Treatment of Varicose Veins - Patient Information

Introduction

Varicose veins are swollen veins that lie under your skin. They look lumpy and dark blue or purple through your skin. They usually affect your legs, particularly your calf and sometimes your thigh. Varicose veins develop when blood doesn't flow properly through the veins in your legs.

There are two main types of veins in your legs: superficial veins – These lie under your skin and include the long and short saphenous veins; and deep veins. The saphenous veins are connected to the deep veins inside your legs by perforator veins. When blood doesn't flow properly from your superficial veins to your deep veins, pressure can build up. This is often due to problems with the one way valves that stop blood leaking back into your superficial veins. This results in blood collecting or pooling in your superficial veins and these are called varicose veins.

Once you are scheduled for varicose vein treatments, the following preparations will help give you the best results:

1. Varicose Vein treatments can require anesthesia, therefore please avoid solid food intake beginning 8 hours before your scheduled surgery time, and please avoid any further liquids beginning 8 hours before your scheduled surgery time

2. If you are taking anticoagulation medications, you will be advised whether or not to discontinue your medication prior to your surgery. If you are taking Aspirin, Plavix, Pletal, or a similar medicine, you may continue these as per your routine. If you are taking Coumadin or one of the more modern anticoagulation medications, you will be advised specifically regarding whether you should continue the medication and if not, how early the Coumadin or other anticoagulation should be discontinued. In each instance, your doctor will advise you carefully.

3. Please shave your leg to be treated from groin to ankle

4. Please inform our nursing, anesthesia, and physician staff of any and all medication allergies

5. Bring loose clothing with you so that you will have something easy to wear going home.

6. Although we will already have a list of your medications, if you will simply bring a new written list of your medicines on the day of surgery including, herbal supplements and vitamins, we often find this to be very helpful.

What are the varicose vein treatment methods?

Varicose veins can be treated by multiple techniques, please see this page for a full list of our treatment services. Most commonly varicose veins are eliminated by using EVLA, endovenous laser thermal ablation and microphlebectomy.

Recommendations for post-treatment care:

1. You will be taken from the operating theater into one of the examination rooms where you will meet with your family. You will be awake but will be quite sleepy in most instances. We will provide for you crackers and a soft drink to help you with your recovery. If you feel a little nauseated or uncomfortable in any manner, please notify our nursing staff right away so that we can help you.

2. After you leave the vein center, you may travel home and will likely rest comfortably. If you are not nauseated, you may drink and eat a little food by means of a drive-thru restaurant. Please do not try to walk into a restaurant as you may faint or have difficulty walking due to your sedation.

3. You may travel quite long distances in your car to return home. We recommend no further than between 3 hours to 5 hours, stopping to move around a little bit and perhaps eat a little food before reaching home. If you live quite a long distance, you may wish to remain in a nearby motel. We have special arrangements and rates for a nearby Marriott Courtyard Hotel approximately one mile from our Birmingham vein center. Similar arrangements have been made with the Tuscaloosa Marriott Courtyard should you travel a long distance to that facility.

4. Please feel comfortable to rest and relax on the day of your operation. Your leg is wrapped to provide firm compression so that you do not need to elevate your leg except for specific situations.

5. We recommend that you do not walk or put heavy weight on the treated leg on the day of surgery. You may touch your foot to the floor for balance and may place a small amount of weight. Using a crutch or a walker or similar support is often helpful.

6. On the day after surgery, you may walk on your treated leg in a normal manner. Your leg will be tender, but no harm can be caused by your walking.

7. After 24 hours you may remove the dressings at home. You may also then take a shower if you wish. If you have small paper steri-strips on phlebectomy sites, you may leave those alone because they will either begin to fall off after 7 to 10 days or we will remove them when you return to our clinic.

8. Once your bandages have been removed, we recommend you then put on your thigh high compression stocking. We also recommend that you wear these stockings during the daytime for the next two weeks. Compression hose will keep the treated veins in a collapsed state and allowmore rapidhealing. Often you will not have as much bruising or discomfort if you wear the compression stocking.

9. You may walk and be as active as is comfortable for you. We do not recommend vigorous exercisefor one week, after which you may resume some type of limited exercise if that is your routine. You will find some discomfort in your leg while trying to exercise. We recommend you do not force the exercise program but do as much as you can and what you wish to do as long as you do not have pain.

10. The inside of your thigh, and/or the back of your calf, may become red and tender during the first 2 weeks after surgery. The second week is often more intense than the first. This is the body’s normal inflammatory response to the successfully closed vein.

11. Postoperative pain is usually quite minor. If possible, please be sure to take Ibuprofen 400 mg to 600 mg two times to three times a day for at least two weeks. If your leg continues to bother you, please stay on the Ibuprofen until you no longer are having discomfort. You may also apply an ice pack in the morning and heat compression in the evenings. Ice will help control the inflammatory reaction and heat will help the vein begin to dissolve away more rapidly. Most importantly, taking some type of anti-inflammatory medication will be very beneficial.

12. Once you have resumed a normal diet which is often the day after your procedure, you may then resume all normal medications.

13. You will note that your leg and foot will swell somewhat for the next couple of months. Usually two months to four months are required during the healing process before swelling tends to diminish.

14. You may develop painful lumps which are clotted varicose veins or blood which has collected under the skin. These lumps will become red and tender and are often a concern to our patients. These changes are also normal and are a good sign of a successful treatment. These lumps will completely disappear over the next couple of months.

15. Please avoid soaking in hot tubs or spas for at least four weeks after surgery.

16. Skin numbness is a fairly common postoperative occurrence, noted on the inside of the thigh, sometimes on the front of the calf, and sometimes all the way down to the foot. Skin numbness is a minor problem due to close proximity of the origins of some of the skin nerves to the treated vein. The temperature of the laser being used to close the vein in some ways will irritate the small skin nerves. In almost every case, the nerves tend to reawaken or simply grow back. Return of skin sensation most often occurs at least within one year. These nerves have no motor function and therefore are simply an annoyance due to the numb feeling at certain spots.

17. Although your leg vein circulation has been corrected and restored to normal, we still recommend that you wear compression stockings when you travel distances longer than two hours. If you travel by airplane, wearing compression stockings are particularly helpful to prevent you from developing leg vein blood clots.

18. Before you are discharged home, you will be given an appointment to return for a follow up examination as well as an ultrasound evaluation. This is to make sure you are recovering in a normal fashion.

19. After you go home, please feel free to call our doctors on their cellular telephones if you have any concern. Most of the time of you will be answered directly, if not your call will be returned in a very short time.

Thank you for seeking consultation and treatment with the Alabama Vein Center in Birmingham, Tuscaloosa, and Prattville, near Montgomery, Alabama. Our efforts are to offer you the best and safest treatment options available today. If you have questions, please call or e-mail for answers and we will be pleased to respond. Be patient as we observe the results of treatment, for often several months must pass before we see the results we all desire. We look forward to working with you as we provide this specialty care for your vein problems.