Nurses General Nursing
Published May 25, 2007
passinthru
26 Posts
So my leg is throbbing after a long hard shift on my feet. The veins are very tortuous and UGLY. The problem is only in one leg but the vein is like a rope up my leg. I don't remember a time in the last 20 years when I didn't have a problem here, it has only gotten worse. I blame many long shifts on my feet. I am thinking of looking into surgical options at this point. Just wondering if anyone else has personally dealt with varicose veins and their treatment or has any insight into the pros and cons of surgical treatment. I've got another 10-15 years to work and wondering how I am going to make it.
CIRQL8
295 Posts
The first thing that you're going to hear from EVREYBODY is that we don't and can't give medical advice on this forum. We are not doctors (not all of us are even nurses...) and have no license to give medical advice. Those of us that are licensed are specifically prohibited from giving medical advice!!
Depending on how the moderators interperet your question, your thread may even get frozen or deleted...
That being said, I work in the OR, and the only things that I have seen for varicose veins are vein stripping and laser treatment. The laser was called ELVS, but I think that the laser/treatment has been re-named. I know that there are other treatments as well.
Perhaps you should speak w/ your doctor to see if it is, in fact, varicose veins and not something else. If it is varicose veins you may want to ask about a referral to a vascular surgeon or other appropriate specialist to see what your treatment options are.
Psqrd
206 Posts
As the above poster stated about giving medical advice is a ditto but what I can tell you is my own personal experience with this problem.
It started when I was in the military and actually had several veins "stripped" out of my lower leg...it hardly fixed anything. Later in life I had an ultra sound done on my legs and was diagnosed with regurgitating veins...this where the one way valves in the veins in my leg were completely blown...the blood actually flowed in the wrong direction.
The only cure I have used that has helped was prescribed by my doctor which was the below the knee compression stockings...similar to Ted hose but better color. Now all day on my feet is painless and most importantly about 50% less edema in my ankles and lower leg. I have since seen many nurses sporting these stockings from like mine which are below the knee to all the way up to the hip. My wife gives me a teaser with calling them my "special" socks, making sure I have them on before a long day on my feet.
You have my sympathies, I am very familiar with the "ache" and wish you luck.
P.S. I know you can buy them off the shelf but by being prescribed number one I didn't have to pay for them my health insurance did and number two they should be fitted to you by an expert.
good luck P2
You gotta love the internet!! I don't know what you all are seeing, but some of the sponsor ads to the left of my screen are about varicose veins. Coincidence? I don't think so!!
Bluehair
436 Posts
Usual disclaimer about checking in with your MD.
I have had radiofrequency ablation of my 'boa constrictors' as I used to call them. Large, painful ropey varicosities on both legs. Ultrasound diagnosed regurg due to incompetent valves so my insurance paid everything (except for usual co-pay stuff). BIG improvement!!! From all reports MUCH less painful than having veins stripped. They did it under light anesthesia (mostly because my surgeon is good but not particularly speedy and lying still on the table was problematic without drugs). He numbed the area with local, then inserts a catheter up the vein (ultrasound guided). When they get to the right location, they infuse a little solution of some sort (I was sleepy, remember) and basically fry the vessel from the inside out as they withdraw the catheter. Legs were wrapped for 2-3 days with gauze and Ace wraps. I walked like a mummy! That is the worst part. It didn't really hurt, but the wraps were a pain. I had to re-wrap them a couple of times a day even though I was just hanging around the house with my feet up on the sofa. They did a follow-up ultrasound to make sure everything is staying closed and that was it. The next 4-5 days I only worked 4 hours, too cheap to take all the time off. NO LIFTING for 2 week minimum. You can walk, but can't lift more than 5# because they don't want anything to try and regurg back down those vessels. I wore those heavy duty compression hose for about 6 weeks after. It never really hurt (tylenol did the job), but my legs would feel a bit 'full' that first week or so, improved immediately as soon as I propped up on the sofa for an hour. I would recommend this to anyone. No more pain, minimal swelling now after long days. I did just have a follow-up done and he had to do an injeciton of a couple of vessels that were getting a bot more enlarged (more incompetent valves). It was explained to me that when we changed the flow patterns shutting off those big ones, these were there all the time but not noticieable til they had more flow. This time it was a quick injection of foam in the ultrasound dept. Took 15 minutes, no pain (quick prick with a 25 ga needle, US to guide were to inject the foam). 1 day wrapped in ace for good measure and 2 weeks no lifting. I was back at work the next day. Cake walk and worth it!!! INsurance paid this too. They would prefer you did this than have venous stasus (sp) ulcers when you get older, a risk factor if you don't get these treated.
Long post, sorry, but I am so happy with my results I would encourage you to at least check into it!!!
Good luck!!!
