How to Treat and Manage Varicose Veins



Posted: Saturday, March 14, 2009

by Nancy Nurse
NET Education, Inc.

Millions of Americans suffer from the unsightly protrusion of varicose veins. Not everyone who stands on their feet most of the day gets varicose veins. Likewise, those who are not on their feet all day still get varicose veins. It is perhaps not unfair to call such a condition familial, and as such, cause a predisposed weakness in the superficial venous system.

Varicose veins are dilated, tortous and found under the skin in the subcutaneous layer, found in the saphenous system. Primary varicosities are those in which the superficial veins become dilated and may become unusable as a transport system. Secondary varicosities result from incompetent deep vein valvular incompetency. These types of varicosities are commonly seen as hemorrhoids, arteriovenous fistulas and malformations of other types.

As previously stated, these types of varicosities are familial in tendancy, it is also therefore not unusual to note that there is not real etiology that can trace where they come from. As it is with many diseases and phenotypic abberations, medicine takes the road of least resistance and treats only the symptoms - not that treating the symptoms doesn't help the individual suffering with such an abnormality.

It is suggested that activities that require long hours of standing in one place be avoided, and that pregnancy can cause an exacerbation of the varicosities. Elastic stockings that help to reverse the pressure are also suggested by medical experts. Then there are the surgical interventions such as vein stripping.

The discomfort of varicose veins varies from person to person. Along with the pain comes the altered self image. When people with varicose veins become very self conscious about their appearance, wearing swimsuits or skirts becomes a problem. Even men have to adjust their wardrobe, such as choosing not to wear shorts to the beach or gym.

Treatment is usually not indicated if the varicose veins are only a cosmetic problem. Although it is the choice of the individual whether or not they feel that vein stripping will enhance their self image. Management usually involves rest and elevation of the effected extremities.

Sclerotherapy is used in treatment by a IV injection of a sclerosing agent such as sodium tetradecyl. This is a relatively safe procedure and causes minimal discomfort. After injection, the leg is wrapped with an elastic bandage for 24 to 72 hours. Tenderness can last up to three weeks, but eventually the vein disappears.

With surgical intervention using vein ligation, bleeding becomes a possible complication as does clotting. After a patient has had vein ligation, they should be encouraged to cough and deep breathe so to promote venous return to the heart. Postoperatively, the extremities should be elevated to about 15 degrees to prevent blood pooling and extreme edema. Compression elastic stockings are applied and left on for eight hours and then removed for about 15 minutes to a half hour then reapplied.

With long term management of varicose veins it is important to promote good circulation, healthy diet, and improved self image. The patient should be taught proper care of their lower extremities, including bathing, cleanliness, using pressure stocking properly and being measured for stockings by a professional. The patient should be taught relaxation techniques and how to best elevate and reduce pressure on their veins. This can be done by instructing patients who have to stand for long periods of time to shift their weight regularly, use a step stool, and try to take frequent breaks so that they can elevate their legs. Weight reduction also can help with the pain and increased tortuosity of the veins. Therefore a healthy way of eating should be taught. Enlisting the help of a dietician would be a good step.

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