Normal circulation involves blood carrying oxygen being pumped from the heart into the tissues via arteries and then returning de-oxygenated blood carrying other waste products from the tissues back to the heart through the veins. Your arteries might be in good health but if your veins are not working properly and leaking back into the tissues due to varicose veins then in the long term tissue damage to your lower legs can occur leaving you at risk of varicose leg ulcers later in life.  

Walking compresses the deep veins in the leg muscles and this pumps the blood out of the legs. This is the most important mechanism to improve clearance of venous blood out of the legs. If you sit on an aeroplane for a long flight you might be aware of some ankle swelling because you haven’t been walking.

People with venous disease will often find relief from their swollen feet and ankles and alleviation of tired and aching legs by elevating their legs at the end of the day.

There are many and varied medications and devices marketed as circulation boosters (e.g. the brand Revitive).   Medical Graduated Compression Stockings have Evidence Based Medicine to support their use to improve leg vein circulation and improve leg vein health.  

But these methods only provide temporary relief and do not prevent tissue damage from occurring in the long term. An Ultrasound investigation can establish if your aching or swollen legs are caused by poor venous circulation. 

The price of the initial consultation at our Vein Clinic in Brisbane and Toowoomba includes a venous duplex ultrasound examination for which there is a medicare rebate. 

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AuthorNicholas Kemp

So party season is upon us and for many women that will mean wearing high heels more often than usual.  

A US study compared the venous blood pressure in the legs of women walking on a treadmill with and without high-heeled shoes.  Normal walking coordinates the foot and calf pump. When the foot is off the floor, the foot veins fill with blood. As the heel and arch of the foot contact the floor, the blood flows into the relaxed calf veins. The calf muscles then contract which propels blood up the deep veins.


High heels change the natural walking motion, shifting the weight to the fore foot and toes and causes the calf muscles to remain contracted. This results in a decrease in the filling of the foot and calf veins and a less forceful calf muscle pump. This lose of efficiency causes pooling of venous blood in the leg. 
 
You don't have to stop wearing heels, but you should be aware of what you are doing - make an effort to stretch your calf muscles throughout the day to ensure good blood flow in the legs, and mix up your footwear, give your legs a break! Remember to keep active and walk at least 30 min a day to ensure your calves are pumping blood back up the system - your legs (and your waistline) will thank you. 

Happy Holidays!

Dr Nick Kemp is a regular columnist for Style Magazine in which this post was published. You can read his column each month in the Expert section in which he covers all matters of phlebology with the odd bit of humour thrown in.  

Posted
AuthorNicholas Kemp

Queenslanders love summer, it's what we're famous for, but for those living with varicose veins or venous insufficiency the sunny warm months can be three months of nightmares by bringing extra discomfort or self consciousness. Varicose veins can prevent us from enjoying the months when bare legs and trips to the beach are common. Here’s what you need to know about varicose veins during the summer.

Excessive heat expands veins

Frequent exposure to high temperatures can dilate the veins, allowing for more blood to pool, thus causing them to expand or bulge, placing more stress on valves in the veins. Staying cool is the best way to prevent this from happening. Cooling exercises (like swimming or indoor yoga) can help promote blood circulation without exposure to excessive heat.

The sun can agitate varicose veins

While the sun may not cause varicose or spider veins, it can certainly exacerbate them. UV rays weaken the skin’s upper layers, depleting moisture. As a result, the skin can lose some elasticity or ability to move – which may aggravate weak veins. If you have varicose vein symptoms, avoid excessive exposure to the sun or tanning beds, wear sunscreen, and stay hydrated!

Don’t let venus problems derail your ruin plans—follow these tips for a happy, healthy, vein-pain-free summer.

  • Stay Cool. If you have vein problems of any kind, it’s a good idea to keep your body as cool as possible during the summer. Make sure you wear clothes that aren't going to have you burning up in the summer heat and think about hitting the water to cool down if you plan to be outside for a prolonged period of time.

  • Exercise to keep the blood circulating. In addition to offering great respite from the summer heat, swimming is one of the best ways to promote normal circulation and keep blood vessels from dilating. A low-impact exercise that saves you joint and leg muscle pain while increasing your heart rate, swimming pumps the muscles of the lower and upper body to improve circulation to the heart and lungs. Not near a pool or the beach? Keep moving by taking an evening walk around our beautiful city - the walkways along the river and around Kangaroo Point and the Story Bridge are really enjoyable this time of year.

  • Keep hydrated! Keeping your body properly hydrated will help it effectively circulate blood, heal injuries faster and allow for healthier skin. Anyone with vein problems should pay close attention to their hydration levels during the summer, when the heat can easily dry anyone out. If you plan on being outside, take a water bottle everywhere.

  • Flatten out for summer! Opt for summery flats and sandals rather than high heels that keep your calf muscles from effectively pumping blood out of the leg. There’s a major beauty and fitness plus to this one – wearing lower heels makes your calves work a little harder, keeping them curvy and strong!

  • Remember the basics. We've been hearing it for years, but always remember to SLIP, SLOP, SLAP - especially in the summer months! Slather on the sun block and high SPF moisturisers, not just on your legs, but also on your face and nose, where thinner skin is more prone to developing spider veins, and cover up or seek shade if you’ll be outside for long periods of time.

Posted
AuthorNicholas Kemp

Spider veins or telangiectasia on the legs often cause considerable distress because of their unsightly appearance. Sometimes they are associated with underlying varicose veins so it is important that you are properly assessed before proceeding with treatment. This may involve having a venous colour duplex ultrasound performed on your legs to assess the underlying saphenous veins.

In women the most common places for spider veins to appear are on the outside of the thighs and inside the knees.

Treatment almost always involves sclerotherapy. Vascular laser is most unlikely to clear spider veins if they are significant.

The most common agents used for sclerotherapy are the two detergent sclerosants

  • Polidocanol (“Aethoxysklerol”)

  • Sodium tetradecyl sulfate (“Fibrovein”)

Hypertonic saline historically had a role in treating spider veins but it is rarely used today because it is relatively inefficient, has a tendency to cause ulceration and worldwide has been superceded by the detergent sclerosants.

Lateral thigh

Before and after

after
Posted
AuthorNicholas Kemp

There was a recent TV feature on Channel 9 Television about laser treatment of varicose veins being painless. Is this true? Pain is certainly minimal in comparison to surgery but people do experience some pain so saying its painless is not entirely true.  The measure of pain is subjective as each individual has different tolerance thresholds for pain.  

Prior to the Laser being turned on and withdrawn through the vein, Tumescent Anaesthetic needs to be injected along the entire length of the vein with a series of needles so that the vein becomes enveloped in an anaesthetic blanket.  These injections are relatively painless but they are not painLESS.

Once the anaesthetic is inserted you can be confident that the laser treatment is completely painLESS no matter what type of laser or frequency of laser is being used.  

Following treatment the anaesthetic takes several hours to wear off and this is when some discomfort might develop.  Any dull ache that might develop which normally would only last a few days can normally be managed with ibuprofen or paracetamol. 

With the use of the newer types of Lasers there is often minimal or next to no pain over the recovery period.  There has been a trend towards the use of lower frequency Lasers (1470nm) which specifically target water in the vein wall rather than the blood inside the vein. The lower power settings required for these new types of Lasers accounts for the significant reduction in post procedural pain. 

Posted
AuthorNicholas Kemp