Dr. Asbjornsen presents at the 2022 Maine Osteopathic Association conference

Earlier this summer, Dr. Asbjornsen presented a seminar called "Aging & Vein Health" to doctors at the Maine Osteopathic Association's annual conference. There's so much useful information in the presentation, that we wanted to share it more widely!

Here are just a few of the things you'll learn:

• How vein disease presents differently depending on a person's age
• There are different categories of older adults in the general term "seniors"
• Several modern, non-invasive treatments can help decrease the leg pain and discomfort associated with vein disease
• Get to know more about Dr. Asbjornsen and her passion for vein health

Click here to watch the full video, or visit the Vein Healthcare Center YouTube channel.

Thank you, nurses!

In 1993, the American Nurses Association declared May 6-12 as the annual week to celebrate and elevate the nursing profession. (Fun fact: May 12 is Florence Nightingale's birthday!)

The week features events all across the country to honor nurses and their work and to educate the public about nurses' indispensable role in public health.

At Vein Healthcare Center, we know that nurses are often on the front lines of health care, and we tip our hats to them! We are well aware that venous disease can be a real occupational hazard for nurses who are often on their feet for hours at a time. We recently shared the story of Beth, a nurse from Maine who suffered from venous disease but eventually found relief.

And we'll never tire of sharing these tips for how nurses can take care of themselves by taking care of their feet. 

Lastly, if you're a nurse, tune into Nurses4Us: Elevating the Profession on Wednesday, May 8 from 1:00pm-2:00pm. Hosted by ANA, the free webinar explores Nursing Now, a 3-year global campaign to improve health by raising the profile and status of nursing worldwide.

Happy National Nurses Week to all of the nurses out there. Thank you for all you do!

Visit the Vein Healthcare Center in South Portland, Maine, or learn more about Dr. Cindy Asbjornsen.

New Year’s Resolutions Are Good…For Your Veins!

“This is the year I take better care of myself.” 

Sound familiar? Every new year people resolve to quit smoking, exercise, visit the doctor, and commit to living a healthier lifestyle. There are a multitude of reasons why these are excellent resolutions, but consider one more: veins. 

Vein disease affects millions of people. It occurs when valves in the veins of the legs can’t efficiently pump blood back up to the heart. Vein disease can cause pain, swelling, varicose veins, or worse. It’s also chronic and progressive, and if left untreated, can lead to serious medical complications. 

“Venous disease is one of the most common health conditions among Americans,” said Dr. Cindy Asbjornsen, Board-certified vein specialist at the Vein Healthcare Center, “but most people don’t realize that it may affect them, or that there are modern, minimally invasive treatments available.” 

Here are three things that people can do to improve— or prevent— vein problems in the new year: 

1. Quit smoking. Smoking and exposure to second-hand smoke affects veins, arteries and the entire circulatory system. It can make venous symptoms, like leg aches and pains, even worse. 

2. Exercise. This can be as simple and effective as walking just 30 minutes a day. Walking causes the rhythmic contraction of calf muscles and helps promote blood flow to the heart.  

3. See your doctor. Ask your primary care physician about venous issues, especially if “bad veins” run in your family. Your doctor can refer you to a Board-certified phlebologist for a screening and evaluation.  

Contact the Vein Healthcare Center to schedule an evaluation appointment, or to find out more about vein health and treatment. 

Have a happy and healthy new year!

Are graduated compression stockings the same as TED hose?

In a word: no. TED hose are not the same as graduated compression stockings. There are many people who do not realize there is a difference.

T.E.D. is an acronym for Thrombo Embolic Deterrent, so T.E.D. hose are "anti-embolic" stockings. They are often worn after surgery to help prevent Deep Vein Thrombosis -- also known as DVT. They work well for this purpose, but they are only 8-15mmHg of compression. As soon as someone is out of bed post surgery and is able to stand, there is more pressure on the veins and the TED hose become much less effective. 

TED hose do not help with the symptoms of venous disease, nor do they halt the progression of venous disease.   

A graduated compression stocking prescribed for chronic superficial venous insufficiency is generally 20-30 mmHg, which means there is approximately 30mmHg of pressure at the ankle, 25 mmHg in the mid-calf, 20 around the knee, 15mmHg in the lower thigh, 10 mmHg in the mid thigh, and 5 mmHg in the upper thigh. This graduation encourages good venous return. Another difference is that, in general, compression stockings are much more tolerable to wear on a daily basis. 

