Varicose Veins, A Simple Guide To The Condition, Treatment And Related Diseases

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Varicose veins are swollen veins in the legs
The affected area will be painful and turn red
The risk for varicose veins is related to older age
Immobility, pregnancy or obesity and overweight

Varicose veins can cause an itchy rash or dermatitis
Inflammation of the varicose veins called phlebitis
Discolored skin in the area around the varicose vein
Due to the leakage of a blood dye called hemosiderin

Blood clot can occur in the vein due to inactivity
Medicine such as the Pill may increase coagulability
It may be a sign of deep vein thrombosis
A venogram will confirm the diagnosis

Treatment is with compression stocking
With regular exercise and avoiding standing
Sclerosing of the varicose vein can be by injection
Surgical removal is done by stripping and vein ligation

-An original poem by Kenneth Kee

No treatment if condition is mild

a. Elastic stocking support stockings and pressure bandaging compress the valves of the veins together to prevent backflow and prevent dilation of the veins.

Once the stockings are in place, exercise by walking as much as possible.
While stockings can slow down the natural course of the disease and reduce the painful symptoms, they can not cure the disease.

b. Traditional Sclerotherapy
Here the veins are injected with a small amount of a solution causing them to collapse and disappear.

Foam Sclerotherapy is similar to traditional sclerotherapy but using a foaming agent making it more suitable for larger veins.

c. Surgical treatment: Tying and stripping of veins

Varicose Veins are swollen veins in the legs which have ballooned up over time.

Varicose veins are quite common in Singapore women especially those who have to stand for long periods such as teachers, housewives, pregnant women and hawkers.

This patient is a 52 year old housewife who had 5 pregnancies each of which cause her varicose veins to be come worse.

She had varicose veins since 10 years ago.
Recently the veins become swollen and painful.
In spite of many treatments by other doctors both public and private, her varicose conditions did not improve.
After Chinese medicines cause ulcers in one varicose vein near the ankle of her Varicose veins, her family brought her to see me.

To me the most important goal of treatment was to treat the ulcer before going on treat the varicose veins.

I had to do a complete debridement of her ulcers patiently cleaning it , applying antibiotic ointment and wrapping her whole leg from foot to knee with bandages to ensure proper flow of blood.
A compression stocking was used over the bandaging to ensure blood flow is good.
Fortunately she did not have any diabetes or any other illness which may affect the healing of her wound.

Hydrogen peroxide slightly diluted is one of the best cleaning solution for any wound because it provides oxygen and at the same time the bubbling oxygen will bring any debris to the surface.
I use it all the time for my patients.

She was told to return daily for cleaning and application of antibiotic ointment.
While at home she was to keep her affected foot raised while sitting at home or sleeping.
She was allowed to walk with her compression stocking.
Slowly the wound become smaller and smaller until it finally closed.

Once the ulcer closed I told her that I was going to treat the vein which leads to the ulcer first to ensure that there is no recurrence of the ulcer.
I used a insulin syringe to inject the sclerosing chemical (phenol in almond oil used in hemorrhoid injection) into the vein before the ulcer to kill off the blood vessel under local anesthetic.
The leg was bandaged with a compression stocking placed over her affected.

The patient was initially apprehensive but she accepted my decision.
After 1 week of treatment the vein was found to be flat and did not give any problems.

I then referred her to a microvascular surgeon to remove the remaining varicose veins.

As far as I know she had no more problems with her varicose veins since the surgery