Ahh, yes, thanks for the first hand report of your experience. I have been thinking about future possibility of stasis ulcers (Ooooh, yuk!!) I wouldn't like that. My question for you, bluehair, is...who did this for you? A general surgeon, vascular surgeon? We live in a very rural area so I am wondering where to look for a doctor. I am encouraged that there may be hope for what ails me. Thanks.
justme1972
2,441 Posts
In my area, there is something called a "Vein Clinic", that specialized in varicose veins. I would probably start at a place something like that.
If yours can be cosmetically removed, I had a friend that went through that procedure, and she described it to be similar to having hot lava injections if that gives you an idea of how hard they are to remove.
I also live in a pretty rural area. We are 3 hours from an airport other than the local airstrip. Town is about 26,000 surrounded by lots of desert. We have 2 board certified vascular surgeons at our hospital here and one of them did it. He went for special training about a year ago and has had a steady clientele.
I've had my problem since I was 20 years old and I am 38 now...the last time I had a surgeon look at them he refused to treat them stating that they would just come back! Later I realized it was an HMO and I am sure that they did not want to pay for it. I like the sound of the Radio Freq ablation...definately going to check into that.
Just read up on venous stasis ulcers...that sounds bad! I have the edema, tried the lasix but that led to flank pain...so I stopped that and stayed with my "special" socks.
Daytonite, BSN, RN
1 Article; 14,604 Posts
passinthru. . .my experience with varicose veins started out much like yours. one leg. it was a concentration of them in one area on the medial side of my lower leg a few inches above my ankle. i was always worried about them. as i started out in nursing they started to get larger. doctors told me that the danger was of developing status ulcers. i was fitted and wore jobst stockings for many years. it was an internal medicine physician that prescribed them.
however, there is more to my story and should serve as a warning to others. i had a patient who i noticed when i was doing my admission assessment had some real garden hoses in his lower legs. he, too, was in a business where he stood on his feet for long hours. his problem, however, was that he had developed spontaneous bleeding from some of these veins. a new worry to think about! and, i obsessed over this all the time. it eventually happened to me, but not because of a spontaneous rupture, but because of my cats. i've had cats since i was a child. one of the cats one day managed to get a claw smack dab in the middle of one of my own garden hoses. it wasn't the cat's fault. the cat was only trying to steady themselves as they climbed out of my lap, which i should have protected better. you should have seen the fountain of blood that shot up and into the air from the little puncture. and, unlike arterial blood, it doesn't spurt. the fountain just keeps on flowing. i slapped my hand over it and applied pressure. every time i removed pressure, the thing started bleeding like a fountain again. after a half hour i hobbled to my portable iv kit that i took back and forth to work with me (i was a supervisor at the time, but often had to do iv restarts for the nursing staff) and folded up a piece of sterile 2 x 2 and kept it in place with a small piece of tegaderm. that stopped the bleeding. about 2 weeks after this i noticed a white flake of skin over the puncture when i was changing these tegaderm dressings. thinking it was probably all healed at this point, i carefully worked the flake of skin off (nurses!). there was an immediate fountain of bleeding from the puncture wound! it took a total of 3 months for that puncture to heal. after that i was insisting that the doctors do something about these things.
i was sent to a general surgeon who did selective phlebectomies on that leg with a high ligation of the saphenous vein at the groin. this was in the early 1990's. the varicose veins in my legs reduced nicely almost right away. however, there have been long-term complications as a result of this surgery. first of all, the circulation has been compromised somewhat. i get edema in that leg upon standing all the time all the way to the top of my thigh. and, a huge area of skin discoloration has developed on my lower leg. unless it can be hidden, i'd never wear a knee-length dress again. and, i've developed 3 stasis ulcers since then. one took over a year to heal. two were the result of cat scratches (my carelessness again). however, worse was that i had to be off work for weeks and weeks because i had to be off my leg with it elevated. the jobst stockings weren't going to help the healing of the stasis ulcers, i was told. it was a horrible situation because it put me in a real financial bind and put my job security in jeopardy. the third and final stasis ulcer developed in an odd place on the lateral side of that lower leg just 4 years ago and i still have no clue as to how it happened. there is a horrid looking discoloration, not really a scar, marking it's spot that still persists. healing was made complicated when they found my blood sugars were elevated at the time as well--type ii diabetes.
i am currently on a diuretic to help keep the swelling down in this leg, and i will often wear my jobst stockings if i am going to be up and moving around. however, most of the time i spend with my leg elevated or in bed where my legs are at my waist level to keep the swelling to a minimum.
i'm really not sure what the treatment is today. however, i wouldn't be surprised to hear that jobst stockings are involved. i've been told by other doctors since that the phlebectomies should not have been done to the extent that they were. worse, i've now seen varicosities developing, get this, on the sole of my foot on the involved leg. i think the doctor's who deal with this are the general surgeons. i would recommend that you investigate the subject of the treatment of these. this is way beyond spider vein treatment. good luck.