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What is treatment like?
| In most cases, we treat veins through a process called Sclerotherapy. Sclerotherapy involves the injection of an irritating substance into a vein with the intent of causing it to sclerose, or scar down. We use a highly effective but extremely safe injection solution called Sodium Tetradecyl Sulfate (STS). This solution is converted to a foam of micro bubbles. This reduces the number of injections required, making it safer and more comfortable. This is a non-surgical procedure and takes less time than you might think. |
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Does the treatment hurt?
Over the past few months, we have found a new topical anesthetic gel that patients apply 2-3 hours before the treatments. Most patients tolerate treatment sessions from 30 minutes up to 2 hours with minimal to no discomfort.
If a patient prefers not to use the numbing gel, that is not a problem. Sclerotherapy (treatment using vein injections) has been done for years without numbing medicine and patients have tolerated it just fine. Patients describe a temporary pricking or burning sensation that quickly subsides. Tylenol or ice can be used if a patient experiences discomfort after treatment. |
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Do you do laser treatment for spider veins?
| While we do have a laser available that is occasionally used to treat leg veins, we have found over the years that sclerotherapy (injection treatment) is more effective, hurts less, has fewer complications, less cost, and is far more efficient. While laser treatment has made the news a lot, most vein centers dedicated to vein treatment agree that topical laser treatment has been a big disappointment. |
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4. |
I have large "varicose veins." Don't I need surgery for that?
No. We have achieved long-term results (i.e., permanent closure) of bad large veins in approximately 98% of patients treated with our Ultrasound Guided Injection Protocol.
We begin with an Ultrasound Mapping of your large vein system, identifying all of the roots of the bad veins. Then, we do a series of injection treatments designed to gradually get your veins under control. We call this series stage I, which usually takes 2-3 visits over a month.
Finally, we follow the vein system over a year to be sure all the bad veins fully resorb and watch for your body's inclination to reopen these blood vessels. |
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What is Foam Sclerotherapy?
| Foam Sclerotherapy is the procedure by which a micro-foam of STS is injected into the veins. This requires the use of ultrasound to guide the injections when treating large veins. |
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6. |
I love to exercise every day. Can I still do this throughout treatment?
If you have spider veins, you can do anything before your treatment sessions. Afterwards, you can walk on the treadmill, walk in your neighborhood, bike, swim, or do the elliptical machine. We suggest no pounding exercise (running, jogging, aerobics), or weight-lifting for the rest of the day after your treatments. The next day, you may resume any and all activity.
If you have large varicose veins, you will be off your feet with your legs up for 2 hours, up to 24 hours, depending on your size and the size of your bad veins. Once we perform the ultrasound map of your large veins, we can advise you of this "elevation" time. Once your elevation period is over, you can usually resume walking, treadmill, driving, biking, swimming, and the elliptical machine. In most cases, you can resume full activity (jogging, running, tennis, weights) in 1-2 weeks after your first large vein treatment. |
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7. |
Why do you refer to this as vein disease? I thought I just had a few ugly spider veins.
While it is scary to people to be told they have a "disease," we like to emphasize that:
- This is an important problem
- It involves your circulation
- It is genetic
- There are good reasons to take care of these veins.
Acne is a disease caused by bacteria and hormones. It happens to affect the appearance of our faces. Varicose veins are largely caused by genetics, as well as hormones (pregnancy), trauma, and other factors. This problem happens to affect the appearance of one's legs. We don't mean to scare you or upset you by referring to this as a "disease." If this term bothers you, let us know. |
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8. |
I'm confused. You say I need veins to carry my blood back to my heart. Then you tell me you plan to close and get rid of these veins. How will my blood get back to my heart?
Remember, these are bad veins that are useless. They are not doing their job. They are no longer carrying blood back to the heart. In fact, they can cause problems other than just the cosmetic nuisance (discomfort, leg cramps, restless legs, blood clots, leg ulcers, hemorrhaging, delayed wound healing).
Fortunately, your body is very smart and has already made lots of new veins to take over for these bad veins. Your body is making new veins on an ongoing basis. You have miles of extra veins. When we treat your bad veins, the blood gets shifted to the new veins that are already there. Treatment actually improves your circulation! |
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9. |
So many of my friends have had vein treatment including sclerotherapy, and have been disappointed. They say the injections didn't work, the veins came back, or they just made new veins. How is your approach different?
At VeinCare, we do many things differently. Our experienced ultrasound technologist, Joy Shaker, does a quick ultrasound on every new patient at the time of the consultation. This way we make sure there is not a subtle underlying problem that's "feeding" the surface veins.
Then, we very thoroughly treat your veins layer by layer, inside out, top down. We start at the top of the leg and work down. While this process is more involved and takes longer, it works! We feel so strongly about our work that we offer the VeinCare Promise -- bad veins are guaranteed to be gone at the end of treatment or your money back!
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10. |
Do you do VNUS Closure? Or EVLT (Endovenous Laser Therapy)?
These are 2 of the newer, less-invasive surgical procedures performed on the large varicose veins only. Although some doctors still perform VNUS Closure, most experienced vein specialists are gradually doing less of this and more of EVLR. These procedures are designed to be performed on the main veins, especially the Greater Saphenous Vein (GSB). A small incision is made near the inside of the knee and a series of tubes (catheters and wires) are threaded up the vein, ending with a catheter that is connected to a radio frequency source (VNUS Closure) or to a laser source (EVLT), The power source is turned on and the catheter is gradually withdrawn from the vein, leaving a burned, closed vein behind. This vein then shrivels and is resorbed by the body.
We do offer EVLT as an option. Many patients are not eligible for these procedures because their veins are tortuous (curvy, twisty), have weakened enlarged "bulbs", are too close to the skin, etc. In our experience, it is a much more invasive process for the patient, involves significantly more pain post-op, and does not address the entire large vein system, just that one segment.
If a patient prefers this option and is an appropriate candidate medically, we are happy to use this approach.
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11. |
Will I have to wear bandages, wraps, or stockings?
| No. Our treatment is very different, treating the deeper layers thoroughly and slowly working inside out. Because of this, you will walk out as you walked in and can proceed with most normal activity, depending on the nature and severity of your problem. |
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12. |
If I have discomfort or have had any complications, will my Insurance pay for this?
It depends on your Insurance policy. Very few insurance companies provide coverage for vein problems. Spider veins injections are generally considered cosmetic.
It may be worth looking into your Insurance policy if:
- You experience discomfort that interferes with daily activities
- You have symptoms that have been discussed with multiple physicians and documented in those records
- You have worn prescription stockings faithfully for at least
the past three months
- You have had at least one complication from large veins (leg ulcers, blood clot, hemorrhage)
We suggest you fax us a copy of the pages in your Insurance policy booklet that pertain to the care of vein disease (fax: 919.844.2011). If you do this before your appointment, we can look into this and have some answers for you at your consultation. |
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13. |
Could I have prevented "Bad Veins"?
You may have been told you did something to cause this problem. Pregnancy, weight gain, standing long hours at work, or not wearing stockings. You did not cause this! Most experts believe this problem is hereditary and that these other actors only aggravate the problem.
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14. |
My obstetrician told me to wait until after I have all my children before doing anything about my veins. S/he says they'll just come back and I'm wasting my time.
Many fine doctors are not aware that many of the newer treatments can be done before child-bearing or in between pregnancies. if you can allow us 6-12 months to treat and observe your response to treatment, the veins we treat will not come back!
Your next pregnancy will be a lot more comfortable and your risk for pregnancy-associated vein complications markedly reduced. You may develop new veins but the ones we treat are gone for good! |
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