2, 9, 2022

Flying after vein treatment

2022-08-18T16:01:37-07:00

Patients traveling and flying from different states or countries to seek treatment at La Jolla Vein & Vascular can return to the air within 24-hours after the procedure (although it’s understandable if the stay is extended to take in the beautiful sights of San Diego). Although a patient can easily resume most day-to-day activities right after treatment, it’s recommended to avoid air travel for the first 24-hours. Once in the air, however, it’s important to wear the prescribed compression stockings and work on increasing the circulation in your legs. To do this, please make sure to pump the calf muscles regularly and get up from your chair every two hours. It’s the best way to facilitate healing in the air—and it’s a sure fire way to avoid economy class syndrome.

There are risks of flying after vein treatment that you need to know about. 

Factors that influence the risks after vein treatment include: 

  • The length of the flight
  • How soon after treatment
  • The type of vein procedure

For flying longer than 4 hours:

If patients have been treated with endovenous laser ablation (EVLA) or ultrasound guided sclerotherapy (UGS), there is an increased risk in development of in-flight deep vein thrombosis (DVT, a leg blood clot). 

If patients have had varicose veins treated, the risk of deep vein thrombosis increases when flying on long-haul flights. 

Although waiting to fly long distances for 3-4 weeks is ideal, sometimes there is no choice. If it cannot be avoided, here are some preventative measures to follow.

1.Wear compression stockings or compression socks: wearing compression helps support consistent blood flow, prevents blood settling in the lower legs because of gravity, and improves lymphatic drainage preventing swelling.

2.Keep moving: Movement is key. It helps contract the calf muscle which helps to move blood around the legs.

3.Hydrate well: Drink water and avoid alcohol (which causes dehydration).

4.Blood thinners: Patients at a particularly high risk of DVT may be prescribed and be taking blood thinners.

5.Most importantly, if you have any questions or concerns to discuss about flying during this time, please contact our office, so you can both be well informed and prepared.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

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. 

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. 

Flying after vein treatment2022-08-18T16:01:37-07:00

12, 8, 2022

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

25, 7, 2022

Improving your vein health through exercise

2022-12-13T14:12:46-08:00

Physical activity and exercise provides a wide range of benefits for vascular health and may help to avoid evolution of mild cases of varicose veins. In fact, exercise is considered to be a fundamental element in improving the symptomatology of patients affected by varicose veins. A sedentary person diagnosed with this medical condition has a much higher risk of worsening the symptoms when compared with an active person with the same condition. This is a result of blood pooling in the veins, causing an increase in venous hypertension and symptoms.

The main goal of exercise in regards to varicose veins is to contract and move the muscles of the leg, helping to pump the blood upwards, avoiding edema or retention of liquid in the ankles. With this in mind, the recommended exercises are those with aerobic characteristics rather than those with anaerobic ones. Through this physical activity, the pressure in the veins is improved, as well as the resulting symptomatology.

Therefore, any exercise that involves moving the lower limbs and promote cyclical muscle contractions is advisable, including stand on tiptoes, move the toes, perform foot bending and rotation, do pedaling movements, among others. These can be easily performed throughout the day without the necessity to go out and exercise, and are especially useful during work hours or while doing daily tasks at home.

When walking or running, pressure is exerted on the sole of the foot, which causes the circulation to be activated from the bottom up, while the constant contraction of the muscles during cycling causes the same effect, but without the presence of high impact, an important factor for those with joint issues.

Swimming is one of the best exercises to practice when affected by varicose veins. The double effect of the water and the movement of the lower limbs cause an incredible increase in blood circulation. This is helpful also for patients who have significant symptoms related to the effects of gravity, like standing.

Other disciplines like yoga, pilates, or rhythmic gymnastics also help stimulate circulation by mobilizing the accumulated blood in the thighs, while relaxing the whole body.

Hiking is a great activity for using the calf-muscle pump. However, in warm weather, symptoms of varicose veins worsen. To get the maximal benefit of exercise and reducing symptoms, outdoor exercising when the weather is cooler, like in the morning is advised.

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

Improving your vein health through exercise2022-12-13T14:12:46-08:00

The Truth About Restless Leg Syndrome

2022-12-13T13:57:28-08:00

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

Those who suffer from varicose veins often report a feeling of restless leg syndrome, 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.

