About Nisha Bunke

This author has not yet filled in any details.
So far Nisha Bunke has created 114 blog entries.

7, 5, 2020

What your skin says about your vascular health

2021-11-05T04:08:48-07:00

Darkening of the skin around the ankles may indicate chronic venous reflux disease, a condition of the vein valves, detectable by ultrasound.

venous leg ulcers

Chronic venous insufficiency (CVI) can cause the skin to become discolored, usually around the ankles. Over time, ulcerations or skin wounds may develop.

Over time, leakage of the blood into the area surrounding the veins can cause tissue to die. The resulting pooling of blood in the tissue causes a darkening of the skin. It is at this stage that the skin is actually stained by your own blood.  This is also known as venous stasis skin changes, skin hyperpigmentation, or venous stasis dermatitis because the skin is often inflamed, itchy and eczema-like.  This is most frequently caused by venous reflux, an underlying condition that can be treated. When skin changes like these are present, the condition is termed chronic venous insufficiency.  Over time, the skin condition may worsen and the skin may become darker, firm to touch, scaly and itchy, and the skin may break down causing a venous leg ulcer.

What your skin says about your vascular health2021-11-05T04:08:48-07:00

Varicose Veins Common Cause For Restless Legs Symptoms

2021-11-15T13:32:16-08:00

The restless leg was a reported symptom in 30% of people who suffer from varicose veins, in our study.

Varicose Veins

Those who suffer from varicose veins often report a feeling of restless legs, especially at night when in bed. In our study, about 30% of patients with varicose veins complained of nocturnal restless legs.

Restless legs refer to the specific symptoms of restlessness and urge to move the legs. This is different than Restless legs syndrome (RLS), which is a sensorimotor movement disorder characterized by uncomfortable sensations in the legs and an urge to move them.  This is a diagnosis based on a collection of nocturnal symptoms. There are many causes of restless legs syndrome such as neurological disorders, anemia, and kidney disease to name a few, and is often treated with medication. Vascular causes, such as venous insufficiency is often overlooked as a cause for Restless Legs Syndrome. We have case studies of patients who used medication to treat RLS symptoms for years without resolution of symptoms. In our study, 98% of the patients with venous insufficiency and restless legs, had resolution of symptoms following treatment.  In another study, by Hayes, CL et. al, 35 patients with RLS and superficial venous insufficiency underwent endovenous ablation of refluxing superficial veins and ultrasound-guided sclerotherapy of varicose veins. 89% of patients reported alleviation of symptoms.

If a patient has restless legs symptoms and evidence of varicose veins of the legs, a work-up for venous insufficiency should be considered. The workup involves a duplex ultrasound evaluation of the leg veins. This may eliminate the need for medication for RLS in some cases.

Varicose Veins Common Cause For Restless Legs Symptoms2021-11-15T13:32:16-08:00

Varicose Veins are Inherited

2020-08-19T01:12:15-07:00

This picture shows the strong correlation between genetics and varicose veins.

One of the strongest risk factors for varicose veins is a family history. We often see mothers and their daughters, fathers and sons, siblings, and some times the entire family for similar varicose vein issues. This picture demonstrates a mother and her daughter with ironically the same varicose vein pattern of distribution. Don’t want your mother’s legs? Stay on top of your vein condition and have them treated or maintenance treatment to avoid bulging varicosities.

 

Varicose Veins are Inherited2020-08-19T01:12:15-07:00

29, 4, 2020

Vein Care Delivered To Your Home: In-home ultrasound diagnostics

2020-08-19T01:11:28-07:00

We now offer mobile ultrasound services!

Right now we want you to stay home.  But, that won’t stop us from helping you!

Enjoy a thorough vascular assessment from the convenience of your own home.

  1. Have your physician consultation, conservative management or follow-up visit by telemedicine (video) or by telephone (it’s your preference!).
  2. For the ultrasound portion, our Registered Vascular Technologist (RVT) will bring the same hospital grade quality ultrasound technology to your home, while taking proper COVID precautions and utilizing personal protective equipment (PPE).

Ultrasound Services include:

  1. Complete venous reflux study and vein mapping
  2. Deep Venous Thrombosis (DVT study for blood clots)
  3. Arterial study of the legs
  4. Follow-up, post-procedure checks
  5. Carotid Artery Screening
  6. Abdominal Aortic Aneurysm Screening

 

Whether you have immediate concerns about leg pain, discomfort, blood clots, or are looking for a first-time consultation or continued follow-up care, we are here for you.

