Vascular Disease Foundation - Fighting Vascular Disease... Improving Vascular Health.

Interactive Learning : Ask the Expert

 

Ask the Expert Live Chat Transcript - Tuesday, September 7, 2010

Jean White, RVT


Quality Vascular Imaging, Inc

 

 

Jean has generously donated her time to answer our patients' general questions about vascular disease. The below transcript details all of the questions asked by our participants as well as her answers.

Moderator- VDF: Welcome everyone! Thanks for joining us today, we're glad you're here! You may now go ahead and type your questions for Jean to answer. We appreciate everyone's patience as she works to answers everyone's questions.


Sharon: I sit at a desk most of the time. Would compression hose make any difference? My mom has towear them as she gets swelling and has varicose veins. Would wearing them prevent my having varicose veins?

Speaker Jean White, RVT: Sharon, wearing compression stockings would be extremely helpful if you yourself have any signs of venous disease. Swelling, aching, resting leg cramps, varicose veins, etc.

Sharon: Thanks - is there a time when they wouldn't be needed? Like at night? What about long travel in car or plane? Can they be helpful then?

Speaker Jean White, RVT: Stockings come in a many different colors and compressions (tightness). They are no longer "your grandma's hose" they are actually quite fashionable.

Sharon: What's the best ways to prevent varicose veins?

Speaker Jean White, RVT: Sharon. First of all, there is a big genetic factor when it comes to varicose veins so despite doing everything you can to prevent you might still get varicose veins. But some things that might help prevent are: stockings, regular exercise (walking, swimming, bicycling), maintaining proper weight.

Sharon: Thanks. One more question then. If you start seeing varicose veins, is it better to have it fixed (injection or?) when still small or does that just mean I'd have to have to do them more often. Or, better to wait awhile to see how big they get?

Speaker Jean White, RVT: Sharon. A treatment plan can be decided after a venous duplex ultrasound is performed. The treatments available today vary based on size and location of the diseased veins. I personally believe you should seek treatment sooner than later. It is a very personal choice. But unless you seek medical help you don't know what your choices are...You can always decide not to do treatment. But remain active, maintain proper weight, and wear stockings.

Sharon - that makes good sense. Thanks!


VDF Moderator: For those on the chat today interested in compression therapy, VDF recently published a wonderful article on the use and care of compression therapy. You can view a copy of the article online: http://www.keepingincirculation.org/articl…

__________________________________________________________________________________________________

VDF Moderator: This next question was e-mailed to us ahead of time: My aunt is suffering with severe various veins. It is now spreading to her shoulders. She experiences a lot burning and swelling. Could you please make any recommendations? Doctors seem to disregard this and don't want to do the popper testing. We need to know what tests should be done. Any help would be greatly appreciated. Thanks, Heidi

Speaker Jean White, RVT: Heidi. I am not sure if you mean varicose veins instead of various veins. If you are speaking of varicose veins, you say they are spreading to her shoulders. That is uncommon. If she has dilated veins near the shoulder with swelling and pain she should have an upper extremity (arm) venous duplex examination to make sure she does not have a blood clot in her arm.


Chai T.: Well, I'm interested in learning more about ultrasound in detecting/preventing both PAD and
DVTs...can it detect both?

Speaker Jean White, RVT: Chai T. Ultrasound can absolutely detect both PAD and DVT. Your doctor can order a lower extremity arterial duplex with an ankle brachial pressure for PAD. or a lower extremity venous duplex ultraound if deep venous thrombosis is suspected.

Chai T.: Are there any self-testing devices available? I live in a quite rural environment and would like to avoid the travel involved in visiting a hospital, a serious disincentive for us. Thank you.

VDF Moderator: Hi Chai, Jeannie thought you might like to read about chronic venous insuffiencency. You can find information on our Web site at: http://www.vdf.org/diseaseinfo/cvi/

Speaker Jean White, RVT: Chai T. You can visit the VDF website and look at the symptoms for PAD and DVT to determine if you have some of the symptoms. I do NOT know of or recommend self testing.


VDF Moderator:  This next question was also e-mailed to us ahead of time: Here is a question. I read that swimming is a good exercise for vein problems, but without anything on the legs? If you wore stockings or bandages into a pool, the chlorine would wreck them very quickly, I would think. We probably won’t be going anyway, but my son used to be a great swimmer. He could swim the whole length of an Olympic
sized pool underwater. Thanks. Mary

Speaker Jean White, RVT: Mary. Yes swimming is wonderful exercise for vein problems. First of all, when in the water, pressure from the water is transmitted on your veins externally, just like stockings. Secondly, while swimming you use your calf muscle pump which forces the muscles to contract, squishing your veins, and therefore ejecting blood from your calf towards your heart. This improves venous blood flow!


Lisa: I am a 52 years old female with varicose veins all over my legs and discolored skin on my shins and ankles. Injuries to my shins take a very long time to heal, sometimes many weeks. Could I have PAD?

VDF Moderator:  Hi Lisa, while Jeannie works to answer your question, I would be happy to send you an educational pamphlet on varicose veins. If you would like a free copy, please e-mail me at info@vdf.org after the chat with your mailing address and we'd be happy to send you a copy.

