Hi, Doctor Gan here. Some of the patients that I meet, have noticed varicose veins just pop up in their legs. There other patients that have had these varicose veins for many years. These same group of patients, for personal reasons, may not be ready to get treatment straight away. However, they do want to reduce their symptoms, even prevent the progression of vein disease. If you happen to fall into this category, today I’m going to be discussing some of the conservative options available to reduce symptoms, and even prevent progression.
Now, the first form of treatment is compression stockings. Now, compression stockings, in my opinion, is one of the best forms of treatments because it reduces symptoms such as aching and swelling in your leg, and it also prevents the formation of a clot. The only challenge that patients have is that they find it a little bit cumbersome to put these stockings on and even take off, and they may also find it uncomfortable because it’s probably the tightest stockings they’ve ever worn.
It’s important to note that these stockings are not the same stockings you get in the supermarket or store. They are actually medical grade stockings that you need to measure specifically for your legs, and therefore they can be a lot tighter than you expect. At our clinic, this is a service we offer, so if this is a form of treatment that you plan to pursue, we are happy to help.
Another option available is exercise. Now, the calf muscle pump is one of the best pumps we have in our body, and what it does is every time it basically squeezes together, it pushes blood all the way from your legs back up to your heart, and it improves the blood flow. So, by actually flexing and extending your foot, you’re actually activating this calf muscle pump that is pumping blood back up to your heart, and this can improve symptoms. Now, by exercising, you’re also keeping your weight down, which eventually helps reduce symptoms and even prevent progression of vein disease.
A third option is elevation of your legs. Now, elevation is great because when you’re standing for long periods of time, you’re basically through gravity, you’re getting blood flowing all the way to your legs, and if your valves in your veins are damaged, it’s going to be hard for it to be pumped up. And so, by elevating your legs by putting it up on a table or a chair, a little bit above your heart level, you’re basically allowing gravity to get that blood back into the heart.
Now, another option is lying on your bed and actually putting your legs on the wall, and this can actually help relieve symptoms quite quickly. The next option available is medications. Now, medications can include anti-inflammatories such as Ibuprofen or Voltaren, they are essentially non steroidal anti-inflammatory drugs. I’m not a huge fan personally, because anti-inflammatories can often cause a lot of trouble in your tummy, with your gut flora, which are the bugs in your tummy.
They can cause symptoms such as gastritis, and nausea at times, and even the formation of ulcers. So they cause irritating symptoms that you did not really want to have, but I can understand that for some patients that have reached the end, where compression’s not helping and elevation’s not helping, some anti-inflammatories can help. Now, I would advise that if you reached this level of pain or symptoms that you can’t handle and you need medication, you may have to look at treatment options because you using medication, is really kind of a bandaid effect.
Now, the final option that I have, which I think is actually very important, is essentially food, and we’ve heard the saying, food is medicine, and there are certain types of food, especially fruits and vegetables that are great for your vein health. And flavonoids is a type of chemical that’s actually found in vegetables and fruits. It’s an antioxidant. It basically prevents clot formation, and also improves vein health, reduces blood pressure and reduces cholesterol. This can be found in most berries, it can be found in grapes, it can be found in olives and even apples.
It’s full of vitamin C, which is great for your skin as well as your vein health, and if you’re eating healthy what that tends to mean, is that you tend to have a better weight, so it’s a win, win, any way you look at it. If you need further information regarding the conservative options available, we are always happy to help. Visit our website at doctorvein.com.au, or book yourself in for consultation.
Hi, Dr. Gan from Doctor Vein Medical Clinic. Some of the patients coming in for treatment of their spider veins or varicose veins often are a little bit concerned about needles, specifically, are they going to be painful? Is it going to cause discomfort? I can understand where this comes from because if you’ve never had this procedure done before, it’s quite normal to actually feel a little bit anxious because you’re not sure what’s going to happen on the day, and if you actually go to a doctor and you actually speak about this, no one really talks about, are you going to feel any discomfort? They just mention, “This is a procedure. We’re gonna do it. We’re gonna do it under local anaesthetic. You shouldn’t feel it, and it’s gonna be fine,” and most of the time, it is fine.
