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So far Nisha Bunke has created 114 blog entries.

9, 6, 2020

Link Between Leg Heaviness and Your Veins

2022-01-04T04:54:24-08:00

One of the most common symptoms of venous reflux disease is a feeling of leg heaviness. Venous reflux disease refers to ‘leaky’ vein valves in the leg.  Healthy veins return blood flow from the legs to the heart. When the valves are weak and leaky, blood will backflow or ‘reflux’ and pool in the leg veins, instead of returning up toward the heart.  This increases the pressure in your legs, giving you that tired, heavy feeling. Leg heaviness tends to worsen throughout the day, especially after long periods of standing.  You may notice that elevating your legs or using compression stockings reduce the symptoms of leg heaviness. Leg tiredness, fatigue, ankle swelling are other common symptoms of venous reflux disease.

image of varicose veins

image of varicose veins

Varicose veins most frequently cause the legs to become heavy, achy and tired. But, these symptoms can be present even in the absence of varicose veins. Venous insufficiency, the underlying cause for varicose veins can cause leg heaviness, tiredness and swelling even before bulging veins are visible.

 

Link Between Leg Heaviness and Your Veins2022-01-04T04:54:24-08:00

Why Leg Pain Worsens with Menstruation

2021-11-15T11:47:21-08:00

Leg pain from varicose veins tends to worsen just before menstruation.

Many women who suffer from varicose veins or venous reflux disease (without any visible signs of disease) commonly experience increased leg discomfort, leg fatigue and swelling prior to menstruation.  The reason for this is the hormone progesterone. Progesterone rises about a week before menstruation. Progesterone has a significant effect on the veins. Progesterone causes the vein walls to relax, allowing more blood to pool within them. The increased pressure caused by the excessive pooling of blood worsens symptoms.  Saphenous veins, the large superficial blood vessels found in legs, are particularly susceptible to varicosity due to extra progesterone. This is also a reason pregnancy contributes to the development of varicose veins. We have had several patients who have reported their first sign of pregnancy was leg and varicose vein pain (because of the hormone changes).

Symptoms prior and during menstruation can be treated conservatively, with leg elevation, exercise, compression therapy, ibuprofen, and ice packs.
Leg pain from varicose veins

Leg pain from varicose veins

Leg swelling from varicose veins

Leg swelling from varicose veins

Why Leg Pain Worsens with Menstruation2021-11-15T11:47:21-08:00

COVID Precautions at La Jolla Vein Care

2020-09-18T02:11:40-07:00

While we offer telemedicine visits and in-home ultrasound diagnostics, if you prefer or need to come to our office, we want you to know about the extensive COVID precautions we have taken to ensure our office is one of the safest places you can be.

We want you to know that our first concern has always been the safety and care of our patients and our team. Although the coronavirus pandemic is new to many of us, infection control is not new to healthcare. For decades, OSHA has mandated that medical practices follow the strictest guidelines in infection control.  In order to put your mind at ease we at La Jolla Vein Care want to share with you some of the practices we employ to ensure our patients that our office is one of the safest places you can be.

 

La Jolla Vein Care Staff wearing masks

La Jolla Vein Care Staff wearing masks during procedures

 

  • Less appointments will be scheduled throughout the day so that there will be minimal people in the lobby, with little or no wait time.
  •  We’re extending our hours and offering after-hours appointments to minimize the number of patients in office at a given time.
  •  Park and Wait check in. If you prefer, you can wait in your car and we will text you when we are ready to room you. We recommend this for patients checking in prior to procedures.
  • Prior to every visit, we will ask you screening questions, to ensure symptomatic or at-risk patients reschedule their appointments to avoid community spread.
  •  You must wear a mask or cloth facial covering to be permitted into the building. You will be provided with a mask and asked to wear it while in our office. You also will be asked to disinfect your hands with hand sanitizer. Please note only the front entrance is open at the Scripps XiMED building. There is currently no third-floor access via the parking structure.
  • Our staff are required to wear masks for your protection.
  • We are seeing all patients in suite 530.  When you enter our waiting room you will notice that some chairs have been removed in accordance with national social-distancing recommendations.
  • We are eliminating coffee service, snacks and water coolersfrom our waiting area to reduce chance of community transmission.
  • Daily, we are screening our staff and following CDC guidelines regarding staff members who are ill or may have been potentially exposed to COVID-19
  • As a medical facility, we have always had a policy of sanitizing any surface after each patient encounter – but we are increasing our vigilance and frequency of disinfecting during this time.
  • Please fill out any forms electronically if able and return them prior to your appointment.
  • If you need to fill out any forms or sign consents, we have single use pens.
  • We encourage Virtual options and mobile ultrasound at-home visits when possible.

