18, 8, 2022

Symptoms of vein disease to look out for

2022-07-20T14:09:35-07:00

An estimated 80 million Americans suffer from a vein-related condition with symptoms. 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. If you’re experiencing pain, fatigue, heaviness, cramping, or restlessness in your legs, you should seek expert consultation. Today, a venous duplex scan is used to view internal images of your veins, even the veins beneath the muscles (deep veins). The ultrasound exam, which is painless with no additional symptoms 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. At La Jolla Vein & Vascular, we treat venous reflux disease with a tailored approach to the patient’s needs and symptoms. 

 

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. 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.

If you experience any vein disease symptoms, please call our office at (858)-434-5998 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 

 

For more information on vein health please check out our Youtube Channel or visit our helpful guide of resources. 

 

Symptoms of vein disease to look out for2022-07-20T14:09:35-07:00

La Jolla Vein & Vascular Featured in a Fox 5 Segment

2022-12-13T13:25:29-08:00

At La Jolla Vein and Vascular, we are excited to share with you our FOX 5 Localist Segment where Dr Nisha Bunke shares what our clinic can offer. 

 “Bringing Experts Together for Unparalleled Vein and Vascular Care”

 

Check out our Fox 5 segment here 

fox5segment

 

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. As mentioned in the Fox 5 segment, La Jolla Vein and Vascular offers a variety of services for vein and vascular health. 

 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

 

Our accredited center is also a nationally known teaching site and center of excellence. 

 

➡Vascular conditions we treat: 

 

-varicose veins and spider veins

 

 -chronic venous insufficiency 

 

-pelvic congestion and labial veins 

 

-varicocele (varicose veins in the scrotum) 

 

-uterine fibroids 

 

-deep vein thrombosis 

 

-May Thurner peripheral arterial disease 

 

-knee arthritis (genicular artery embolization) 

 

-leg ulcers 

 

-chronic leg swelling 

 

-lymphedema

 

If you experience any vein disease symptoms, please call our office at (858)-550-0330 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 

 

For more information on vein health mentioned in our Fox 5 segment please check out our Youtube Channel or visit our helpful guide of resources. 

 

La Jolla Vein & Vascular Featured in a Fox 5 Segment2022-12-13T13:25:29-08:00

What you need to know about compression stockings

2022-07-20T13:10:20-07:00

At La Jolla Vein and Vascular, we suggest patients use compression stockings for better vein health. There are a few different types to choose from listed below. But first, knowing the benefits of using compression stockings for your vein health empowers you to decide with your physician which type is best for you. 

Benefits of compression stockings for vein and vascular health: 

  1. Wearing compression stockings or socks places pressure on the veins in the lower legs.
  2. The pressure helps improve blood flow
  3. The pressure helps prevent further spider veins and varicose veins
  4. Compression stockings also relieve leg swelling
  5. Reduces the risk of blood clots in the legs

 

Anti-embolism stockings, also known as TED hoses, are designed specifically for non-mobile patients or those confined to a bed. These are the white stockings used for hospital patients. They are low-cost temporary solutions commonly used for patients in nursing homes and post-surgery to prevent deep vein thrombosis (DVT).

 

Graduated compression therapy provides external support to the vein walls and works in conjunction with the calf muscle pump. Compression stockings improve circulation while helping to minimize and control leg and ankle swelling.

However, for ambulatory (walking patients who are not bed-bound), TED hoses do not offer sufficient support to counter the effects of gravity.  They have not graduated compression and only offer about 8-18mmhg compression. TED hose does not help the symptoms of venous disease and varicose veins. TED hose cannot be used for vein treatment and should not be used for daily support in walking patients.

In comparison, graduated compression stockings are medically therapeutic and designed for people who are mobile. Graduated compression means that they are tightest around the ankle and gradually ease as they go up. These can help reduce the risk of DVT in patients who travel by plane or car and reduce symptoms such as leg swelling (edema), aching, heaviness, fatigue, pain from varicose veins, and useful for pregnant women to reduce pain from varicose veins.

 

 For more information and to book a consultation, please give our office a call at 858-550-0330. 

 

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

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

What you need to know about compression stockings2022-07-20T13:10:20-07:00

Tips to reduce discomfort from varicose veins

2022-07-19T18:14:43-07:00

How To Reduce Discomfort From Varicose Veins:

Varicose and spider veins may be treated with lifestyle changes or medical procedures.

The goals of treatment are to relieve symptoms, prevent complications, and for some to improve appearance.  Lifestyle changes can ease the symptoms but do not cause the veins to vanish.  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.
  • 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.
  • Weight loss or maintaining a healthy weight: Being overweight puts extra pressure on your veins.
  • 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.
  • 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. Over-the-counter support hose or TED hose are not adequate to reduce symptoms in venous disease for active patients.
  • Supplements such as horse chestnut and grape seed extract can help reduce symptoms of venous disease
  • Anti-inflammatory medications such as ibuprofen
  • ice packs can be applied to veins that are tender to reduce inflammation

 For more information and to book a consultation, please give our office a call at 858-550-0330. 