This probably stems from immunisations that people got when they were kids or even as adults, and even dental procedures where they had local anaesthetic, which, really, even with dental procedures these days, they do it so quickly and so finely that most patients do not feel anything at all.
Today, I’m going to actually be talking about the needles that I use, and, specifically, I’m going to actually use myself as a demo model and show you the placement of a needle into my skin.
It all comes down to what types of treatments that’s been done. If sclerotherapy or micro-sclerotherapy, whereby we’re injecting a solution to these really fine, baby spider veins, I usually use very, very small needles, and these needles are so fine that you just feel a little bit of a prick as it goes in, and other than that, you don’t really feel it. There’s some parts of our bodies, especially around your feet and ankles that are a little bit more sensitive, and also around the knees into the back of the knee. They’re more sensitive than the rest of your body, but for most places, especially in the legs, you’re not going to really feel much. I’m going to demonstrate with my arm, and I’m going to use my forearm, how it actually feels using one of these needles.
To give you a little bit of a back story, I’m actually terrible with needles. I can give needles, but receiving needles, forget about it. I’m really bad at it. Even though I’ve done thousands and thousands of needles in some form for patients, I’m really bad at receiving it. To be honest, I think about probably four to five years ago, I was getting blood taken, and the young girl was really worried because she thought I was going to pass out, but I’ve actually improved since then. I’m actually quite good. I can watch the procedure being done, and I’m getting better, and before you start judging me and thinking that, come on, it’s just a needle, it’s actually a very common thing for men, and I know I’m defending myself here, but it does happen for some patients, that are a bit worried about needles. I’m one of those people. I’m actually going to be sticking a needle in my forearm right now while I’m actually taking this video. If I can do that, then it can’t be that bad.
This is the needle that we use or I basically I use. Different doctors use different needles. I use a really fine needle here that is … It actually flows really well, and it doesn’t cause much discomfort, so most patients are quite happy.
Placing it on the skin, pierce the skin, in the skin. Didn’t really feel it. It’s actually not to bad. You feel a little bit of prick. I’d be lying if I didn’t say you felt a little bit of a prick. You feel a little bit of a prick, but, other than that, it goes in quite smoothly. Once it’s in, you don’t actually feel anything, and this is a sensitive part of the body, especially around the forearm, around the back of you hand, and take that off, not much of anything, no bleeding, very small needle.
If you’re having sclerotherapy or micro-sclerotherapy, these are the types of needles that I use. For other procedures, such as your ultrasound-guided sclerotherapy, we use a similar needle, but it’s a little bit longer. With this procedure, specifically, I can be completely honest with you, when it happens, patients don’t even realise that it’s happened. Oftentimes, I’ve finished the procedure, and they’re asking me, “Are you finished, or are you done? Did you already do it,” because they’re actually quite surprised that they didn’t actually feel much. Oftentimes, with these procedures, such as your ultrasound-guided procedures, you’re not really going to feel anything.
Moving on to your intravenous laser ablations and even, to that matter, surgical removal of some these varicose veins under local anaesthetic, most patients are quite happy. The ones that actually feel anything or feel a little bit uncomfortable are the ones that are a little bit more sensitive to the local anaesthetic that’s injected rather than the needles themselves. Oftentimes, it’s something that’s very much accepted by patients, and even when they do feel a little bit of the local anaesthetic, it’s very short lived, and they’re often speaking about their families or holidays that they’re going on, so it happens quite quickly and, actually, it doesn’t really concern them that much.
Overall, needles are really well accepted. My hope in this video is that it just removes any worry and concern about these needles, and that for the patient or for person that’s coming in for the first treatment, if you’re watching this, you have nothing to worry about.
