F.A.Q.s
What are varicose veins, and how do I know if I have them?
Varicose veins are diseased veins that no longer allow proper blood flow. Some appear as bluish or green, bulging, curvy or ropey veins just under the skin. Some may be too far below the surface to be visible.
Symptoms of varicose veins include aching, tiredness and cramping, tingling, burning and dry, itchy skin. Signs that indicate underlying problems may include swelling, discoloration of the skin on the lower leg or ankle or leg sores that are slow to heal. Left untreated, varicose veins and venous insufficiency may lead to leg ulcers, bleeding or even blood clots.
Varicose veins develop when excess blood pools in leg veins and causes vein walls to weaken and bulge. Your leg veins have valves that peed blood flowing in the right direction, up and out of your legs, and back to the heart. Diseased valves no longer close properly, and allow blood to flow backwards, down the vein. The blood then pools and stretches the vein walls and further damages vein valves.
How do you know if I am a candidate for treatment?
You are a candidate for treatment if you have varicose veins or venous insufficiency. We determine this by assessing the health of the veins in your legs. We start by asking how your legs feel and whether you are experiencing symptoms, and then look for signs that may indicate underlying problems. We confirm the health of your venous system using ultrasound to scan veins as blood flows through them. If you think you may be a candidate please call to schedule a free consultation.
Do I need a referral from my doctor?
You will not need a referral, in most cases. You may call us if you have questions regarding your insurance policy.
Does insurance cover treatment?
Almost all insurance policies cover the treatment of varicose veins and venous insufficiency. The treatment of spider veins is considered cosmetic and is not covered by insurance.
What can I expect at my free consultation?
You initial consultation includes an assessment of your venous system, a review of your signs and symptoms and an explanation of varicose veins and their effect on your circulatory system. Our vein experts will be able to tell you if your circumstances warrant further examination, which would begin with an ultrasound mapping of your venous system. This mapping is not a part of your initial consultation.
What is a vein mapping and why do you do it?
Vein mapping is a non-invasive ultrasound examination of the veins in your legs. It shows the size and shape of your veins, blood flowing through your legs and how the valves in your veins are functioning. This information is used to identify the exact cause of your problem and determine the proper course of treatment. Almost all insurance policies cover this mapping procedure.
How does the laser treatment work?
The area of the vein to be treated is numbed and a laser fiber is threaded through the vein to the source of the problem. Laser energy is applied causing the vein to collapse and seal, permanently. This sealed vein breaks down and is reabsorbed by your body over a period of several weeks or months. Blood that used to flow through that vein now flows through other, healthier veins and proper circulation is restored.
What happens to the blood after you seal the diseased vein?
We treat veins in the superficial venous system. These are the veins that are between leg muscles and the skin, and make up about 10% of your leg veins. The other 90% of leg veins are deep in the leg muscle and make up your deep venous system. After a vein is treated the blood flows through other, healthier veins, to your deep venous system back to your heart.
What if I need these veins for surgery in the future?
We only treat the diseased veins. These veins are not candidates for surgery, and do not provide good circulation in your legs. Removing them allows blood to flow through other healthier veins and restores proper circulation.
Will I have to take a whole day off of work for a laser treatment?
No. Laser treatments can be performed in less than one hour. You may return to work immediately, if you choose. We offer evening and Saturday appointments on select days and clinics throughout the week.
I have a busy schedule. Will I have a lengthy recovery time?
Laser treatments are minimally invasive and have little effect on surrounding tissues, therefore the recovery time is much shorter, and with less discomfort, than older methods such as vein stripping. Resuming most normal activities immediately is recommended because it promotes rapid healing. Ask your vein specialist when you can return to more strenuous activities, such as running and exercising.
I don't like needles. Does the laser procedure hurt?
We understand that nobody like needles. There is some discomfort with most medical procedures and we take great care to minimize this discomfort. We use a 4-step numbing process that first desensitizes the skin, and then numbs the area along the vein. You will feel no pain during the actual laser portion of the treatment.
What can I expect after a laser treatment session?
You can expect some tenderness and bruising along the vein line that will last for a few days or a week. Applying cold packs to the affected areas, taking frequent short walks, messaging your legs, and elevating your feet when possible, all help minimize discomfort and speed recovery.
Can I just treat the unsightly, visible veins?
This is not recommended, and most insurance companies require treatment therapy that includes treating the source veins. Treating only the unsightly varicose veins does not address the underlying causes and will not improve circulation. Removing the symptom without addressing the source will allow the progression of the vein disease and could lead to more serious conditions such as leg ulcers, bleeding veins, permanent discoloration of the skin or even blood clots.
What happens if I treat only my spider veins?
Spider veins are a type of varicose vein. Excess blood pooling in veins puts pressure on the vessels all the way out to the skin. Excess pressure on the surface veins weakens these vein walls, producing varicosities that appear as tiny blue, red or green "webs". Treating only the spider veins will not improve your circulation, and you will likely continue to develop new spider veins. Treating spider veins is considered cosmetic because it does not address the underlying circulatory conditions.
Will I have to wear compression stockings?
Yes. Wearing compression stockings is an integral part of a vein treatment therapy. Properly fitted gradient compression stockings provide support in the areas that need it the most, promote rapid healing and also make your legs feel better. The length of time to wear them depends on the individual therapy and specific treatment method, and can vary between several days and weeks. Many insurance companies require a trail period of stocking use before approving vein treatment therapy.
Is Microphlebectomy the same thing as vein stripping?
Both methods involve the removal veins. Typically, when we refer to vein stripping, we are talking about the surgical removal of an entire vein, or a long section of vein, through a single entry point. Microphlebectomy is the surgical removal of short sections of vein and is sometimes used to remove portions of veins that interfere with treatments, or that are particularly unsightly. For most patients this procedure is not needed.
What are my treatment options?
Treatment therapies vary depending on individual conditions and may include the following:
- Endovenous Laser Ablation (EVLA) - Laser energy is used to permanently seal the vein.
- Ultrasound-guided Sclerotherapy (USGS) - Ultrasound guidance is used to "see" the veins while we deliver medicine to the precise location.
- Transcatheter Closure (TCC) - A tiny catheter is used to deliver medication to the entire length of a vein at one time, through a single entry point.
- Microphlebectomy - Short sections of vein are removed through tiny incisions.
Can I be cured of varicose veins?
Varicose veins can be successfully treated, but the disorder cannot be permanently cured. The risk factors that contribute to varicose veins are still present after treatment, which may mean that patients will need to return for follow-up treatments at some time after their initial treatment.
Can I prevent varicose veins?
There are many measures you can take to help prevent varicose veins. Regular exercise, weight management, proper diet and a healthy lifestyle are important for good vein health. Avoiding risk factors such as standing or sitting for long periods, and using preventative measures, such as wearing support hose and elevating your legs can also be helpful. There are certain factors you can't avoid, such as heredity, changing hormone levels and large blood volumes during pregnancy.
Do varicose veins cause Restless Leg Syndrome (RLS)?
The cause of RLS is unknown and is used to describe certain symptoms including itching, tingling, burning and a constant urge to move your legs. Vein disease affects 50% of adults living in the United States. Many people with venous insufficiency experience some form of restlessness ranging from mild to severe in nature. Medications used to treat RLS including pramipexole (Mirapex) and ropinirole (Requip) may provide some relief of symptoms but often have negative side effects including nausea, lightheadedness, fatigue and increased risk of heart disease. Successful treatment of venous insufficiency can decrease or eradicate symptoms and the need for medication altogether.
