Varicose Veins Questions That You Should be Asking

Varicose Veins Questions That You Should be Asking

5 Worthy Questions You Should Ask About Varicose and Spider Veins

Don’t Forget to Write Down These Initial Consultation Questions

The varicose veins “Should Ask Questions” (SAQs) are a great way to find out about a medical practice. SAQs are traditionally what people need to ask at a job interview.

Whereas FAQs are questions that patients are usually asking when looking for a vein center, your SAQs are the questions that an informed person prepares ahead of time to ask at their vein consultation.

Sometimes things get confusing.

There is a lot of new information to learn about on your initial consultation for your varicose vein problem. Often you forget to ask these questions during that initial vein consultation.

Sometimes it can be overwhelming.

Just like new drivers are usually ignorant to the basics of car maintenance – like the average annual maintenance costs – this great blog article can help educate you on questions you should be asking and why it is important to ask those questions.

It’s important to know how to choose the right varicose vein clinic.

Let’s get started.

#1 Are Varicose Veins Cosmetic?

Many primary care doctors dismiss their patient’s vein concerns. They just tell them that their vein problems are cosmetic.

Sometimes the symptoms of varicose veins are vague. Heaviness, tiredness, and aching legs are common complaints that many people have.

For this reason, many family doctors reject these symptoms as serious without even having their patients stand up for a few minutes and really look for bulging varicose veins. They are simply forgotten without even a thorough physical examination.

Even when visible are seen while sitting on an exam table, varicose veins might appear at first glance to be a cosmetic issue. The truth is that they can cause real medical problems beyond just being ugly.

Although you might not have the typical symptoms of varicose veins, you must be aware of some serious medical problems that can occur if you ignore or neglect them.

The Cleveland Clinic writes about varicose veins and the cosmetic issue on their web site:

Varicose veins might appear to be a cosmetic issue, but they can cause problems beyond just making your legs look unattractive. Even if you aren’t bothered by your varicose veins, you should be aware of some problems that can occur if you ignore them too long.

There is a very strong possibility that if left untreated, your bulging, ropey enlarged varicose veins will only worsen with time.

In general, the worse they are – the worse they will get. That’s a fact.

The more enlarged they are – the more pressure is on the vein walls. Those veins that are connected to the varicose veins will also enlarge over time.

This concept was studied in Europe which resulted in the ASVAL theory of varicose vein therapy. They found that if you intervene early enough on the varicose veins, the saphenous vein damage may be reversible.

Therefore, varicose vein disease is often a snowball type effect. The bigger they get, the more rapidly they will enlarge. That causes the veins that they are connected to – to also enlarge.

For patients who suffer with symptoms from their varicose veins, the pain, swelling, aching, throbbing and night cramps will inevitably worsen.

However, on the other hand, some people with extremely large veins have absolutely no symptoms at all!

Doctors can’t completely understand or predict why someone with large and ropey veins will experience severe pain and discomfort while another person with huge varicose veins will not.

However, in general the worse the varicose veins become, the more likely you are to suffer from their sequelae.

Dark, firm, and hardened areas on the inside of the ankle is a sign of more advanced varicose vein disease.

When venous insufficiency advances to this stage, the chances for future leg ulcerations also increases. This is often associated with fluid discharge, severe pain, and infection.

Stagnant blood in the overly enlarged veins predisposes you to the development of blood clots which is called thrombophlebitis or phlebitis for short.

The chances of bleeding episodes from the leg veins are also not uncommon when the overlying skin becomes very thin.

#2 Does Exercise Affect Varicose Veins Either for the Better or Worse?

Some people hope that exercise will help keep their varicose veins from becoming worse. Others are concerned that exercise will make them worse.

Unfortunately, neither is true.

Exercise has little or no effect on the varicose or spider veins in your legs.

The reason is that varicose veins are caused by the valves inside of the veins failing. No amount of exercise can repair or fix these valves.

For the same reason, there is no prevention for varicose veins, and no fool-proof cure. The valves will continue to fail no matter what you do to try to stop it.

That’s because the valve failure inside of varicose veins is caused by genetics.

However, a healthy, low-impact, cardiovascular-boosting routine is a great way to promote venous return and healthy legs.

The general rule of thumb is that exercise is helpful to improve venous return and slow down the process.

While varicose veins are mostly the result of heredity, keeping up proper blood flow will help the appearance of the varicose veins and improve your overall vascular health.

There is that hope perpetuated by the echo chamber of vein web sites that moderate exercise may reduce the chances of forming new varicose veins or worsening the already weakened veins. This has never been proven scientifically.

What is certain is that the veins in the calf muscle are necessary to pump blood back into the heart. When you exercise, blood is pumped toward your heart from your calf muscles and from the veins in the arch of the foot.

Exercises that strengthen the calf muscles should be a part of your workout plan. Walking is especially helpful in that regard.

Athletes and highly active people are often shocked to learn they have symptomatic vein disease.  They can present with tired and achy legs. Even young and extremely healthy individuals can get varicose or spider veins.

The important thing to remember is that the underlying cause of vein disease is venous reflux. That means blood is backing up because the valves inside the veins are not working properly.

Some exercises improve this while other exercises only inflame the condition. Walking is very beneficial to activate the calf muscle pump.

