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So far Nisha Bunke has created 114 blog entries.

27, 5, 2020

Vein Treatment During COVID-19

2020-09-18T18:57:42-07:00

The International Union of Phlebology (UIP) Published a Consensus Document in the Journal of Vascular Surgery regarding the treatment of patients with vein disorders during COVID: Triage of Patients with Venous and Lymphatic Diseases during the COVID-19 pandemic- the Venous and Lymphatic Triage and Acuity Scale (VELTAS). 

We are pleased to report that our own practice guidelines are entirely consistent with the recent UIP recommendations; and we are excelling at allowing urgent as well as semi-urgent (patients who are highly symptomatic) to be seen typically within one week.

The purpose of the triage scale developed by International Union of Phlebology (UIP) is to ensure that patients with venous and lymphatic disorders receive care in a timely fashion without compromising healthcare resources needed for the pandemic and without imposing undue risks to patients and health care providers.

Triage urgency was categorised into four groups and individual conditions were allocated to each class of triage. These included 1) Medical Emergencies (requiring immediate attendance), example massive pulmonary embolism; 2) Urgent (to be seen as soon as possible), example deep vein thrombosis ; 3) Semi-urgent (to be attended to within 30-90 days), example highly symptomatic CVD, and 4) Discretionary/Non-urgent- (to be seen within 6-12 months).

La Jolla Vein Care’s statement is as follows:

‘While we continue to encourage virtual visits and at-home mobile ultrasound diagnostics, our office has re-opened for medical necessity treatments and for those who require in-office visits. Medical necessity conditions include complications from venous reflux disease and varicose veins such as thrombophlebitis (blood clots), vein hemorrhages, venous leg ulcerations (open leg wounds), and symptoms that interfere with one’s ability to work or maintain daily activities such as leg pain, heaviness, throbbing, swelling and night symptoms that interfere with rest such as restlessness and night cramps.’ Cosmetic spider vein treatments are postponed until a future date.

This means that patients who suffer from symptoms of varicose veins and CVI, and those with complications do not have to put off their vein care. We continue to be committed on a daily basis to helping our patients. If you have a vein condition you would like to have addressed, please call us at 858-550-0330.

 

Vein Treatment During COVID-192020-09-18T18:57:42-07:00

Memorial Day Observation

2020-09-18T18:59:22-07:00

In observance of Memorial Day, our office is closed. We would like to honor the men and women who have sacrificed their lives while serving in the military. Most of us at La Jolla Vein Care have a direct military connection, and we continue to honor veterans and current military. We have chosen to be a vein care provider for veterans, military retirees, and active military and their spouses with VA CHAMPS, and Tricare.

Both Dr. Bunke and Dr. Lucas have cared for veterans at the VA HealthCare San Diego and VA Memphis correspondingly.

Memorial Day Observation2020-09-18T18:59:22-07:00

How to Treat Leg Spider Veins

2020-09-18T19:01:10-07:00

Spider veins and reticular veins of the legs are most commonly treated with sclerotherapy. Sclerotherapy involves an injection of a medication into the vein.  This will cause the vein to collapse and gradually fade away. Sclerotherapy has been used to treat spider veins for decades, but modern solutions such as Asclera, allow for spider veins to be treated with minimal discomfort and immediate return to activities. Saline solutions are rarely used these days by vein specialists, because alternatives solutions are less painful and better tolerated. Sclerotherapy is the preferred  over laser in most cases of spider veins on the legs, because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Laser may be used for the fine thread like veins, most common on the face. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Wearing compression stockings after treatment will improve results.

 

How to Treat Leg Spider Veins2020-09-18T19:01:10-07:00

Nutritional tips for varicose veins

2020-09-18T19:02:32-07:00

Varicose veins are bulging, purplish-colored veins that occur when the one-way valves, which are responsible for regulating the constant flow of blood, become weak, especially in the lower limbs. Although many consider them a simple aesthetic problem, they can be a sign of circulation disorders, fluid retention, and inflammatory diseases. Fortunately, this condition can be significantly improved by making better nutritional choices before it becomes chronic.

