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Jewish News 29 April 2021

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VARICOSE VEINS

lthough well over ninety percent of people will have areas of thread or spider veins on their legs, more serious problems with leg veins will affect at least half of us at some point. True varicose veins affect men as well as women; they are associated with a strong family history and pregnancy, the contraceptive pill and jobs that involve long periods of standing. The larger veins that stick out especially when standing usually ache, itch or throb and they certainly do not look good when on the beach. Less commonly, these varicose veins can cause leg ulcers at the ankle, needing months of bandaging and special dressings to the wound, which are applied two or three times a week. The varicose veins can also clot off (called phlebitis). This presents a risk of devel-

oping a deep vein thrombosis and even having the clot migrate up into the lungs (a pulmonary embolus). Occasionally, the varicose veins bleed profusely if knocked. This, therefore, affects those of us who enjoy contact sports such as rugby or horse riding as well as people with delicate skin. It’s therefore wise not to just ignore your varicose veins but to see a specialist – this would be a vascular surgeon. At your first visit, the specialist doctor will listen to your medical history to assess the causes and significance of your veins. Your legs will then be examined. It is usual to have an ultrasound scan (a duplex scan) of the veins in your legs. With the information found from this, your surgeon will be able to make a treatment plan for you. Although sometimes no treatment is needed, often a procedure is recom-

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mended. This usually involves using an ultrasound and passing a wire up along the varicose vein just under the skin. When accurately placed, a little heater at the tip of the wire is turned on and these seals off the non-functioning vein. The heat is generated either by a laser or high noise (radiofrequency). This is called endothermal ablation of the saphenous vein. At the same time, the varicose veins can be removed with little cuts over them. The whole procedure is undertaken under local anaesthetic, often with some sedation as a day case procedure. It is wise to have the procedure undertaken in a proper operating theatre with sterile clean conditions. It is expected that you will be up and about within a couple of days, although it is often best not to drive for a little while. Any leg bruising usually fades quickly. If the thread veins are troublesome, Varicose veins affect at least half of us at times ask your specialist about microscleSometimes support stockings are rotherapy. This involves putting a little suggested. These can come up to the needle into the thread vein and injecting knee and rarely need to go up the thigh. a recognised chemical that causes the They treat or prevent the development vein to clear. The leg is then bandaged of ankle leg ulcers. They always feel tight for a couple of days. The best results when you first put them on, but this is usually take several weeks, so don’t be normal and a lot of people have a sense in a rush to have repeated treatments of relief when they are on. You may need quickly. to wear the stockings for some time and Occasionally, the technique is marred then your GPwill replace them regularly. by a brown pigmentation along the vein, There are so many different treatwhich will take ages to fade, if at all. ments available to manage varicose veins If the thread veins are very fine (less – please do not ignore yours – but make than one millimeter in diameter), then perhaps a course of skin laser treatment sure you get an expert to assess them. would be indicated. This should only be undertaken by specialists and often requires several sessions before the veins Daryll Baker fade. Don’t go out in the sun without Vascular surgeon, Royal Free Hospital covering the treated area with a high Contact: daryllbaker@btinternet.com factor sun block. 07934 072213

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