Varicose Veins

This common problem is quite specific to human beings only. It is probably a consequence of our ancestors deciding to walk upright all those millennia ago .The heart pumps oxygen-rich blood to all areas of the body via arteries .This blood releases oxygen to the body tissues and has to return to the heart via the veins . Because the heart is above the legs in the standing or sitting position , blood has to flow “uphill” to reach the heart. Whilst walking , the calf muscles contract and pushes blood back towards the heart. Evolution has probably caused one-way valves to originate in all the veins situated lower than the heart so that the calf muscle pump can effectively cause blood from the legs to be able to flow back “uphill” to the heart without “falling back down” to the feet.
Varicose , or distended engorged veins develop when these valves become diseased or stop working .The blood then tends to remain in these veins and do not return to the heart promptly. The circulation is therefore generally poorer when a person has large varicose veins. .The result is unsightly veins which cause aching  , swelling and eventually also permanent discolouration of the skin around the ankles .It commonly leads to chronic ulcers of the lower legs which can take a long time to heal.
Varicose veins seem to affect females more often than males .It appears that certain hormonal changes trigger the onset of varicose veins .Therefore some women experience the onset of varicose veins in puberty or after commencing on female hormone treatment .Most women recognize the development of varicose veins when they fall pregnant , or notice that existing veins get worse during pregnancy .Approximately 8% of  the population have varicose veins already during their teenage years and this number rises to 70% in people over the age of 70 years.
  
Dr . Albert Liebenberg has been confronted with the problem of varicose veins for most of his general practice career .Trying to heal chronic leg ulcers after only minimal trauma , or after small cancer spots have been removed from the legs of varicose vein sufferers , can be a daunting task .These ulcers require frequent visits for wound care and sometimes continue for many months . It occupies a lot of the wound care team’s time and is obviously costly , sometimes also requiring repeated courses of antibiotics to treat infected ulcers . Chronic leg ulceration may delay surgery for other pressing problems such as knee joint replacement , hip replacement and bunion removal .Many surgeons and hospitals may defer elective surgery if the patient has an infected ulcer , because it may cause complications after the surgical procedure .Long term diabetics have a much increased risk for infection and treating varicose veins proactively in these patients lessens their risk for chronic infected leg ulcers .Many people have to use warfarin to thin the blood due to other medical conditions such as irregular heartbeat . This combination may place them at risk for formal surgical procedures and general anaesthetic .
  Treating these veins improves the circulation in general , because blood then flows back through the more efficient deep vein system of the legs .Treatment also removes the unsightly veins and help prevent the consequences of darkening and ulceration of the skin .
Appropriate treatment can be recommended by a doctor after evaluating the problem veins .Ultrasound is often used to diagnose problems with veins . Smaller “broken “ capillaries are often fed by deeper varicose veins that are not readily visible yet (25% of the time).Broken capillaries can be treated by direct injection .Larger veins can be treated by surgery or injection.
Dr . Liebenberg has started treating these problem veins by using the “injection method” or sclerotherapy , as it is known .It is a method that has been used in Europe since the 1920’s and has found favour in Australia since the early 1990’s . A sclerosant is injected into the sick veins to cause them to “collapse”. This does not require local or general anaesthetic , because it is quite painless and resembles an “ant bite”. It is done as an outpatient procedure .Regular walking and  special  compression stockings are required afterwards for a 2 week period .The treatment guidelines of the Australasian College of  Phlebology are followed .Being on blood thinning medication is generally not a contra-indication for sclerotherapy  and neither does sclerotherapy treatment have to be deferred because of chronic ulcers .Treating the underlying varicose veins in fact speed up the healing of these ulcers .

This method of treatment can be used in conjunction with surgical removal of veins , or even after previous surgical stripping of veins .People who are affected by varicose veins tend to develop more veins during the course of their lives and can be treated again in future if required .