General FAQ's
Fact Sheet on Phlebology
Introduction:
If you suffer from problems related to varicose veins and spider veins, you are not alone. It is estimated that more than 80 million Americans, men and women, suffer from some form of venous disease.
Help is available for patients with spider veins, painful varicose veins, leg swelling, and venous stasis problems. Dr Kenneth Harper, a board certified surgeon and phlebologist, offers advanced care for all types of venous disease. Vein Specialists of the South, LLC is located at 556 Third Street, Suite A, in downtown Macon GA.
Common Questions & Answers:
What is phlebology and what are Dr. Harper's credentials?
Phlebology is the medical specialty devoted to the evaluation and treatment of patients with venous disease. This includes spider veins, varicose veins, venous ulcers, and leg swelling. Phlebology has been an established medical specialty in Europe for over 50 years. In the United States serious interest in phlebology developed over the last 20 years. Dr. Harper is a board certified surgeon: American Board of Surgery since 1986. Dr Harper established his phlebology practice in 1997. Dr Harper is a board certified or a Diplomat of the American Board of Phlebology and is an active member of the American College of Phlebology. He regularly lectures at American College of Phlebology meetings and was recognized in 2007 with the Platinum Abstract award for research on compression hose and venous disease. In 2009, Dr. Harper attained certification for vascular lab interpretation: Registered Physician for Vascular Interpretation.
What is the function of veins?
You have two types of blood vessels that circulate blood throughout your body. Arteries carry blood away from the heart while veins channel blood back to the heart. Leg veins have one-way valves which open and close to maintain unidirectional blood flow to the heart. However, if the valves do not function accordingly, then blood does not flow efficiently. If the valves do not close properly then blood gravitates down the leg when the patient is in the sitting and standing positions. This reversal of blood flow, known as "reflux", may cause signs and symptoms of venous disease.
What are the signs and symptoms of venous disease?
Visible signs may include spider veins, varicose veins, venous ulcers and leg swelling. Spider veins are small red, blue, or purple veins on the surface of the skin. Varicose veins are larger distended superficial veins.
Common physical symptoms are leg pain, fatigue, heaviness, aching, burning, throbbing, itching, and cramping. More advanced symptoms include leg swelling, skin discoloration and skin ulceration.
Who is at risk for venous disease?
Predisposing factors include inherited traits, gender, age, obesity, trauma, and occupation. Heredity is the number one factor in the development of varicosities. Varicose veins are more common in women because of hormonal factors including pregnancy, puberty, menopause, and birth control or hormone replacement therapy. Varicosities from pregnancy often improve within 3 months of delivery but may not resolve after successive pregnancies.
What preventive measures can I take?
Although procedures may correct venous reflux, long-term success may require you to comply with the following conservative care guidelines. 1. Treat your symptoms and prevent progression of venous disease by wearing compression hose. 2. Exercising your calf muscle compresses your veins and massage blood towards your heart. 3. Elevate your legs daily and avoid prolonged standing. 4. Avoid high heel shoes except on special occasions. 5. Maintain a healthy weight. 6. Avoid or minimize: heavy weight lifting, pounding exercises, local trauma, hot baths, sun bathing or the tanning bed.
How can 'bad' veins be treated?
Corrective procedures may be indicated for venous disease. Treatment results are best when corrective procedures are paired with the conservative guidelines listed above. Treatments may include cosmetic treatments versus medically necessary procedures. A "mapping" ultrasound of your legs will diagnose which veins have "reflux". This diagnosis along with symptoms of venous disease will aid Dr Harper in making your treatment recommendations. Though vein procedures are elective, delaying treatment will allow your chronic condition to worsen with time. Thankfully with the evaluation and treatment methods available today, spider veins and varicose veins can be treated at a level of effectiveness and safety previously unattainable.
What about cosmetic treatments (sclerotherapy)?
Sclerotherapy is the 'gold standard' of spider vein treatment. The treatment is an office-based procedure (at Spa Medical) in which a tiny needle is used to inject the vein with a medication that irritates the lining of the vein wall. In response to a series of treatments, the vein collapses and disappears. Normal activities are resumed immediately and compression hose are worn after each treatment to assist in healing. Maintenance sclerotherapy sessions every 6-18 months may be necessary to treat new spider veins.
What are the medical procedures for venous disease?
