-Health -
Varicose Veins In Your Leg:
Never Ignore Them
By Dr. K.K.Pandey
Senior Cardiovascular & Thoracic Surgeon, Indraprastha Apollo Hospital New Delhi
Comfortable & sedentary lifestyle, modem fashion, special postures adopted while performing professional duties have contributed to increased incidence of a set of diseases unheard in past. Varicose vein disease is one of them and is a direct result of a sedentary life style, adopted by modem youth today. The problem of varicose veins has become very common during these days. According to one estimate, 15 to 20 per cent of population in our country is suffering from varicose vein problems these days.
Ladies suffer from varicose vein problems four times more than their male counter-parts. There is an increased risk of development of varicose vein among young females who wear tight jeans & high heeled sandals.
What are Varicose Veins?
Varicose veins are actually abnormal veins lying just beneath the skin of your leg & thigh. These varicose veins are prominently visible, corkscrew like, entangled in one another. It looks as if a number of earthworms or blue-colored spiders are lying under your leg skin. In these veins, the mechanism of carrying impure blood from lower limb back to heart gets deranged either due to defective valves of vein or absence of valves by birth. The function of these valves is to control blood flow in the veins.
Veins are those blood pipes, which collect impure blood from your lower limbs and carry it back to MW heart and then lung for purification. The job of vein is difficult, as it has to push blood upwards from leg against gravity towards heart. This function of vein is made possible by valves which open up & allow blood to flow only in one direction, but when a person stands up these valves get closed to prevent blood from going down towards feet. In other words, these valves of veins constantly maintain a unidirectional flow of blood that is always towards the heart. When these valves are absent or become defective, these varicose veins fail to control blood flow in one-way direction & in the process they become dilated & swollen under the skin due to high backpressure and this results into pooling of impure blood into the feet.
Features of Varicose Veins
Varicose veins cause permanent swelling & heaviness in feet. Skin of leg develops black or blue colored patches. In thigh & leg, under the skin develop snake or earthworm like blue colored veins, resulting into distortion of shape of leg & foot.
A person suffering from varicose vein, develop pain in foot & leg while walking or on prolonged standing. If varicose veins are not treated effectively, leg skin will develop eczema & an ulcer that never heals. These ulcers caused by varicose veins are called varicose ulcers. Sometimes there occurs massive bleeding from varicose ulcer. Ultimately, person is forced to lead a disabled life.
What causes Varicose Veins?
In forty per cent of patients, varicose vein are due to hereditary & run into families and generations. The other important causative factors are obesity, lack of exercises, and abnormal pressure on veins during pregnancy, abnormal life style, prolonged standing and prolonged sitting with legs down.
Due to advanced age, overweight and lack of exercises, veins of legs become very weak and therefore develop into varicose veins. Due to obesity, a lot of fat gets deposited in the leg. This weakens the support system of veins that result into veins becoming dilated & tortuous.
In today’s modern age, a lot of occupations & professions have sprung up where a person is required to either constantly standup for a long time or made to sit with legs hanging down for a considerable time. Computer professionals, receptionists, security guards, traffic policemen, salesmen working at counters in shops & departmental stores and persons doing desk jobs day in & day out are the worst sufferers of varicose veins. Previous fracture of bone during road traffic accidents, previous deep veins thrombosis or previous incidence of clotting in the veins is the significant contributor to development varicose veins & varicose ulcer.
Why ladies are more susceptible to Varicose Veins?
Among females, due to some hormones, the walls of veins become enlarged & dilated. Besides, during pregnancy because of lot of pressure on leg veins, veins become weak and varicosed. In majority of women after delivery varicosity disappear on its own & veins assume normal diameter & shape. In some ladies due to tumor of uterus or tumor in abdomen, varicose veins are likely to develop One should be vigilant in such cases.
Fashion is playing havoc among ladies. High heeled sandals & tight belts & panties are significant contributors to development of varicose veins, as these items obstruct the normal flow of blood in veins.