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

 

The Truth About Restless Leg Syndrome2022-12-13T13:57:28-08:00

5, 4, 2022

How Cholesterol Affects Your Vascular Health

2022-04-05T12:23:27-07:00

How cholesterol affects your vascular health

When it comes to vascular disease, cholesterol is enemy number one. Cholesterol is a waxy, fat-like substance found in the walls of human cells. The human body produces cholesterol but it also comes from foods that are high in animal fats such as eggs, cheese and meat.

But all cholesterol is not created equal. It comes in two very different types:

  • Good cholesterol, or high-density lipoprotein (HDL), helps keep arteries from becoming blocked.
  • Bad cholesterol, or low-density lipoprotein (LDL) can build up and cause blockages in the arteries.

Triglycerides are fats produced by the liver. They can cause the same kinds of health problems as LDL. Over time, a buildup of extra cholesterol, or plaque, can narrow the insides of blood vessels. Eventually, the plaque causes hardening of the arteries, also called atherosclerosis. This condition can lead to vascular disease, strokes, heart attacks, aneurysms and other life-threatening problems.

When doctors tell you to “know your numbers,” one of those numbers is your cholesterol level. For good vascular health:

  • Total cholesterol should be less than 200.
  • Good cholesterol (HDL) should be more than 60. 
  • Bad cholesterol (LDL) should be less than 130.
  • Triglycerides should be less than 150.

Why take statins for cholesterol control?

All types of atherosclerosis are improved when patients take statins.

Side effects are relatively rare, and if a patient does not tolerate one statin, there are many different ones that can be tried.

What are statins?

Statins act as a key control point in the metabolism of serum cholesterol.

Specifically, when “bad” (LDL) cholesterol is high, the risk of heart attack and stroke is high.

Can lifestyle changes impact cholesterol levels?

Yes. Even slight lifestyle choices can impact vascular disease. For example, a 10-pound weight loss can result in a 5 to 8 percent reduction in LDL.

If lifestyle changes are not enough to bring your numbers to a healthy level, medication may help. Total cholesterol levels that are borderline high (between 150-199 mg /dL) or high (200 mg / dL or more) may require treatment with a statin drug. Some conditions actually benefit from a statin even if your numbers are normal.

Who benefits from taking statins?

  • People who are at risk of heart attack and stroke due to high cholesterol
  • Patients with hardening of the arteries supplying oxygen-rich blood to the brain or the legs
  • Vascular surgery patients. During a vascular procedure, they have fewer complications

Do statins affect plaque in the blood vessels?

Newer research suggests that statins don’t just stop plaque from getting worse, they may also reduce plaque in the leg arteries. Studies also now suggest that statins keep plaque stable so it is less likely to break off and form blood clots that cause heart attacks and strokes. Statins also improve the function of cells inside of the artery.

Don’t statins have side effects?

Few statin side effects have been recorded since they were introduced 40 years ago. Most mild side effects, such as muscle pain and cramps, can be avoided by switching statins. Serious side effects are rare but it is important to be aware of them. They include:

  • Liver damage. This very rare condition doesn’t cause symptoms, so laboratory tests are ordered when patients first start taking statins.
  • A wide range of muscle injuries. In rare cases, inflammation of the muscles can occur. At its worst, this rapid muscle destruction can lead to kidney failure.

 

How Cholesterol Affects Your Vascular Health2022-04-05T12:23:27-07:00

28, 3, 2022

Asclera: A New Treatment For Spider Veins and Small Varicose Veins

2022-12-13T13:26:40-08:00

What is polidocanol (Asclera)?

A variety of sclerosant medications can be used for veins, but at La Jolla Vein Care, we prefer polidocanol (brand name Asclera), because it is the most comfortable for the patient and has the lowest risk of side effects. It is a detergent-type medication that injures the inner lining of the veins. This causes the vein to stop flowing, then eventually close down completely. Polidocanol has been well-studied and has been approved by the FDA since 2010 for the treatment of varicose veins and has been used in Europe for decades. Polidocanol is turned into a foam to treat larger veins. This is an off-label use of the sclerosant but very effective and well tolerated. Asclera (polidocanol) Injection is a prescription medicine that is used in a procedure called sclerotherapy to remove unwanted veins on your legs. It is administered by a healthcare provider to treat two types of veins:

Uncomplicated spider veins (very small varicose veins ≤ 1 mm in diameter)
Uncomplicated small varicose veins (1 to 3 mm in diameter) known as reticular veins
Asclera has not been studied in varicose veins more than 3 mm in diameter. La Jolla Vein Care providers have extensive experience with foam sclerotherapy.