 

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

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

Tips to reduce discomfort from varicose veins2022-07-19T18:14:43-07:00

What you need to know about leg ulcers

2022-07-19T18:05:28-07:00

A leg ulceration is the most severe form of chronic venous insufficiency.  This is referred to as a ‘venous leg ulcer.’  Venous leg ulcers make up 70% of all chronic leg wounds.  Therefore, a venous leg ulcer is much more common than a diabetic or arterial ulcer.  It is caused by long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination.  Venous reflux is the most common cause of a venous leg ulcer.  The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest).  The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually, the skin will break open.  The leg wound can be healed by treating the underlying vein condition.  Venous leg ulcers can also be prevented by early intervention with non-invasive procedures.  If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

 

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is an inflammatory condition caused by long standing, untreated venous reflux disease.  Commonly, venous reflux disease causes a collection of symptoms such as leg swelling, heaviness, fatigue and varicose veins. But, over time, when blood is no longer circulating properly in the leg veins, skin changes can also appear. When skin changes appear, this is termed, chronic venous insufficiency (CVI). Venous stasis is another term used for this condition.   Chronic inflammation from CVI causes the skin around the ankles to darken, become dry, itchy, and firm. In severe cases, the skin can start to break down and ulcerate. The ulcer (wound) occurs in the inner or outer ankle and is also referred to as a stasis ulcer or venous ulcer.

Venous stasis skin changes associated with venous insufficiency include:

  • Darkening of the skin along the ankles
  • Itching and dry skin around the ankles (venous eczema)
  • Development of wounds around the ankles, called venous leg ulcers

How are leg ulcers treated? 

Venous leg ulcers, depending on the severity, can be healed with a combination of correction of the underlying venous reflux, wound care clinic referral, and compression therapy. A detailed ultrasound will determine what specific treatment is needed depending on where the underlying reflux lies (for example, in the saphenous veins, perforator veins and tributaries). Deep vein reflux is also present in many individuals with ulcers.

 

 

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

 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

 

What you need to know about leg ulcers2022-07-19T18:05:28-07:00

Swelling & Varicose Veins

2022-07-19T17:52:04-07:00

Complications of Untreated Varicose Veins and Venous Insufficiency: Swelling of the Ankles/legs

 

Leg swelling (swelling is also known as edema), is a common complaint related to varicose veins and underlying venous insufficiency. Leg swelling can be present simply from underlying venous insufficiency without visible signs of varicose veins or spider veins. As a result, a venous insufficiency study by duplex ultrasound scanning is part of the recommended work-up. 

 

The Duplex Ultrasound involves using high frequency sound waves to look at the speed of blood flow, and structure of the blood vessels. The term “duplex” refers to the fact that two modes of ultrasound are used, Doppler and B-mode. The B-mode transducer obtains an image of the vessel being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.

 

This usually usually affects the ankles. Most people with vein-related experience progressive swelling throughout the day, that is worse at night time and improved in the morning (they usually wake up with normal appearing legs in the morning but by night-time, shoes may feel tight.) Vein-related swelling is worse at the end of the day, with prolonged standing, sitting or with air travel, heat and menstruation. The degree of swelling varies from one person to another.

 

It is a common symptom of varicose veins and venous insufficiency. The legs often feel heavy. It is common to notice sock lines around the ankles by the end of the day.

 

Compression stockings and leg elevation will help reduce swelling. If the swelling can be attributed to the varicose veins or venous insufficiency, correction of the underlying vein problem will reduce swelling.

 

For more information check out our website resources and to book a consultation, please give our office a call at 858-550-0330. 

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

 

Swelling & Varicose Veins2022-07-19T17:52:04-07:00

Hemorrhages & Varicose Veins

2022-07-19T17:31:08-07:00

Complications of Untreated Varicose Veins: Bleeding or Hemorrhage Caused by Vein Rupture

 

Untreated varicose veins are at a higher than usual risk of bleeding or spontaneous rupture, hemorrhage. Over time, varicose veins become larger, and the vein wall becomes weak and stretched out. These veins, which are already weak, are also under high pressure (because of venous reflux, or the ‘backflow’ and pooling of blood in these veins). As a result, the high pressure can cause the veins to spontaneously burst and bleed heavily. Because they are under high pressure, they bleed like an arterial bleed and patients describe the bleeding as ‘blood shooting across the room.’  

 

The varicose veins that are susceptible are veins closest to the surface of the skin.

Most patients describe that it occurs during or after a warm shower (warm water causes veins to relax and dilate, allowing more blood to pool within the veins) or during sleep. It is painless and patients report that they notice it because they feel something wet in bed.  Patients who are on blood thinners can lose large amounts of blood, especially if it occurs while they are sleeping. Some people have required blood transfusions. The small blue spider veins around the ankle are equally at risk of rupture as are the larger bulging veins.

hemorrhage

This is a patient who experienced spontaneous hemorrhage of their varicose veins. Notice the appearance of the blue, bulging veins that we describe as, ‘blue blebs.’ These veins are dilated, weak, and are close to the surface of the skin. The pooling blood within these veins causes high pressure, ultimately resulting in a spontaneous rupture or hemorrhage. The bleeding is rapid since varicose veins are under high pressure.  This is a common condition that we see at La Jolla Vein Care.