 

COVID Precautions at La Jolla Vein Care2020-09-18T02:11:40-07:00

Spider Veins Along the Ankle Indicate Underlying Reflux Disease

2021-11-03T16:57:45-07:00

Bluish and red-colored spider veins along the inner ankle and foot are referred to as corona phlebectasia in the vein world. This description refers to the ‘crown’ or cluster like distribution of these small blood vessels. Spider veins are often falsely considered as a cosmetic issue. But on the contrary, the presence of corona phlebectasia is a clinical sign that is often associated with underlying venous reflux, most commonly saphenous vein reflux, but the deep or perforator veins can also be incompetent. The underlying disease can be evaluated by a duplex ultrasound examination. Whenever corona phlebectasia is present, a duplex ultrasound examination should be offered to evaluate the underlying cause for the development of spider veins around the ankle. This will help accurately determine the treatment plan.

Spider Veins Along the Ankle Indicate Underlying Reflux Disease2021-11-03T16:57:45-07:00

Blood Vessel Diseases that can be Diagnosed with Duplex Ultrasound

2020-09-18T18:19:53-07:00

Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound uses sound waves to get images of your blood vessels. It also helps determine how fast blood moves through the vessels. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel. Using duplex ultrasound technology, the structure of your blood vessels, the valve function, the movement of your red blood cells and direction of blood flow through the vessels, and any blockages or blood clots can be seen.

Diseases of the blood vessels can affect both veins and arteries.

Vascular refers to the blood vessels in the body. There are two main types of blood vessels; the arteries and veins. Arteries bring oxygen-rich blood from the heart to every inch of the body; vein return the blood back to the heart and lungs for more oxygen. Vascular disease is when the blood vessels are no longer healthy.

Common types of vein disease include:

  • Varicose veins
  • Chronic venous insufficiency
  • Deep venous thrombosis

Common types of artery disease includes:

  • Carotid artery disease and stroke (TIA or Stroke)*
  • Lower extremity arterial disease (PAD)**
  • Upper extremity arterial disease
  • Abdominal aortic aneurysm (AAA)
Blood Vessel Diseases that can be Diagnosed with Duplex Ultrasound2020-09-18T18:19:53-07:00

What to Expect After Saphenous Vein Ablation

2021-11-05T10:57:18-07:00

After a vein ablation procedure, such as radiofrequency or laser ablation, it is normal for your leg to feel swollen. The swelling is the fluid that was placed around the vein called a tumescent anesthetic. You will feel the swelling in the location where the vein was treated. If the vein in the thigh was treated, your thigh will feel swollen. If the vein on the back of your calf was treated,  the calf will feel swollen. The tumescent will slowly be absorbed by the evening or the next morning.

Applying gauze inside of your stocking

Apply Gauze Inside of Your Stocking

Sometimes, the tumescent will leak out from the tiny needle puncture sites. For this reason, we will apply gauze inside of your stocking. At night before going to bed, reach in and pull out the gauze and throw it away. It only takes one drop of blood to make the gauze look blood-tinged. This is also normal and nothing to worry about.

Before going to bed, remove the ace bandage that overlies your stocking. You will wear the stockings overnight (for 72 hours to be exact). If your stocking causes foot pain or leg pain, or numbness in the toes, please remove your stocking during the night and sleep without it. It may be too tight. Call us in the morning so we can further advise.

What to do when the leg feels sore and achy?

leg feels sore and achy

On the evening of the procedure, your leg may also feel sore and achy. When it starts to throb, get up and walk. This usually helps it to feel better. Ibuprofen or Tylenol are helpful to reduce discomfort. You can also apply ice, by placing ice in a zip lock bag and applying the cold to the sore areas on the leg. You do not need to sleep with your legs elevated, but may do so if this is more comfortable.

When you are sitting for longer periods, such as watching a movie at night, elevate your legs.

To avoid blood clots, walk frequently throughout the day. A rule of thumb is to walk at least 30 minutes, twice a day. There is no limit to walking. After your procedure, you will be asked to walk 30 minutes around campus prior to getting into your car. This will help get the blood circulating and stimulate the tumescent to be absorbed.

