One Chef's Perspective

Joshua B. is a chef. Years in the restaurant business have kept him on his feet for extended periods of time, which— combined with a family history of varicose veins— was a recipe for unhealthy legs. 

“I started getting varicose veins in high school, but as unsightly as they were, they never really bothered me,” said Joshua.

As the New Hampshire native got older, his veins got worse. They continued to get bigger and stay swollen for longer periods of time. Even crawling on the floor with his young kids was hard because of the varicose veins on his knees. But the self-proclaimed “tough guy” continued to live with the discomfort. When he was about 27 years old, however, he started to experience undeniable medical issues.

The skin covering Joshua’s veins gradually got thinner and thinner, especially on the insides of his ankles. Eventually the skin got so thin on the inside of his right ankle that it ruptured and began spraying blood “like a squirt gun coming out of the side of his foot,” as Joshua described it.

“It was scary. I didn’t know what to do, so I rushed to the emergency room where they gave me a Novocaine injection and stitches that stayed in for a week,” he said.

That was the first emergency. Ten months later another bleeder opened up higher up on Joshua’s right leg. He finally began to take the problem seriously
and went to two different doctors for treatment.

One physician encouraged vein stripping. The other physician advised against it but offered no alternatives. Joshua was confused: “I never really had a clear path of what to do.”

Finally, Joshua found his way to the Vein Healthcare Center. An ultrasound revealed the source of the problem, and Joshua worked with Dr. Cindy Asbjornsen on a treatment plan. He proceeded to have endovenous laser ablation (EVLA) on his right leg first, followed by his left leg two months later. Dr. Asbjornsen followed both EVLA procedures with sclerotherapy. As Joshua put it, the EVLA “dams up the river,” and then the sclerotherapy gets rid of the other streams leading up to it.

Joshua was nervous before the procedures, but found that it was a lot easier than he expected. Although his goal was to restore healthy venous return
in his legs, he’s been surprised by how much more comfortable and confident he feels.

“I’m not as apprehensive about wearing shorts and showing off my legs now, because before they were gnarly and bumpy,” he said. “They’re not Tom Brady’s legs yet, but they look much better than they did.”

Overall, the experience has been an educational one for Joshua. Once he really understood what varicose veins were and what his specific problem was, he couldn’t wait to fix it. In fact, he wishes a vein exam could be part of every general physical.

“It’s a quick thing to look at someone’s legs to see if there are varicosities. There are a lot of possible treatments, and the earlier you start the better off you are.”

Click here to read more about real patients' experiences with vein disease and treatment. If you have any questions, we encourage you to contact us at the Vein Healthcare Center!

10 Tips To Make Your Legs Feel Better

If your legs feel achy or tired, it may be a venous issue. Best to check with a vein specialist for a thorough evaluation. (See tip #10 below!)


In the meantime, there are things you can do to alleviate your discomfort and perhaps even prevent your symptoms from progressing:


1. Elevate. Elevate your legs above your heart as often as possible -- for as long as 30 minutes or as briefly as three minutes. The best time is after you have been standing or after a hot shower.



2. Wear loose-fitting clothing. Avoid tight-fitting clothes around your legs and waist. It will help by not impeding circulation in your lower body.



3. Avoid high heels. High-heeled shoes shorten the muscles in the back of your leg and prevent deep veins from operating at their full capacity.



4. Sit properly. Focus on good posture and avoid crossing your legs  or sitting in ways that can compress veins for prolonged periods.



5. Walk. Walking causes the rhythmic contraction of calf muscles and helps promote blood flow to the heart. Walk at least 30 minutes every day – all at once, or in shorter increments.



6. Take a break. Take frequent walking breaks to avoid sitting or standing for periods of more than two hours.



7. Wear compression stockings. Wearing compression stockings purchased from your pharmacy will help promote the flow of blood when you are flying, on your feet for long periods, or carrying heavy loads.



8. Don’t smoke. Smoking and exposure to second-hand smoke constricts veins and affects overall circulation.



9. Know your history. Women with a family history of vein disorders, or those who have relatives with varicose veins, should wear compression stockings during menarche and menopause, and during pregnancy – most importantly, during the first trimester.



