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.

Using ultrasound for vein treatment

Ultrasound is an essential tool in vein care, as well as non-invasive and comfortable for the patient. In addition to mapping a patient’s veins and diagnosing vein disorders, ultrasound is used throughout the treatment of veins, acting like the physician’s “eyes inside the leg.”

After a diagnostic ultrasound is performed and the doctor establishes a treatment plan to fix the problem, ultrasound may be used. In endovenous laser ablation for example, seeing where the healthy vein connects with the unhealthy vein is very important; ultrasound is the best modality to visualize this area.

Another example is ultrasound-guided sclerotherapy, which uses the guidance of ultrasound to find leaking veins that are not visible and can’t be seen with a hand-held light used to view veins near the surface (transcutaneous illumination). Ultrasound-guided sclerotherapy is often used to treat perforator veins, or veins that connect the superficial system (above the muscles in the leg) to the deep system (veins under and between the muscles of the leg).     

After the vein treatment and a designated amount of time for healing, the physician will use ultrasound again to assess the effectiveness of the treatment plan.

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.