A Pittsburgh Vascular Surgeon’s Varicose Vein Advice

A Pittsburgh Vascular Surgeon’s Varicose Vein Advice

Varicose Vein Care for Pittsburgh: 10 Essential Recommendations

Discover the Truth from a Vein Specialist with Over Thirty Years of Experience.

Varicose vein treatment is evolving rapidly so you need some trusted advice.

The latest FDA approved varicose veins treatments that are currently being performed don’t even have insurance codes yet.

That is because these varicose vein procedures are so new.

In this environment of such rapidly advancing changes, you need some guidance that you can trust.

For people with varicose veins, here are my very best suggestions and ideas from specializing in treating varicose veins for over thirty years.

Included in this article are also some hidden truths and warnings. You must be aware of how the system of vein health care management in this country works.

We will also take a peek behind the scenes into the varicose vein world which will affect your vein procedures.

Here we go.

Recommendation # 1 – Varicose Vein Treatments Should Only Be Done in an Inspected Vein Center

Treating varicose veins involves sealing veins with a laser or radiofrequency catheter, injecting medicine into them or removing them (phlebectomy).

This requires breaking the skin with a needle and introducing needles or catheters into your blood stream.

Questions people never ask when looking for a vein center:

  • Has the vein center has never been inspected (or accredited)?
  • How do you know if the needles are free of AIDs or hepatitis C?
  • How do you know if the autoclaves are functioning properly if they’ve never been inspected?

You don’t.

It’s insane that vein centers don’t have to be inspected by law.

Respected vein centers have voluntarily acquired accreditation.

They have volunteered to be inspected by the only regulatory body in the United States that performs this function. It is called the Intersocietal Accreditation Commission.

Make sure your vein center is safe.

Make sure that it has been inspected like hospitals, restaurants, and cars are inspected.

Recommendation # 2 – Get your varicose veins fixed when they are still small.

Men are biggest offenders in this regard.

Men usually wait until their varicose veins are enormous before they seek advice. That’s because in my experience, most men don’t care much about what their legs look like.

They wait until complications occur or their legs become painful.

Varicose veins never get better on their own.

They only get larger.

When they enlarge, they cause symptoms like heaviness, aching, and swelling.

Later, complications like painful blood clots called phlebitis and sometimes bleeding occur.

When veins bleed, they bleed a lot. They squirt. It’s very scary.

When the varicose veins become very large, I always hear the same thing from patients on their initial consultation.

“I should have come sooner” is the common refrain after patients learn what is involved to treat their huge varicose veins.

Often neglected varicose veins also cause surrounding spider veins to occur. Since spider veins are not covered by insurance, people could have saved significant time and expense if they would have had their varicose veins treated before they became large and caused other problems.

Recommendation # 3 – Don’t wait until you’ve had a complication from neglected veins.

Common complications are blood clots, bleeding and sores on the skin or ulcers.

Ulcerations from varicose veins are difficult to treat and usually painful.

An ounce of prevention is worth … you know the rest.

Recommendation # 4 – Research your vein doctor.

Spend at least the same amount of time you would in purchasing a used car, a stock, a TV, or a college for your child.

For some reason, most people will research products but not their doctors.

  • Eighty-one percent of consumers conduct online research before they buy something.
  • Sixty percent use a search engine to find the products they want to buy.
  • Sixty-one percent of people will read product reviews before purchasing.

Many people will visit three stores before purchasing anything.

So why do people choose their vein doctors and vein centers so nonchalantly?

Beats me. There are memes for this.

I can’t tell you how many people choose the closest doctor.

That’s why vein franchises set up offices all over the city where they sublet another doctor’s office one day per week. They know this so you don’t have to drive very far.

I know, I know.

They think all vein doctors are the same.

Right? Wrong.

Despite a Nietzschean mastery of fate, I suggest that all vein doctors are not the same.

Don’t fall for desperate promotional stunts like free vein screenings.

