DR. K.K. PANDEY
These days, as health awareness is setting in, people are getting more concerned about blue-colored spider like veins which appear in their legs. The more we adopt a comfortable, luxurious and sedentary life style, the more our legs are falling victim to the onslaught of varicose veins. In the initial stages, we naturally try to ignore them, but when the problem becomes enormous; we jump the gun and without giving any proper thought, start consulting doctors. Ultimately, we end up receiving totally multiple divergent medical advices and get really confused. Unfortunately, this kind of injudicious treatment leads to blackening and non healing ulcer of legs in the end.
Who are the Victims of Varicose Veins?
Ladies and shopkeepers are the most vulnerable to the risk of developing varicose veins. Computer
professionals, office clerks, receptionists working in multi star hotels and big show rooms fall easy prey to an onslaught of varicose veins. Traffic policemen, police control room personnel, junior level police officers involved with FIR registration and preparation of court cases at police stations,
scientists and technologists working in laboratories are perfect hosts to varicose veins of leg. Our judiciary and legal fraternity is not far away from developing varicose veins.
Our teacher community and call centre professionals are also susceptible to developing varicosity of legs. In other words, whosoever bids farewell to a regular habit of daily morning walk and adopts wittingly or unwittingly a profession where a prolonged sitting for hours is mandatory will develop , sooner or later, severe varicose veins of leg with associated complications.
How to Identify Varicose Veins?
Carefully observe your legs and feet. If you find earthworm or spider –like blue-coloured thin veins in your leg skin or you notice black spots or areas on your legs especially in lower parts, you have already developed varicose veins. If you develop leg swelling or pain after a moderate walk, you have started inching certainly towards developing varicose veins. If after a long walk you observe light red patches and prominent blue-coloured veins, you undoubtedly have laid the foundation for varicose veins.
Why do Varicose Veins Occur?
If you are habitual of a cozy and sedentary life style, you are not far away from developing varicose veins. For example and by way of an analogy, if you go for a bath and in the bathroom both the tap that supply pure water and the drainage pipe are working smoothly, the bather will not find any problem because after using pure water for bath, the soap-mixed used water thus collected will keep going out through drain pipe . On the contrary, imagine a situation where drainage pipe of your bath room gets narrowed or blocked or under functioning due to any reason, this will result into stagnation of soap-mixed dirty water inside the bathroom. Finally, this impure water will try to find a way out of bath room. Either it will start oozing from the wall itself or will go out through holes in the door or it will raise its water level to go out through the windows of bath room.
In the same way, imagine your leg in place of bath room. Your leg is getting uninterrupted pure blood supply through arteries just like a tap in the bathroom. This pure blood is a sole supplier of oxygen that is consumed during walking. After leg muscles have used the oxygen, the blood in the legs becomes impure due to depleted oxygen content. This blood now needs replenishment with oxygen in order to re- circulate and then re- supply oxygen to leg. For replenishment with oxygen, this stagnated impure blood now must leave the leg and reach the lung through the heart. After purification of blood in the lung, this oxygen- enriched blood will come back again into circulation through heart and again enter the leg through arteries.
If due to any reason, this impure blood pooled inside the leg does not ascend up and thus fail to reach the lung, it will keep on collecting inside the leg and start filling otherwise collapsed veins underneath the skin. When these superficial veins start dilating due to abnormal filling of blood, they will become visible on the skin like a spider. This is the beginning of varicose veins.
Where to Go If you Have Varicose veins?
If you think you have varicose veins in your leg, please do not sit idle and be prompt in consulting a Vascular Surgeon. In India, it has been observed a patient of varicose veins , generally due to ignorance, either goes to a skin specialist or a bone specialist. Sometimes, these patients go to a quack or a massager for treatment. They get alarmed, when they develop a non healing ulcer in their leg. Even then, some of them keep getting regular dressings at nearby clinics with no result. Therefore always remember only an experienced vascular surgeon can advise you a correct treatment of varicose veins.
What is the Correct Treatment of Varicose Veins?
In the early stage of development of varicose veins, neither surgery nor laser nor RFA treatment is required. What requires of a patient is a drastic change in his or her daily life style. One has to walk regularly in a nearby park for at least two hours in a day including morning and evening (one hour each). And, one has to avoid prolonged (not more than one hour) sitting on the chair and prolonged standing. One must reduce extra weight and wear scientifically made specialized graduated compression stockings while walking. A patient of varicose veins has to keep in touch with a vascular surgeon every two months.
If you already have fully- developed varicose veins in legs or you have black spots or black areas or you have persistent leg swelling with redness or you have developed leg ulcers– in any of such conditions, you will require either conventional surgery or endovenous laser or radiofrequency ablation technique. For the effective treatment of varicose veins, one should go to a hospital where there is a department of vascular surgery as well as availability of the facility for all these different treatments.
What is the Difference between Surgery and Laser Techniques?
The basic motto of both the methods is the same , that is, to get your legs rid of varicose veins. There are always two ways to get rid of garbage in the house. Either you throw it outside your house in the dustbin or you burn it there itself inside your house. Similarly, the job of throwing out the varicose veins from leg lies with conventional surgery but, at the same time, work of destruction of varicose veins inside the leg is performed by the laser or RFA techniques. Therefore, methods of treatment may differ, but ultimately the aim remains the same. Both the techniques are useful but have their own limitations. A proper case selection for each technique is very important.
Advantage of the Laser technique
In this technique, no skin cuts are given. Therefore, there occurs generally no need for either putting stitches or their subsequent removal. It shortens hospital stay; the patient can go home the same day or next day in the morning. There are no hassles about bleeding and dressings as well. A patient can resume office work the very next day. After a long experience with laser technique, I can say it is a smooth and useful technique from patient’s as well as treatment’s point- of –view.
R.F.A. Treatment is another Latest Technique
This is the most contemporary technique that is gaining popularity these days. No surgical cuts in skin are required. Within twenty four hours, the patient can go home. No bed rest and dressings are needed after treatment. Patient can go to work office on the very next day. Within a year after RFA treatment, a patient can get rid of graduated compression stockings. In comparison to Laser, this technique is more user friendly and proving to be slightly better for the time being. However, a detailed future study of long term results will correctly evaluate both the non surgical techniques.
The author is a Senior Consultant in the Department of Cardiothoracic & Vascular Surgery at Indraprastha Apollo Hospital, New Delhi India. He has worked previously as a consultant Cardiovascular & Thoracic Surgeon at Batra Hospital and Dr. Ram Manohar Lohia Hospital, New Delhi India. He has also worked at the well-known Bakulev Institute of Cardiovascular Surgery, Moscow.
He can be contacted at: firstname.lastname@example.org