15, 6, 2022

Causes of Osteoarthritis

2022-05-13T17:16:22-07:00

Causes Of Osteoarthritis (OA)

 

Although Knee Osteoarthritis affects as many as 45 percent of people in their lifetime, the exact cause is unknown. However, medical practitioners have discovered several risks that increase the chances of developing knee osteoarthritis. These include:

Advanced Age

Obesity

Joint Trauma

Family History

Congenital Disabilities or Illnesses

Chronic Injury and Joint Stress

Lack of Exercise

Poor Muscle Tone

Female Sex

 

Advanced Age

Your susceptibility to developing osteoarthritis increases with age. As you grow old, the cartilage in the knee joint wears down, making it prone to damage and thinning. According to research done by the Arthritis Foundation, about 19 percent of people over 45 years have knee OA. The research further indicates that 37 percent of people over 60 years have the condition, although not all will have the symptoms.

 

Obesity

The knees support the weight from the thighs upwards. Obese people are at two times more risk of developing knee arthritis than individuals who are not.

 

Joint Trauma

Surgery, a broken bone, or severe injuries that affect the knee joint can also lead to knee osteoarthritis. These symptoms may not be present immediately after the injuries but may reveal years later.

 

Family History

Hereditary genes also play a crucial role in the susceptibility of knee arthritis. For instance, if your mother had knee OA, you are more likely to develop the condition than people with no family history of the condition are.

 

Congenital Disabilities or Illnesses

Septic arthritis, gout, poor bone alignment, congenital conditions, and metabolic disorder can also increase your susceptibility to contracting knee arthritis.

 

Chronic Injury and Joint Stress

Individuals whose daily activities involve heavy lifting while standing, crawling, or squatting tend to experience mini-traumas. These mini traumas can lead to knee osteoarthritis over time—bodybuilders and other athletes who participate in high-impact sports are prone to knee osteoarthritis development.

 

Lack of Exercise

Although putting too much stress on your knee joint can lead to arthritis, lack of exercise can also cause OA. Exercise helps in boosting the cartilage’s health and repair. Additionally, the knee joints contain fluid-rich nutrients that need to be circulated in the knee joint capsule. Regular exercise promotes proper circulation of the joint fluid.

 

Poor Muscle Tone

Poor hamstring, calf, and quadriceps muscle development can put more stress on the knee’s bones and cartilage, causing knee osteoarthritis.

 

Female Sex

Research shows that women are about 40 percent more likely to develop knee arthritis than men are.

 

 So, if this is you and you’ve been experiencing pain, please give our office a call at 858-550-0330. 

 

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

 

Causes of Osteoarthritis2022-05-13T17:16:22-07:00

Signs of Osteoarthritis

2022-05-30T13:29:11-07:00

For most people, the knee osteoarthritis symptoms come and go, worsening over time. While it is easy to dismiss early knee OA signs and symptoms, the symptoms become worse if left untreated, causing mobility issues. 

 

Some of the common OA signs and symptoms include:

 

Knee Pain: Knee pain is the most reported OA symptom. The pain description often varies from one person to the other depending on their condition and situation. Sometimes the pain may come and go, while the person may experience chronic low levels of pain with intermittent intense pain flare-ups. On the other hand, you may experience a dull, aching. Most often, knee OA pain gets worse, especially when doing activities that put a strain on the knee, such as walking upstairs or squatting.

 

Swelling: Damaged cartilage causes the femur and tibia bones to rub together, leading to irritation. The irritation forces the body to produce excess fluid at the joint, making the knee swell.

 

Stiffness: The swelling and friction in the knee make the joint stiff. You may often experience 30 minutes of stiffness after sitting for an extended period or early in the morning. Knee stiffness can also be accompanied by reduced motion range and visible swelling.

 

Redness and Warmth: The irritation develops when the knee joint’s bones rub each other causing the skin over the knee to become warm and red. These signs could also indicate an infection that requires medical attention.

 

Reduced Range of Motion: The swelling in the knee limits your range of motion. Mild to moderate knee OA makes it hard for you to bend or straighten the knee completely.

Worsening Symptoms with Inactivity

Your knees tend to become stiff after long periods of sitting or sleeping. In most cases, you will notice pain and stiffness after waking up in the morning or sitting for long hours.

 

Popping or Crunching: A popping or crunching sound when bending your knee indicates knee joint friction.

 

Buckling or Locking Up: People with moderate to severe knee OA can also cause a sensation of knee-buckling. The sensation develops when there are uneven flaps or grooves, or cartilage breaks off and sticks in the joint.

 

 So, if this is you and you’ve been experiencing  osteoarthritis pain, please give our office a call at 858-550-0330. 