What to do if you have Varicose Veins?
In our country people are quite ignorant of this disease of varicose veins. Patients of varicose veins due to ignorance, either goes to a general surgeon, a general physician or a bone specialist for consultation. When varicose veins gets complicated & turns into a varicose ulcer, these patients then go to either a skin specialist or a homoeopath for treatment of so-called eczema & skin problem. Sometimes varicose vein is misdiagnosed as arthritis or sciatica. Because of ignorance & misdiagnosis, a patient of varicose vein keeps on shunting from one specialist to another. This leads to a considerable delay in treatment and disability increases.
If any person is having blue colored visible spider-like veins or blue- colored long threads under skin & dark colored patches or ulcer in legs, immediately consult a Cardiovascular or a Vascular Surgeon instead of a general surgeon. If suspicion of varicose vein arises, never make delay in seeking consultation & treatment by a Cardiovascular Surgeon / Vascular Surgeon, so that timely intervention may prevent further complications.
Treatment of Varicose Veins
1. For an effective treatment of varicose veins, always go to a hospital where services of a full-time Vascular or a Cardiovascular Surgeon are available.
2. In the early stages of varicose veins, exercise and sometimes medical treatment including sclerotherapy suffice.
3. In advanced stages of varicose veins, surgery is required. ‘Mere is various surgical treatments, like phlebectomy, vein stripping. In phlebectomy, small- sized varicose vein are removed while in stripping long- sized varicose veins are removed. There are no harmful effects on the body or legs after removal of varicose veins.
4. Sometimes special techniques like endoscopy are used for varicose veins operation especially in cases of varicose ulcer. In this technique, connecting channels are tied under endoscopic vision to prevent pooling of impure blood in the feet to minimize the chances of recurrence of ulcers. This technique was evolved in our hospital and being practiced.
5. In a few selected cases, a new laser technique perfected in our hospital is also employed for varicose veins treatment, which shortens the hospital stay & minimizes the number of cuts in the skin. This technique is not suitable for all cases of varicose veins.
Varocose Veins in Early stage:Be Careful Varocose Veins reached to an advanced stage due to neglect
Leg Ulcer May Cause Loss of
Your Foot
by Dr. K.K. Pandey
Many a times, an injury or a simple scratching on the leg result into a long-standing leg ulcer and if not treated adequately may result into a situation, where you have no option left except losing the leg. It is a common notion general public that leg ulcer is generally caused by eczema or a skin disease, therefore patients of leg ulcers more often either go to a skin specialist or a homeopath for treatment. Some of these patients consult a general surgeon too, where a continuous process of daily dressings, and minor surgical cleanings goes on for months. All sorts of antibiotics are tried; even then leg ulcer refuses to heal. Some of these patients even go to quacks practicing ancient medicines and get treated for years. It has been observed all sorts of these treatments ultimately fail and result into a loss of foot.
What causes leg ulcers?
Many people, including even educated ones in our subcontinent, are not aware of the fact that the leg and foot ulcers, which do not heal over a period of time, are caused by diseases of veins in almost 75 percent of cases. Veins in our body form a drainage system of all the four limbs and other organs of the body. Veins collect impure blood, deficient in oxygen from all the organs of the body and carry it back to heart and lung for purification and thus keep on replenishing the blood with oxygen
If this drainage system of veins becomes defective due to any reason, a large portion of the impure blood starts collecting into the legs, and this leads to undue backpressure on the veins of lower limbs. If timely intervention is not initiated, it may lead to ulcers on your legs & feet.
These ulcers are called venous ulcers, and diseases of veins are responsible for these ulcers. Among the disease of veins, chronic venous insufficiency (CVI) tops the list.
