Comprehensive Vein Care and Treatment

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Welcome to the show. I'm Deborah Howell. Today we'll be talking about something that's very important to our well-being with Dr. Son Duong, a board-certified vascular surgeon at Orange Coast Memorial Medical Center. Venus disease affects women and men of all ages and ethnicities, and the severity of the disease can range from spider veins to dilated varicose veins. Dr. Son Duong is here to discuss the causes, diagnosis, and treatment of varicose veins, including radiofrequency ablation. Welcome, Dr. Duong.

Son Duong, MD: Good morning, Deborah. Thank you for this opportunity to talk to you.

Deborah Howell (Host): Very, very happy to have you on the show. Can you tell us what venous disease is?

Son Duong, MD: Yes, venous disease. Venous disease includes various conditions, but when a patient walking to my office, usually what's on their mind is usually spider veins and varicose veins. And that's just a portion of the large spectrum of venous disease that I see and treat. The spider veins is a very minimal form of vein disease, and varicose veins are a little more severe in staging.

Deborah Howell (Host): Are they both painful or are just the larger ones?

Son Duong, MD: Usually, spider veins do not have symptoms associated with them, usually just the aesthetic appearance of the vein.

Deborah Howell (Host): Right.

Son Duong, MD: Whereas the severity of the veins, the disease becomes more severe. The veins become more dilated and enlarged, and usually I see more symptoms associated with the vein. Symptoms include heaviness of the leg, pressure feeling, leg tightness, fatigue, aching, itching, and swelling. And usually these symptoms are more severe toward the end of the day.

Deborah Howell (Host): You know, I hadn't heard itching before.

Son Duong, MD: Yes, it's one of the rare symptoms. Sometimes another symptom I see is the leg feeling warmer than the normal leg.

Deborah Howell (Host): And what would be the cause of that?

Son Duong, MD: The underlying cause of vein disease in the leg is usually increasing pressure. We call it venous hypertension. And it's caused because of the dysfunction of the valve in the vein. The veins are the vessels that carry the blood, from the feet, legs, and carry the blood toward the heart. And there are valves in the vein that prevent the blood from flowing back down because of gravity. So when the valve becomes dysfunctional, it's like a leaky valve, so the blood will fall down to the foot and cause increasing pressure.

Deborah Howell (Host): I see. Okay. Thank you for explaining that. What are some of the risk factors that contribute to varicose veins?

Son Duong, MD: Vein disease can run in the family. So that's something you cannot do to prevent. It's a disease of increasing age. It can be a disease of occupation, work that requires a lot of standing, can predispose someone to varicose vein and venous convocation. People who have conditions that are associated with hormonal changes, for example, on birth-control pills, pregnancy, those taking estrogen supplements are at high risk for varicose veins and spider veins, the leg swelling. The most severe form of vein disease may include skin changes, which we call venous stasis. The skin in the calf becomes thickened, scarred, and changed in color to a brownish skin color. And that's a more severe stage, which may lead to an ulceration in the skin of the calf.

Deborah Howell (Host): And how does one get diagnosed with venous disease? And then when, at what point, should someone seek treatment?

Son Duong, MD: I see patients who come see me just because of the appearance of the vein and other comes because of the symptoms. But to diagnose the veins it's usually the most effective way is by facial exam to make the to confirm the diagnosis of underlying veins used venous to look for reflux in the vein. There are ways that we don't have to do an intervention. We can start with a conservative measurement with milder symptoms. One can wear compression stockings. And things like leg elevation, exercise that can relieve symptoms. With more severe symptoms, swelling, pain, and those with ulcerations in the legs, we can employ ablation of the vein, which use laser or radiofrequency technology to treat the refluxing source of blood flow in the vein. That can be quite effective. And for the varicose veins, the varicosity, the bulging veins in the calves, now we can remove them with small stab incisions in the leg to get rid of them completely.

Deborah Howell (Host): And does the body miss those veins?

Son Duong, MD: No, because those of the veins are abnormal. Removing them will not cause any bad function in the legs because the leg has a deeper set of veins that can carry out the normal function that will return the blood to the heart.

Deborah Howell (Host): And I also know a lot of people wonder if those little spider veins grow up to become varicose veins.

Son Duong, MD: Yes. In some cases, the spider vein can be enlarged. But usually the spider vein is very superficial and most of the time, it does not cause any problem. The spider veins only cause just bad appearance of the skin. To treat the spider vein, the best treatment is what we call sclerotherapy or injection of a medication to close down those tiny veins in the skin. And that can cause a fading of the veins and disappearance of the veins.

Deborah Howell (Host): How long does it take for those veins to disappear?

Son Duong, MD: Usually it takes from a few weeks to a few months. That all depends on the individual. With the treatment, the vein must have some time to heal. The goal of treatment is to close the vein to stop the blood flow through that abnormal vein. And so we have to give the body to heal by closing down and to absorb those scar down veins.

Deborah Howell (Host): So it's really quite important before your leg turns brown or you start to see major bulging to see your doctor. And would this be something that your regular doctor during a regular yearly annual visit would, you know, take a look at your legs and see how you're doing?

Son Duong, MD: Certainly. There are many causes of pain, swelling, and fatigue in the legs. With vein disease, the visual cues are important. You just need to look at the legs. If there's presence of spider veins, bulging varicose veins, darkening the skin, then most of the time there's the underlying venous hypertension, venous reflux that causes the appearance of the skin of the vein.

Deborah Howell (Host): Well, thank you so much, Dr. Duong. I know how busy you are. We appreciate you taking the time to talk to us today about venous disease. And for more information or to listen to a podcast of this show, please go to MemorialCare.org. That's all for this time. I'm Deborah Howell. Thank you so much for listening and have yourself a great day.