26, 4, 2020

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

Health Risks of Working-From-Home

2020-08-19T00:48:02-07:00

Prolonged desk work can increase the risk of blood clots in leg veins.

As many Americans are working from home, we have received many calls from patients regarding thrombophlebitis. This is not a new scenario for us, over the years frequently patients come in for assessment of leg pain after working on their computers for 12 hours straight.

ThromboPhlebitis refers to blood clots in the leg veins and inflammation of the surrounding vein. The inflammation causes leg pain and redness of the surrounding skin. You may also feel hard lumps in the leg veins.

Inactivity, sitting for long periods of time, like sitting at your desk, working on your computer for many hours without walking or getting up for a light walk or exercise, affects the blood flow in the leg veins. Your calf muscle pump, which is used when walking and moving about helps to move blood back to your heart. Sitting for too long of periods, increases the risk of your blood pooling in the leg veins and can even form blood clots. Blood clots that form in the deep veins are serious as they can travel to the heart and lungs (deep venous thrombosis). Blood clots that form in the surface veins, are called superficial thrombophlebitis (STP).  With STP, you can typically feel lumps that can be painful. People who have varicose veins, have an increased risk of developing STP especially with inactivity.

Tips to Avoid Phlebitis When Working From Home:

  1. Avoid sitting at your desk or computer for longer than 45 minutes without taking a break to get up and walk about.
  2. Try to walk at least 30 minutes a day or other exercise
  3. When sitting, do calf raises to pump the calf veins.
  4. If you have varicose veins, you should wear compression stockings during the day time.
Health Risks of Working-From-Home2020-08-19T00:48:02-07:00

Wendy Williams Show Kathy Bates Bring Light to Lymphedema

2021-11-15T11:03:12-08:00

Both Wendy Williams and Kathy Bates Suffer from Lymphedema.

This week’s Wendy Williams Show host, Wendy Williams discussed her struggles with lymphedema with guest, Kathy Bates who also has lymphedema. They both agreed that lymphedema is not given enough attention in medical education and in the medical community. We agree. Our medical speciality and society The American Vein & Lymphatic Society (AVLS) specializes in both vein and lymphatic disorders.

Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell.  Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. In our field, we also see phlebolymphedema, which is lymphedema secondary to chronic venous insufficiency. Venous hypertension can overload the lymphatic transport system, slowing fluid removal and causing subsequent lymphatic edema, in addition to venous edema. The result is swelling in the legs that is greater than venous edema.

n 2016, Kathy Bates was a speaker at our annual congress.   The American Vein & Lymphatic Society (AVLS) hosted what has become the largest and most comprehensive meeting dedicated to venous and lymphatic disorders in the U.S. Bates outspokenly discussed surviving and managing lymphedema after she had breast cancer and underwent a double mastectomy.

Lymphedema is not cured but can be managed. In our clinic, we may refer to one of our trusted lymphedema therapists for manual lymphatic drainage and prescribe compression therapy. We also offer lymphatic pump therapy in the office. It is also important to evaluate the deep and superficial venous system prior to initiating therapy.

 

Wendy Williams Show Kathy Bates Bring Light to Lymphedema2021-11-15T11:03:12-08:00

Olympic Athletes Who Suffer from Varicose Veins

2022-01-03T13:04:37-08:00

Even Olympic gold medalists get varicose veins! Including swimmers and beach volleyball players…….

It is a huge misconception that people who take care of their bodies don’t get varicose veins.  In contrast, most of our patients take great care of their health.  At La Jolla Vein Care, we routinely care for competitive athletes, marathon runners, Iron Man competitors who all suffer from varicose veins and its underlying cause venous reflux disease. We see it all.

Olympic swimmer and gold-medalist, Summer Sanders shares her story of suffering from varicose veins. “As a life-long athlete and Olympic swimmer, I never thought a condition like varicose veins or chronic venous insufficiency (CVI) would affect me. It soon hit me that, even though I was active, I was starting to get my mother’s legs.

It’s important for people to realize that varicose veins and CVI can happen to anyone and they are more than just a cosmetic issue. But you don’t have to live with the uncomfortable and painful symptoms. There are minimally-invasive treatments available that are covered by many insurance plans.

In the past, Summer shared her story as the spokesperson of a campaign called “Rethink Varicose Veins,” which aims to educate the public about this common condition and help to dispel some myths.

“Like many moms, my lifestyle requires me to be on my feet constantly. I noticed my legs were heavy and achy after a long day, but I assumed these symptoms were just something I had to deal with,” says Summer. “My doctor and I decided the best path for me was a minimally-invasive treatment. The procedure was quick and I was back to my regular activities within a short period of time. Now my legs feel great!”

Olympic gold medalist Misty May-Treanor is another athlete who is outspoken about her varicose vein condition. Misty May-Treanor has three consecutive gold medals under her belt for beach volleyball! If you are suffering from varicose veins, you are not alone!

 

Olympic Athletes Who Suffer from Varicose Veins2022-01-03T13:04:37-08:00

Easter Dinner & Leg Pain: What’s the Correlation?