Patient Results before and after at 26 weeks after last treatment

asclerabeforeascleraafter

The patient was treated for uncomplicated spider veins (≤ 1 mm)
Treated with 0.5% Asclera

ADVERSE REACTIONS:

-Injection site hematoma
-Injection site irritation
-Injection site discoloration
-Injection site pain
-Injection site itching
-Injection site warmth
-Neovascularization
-Injection site clotting

How often do I need treatment to see results?

The number and frequency of treatments depends on the size of the vessels and their location. Ask your provider about an individualized treatment approach that is right for you.

asclerabeforeafter

How does Asclera work?

Asclera is a sclerosing agent that is injected into the vein. It works by damaging the endothelium, the inside lining of blood vessels. This causes blood platelets and cellular debris to attach to the lining of the vessels. Eventually, cellular debris and platelets cause the blood vessel to clot. Over time, the clotted vein will be replaced with tissue.

How satisfied are patients who use Asclera?

88% of clinical study patients were satisfied or very satisfied with their Asclera treatment after 12 weeks.

ascleragraph
How long is each Asclera session?

A typical session lasts 15 to 45 minutes. Generally, 1 to 3 injections may be necessary to treat a given spider or reticular vein. Repeat treatment sessions may be necessary. Any additional treatment sessions are usually separated by 1 to 2 weeks.

What should I expect after being treated with Asclera?

Following treatment, you’ll need to wear compression stockings day and night for 2 to 3 days, then for 2 to 3 weeks during the daytime, as directed by your provider. Compression stockings are designed to apply pressure to your lower legs, helping to maintain blood flow, and reduce discomfort and swelling. Compression helps your legs heal and is necessary to reduce the risk of deep vein thrombosis.

Are there activities I should avoid after receiving an Asclera Injection?

For 2 to 3 days following the treatment, avoid:
-Heavy exercise
-Sunbathing
-Long plane flights
-Hot baths, hot tubs, or saunas

Possible side effects to Asclera treatments:

Temporary side effects may occur at the site of the injection, including:

-Bruising
-Raised red areas
-Small skin sores
-Darkened skin in the form of lines or spots
-Multiple tiny red blood vessels
-These side effects usually go away within a few days to several weeks. Some side effects may take months or years to resolve.

For more information or to book an appointment for Asclera therapy, please call our office at 858-550-0330.

Asclera: A New Treatment For Spider Veins and Small Varicose Veins2022-12-13T13:26:40-08:00

The 9 Best Ways to Treat Varicose Veins Without Procedures

2022-03-17T10:12:06-07:00

The 9 best ways to treat varicose veins without procedures: conservative management and self-care.  

 

Conservative Management and Self-Care for Varicose Veins

Conservative management and lifestyle changes can ease the symptoms of varicose veins and help reduce complications such as thrombophlebitis (blood clots within veins) and vein rupture, but do not cause the veins to vanish. These measures are helpful if an individual is not a candidate for vein procedures or wishes to delay interventional treatment. More common options include:

 

Compression stockings: These elastic stockings squeeze or compress the veins to help circulate blood. The compression stockings prevent blood from flowing backward and pooling in the legs. Compression stockings must be graduated, medical grade compression to be beneficial. TED hose are not adequate to reduce symptoms in venous disease for active patients. Compression stockings come in different strengths and the most common strength for the treatment of varicose veins is 20-30mmhg. Your doctor should advise you which strength of compression stockings you should wear. In patients with peripheral arterial disease (PAD), diabetics, and neuropathies, compression may be contraindicated or lesser strengths of compression may be advised. 

 

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. 

 

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. 

 

Avoid inactivity: Standing or sitting for long periods of time can aggravate your vein condition. 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. 

 

Dietary Supplements: Supplements such as horse chestnut and grape seed extract can help reduce symptoms of venous disease. Vasculera is a prescription medication that may be helpful for some. Always check with your PCP before starting supplements or new medications as there may be side effects. 