What to Expect After Saphenous Vein Ablation2021-11-05T10:57:18-07:00

31, 5, 2020

Approach to Vein Treatment

2020-09-18T18:51:19-07:00

Venous Reflux Disease is Treated By a Staged Approach

Step 1: The Underlying Problem

The first step is to treat the underlying problem, the venous reflux. The specific pattern of venous reflux was detected by ultrasound. Venous reflux usually starts in the saphenous veins. The saphenous veins are most effectively treated with vein ablation procedures. This involves placing a small catheter withinpage2image34774576

the vein and using heat or a solution to produce injury and eventual closure of
the vein. The most commonly used treatments for the saphenous veins are radiofrequency ablation (RFA), laser ablation, mechanico-chemical ablation
(MOCA or Clarivein), and in some cases Varithena Foam. The treatment Step recommendation is customized, based on where reflux is present and other clinical factors.

Step 2: Varicose Veinsvaricose vein valve image on legs

After the underlying saphenous vein reflux is corrected, the bulging veins (varicose veins) can be treated by injecting a foamed medication that will cause them to scar and eventually dissolve (foam sclerotherapy), or to remove them using tiny incisions. The most common method is foam sclerotherapy. This is also known as ultrasound-guided foam sclerotherapy (UGFS).

Step 3: Spider Veins

Spider vein treatment is always considered a cosmetic procedure. If improved cosmesis is a goal of treatment, make sure to discuss this with your doctor and plan on having cosmetic treatment as the last step. Spider vein treatment is accomplished by sclerotherapy, which is an injection of a liquid medication into the spider veins. Ask your provider for an estimate about how many treatment sessions/ vials are necessary to get the results you want.

photo of spider veins

close up photo of spider veins

page2image66292544

Approach to Vein Treatment2020-09-18T18:51:19-07:00

Best Exercises for Varicose Veins

2020-09-18T18:53:02-07:00

Physical activity provides a wide range of benefits for vascular health and may help to avoid evolution of mild cases of varicose veins. In fact, exercise is considered to be a fundamental element in improving the symptomatology of patients affected by varicose veins. A sedentary person diagnosed with this medical condition has a much higher risk of worsening the symptoms when compared with an active person with the same condition. This is a result of blood pooling in the veins, causing an increase in venous hypertension and symptoms.

The main goal of exercise in regards to varicose veins is to contract and move the muscles of the leg, helping to pump the blood upwards, avoiding edema or retention of liquid in the ankles. With this in mind, the recommended exercises are those with aerobic characteristics rather than those with anaerobic ones. Through this physical activity, the pressure in the veins is improved, as well as the resulting symptomatology.

Therefore, any exercise that involves moving the lower limbs and promote cyclical muscle contractions is advisable, including stand on tiptoes, move the toes, perform foot bending and rotation, do pedaling movements, among others. These can be easily performed throughout the day without the necessity to go out and exercise, and are especially useful during work hours or while doing daily tasks at home.

When walking or running, pressure is exerted on the sole of the foot, which causes the circulation to be activated from the bottom up, while the constant contraction of the muscles during cycling causes the same effect, but without the presence of high impact, an important factor for those with joint issues.

Swimming is one of the best exercises to practice when affected by varicose veins. The double effect of the water and the movement of the lower limbs cause an incredible increase in blood circulation. This is helpful also for patients who have significant symptoms related to the effects of gravity, like standing.

Other disciplines like yoga, pilates, or rhythmic gymnastics also help stimulate circulation by mobilizing the accumulated blood in the thighs, while relaxing the whole body.

Hiking is a great activity for using the calf-muscle pump. However, in warm weather, symptoms of varicose veins worsen. To get the maximal benefit of exercise and reducing symptoms, outdoor exercising when the weather is cooler, like in the morning is advised.

Best Exercises for Varicose Veins2020-09-18T18:53:02-07:00

Micro-Phlebectomy to Remove Varicose Veins

2021-12-30T11:47:53-08:00
Micro-Phlebectomy involves using a scalpel to make tiny incisions (less than 3mm- about the size of a grain of rice) along the legs to remove the veins. This is performed with local anesthesia that is used to numb the skin of the leg. This procedure may take 1 to 2 hours, depending on the extent of the individual’s varicose veins. Return to normal activities after the procedure is possible. There will be significant bruising with this procedure. The benefit is that the veins are removed immediately, although it may take several weeks for the bruising to resolve. This procedure may be performed in conjunction with other procedures or stand-alone, depending on the individual’s specific vein issue. Alternatives to Micro-phlebectomy are foam sclerotherapy, which is an injection into varicose veins to cause them to shrink and eventually disappear. Discuss with your doctor which treatment is better for you.

