Keeping Leg Veins Healthy in Covid-19 Lockdown

Pandemic, Paranoia and Problems

The Covid-19 pandemic has changed the way the world lives. Our priorities have changed and rightfully so. Preventing ourselves from the yet to be fully understood novel disease is important but getting paranoid about it will not help. The World Health Organisation and many scientists have pointed out that the pandemic will last for atleast two years. Use of face mask, Physical distancing and Hand sanitation are our best defence against this virus till science comes up with a vaccine or cure.

One of the fallout of the pandemic is other health issues are being neglected by patients since there is fear of contracting Covid infection while visiting doctors and hospitals. Many patients who suffer from varicose veins of legs too are being affected and are developing painful complications such as leg pain, swelling, ulcer and even vein blockages! Delaying the treatment and lack of exercise or activity in the lockdown period are the two main reasons for this.

Varicose Veins and Blood circulation

Varicose Veins in legs result in poor blood circulation which in turn causes various painful complications such as leg pain, swelling, ulcer and even vein blockages!

Following are some measures which can be taken at home in this lockdown period to improve blood circulation in leg veins:

Avoid prolonged sitting

If you are working from home, avoid sitting for prolonged periods. After 30 minutes, make sure you walk about for 5 minutes and stretch your body.

Calf muscle strengthing

The calf muscles play an important role in returning blood in leg veins to heart. Do calf muscle strengthing exercise – support your back against a wall and raise both heels (“tippy toe” movements). Do 15 to 20 repetitions, twice daily.

Compression stockings

Use of correct stockings, one which provide “graduated compression” will help in improving the blood circulation.

Appropriate clothing

Avoid wearing tight, ill fitting clothing which will decrease venous blood return from legs.

Leg elevation

This is an effective and the easiest way to improve blood circulation in leg veins. It can be done in following manner:

On a pillow cushion

Start by lying down on your bed or a couch and place your legs on a stack of pillows. Be sure to keep your feet at a level above your heart to get the most benefits. You can do your office work, watch television or even meditate in this position. Do not elevate your legs on a hard surface without a cushion because the edges of the desk or table can dig into your skin. This can cause bruising along with leg pain and will do more harm than good to your circulation.

Against the wall

Lay on the floor with your bottom against the wall and lift your legs straight up in the air as you rest them on the wall. It is important that you place a pillow beneath your head to feel more comfortable and prevent neck or back injury. Keep this pose for only five to ten minutes at a time so that you do not put added stress on other parts of your body. Aim to get in at least ten minutes of elevation at a time, two times a day for improved circulation.

While sleeping

Place pillows at the foot of your bed for your legs to rest on. Make sure the pillows extend from heel to knees to avoid strain on back. For those who are concerned with kicking the pillows during the night, you can place pillows directly under the mattress.

Prevention is better than Cure

It is important to understand our leg vein problems with scientific information and take right measures to prevent them from increasing. And as far as the Covid19 pandemic is concerned, it is important to realize that pragmatism not panic, change not chaos, world co-operation not fervour nationalism will help humanity to triumph over this crisis.

leg vein

Winter and Varicose Veins

“Winter is the best time to treat Varicose Veins”
By Dr. Ashish D. Dhadas, Varicose Veins expert

Winter is here and warm, long clothes now come out of the closet. This does help in hiding those cosmetically unpleasant, painful spider veins and varicose veins on the legs. However, as the summer season arrives, you want to wear your favorite short dresses for the best summer vacation pictures. Wearing clothes as per one’s own comfort zone and looking good, is so very essential for a confident you.

People who have varicose veins are often tired of them and want to know more about how they can treat them. In this article you will get to know the reasons behind those ugly looking veins on your legs and how can you get rid of them.

If you’ve been putting off varicose veins treatment, you may have good reason to make the call before the cooler season ends. While the varicose veins specialists can perform this procedure at any time of the year, patients often find the healing process is easier and more convenient during the winter. Your legs will look great for summer if you wear compression socks, and avoid UV rays after your laser treatment this winter.