Procedures may be indicated for the underlying causes of venous disease as well as the more visual results of venous disease (varicose veins). Traditional surgery was limited to vein stripping. New minimally invasive endovenous thermal ablation procedures like "Venous Closure" are an alternative to vein stripping that treat the underlying cause of venous disease, which is usually reflux in the saphenous veins. In the 'Closure' procedure, a small catheter is inserted into the damaged vein and radiofrequency energy (heat) is delivered to the vein wall. As the heat is introduced, the vein collapses and is sealed shut, eliminating the source of the underlying reflux.
The veins that connect the deep veins to the superficial veins are the perforator veins. If unhealthy perforators are detected, recommendations may include treating these veins with the 'Closure' device, open ligation or ultrasound guided sclerotherapy. If the perforator vein is ligated you may have an inch long incision to the specified site.
The superficial varicosities close to the skin are removed through tiny phlebectomy incisions (approx 3 mm in size). These microincisions leave nearly imperceptible scars.
Where will my procedure take place?
Your procedure will be an outpatient procedure here in our office 556 Third Street Suite A, Macon GA 31210.
Will I have pain during or after the procedure?
We use a gentle numbing solution of Lidocaine to keep you comfortable during the procedure. You may have mild discomfort while the numbing is infused and after the numbing wears off in 4-6 hours. Tylenol is recommended to improve post-op discomfort. To ease your nerves and make your experience more pleasant, Dr Harper may prescribe an oral relaxation medication for you to bring to the office on the day of your procedure. If so you should not drive until the following morning.
Is there a problem with treating the varicose veins in the leg in relationship to future heart bypass surgery?
No, the veins treated are diseased and therefore not good candidates for use in a bypass operation. In fact, correcting the poorly functioning veins can preserve healthy veins for future bypass operations. Other viable vessels (apart from Saphenous Veins) for cardiac bypass include the internal mammary artery and the radial artery.
What kind of results should I expect?
Success is dependant upon your initial assessment, an accurate treatment recommendation, the skill of your provider, and your compliance to the treatment plan. It is important for you and Dr Harper to discuss your primary concerns and expectations prior to scheduling any procedures. When seeking improvement from physical symptoms it is important to know that your venous disease may not be the only source of your symptoms. That being said, if you have symptoms arising from another etiology you are likely to still have these symptoms post procedure. If your main desire is cosmetic improvement, it is important for you to know that until your underlying reflux is treated you might not have satisfactory cosmetic results.
If you are proactive in treatments your end results are expected to be better than a patient who is not compliant. Our hope is that after treating your venous reflux you will have improvement in your pre-op symptoms and visual varicosities. It is important to note that if your venous disease is advanced some of your symptoms (swelling, skin changes) may be chronic in nature.
Are treatments covered by insurance?
Insurance companies most often consider the treatment of symptomatic varicose veins medically necessary. Your insurance carrier may require that you meet certain standards prior to approving your procedure. Our patient care coordinator will supply this information at the time of your consultation when you schedule your procedure. The insurance prior determination process will be directed by out business and insurance staff.
When you are ready for cosmetic spider vein treatment this will not be covered under your insurance plan. Sclerotherapy will be scheduled at Spa Medical a division of Vein Specialists of the South, LLC at 556 Third Street, Macon GA 478-743-2299.
What are the risks associated with my procedures?
The risks associated with these office-based procedures are minimal. However, no procedure/treatment is risk free. After your procedure you may experience bruising, mild to moderate discomfort, skin discoloration, numbness, tingling, burning, and increased swelling. The risk of infection is low. If you have had a history of poor wound healing after surgery or a history of skin infection (i.e.staph infection) it is important to discuss this information with Dr Harper. After the procedure you may have increased swelling related to administration of the local numbing fluid. This post-op swelling may last from 24 hours to several weeks. If you experience numbness, burning, or tingling post procedure these symptoms may take 6 months or more to gradually improve. The risk of these post-op complaints increases if Dr Harper works in your shin or ankle area where there is very little fat to separate the nerves from the veins. Risk of blood clot and allergic reaction from the procedure are rare.
How can I let friends and family know that there is help available?
Please tell your friends and family to contact our office for a new patient appointment. Call 478-743-2472 or ask them to visit our website at www.veinspecialists.com. It is helpful if you pass on your conservative care guidelines so your friends and family may start managing symptoms prior to their first visit.