2021-11-04T19:53:27-07:00

After a holiday, patients frequently complain about leg pain. Especially, holidays where hours of cooking are involved like Thanksgiving, Easter, Christmas, Passover, etc. Some people who may have mild venous reflux disease, may not notice any symptoms until they are standing for hours- like during cooking. Over the years, we always hear from patients that their legs were aching and fatigued after cooking. The reason for this is venous reflux disease causes backflow of blood. The blood pools in the legs and the pooling of blood causes sensations of heaviness, fatigue, aching, and even night cramps and restlessness. Ankle swelling may also be more prominent. Elevating the legs allows the blood to flow in the correct direction and reduces the pooling of blood and symptoms. Wearing compression stockings during cooking can be helpful to reduce symptoms. Also when standing upright for hours, it is helpful to do calf pump raises.

Diagram of healthy and diseased vein valves

Leaky vein valves allow blood to pool, causing leg pain, heaviness, and fatigue.

Easter Dinner & Leg Pain: What’s the Correlation?2021-11-04T19:53:27-07:00

6 Stages of Venous Disease, Which Stage Am I?

2021-11-13T12:32:18-08:00

Venous Reflux Disease is progressive and worsens over time.

venous disease is progressive and worsens over time.

venous disease is progressive and worsens over time.

Venous reflux disease is also known as venous stasis, chronic venous insufficiency, or venous incompetence. 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

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. See the image to better understand the 6 main stages of venous disease. Stage 6 is the open leg wound, known as 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

6 Stages of Venous Disease, Which Stage Am I?2021-11-13T12:32:18-08:00

Hidden Signs That Varicose Veins Are Developing

2021-10-29T19:03:03-07:00

Varicose Veins Are Not Always Visible to the Naked Eye

An estimated 80 million Americans suffer from a vein-related condition. Since most veins lie deep under the skin’s surface, vein disorders are not always visible to the naked eye. As a result, it’s important to be aware of the symptoms that might reveal an underlying vein condition such as

A duplex ultrasound examination can be done to properly diagnose varicose veins and underlying vein conditions. An ultrasound uses sound waves to create pictures of the blood vessels inside your body. The ultrasound exam, which is painless and takes fewer than 30 minutes, allows a trained specialist to examine your venous system to determine if your symptoms are connected to a vein-related condition. The good news is that many vein conditions can be easily treated. Often, you just need to look beneath the surface to get moving in the right direction.

Hidden Signs That Varicose Veins Are Developing2021-10-29T19:03:03-07:00

What Your Ankles Say About Your Health

2021-11-13T13:50:53-08:00

5 signs of venous reflux disease were found on the ankles

venous reflux disease were found on the ankles

Venous reflux disease refers to ‘leaky valves in the leg veins. It is also referred to as venous insufficiency. When the one-way valves that help blood in the veins flow from the feet to the heart, no longer work properly, blood begins to pool around the ankles. Over time, the pooling of blood causes increased hydrostatic pressure within the blood vessels. This is referred to as venous hypertension in the medical community. Venous hypertension is associated with chronic venous insufficiency, which means the vein valves have become leaky for a long time before physical signs are apparent. An ultrasound examination can first identify if the underlying veins are weak and leaky not visible to the naked eye, long before physical signs become apparent. Some signs you may see that may indicate underlying venous reflux disease include:

chronic venous insufficiency or venous reflux disease

Darkening of skin, and itchiness are a sign of chronic venous insufficiency or venous reflux disease

  1. Skin darkening around the ankle (hyperpigmentation). This is also referred to as venous stasis. This is a result of long-standing venous reflux or pooling of blood.
  2. Itchy, scaly skin around the ankles. This is referred to as venous eczema. This skin becomes itchy and scaly from chronic inflammation.
  3. spider veins in the inner ankle. These are commonly associated with venous reflux in the great saphenous vein. The great saphenous vein courses the ankle all the way to the groin. When blood pools from thigh upper thigh all the way to the ankle, small spider veins may appear in the ankle. These are commonly perceived as cosmetic because most people don’t realize there is an underlying problem.
  4. ankle swelling (edema). There are many causes for ankle swelling. Some are serious like heart conditions where others are less serious like a salty diet. When ankle swelling is present talk to your doctor about the various causes. However, one of the most common causes of ankle swelling is venous reflux disease. Anyone who has ankle swelling can benefit from an ultrasound examination to determine if venous reflux disease is present.
  5. skin ulceration and breakdown in the ankle. Over time, pooling of blood in the ankles and venous hypertension causes the skin to darken, it can become scaly and itchy and eventually ulcerate because the skin breaks down from chronic inflammation. This is called a venous leg ulcer. Venous leg ulcers are treated by treating the underlying venous reflux disease.

All of these signs and symptoms can be reduced by treating the underlying problem, venous reflux disease. See our treatments page to better understand treatment options.

What Your Ankles Say About Your Health2021-11-13T13:50:53-08:00
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