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Medical Forum / General / General / February 2004

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Help for Younger Man with Varicose Veins?

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Ryan - 12 Feb 2004 14:01 GMT
Hi,

I am at 35 year old male who has had trouble with varicose veins in my
legs for years and ignored it. I am beginning to think something has
to be done, but am unsure where to turn.

I am not sure of the cause of my veins, but they are common on my
mother's side of the family. I am not overweight, but was up to my
teens. Since my early 20's I have been at the correct weight for my
height and workout daily. I have very muscular legs from my workouts.

While my legs are hairy like most men and that covers the appearance
of most of the veins, I noticed a year or two ago that sometimes at
night I was feel a light aching in my calf off and on and then it
would ago away. It took me a while to realize this aching was coming
from the same calf where my varicose veins are. I am unsure if it's
related. It will come, then go for months and then return for a day or
two.

In any event, this week I finally look a good look at my calfs and
it's not pretty. I have a very large mess of varicose veins on the
inside of my right calf, a few more varicose veins near my ankle and a
smaller, almost spider vein near the side of my knee on the same let.
My left calf have some smaller varicose veins, but I'd swear that calf
didn't have any a few years ago so I assume this sitution is worsening
and need to take action.

I had read about laser vein removal and saw a local doctor a few
months ago who looked at my legs and said the veins were too large for
lazer methods to me used. He then told me I need to find a "vascular
surgeon" but couldn't name any to refer me to.

I am left with two questions. I want these veins gone, I am a healthy
man in very good shape otherwise and I believe the ache I feel may be
related to the veins. I feel I have to do something before things get
worse. My questions are:

1. Is removel of varicose veins normally covered my health insurance?
This is not just a cosmetic issue and I just can't shell out the cost
of removal out of my pocket.

2. Where do I find a vascular surgeon? I looked in my large book of
providers given to me by my health insurance company but can't even
find a listing for that type of doctor.

I keep putting this off because I don't know how to proceed and want
to take action. I'd like to have this done and over with before summer
when I am wearing shorts again.

Any input would be helpful. Thanks!
Howard McCollister - 12 Feb 2004 16:26 GMT
> Hi,
>
[quoted text clipped - 46 lines]
>
> Any input would be helpful. Thanks!

You may find a vascular surgeon that would operate on your varicose veins,
but generally it's more common to find that it's a procedure that is done by
general surgeons.

I strongly recommend transilluminated powered phlebectomy (TriVex). Look at
http://www.endo.smith-nephew.com/US/node.asp?NodeId=3422   then find a
surgeon that can do it. It is vastly superior to the older stab-avulsion
technique.

HMc
Howard McCollister - 12 Feb 2004 16:30 GMT
> Hi,
>
[quoted text clipped - 14 lines]
> related. It will come, then go for months and then return for a day or
> two.

> Any input would be helpful. Thanks!

If you look at http://www.endo.smith-nephew.com/US/node.asp?NodeId=3422 ,
you will find a physician locator for the TriVex varicose vein procedure.
You should find the one closest to you and make an appointment.

HMc
doe - 12 Feb 2004 17:05 GMT
>Subject: Help for Younger Man with Varicose Veins?
>From: welziak@snet.net  (Ryan)
[quoted text clipped - 51 lines]
>
>Any input would be helpful. Thanks!

It seems Dr. Shute and his use of tocopherol in those with  varicose veins was
right on target ..

World J Surg 2003 Apr;27(4):473-5

Long saphenous vein stripping reduces local level of reactive oxygen
metabolites in patients with varicose disease of the lower limbs.

Flore R, Santoliquido A, Antonio DL, Pola E, Flex A, Pola R, Muzi MG, Farinon
A, Rulli F, Gaetani E, Tondi P, Gerardino L, Gasbarrini A
Department of Medicine, A. Gemelli University Hospital, Universita Cattolica
del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy.

[Medline record in process]

Long saphenous vein (LSV) stripping is the most common surgical procedure in
patients affected by varicose disease of the lower limbs. Reactive oxygen
metabolites (ROM) generation plays a crucial role in chronic venous
insufficiency (CVI). The aim of this study was to investigate whether ROM
generation is increased in patients affected by varicose disease versus healthy
controls and whether LSV stripping has a positive effect on the local
production of ROM. The local production of ROM was assessed measuring
hydroperoxides in the blood collected from the leg of 30 patients consecutively
undergoing LSV stripping and 30 controls. In both the patient group and the
control group, the test was repeated 30 days later. We found that ROM levels
before surgery are higher in varicose vein patients than in controls ( p
<.0001) and that ROM are significantly reduced 30 days after LSV stripping ( p
<.0001). At that time point, no significant differences between patients and
controls was found. We also found that sex and age do not affect ROM
concentration in patients and controls, either before or after surgery. In
conclusion, our data indicate that CVI is characterized by significant
oxidative stress and that LSV stripping is able to normalize local production
of ROM in patients with varicose disease of the lower limbs. We suggest that
measurement of ROM might be useful to test the positive effects of LSV
stripping in these patients.

PMID: 12658495, UI: 22545409

Who loves ya.
Tom

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