How exercise impacts veins (and vice versa)

In our last post we began discussing how physically active people experiencing leg pain are possibly experiencing the effects of vein insufficiency. In this post we take a closer look.

During exercise your muscles require more oxygen, so veins dilate to increase the volume of blood flowing through the circulatory system—but if your veins are not working properly, that means more blood can pool in your legs. On the other hand, exercise is beneficial from a venous standpoint because anything that improves the function of the foot and calf muscle pumps to get the blood back up to the heart is good.

Walking is the best exercise for improving the muscle-pump function, especially following vein treatment. Although walking can help manage the symptoms, it does not prevent vein problems. Neither does exercise cause vein problems, except in extreme cases. Physical activities that require your legs to support heavier weight over prolonged periods of time, such as weightlifting or backpacking can put someone at increased risk for developing venous issues. Repeated exposure to increased intra-abdominal pressure, or pressure that is transmitted to lower extremities, can cause the normal system of valves and veins to weaken over time and become incompetent.

Repetitive motion sports such as endurance running, cycling and tennis can also put a lot of stress on your leg veins and over time may overcome a normal venous system.

In general, exercise (and working out the muscle pumps) is not detrimental for the vast majority of athletes who are participating in a more typical spectrum of activity. In fact, maximizing the efficiency of that system is beneficial.

Depending on each individual’s degree of vein disease, he or she may become more symptomatic because the foot pump no longer counters the vein insufficiency. One person’s level of activity, for instance, may be associated with the progression of vein disease if they have some pre-existing risk factors, such as age or family history.

While exercise can influence vein dysfunction, it doesn’t necessarily prevent it or cause it. But can poorly performing veins affect athletic performance? The short answer is yes. If the venous system is not working correctly, then the “extra” de-oxygenated blood (and blood waste products like lactate) can cause discomfort, cramping, fatigue, or other conditions that diminish performance.

Even if legs feel great during training, vein issues can also cause legs to hurt after exertion and slow your recovery.

In our next post about athletes, exercise, and veins, we’ll turn to treatments to fix the problem. And be sure to visit the Vein Healthcare Center in South Portland, Maine to learn more about your options for treatment.

Changes in the skin

Did you know that changes in the skin might be a clue to venous disease?

If you notice redness around the ankles, see other color changes on your legs, or find that your skin has become harder or thicker in the lower leg, it’s likely you are experiencing a common symptom of venous disease. These skin changes can be mild, or they can cause pain and involve larger areas of the skin.

Other skin changes, such as dermatitis (inflammation of the skin), cellulitis (bacterial skin infection), dry or scaly skin, or brown “stains” on the skin, can be signs of advanced venous disease.

If you do observe these types of changes—especially if you are experiencing other vein symptoms, such as aching or throbbing legs, or if vein problems run in your family—consider talking to your primary care doctor, or visiting a physician who specializes in vein health.

What is Lymphedema?

In a previous post we discussed the problem of edema, as well as some tips for relief. Here we'll introduce the condition of lymphedema, a related--but different--condition.

To review briefly, edema is swelling that happens because of the accumulation of excess tissue fluid that had not yet returned to the circulatory system. The excess fluid eventually leaves the area as it heals and the swelling goes down.

Lymphedema, on the other hand, occurs when the lymphatic system is damaged or blocked and protein-rich fluid builds up in soft body tissues causing swelling. Primary lymphedema is caused by the abnormal development of the lymph system, before birth.

Secondary lymphedema, a more common condition, is caused by damage to the lymph system any time after birth, or by the removal of lymph nodes because of injury, trauma, infection of the lymphatics, or cancer biopsy. In fact, lymphedema is a common problem that may be caused by cancer and cancer treatment, although the patient may not notice any swelling until months or years after treatment.           

Lymphedema usually affects the arm or leg, but it can also affect other parts of the body. Swelling ranges from mild, hardly noticeable changes in the size of the arm or leg to extreme swelling that can make it impossible to use the affected limb.

Unfortunately, there is no cure for this chronic condition, only treatment and management. 

To learn more about lymphedema--and its close cousin phlebolymphedema--read the cover story in Vein Health News. Just click here to read "Mutually Interdependent: the Venous and Lymphatic Systems."

3 reasons to visit a vein specialist this year

At the start of a new year, many people schedule visits to their family doctor, dentist and other physicians, but who should plan to visit a vein doctor, and why? People often discount their bulging or uncomfortable veins because they’ve been told for years that such issues are merely cosmetic and never covered by insurance. Not true!

Today, venous disease and its accompanying symptoms— including, but not limited to, varicose veins— are recognized for the health issues they truly are. Improving one’s quality of life also shouldn’t be underestimated, so here are just three reasons to consider an evaluation with an experienced, board-certified phlebologist:

1. You’re embarrassed to show your legs – Whether you have thick, ropy varicose veins, or spindly spider veins, there are modern, minimally invasive procedures to treat an array of vein disorders. While varicose veins can hinder confidence and the ability to participate fully in life’s activities, venous disease is never simply cosmetic. It is a progressive disease that can lead to incapacitating symptoms, heightened pain, and intensified health concerns.

2. Your legs often feel tired or heavy – These are two of the most common (and early) symptoms of a vein problem. Intense leg fatigue at the end of the day is a sign. Heaviness is usually a result of mild swelling due to poor venous return (blood flow back up to the heart). These symptoms can be easily treated with compression stockings or other minimally invasive therapies.