 

Call now to schedule your in-home ultrasound diagnostics and physician telemedicine visit.

Call 858-550-0330

Vein Care Delivered To Your Home: In-home ultrasound diagnostics2020-08-19T01:11:28-07:00

Local Business Shout Out

2021-11-04T13:41:14-07:00

During these uncertain times, we want to pause and show support for local businesses. We want to express our heart-felt appreciation to all the local businesses that have provided amazing service over the years. Here are a few:

Our office designs are inspired by nature and healing. We do our best to bring outdoor and nature elements into our medical office by using water, plants, wood, and ocean-inspired photography.
Our lobby waterfall in suite 410 was custom designed by LL Waterfall Design nearly a decade ago, to create a tranquil environment while guests relax in the lobby. https://www.llwaterfalldesign.com
We love having abundant plants in both offices. Studies have shown that plants create a relaxing environment, reduce physical symptoms of stress and clean the air by absorbing toxins. Evergreen interiors designed and maintain the beautiful plants in both offices.
IMG 1235
We love our wall signage that creative juice signage literally designed and put up overnight. Service was amazing.
@creativejuicessignage on Instagram
IMG 1234
Each exam room in Suite 530 was inspired by an ocean theme, to create a relaxing environment. Some of our rooms actually display murals of local beaches! Thanks to muralsmyway.com
IMG 0412 1030x773 1
Suite 530 lobby displays ocean and nature-themed photography by photographer Aaron Chang. The hallways display his son, Saxton Chang’s ocean photography as well.
IMG 1236

aaron chang photography

We also want to give a shout-out to our amazing photographer over the years, Clay Chapman Photography, claychapman.com.
Local Business Shout Out2021-11-04T13:41:14-07:00

Vein Valves Don’t Work in Venous Reflux Disease

2021-11-15T13:17:51-08:00

Vein valves and the direction of blood flow can be seen on ultrasound. Ultrasound is an important tool in the diagnosis of venous reflux disease.

Humen Circulatory System

In the circulatory system, the veins carry de-oxygenated blood back to the heart. The leg veins carry blood toward the heart, against gravity. Therefore, the leg veins have one-way valves the prevent backflow of blood. When the valves do not function properly, they allow blood to flow backward, causing the pooling of blood. This is referred to as venous reflux or venous insufficiency. Eventually, the backflow of the blood will cause varicose veins to develop and symptoms related to the increased pressure in the leg veins such as leg heaviness, aching, swelling, restless legs, night cramps, throbbing, and pain.

Vein Valves Don’t Work in Venous Reflux Disease2021-11-15T13:17:51-08:00

Warm Weather Worsens Leg Symptoms

2020-08-19T01:00:26-07:00

Warm weather can worsen symptoms of varicose veins and venous reflux disease.

This weekend, most of San Diego was blessed with sunny, warm-weather. Warmer weather tends to worsen symptoms of varicose veins, like increased leg heaviness, pain or you may feel that your legs fatigue more quickly during warm weather. For those who have spider veins, they can feel more itchy or burning.  This leads many people to seek leg vein help during warmer months.

The cause: Leg symptoms of varicose veins and venous reflux disease (the underlying cause for varicose veins) tend to worsen in warmer weather because heat causes the surface veins to relax and enlarge. When this happens to unhealthy veins, the blood pools and causes increased pressure within the veins. Increased pressure within in the veins is called venous hypertension. Venous hypertension causes inflammation. Therefore, inflammation causes the veins to feel warm, painful, itchy or burning. Since gravity causes blood to pool around the ankles for many people with venous reflux disease, you may feel symptoms in your ankles rather than the calfs. The skin around the ankles can become itchy, and dry. The best way to alleviate this in the long term is treatment of underlying venous reflux. Conservative management is aimed at reducing or preventing the blood from pooling. This can be accomplished with compression stockings- these may be difficult to tolerate in warm weather. Staying active helps, and when sitting elevate the legs and ice any areas of pain to reduce inflammation.

Warm Weather Worsens Leg Symptoms2020-08-19T01:00:26-07:00

Study Finds Nearly 50% Nurses Have Venous Reflux

2022-01-04T10:10:57-08:00

Women in nursing professions are at high risk for developing varicose veins as it requires physical work and prolonged standing.