Why are they so fatty and visible? What are the causes?

Varicose veins occur when veins do not function properly. As blood flows through a vein, the cup-like valves alternately open to allow blood through, and then close to prevent backflow. When these valves fail, blood begins to collect in the veins rather than continuing toward your heart. Instead of flowing from one valve to the next, the blood continues to pool in the vein, increasing venous pressure and the likelihood of congestion while causing the vein to enlarge.
Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. A previous leg injury may cause deep venous thrombosis which in turn can damage the valves resulting in varicosities. Contrary to popular belief, sitting with crossed legs will not cause varicose veins, although it can aggravate an existing condition.

How can you get rid of them? What treatment can be done?

• Stay physically active to strengthen your leg muscles and enhance circulation. To do so, you can opt for running, brisk walking or dancing. Remember not to go overboard with these activities.
• Try to stay healthy by maintaining a proper weight to take that pressure off from your legs, knees and feet.
• Do not wear stilettos for too long, avoid crossing your legs for too long while sitting and if you stand for too long, shift your weight from one leg to another every few minutes.

Every patient is different and each has findings that require specific treatment for relief of symptoms and correction of vein problems. A single treatment or a combination of the minimally invasive approaches may be necessary.

CLaCS (Cryo Laser and Cryo sclerotherapy) is a painless procedure done under local anaesthesia. The high flow of ice-cold air directed onto the skin at the site of laser or needle application removes the discomfort and most patients have little pain from the treatment. The patient returns to work and usual activities with 4 -6 hrs. Exercise is permitted as well after 24 hrs.

varicose veins during preganancy

Pregnancy and Varicose Veins

By Dr. Ashish D. Dhadas, varicose veins Specialist, Dombivli, Mumbai

Women frequently ask, “How do I prevent varicose veins during my pregnancy?” or “What shall I do about my varicose veins now that I am pregnant?” These are good questions that deserve proper answers

Several factors are at play during pregnancy which promote the development of varicose veins

1) Circulating hormones of pregnancy have a direct influence on the veins and their valves that cause both to become more distensible and less strong.
2) The enlarging gravid uterus in the pelvis exerts direct pressure on the large veins of the abdomen and pelvis making it more difficult for the venous blood to drain from the lower extremities.
3) Increased volume of blood in the circulation of pregnant women results in simply more blood in the legs for the veins to contain.

At Surekha Varicose Veins Clinic, we advise women with varicose veins who plan to become pregnant to have the varicose veins treated PRIOR to the pregnancy. With the minimally invasive procedures available today from qualified and experienced vein doctors, the varicose vein problem should be dealt with pre-emptively. There is no place for what varicose veins specialist told patients in the past, “Finish having all your children and then have your varicose veins fixed”. Why suffer with varicose veins through one or more pregnancies if the whole problem could be avoided? Minimally invasive ablation procedures carry minimal risks, can be done easily and offer a quick return to normal activities. Future pregnancies become much more comfortable and the risk for acute clotting of the varicosities (acute thrombophlebitis) is much reduced.

If a woman with varicose veins finds herself pregnant or develops varicose veins after becoming pregnant, so-called conservative therapy should be followed. “Conservative therapy” means daily wearing of prescription-grade graduated compression stockings whenever out of bed, exercise and elevation whenever possible.
The compression stockings that one finds as ‘over the counter’ product at medical stores are almost worthless when compared to the benefits of prescription-grade graduated compression stockings that are fitted to the patient after the measurements are taken. Brands such as Sigvaris, Bauerfeind, and others are examples of the graduated compression stockings that come in different sizes and are selected after careful measurements have been made.

The term “graduated” refers to the tapering effect of the pressure or tightness of the stockings such that the greatest compression is at the ankle and lower leg and less as the stocking goes higher. This creates a pressure differential in the leg that promotes the proper drainage of the blood and helps to overcome the problems in the veins and circulation that occurs with pregnancy. The stockings should be applied in the mornings (as soon as possible after getting up in the morning) and only be removed when going to bed at night.