10. See a vein specialist. Contact a board certified phlebologist for a screening and evaluation, or to find out more about risks, prevention, and treatment of venous disease.

To make an appointment with Dr. Cindy Asbjornsen, founder of the Vein Healthcare Center, click here or call 207-221-7799. We can help make your legs feel better!

15 Facts About Vein Disease

There are a lot of myths about venous (vein) disease, and how to treat it. Rather than add to the confusion by repeating them here, we're happy to present these 15 facts to consider.

1. Vein problems are among the most common chronic conditions in North America.

2. Approximately half of the U.S. population has venous disease.

3. In this country, 50 to 55 percent of women and 40 to 45 percent of men have venous disease— of these, 20 to 25 percent of the women and 10 to 15 percent of men will have visible varicose veins.

4. Varicose veins affect one out of two people age 50 and older, and 15 to 25 percent of all adults.

5. Every year an estimated 4.6 million U.S. work days are lost due to venous disease.

6. Gender and age are two primary risk factors in the development of venous insufficiency.

7. Individuals who have been pregnant more than once, have a family history, or spend a great deal of time standing increase their risk of the disease.

8. If varicose veins are not treated, they will not go away on their own; in fact, they usually get worse over time.

9. Without treatment, early symptoms of venous disease can lead to lipodermosclerosis, a disease of the skin and connective tissue; an increased chance of superficial venous thrombophlebitis, clotting in the superficial veins that causes severe pain; or ulceration, wounds on the leg that will not heal.

10. Venous disease can be a factor in chronic leg cramping or restless leg syndrome.

11. Symptoms and progression can usually be controlled with compression.

12. Some people with venous disease present with no symptoms.

13. Treatment can stop the progression of the disease; it can restore health and quality of life for those with early stage symptoms and for those struggling with late-stage symptoms.

14. For most people, even debilitating symptoms are treatable.

15. It’s critical that an evaluation involve close attention to the entire venous system, so that poorly functioning veins can be treated at the source. 

Education is an important first step toward better health – and that includes your vein health! 

To learn more about the prevention and treatment of venous disease, visit a phlebologist (vein specialist) certified by the American Board of Phlebology (ABPh). While many practitioners may practice vein care, a board certified phlebologist meets the ABPh’s high standard and has the knowledge, skills, and experience to provide quality patient care related to the treatment of all aspects of venous disease.

If you'd like to schedule an evaluation of your vein health, contact us at Vein Healthcare Center. We're happy to answer your questions!

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.

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. 

Dos and don'ts for holiday healthy legs

Venous disease -- including spider veins, varicose veins, and leg ulcers -- does not stop for the holidays. But don't worry! We at the Vein Healthcare Center in Maine, have some tips to help you alleviate the symptoms of vein disease and prevent them from getting worse.

As you're out and about this holiday season, DO wear loose-fitting clothing. Santa’s red suit, for example, is roomy and comfortable and wouldn’t impede circulation in his lower body.

DO walk for at least thirty minutes a day-- like in a mall or large department store! The calf muscle contractions caused by walking can go a long way toward venous disease prevention and help keep the muscles of the lower legs healthy. And when you're out and on your feet, DO take a break every hour or so.

Now for a few DON'Ts. DON'T wear high-heeled shoes (or boots), as they shorten the muscles in your calf and prevent deep veins from working at their full capacity.

If you're taking any holiday trips long distances -- by plane, train, or automobile -- DON'T forget to wear compression stockings to keep the blood in your lower limbs moving in the right direction.

This last DON'T shouldn't surprise you: DON'T smoke. Smoking (even a corncob pipe) and exposure to second-hand smoke constricts veins and affects overall circulation.

Tips like these can help alleviate (or prevent) the symptoms of vein disease, but if you are experiencing symptoms, consider being screened by a Board-certified phlebologist like Dr. Cindy Asbjornsen. Contact us to schedule an evaluation appointment, or to find out more about vein health and treatment.

