- Q)Who are vascular surgeons and what kind of problems do vascular surgeons treat?
A) Vascular surgeons have a well rounded background training in medicine and surgery that provides them with the unique skills to offer a wide variety of treatment options from conservative medical management, interventional options such as angioplasty, to surgery for all circulation disorders affecting blood vessels outside of the heart and brain. Treatment plans are specific to the patient's disease with the goal of improving the quality of life and health of the life of patients. Vascular surgeons have five years of post medical school training followed by a 1-2 year specialized in-depth vascular training program and are board certified in both general and vascular surgery.
- Q)Why are women more prone to varicose veins than men are?
A) Pregnancy is the main reason, most commonly due to increased pressure from the expanding uterus directly against the main veins that drain the legs. In some women the veins become inflamed during pregnancy, most often due to increased pressure from the uterus on the main veins that drain the legs. Increased levels of progesterone during pregnancy and also around the time of menstruation cause the blood vessels to relax. Venous dilation begins in the first trimester of pregnancy due to hormonal changes. Dilation of the vein wall may produce valvular incompetence, or leaking. The impairment or reduction of venous return from the legs increases within months of pregnancy and combined with increased blood volume due to pregnancy and increased weight and size of the uterus, all contribute to swelling in the legs, discomfort in the legs, and formation of varicose veins.
- Q)Are varicose veins or spider veins inherited?
A) While medical science has not yet provided a definite answer as to what causes varicose veins, it is known that varicose veins develop when the walls of the veins or valves are weak. Some people are born with weak valves or veins, while for others disease or injury can cause damage to the vessels. Heredity is an important factor, but vein valves can be affected by pregnancy, obesity and in the elderly when the veins tend to lose their elasticity with aging and the muscles supporting the veins weaken.
- Q)What causes hardening of the arteries?
A) The specific cause of atherosclerosis is not known, but it does occur when fatty substances such as cholesterol build-up inside the arteries, eventually creating a narrowed, or blocked opening that restricts blood flow. There are risk factors strongly associated with development of the disease which include cigarette smoking, high blood pressure, high levels of fat in diet, diabetes, overweight, lack of regular exercise, stress and family history.
- Q)What good is a compression stocking?
A) The compression of a support stocking functions similar to the muscles in the leg, squeezing the veins so that the blood is pushed upward. Custom fit compression stockings should be prescribed by your doctor and carefully fitted for the best results. It is essential that they give plenty of support to the lower leg without squeezing the calf or thigh and the doctors' prescription ensures exact compression distributed in a graduated manner up the leg. Stockings should be put on as soon as you get out of bed and be worn on all day because they are designed to keep leg swelling at a low point, such as after elevation or in morning. The compression serves to counter, or balance the increased venous pressure in the legs and reduces venous volume, increasing venous flow. The compression also supports superficial veins.
- Q)I have intermittent claudication, will I be in any danger if I continue to walk while experiencing leg pain.
A) There is no danger of leg damage by continuing to walk during pain, but many patients simply find it too difficult until they rest. When patients are faithful to exercise and eliminate risk factors such as smoking, obesity, maintain control of both blood pressure and blood sugar and avoid trauma or injury to the lower extremities, most find that they will improve significantly with conservative medical management. A progressive exercise program, specifically in the form of walking, stimulates the development of new, collateral circulation. This new circulation helps to relieve the pain, cramping and discomfort of claudication by increasing the blood flow around the areas of a blocked artery. Dr. King will prescribe specifically the type and amount of daily exercise needed to develop new blood vessels, but it is generally in a progressive plan of at least 30 minutes daily. Additionally, there are a few medications such as Trentol and Pletal, which may relieve the pain, caused by intermittent claudication and help you to walk farther and longer without pain. The combination of medication and a walking program are often used.
- Q)Can't I just lie down on the couch or bed; must my legs be up above my heart?
A)Yes, you must have the legs above the level of the heart since the pressure in the blood vessels increases at all points below the heart and decreases at all points above the heart. Therefore, the patient's feet must be well above the level of the heart in order to drain the legs of excess fluids. Lying down with the knees slightly bent and supported by several pillows is recommended.
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