 

Dietary Changes and High Fiber Diet: A flavonoid rich diet including berries, and green teas, can reduce inflammation and pain. A high fiber diet can increase abdominal pressure and may be helpful for varicose veins. Make sure to drink plenty of water with your high fiber diet. 

 

Anti-inflammatory Medications: are helpful to reduce pain and inflammation, but check with your doctor first to make sure you don’t have contraindications to using them. Ibuprofen and Advil are common oral anti-inflammatory medications. There are also anti-inflammatory cream or gels that can be applied topically to the painful veins, such as Voltaren gel. 

Ice packs: and heating pads can be applied to tender veins. Ice packs and heating pads can be used in an alternating manner. 

Weight loss or maintaining a healthy weight: Being overweight puts extra pressure on your veins. It’s optimal to manage your weight to reduce extra symptoms and pain. These are the 9 best ways to treat varicose veins with conservative management. 

The 9 Best Ways to Treat Varicose Veins Without Procedures2022-03-17T10:12:06-07:00

One Way To Reduce Bruising After Surgery

2022-03-17T10:10:31-07:00

One of the most common side effects after surgery is bruising. Whether it is due to plastic surgery or vein surgery, bruising and swelling are inevitable. One of the most powerful tools that we recommend for patients undergoing any type of surgery and one way to reduce bruising after surgery is RECOVA post surgery cream

 

Dr Nishe Bunke created RECOVA cream as a post surgical recovery cream specifically designed to reduce bruising, swelling, redness, and pain. RECOVA skin creams are packed with antioxidants and natural ingredients that promote healing and reduce inflammation. 

 

RECOVA cream aids in reducing pain, swelling, and discoloration after cosmetic surgery, injections, and procedures, laser treatments, varicose vein procedures, Sclerotherapy, minor injuries, and is one way to reduce bruising after surgery.

 

Our patients at La Jolla Vein Care have seen quick transformation post procedures. The combination of natural ingredients in RECOVA cream helps aid in quicker recovery.

 

 The powerful ingredients included in RECOVA are listed below:  

 

  • Arnica Montana is a flower extract that helps with inflammation, swelling, and bruise recovery. 

 

  • Grapeseed Oil has numerous benefits and includes numerous vitamins such as vitamin E. It is a flavonoid that aids in chronic venous insufficiency, varicose veins, and edema. 

 

  • Bromelain is an enzyme that is a natural remedy for inflammation and swelling.

 

  • Horse Chestnut is used to improve poor blood circulation, reduce swelling, and for varicose vein symptoms. 

 

  • Caprylhydroxamic Acid is an amino acid derived from coconut oil used as a gentle preservative that ensures product safety and longevity. 

 

  • Witch Hazel is used for swelling and inflammation. It is used to shrink varicose veins and hemorrhoids as well as reduce rosacea and clear redness of the skin. 

 

  • Butcher’s Broom is used for natural anti-inflammatory properties. It is used to reduce swelling and reduce varicose vein symptoms. 

 

  • Sunflower Seed Oil is packed with vitamins A, E, C, and D. 

 

  • Menthol is not present in the tinted RECOVA, since Tinted Arnica is often used around the eyes. 

 

The combination of these ingredients contributes to an overall comforting and healing sensation when applied to the skin. 

 

RECOVA is a tool that stands out due to its natural ingredients that aid in venous disease symptoms. RECOVA is hypoallergenic, and non comedogenic. RECOVA is also free of parabens, phthalates, preservatives, synthetic additives, and dyes, and never tested on animals. 

 

Patients have used RECOVA cream after vein procedures and have seen quick and lasting results. We recommend physicians offer this for patients if they complain of redness, itching, and bruising after their procedures. RECOVA offers immediate soothing relief of discomfort for our patients. 

 

Check out RECOVA online for more information and to purchase RECOVA tinted arnica cream and RECOVA post surgery cream. 

Below are a few patient transformations while using RECOVA Cream post surgical procedures.

one way to reduce bruising after surgery one way to reduce bruising after surgery

before 3 after 3one way to reduce bruising after surgery

One Way To Reduce Bruising After Surgery2022-03-17T10:10:31-07:00

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