Vein tips for hot days

Heat dilates veins. That means that varicose veins (or "leaky" veins) and other symptoms can worsen in warmer weather. 

Here are some quick tips for vein relief:

• Stay as cool as possible. 
• Stay hydrated. Drink plenty of water.
• Take a walk. If the temperature outside is too hot, try a stroll through the mall or another climate-controlled building.
• Go for a swim. Like walking, swimming pumps the calf muscles and improves circulation. Plus, a swim can cool you off!
• Elevate the legs whenever possible.
• Schedule an evaluation with a Board certified phlebologist.

Click here for additional ways to ease symptoms of vein disease. Click here to schedule an appointment for a complete evaluation of your vein health so you can treat the problem at its source.

Be aware of DVT and travel safely this summer

Summer may be BBQ season, but it’s also the time when people travel long distances in planes, trains, and automobiles. For us in vein healthcare, that means increased risks of Deep Vein Thombosis, or DVT.

The deep vein system carries about 80% of blood from the feet back up to the heart. Deep veins are located under the muscle and connective tissue layers in the legs. A blood clot in a deep vein can be dangerous because the high pressure in the system could cause the clot to break free from the vein wall and enter the blood stream. The DVT could then travel up through the legs into another part of the body such as the lungs, where it would become a pulmonary embolism (PE).

DVT or PE symptoms are often misinterpreted as something less serious. A blood clot in the leg may feel like a “charley horse,” shin splints, or a twisted ankle. Symptoms from PE are often attributed to a pulled muscle in the chest, costochondritis (inflammation of the joint between ribs and breast bone), asthma, or a “touch of pneumonia.”

So what are some of the signs to look for? For DVT, the leg may be warm to the touch; swelling in the leg (can also occur in the arm); leg (or arm) pain or tenderness; reddish or bluish skin discoloration.

For PE, be aware of a sudden shortness of breath; sharp, stabbing chest pain (may get worse with deep breath); rapid heart rate or breathing; feeling lightheaded or fainting; unexplained coughing, sometimes with bloody mucus.

In half of DVT and PE cases, no symptoms present at all—but both conditions are medical emergencies. Any of these symptoms should be regarded as a DVT or PE until proven otherwise, especially if someone is in a risk category (including whether there is a history of blood clots in your family).

Awareness is key-- and so is prevention. When traveling long distances, stay well hydrated, stretch legs your legs and pump your feet periodically, avoid or moderate alcohol and caffeine, and consider wearing graduated compression stockings on your trip.

To find out more about DVT and other vein issues, contact us at the Vein Healthcare Center. We will evaluate your vein health — including spider veins, varicose veins, and leg ulcers.

Dealing with veins in the summer

Although the first day of summer is technically June 21, many New Englanders consider Memorial Day to be the unofficial start of the summer. 

’Tis the season for people to dust off their BBQ grills and motorcycles— and shorts, swimsuits, and sandals. This time of year brings joy to most, but for those dealing with vein issues, it can produce discomfort and anxiety.

If you suffer from symptoms of vein disease, shorts season can be a tough time. Here are a few @VHC blog posts that can help:

• Don’t let varicose veins ruin your summer. Click here to read.
• Vein treatments in the summer, Part 1. Click here to read.
• Vein treatments in the summer, Part 2: Click here to read.

To find out more about how to treat vein issues, contact us at the Vein Healthcare Center. We will evaluate your vein health — including spider veins, varicose veins, and leg ulcers — and recommend the best treatment for your individual condition and health goals. Schedule your appointment today.

Celebrating women's health

The 19th annual National Women's Health Week kicks off on Mother's Day, May 13! Led by the U.S. Department of Health and Human Services' Office on Women’s Health, it's a chance for women to consider their own health and take steps toward being healthier.

At the Vein Healthcare Center, we encourage all women to pay attention to what their bodies are telling them, including their legs -- especially if venous disease seems to run in the family. 

To celebrate women's health, this week and every week, we'd like to offer you our eArticle called "Women and Vein Treatments." You can learn about the three potential high-risk times that women are vulnerable to venous disease, how pregnancy impacts veins, and what kind of vein treatments are available today.