 

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

 

Signs of Osteoarthritis2022-05-30T13:29:11-07:00

20, 5, 2022

Signs and Symptoms of Varicoceles

2022-04-29T16:45:32-07:00

 

 

What are Varicoceles? 

A varicocele is a term used to describe abnormal enlargement of the veins within the scrotum. The veins carry blood from the various body organs back to the heart. Typically, veins have valves that prevent blood backflow. When the valves in the veins within the scrotum don’t work as they should, blood tends to collect in the scrotum.

Signs and Symptoms of Varicoceles

Most often, Varicoceles have no symptoms or signs. As mentioned earlier, you will barely notice it. However, although rarely, the condition might cause pain. When it does cause pain, it might;

  • Switch from a sharp to a dull discomfort
  • Become worse over the day
  • Increase when due to physical exertion or standing for extended periods
  • Pain that goes away when you lie on your back
  • Impaired infertility

Over time, varicoceles may become more enlarged and become noticeable. Varicoceles are often described as looking like a “bag of worms” sometimes, the condition may also cause a swollen testicle, most often on the left side.

 

When Should You Seek a Doctor?

 

Since symptoms do not accompany varicocele, it often does not require treatment. In some cases, varicoceles are discovered during a fertility evaluation. However, you should see a doctor if you notice any of the following.

  • Pain or swelling in the scrotum
  • Discover a mass on the scrotum
  • You are having a problem with your fertility
  • When you notice that one of your testicles is larger than the other

 

For more information on vein and vascular treatment please visit our YouTube Channel.

Signs and Symptoms of Varicoceles2022-04-29T16:45:32-07:00

What are Non Healing Ulcers & Wounds?

2022-04-28T17:17:13-07:00

Non-Healing Ulcers &  Wounds

 

We might all be familiar with non healing ulcers & wounds in a general manner, but certain types of ulcers behave quite differently due to various contributing factors. These are non healing ulcers or non healing wounds, and if not treated with care and in good time, such wounds can pose a serious risk to the patient’s health. Severe cases may lead to amputation of the affected limbs or loss of life in the most extreme circumstances. The nonhealing ulcers cases we treat here at La Jolla Vein & Vascular fall under peripheral arterial disease (PAD) and a subcategory of arterial disease.

Non-healing wounds or ulcers do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

foot ulcer

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non-healing ulcers, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

 

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

 

Pressure Ulcers

 

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

 

Diabetic Ulcers

 

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The high amputation rate among diabetics is attributable, in part, to the neuropathic effects of the ailment. Neuropathy leads to a lack of pain perception in the affected individual, meaning that they may be entirely unaware of minor wounds on their feet and legs in good time, allowing for their infection or repeat injury. It is also made more likely by the immunosuppressive effects of the condition, which makes the patient more vulnerable to infection.

foot ulcer2

What are Non Healing Ulcers & Wounds?2022-04-28T17:17:13-07:00

22, 4, 2022

A deeper look into chronic venous insufficiency

2022-04-15T15:36:06-07:00

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

 

Chronic Venous Insufficiency is progressive and worsens over time.

Chronic Venous Insufficiency is also known as venous stasis, 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. 

 

A deeper look into chronic venous insufficiency2022-04-15T15:36:06-07:00

Varicose Veins Before & After: Patient Transformations Part 1

2022-04-15T15:34:00-07:00

What are varicose veins?

varicose

Varicose veins are the twisted, bulging veins just beneath the surface of the skin. Varicose veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs, but they also can form in other parts of the body.

Varicose veins are caused by leaky vein valves, which allow blood to pool within the veins causing them to stretch and become enlarged. Varicose veins can be an isolated finding, but the majority of the time, they are caused by underlying venous reflux disease. Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence. Reflux may occur in the deep and/or superficial leg veins.

In our study, led by Dr. Nisha Bunke and published in the Journal of Vascular Ultrasound in 2018, we studied over 1,000 legs with this vein disease. Over 90% of the time, the source of the varicose veins were the great and small saphenous veins. The Great Saphenous Vein (GSV) courses up the middle of the thigh and calf and the small saphenous vein (SSV), which courses along 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. 

La Jolla Vein Care Before and After Transformations:

 

At La Jolla Vein Care, we are here for our patients from beginning to the end. We love seeing the transformations that take place. Below are a few cases from our patient transformations from before varicose vein treatment to after treatment.

pt1

pt2

pt3

 

Varicose Veins Before & After: Patient Transformations Part 12022-04-15T15:34:00-07:00

Spider Veins Before and After Patient Transformation

2022-04-13T11:56:42-07:00

What are spider veins?