Though compression stockings are much easier to put on than TED hose, they can still be difficult to put on. So if you are prescribed to wear either compression stockings or TED hose, ask your provider for tips -- or even coaching -- for how to put them on and take them off. (That's called "donning" and "doffing" in the compression business.) There are lots of online resources to guide you.

If you have any questions about compression therapy or T.E.D. hose, contact us at the Vein Healthcare Center. We're here to help!

Are varicose veins a cosmetic issue or a medical issue?

This is a question we get at the Vein Healthcare Center all the time. Most healthcare providers would agree that if a patient is having pain and is unable to perform his or her work due to varicose veins, then it is medically necessary.

But all factors must be weighed when drawing a line between medical and “simply cosmetic,” not the least of which is restoring patients’ confidence and overall well-being. Even if a patient isn’t experiencing physical pain – but won’t swim in a pool or wear shorts to the beach because she’s ashamed of varicose veins – her quality of life is markedly diminished.

Additionally, it is common for venous disorders to be undiagnosed or undertreated. It’s important to remember that varicose veins are a symptom of early stage venous disease, and if left untreated could lead to larger medical issues.

From the perspective of insurance companies the difference between “cosmetic” and “medical” may be whether or not a vein has a connection to the deep system; if it does and the connection is leaking, then they consider treatment medical necessary. That said, there are many vein procedures that are covered by insurance, and one should not assume that treatment won’t be covered. Feel free to contact us at the Vein Healthcare Center to discuss the details of your coverage.

At the Vein Healthcare Center, our basic philosophy is that treating problematic veins isn’t about vanity – it’s about health and quality of life.

If you’re not sure whether or not you have vein disease, click here to find out more, or schedule an appointment for a full evaluation of your vein health.

Are varicose veins a cosmetic issue or a medical issue?

This is a question we get at the Vein Healthcare Center all the time.  Most healthcare providers would agree that if a patient is having pain and is unable to perform his or her work due to varicose veins, then it is medically necessary.

But all factors must be weighed when drawing a line between medical and “simply cosmetic,” not the least of which is restoring patients’ confidence and overall well-being. Even if a patient isn’t experiencing physical pain – but won’t swim in a pool or wear shorts to the beach because he’s ashamed of varicose veins – her quality of life is markedly diminished.

Additionally, it is common for venous disorders to be undiagnosed or undertreated. It’s important to remember that varicose veins are a symptom of early stage venous disease, and if left untreated could lead to larger medical issues.

From the perspective of insurance companies the difference between “cosmetic” and “medical” may be whether or not a vein has a connection to the deep system; if it does and the connection is leaking, then they consider treatment medical necessary. That said, there are many vein procedures that are covered by insurance, and one should not assume that treatment won’t be covered. Feel free to contact us at VHC to discuss the details of your coverage.

At VHC, our basic philosophy is that treating problematic veins isn’t about vanity – it’s about health and quality of life.

If you’re not sure whether or not you have vein disease, click here to find out more.

A round-up of “how to’s”

Over the years, we’ve posted a lot of quick tips for vein care at home, so as a year-end gift we’re putting them all in one place!

• How to tell if you have venous disease
• How to keep your veins healthy in the winter
• How to do the “foot pump”
• How to properly elevate your legs
• How to treat venous symptoms naturally
• Quick tips for coping with spider veins 

Don’t forget that while these “how to’s” can help with the symptoms of vein disease, an evaluation by a qualified phlebologist can give you a complete picture of your venous health and options for treatment. If you ever have any questions, don’t hesitate to contact us at the Vein Healthcare Center.

Happy holidays from all of us at VHC!

Compression Before Laser Treatment

For years, patients suffering from varicose veins and other vein conditions had few options for treatment. Now, endovenous ablation, or EVLA for short, is considered the gold standard in vein treatment. EVLA is minimally invasive procedure that is done on an outpatient basis, and recovery time for most people is very quick.

Graduated compression stockings play an essential role before and after vein treatments, including EVLA. Anyone that undergoes EVLA, sclerotherapy or other treatments for venous insufficiency must wear graduated compression stockings immediately following the procedure and during the recovery period. What some may not realize is that there are reasons to wear compression before treatment too.

Before a vein procedure, wearing compression stockings gives a person a snapshot of what vein health feels like. Since compression alleviates symptoms, it becomes easier for a phlebologist (vein specialist) to tease out, or confirm whether the leg pain is due to muscular-skeletal issues, the nervous system, or venous disease. Another benefit to wearing compression prior to treatment is that it’s good to confirm that the patient can tolerate stockings, and/or that the stockings fit properly. (After the procedure is the worst time to discover that the stockings don’t fit!)

