The Anatomy of a Comprehensive Vein Treatment Center -Articles By The Long Island Vein Doctor P 5

The Long Island Vein Doctor

By Mark Schwatz, MD, FACS, RPVI

Mark Schwartz MD, FACS, RPVI The North Shore Vein Center 1 Hollow Lane, Suite 210 Lake Success, NY 11042 516-869-8346 Visit Website

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Vascular Conditions Associated with Pregnancy How pregnancy increases the risk for varicose veins Varicose veins are a very common condition in the United States and affect about 25% of women. The process of valve failure is almost entirely hereditary. However, certain conditions such as hormonal changes and pregnancy can play a unique role in women of childbearing ages.

Pregnant women frequently develop new onset varicose veins as the pregnancy progresses. Not only does pregnancy increase the volume of blood in a woman’s body, but the enlarging womb also decreases the flow of blood traveling out of the legs. In addition, there is weight gain and a surge of hormones that contribute to weakening of the walls of the veins, allowing them to dilate more.

The majority of women who do develop varicosities of the leg veins will retain these veins after pregnancy. Multiple pregnancies are also associated with varicose veins. In fact, with multiple pregnancies, the varicosities always worsen in size, shape and symptoms.

Unfortunately, there is no way to prevent the development of varicose veins, but there are conservative measures that may lessen their symptoms and delay the worsening of existing varicose veins. If problems persist, you may want to seek treatment.

For more information on how to schedule a free vein screening with Dr. Mark Schwartz at The North Shore Vein Center, call 516-869-VEIN (8346) or visit our website http://www.NorthShoreVein.com. The North Shore Vein Center is a fully certified outpatient facility through AAAASF and AAAHC. Dr. Schwartz is board certified in General Surgery, Vascular surgery and Phlebology (vein therapy).

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Men Can Now Take a Stand Against Varicose Veins An estimated 30%-40% of the U.S. adult population is affected with vein problems in the legs. However, most men are surprised to learn that, they too, can develop vein conditions they previously believed affected only women. While it's true that cosmetic conditions, such as spider veins, arise mostly in women, there are other vein conditions — even painful ones — that occur more commonly in men, including the development of larger, bulging varicose veins.

However, men are less likely to seek medical treatment for minor ailments, such as leg veins because they wear trousers and tend to have hairy legs, which cover up their varicose veins to some degree. In addition, men that suffer from varicose veins tend to have much larger varicosities than women and experience more symptomatic disease including throbbing, heaviness, pain and ulcerations.

Varicose veins are abnormally swollen and tortuous veins. They are usually situated quite near the surface and are often visible beneath the skin. Varicose veins can vary in size from quite small (2-3mm across) to very large (2-3cms across).

Patients may have no symptoms at all and may become aware of them solely by their unsightly appearance. However, they can also lead to a feeling of heaviness, swelling, aching, restless legs, cramps and itching. Symptoms are often exacerbated by standing, hot weather or exercise.

Treatment options have improved significantly over the past few years, and men are now more willing to get rid of their bothersome veins using a routine office procedure called Endovenous Laser Therapy (EVLT). This procedure is covered by most insurance carriers for patients with significant symptoms who have failed attempts at conservative therapy. EVLT will eliminate all varicose veins in a single office visit with no downtime.

Patients may experience mild bruising or swelling, but will be able to return to normal activities within a few days.

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Treatments should be performed by a vein specialist — a vascular surgeon or a Phlebologist (a doctor who specifically treats varicose veins). The service provided should be comprehensive and include an ultrasound vein mapping and an individualized treatment plan based on the ultrasound findings.

Some patients are concerned that they may need their veins for possible heart or leg bypass surgery later in life. In fact, varicose veins are unsuitable for use in these situations. Varicose veins are diseased veins and would be detrimental to the success of these operations, where more healthy veins or arteries are required. It is also relatively uncommon for patients who have their varicose veins removed to subsequently require bypass surgery.

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3/5/13 The Anatomy of a Comprehensive Vein Treatment Center What to assess when seeking care for your varicose and/or spider veins Over 80 million people have varicose veins or spider veins. These conditions are often hereditary, but hormonal factors including puberty, pregnancy, menopause, and the use of birth control pills can also play a role. Additional external factors may include age, leg injury, obesity, lack of exercise, and prolonged sitting or standing.

Spider veins are small clusters of red, blue or purple veins that are commonly found on the calves, thighs and ankles. These annoying, unattractive veins are actually enlarged capillaries, which present as purplish or reddish lines or web-like discolorations.