 

If someone you know has experienced bleeding from their varicose veins, they should be seen by a doctor. Treatment will prevent the veins from bursting again. This is a common condition that we see at La Jolla Vein Care.

 

For more information and to book a consultation, please give our office a call at 858-550-0330. 

 

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

 

Hemorrhages & Varicose Veins2022-07-19T17:31:08-07:00

Cellulitis & Varicose Veins

2022-07-19T17:21:50-07:00

Complications of Untreated Varicose Veins and Venous Insufficiency: Cellulitis

Cellulitis is a bacterial infection of the skin and tissues beneath the skin. Cellulitis infections can occur in the legs of people with untreated varicose veins and chronic venous insufficiency.  The reason for this is chronic venous insufficiency-which causes inflammation within the skin and underlying tissues. This inflammatory process causes the skin to become firm, eczema-like, dry, itchy, and fragile. Healthy skin acts as a barrier to bacteria, preventing infections. But, in chronic venous insufficiency, the skin is fragile and this barrier is susceptible to bacterial infections that can enter the tissues through cracks or breakages within the skin.  In chronic venous insufficiency, the skin around the ankles is most affected and infections can begin here.

Cellulitis usually begins as a small area of pain and redness on the skin. This area spreads to surrounding tissues, resulting in the typical signs of inflammation such as redness, swelling, warmth, and pain. Fever and chills may develop and the redness will spread affecting more of the leg. It is treated with antibiotics. If you believe you have signs of cellulitis, you need to contact your doctor right away as untreated cellulitis can spread rapidly.

This complication can be avoided by treating the varicose veins and eliminating underlying venous insufficiency, which will, in turn, reduce inflammation and improve the skin condition. 

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

Practicing good skin hygiene is important. Keep your skin moisturized so that it doesn’t flake or crack easily. If the skin is not broken or leaking fluid but is inflamed, your doctor may recommend an anti-itch cream, such as one containing hydrocortisone; a cream containing zinc oxide to protect the skin; or an antifungal cream to prevent fungal infections.

Skin that is leaking fluid is treated with wet compresses. If you have ulcers on your legs, we at La Jolla Vein & Vascular will show you how to apply layered compression bandages to protect the skin and maintain blood flow.

 For more information and to book a consultation, please give our office a call at 858-550-0330. 

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

Cellulitis & Varicose Veins2022-07-19T17:21:50-07:00

27, 7, 2022

How to know your reflux disease is worsening over time

2022-12-13T13:40:13-08:00

Venous Reflux Disease is progressive and worsens over time.

Unfortunately, venous reflux 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 reflux disease. Stage 6 is the open leg wound, known as a venous leg ulcer.

Stage 1. Healthy Veins, Stage 2. Spider Veins

Stage 3. reticular veins and varicose veins

Stage 4. Venous Nodes – Edema venous insufficiency

Stage 5. Chronic insufficiency

Stage 6. Venous eczema and venous leg ulcer

If you experience any vein disease symptoms, please call our office at (858)-550-0330 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 

 

For more information on vein health please check out our Youtube Channel or visit our helpful guide of resources on our website. 

 

How to know your reflux disease is worsening over time2022-12-13T13:40:13-08:00

Vein Health & Your Nutrition

2022-06-25T17:32:08-07:00

One’s vein health and nutrition is very important. One contributing factor that can influence your vein health is through your diet and what foods you consume on a daily basis. There are nutrient dense foods that help contribute to your health. For vein health specifically, foods that are rich in flavonoids may improve symptoms of venous disease. Flavonoids help protect plants from environmental toxins and help repair damage. They can be found in a variety of foods, such as fruits and vegetables. When we eat foods rich in flavonoids, it appears that we also benefit from this “antioxidant” power. It’s important to include in your daily nutrition foods that have antioxidants. 

 

In addition to having antioxidant qualities, research shows that flavonoids have other potential influences on vascular health, such as lowering blood pressure, improving blood flow to the brain and heart, and making blood platelets less sticky and able to clot.Flavonoids are also well known for their ‘venoactive’ effects on the blood vessels and have been proven to reduce symptoms of venous disease such as leg aching, heaviness and swelling.

Foods that are flavonoid rich include cocoa and chocolate, bell peppers, spinach, broccoli, grapes, blueberries, cranberries, apples, peanuts, onions, garlic, tea and red wine.

Besides improving your nutrition for your vein health, remind the cook to use compression socks- long hours of standing in the kitchen can cause leg fatigue, heaviness and swelling and eventually be a sign of venous disease. 

If you experience any vein disease symptoms, please call our office at (858)-434-5998 to schedule a consultation with one of our knowledgeable doctors at La Jolla Vein and Vascular. 

 

For more information on vein health please check out our Youtube Channel or visit our helpful guide of resources

 

Vein Health & Your Nutrition2022-06-25T17:32:08-07:00

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