Popular Questions About Vein Treatment | HuffPost Life

It's not a pretty subject, but it is an important one: varicose veins affect a large proportion of the UK population at some point in their lives. Surgical treatment of varicose veins is my business, so I notice many recurring questions from patients about the condition and its treatment.

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Consultant Vascular Surgeon at <a href="http://www.radiancehealth.co.uk/" rel="nofollow">Radiance Health</a>

Consultant Vascular Surgeon at <a href="http://www.radiancehealth.co.uk/" rel="nofollow">Radiance Health</a>

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It's not a pretty subject, but it is an important one: varicose veins affect a large proportion of the UK population at some point in their lives. Surgical treatment of varicose veins is my business, so I notice many recurring questions from patients about the condition and its treatment.

I see and treat hundreds of patients every year with vein disorders. Varicose veins cause a wide spectrum of problems, from the purely cosmetic dissatisfaction and embarrassment, to painful aching and 'heavy legs' and ultimately severe skin damage and ulceration. There is often some confusion about the solutions available.

Until the turn of the century, the only surgical option was the high tie and strip operation, with prolonged post operative recovery times and quite high recurrence rates. The exciting news, though, is that we've come a long way from only a single choice in resolving the varicose veins problem.

The treatment methods developed over the last decade are minimally-invasive and can be performed largely under local anaesthetic with no scars and rapid recovery from treatment. Look out for Endovenous Laser Treatment, radiofrequency ablation and foam sclerotherapy as examples of innovative procedures with good long-term results in experienced hands. Patients considering treatment for varicose veins should seek a consultant who has experience in most or all of these options. Surgeons who can only provide open surgery (the high tie and strip) are out of date and well behind the times.

Veins are blood pipes that allow blood to flow back from the legs to the body. Patients often ask whether treating faulty varicose veins will cause a problem with the blood flow from the leg. This is absolutely not the case- we have enough veins in our legs to make a pair of fishnet stockings- we just can't see them all on the skin surface. The vast majority of the blood flow back to the body goes back in the deep leg veins which are not affected by varicose veins surgery, and the blood from the legs is 're-routed' into the deep veins after surgery.

Deep vein thrombosis, or DVT, is a common worry, too. A DVT is a serious matter, and is a possibility after any kind of surgery. After vein surgery though, the risk is very low when compared to other types of surgery, such as knee replacement or abdominal operations.

As a rough guide, the risk of DVT after vein surgery is about one in 1,000 cases and every possible precaution should be taken to prevent this serious complication. Using anticoagulant "blood thinning" drugs before treatment and preferring local rather than general anesthesia to reduce immobility time after surgery, are both common practices which reduce the risk to an absolute minimum. Sadly there is no way of eliminating the risk entirely.

For patients who consider themselves to be at a particularly high risk of DVT- for example, those who have had a previous DVT, or have known risk factors for DVT- it's sensible to request prolonged anticoagulant injections for 3 to 5 days after vein surgery.

Probably the most voiced varicose veins treatment question I get is about flying, particularly after surgery and the risk of DVT. We do know that there is an association between flying and the risk of DVT, but again the risk is quite low and largely confined to long haul flight. For this reason, it is sensible for patients to avoid long-haul flights for about a month after treatment. For patients who absolutely have to fly, again anticoagulant injections close to the time of the flights reduce risk as much as possible.

In short, varicose veins treatment in the 21st century is simple, effective, and though not without a small element of risk, pretty much as safe as surgery can ever be.

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How Experts Would Handle 11 Health Dilemmas

Getting To Sleep Late(01 of11)

We always hear you should spend some time away from screens before bed -- but if you have to work late one night, is it better to spend time unwinding, even if it means staying up a bit later, or is it better to just go right to bed?I am a big proponent of consistent wake times. Bed times, in my opinion, are much less important; if a patient is consistent with their wake time and routines, bed times usually take care of themselves. Plus, deemphasizing when an individual goes to bed often helps remove the performance anxiety we associate with insomnia. For me, this one is a no brainer: Unwind first, if you feel like you need it. If you are someone who can go to sleep without that down time, knock yourself out.--W. Christopher Winter, M.D., medical director of the Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Va. (credit:Alamy)

Restaurant Indulgences(02 of11)

If you've decided to indulge in one thing while out for a meal, which should it be: the bread basket or dessert?I think it's better to share a dessert (of course be the last to taste so there's only a bite or two left). The bread basket is a trigger point for the whole meal. Once people make the choice to have the bread they are subconsciously choosing to let the whole meal go and they ultimately end up eating dessert too. If you save it for dessert (eating clean the whole meal before and skipping the bread), you'll save a ton of calories.--Heather Bauer, R.D., CDN, founder of bestowed.com and HuffPost blogger (credit:Alamy)

Walking In Heels(03 of11)

More steps are almost always better -- but is it still worth walking that extra bit if you're wearing heels?No! I do not subscribe to walking in heels for exercise being a good idea. High heels shift your body weight to the ball of your feet and misalign your whole skeleton. Exercise in this body position makes you very prone to injury to knees, hips, back and feet. Exercising later in more appropriate shoes is ideal. Everyone wants to get in as much physical activity as possible, but putting yourself at risk for injury and trauma isn't smart. Exercise should be done with the goal of strengthening your body, not causing harm. Sneakers are always best for physical activity. --Jackie Sutera, D.P.M., podiatrist in New York City (credit:Alamy)

Tackling Your To-Do List(04 of11)

