As the leader in vein care in the region, Rocky Mountain Vein Clinic is continuing to make resources available to our patients in an effort to educate you on all the various issues relating to the treatment and care of venous disease. Two new vehicles are now available for you to learn more about the symptoms, treatment, and services available in your area.
New Website – we have undertaken a comprehensive upgrade to our current information rich web site to give you even more and easier information. We have converted our text driven site to now offer easy to view videos of the treatment procedure so that you will be able to fully understand the step-by-step process in treating your varicose vein disease. This video is narrated by Dr. James (Bo) Johnson for your convenience and help. This will allow you to better understand the process and be able to ask more appropriate questions during your consultation or procedure planning period.
Other upgrades are:
- Expanded procedure videos
- View our (pre-recorded) educational webinar (presented by Dr. Johnson)
- Comprehensive questions and answers area
- Downloadable patient forms for convenience
- Overview of our talented and dedicated staff
- Expanded resource links to other medical sites
Facebook – you can follow our daily/weekly updates on activities taking place at our Cody and Billings offices. You can post a question for other readers or find out what others think about the procedures and treatment options.
Periodically we will post case studies with before/after photos so you can see the remarkable improvements in the appearance of the legs. This is only part of the success – the real benefits come from treating all the debilitating symptoms caused by varicose veins. You will be able to resume your normal lifestyle in no time.
Hi — We are adding a regular feature to the RMVC Newsletter in this space, where I’ll be discussing technical details of different aspects of vein care. In the next few issues, we’ll cover sclerotherapy. Today we’ll describe what it is and in further issues we’ll cover where it is best used, then side effects and complications.
What is Venous Sclerotherapy?
Sclerotherapy is one method of closing veins that are abnormal and contributing to your symptoms.
Its success rate (percentage of veins remaining closed) with bigger veins is not as high as laser or radio frequency techniques, but it can be used in veins that are too small or twisted for those procedures.
Sclerotherapy involves injecting a vein with a sclerosing agent, or irritant, which inflames the inside lining (endothelium) of the vein. The vein contracts, some of its blood is squeezed out and the rest clots. Applying pressure with compression stockings makes the vein walls stick together so the vein stays closed. Healing with a normal inflammatory process over the next week or two turns the vein into a thread of scar tissue that the body gradually absorbs.
The compression applied after the injection is an essential part of the therapy.
Sclerotherapy has been around in one form or another for well over 100 years.
Foam sclerotherapy is a modification of earlier methods where a standard detergent sclerosant such as STD (sodium tetradecyl sulphate) is mixed with four times its volume of air or carbon dioxide to create foam of micro bubbles. This foam is then injected into the veins. Foam is more effective than liquid sclerosant, and we can treat four times the number of veins in each session.
There is a maximum dose of sclerosing agent recommended for use at one time, and a maximum recommended amount of foam. Most of the foam remains in the vein, but some will always travel into the general circulation. As long as the total volume used is kept low, between 10-20 ml, this doesn’t appear to cause problems. Larger volumes begin to increase the risk of complications. There are practitioners who will inject 30-40 ml of foam at one sitting, but we are more conservative.
Ultrasound-guided foam sclerotherapy is a further development in which the foam injection is guided using ultrasound. An experienced ultrasound technician is able to locate abnormal veins that are too deep to see, enabling the doctor to inject veins otherwise impossible to find. The technician and the doctor then track the foam as it travels in the vein and are better able to avoid its spreading beyond the targeted veins.
Next time, we’ll discuss side effects and possible complications.
TOPIC: Compression Stockings
During the initial evaluation at RMVC, patients are measured for compression stockings. I often receive a negative reaction at first when I explain to patients they will need to wear these stockings for 2 weeks day and night after a procedure, but they are an essential part of the successful outcome for vein treatment. I ask patients to give them a try, as stockings have come a long way since they may have worn them 10 years ago. Stockings are now made specifically for men or women with a much softer feel and various colors.
Stockings are fitted using ankle, calf, and thigh measurements to ensure the proper fit and if worn daily the compression lasts 6-9 months. Rubber gloves make the donning process much easier, and for patients with limited range of motion or strength, we have stocking donning devices available.
“It Stays” is a roll-on body adhesive also available if stockings roll or slip down the leg. After any procedure, patient compliance with stockings is extremely important. The compression stocking will keep the closed veins compressed in order to avoid reopening of the treated vein.
The sooner patients can be fitted and start wearing compression stockings, the better. Not only will they help with leg pain, heaviness, and cramping while wearing, but most insurance companies now require a 3 month trial of conservative therapy before they will preauthorize any vein treatment to be completed.
After vein treatment is completed, patients can transition into a lighter compression stocking to wear for preventative care. Wearing stockings when sitting or standing for long periods, or during travel is one of the best ways to prevent or slow down future venous disease. The same patient that once told me they hated the idea of wearing a stocking will tell me after treatment has been completed that they love their stockings because of how great they make their legs feel.
Rocky Mountain Vein Clinics – New Office & Expansion
To area providers and all our past and present patients, I would like to make you aware of some exciting changes that will be taking place over the summer months. In Billings, we will be moving our offices into new and larger office space in the same complex that we are presently located. We will be moving one building over and will be doubling our space. The new address will be 2820 Central Avenue, Suite A. Our new expansion will provide us with new treatment rooms and give you an even more comfortable experience.
We are very excited about the addition of Dr. Jonie Hines to our staff. She will be joining us in September and will work in both the Cody and Billings locations.
We will keep you updated with these new exciting activities on our Facebook page and web site.