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.

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.

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. 

Listen to your legs

Sometimes venous disease is very obvious. Bulging, twisty veins that wrap around your legs is one manifestation. Purple spidery veins on the backs of your thighs may be another. But there are other, more subtle clues that your veins may not be working as well as they should.

Do your legs sometimes feel achy or throbbing? Do you have leg cramps in the middle of the night? Are your legs exhausted by the end of the day?

These may be signs of vein disease, and it's best not to ignore them for a couple of reasons. For one thing, your body is trying to tell you something is wrong. Waiting for the issues to go away on their own may actually make them worse as time goes on. If you find out what the problem is, you can take steps to fix it!

Sue, age 63, from North Yarmouth, Maine is one of our patients at the Vein Healthcare Center. Here's what Sue had to say about her own experience:

“I work at a daycare and when I came home at the end of the day, my legs were like cement. I could not move them. It was affecting me tremendously but because it didn’t hurt, I had no idea my veins were the problem. I had EVLA done in both legs, and they felt much lighter right away.”

You can read more patient experiences like Sue's by clicking here. If you are having issues with your legs that you can't quite explain, take a look at this list of questions, and see if you can relate. Finally, contact us at the Vein Healthcare Center to make an appointment for an evaluation of your venous system. There may be a way to fix the problem.

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.

Sclerotherapy Q&A with Alison Scheib, PA-C – Part 3

In our two previous posts we spoke with Alison Scheib, PA-C and sclerotherapy specialist at the Vein Healthcare Center, about post-treatment issues with sclerotherapy. In our final installment, we ask her some of the most popular questions that arise about this procedure. 

What are the most common side effects after treatment?

The most common side effects are bruising and tenderness of the treated veins. The bruising is usually fully resolved within two weeks and the tenderness responds well to heat and elevation. I do want to add that patients who follow the post-procedure guidelines for care will help promote the most effective healing. After each sclerotherapy session, compression stockings should be worn for 10 days, in most cases.

How much does sclerotherapy cost and does insurance cover it?

Costs vary, but it’s usually about $300-$500 per session based on how the vein is visualized (light-assisted vs. ultrasound). Insurers describe sclerotherapy as an “adjunct” procedure and will cover it in part or in full if a bigger procedure has been done in the past, such as radiofrequency or laser ablation, or if there is an open ulcer. Patients should work with their treatment provider to understand their health insurance coverage.

What is the one question that patients ask you the most?

“Will it hurt?” Everyone’s experience is different, but most people describe it as very tolerable. It is always possible to stop the procedure or take a break if someone does find it very uncomfortable, but most patients say there is only minor discomfort. The medicine is pH balanced and vein access is with a 27-32g (very small) needle so it’s really just a very small perceivable pinch.

If you have any questions about sclerotherapy, or what to expect before, during or afterwards, feel free to contact us at the Vein Healthcare Center: email connect@veinhealthcare.com, or call (207) 221-7799.

Sclerotherapy Q&A with Alison Scheib, PA-C – Part 2

In our last post, we discussed the basics of sclerotherapy with Alison Scheib, PA-C and sclerotherapy specialist at the Vein Healthcare Center. Now we talk with Ali about what to expect after a sclerotherapy procedure.

What should someone expect right after sclerotherapy?

Immediately following the procedure, there may be mild itching of your legs. It typically resolves within an hour. For the next few days, there may be some tenderness and bruising. About two weeks following the procedure, you may feel hard bumps in the area of the treated vein, which usually disappear over the course of several months.

How will the leg look or feel a week after sclerotherapy? A month?

Usually, the changes noticed in the first two months are improvement in symptoms. Patients have reported to me that their legs feel lighter, or without pain. The large, lumpy veins slowly disappear, usually 2-6 months after the procedure, and the smaller veins may disappear over the following six months. All veins clear up large to small, high to low. 

Are the results of treatment with sclerotherapy permanent?

Yes, once the vein has collapsed, it typically gets reabsorbed into the body and is permanently gone. Because that vein no longer exists, it cannot cause problems in the future. That said, all the veins in the body have the same genetic makeup and have generally been exposed to the same environmental stresses and, in theory, have the same risk of failing. In other words, if a patient has one bad vein, it is very likely that at some point they will have other bad veins. It’s important to note that healthy lifestyle changes can make a big difference in managing chronic venous issues and preventing future problems.

Can you go to work after treatment? What about exercise?

Yes, you can go to work after treatment. However, you should avoid heavy lifting and strenuous physical activity while standing for the first five days following sclerotherapy. Walking is great exercise after treatment. In fact, walking 30 minutes a day is a post-op requirement!

To read the conclusion of our conversation with Ali, click here. We ask some specific questions about common side effects and whether sclerotherapy is covered by insurance. Plus, the one question that patients ask most…

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. 

Summer and veins

After a long and especially frigid New England winter, it will officially be summer in just a few weeks. What does that mean for those who suffer from vein disease symptoms, such as throbbing, aching legs, legs that tire easily…or having to wear shorts?

We’ve compiled a few @VHC blog posts to help you navigate vein issues (and treatment) during the summer months:

• 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.

And for those who are traveling this summer, prevent blood clots on long trips by plane, train or automobile. Click here to read.