Or even more unscrupulous, some will actually pay you fifty dollars to come in to see them (this is currently being offered by an opportunistic vein franchise in Pittsburgh.)

Does it even sound right that a doctor would not only give you a free consultation but would actually pay you to come in their office to treat you?

Recommendation # 5 – Choose a vascular surgeon – not a phlebologist – to treat your varicose veins.

The word, phlebologist, came from the word phlebology, which is the study of veins.

However, the only specialty approved by the American Board of Medical Specialists that comprehensibly trains doctors to treat veins is vascular surgery.

Non vein specialists like cardiologists, radiologists, family doctors, and emergency room doctors need something to call themselves to make their treating veins sound legitimate.

This organization has supplied vein doctors with a certificate (not board certification) verifying that they have passed a vein test and have some experience treating veins.

Know the difference between a phlebologist and a board certified vascular surgeon.

Recommendation # 6 Watch your weight and avoid high heels.

Excess weight in the abdomen makes it more difficult for blood to return back to the heart. It increases venous stasis. That means the blood cannot return to the heart as well as it should from the intra abdominal pressure.

Being overweight increases the venous pressure in your legs.

Increased pressure in your veins exacerbates the genetic predisposition that many people have to develop varicose veins.

Obesity is also a risk factor for blood clots. That includes the superficial blood clots and the more dangerous deep vein blood clots.

Wearing high heels prevents your calf muscles from contracting. For the venous system, your calves pump the blood back to your heart.

The heart pumps your blood through the arteries. Once the blood reaches the veins, the heart can no longer push the blood along the blood vessels. Once in the veins, the calf muscles are the pump.

Recommendation # 7 – Wearing support stockings won’t prevent your varicose veins from getting larger.

Compression stockings will just make your legs feel better.

Varicose veins are caused when the valves inside your veins don’t close properly.

Compression stockings, exercise or anything you try to do to help your varicose veins to go away will not work.

As soon as you notice that the veins in your legs are bulging and are symptomatic, seek proper medical advice.

Recommendation # 8 – Don’t put off varicose vein treatment.

Insurance companies are making the reimbursement of varicose vein treatments more and more difficult. What insurance used to cover is no longer what they presently cover.

The reason is the exponential increase in the number of claims for veins that they have received over the past ten years. Insurance companies try to discourage you from having vein treatments.

One way that they do that is to require a three-month trial of conservative medical management with stockings before definitive treatment can begin. You and I know that stockings will not improve your varicose veins.

As soon as you take off your stockings, your varicose veins will be back. Doctors have proven that the three-month trial of stockings is worthless with consensus studies published in the United States and Great Britain.

Therefore, support stockings before definitive treatment is truly worthless.

There are countless other cut backs that health insurance companies are doing to cut costs. The longer you wait to have your abnormal veins treated, the less the chances that they will be covered at current levels.

Recommendation # 9 – Don’t fall for varicose veins creams or serums.

That also goes for spider veins.

These creams just provide camouflage for your veins.

There are thousands of these kinds of offers and advertisements on the internet and in magazines.

Don’t fall for them!

They are scams.

Recommendation # 10 – Once treated, follow-up and maintain the venous health of your legs.

New varicose veins can appear.

Varicose vein disease is genetic.

New varicose veins will appear as you age.

If treated properly, the same veins will not come back.

However, because of your genetics over time it is likely that you will make new veins.

It’s not like getting a cavity filled.

Even with a dentist you must maintain and get regular checkups.

Another analogy is exercise. You have to maintain the improvements in your body.

That goes for venous disease as well.


These top ten varicose vein tips are invaluable advice to maintain your venous health.

These recommendations come from a lifetime of experience treating venous disease and varicose veins.

Be smart about the health of your legs and your veins.

Seek help only from an experienced vascular surgeon in an accredited and inspected vein center.

If you live in Pittsburgh, call the only accredited varicose vein clinic at 724-969-0600 to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.