They are the fine, thread-like reddish veins at the surface of the skin, and are often considered a cosmetic issue, but they can be associated with underlying feeder veins, not visible to the naked eye.  Feeder veins are the ‘blue veins’ also known as ‘reticular veins,’ that give rise to spider veins. They may also be a sign of underlying venous insufficiency. For example, they are usually located in the inner ankles and inner thighs can indicate an underlying problem with the saphenous vein. As a result, an ultrasound examination may be recommended to identify and effectively treat the underlying source.

What are the symptoms?

Vein conditions affect people differently. For some, they can be a painless cosmetic concern, and for others they may cause symptoms. The most common symptoms are burning, throbbing, and localized pain. They can also feel hot and itchy and bleed.

What are the causes?

They are caused by the same condition that causes varicose veins. Leaky vein valves allow blood to pool within the veins causing them to stretch and become enlarged. Spider veins on other areas of the body, such as the face, and chest can be caused by sun damage, hormone changes or liver disease. Hormones, such as with pregnancy, birth control or hormone replacement therapy can weaken the vein wall.

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.

 

Below are La Jolla Vein Care patient transformations before and after vein treatment for spider veins. 

spider veins

spiderveins2

spider veins

Spider Veins Before and After Patient Transformation2022-04-13T11:56:42-07:00

30, 3, 2022

What is Carotid Artery Disease?

2022-03-30T16:49:46-07:00

What is carotid artery disease? 

Your carotid arteries are two main arteries that carry blood from your heart, up through your neck, to your brain. Healthy carotid arteries are smooth and unobstructed, allowing blood to flow freely to the brain and provide oxygen, glucose and other nutrients that your brain cells need. Carotid artery disease is a vascular disease.

Typically with age, the carotid arteries build up plaque, made up mostly of fat and cholesterol. Plaque narrows the insides of the arteries and makes them stiff. This process is commonly referred to as “hardening of the arteries,” or atherosclerosis. Carotid artery disease results when the carotid arteries become narrow or obstructed and provide a risk of the plaque traveling to the brain and causing a stroke.

What is a stroke?

Strokes are the third leading cause of death in the United States and the leading cause of perma- nent disability in older Healthy Plaque Build Up adults. Approximately 25% of strokes occur when bits of carotid plaque or clot break off and flow to the brain. If left untreated, carotid artery disease may lead to stroke, where lack of oxygen and other essential nutrients cause damage to the brain. Depending on its severity, a stroke can be fatal.

Symptoms of carotid artery disease: 

  • There may be no symptoms in the early stages of carotid artery disease, and stroke could be the first sign of the condition.
  • Stroke, however, typically has warning signs, referred to as mini-strokes or transient ischemic attacks (TIAs).
  • Mini-stroke symptoms are usually temporary, lasting a few minutes to a few hours, and should be treated as serious medical emergencies requiring immediate treatment because they are strong predictors of future stroke.

Some symptoms of stroke or TIA may include:

– Weakness, numbness, or tingling on one side of the body

– Inability to control movement of a body part

– Loss of vision or blurred vision in one or both eyes

– Inability to speak clearly

– Difficulty talking or comprehending what others are saying

Causes and risk factors of carotid disease:

  • High blood pressure and age
  • Diabetes
  • Smoking
  • High cholesterol and obesity
  • Lack of exercise
  • Family history of hardening of the arteries and/or stroke

Diagnosis of carotid artery disease: 

If your doctor suspects carotid artery disease, it can be confirmed by undergoing a noninvasive duplex ultrasound examination. The ultrasound can also show how severe the disease is. If you experience symptoms of a mini-stroke, seek medical attention immediately. Your physician may then ask you to see a vascular specialist since they are highly trained in every type of vascular procedure.

 

Treatment:

Depending on the severity of your condition, treatment options may include lifestyle changes, medications, or procedures such as carotid endarterectomy (cleaning out the plaque with surgery), or in select cases, carotid artery stenting. Some patients benefit from surgery even if they are having no symptoms based upon life expectancy and degree of narrowing.

 

What is Carotid Artery Disease?2022-03-30T16:49:46-07:00

What is Peripheral Arterial Disease?

2022-03-29T11:41:41-07:00

What is Peripheral Arterial Disease?

You probably are familiar with the terms angina and heart attack, which are related to a blockage of blood flow to the heart. That same sort of blockage can occur elsewhere in the body, depriving the limbs (the peripheral parts of the body) of oxygen and nutrients. Left untreated, the disease can lead to amputation.

Healthy peripheral arteries are smooth and unobstructed, allowing blood to freely provide the legs with oxygen, glucose and other nutrients. As we age, peripheral arteries build up plaque, a sticky substance made up mostly of fat and cholesterol. Plaque narrows the passageway within the arteries and causes them to become stiff, which then leads into peripheral arterial disease. 

