Self-Assessment

  1. Family history of varicose veins and vein surgery put you at risk for developing vein disease and venous insufficiency. Ask your mother, father, and other close relatives whether or not they have had varicose veins or vein surgery. If first degree relatives have had vein problems, you are at risk for developing them. You may actually have venous insufficiency and don’t even know it.
  2. Pregnancy causes increased levels of estrogen and progesterone which cause softening of the walls of the veins. Pregnant women also retain a greater volume of fluid that can result in over stretched veins and valve damage. Varicose veins may become competent once the hormone levels decrease, fluid volume go down, and the vein walls tighten back up following the delivery of the baby. Varicose veins that do not go away by six to twelve months after a delivery need to be treated or the vein disease will progress.
  3. If you have been previously diagnosed using a handheld Doppler or Duplex Doppler (Ultrasound and Doppler), you need to be treated. Vein disease (venous insufficiency/venous reflux) is a progressive disease. It does not get better with conservative therapy.
  4. If you have bulging veins, you probably have venous insufficiency. Venous insufficiency needs to be treated because it is a progressive disease. You will need to have a Duplex Untrasound examination to determine the extent of your vein disease. You do not want to wait until you have infected, bleeding ulcers to have your disease treated.
  5. Small red and purple “spider” veins may or may not be a sign of vein disease. Venous insufficiency of the larger veins causes back flow of blood to the tiny, superficial veins which are called spider veins. It is important to be tested for back flow from the larger veins before doing sclerotherapy of the tiny spider veins to make sure they are not caused by vein disease in the larger veins. One reason sclerotherapy does not work is that vein disease of the larger veins continues to cause the spider veins to form and come back after sclerotherapy.
  6. Once the blood pools and distends the veins to a particular diameter, you may feel aching, pain, or cramping. The lack of flow of blood results in decreased delivery of oxygen and nutrients to the cells and build up of waste products which causes itching and burning of the skin. As the blood collects in the legs over the course of the day your feet, ankles, and legs may swell and feel heavy. And you may get the sensation of restless legs. Gravity helps to return the blood to your heart at night when you are lying down so that the symptoms are gone in the morning when you get out of bed.
  7. Aching, swelling, and heaviness will go away when you put your legs up. Even though the valves that route the blood back to your heart are not working, when you put your legs above your heart, gravity causes the blood to flow back to the heart. This allows the veins to shrink back down and removes the extra blood from your legs so that the aching, swelling and heaviness goes away.
  8. As blood leaks out of the distended veins and into the skin and tissues under the skin, the skin will get tough like an elephant’s skin, brown pigmentation will accumulate, scaling of the skin will take place, and the skin will break down forming open wounds, weeping sores, and ulcers. In the most extreme cases infected, bleeding ulcers will form that will be very difficult to treat and to get to heal. Vein disease needs to be treated long before these problems develop. Once they develop, it will be very difficult to repair the damage to the tissues.
  9. Vein disease can also present itself after trauma or injury. Varicose veins, aching, swelling, heaviness may be the result of distended veins secondary to a traumatic injury.