The second most common cause of leg & foot ulcer is the disease of arteries. In fact, it is only artery, which carries oxygen-enriched pure blood from our heart to various organs of body including our limbs. About in 20 percent cases of leg or foot ulcers, arterial disease is mainly responsible. Disease of the artery leads to narrowing of its diameter and this result into decreased supply of pure blood and hence less oxygen supply to various organs including legs in our body. In such a scenario, where leg is already deficient in oxygen, a simple injury in leg may lead to dangerous complications. Apparently, a simple looking ulcer will not heal despite antibiotics and medical management and gradually over a period of time, will develop into a large ulcer with complications and ultimately result into amputation of foot or leg.
In 5% cases of leg and foot ulcers, the diabetes it the culprit, the third most common cause after venous and arterial disease. There is decreased sensitivity in diabetic patients and hence, very less perception of pain due to leg and foot ulcer. Because of this precise reason, diabetic patients tend to become less aware of their injury and ulcer on their leg and foot. Hence they became careless in management and their ulcer assumes dangerous proportions. Besides this, in diabetic patients, by and large, diseases of arteries are known to co-exist. This further jeopardizes the oxygen supply of legs to a dangerously- low level, and will result into a non-healing ulcer and gangrene of the foot.
Blood pressure, obesity, fire burn, disease of joints like rheumatoid arthritis, anemia and infection do play an important role in the development of leg and foot ulcers.
Where to go, if you have leg ulcers?
If your leg and foot ulcer do not heal completely within a period of 2-3 weeks, immediately consult a Cardiovascular or a Vascular Surgeon instead of a General Surgeon or a Plastic Surgeon. The patients must visit a hospital where active and full- time services of a Cardiovascular or a Vascular Surgeon are available. Patients must ensure before entering a hospital whether the hospital is equipped with necessary and relevant investigatory facilities like Angiography, Venography, Nuclear Medicine, Doppler Study and M.R.I. Such patients should prefer hospitals, which provide facilities like hyperbaric oxygen therapy and therapy and where arterial & venous bypass surgical facilities including artificial grafts are available.
What to do if you have non-healing leg ulcer?
1. Consult immediately a Vascular or a Cardiovascular Surgeon.
2. 2. Reduce your weight. Excess weight delays healing. The process of carrying deoxygenated blood from legs back to heart gets slowed down.
3. 3.Avoid cold exposure. It is very essential to keep your legs and feet warm. Room must be warm and comfortable.
4. Avoid any ointment and cream, because of risk of developing eczemas over the skin surrounding the ulcer. This may hamper the healing process. There should not be any moisture over the leg and foot having ulcers.
5. Daily cleaning of wound is essential. Leg and foot should be soaked daily, for half an hour in potassium permagnate solution before cleaning and dressing.
6. Daily exercise of legs and foot if of utmost importance. Leg ulcers are difficult to heal in a patient who remains confined to bed.
7. Avoid high-heeled sandals, shoes and chappals. Shoes must be very soft and comfortable. Tight shoes do more harm than good to legs and feet. Avoid walking bare –footed even inside the house. It is desirable to wear soft shoes while at home.
8. Never apply tight dressing or bandage over the legs & foot. Bandage or dressing if wrongly applied will be harmful to leg ulcer, and even may cause dangerous complications.
9. Keep your legs elevated during night times in bed. Put one or two pillows underneath your legs.
About Dr. K. K.Pandey
Dr.K.K.Pandey is a Senior Consultant in the Department of Cardiothoracic & Vascular
Surgery at Indraprastha Apollo Hospital, New Delhi . 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 well-known Bakulev Institute of Cardiovascular Surgery, Moscow. He can be contacted at the following telephone numbers:Apollo Hospital-26925801-Ext. No,-1048,1080; 26825703(Direct)
Home —— 26945441,26955789
Mobile —- 9911,114081 ; 9810,114081
Email: drpandeyg@gmail.com
@The Article is exclusively contributed by the Doctor for Snowline magazine published by Himgiri Prakashan in the welfare of the patients suffering from such diseases. We profusely thank the Doctor.-Editor