A moderate blockage in one of arteries in a major leg muscle, such as the calf or thigh, can cause pain when walking.This pain can be temporarily decreased with rest, but will act up again with more walking or activity.

Lower extremity pain, similar to angina, is called claudication by medical providers. The pain itself is not limb-threatening but it is a sign that the person should make lifestyle changes and see a doctor. 

Examples of possible treatments for peripheral arterial disease include: 

  • Smoking cessation 
  • Daily exercise
  • Medical management

If the disease becomes more severe, the limb can be starved of basic nutrients and the patient begins to suffer pain at rest (especially at night). Sores that won’t heal may develop on the feet. This is a very concerning sign for losing toes or even amputation of the leg. An urgent referral to a vascular surgeon is necessary to prevent limb loss in this situation.

Causes and risk factors of Peripheral Arterial Disease:

  • Age
  • Gender—males are more prone to the condition than females
  • Hypertension (high blood pressure) 
  • Diabetes
  • Smoking
  • High cholesterol
  • Obesity
  • Lack of exercise
  • Family history of vascular problems

Leg pain does not always indicate PAD, but older patients, especially those who are at risk, should see a physician. A simple, noninvasive ultrasound and leg blood pressure examination can diagnose peripheral arterial disease and determine its severity.

If you experience symptoms of peripheral arterial disease, ask your primary care physician to refer you to a vascular surgeon. Vascular surgeons can perform any necessary treatments, including medication management, minimally invasive endovascular angioplasty and stent procedures, and open bypass surgery.

 

Treatment for Peripheral Arterial Disease:

Depending on the severity of your condition, treatment options may include lifestyle changes, medications, minimally invasive angioplasty/stenting, or open bypass surgery.

 

What is Peripheral Arterial Disease?2022-03-29T11:41:41-07:00

The Best Way to Treat Reticular Veins

2022-03-17T10:17:12-07:00

The best treatment for Reticular Veins is through a painless alternative to traditional sclerotherapy: Cryo-Sclerotherapy.

Why have I been offered cryo-sclerotherapy?

 

We recommend patients undergo cry-sclerotherapy to mainly treat spider veins and small varicose veins at the skin surface (also known as reticular veins). Traditional sclerotherapy involves injection of a medication into the vein using a tiny needle. This causes the vein to collapse and eventually fade away. The medication will be administered in a liquid and /or foam formulation, depending on the size of the veins. Cryo-sclerotherapy is the combination of traditional sclerotherapy in combination with the use of a cryo device. The cryo device delivers puffs of cold air simultaneously during sclerotherapy. The result  is the cold air anesthetizes the skin so the treatment is relatively painless. This is especially helpful for treatment of sensitive areas like the inner ankles and thighs. Instead of feeling the needle prick, you will feel puffs of cold air instead. The cold air may also reduce bruising and pain. 

 

What should I expect on my treatment days? 

 

You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol. The sclerosant medication will then be injected into your veins with a fine needle. Just before the needle is used, you will feel puffs of cold air. The cold air will anesthetize the skin, so that the prick from the needle is not felt or lessened. Every time the needle is used, you will feel puffs of cold air instead. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car. It is normal for your legs to be achy and tender to the touch after treatment. 

 

What should I do after treatment?

 

You will be instructed on how long to wear compression stockings after treatment, depending on the size of the veins that are treated. Most patients wear thigh-high compression stockings continuously for 1-3 days, then another 7 days. 

 

You may shower with the stockings on or take a quick cool shower with them off. 

 

You should walk 30 minutes twice daily after treatment and move your legs frequently throughout the day with short walks and/or calf exercises. This avoids pooling of blood in the legs. Avoid prolonged sitting during the day. 

 

It is normal to have aching in the treated veins. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve). 

 

What should I avoid after treatment? 

 

For at least two weeks after treatment, you should avoid strenuous exercise (anything more than a brisk walk), heavy lifting, saunas or hot tubs, and leg massages. All of these dilate the superficial veins and interfere with their healing. You should also avoid airline travel for two weeks after treatment. 

 

What are the possible side effects? 

 

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. 

 

The skin overlying treated veins may also develop brownish hyperpigmentation as the blood products within those veins are absorbed by the body; in some patients it can take up to a year to fade. Some patients temporarily develop some very fine, pink spider veins in areas where veins have been treated (telangiectatic matting). These usually resolve spontaneously over several weeks but occasionally require additional treatment to clear. 

 

Many patients will feel their veins look a bit worse in the first month after sclerotherapy, but through the best treatment for reticular veins, cryo-sclerotherapy, patients have reported it to be a more painless approach for treatment.  

 

The Best Way to Treat Reticular Veins2022-03-17T10:17:12-07:00

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