To actually end this, I would like to mention a patient that I recently treated. She had a needle phobia. That’s why she came in. She said, “I have a phobia with needles.” The first thing I was thinking at that time was that this is going to be a very interesting case, and I was talking to her about, “Is this something you really wanna do because if you’re scared about needles and I’m gonna have give you a few needles into your legs, is this something that you really wanna do?” She was quite adamant that she wanted to do it. To be honest, after I treated her and we completed treatment, she did really well and she actually told me that she didn’t actually feel uncomfortable at all. She said most of the discomfort was in her head because she had this idea that it’s going to really, really hurt, and she didn’t actually feel any of that, so she did really well, and she said the needles are actually not a big deal.
I hope this gives you some sort of idea about needles. Hopefully, you have no concerns if you come in for your treatment.
Patients that are currently pregnant or even planning to get pregnant or in the process can have a tough time with varicose veins. It can be quite challenging when you develop veins in your lower limbs. You go from one day having nice smooth legs to another day where all these changes of pregnancy are happening and it can be quite overwhelming.
What’s worse is as the pregnancy actually progresses, these symptoms can actually get worse. This can include symptoms like pain, aching, even swelling or heaviness in the legs. This is because the uterus or the womb gets bigger, putting a lot of pressure on vessels in your tummy. This prevents blood from actually returning back into your heart and therefore you get a lot of blood actually stagnating in your legs.
This then causes these veins that were usually quite small to start bulging and popping up in your legs. A lot of patients can deal with the signs such as the varicose veins, but they can’t deal with the symptoms, which can be quite annoying. Now during pregnancy as well, you get a lot of hormonal changes and this is due to progesterone predominantly. It can be also due to estrogen causing a lot of these valve changes in your veins and also distension.
What I generally tell patients, especially if you’re pregnant, is unfortunately you can’t have treatment now. You have to sort of wait till you have the delivery and oftentimes wait until you’re done with breastfeeding. More importantly if you are pregnant and you are developing symptoms, the options are, you can wear medical grade compression stockings that basically avoid that distension of your veins and keep your legs nice and tight.
This is something we can help you with at our clinic, especially if you’re going through that period where you’re in that grey area where you are pregnant and you can’t get treated at this time.
The other thing you can do is actually elevate your legs above your heart as much as possible. I know with you being pregnant, the chances are the last thing you want to do is lifting your legs and putting it against a wall. If you can lift it and put it on an area sort of a little bit higher that it’s comfortable enough for you, this allows draining of blood back into your heart.
Now there is a myth or a little saying that goes around that a lot of patients come to me and say, I’ve been told that I should get my veins treated once I’ve completed the number of children that I want to have.
This is not true at all and the reason for this is because if you wait till you complete your pregnancy, oftentimes you’re going to struggle with quite a bit with symptoms during the pregnancy with your varicose veins. You are going to have quite a lot to treat if you wait long enough and I often tell patients that if you have a lot to treat, this going to be a lot more costly for you, as there will be quite a lot of treatment needed. Cosmetically it may not look so good, if you do wait.
I tend to tell patients, to get their varicose veins treated in between pregnancies. The other thing is you can’t get treated during pregnancy, during delivery times, and oftentimes within the first three to six months.
So you do have to actually wait because that is a time where you may consider breastfeeding or you may not. It also gives you the opportunity for your body to go back to normal and the possibility the veins will actually regress, usually during the first three to six months.
We actually give your body that chance to get back to what was normal or what could be a reduction in these veins. Now, I hope I sort of made this clear in terms of the conservative options if you were pregnant, as well as some of the reasons why you get this varicose veins and when you optimally really want to get them treated.
Many of the patients that I treat with varicose veins only have maybe one symptom. In my previous blogs and even in my other videos, I’ve mentioned these symptoms. They include heaviness at the end of the day, aching in the legs, sometimes even pain. They may be associated with some swelling in the legs.