Walking serves to stretch and strengthen your calf pump, improving blood flow back toward your heart.

Lifting weights – not so much.

Exercise that is too strenuous puts a strain on your venous return and tends to impair the venous circulation.

#3 Is there a Link Between Varicose Veins, Blood Clots and Flying?

It is important to remember that flying for over an hour or two has risk especially if you have varicose veins or venous insufficiency. There is even a slight risk of developing blood clots if you have completely normal veins.

There are a number of factors that increase the risk of developing blood clots. Unfortunately, one of these factors may be varicose veins and venous insufficiency.

That is also conclusive evidence that a person suffering from varicose veins and venous insufficiency does have a slightly increased chance of developing blood clots.

One study suggested that varicose veins increased the chance of developing blood clots from 0.9% to 5.6%. It is unclear whether it is the varicose veins themselves that cause this increase in risk, or if people who are susceptible to varicose veins are simply also susceptible to blood clots.

However, the level of this risk is usually ranked alongside pregnancy and oral contraceptives, suggesting that it is considered no more dangerous than these factors.

While having varicose veins may increase your risk of developing blood clots, the chances of it developing are still very low, particularly if you take measures throughout the flights or on long car rides to reduce this risk (like walking).

Long car rides and long flights are equally risky for developing blood clots. It’s the immobilization (not walking) that causes clots – not the altitude.

Don’t fall for self-help home remedies and goofy natural remedies to prevent or treat varicose veins that are all of the internet.

They are worthless.

 #4 Can You Prevent Varicose and Spider Veins?

There’s no way to definitively prevent varicose or spider veins.

Don’t believe everything you read on the internet about varicose veins and their prevention.

There is an endless supply of bad advice, myths, and misinformation about varicose veins. Some of this information is found in copycat lists.

Some of the advice in mainstream vein blogs is oversimplified advice. If you don’t treat veins for a living, people are not able to recognize the truth from the BS.

All that it takes is one well known and respected institution to present something as fact and it can and will be repeated as the gospel. This has been described as “parrots in the echo chamber”.

Lazy web site bloggers love to recycle, chime in, paraphrase, and mindlessly repeat lists from high profile sites.

If the misinformation gains traction on the internet, another layer of copycats regurgitates the distortions.

Some unproven (parroting in the echo chamber) methods to prevent varicose veins are included in the following list. Remember the following is all conjecture.

In terms of preventing varicose veins, the truth is that:

Avoiding wearing tight clothing is a myth in trying to prevent veins.

Eating a high fiber diet have never been shown to be helpful to prevent unwanted veins.

Shifting your sitting or standing position doesn’t prevent veins.

Avoiding heat doesn’t stop veins from forming (although heat does make blood vessels dilate)

Avoiding salt in your diet has never been proven to prevent new veins.

Crossing your legs has no effect in causing varicose or spider veins at all.

Here’s another list of unproven measures to prevent veins that has been mindlessly repeated that has no scientific basis in truth – from our government (the National Institute of Health).

The same measures you can take to treat the discomfort from varicose veins at home can help prevent varicose veins, including:

  1. Exercising
  2. Watching your weight.
  3. Eating a high-fiber, low-salt diet.
  4. Avoiding high heels and tight hosiery.
  5. Elevating your legs.
  6. Changing your sitting or standing position regularly.

Here is another list of completely unsubstantiated recommendations to prevent varicose and spider veins from another vein web site.

The bullet points below were more unproven and regurgitated recommendations to prevent varicose veins:

  • Don’t keep your legs crossed when sitting.
  • Try to limit your use of high heels.
  • Avoid wearing clothing that constricts circulation at the waist, groin, or legs (think super-tight jeans).
  • Avoid excessive heat on your legs, such as hot tubs and hot baths. Heat will tend to increase vein distention and lead to more pooling of blood.
  • Taking medications that contain estrogen and progesterone, such as oral contraceptives or medicines used for hormone-replacement therapy, may add to the risk of developing varicose or spider veins.

To sum it all up:

Improving your venous circulation and the calf muscle tone can theoretically reduce your risk of developing varicose veins or getting additional ones.

The same things that you can use to treat the discomfort from varicose veins may help delay or slow down the inevitable development of new varicose veins.

However, remember none of the above recommendations have ever been proven.

#5 Will Insurance Cover My Varicose Veins?

No insurance covers spider veins unless they have bled.

The number of varicose vein treatments is increasing exponentially.

Varicose vein coverage by insurance companies is unsustainable. That is because there have been many cases of insurance fraud and abuse.

There are shocking facts about varicose vein treatment where the doctor submitted either normal veins or cosmetic veins for insurance coverage.

With the explosion of technology with new minimally invasive treatments for the treatment of varicose veins, both the government and the commercial insurance companies have decided to restrict coverage.

As time passes, more and more limitations and denials for coverage are occurring.

That trend will continue.

If you have symptomatic varicose veins, there is no reason to wait.

At this rate, varicose veins will soon no longer be a covered service unless they are at an advanced stage causing skin ulcerations or bleeding.

Varicose veins never improve.

Worsening of the condition is inevitable.

Seek medical advice while your varicose veins are still covered by insurance.

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.