Alternatively, many who think that they could never tolerate compression stockings try on a modern stocking and find them quite bearable. Since compression prevents the progression of vein disease and controls symptoms, some people may even decide to take a more conservative approach, rather than proceed with definitive treatment.

Vein disease isn’t always obvious

Vein disease isn’t always obvious. 

The 65-year-old woman in the picture to the right sought treatment because of the bulging veins in her right leg, but at her initial evaluation it became apparent that both legs were affected. Even more surprising, the vein problem was worse on her left leg than her right.

The patient had EVLA treatment on both legs, followed by ultrasound-guided sclerotherapy, and now enjoys healthy-looking legs that no longer ache.

If you have symptoms that you think may be related to venous insufficiency, read our previous blog post “How to tell if you have venous disease,” or click here to learn more. Even if you are experiencing only mild symptoms of venous (vein) disease, as the disease progresses it can lead to chronic venous insufficiency and result in serious medical complications.

Environmental risks for vein disease

There are a number of risk factors for vein problems. Aging is one of the leading risk factors for the development of vein issues. Heredity is another. (If one parent has vein disease you have about a 33% chance of also developing vein problems. If both of your parents have vein issues, then your chances go up to 90 percent.)

While aging and family history are risk factors that can’t be controlled (try as we might), venous disease can be aggravated by environmental risks. It is much more common in “industrial countries” like the U.S., where riding in cars and sitting in front of a computer or television seem like a way of life.

             

We explored the risks involved in sitting in a previous post, but standing for long periods (with or without high heels) is also a risk factor. Research has shown that the more hours one stands, the more likely it is that a vein issue will develop. Likewise, lying in one position for too long can cause serious vein problems. Patients in the hospital or on bed rest, for example, may experience a slowdown in blood flow that can lead to blood pooling in the extremities.

As Dr. Asbjornsen explained in her chapter “Risk Factors and Other Causes for Vein Problems” in the book Healthy Veins…Healthy Legs, it is possible to reduce some risk factors for vein disease.

There are many treatment options today that are minimally invasive and highly successful, but education and prevention are the most important keys to vein health. Even if you are not experiencing symptoms, a venous screening can evaluate the condition of your venous system, help you avoid blood clots, and help you begin lifestyle changes that can prevent symptoms from occurring. 

Seeing is believing

Understandably, sometimes the easiest way for people to decide to get their vein problems treated is for them to see with their own eyes what is possible. We invite you to take a look at the results experienced by several patients of the VeinHealthcare Center in our new e-booklet Perspectives.

In addition to sharing the true stories of people with vein disease, you’ll see the treatment results of eight different patients—with before and after pictures, of course. Click here to see for yourself.

What is ultrasound mapping?

Vein disease, which often manifests as varicose veins, is defined as the impairment of blood flow towards your heart. Oxygenated blood is constantly being pumped from the heart to the rest of our bodies through arteries. It is the job of our veins to carry deoxygenated blood back up to the heart.

Healthy veins have valves that open and close to assist the return of blood to the heart. Vein disease occurs when these valves become damaged, allowing the backward flow of blood in the legs where it can pool, leading to a feeling of heaviness and fatigue and causing varicose veins or other skin changes.

Ultrasound is a tool used to diagnose if and where a vein valve (or multiple valves) in the legs is damaged. High-frequency sound waves are used to create images that allow the doctor to see which veins have flow going in which direction—like a road map for the venous system.

A healthy vein will only allow flow from the feet towards the heart. Faulty veins are often connected, so finding the “source” of the problem is a complicated, but critical, step in establishing where exactly treatment should start.

Ultrasound is the gold standard for evaluation of chronic venous disease, and it is important to have a qualified sonographer perform the mapping in order to have accurate diagnostic results. To learn more about what to expect at a vein evaluation, visit our previous post on the topic.

How to properly elevate your legs

There are a variety of vein treatments for varicose veins and other venous diseases. Board certified vein specialist Dr. Cindy Asbjornsen supports the minimum intervention that will meet each patient's goals for treatment. In some cases, elevation of the legs can alleviate the pain or swelling that is the result of early stage vein disease.

Leg elevation means raising the legs above heart level. The ideal position is to lie on a couch with the back on the cushions and feet up on the armrest, so feet are at a slight angle higher than the heart. Lying down with the legs resting on three or four pillows also works well.

Here are more tips on how to get the most out of this accessible therapy:

• Elevating at intervals throughout the day can encourage blood flow from the legs and decrease the pooling of blood.

• Legs should be elevated as often as possible, for as long as 30 minutes or as briefly as three minutes.