Preparing for your Procedure:

There are no medication restrictions before the procedure. If you have asthma, please bring your inhaler with you to your appointment, or your doctor may have recommended taking an antihistamine such as Claritin prior to the procedure. You should take this the morning of your treatment.

Please notify our office if you are scheduled to have any type of medical procedure or surgery 2 weeks prior to or after your treatment.

If you choose to take the light sedative offered, be sure to make arrangements for transportation to and from the procedure, as you will not be able to drive yourself home. The morning of your procedure, please shower and thoroughly wash your leg with soap from your groin to your ankle and wear loose-fitting pants to your appointment. It is also advised for you to bring an extra pair of underwear with you to your appointment. It would be best if you have a light meal before you arrive. You may bring a book or an iPod to listen to during the procedure. We also offer a movie to watch during the procedure. If you already have 30-40 thigh-high compression stockings, please bring them with you to your appointment. If not, we will fit you for stockings on the day of your procedure.

 

Micro-Phlebectomy to Remove Varicose Veins2021-12-30T11:47:53-08:00

How to Manage Varicose Vein Pain at Home

2021-11-03T16:37:58-07:00

While venous interventions are the best way to alleviate long-term pain related to varicose veins, symptoms can be managed conservatively at home. Especially under the stay-at-home safe harbor orders.  Conservative management can be helpful to relieve symptoms and also prevent complications (such as thrombophlebitis). These include:

  • Avoid standing or sitting for long periods of time:  To keep blood moving when you have to sit or stand for long periods, try these tips: at work, take walking breaks and try walking during your lunch hour. While sitting, try flexing your feet up and down 10 times an hour. When standing, raise yourself up and down on your toes or rock back and forth on your heels.

Varicose Vein Pain, Walking Breaks At Work

  • Exercise: Exercising is good for your veins because it improves blood flow. Walking, cycling or swimming are great exercises for vein health. But be sure to check with your doctor before starting any exercise program.

exercises for vein health

  • Weight loss or maintaining a healthy weight: Being overweight puts extra pressure on your veins.

Manage Varicose Vein Pain Method, Weight Loss or Maintaining A Healthy Weight

  • Leg elevation: Use leg elevation three or four times a day for about 15 minutes at a time. Even elevating your legs on a step stool or ottoman is beneficial. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms.

Manage Varicose Vein Pain Method, Leg Elevation

  • Compression stockings: These elastic stockings squeeze or compress the veins and prevent blood from flowing backward. Compression stockings must be graduated, medical-grade compression to be beneficial. TED hose are not adequate to reduce symptoms in venous disease for active patients. Although we typically recommend being fit for compression stockings, compression stockings can be purchased at home, from online resources. Email us if you would like suggestions.

Manage Varicose Vein Method Compression Stockings

  • Supplements such as horse chestnut and grape seed extract can help reduce symptoms of venous disease. Vascular is a prescription medication that may be helpful for some. Always check with your PCP before starting supplements or new medications as there may be side effects.
  • A flavinoid-rich diet including berries, green teas can reduce inflammation and pain.
  • Anti-inflammatory medications such as ibuprofen
  • ice packs are my favorite way of reducing painful veins. Put ice cubes in a ziplock bag and apply to tender veins.
  • Anti-inflammatory creams can be prescribed to apply directly to painful veins.
How to Manage Varicose Vein Pain at Home2021-11-03T16:37:58-07:00
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© Copyright 2010-2024, La Jolla Vein & Vascular | All Rights Reserved

CONTACT INFORMATION

La Jolla/UTC

Vista

Patient Privacy Practices

Privacy Policy

Hippa Privacy Practices
HIPAAOneTM Certified Seal 2

Use the search features below to find articles and insights for the diagnosis and treatment of vascular disease

TWO CONVENIENT LOCATIONS THROUGHOUT SAN DIEGO

La Jolla/ UTC

North County San Diego/ Vista — Endovascular Center
Now Open! Call/Text for Appointments

© Copyright 2010-2024, La Jolla Vein & Vascular | All Rights Reserved

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