With the right information, women have the ability to reduce their risk of developing venous disease or decrease its severity. If you'd like to find out more about your vein health and schedule an evaluation, don't hesitate to contact us at the Vein Healthcare Center. 

It’s almost shorts season

"I just wanted to be able to look at my legs and not feel awful. For the first summer in 25 years, I wore shorts and did not feel embarrassed." - Shaye R. 

"I wore a skirt for the first time in decades." - Jane S.

"Even though I'm only 30, I gave up caring what my legs looked like, but now you can see the shape of my legs again!” - Lisa F.

For these former patients of the Vein Healthcare Center, their main goal was to make their legs feel better. But after vein treatment, they were delighted to find that their legs also look better.

As summer approaches -- shorts and skirts weather -- it can be emotionally difficult for those with visible vein disease to enjoy their time out and about. At the Vein Healthcare Center, our philosophy is that patients who want to treat their problematic veins aren't being vain, they want to improve their health and quality of life. Being comfortable with their legs in public is part of that quality of life.

To hear more about patient experiences at the Vein Healthcare Center before and after venous treatment, check out Perspectives, a resource you can download and share.

Education is an important first step toward better vein health. The next step is to receive a complete evaluation. To schedule a new patient visit, call us at (207) 221-7799 or request an appointment online. 

Hidden signs of vein disease

Sometimes vein disease is unmistakable. Large, bulging varicose veins are a sure sign, as are bluish spider veins. But sometimes vein issues are harder to detect.

The 65-year-old woman in the picture to the right sought help because of veins in her right leg, but in her initial evaluation it became apparent through skilled ultrasound mapping that both legs were affected. Even she didn’t realize the disease was actually worse in her left leg than her right.

Other symptoms that may indicate vein problems are heaviness or aching in the legs. Swelling, throbbing, cramping, or burning sensations in the leg are other signs, as are restless legs. If you think you might be suffering from one or more symptoms of vein disease, ask yourself these 12 questions to find out more.

As for the patient in the picture, she had EVLA treatment on both legs, followed by ultrasound-guided sclerotherapy. Both of her legs – and her quality of life – have distinctly improved.

Treatment is individual

Just as every person is unique, so should every health treatment plan be.

If you decide to pursue vein treatment, be clear about what you want. Do you want to wear shorts or skirts again? Do you want your legs to feel good even after standing on your feet all day? Or are you happy to control your venous reflux with compression therapy?

Whatever your desired outcome, make sure you work with a doctor who will listen to you and help you achieve your goals. Of course, we recommend vein care from vein specialist certified by the American Board of Venous and Lymphatic Medicine (ABVLM).

Vein therapies today are performed by a variety of providers; some may lack adequate training or oversight, and some treat cosmetic concerns without taking the overall health and venous health of the patient into account.

Without a full understanding of both vein health and pathology, wrong treatment options can cause more damage to the venous system – and decrease your quality of life. When treated by a certified phlebologist committed to your overall health, you should receive professional medical care you deserve. 

If you’re wondering if you have symptoms of venous disease, click here to learn more about it.

Men, women and veins

Gender and age are two primary risk factors in the development of venous insufficiency. The U.S. estimate for varicose veins is 40% in females and 22% in males. 72% of American women and 42% of men will experience varicose veins symptoms by the time they reach their sixties (although vein problems can occur at almost any age).

While it’s true that women are more likely than men to have venous disease, including varicose veins and spider veins, men are more likely to suffer from the worst vein problems, such as ulcers. Why is this the case?

Dr. Cindy Asbjornsen has observed that women tend to get help for their vein issues right away, while men will often wait until the problem becomes too painful to ignore. Leg ulcers, or wounds that won’t heal, are often the result. Conditions like varicose veins get worse with time, so the longer someone waits, the more extensive the condition—and often, the treatment.

Even men who are athletic are susceptible to venous disease. The important thing is to seek help for vein issues as soon as symptoms present themselves.