If you have any questions about vein health, whatever the season, you’re welcome to contact the Vein Healthcare Center. And happy almost summer!

True Stories

Have you thought about getting treatment for your varicose veins, leg ulcers, or other, less visible symptoms of vein disease? If you’re considering whether or not to seek treatment for your vein issues, it might help to hear about other people who have suffered from vein disease and found relief.

We’ve put together an e-booklet called Perspectives, in which we share the experiences of real patients of Dr. Cindy Asbjornsen. You’ll read about patients whose legs look and feel better as a result of having their vein problems diagnosed and treated. But it isn’t just their legs that have improved—so, too, have the quality of their lives. 

Click here to read their stories.

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.

What is Restless Leg Syndrome?

The short answer to this question is: we’re not exactly sure. In fact, a single unifying cause of Restless Leg Syndrome (RLS) has yet to be established. We do know is that there are many potential causes for RLS, including pregnancy, diabetes, and rheumatoid arthritis, not to mention medications such as antihistamines, anti-depressants, and a certain class of high blood pressure medicine.

RLS is considered a disruptive neurologic disorder, affecting approximately 10 percent of the U.S. population. It occurs in men and women, though the incidence is twice as high in women. RLS is not diagnosed through laboratory testing, but rather through evaluation of symptoms.

According to the International Restless Legs Syndrome Study Group, the four primary features of RLS are:
• An urge to move, usually due to uncomfortable sensations that occur primarily in the legs

• Motor restlessness (expressed as activity) that relieves the urge to move

• Worsening of symptoms by relaxation

• Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night

About 40 percent of people with RLS have problems with their veins. In our next post, we’ll discuss the possible links between venous disease and RLS.

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!

Considering Treatment for Varicose Veins and Vein Disease? Here’s What to Expect

For those suffering from the effects of vein disease, including varicose veins, the dog days of summer are the perfect time to consider treatment.

Summer is often full of activities and busy schedules, but there is never a good reason to procrastinate when it comes to good health. Plus, if the appearance of varicose veins is a concern, scheduling an evaluation with a certified phlebologist now can allow plenty of time to learn about venous issues and review options for treatment so you’ll be able to show off your legs next summer.

Getting Started With Vein Care

A venous evaluation starts with a medical history,
physical exam, and ultrasound assessment 

Dr. Cindy Asbjornsen, founder of the Maine Phlebology Association is certified by the American Board of Phlebology and treats patients at the Vein Healthcare Center in South Portland, Maine where she cares for all levels of venous disease, including spider veins, varicose veins and venous stasis ulcers. According to Dr. Asbjornsen, proper treatment of insufficient veins starts with the first consultation: a history, physical exam, and ultrasound assessment. “Every part of the evaluation is critical to effective vein treatment,” said Dr. Asbjornsen. “I’m treating the whole patient, not just his or her legs, so it’s important to get the whole picture.”

If you are considering taking the next step toward better vein health, here’s what you can expect from your first visit:

1. Health history. Patients are asked to describe the current state of their veins, what makes their veins feel better, and how their quality of life is affected. Board certified phlebologists don’t just stop at the legs but rather review all of the patient’s systems from head to toe.

2. Other considerations. Past medical, family, and surgical histories are also taken into account, as well as a social history. Details about lifestyle— whether or not a patient smokes, runs marathons, or stands for his/her job all day, for example— are all relevant to good venous care.

3. Physical exam. The specialist will take a patient’s vital signs, then look closely at the patient’s legs and feet. The doctor will rate the patient’s level of disease and health on universal standardized scales. Vein specialists use the “CEAP classification,” which helps us categorize disease. (CEAP stands for: clinical severity, etiology or cause, anatomy, and pathophysiology.)

4. Ultrasound mapping. The veins of the lower legs are evaluated using ultrasound waves to see which veins have flow going in which direction. A healthy vein will only allow flow from the feet towards the heart. Faulty veins are often connected, and finding the “source” of the problem is a complicated, but critical, step in establishing the site where treatment should start.

5. The whole picture. Once the evaluation is complete, the whole picture should be taken into account before determining the best treatment for the patient. The doctor will present the patient with all of the potential options, including conservative treatments[http://veinhealthcarecenter.com/treatment-options.php?Other-4]. In the end, the patient decides how he/she wants to proceed.

6. Timing.  Consultations generally take between 45 to 90 minutes, depending upon the extent of the problem and whether or not an ultrasound occurs in the same visit.

7. Pre-visit paperwork. New patients can prepare for their first consultation by filling out any required paperwork ahead of time; filling it out at the office will just delay their appointment— and other patients too.

8. Removing socks and shoes. Patients should also know that they will be asked to wear a short garment and to take off socks and shoes. Doctors need to visually inspect the patient’s legs and feet, so they must be adequately exposed.

9. Drink water. It’s also helpful for patients to drink water before the exam; hydration can cause the veins to bulge, making it easier to see the problem.

While full consultations are not free, they are partially or completely covered by most insurance companies, especially if the policy covers specialist visits. Those with Medicare and supplemental coverage usually pay no out-of-pocket expenses. So, if you’ve been considering an evaluation from a certified phlebologist, don’t wait. It’s always the right time to improve your vein health.