Varicose veins are thick, blue, ropy veins that have lost their ability to circulate blood back to the heart causing it to pool in the legs. Healthy veins function using one-way valves that keep the blood moving in the right direction. Sometimes a vein may become incompetent, allowing blood to leak back down, away from the heart and lungs, and pool in the legs. This congestion can result in fatigue, swelling, throbbing, heaviness, aching and restlessness in the legs. In advanced cases, skin rash, pigmentation changes, inflammation, ulceration, and bleeding may occur.

Treatment options vary. Most patients shy away from treatment as they are most familiar with out-dated stripping procedures that were painful and came with a prolonged convalescence. Recent advances in vein treatment now offer patients an easier alternative. Procedures are now being performed in an office setting, with no general anesthesia and no downtime.

With all of these changes, patients are confronted with various options about where they can obtain treatment. Lately, there are a lot of physicians offering vein care as a supplement to their overall practice, as well as a multitude of “laser clinics� cropping up offering basic treatments.

So how do you know you are getting the best advice and the most up-to-date treatments available? Here are some points to consider.

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The Facility Is the vein clinic focused exclusively on vein treatment? In many practices, diverse mixes of patients are frequently lumped together in the same office. Even a vascular surgeon may see a variety of patients, and it’s inevitable that the more serious, arterial-related patients will take precedence over those seeking treatment for varicose veins. This is why choosing a vein-dedicated practice is important. Vein patients generally present with more isolated problems. This allows these vein practices to run more efficiently with improved patient flow, less wait times, and superior patient satisfaction.

Do the facilities look clean and professional? Vein specialists generally do all their diagnostic testing and perform all of their procedures right in their vein clinics, so the appearance of the office can tell you a lot about the practice.

Are there RVT ultrasound technicians on-site? RVT technicians are the most credentialed to perform ultrasound-guided diagnostics as part of the evaluation process.

Frequent questions you will want to ask include: “How are my vein problems diagnosed?” and “Are you proceeding with treatment without a thorough Ultrasound?”

Ultrasound evaluation of vein anatomy and physiology is mandatory, and any clinic that does not offer it is not providing a thorough evaluation.

Is the facility a fully certified ambulatory surgical center by the AAAASF and the AAAHC? These organizations provide accreditation to out-patient surgical facilities with the goal of improving patient safety and quality of care.

The Physician Are you satisfied with the vein doctor’s credentials? Vein specialists are board certified in general surgery, but also more specifically in vascular surgery and phlebology (specialty in venous diseases). To find out more about your doctor’s certifications visit the American Board of Surgery at www.absurgery.org. To find out more about your doctor’s specialty, visit the American College of Phlebology at www.phlebology.org.

Does your doctor hold either an RPVI or RVT designation? This designation shows that they are qualified to interpret ultrasound exams, which represent the single most important tool in diagnosing your vein problems. While many doctors may claim to be experts, only a qualified vein specialist has the deep and broad knowledge of your venous system that

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will yield the most accurate diagnosis and underlying causes of your varicose veins.

Most importantly, are you comfortable talking to the vein doctor? Your doctor should be knowledgeable and able to answer any questions that you may have. You don’t want to be in a position of having this important work done to your body without feeling like you can’t ask as many questions as you like – and be completely satisfied with the answers you receive.

Is the doctor performing all of your treatments? Some doctors delegate various follow-up treatments to ancillary personnel. Whether or not they are qualified, they may not be aware of your entire case and what exactly has been done up to that point. This can lead to poor follow-up and disjointed care.

Advanced Procedures Does the clinic offer state-of-the-art laser procedures? A qualified vein specialist has all the necessary equipment to treat your veins with exactly the right procedures tailored to your specific problem. Many part-time phlebologists offer only one or two modalities of therapy centered on sclerotherapy. You’ll want to be sure that any vein specialist you see offers all the latest and most up-to-date treatments available for vein conditions, and that he or she has successfully treated many patients before you.

What procedures should a comprehensive vein clinic offer? Varicose veins: EVLT or EVLA and VNUS Closure. Spider veins: Vein Gogh (as seen on The Doctors TV Show) and/or Veinwave technology coupled with a combination of ultrasound-guided sclerotherapy and VeinLite sclerotherapy containing FDA approved medications including both AscleraTM and SotradecolTM. Saline injections are relatively dated, not currently approved by the FDA for sclerotherapy, can be painful, and may lead to increased complications.

Affiliations What affiliations should my doctor have? All vein specialists should be affiliated with The American College of Phlebology, The American Venous Forum and be a Fellow of The American College of Surgeons. These memberships show a dedication to the field of Surgery and Phlebology that all patients should expect of their provider.

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