In a diet to prevent varicose veins, it is suggested to increase the intake of some foods that promote blood flow. Similarly, the aim is to control total calorie consumption, since lowering the body mass index is a determining factor both in avoiding varicose veins and in reducing them.

Another objective is to help control the body’s inflammatory processes, whose alteration may trigger this condition. Additionally, this allows decreasing the pressure on the legs, which controls symptoms, such as heaviness and pain. So, what you need to do nutritionally speaking?

Increase Omega-3 consumption. Due to their ability to cleanse the arteries, these fatty acids are ideal for reactivating circulation, lowering cholesterol, and preventing possible blockages. These healthy fats control excess inflammation and help maintain good cardiovascular health. Choose oily fish, nuts, and seeds.

Eat more fiber. Fiber-rich foods are allies in lowering cholesterol levels and optimizing circulation. They also reduce constipation so that there are no difficulties due to the pressure produced by the difficulties in defecating. Choose fruits, vegetables, whole grains, legumes, nuts, and seeds.

Consume more folic acid. Foods containing folic acid help reduce homocysteine, an element that causes injury to the artery walls. They also prevent the appearance of thrombi, a chronic disorder that affects varicose veins and cardiovascular disease. Choose spinach, asparagus, cabbage, beef liver, whole grains, and nuts.

Increase the dose of vitamin E. This well-known antioxidant is essential in preventing varicose veins because it promotes the breakdown of lipids in the blood and optimizes circulation. Choose fruits, avocado, and olive oil.

Include diuretic ingredients. These can stimulate the elimination of retained fluids to decrease the overload of the legs. Therefore, their inclusion in the diet promotes the relief of varicose veins and prevents other diseases associated with poor circulation. Choose pineapple, artichoke, lemon, cucumber, blueberries, and parsley.

Limit salt consumption. Maintaining a sodium-rich diet is one of the factors that increase the risk of varicose veins, producing edema and high blood pressure. Because of this, it is essential to limit its intake and seek healthy alternatives. Choose healthy spices like oregano, thyme, garlic, and turmeric.

Consume healthier drinks. Healthy drinks complement the effects of the diet to prevent varicose veins. Adequate fluid assimilation helps balance inflammatory processes and promotes proper blood flow by regulating fluids in the tissues. Choose plain water and healthy smoothies or juices.

Nutritional tips for varicose veins2020-09-18T19:02:32-07:00

Leaky Vein Valve Disease and Varicose Veins

2021-11-05T10:56:55-07:00

Venous reflux disease refers to ‘leaky valves in the veins of the legs. Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small saphenous vein, which courses up 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. Symptoms 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.

Leaky Vein Valve Disease and Varicose Veins

Leaky Vein Valve Disease and Varicose Veins2021-11-05T10:56:55-07:00

Venous Reflux is a Progressive Condition, Worsens Over Time

2021-12-31T14:18:52-08:00

6 Chronic Venous Insufficiency Stages

Venous reflux disease is also known as venous stasis, venous insufficiency, or venous incompetence. Venous reflux disease refers to “leaky valves” in the veins of the legs. Venous reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside of the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and the small saphenous vein, which courses up 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. Symptoms 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.

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 3. reticular veins and varicose veins

Stage 3. reticular veins and varicose veins

Stage 4. Venous Nodes - Edema venous insufficiency

Stage 4. Venous Nodes - Edema venous insufficiency

Stage 5. Chronic insufficiency

Stage 5. Chronic insufficiency

Stage 6. Venous eczema and venous leg ulcer

Stage 6. Venous eczema and venous leg ulcer

Venous Reflux is a Progressive Condition, Worsens Over Time2021-12-31T14:18:52-08:00

We’re Open: Extended hours, Curb-side check-in, & Virtual Visits

2020-09-18T19:08:55-07:00

We’re Open

Resuming In-office Services

La Jolla Vein Care has been actively monitoring the COVID-19 pandemic and its impact on our patient care and office protocols.  Our highest priority is to continue providing the highest standard in vein care in a safe environment for our patients and staff.  We have created and implemented a strategic plan using best available practices to minimize the risk of person-to-person COVID-19 exposure in our practice.  These guidelines are in compliance with all State, Local, and CDC guidelines and guidance of the CMA, California Department of Public Health, Center for Disease Control.

