Published Thursday, April 27th, 2017 at 09:30 am
Vascular surgeon Max Mahendran says your first consultation is an important step in the management of varicose veins.
They are often underestimated and ignored as a cosmetic nuisance as they can often be unsightly.
But it is a chronic condition that gets progressively worse over time, so it is essential to understand the disease.
Before the visible veins develop, there is a pressure build-up in the internal veins due to failure of one-way valves returning blood back to your heart and lungs for oxygenation.
Increasing congestion causes the superficial veins to stretch, enlarge and twist to appear as bulging varicose veins.
The congestion causes heaviness, discomfort, ankle swelling, cramps and tiredness of the legs. The swollen veins continue to stretch and become thin causing the proteins and blood cells to leach out under the skin. This irritates the skin causing itching, eczema, and pigmentation. Progression can lead to ulcer formation.
Understanding this ‘timeline effect’ of varicose veins is the first step to recognise this as a significant medical issue and prevent potential problems.
Ignored varicose veins behave like a neglected bucket of water. Eventual skin damage can occur like a rusting bucket.
The Mater Private Hospital Cork promotes the initiative Healthy Legs for Healthy Life to improve wellbeing by education, assessment, and solutions.
Mr Max Mahendran is a vascular surgeon dealing with varicose vein diseases exclusively.
He recommends the 4Es solution to ‘empty that bucket’.
Raise the legs while sitting at home on the sofa or at the office by keeping a leg rest under your desk. This boosts natural circulation by getting rid of the congestion and reducing fatigue. "After a long tiring day, revitalise your legs with a cool shower or foot soak as the cold water constricts the leg veins.
When you walk, the calf muscles rhythmically contract and relax acting as a second heart, pushing the blood up the veins against gravity. Regular walks increase flow in the vein, reduces the pooling of unhealthy blood, improves symptoms, and prevent clots.
A simple exercise at your desk to contract the calf muscle is to raise the heel up and down while the foot is flat on the floor, in a ‘chew the ground’ motion.
Compression socks are the medicine that you wear for the varicose veins. Flight socks reduce the fluid build-up at work from prolonged sitting or standing.
"Preventing congestion of the subcutaneous tissue will prevent skin damage. Your legs will feel lighter when you get home with more energy and improved mood.
Technologies in the management of varicose veins have significantly advanced in the last decade. A consultation with a specialist vascular surgeon, will offer you assessment and solutions. Your family doctor can make a referral.
Mr Mahendran explains the process: “Your first consultation is an important stage in the management of your varicose veins. The process involves discussing your symptoms and your general medical condition, which will influence the choice of treatment for your veins.
“Your legs are then assessed for signs of advanced venous disease such as inflammation or phlebitis, swelling, ulcerations and other signs of skin breakdown.
"A venous ultrasound scan is crucial as the underlying problem in the vein cannot be ascertained correctly just by looking at the leg and the external appearance of the varicose veins.
“Individualised treatment plans are then designed based on the results of the scan.
"The management options and the procedure techniques are discussed with you in detail giving you the chance to understand the treatment and to discuss the merits of procedures.”
*This feature first appeared in the Irish Examiner Feel Good on Friday 7th April 2017