Now one of the symptoms that often gets overlooked is itchiness in the legs. Now, the story that I often hear from these patients is that they may have noticed varicose veins for many, many years, but it hasn’t really bothered them. But progressively over the last few years they’ve noticed that they have a lot of itchiness, especially around the ankle. Some of these patients may even use a bit of steroid creams to try to help, but they find that it helps for a while, but eventually, once they stop using the creams, the the itchiness just progresses.
Now the cause of this itchiness is a condition known as varicose eczema. Now eczema is a condition whereby you get a red, itchy rash. With varicose eczema, you get the red, itchy rash because of the varicose veins in that area. Some of the other symptoms or signs that you may see is that you might find that the skin might get a little bit dry. There might be a little bit of swelling, and the skin around it might actually get a little bit darker. Now when left untreated, this can worsen the skin condition, causing it to eventually break out into a wound, also known as an ulcer.
Now the cause of this varicose eczema is because of varicose veins having a lot of pressure in them. This causes a bit of fluid to leak out into the skin and then your immunity reacts to the skin, causing it to be itchy.
Now what can you do to treat this varicose eczema or itchiness? A conservative approach would be using moisturizing creams to lubricate or almost hydrate the skin. Now if it’s really bad and it’s very itchy, you can sometimes even use steroid creams to help to reduce that itchiness, but oftentimes, as I mentioned earlier, when you stop these creams, the itchiness tends to come back.
Now because it’s due to varicose veins, you can also wear compression stockings to try to alleviate or reduce the symptoms of these varicose veins, and even not standing for long periods or continuously walking can improve the varicose veins. Eventually, if you want to eradicate or completely get rid of the itchiness, the only way you can do this is to treat these varicose veins, because once these varicose veins get treated, the pressure then reduces and this causes less leaking into the skin, therefore causing less itchiness.
The skin itself with the color changes sometimes can get better, but it just depends on how severe it is. But oftentimes you will find that there’ll be a dramatic difference in terms of the skin condition, including the dryness kind of disappearing and the skin getting a lot more hydration.
Now here at Doctor Vein we are very happy to help in any way possible. If you need further information, visit our website at doctorvein.com.au or book yourself in for consultation.
Hi, Dr. Gan from Dr. Vein Medical Clinic. Lasers have become such a common word that most households know what they are. They come in some form of treatment, whether it be lasers your eyes, lasers to your skin, your face, or even other parts of your body. Now, we receive a lot of phone calls from patients asking us about laser treatment for their veins. There are many clinics out there offering laser treatments in some way or form, but not all lasers are the same. In today’s video, I’m going to break down the different forms of treatment, specifically laser treatment for vein disease. Now, it may come as a shock or surprise to you that laser is an acronym for a longer word, and essentially it means light amplification by stimulated emission of radiation. I reckoned laser is probably an easier word to use because no one’s going to remember the longer form.
Now, to break down what lasers actually do, essentially they amplify energy at different frequencies and target different parts of your body, and by doing this, they can avoid damaging tissues that we’re not actually aiming at. And so, lasers for vein disease can come in two forms. Now, the first form is the superficial lasers, which is what a lot of patients talk about. Now, these superficial lasers target the spider veins or even abnormal vessels that you can find on your legs, on your abdomen, on your face, even these broken capillaries, so they’re quite targeted for these vessels, and they’re targeted by having different frequencies, as I mentioned earlier.
Now, they work really well as long as there is no deeper cause of vein disease. What I mean by this is that sometimes when you look at your leg, you can see a bunch of spider veins or even little clusters of spider veins here and there, and you may also see some greenish bulging veins. Not very big, but you can kind of see these greenish veins and also these big varicose veins. Now, if you do not treat the varicose veins or these little green veins, what will happen is that they will continue to feed into the spider veins. What will happen eventually if you do have laser is that these bunches or clusters of spider veins will actually get even worse over time, and sometimes they may go away after initial treatment, but then they’ll come back very soon within three to six months. So it’s always important to get the deeper veins treated before you even touch the spider veins.
