Prepare for a Uterine Fibroid Embolization Procedure

 

The healthcare professional will first need to ascertain if the fibroid tumors are the underlying cause of any visible and diagnosable symptoms. Afterward, they’ll need to determine the size, location, and the number of fibroids. This can be done with the help of an ultrasound machine or magnetic resonance imaging (MRI) equipment.

Moreover, your gynecologist may also need to run a physical examination through a laparoscopy examination. This test gives a clearer picture of the uterus and the invasive fibroids. You could also have a biopsy of the inner lining of the uterus if you are bleeding excessively in between your periods. The procedure known as endometrium helps rule out cancer as the cause of bleeding.

If you are on any medication, supplements, or herbal remedies, you’ll need to inform the doctor before the procedure. Additionally, make a list of any known allergies, including general and local anesthesia and the dye or contrast materials.

It’s also wise to notify the healthcare team if you have recently suffered an illness, just finished treatment, or are on other medication. For example, if you’re on blood thinners, the healthcare provider may advise you temporarily halt the medication in preparation for the procedure.

Women who suspect they are pregnant should let the doctor know well before the uterine fibroid embolization treatment. Some imaging tests are usually not performed during pregnancy in a bid to minimize any radiation exposure to the fetus. In the case of an imaging test, such as an x-ray, which is essential to the operation, particular care guidelines must be followed to manage and reduce radiation exposure.

While preparing for the procedure, you’ll likely be put off solid meals after midnight to the procedure’s day. While the procedure takes a few hours, the doctor could request to stay overnight for further observation.

 

What Equipment to Expect

 

Since this is a minimally invasive procedure, the tools and equipment used are reasonably common and risk-free. Some of the equipment to be used in uterine fibroid embolization treatment includes a catheter, x-ray machines, and various embolic agents and medications.

The synthetic material used is known as embolic agents and varies in composition and efficacy. The three most common types of embolic agents are;

-Gelfoam whose texture resembles spongy material

-Polyvinyl alcohol, which resembles coarse sand

-Microspheres, which is a polyacrylamide sphere coated with gelatin

These tolls, equipment, and medication are all safe to use during the uterine fibroid embolization treatment.

 

Benefits and Risks Associated with Uterine Embolization Treatment

 

Some of the advantages of uterine fibroid embolization include;

-There’s no need for surgery as the procedure is minimally invasive

-You can resume regular activity sooner and faster

-The procedure is highly effective, boasting well over 90% efficacy rating

-Fibroids rarely regrow after the uterine embolization treatment

-On the other hand, some of the risks that could occur during the procedure are;

-The procedure pierces the skin and could leave an infection if not properly cleaned

-The embolic agents need to be guided carefully, or they could lodge in the wrong area

-Fibroids can lead to chronic pain and an array of other conditions. With uterine embolization treatment, you can now get relief and get back to your healthy self.

 

What To Expect during Uterine Fibroid Embolization Procedure

 

A UFE usually takes between 1 and 3 hours and patients usually require about 6 hours of bed rest after the procedure. Patients may experience mild discomfort as the embolization takes full effect. The fibroid tumors breaking down and exiting the body may cause light bleeding for the few weeks after the procedure. Most patients can expect to return to normal activity 7 to 10 days after the procedure. Our physicians will most likely recommend a follow-up consultation after the UFE 1 to 3 weeks afterward and an ultrasound or MRI 3 to 6 months later to monitor your progress.

 

What is Uterine Fibroid Embolization (UFE)2022-04-29T17:29:18-07:00

What are the risk factors & treatments for uterine fibroids?

Who is at Risk of Developing Uterine Fibroids?

 

There are certain natural circumstances, habits, and lifestyle choices that have been shown to come with an increased chance of developing uterine fibroids, as follow:

Ethnic Origin

Research indicates that women of African American ethnicity are at a significantly higher risk of developing uterine fibroids than Caucasian women for comparison. 

Age

A woman’s advancing age places her at increased risk of developing uterine fibroids. The condition will mostly be found in women in their mid-late forties or early fifties, where the majority enter or pass through their menopausal years. 

Family History

Simple stated, this means that those with a history of uterine fibroids will be more likely to develop the condition. 

Eating Habits

It is believed that the consumption of red meat (beef, ham, etc) in copious amounts will increase the risks of uterine fibroid development. The consumption of green vegetables, on the other hand, is thought to reduce these odds. 

Obesity

Being overweight is considered to be another variable increasing women’s risk of developing this condition, with overweight patients being two to three times more likely to be affected than the average population. 