If you're really stressed about your to-do list, should you tackle the biggest or the smallest item first?When we are really stressed we need a positive experience, and one that can be accomplished pretty soon. So pick something, but not the biggest or the most difficult; instead, something that can realistically be tackled and done. Then congratulate yourself for doing that and pick another, then another, then another...--Lloyd Sederer, HuffPost mental health editor and Medical Director of the New York State Office of Mental Health (credit:Shutterstock)

Rushing At The Gym(05 of11)

If you only have 15 minutes to exercise, is it better to opt for cardio or weight training?If you only have 15 or 20 minutes to work out, your goal should be to subject your body to an ideal combination of muscular strain and cardiovascular stress. While this may sound unpleasant, it's going to give you the most bang for your buck if you want to get lean, strong and fast in as little time as possible. To achieve this effect, use any of my favorite resistance training exercises that "crossover" to also be cardio exercises, including: Dumbbell or Kettlebell Swing, Squat to Overhead Press, Turkish Get-Up, Uphill Sprints Holding or Carrying a Weight and Burpees.--Ben Greenfield, fitness and triathlon expert, Get-Fit Guy podcast host (credit:Alamy)

Fat Vs. Protein(06 of11)

If your only protein choice for hours is high in saturated fats, should you eat a bit, or skip it?Personally I would try my best to avoid a high saturated fat protein source. It would probably make me feel sick. People who eat a lower fat diet and then dive into a high fat meal tend to complain of stomach aches. When you look at the nutrient analysis for protein sources that are high in saturated fat like fried fish, the amount of protein is very low. Therefore a protein source that is high in saturated fat may not always be your best source of protein. Best bet is to plan ahead. I always carry nuts or roasted edamame in my purse to fill in any gaps of missing protein in my meal.--Toby Smithson, R.D., founder of DiabetesEveryDay.com (credit:Alamy)

Early Morning Workout?(07 of11)

We all know how important sleep and exercise are for our health -- so if you got a bad night's rest, is it better to sleep in for an extra hour, or push through your morning workout?From the fitness expert:One of the most important recovery, mental and immune system boosting activities for the human body is sleep. If you're short on sleep, you experience higher levels of inflammation and a decrease in the hormones that help you lose fat and stabilize your appetite. For this reason, you should never sacrifice sleep to exercise -- as you're likely to put your body into an unhealthy state.--Ben Greenfield, fitness and triathlon expert, Get-Fit Guy podcast hostFrom the sleep expert:It is better to get up at your usual time to keep your body clock on consistent timing.--Philip Gehrman, Ph.D., clinical director of the Behavioral Sleep Medicine Program at the University of Pennsylvania (credit:Alamy)

Midnight Snacks(08 of11)

We've heard it's not great to nosh late at night -- but if you haven't had a chance to eat dinner all evening, is it better to eat late or go to bed starving?Eat something but more snack size rather than meal size. Having a gnawing hunger or eating too much food both will lead to poor sleep quality. Try 1/4 cup tuna salad (homemade/healthy mayo), six multi-seed crackers and cut fresh veggies.--Dawn Jackson Blatner, R.D., author of The Flexitarian Diet (credit:Alamy)

Bad Breakfast Choices(09 of11)

Ideally we'd be prepared -- but if you're stuck in an all-morning meeting and the only food choice is a pastry, is it better to eat it or skip breakfast?SKIP IT. There is nothing actually filling about a pastry -- no fiber, no water -- so it wouldn't help my hunger. In fact, many times eating something high in sugar like this will lead to an energy crash, so I wouldn't be full and it makes me tired. No thank you! (I have apples and almonds at my office for situations like this.)----Dawn Jackson Blatner, R.D., author of The Flexitarian Diet (credit:Alamy)

Should You Google?(10 of11)

Pouding headache? A weird pain in your side? When you have an unusual system, is it a good idea to Google your symptoms to be a better informed patient, or does searching the internet for a diagnosis only put you at risk for cyberchondria?We all know the saying that a little knowledge is a dangerous thing, and that's certainly true when you think you know more than you do! Medical information emphasizes the dire, with good reason. It is the most dire explanation for any given set of symptoms that most needs to be found, and addressed. That by no means indicates it is the most likely, however.But while a little knowledge is a potentially dangerous thing, total ignorance is even more so. Doctors are human, and fallible. Mea culpa! There have been times I have come faster to a correct diagnosis, or considered something important, because my patient came to me armed with a Google search, and asked me: 'what about ______?'So, yes -- Google your symptoms. But do so reasonably, and humbly. Reasonably means prioritize credible sites- not those devoted to conspiracy theories. One very good portal is healthfinder.gov. Humbly means to remember that an hour of Internet surfing is NOT a substitute for four years of medical school and several more of residency training. So, use a Google search to generate good questions- but not to cultivate a passion for any given answer. There have been times I have struggled mightily to disabuse a patient of a false conviction based on a wayward Internet search, and we have both suffered for it. Don't let that be you. Informed is empowered, and is much better than uninformed. But misinformed and unwilling to recognize it may be the worst of all. Google accordingly!--David Katz, M.D., founding director of Yale University's Prevention Research Center (credit:Alamy)

Late-Night Fight(11 of11)

If you're having a disagreement with your partner late at night, is it better to "never go to bed angry" or "sleep on it"?Most psychologists will recommend that people take the time that they need to calm down to think rationally about conflicts. They are much more likely to develop effective solutions or understand another person's perspective when they aren't upset. Sleep does allow time to pass, and many people report that they are able to view their situation from a different angle the following day. Perhaps one exception is when a person is unable to fall asleep at all because they are so angry. In these situations, addressing the problem before bed may provide some closure.--Steven Meyers, professor of psychology at Roosevelt University in Chicago, Ill. (credit:Alamy)

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