Symptoms of venous disease include:

•     Leg fatigue or heaviness – It is an early warning sign when legs feel good upon waking but are intensely tired or heavy at the end of the day.
•     Swelling – This can be caused by many things but also serves as a very early warning sign for vein problems.
•     Skin changes – Redness, skin thickening or other color changes on the legs and/or ankles is a common (and commonly overlooked) symptom.
•     Other skin changes, such as dermatitis, cellulitis, dry or scaly skin, or brown “stains” on the skin can be signs of advanced venous disease, and should be evaluated by a physician.
•     Spider veins – Blue- or purple-colored veins that occur under the skin but are close enough to be seen on the surface can be the “tip of the iceberg.
•     Varicose veins – Another sign of early stage venous disease, varicose veins are visible veins in the leg that bulge, often protruding through the skin.
•     Ulcers – An open wound on the leg or ankle that fails to heal can be the result of ongoing venous disease, often an indication that venous disease has reached an advanced stage.

Remember, some people with venous disease present with no symptoms, only skin changes and/or bulging veins. The key for anyone, regardless of gender, is to get evaluated as soon as he or she suspects there’s a problem.

Varicose veins during pregnancy—how to prevent them, how to treat them

In honor of Mothers Day, we’re discussing the topic of varicose veins during pregnancy, but with a focus on the positive: prevention and treatment. (We explore the effect of pregnancy on veins in greater depth in a previous blog post. Click here to read more.)

During pregnancy, the two most important preventative things to consider with vein care are periodically elevating the legs and compression. 

Maternity compression stockings come in a variety of styles and strengths, from knee-highs and thigh-highs, to full-length stockings. Many panty hose styles have more room in the belly and are specially designed to expand during pregnancy without restricting the abdomen. Maternity graduated compression stockings are specially designed to fit more snugly at the ankles and calves and less so toward the top. The gradual change in compression helps the weak valves in the veins to circulate the blood more effectively. Many women who wear maternity graduated compression report that it makes their legs feel great!

Though pregnancy compression stockings (and body garments) are available with a doctor’s prescription, many maternity stores also offer them. Accurate sizing is critical, so it is best to check with a doctor prior to purchasing any type of compression while pregnant.

In most cases, women can be safely treated for varicose veins 6-8 weeks after delivery. Hormonal levels are usually back to normal within that time (if the patient is not breastfeeding), and water retention and any clotting risks have usually returned to baseline.

           

Depending on the type of treatment, breastfeeding may be an issue for some patients. Treatments that require a local anesthetic, such as endovenous laser ablation (ELVA) or microphlebectomy, have been proven safe. Sclerotherapy is not recommended if the patient is breastfeeding, as certain medications used during this procedure have not been proven safe and may be excreted in breast milk. However, if the patient is willing to forgo breastfeeding for 24 hours, sclerotherapy is possible.

Another important preventive measure is knowledge. If someone in your family has had a history of vein issues, chances are you might too. Some vein specialists recommend that women seek evaluation, and possibly treatment, for problematic veins before their first pregnancy, especially if there is a strong family history of vein issues. Evaluation and education can be very important for preventing or controlling issues before you need treatment.

Running on all cylinders

This Saturday the Vein Healthcare Center is co-sponsoring the South Portland MAINEiacs first-ever 5K run, just around the corner from the VHC offices!

We’ve had running, exercise, and athletes on our mind lately, as our latest issue of Vein Health News is hot off the press. In our cover story package, we look at how exercise affects veins (and vice versa); whether athletic compression is worth considering; and how even athletes could be affected by DVT.

Click here to read more about athletes and veins. And get out and enjoy a walk or run in the increasingly crisp autumn air!

Q&A with the newest member of the VHC team

Meet Alison Scheib, PA-C! As a certified Physician Assistant, Ali supports Dr. Cindy Asbjornsen, founder of the Vein Healthcare Center. As a trained sclerotherapist, she performs ultrasound-guided and light-assisted sclerotherapy, a procedure for treating venous insufficiency, particularly smaller “spider veins.”