 

Treatment Options for Uterine Fibroids

The varied nature of uterine fibroid cases and how they affect different patients in different ways means that dealing with the condition has numerous different approaches. Consultations between patients, whether presenting with symptoms or not, and their physicians should be able to see them agree on a course of action that will satisfy the patient’s best interests. Aside from medication, the typical treatment for fibroids is traditional surgical procedures. At Pedes Orange County, we offer a minimally invasive treatment option that can be reviewed below:

Traditional Surgical Procedures

These are considered invasive surgeries that involve extensive physical intervention. They include:

  • An abdominal myomectomy is an option mostly employed in cases where very large, very deeply embedded, or multiple fibroids are encountered. An open abdominal procedure is often the second-to-last option for patients who see hysterectomies as a last resort.
  • Hysterectomy: This major surgical intervention involves the entire removal of the patient’s uterus and is the only guarantee against the recurrent development of uterine fibroids afterward. While most women will have the option of retaining their ovaries, some will have to undergo hormone replacement therapy if they are not to enter menopause.

Minimally Invasive Surgical Procedure (Uterine Fibroids Embolization by La Jolla Vein & Vascular)

At La Jolla Vein & Vascular, we specialize in Uterine Fibroids Embolization. This minimally invasive surgical procedure involves destroying fibroid masses without necessarily removing them entirely. The techniques are most commonly applied in clinical settings due to their effectiveness, proven track record, and minimal patient impact.

  • Uterine artery embolization: (Also known as Uterine fibroid embolization). Embolic agents (small particles) will be introduced into arteries to block blood flow through them, thus starving fibroids of the nutrients needed for their survival and growth.

In surgical procedures that do not entirely remove the uterus, there will be a remaining risk of new uterine fibroid development in the future.

Why Uterine Artery Embolization (UFE) Instead of a Hysterectomy

Benefits of UFE Over Hysterectomy

Uterine artery embolization (UFE ) is a minimally invasive procedure that effectively treats uterine fibroids and is considered an alternative to uterine fibroid surgery removal. Uterine artery embolization (UFE) is typically performed as an outpatient procedure, which means that most women go home the same day for recovery.

UFE has several benefits over hysterectomy. Besides involving only a small nick in the groin or wrist for catheter insertion, the uterus is preserved. There is no scar with UFE. For a UFE, conscious sedation is used, unlike a hysterectomy, where the woman receives general anesthesia. The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

Women who have a hysterectomy that removed both the uterus and ovaries usually get estrogen replacement therapy (ERT) alone. But women who have only the ovaries removed need both estrogen and progestin because estrogen alone can increase the risk of cancer in the uterus.

The recovery time for UFE is generally within 2 weeks, which is significantly faster than the usual 6-week recovery time after hysterectomy.

The idea of having your entire uterus removed is psychologically daunting for women as some women may still want the option to carry a child, do not want to undergo a general surgery, and/or feel like removing the uterus takes away part of their identity as a female.

Treatment for Uterine Fibroids

With modern medication and care, conditions like fibroid tumors have become more treatable and easier to manage. Uterine fibroid embolization, for instance, is a fairly straightforward procedure used in…

 

What are the risk factors & treatments for uterine fibroids?2022-04-29T17:24:18-07:00

What causes uterine fibroids?

What Causes Uterine Fibroids?

While the science is not completely settled on what exactly causes or is behind the formation of uterine fibroids in human beings, there are certain factors that researchers believe play significant roles in triggering their growth or development.

Genetics

In 50 percent of cases, patients will be found to have some genetic abnormality. In many instances, some erroneous translocation will be discovered on some chromosomes.

Hormones

While we may not be completely certain as to what lies at the root cause of uterine fibroids, it has been clearly demonstrated that hormones play a large role in determining their growth or progression. While a woman is pregnant, they will see rapid growth due to the presence of the hormones estrogen and progesterone. Should the patient use anti-hormone medication, the opposite will happen – the fibroids will shrink. Furthermore, fibroids will stop growing or begin shrinking once a patient reaches menopause, which is the point at which these hormones also cease being produced in the female body.

uterine fibroids

Ultrasound image of lower abdomen, ovary and uterus with tumor or uterine fibroid, leiomyoma of female woman patient for gynecological medical exam, analysis and test

Testing and Diagnosis of Uterine Fibroids

In many cases, especially those whereby uterine fibroids do not present any noticeable symptoms for the patient, this condition will be discovered in a regular pelvic exam. This is a routine checkup carried out by gynecologists. While this checkup might determine the presence of a mass or lump on the uterus, further testing will have to be carried out to make a definite diagnosis.

These testing methods include:

Note: Upon learning that fibroids are a type of tumor, the foremost concern for many patients is whether the tumor is cancerous or might predispose them in some way to developing cancer. Fibroids are rarely cancerous, with the chances of such fibroids (leiomyosarcomas) arising at less than one in a thousand.  Additionally, the presence of fibroids in no way increases a patient’s chances of developing any type of cancer.

 

What causes uterine fibroids?2022-04-29T17:20:54-07:00

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