Lisa: that would be great I would appreciate all the information I can get.

VDF Moderator: Lisa, When you e-mail me with you address, I will gladly include our PAD and walking brochure. I think that might help you to get started!

Speaker Jean White, RVT: Lisa. It does sound like venous disease BUT that does not mean that you don't have PAD as well. First of all, are you active? Do you walk regularly and how far if you do?

Lisa: Not very active, I do want to start a walking program.

VDF Moderator: You are most welcome Lisa! You can also read about varicose veins on our Web site: http://www.vdf.org/diseaseinfo/varicose/

Lisa: thanks for all your information and suggested resources. I know it is important to start walking.

Speaker Jean White, RVT: Lisa. Please DO start a walking program! :)

VDF Moderator: Lisa, you can also find some great information about PAD and walking on our P.A.D. Coalition Web site: http://www.padcoalition.org/about-pad/walking/


VDF Moderator:  This next question was e-mail to us ahead of time: my leg veins are bulging badly and I
am told they must be stripped. Why am I told that I must wear compression hose? Don't they further restrict blood flow returning to the heart? How long after striping must compression hose be worn? Until ultrasound tests of my leg arteries show a great reduction of blood flow, isn't it too soon to have my
veins stripped? What are those magic values of reduced blood flow?

Speaker Jean White, RVT: To the questions of leg veins bulging badly. My first recommendation would be to get a vascular ultrasound. Specifically, a venous duplex of the lower extremities for venous insufficiency. I strongly recommend that the sonographer/ vascular technologist is a Registered Vascular Technologist or a Registered Vascular Specialist working in an accredited vascular laboratory. This will give the doctor that you want to have treat you a "map" of the veins in your legs. Treatment can then be decided.


Maria B.: My mom had blot clots in her legs with all of her pregnancies. Does that mean that I am at risk and, if so, what should I look for?

Speaker Jean White, RVT: Maria B. Has your Mom ever been checked for a clotting disorder? You need to consult your doctor and explain your Mom's significant medical history. They may in fact want to check you for a clotting disorder. Please discuss this with your doctor!

VDF Moderator:  Hi Maria, I thought you might like to visit VDF's new Web site educating women about blood clots, http://www.thisisserious.org. The site includes a short risk assessment quiz to check your risk factors for blood clots.

Maria B.: Thank you! Not sure if my mom was ever checked with a clotting disorder. She only had blood clots 40+ years ago with her pregnancies. She recently had a knee replacement with no problems. Thanks again.


VDF Moderator: This next question was also e-mailed to us ahead of time: About a year ago I was blownup in a tank in Iraq. Among my wounds, my right leg became very swollen and sore. Ever since, my leg feels like I am carrying around a dense mass. I get cramps in the leg almost every night when I try to sleep.  No X-rays were taken but my army doctor assured me nothing was broken. He also told me that it was quite normal to have one leg larger than the other. Being blown up in an armored vehicle is called an HE (high energy) wound. I have tried every kind of exercise (swimming, etc.) but to no avail. I have not been able to find a doctor in Nevada who is familiar with High Energy wounds. Does this symptom resemble PAD? Is there any screening that might reveal if there is some internal problem?

Speaker Jean White, RVT: Did you ever have a venous duplex ultrasound of your legs? If not, you may in fact request it be performed. As far as PAD, which is the arterial system a simple ankle brachial blood pressure can be performed. Ask to see a vascular doctor in your area so he or she can order the right tests for you. Go to the doctor finder on the VDF Web site.

VDF Moderator: For our injured soldier, Jeannie would like for you to visit our online doc find on our Web site: http://www.vdf.org/resources/findspecialist.php


VDF Moderator: This next question was also e-mailed to us ahead of time: I was diagnosed with DVT,chronic venous insufficiency of the deep veins, claudication and reflux of my leg. I spent a great amount of time on my feet. What careers are recommended for individuals with this concern to minimize degeneration?

Speaker Jean White, RVT: I would rather not recommend a career for you with your history of DVT and reflux in your deep veins. I would rather encourage you to NOT give up on working at whatever your dream job is and just modify your lifestyle. Wear stockings, at least 30-40mmHg, walk regularly, during lunch elevate your toes above your nose for 10-15 minutes, and swim/walk/ or ride your bike with sport compression stockings EVERYDAY after work. Periodic leg elevation feels great after standing or sitting at work. Don't forget to activate you calf muscle pump! Simply walk or pump your toes toward your head and back down.

__________________________________________________________________________________________________

VDF Moderator: For those online with us today interested in starting a walking program for PAD, check out VDF's newest audio HealthCast on a new exercise treatment for PAD: http://www.vdf.org/interactive/podcasts/


VDF Moderator: Thank you all for joining us today and thanks to Jeannie for her time. We wish you ahealthy day! VDF would like to invite you to join us for our next online chat on Tuesday October 5 at 4pm EST. Dr. Heather Gornik from the Cleveland Clinic will be live answering your general questions about vascular disease.


Disclaimer

The material provided on VDF's Web site and Live Ask the Expert chat are for educational purposes only and are not to be used as a substitute for professional medical services or advice. For more information, please read VDF's important disclaimer.