In addition to spending time with her husband (a fellow PA-C at a veterans hospital) and their two children, Ali loves outdoor activities like swimming and waterskiing. Read on to learn more about Ali.

Q:  What is a Physician Assistant?

A:  A physician assistant, or PA, is a nationally certified and state-licensed medical professional. PAs practice medicine on healthcare teams with physicians and other providers and can prescribe medication. I earned my PA degree from the University of South Alabama and practiced Family Medicine for 15 years in Camden, Maine. 

Q:  How do you help patients at VHC?

A:  I perform ultrasound-guided and light assisted-sclerotherapy on patients, sometimes in follow-up to EVLA treatment. Dr. Asbjornsen and I work together as a team to treat each patient to achieve the best outcome. 

Q: What is your goal for each patient?

A: To make them feel better, both mentally and physically. After treatment, I want them to feel comfortable wearing shorts if that’s important to them. I want them to experience activities that they couldn’t do before because their legs were too sore or tired. I want them to be—and feel—healthier!

Q: Why are you a good fit for VHC?

A: I have the primary care background to see the patient as a whole person, not just the one ailment they’re seeking help for. And like the rest of the staff, I like to spend time with patients to make sure they are comfortable and understand their medical disease and treatment options. 

Q: What do you like the most about vein care?
A: I love being able to focus on one aspect of a patient's healthcare while still treating the "whole" person. I’m also excited that phlebology is still a fairly new specialty, and I’m looking forward to working with Dr. Asbjornsen on doing research that can continue to advance the field.

All in the family

Like the color of your eyes, varicose veins are a trait that runs in the family. Since venous disease does have a strong genetic component, it’s important for people to be aware of venous disease and its symptoms and, as with any illness, to know the family history.

If someone in your family has experienced vein disorders or has visible veins on their legs, your risk of the disease is much higher. For example, someone with first-degree family members with vein issues will find the risk is significantly increased.

But just because you watched your mother and your mother’s mother (and so on) suffer from painful and unsightly veins, that doesn’t mean you’re destined to the same fate. Even if you are not currently experiencing symptoms, an evaluation with an experienced phlebologist (vein specialist) can tell you the condition of your venous system, as well as possible interventions and prevention. Modern vein treatments, such as endovenous laser ablation and sclerotherapy, are minimally invasive and extremely effective.

Leg ulcers, an advanced stage of vein disease

Leg ulcers can occur at any stage of life and, without treatment, can cause overwhelming problems. 

When blood pools in the lower leg over a long period of time, the condition is referred to as venous stasis. When blood leaks into the tissue of the skin it can cause swelling and damage to the tissue. Tissue damage can result in wounds, or ulcers, that are chronic and do not heal if the condition is left untreated. Ulcers may be painful or itchy and often require constant care and dressing.

There are three large classes of ulcers: diabetic, arterial, and venous. Of the three types, venous, or vein-related, is the most common. In fact, venous disease is thought to account for approximately 80% of chronic leg ulcers. Venous ulcers can be caused by venous insufficiency or by a wound that has been exacerbated by venous insufficiency. 

Leg ulcers are often an indication that vein disease has reached an advanced stage. However, the key to properly treating and managing them is to first get them diagnosed. Though ulcers may appear similar, each one has a different cause and thus, very different treatments.

Clinical appearance is the first clue to distinguishing between venous and arterial ulcers. Typically, venous ulcers can appear anywhere between the knee and the ankle, while arterial ulcers are usually found between, or on the tips of, toes.

Another sign is discoloration. Venous-related wounds tend to be ruddy, and the surrounding tissue may be red or hyper-pigmented due to hemosiderin (a pigment formed by the breakdown of hemoglobin). In contrast, the wound bed of an arterial ulcer tends to be black, grayish, or yellow.

The most effective way to diagnose a venous ulcer is with a duplex Doppler ultrasound, which reveals whether or not the blood is flowing in the proper direction, or if there is any pooling occurring.

Ulcers do not heal on their own, but even those who are already experiencing this late-stage symptom can have excellent success with treatment. If you have skin breakdown or infection due to ulceration, you should visit your doctor immediately.