The other thing about superficial lasers is that sometimes certain lasers can do 10 different things. They can do your face, they can do this, they can do that, they can do resurfacing. But getting a specific vascular laser that targets these vessels is one of the lasers that will make a huge difference in terms of the number of treatments you may need. At our clinic, we use a dedicated vascular laser. And all it does is focuses on these abnormal vessels, whether it be spider veins, broken capillaries in your face, or even these vessels on different parts of your body. And because they’re so targeted and the energy emitted from these lasers is quite strong, we can often get rid of these veins quite quickly with a number of treatments rather than having four, five, six treatments.
The second form of laser treatment for veins is what is known as an endovenous laser. And, essentially, an endovenous laser is basically putting a laser fiber directly into the vein itself. And what it does is it creates energy or heat energy that disrupts the inner walls in a lining of the walls of the vein and destroys it. Now, this form of treatment is more for patients that have deeper causes of their varicose veins. Now, in a previous video, I’ve actually explained that you have three levels where you have your deep or your big pipe, which is what I’m talking about right now. Then you’ve got your middle level, which is these veins that you may see bulging out of your skin, and they often are quite pronounced. And then you got the little small spider veins. So, the endovenous lasers are basically targeting these deeper pipes that lie within your leg. The only way to find out whether these veins are not working is to get a duplex ultrasound examination looking at these veins. At our clinic, every time you come in for a consultation, every patient gets an ultrasound examination, because we tend to look for the root cause of vein disease rather than just treat these branches or have a bandaid effect for these small little spider veins. It’s important to treat the cause before we can treat the smaller veins. I hope this gives you a little bit of clarity about the different lasers available for vein disease to get rid of that confusion about getting my veins lasered when we’re talking about superficial lasers versus getting my deeper veins treated, which is the endovenous lasers. And if you’re interested in any further treatment, please feel free to contact our clinic or visit our website at doctorvein.com.au to find out a lot more information about vein disease.
Today, I am going to break down the three different groups of treatment available for varicose veins. The first group being endovascular laser ablations or radio frequency ablations. The second group being an injection technique or Sclerotherapy and finally the third group being surgery.
Now, with the first group, with endovascular laser ablation, this has become the gold standard for the treatment of varicose veins. Here a laser fiber is inserted directly into the damaged vein and what it does is that it basically destroys this vein by creating heat around the vein from the inside out. Now, this entire procedure is done under ultrasound guidance and with local anesthetic and therefore, patients actually tolerate this really well.
The next form of treatment is the injection technique or also known as Sclerotherapy. Here a special solution is injected directly into the damaged vein wall therefore irritating the linings of the vein and breaking down the vein. Your body then absorbs these destroyed vein, similarly to how your body absorbs a bruise. Now, glue can also be injected and what glue does is that, once it’s injected directly into the vein, it basically blocks off the vein wall, not allowing blood to flow directly through it. And therefore, it creates a block in that flow, reducing the symptoms of these varicose veins. Use of glue often takes almost two to three years before it breaks down completely, so it’s important that patients understand that.
Finally, we have surgery. Surgery used to be the only available treatment for varicose veins and the specific procedure was called stripping, that most patients have heard of. Here, similarly to pulling off a sock off your leg, the vein was basically pulled out from the inside out. The issue with this procedure is that the rate of recurrence or development of new veins was quite high after some time. Also, this procedure needs to be done in a hospital under general anesthetic. You also often have a hospital stay, your legs often wrapped with bandages and it can be quite painful. There are other forms of surgery that are non-invasive or minimally invasive, similar to a procedure called hooking technique or phlebectomies where by pieces or segments of veins are basically pulled out after a small incision is made along your leg. This procedure is done completely under local anesthetic and it usually yields the best cosmetic results and patients are quite comfortable going through this. It’s important to note that every patient that presents with vein disease may not have the same vein pathology, therefore it is really important to get assessed to find out exactly what types of treatments you need specifically.
I trust this gives you a bit of insight into the different forms of treatment. If you need further information about treatments of veins, please visit our website at www.doctorvein.com.au.