It is well known to vein specialists that individuals with occupations that require long periods of standing such as nurses, physicians, other health care workers, retail workers, flight attendants, hairdressers, etc. have a higher incidence of varicose veins. Over the years, many studies have substantiated this, and we know from clinical practice that many of our patients are nurses. Nurses who have 12-hour shifts stand on their legs half the day! Nurses who work with radiation wear heavy lead vests throughout the day.

A recent cross-sectional study at Dhulikhel Hospital in Nepal evaluated 181 female nurses for varicose veins and their risk factors. The participants underwent Doppler ultrasound to confirm venous reflux disease and varicose veins, using standard criteria. Out of the 181 nurses, 83 (46%) had varicose veins. In the adjusted model the odds of having varicose veins was 27 times greater with every hour increase in standing time.

Another study in 2018, at a University Hospital in Korea evaluating 414 nurses also showed that standing for long periods of time increased the risk of varicose veins. However, the prevalence of varicose veins among nurses in this study was only 16%. The differences among the two studies may be the average age of the nurses studied, parity, or a number of years in nursing. Increasing age and number of births is also a risk factor for varicose veins.

As a result, we always recommend all our nurses wear compression stockings when at work. Everyone in our practice wears compression stockings on a daily basis (typically a knee-high sock, 20-30mmhg of compression).

1: Shakya R, Karmacharya RM, Shrestha R, Shrestha A. Varicose veins and its risk factors among nurses at Dhulikhel hospital: a cross-sectional study. BMC Nurs.2020 Feb 3;19:8. doi: 10.1186/s12912-020-0401-8.1: Yun MJ, Kim YK, Kang DM, Kim JE, Ha WC, Jung KY, Choi HW. A Study on

2: Prevalence and Risk Factors for Varicose Veins in Nurses at a University
Hospital. Saf Health Work. 2018 Mar;9(1):79-83. DOI: 10.1016/j.shaw.2017.08.005.
Epub 2017 Aug 24.

Study Finds Nearly 50% Nurses Have Venous Reflux2022-01-04T10:10:57-08:00

Night Cramps Commonly Caused by Varicose Veins

2021-12-31T12:29:50-08:00

Leg cramps occurring at night (nocturnal leg cramps) are a common symptom of venous disease. In fact, in the San Diego Population Study, leg cramps were the second most common symptom in people with the venous disease with a prevalence of 14.3%. Leg aching (17.7%) was the most common complaint and tired and swollen legs were also predominant symptoms.

Healthy veins collect the de-oxygenated blood from the tissues. The venous blood, which is low in oxygen and high in waste products is returned to the heart and lungs where it is replenished with oxygen and nutrients.  In diseased veins, the blood circulates poorly, allowing blood to pool and become stagnant. The exact mechanism that causes cramping in the legs is uncertain.  But, when the cramping is caused by poorly functioning veins, the symptoms are often alleviated by correcting the underlying problem.  Conservative measures, such as elevating the legs, walking regularly, and wearing compression therapy may reduce the frequency of night cramps. Treating the underlying venous insufficiency may be curative.

There are many causes for leg cramps and if you suffer from night cramps it is important to be properly evaluated to determine the cause.  Cramps that occur with exercise are more likely to be associated with a more serious condition. If your muscles cramp with walking for a short time and recover with rest this may indicate arterial disease.  Other causes for leg cramps include muscle injury, thyroid conditions, pregnancy, electrolyte imbalance, dehydration or other causes.

To help identify the cause, it may be helpful to keep a log of daily activities, or change in activities; for example, heavy exertion may indicate a muscular cause or long periods of standing or sitting may favor the venous disease.  A recent study showed that prolonged standing at work may be an important risk factor for varicose veins and nocturnal leg cramps.

Check with your primary care physician to rule out other causes for leg cramps. Blood tests can check for thyroid, kidney and electrolyte conditions.  You may also have undiagnosed venous reflux.

At La Jolla Vein Care, our vascular imaging scanners help us detect vascular causes of leg pain. For example, we can utilize one of our three duplex ultrasound imaging systems to scan for blood clots in the leg veins (deep venous thrombosis), venous insufficiency and identify significant problems in the arterial circulation.

 

Call us for more information about our vascular imaging services at 858-550-0330.

Night Cramps Commonly Caused by Varicose Veins2021-12-31T12:29:50-08:00
NEW LJVV Logo WEB

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
Now Open! Call/Text for Appointments

© 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

Toggle Sliding Bar Area
Go to Top