In summary, if a woman has varicose veins during pregnancy, she would be well advised to have the varicose veins eliminated with the modern minimally invasive treatments. If a woman with varicose veins finds herself pregnant, she should begin daily wearing the good quality compression stockings as soon as the pregnancy test is positive.

If varicose veins first develop with a pregnancy, conservative therapy, which is the conscientious daily use of compression stockings, exercise, and elevation whenever possible should be followed. Then the varicose vein problem should be addressed between pregnancies to avoid future difficulties and complications.

veins

Do Varicose Veins run in your family?

By Dr. Ashish D. Dhadas, Varicose Veins expert, Samata Hospital, Dombivli, Mumbai
You have eyes, dimples like your father and skin colour, and varicose veins like your mother. Yes, you read it right! Those ugly looking leg veins can run in your family and may give you a tough time by causing various symptoms. Here, we brief you about the causes and treatment of varicose veins. Read on to know more about it.

Can my Varicose Veins be hereditary?
Yes, varicose veins have a hereditary factor. If you have anyone parent with varicose veins, there is a 80 % chance that you might get them too. Infact, in few cases the trait is seen to be present even in grandparents and paternal relatives (brother/sister of your parents).

What are the Causes?
Varicose veins occur when valves in the leg veins do not function properly. As blood flows through a vein, the cup-like valves open to allow blood through, and then close to prevent backflow. When these valves fail, blood begins to collect in the veins rather than continuing towards your heart. Instead of flowing from one valve to the next, the blood continues to pool in the vein, increasing venous pressure and the likelihood of congestion while causing the vein to enlarge. The superficial veins of the leg have less muscle support than deep veins; hence, they are more likely to become varicosed.

Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. A previous leg injury may cause deep venous thrombosis which in turn can damage the valves resulting in varicosities. Contrary to popular belief, sitting with crossed legs will not cause varicose veins, although it can aggravate an existing condition.

How can I treat my Varicose Veins?
Contrary to popular belief, oral medications and topical oils/creams do not cure varicose veins. Infact, in many cases precious time and money is spent on these and yet the varicose veins progress to cause complications such as bleeding and venous leg ulcer
Every patient of varicose veins is different and each has findings that require specific treatment for relief of symptoms and correction of vein problems. A single treatment or a combination of the minimally invasive approaches may be necessary. This is decided after Venous Colour Doppler (ultrasonography of veins) – a gold standard in the diagnosis of varicose veins.

Varicose veins are traditionally treated by Trendelenburg operation which involves ‘stripping’ of the vein with or without perforator ligation depending on the pathology.

The traditional method of surgical treatment is now being fast replaced by Laser treatment of varicose veins. Laser treatment is more effective, painless, scarless and helps patients to resume work in 48 – 72 hours. 1470 nm diode laser is used worldwide for Endovenous Laser Treatment (EVLT) of Varicose Veins. Venous Colour Doppler (ultrasonography of the leg veins) is the gold standard to evaluate varicose veins and is mandatory before EVLT.

EVLT can be done both under local anaesthesia and regional anaesthesia or sedation. The type of anaesthesia used depends on the phlebologist, disease severity (varicose veins) of the patient and patient’s choice.

After the EVLT is done the patient is required to wear class 2 graduated compression stockings for 4 months. The stockings are to be worn in the morning. They are to be removed at night time while going to bed. The usage of stockings helps in better and optimal closure of the lasered vein. Apart from this, the patient can go about his routine work after 48 to 72 hours. It is recommended that the patient walks for 30 minutes daily after the laser procedure.

In patients below the age of 60 years and especially if they are leading an active lifestyle, it is better they continue usage of class 1 or class 2 stockings. The reason being – varicose veins is a progressive disease of valve degeneration. The faulty vein is treated by laser but other superficial veins are prone to varicosities. Usage of stockings will help the calf muscle pump to perform better thereby preventing/delaying the progression of the disease in other veins.

What to keep in mind?