While we continue to encourage virtual visits and at-home mobile ultrasound diagnostics, our office has re-opened for medical necessity treatments and for those who require in-office visits. Medical necessity conditions include complications from venous reflux disease and varicose veins such as thrombophlebitis (blood clots), vein hemorrhages, venous leg ulcerations (open leg wounds), and symptoms that interfere with one’s ability to work or maintain daily activities such as leg pain, heaviness, throbbing, swelling and night symptoms that interfere with rest such as restlessness and night cramps.

Cosmetic spider vein treatments are postponed until a future date.

 

SAFETY

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.

  • 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.
  • Curb-side 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 beasked 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.
  • 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 guidelinesregarding 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 optionsand mobile ultrasound at-home visits when possible.

 

We want to assure you that we are taking every precaution to make La Jolla Vein Care a place where you can feel safe and comfortable receiving the best possible care. If you have any specific questions, please call us. We look forward to seeing you at your next visit. We hope at this time that you and your loved ones are healthy and safe.

 

Stay connected to learn more about some exciting changes and how we are redefining vein care in 2020, Vein Care ReimaginedTM

 

We’re Open: Extended hours, Curb-side check-in, & Virtual Visits2020-09-18T19:08:55-07:00

How to make compression stocking application a cinch!

2022-01-04T04:40:52-08:00
Stocking Troubles? Tips, tricks, and an easy guide to living in harmony with compression stockings
Applying stockings with ease:

  1. Turn your stocking completely inside out
  2. Locate the smaller foot hole of the stocking and tuck the foot in until you reach the heel
  3. Place your thumbs on either side of the tucked in foot hole, with the heel located on the bottom
  4. Put your foot in the stocking until the heel of the stocking has met your heel
  5. Grab the larger hole or top of the stocking (it should be hanging off your foot) and pull the stocking up onto your leg
  6. Inch and pull the stocking until it has reached either below the crease of your knee for knee highs, or the highest portion of your thigh for thigh highs.
  7. If your stockings slide or have trouble staying up, there is stocking glue that can be applied to the skin.
How to make compression stocking application a cinch!2022-01-04T04:40:52-08:00

Potential Link Between Blood Clots and Coronavirus 

2020-08-19T01:19:16-07:00

Blood Clots in Patients with SARS-CoV-2

Many physicians treating patients with SARS-CoV-2 have noticed an increased incidence of blood clots, including deep venous thrombosis (DVT) and pulmonary embolism.  Studies at this point are lacking but there is a hypothesis that this infection affects coagulation. For this reason, the International Society on Thrombosis and Haemostasis has recommended that all patients with SARS-CoV-2 infection, including those that are not critically ill, should receive prophylactic dose low molecular weight heparin unless contraindicated.

Deep venous thrombosis (DVT)  can pose an additional very serious complication to these patients because blood clots in the veins can break loose and travel to the heart and lungs, blocking blood flow (pulmonary embolism). Deep vein thrombosis signs and symptoms can include: Swelling, leg pain (often cramping or sudden difficulty walking), red discoloration of the skin and a feeling of warmth in the affected leg.

Potential Link Between Blood Clots and Coronavirus 2020-08-19T01:19:16-07:00

What’s so great about the saphenous vein?

2021-12-30T11:31:57-08:00

The great saphenous vein (GSV), previously referred to as the long saphenous vein, is a superficial leg vein that runs from the top of the thigh near the groin, down the inner thigh all the way to the inner ankle. The top blue arrow in this diagram points to the location of the great saphenous vein. In people presenting with varicose veins, the Great Saphenous vein is responsible for varicose veins over 80% of the time and here at La Jolla Vein Care, we have Great Saphenous Vein treatments. Varicose veins originating off the GSV typically appear in the inner thigh, inner calf, across the shin, or start in the thigh and run along the back of the calf. The other superficial vein is largely responsible for varicose veins in the small saphenous vein. The small saphenous vein (SSV) runs along the back of the calf. Varicose veins on the backside of the leg are often caused by leaky valves within the small saphenous vein.

What’s so great about the saphenous vein?2021-12-30T11:31:57-08:00
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TWO CONVENIENT LOCATIONS THROUGHOUT SAN DIEGO

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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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