Breast Feeding and Sclerotherapy

The most common type of sclerosants used in Australia today for the treatment of varicose veins and spider veins involving the legs are the detergent sclerosants. These are small lipid soluble molecules which can theoretically pass into breast milk in minute amounts. There is no evidence that they will do any harm to the baby but then again there is no conclusive evidence regarding their safety.  However detergent sclerosants are very quickly metabolized by the liver and excreted by the kidney, so it is safe to resume breast feeding very soon after treatment.  At The Leg Vein Doctor we recommend to breast feeding mothers that they use a breast pump and store expressed breast milk prior to treatment which can then be used for the first feed after treatment. Normal breast feeding can resume twelve hours after treatment.

Hypertonic saline is a less commonly used sclerosing agent, but it is safe to use during breast feeding.   

Growing Old with Varicose Veins?

A person aged 65 years can now often look forward to a life expectancy well into or beyond their 80's.  Varicose veins might not cause any symptoms but over time they will become progressively larger causing back pressure on the skin around the feet and ankles from the venous hypertension.  This results in tissue damage to the skin around the feet and ankles because of the lack of oxygen and the buildup of toxic waste metabolites. The concern about this is that the skin may breakdown and ulcerate.  Varicose ulceration is the end stage of varicose vein disease and it is a debilitating complication because of the discomfort and substantial inconvenience required due to the long term involvement of nursing care in wound management.  
The Leg Vein Doctor at its Brisbane clinic in Toowong offers various treatment options that can minimize or prevent the eventual complication of varicose ulceration.  Age is hardly ever a barrier for appropriate treatment if there is a risk of venous ulceration of the legs. 

The Australasian College of Phlebology 16th Annual Scientific Meeting

With a new year comes things to look forward to and over the course of 2013 there are a number of events in which The Leg Vein Doctor is participating in both here in Brisbane and some wider afield. 

The Australasian College of Phlebology 16th Annual Scientific Meeting (ASM) is being held during March in Hobart. This event is of interest for a number of reasons. Admittedly the first is because I have never been to Tasmania and I am hoping to utilise my time to fit in a bit of sightseeing to what seems to be an enchanting island. More seriously though, I very much enjoy attending lectures and discussions on developments within the field of phlebology. In the world of medicine, phlebology is considered a relatively young branch, however with the rate of technology and research devoted to the treatment of varicose veins internationally there is a lot to talk about. 

Meeting phlebologists from around the world is also a highlight as it is important to network on a personal level and share experience with other doctors regarding models of best practice for sclerotherapy and endovenous laser ablation as well as other techniques offered overseas. Having received the President's Gold Medal from the Australasian College of Phlebology on top of my proven trackrecord in rural General Practice has allowed me to develop relationships with a wide variety of medical practictioners that have an interest in vascular disease throughout Australia, Europe and America. 

I look forward to sharing my experiences of the conference with you on The Leg Vein Doctor blog page. 

The Leg Vein Doctor Party

The Team at The Leg Vein Doctor are excited to be holding a party this weekend at our leg vein clinic in Toowong.

It will be a pleasure to be joined by past patients from as far a field as Rockhampton, Mackay, Cairns and Mt. Isa as well as those that live closer to home in Brisbane and on the Gold Coast.

I am also looking forward to catching up socially with the other health and fitness professionals I work alongside including phlebologists and other specialist doctors.

General Practice has always been my passion in medicine but suffering from varicose veins and having an unsuccessful surgical treatment lead me down a different training pathway to phlebology.  This is a field I am very passionate about but I wouldn't have got here without the continued support of my patients, colleagues, mentors, friends and wife and two daughters and Labrador and Jack Russell and for that I am grateful!

Ouch! Spider Veins and Pain

Following their intial consultation, patients with spider veins often ask "How much do the needles hurt?".

Because each person has a different pain threshold, it is difficult to give a precise answer to this subjective question. However, I think these are some of the important points that might help in order to assist with patient's expectations: 

• The needles used in sclerotherapy are very fine. They are a slightly larger gauge than acupuncture needles but much smaller than vaccination needles.  At The Leg Vein Doctor, we use 30 to 32 gauge needles. Vaccination needles are 25 gauge.
• The pain arises for three different reasons. Initial puncture of the skin by the needle is the initial source of pain, so small gauge needles cause less pain in this situation. Secondly, pain might arise from tissue expansion.  If the needle tip is not accurately placed with inside the lumen of the vein, the injected sclerosant, rather than running up through the vein, spills outside the vein and causes the tissue to expand.  This will cause pain in the same way as a "boil" causes pain because of the tissue expansion. Small amounts of spillage will always occur but skilled sclerotherapists pay meticulous attention to this aspect of treatment.  Thirdly, the different types of sclerosants each have their own properties and vary in the amount of discomfort they cause if they enter the interstial tissue.  
• Some areas of the leg tend to be more sensitive than other areas.  Just behind the knee and around the feet tend to be quite sensitive areas, so I always use the finest needles possible when injecting in these areas and selecting sclerosants least likely to cause pain.  

At our leg vein clinic we are very mindful of the anxiety patients often have about injections. We understand that these procedures are sometimes uncomfortable so we endeavour to minimize pain by using very fine needles, selecting the most appropriate sclerosants and taking the time not to rush the procedures as this leads to less accuracy with the potential to cause spillage of sclerosant. You are welcome to bring a friend along if you would like someone to hold your hand! Oh and don't forget to bring your iPod to relax or be distracted by your favourite music during treatment sessions.