Hi, Dr. Gan here. Today, I’m going to break down a very common question that I get and that is, “What do I have? Do I have spider veins, or do I have varicose veins?” Now, the issue is a lot of patients actually look on line whether it be Wikipedia or on Google, trying to figure out what they have on their legs. And oftentimes, with the descriptions that you get, you often think that do you just have spider veins? Or do you have varicose veins? Or maybe a mixture?
Now, you’re not alone because many patients have the same question. The challenge is, sometimes spider veins can just look like little red spots on your legs as if someone’s actually drawn with a pen on certain areas of your legs. And they can be quite small, but you do notice them. They would look something similar to what this picture is, there we go. So we got sort of these red, little dots that you get. And these are little, small pen marks.
Another option is, you get spider veins, but they sort of look like little paint brushes have been made. Almost like little strokes have been made around those areas. These are pretty obvious and most patients that notice it will know straightaway that they are spider veins. And this would be an image of what it would look like. So essentially you’re looking at little paintbrushes that are made. And you can see these little spots right there whereby you get these little paint marks. And these are the paintbrushes that you get.
And a third form that you can get is you can have spider veins with varicose veins. Now this can be a little bit challenging to see because oftentimes these varicose veins, sometimes they’re just a little bit green, maybe slightly elevate out of the skin. So it can be a little bit deceiving because you think that it’s quite normal. But you will notice that when it’s actually hot these veins will actually pop out a little bit. So it’s quite obvious when these green veins pop out. But you’d also see spider veins and sometimes you get these blotchy patches.
Now an example out here, now obviously this has been overdone because, just for illustration. We’re looking at, so these spider veins and you see these little blotches with little green lines. Obviously they won’t look as green as that but this is sort of an example of what you’re going to be looking at. So that’s an example of you actually having a bit of spider veins and varicose veins.
Now for some patients, they may not have any spider veins at all and only have varicose veins, and these varicose veins might just be a bulging vein. Now it is very important to note that in some very athletic and slim people, they may only have on vein popping out and this may be normal. So it’s important to get it assessed to find out whether, is it a varicose vein? Oftentimes it will cause you pain, so if it’s causing some form, element of discomfort, then the chances are it is going to be a varicose vein and it’s something that needs to be treated.
Now I hope this sort of helps you distinguish between spider veins and varicose veins. It can be a little bit challenging. Oftentimes another issue is that some patients seem to focus quite a lot on the front, because that’s what you can see. And oftentimes at the back you may have more than just spider veins. You might actually have lots of varicose veins but because we don’t actually have eyes in the back of our heads we can’t really see it. So it’s important to know that you can get quite a lot of varicose at your back which is sort of creating this spider veins coming out in front. So it can be a little bit tricky to sort of figure it out.
But I hope that this video gives you some insight into what the possibilities are, of whether spider vein or varicose vein. If you need to find out a little bit more or you want to find out how you can get rid of them book yourself in for consultation.
We all know, through media or even through the news, that when you fly on a plane, there is always a risk of developing a deep vein thrombosis or DVT. That is why they encourage everyone flying to move around the cabin and do plenty of stretching exercises. Many of my patients are also worried about flying on a plane when they have varicose veins. In this video, I discuss the risk involved and answer the question based on current research, what the dangers are and whether it is acceptable to fly with varicose veins.
Sclerotherapy is one of the most effective ways to treat spider veins of all sizes. Often times if patients have clusters of spider veins, this is the only method available to get rid of them. With many patients, they do however also have varicose veins associated with their spider veins and again, sclerotherapy is a great way to treat both. In this video, I break down how it is done, what is to be expected and after care, once they have been treated.
#Sclerotherapy #SpiderVeins #TreatingSpiderVeins #TreatingVaricoseVeins
What Causes those Unsightly Varicose Veins? Why are you affected more than other people of the same age or even your friends and family. In this video, I break down the commonest causes as to why you develop varicose veins.