• The morning is a good time to elevate.

• The best time to elevate is after a hot shower, or after standing for a long time. 

• A good way to remember to elevate is to pair it with your meals or snacks.

Elevation is a simple, yet powerful, tool that can help improve blood circulation in the veins and provide some relief to venous symptoms. Dr. Asbjornsen believes that elevation is so important for someone with venous disease that at the Vein Healthcare Center recliners and ottomans are provided in the reception area, so that patients can elevate while they wait.

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.

Healthy legs for the holidays: 5 tips for Santa Claus (and the rest of us)

Approximately half of the U.S. population has some form of venous disease, which includes (but is not limited to) varicose veins. According to Dr. Cindy Asbjornsen of the Vein Healthcare Center in Maine, there’s plenty one can do to alleviate the symptoms of vein disease and prevent them from getting worse.

While there is no proof that Santa Claus has venous disease, his job does keep him on his feet or sitting down for long periods of time. These five simple tips can help keep legs healthy this holiday season:

1. Wear loose-fitting clothing. Santa’s red suit, for example, is roomy and comfortable and wouldn’t impede circulation in his lower body.
2. Wear comfortable shoes. Shoes (or boots) with high heels can shorten the muscles in your calf and prevent deep veins from working at their full capacity. 
3. Sit properly. Focus on good posture and avoid crossing legs or sitting in ways that can compress veins for prolonged periods, such as sitting at the mall or in a sleigh.
4. Don’t smoke. Smoking (even pipe smoking) and exposure to second-hand smoke constricts veins and affects overall circulation.
5. Elevate the legs above heart-level as often as possible. Perhaps with a glass of milk and a plate of cookies.

Happy holidays, everyone!

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!

Alternative treatments for vein disease

For many years, most patients solely accepted the traditional Western world approach to medicine and health. A lot has changed in the last two decades. Remedies that many once regarded as “wacky,” such as acupuncture and meditation, are now quite common. Ask any kid and she can show you at least one yoga pose. There are alternatives in vein care, as well.

While there are proven, minimally invastive treatments for venous disease— endovenous laser ablation (EVLA) and sclerotherapy, chief among them— there is growing interest in the effectiveness of herbal supplements and alternative medications. 

Butcher’s broom, gotu kola and horse chestnut extract are just a few of the natural, plant-based medicines that are available over the counter. Diosmin, one citrus-based compound, is considered a “medical food” and is available with a doctor’s prescription. (We take a closer look in Vein Health News; just click on the “Women and Veins” issue and turn to page 12.)

Current research on these and other herbs is promising, but it’s important to remember that while herbal treatments may help eliminate symptoms, their benefits are limited to the period of time that the medication is being taken. They do not fix the underlying cause of the symptoms. 

Something else to note: alternative medications are not regulated in the U.S. If you are considering taking them, understand the proper dosage recommendations, risks, and side effects. Some herbal supplements can be toxic if taken improperly. Work with your doctor (ideally, a board-certified phlebologist) and stay safe!

5 ways to ease venous symptoms at home

There are a number of treatments for venous disease (including varicose veins) that are outpatient procedures, minimally invasive, and virtually pain-free. But did you know that there are things you can do right now, on your own, to alleviate discomfort? These techniques may even help prevent the progression of symptoms.

Here are five ways to make your legs feel better:

1. Elevate. Elevate your legs above your heart – for as long as 30 minutes, or as briefly as three minutes – as often as possible. 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. Don’t smoke. Smoking and exposure to second-hand smoke constricts veins and affects overall circulation.

These are just some of the things you can try if you are experiencing signs of venous disease. Also consider contacting a board certified phlebologist (vein specialist)  for a screening and evaluation, or to find out more about the risks, prevention, and treatment of venous disease.

If left untreated, vein issues today can possibly lead to larger medical problems tomorrow.

Spider Veins? Quick Tips for Coping

Spider vein is the common term for blue or purple-colored veins that occur under the skin but are close enough to be seen on the surface. They are similar to varicose veins but smaller, and like varicose veins, they can cause physical discomfort and be a source of embarrassment and self-consciousness, especially during the summer season.

If you have spider veins, some simple tips can help you feel better and help stop their progression.

4 Quick Tips for Coping with Spider Veins

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

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

        

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

    

4. Contact a board certified phlebologist for an evaluation. In the past, treatment for spider veins has been considered merely cosmetic, but they can be the tip of the iceberg.

Coping with spider veins? 
You've got options. Find out more about venous disease and its treatment, or contact the Vein Healthcare Center to schedule an appointment to get started with your vein care.