3. “Bad veins” run in the family – Approximately 60% of people who have one first-degree relative with venous issues will also have issues. That statistic shoots to almost 90% if someone has two first-degree relatives with vein problems. Many bleeding and blood clotting disorders are also hereditary. If someone has a family history, s/he should be proactive about vein disease prevention and consider going to a vein specialist for a baseline evaluation.

If you have any questions about problem veins, or just don't know where to begin, give us a call at the Vein Healthcare Center. We'll work with you understand venous disease and what your options for treatment may be.

Can treating vein disease help RLS?

As we discussed in our last post, about 40 percent of people with RLS have problems withtheir veins, but we don’t fully understand the relationship between RLS and venous disease. Research shows that there is high correlation of patients who see their RLS resolve when they receive venous treatment. 

One study showed that treatment of venous reflux eliminated or significantly reduced 98 percent of a person’s RLS symptoms. (Ninety-two percent of symptoms did not return after one year.) Another study showed that 95 percent of an individual’s restless legs symptoms were reduced, and 53 percent of symptoms were completely eliminated after vein treatment. Despite this and other research, there are currently no prospective random clinical trials that show that RLS is directly related to veins.

It is worth adding that many phlebologists have found that when patients wear graduated compression stockings, their RLS symptoms improve.

There is no cure for RLS, but many treatment options are available to help manage symptoms, including long-term use of prescription medication. According to Dr. Asbjornsen, many patients in her care have expressed that treatment for venous insufficiency has completely relieved their RLS, although other patients saw no difference at all. 

Research findings and anecdotal evidence do suggest that the patients who are evaluated for restless legs syndrome would benefit from an evaluation for possible vein disease as well. 

An article in the journal Phlebology (2008;23:112-117), for example, concludes that all RLS patients should be properly evaluated for venous reflux before initiation or continuation of drug therapy. http://en.wikipedia.org/wiki/File:Gray1240.png

Books about vein health

More and more, patients are turning to their computers (and mobile devices) to gather information about health-related topics. But don’t forget about “good ol’ fashioned” books! There are a number of publications that can help people make informed decisions about their leg health and overall wellness. Published by the American College of Phlebology (ACP), Healthy Veins…Healthy Legs was written by established vein specialists around the country. The Vein Healthcare Center’s own Dr. Cindy Asbjornsen contributed the chapter about risk factors and other causes for vein problems. The book gives patients a comprehensive look at vein disease, plus practical tips for prevention and management. Many VHC patients turn to Understanding Venous Disease to learn more. The book, written by Dr. Asbjornsen, provides an overview of venous disease, including complications and the latest procedures. It also discusses alternative and conservative treatments.

Another consumer-friendly book is Say Goodbye to Varicose Veins & Spider Veins Now! by Dr. Greg Martin, a board certified phlebologist in Georgia. The book is written in a very accessible style that’s easy to understand. For health professionals, the third (and latest) edition of Fundamentals of Phlebology: Venous Disease for Clinicians is soon to come out. It is considered “the Bible” for phlebologists other allied healthcare professionals who incorporate venous disease treatment in their practices.

Happy reading!

A few more ways to ease venous symptoms at home

In our last post we discussed a number of ways to alleviate the pain and discomfort of venous disease right away. Here are four more ways to make your legs feel better and prevent the progression of symptoms. 1.  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. 2.  Take a break. Take frequent walking breaks to avoid sitting or standing for periods of more than two hours. 3.  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. 4.  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. If you are experiencing signs of venous disease, such as spider veins, or swelling or pain in the leg, considering seeking professional help. A vein specialist certified in the field of phlebology (the branch of medicine that deals with vein health and diseases) can evaluate your vein problems and offer a range of treatments, whether a minimally invasive procedure, or a more conservative approach.

Is it time to get a second opinion?

One way to take control of your own vein health (and overall health) is to seek a second opinion.

Second opinions are common in the field of medicine, including the area of vein health. In fact, second opinions are an essential part of effective diagnosis and treatment of venous disease.

In recent years, there have been many new developments in the treatment of varicose veins and other vein problems, and some doctors may not be familiar with minimally invasive treatment options, such as ultrasound-guided sclerotherapy, or endovenous laser ablation (EVLA).

If you have been told that there is no treatment for your venous symptoms-- or, if you have been told that your venous condition will resolve itself without any intervention-- you may be a good candidate for a second opinion.

Learn more about second opinions and some of the treatment options available, and take control of your vein health!

Varicose Veins? Don’t Let Them Ruin Your Summer

Seasonal Tips for Healthy Legs

Summer is the perfect time to make sure you are doing everything you can to relieve symptoms of varicose veins and other vein problems. Varicose veins can worsen during the summer months, so if vein issues are keeping you from enjoying summer activities, making leg vein health a priority can help you take full advantage of the season.

Relief & Prevention Tips for Healthy Veins

• Stay as cool as possible. Heat dilates veins and causes pain and other symptoms to worsen.
• Swim and walk. Both exercises pump the calf muscles and improve circulation. 
• Wear graduated compression stockings. Wearing compression stockings all day will keep the legs feeling as good at the end of the day as in the morning.
• Stay hydrated. Drink plenty of water and other fluids.
• Elevate the legs whenever possible.
• Schedule an evaluation with a qualified phlebologist.
• Wear graduated compression stockings. Wearing compression stockings all day will keep the legs feeling as good at the end of the day as in the morning.

Don’t Wait Until Summer’s Over to Seek Treatment for Vein Issues

The treatments for venous problems are the same during the summer as the rest of the year.

Find out more about vein treatment options and keeping legs healthy by reading Dr. Cindy Asbjornsen’s Self-conscious About Unsightly Veins? Tips for Relief in the Bangor Daily News and leave concerns about leg vein issues behind this summer!