Tuesday, February 5, 2019

What is Pelvic Venous Congestion Syndrome?

Veins have one-way valves that help keep blood flowing toward the heart. If the valves are weak or damaged, blood can flow in the wrong direction in the veins in the legs and feet, often causing them to swell. When this happens near the pelvis, it is called pelvic venous congestion syndrome. Simply put, varicose can also develop internally, in the pelvis, uterus and ovaries. 

Those internal varicose veins can cause symptoms similar to those in the legs. Patients will often have visible varicose veins on their upper legs or labia, but not always. The main symptom is pelvic pain that lasts for six months or more. 

Patients with PVCS report a prolonged deep and dull ache, often associated with movement, posture, and activities that increase abdominal pressure. Like varicose veins in the leg, the achiness that increases with prolonged standing can often be relieved by lying flat or elevating the legs.

Chronic pelvic pain (CPP) occurs below the belly button in the pelvis. The pain may be unilateral or bilateral – meaning on one side of the pelvis or both – and is often more pronounced on one side than the other. The pain is chronic and appears to have no obvious source. Symptoms may also include rectal discomfort or increased urinary frequency, bloating or gastrointestinal (GI) symptoms.

According to some studies, more than 26% of women suffer from CPP, but data about its prevalence is incomplete. When taking into account the number of factors that could also cause chronic pelvic pain, one can see how misdiagnosis by medical professionals might occur. 

Conditions range from problems in the gastrointestinal tract to gynecologic diseases and urologic abnormalities. While some of these conditions are easily diagnosed, other causes of chronic pelvic pain are extremely difficult to recognize and have often been underdiagnosed or overlooked– even though studies show that PVCS occurs in up to 30 percent of patients who have chronic pelvic pain. 

Pelvic venous congestion syndrome, or PVCS, although easy to describe can be challenging to diagnose. In fact, PVCS is often misdiagnosed or never diagnosed at all. 

To learn more about PVCS and how it is diagnosed and treated, read the latest issue of Vein Health News. If you think your pelvic pain may be related to your venous health, feel free to contact us at the Vein Healthcare Center.

Tuesday, January 22, 2019

One patient's perspective: coast-to-coast commute

One of Dr. Cindy Asbjornsen's patients is a 55-year-old nurse with quite a work commute. Beth lives in Ogunquit, Maine, but she works in California. 

Beth works for a national company that provides healthcare and rehabilitation in homes and hospitals. As a district director, she oversees the clinical operations for five long-term care facilities in the East Bay. She flies from Maine to California every Monday and then flies home on Friday. It takes all day to get from one coast to the other; when she’s at work, she’s on her feet for most of the day; and she’s had vein problems most of her life – a triple whammy in terms of venous health.

Like many people, Beth inherited “bad veins.” Her mother had varicose veins, and all but one of her six siblings have “pretty significant” varicose veins. Beth also has a 35-year-old son with extreme varicosities.

Over time she has experienced more and more problems with varicosities. After the birth of her second child, she had a vein stripping done and then another one in the mid 1990s. In addition, up until the last ten years, Beth has suffered from obesity. She believes that the extra weight combined with the venous insufficiency also caused edema in her legs that’s been difficult to keep in check.

“It feels like I’ve been managing this for more than 30 years,” said Beth. “And my legs are still a hot mess despite everything that’s been done to them.” 

Her occupation has exacerbated her issues, as she spends 10-12 hours on her feet during the week, paired with a commute that requires traveling for hours in a plane twice a week. Despite reducing her weight significantly and wearing compression socks daily, Beth was struggling again with achiness in her legs. By mid-afternoon the pain would be so great she’d have to “pop an ibuprofen” to get through the day.

After going to a board-certified phlebologist for an evaluation, Beth learned about the advances in vein care since the days of vein stripping – and the importance of locating, and treating, the “leaky” vein valve at the source.

After initial endovenous laser ablation (EVLA), Beth is no longer feeling any discomfort in her legs, however her ultrasound evaluation showed that “there was a lot of work to be done.” She has begun to wear full-length compression stockings on flights and at work, and she plans to finish her recommended treatment plan, which will include several sessions of sclerotherapy.

As Beth continues the process, she has this advice for people with similar problems: “The treatment modality is basically painless and simple. If you can get rid of the pain and edema – and the harm that the long-term edema causes – you’d be a fool not to do it.” 

To read more stories of real-life patient experiences, click here. If you're looking for relief from leg pain, varicose veins, or other venous issues, contact the Vein Healthcare Center to make an appointment for a thorough exam.