• DO exercise regularly, focusing on fitness routines that strengthen your legs and improve circulation. Running, power walking or dancing are great choices.
• DO opt for lower-heeled shoes to help tone your calf muscles and keep blood moving through your veins.
• DO wear sunscreen to protect your skin from the sun damage that can spread varicose veins, particularly on the face.
• DO wear graduated support stockings or socks sold at pharmacies. Unlike regular knee-high nylons, socks or girdles that block the movement of blood up the leg, these specially designed stockings and socks apply a gentle, graduated pressure to the leg from the foot upward. This helps decrease the expansion of the vein wall and improves circulation.
• DO choose low-salt, high-fiber foods and snacks like whole grains and fresh fruits and vegetables. The added fiber will help reduce constipation that can cause varicose veins, and eating less salt can help keep varicose vein swelling at bay.

Takeaway: Don’tsit or stand for long periods without a break. If you must stand for too long, shift your weight from one leg to another every few minutes. And if you sit at a desk or work table for most of your workday, stand up and move around or take a quick, brisk walk every half hour.

Ignorance of Pain in Leg Leads to Varicose Veins

• High incidence of mature adults developing varicose veins Says Dr Dhadas
• “The thick green rope-like appearance of varicose veins makes people feel older” Adds
Doctor
Mumbai: As we age, varicose veins become a common health concern. Studies estimate that one in five adults live with varicose veins and about 16 per cent of adults with varicose veins are age 60 or older. 65 per cent of adults in this age group who are diagnosed with varicose veins have reported at least one varicose vein related leg symptom.

A 53-year-old MrAvinash Mistry, once a professional club cricketer, was suffering from varicose veins since the age of 20. However, he neglected the symptoms, Over a period of time, he started developing pain, swelling of the legs and blackening of the skin over the leg.

It was only after small ulcers (non-healing wound) started developing on his leg that he decided to seek treatment and approached Dr Ashish Dhadas at Surekha Varicose Veins, Dombivli, Mumbai

Dr Ashish Dhadas, Varicose Veins Specialist, at Surekha Varicose Veins Clinic, Dombivli, said,
“Avinash Mistry was suffering from varicose veins for many years. For some reason, the disease was not cured in an initial stage. As a result, the skin of his feet became black and had wounds. Even at this stage, we had successfully treated him with varicose veins laser treatment method. However, in the initial stage, treatment is much easier and effective.”

“Varicose veins commonly develop when someone is overweight, there is a family history, a woman is or has been pregnant, or if someone stands for prolonged periods. Both men and women develop varicose veins. Symptoms include fatigue in the legs, leg cramps, leg pain, and swelling of the ankles. If varicose veins are left untreated the vein becomes thick, hard, and painful.

Dr Dhadas adds “Varicose veins can cause serious complications as the disease progresses. It is easier to treat varicose veins in the early stages and the results are extremely good. In advanced stages, treatment is difficult and results take time. Laser Treatment of Varicose Veins is an accepted and preferred modality of treatment worldwide.

It is superior to open surgery in terms of results. Also, it is scarless, painless and the patient can resume to his routine work within 48-72 hours.” EVLT is an Endovenous Laser Treatment of varicose veins. It is painless, scarless and there are no/minimal complications. The patient can resume his/her daily activities at the earliest.

Apart from EVLT, Cryo Laser and Cryo Sclerotherapy (CLaCS) recently introduced in India for the 1st time at Surekha Varicose Veins Clinic is a revolutionary Brazilian technique for the treatment of spider veins and small varicose veins of the legs. CLaCS is a combination of different technologies like augmented reality, transdermal laser, sclerotherapy and skin cooling for local anesthesia, Dr Ashish Dhadas concluded.

MrAvinashMestry said, “I was suffering from varicose veins since the age of 20 but was unaware of this disease. But after the treatment of varicose veins at this age of 53, my 33 years of pain and swelling has gone off. Also, the wounds have healed. I am thankful to Dr.AshishDhadas for all the right guidance and treatment.”