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Pain in Vein

C. Rosenberg

Varicose veins may appear to be nothing more than a cosmetic issue, when in fact this condition could impact long-term health

Wednesday, October 25, 2017

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“People think they’ll live with the varicose veins, or that if they don’t think about them, they won’t bother them. But if you don’t take care of them, they get progressively worse.”

I t took eight pregnancies before Sarah finally did something about the unsightly, painful purple veins crawling up her legs.

Though she’d suffered from varicose veins during most of her pregnancies, no vascular surgeon would treat her during pregnancy; afterward, the condition would improve on its own, so she’d lose her motivation to seek treatment. This time though, she’d made it a priority to see a doctor before her varicose veins disappeared. That decision proved to be a lifesaver.

Four weeks after the birth of her eighth child, Sarah went for an MRV (magnetic resonance venography), a type of imaging similar to an MRI that focuses specifically on blood vessels.

After reviewing the results several days later, the vascular surgeon’s office called her to come in immediately. Sarah recalls being frightened: “They wouldn’t give me any other information.”

Her diagnosis: a rare condition called ovarian vein thrombosis (OVT) — a blood clot in the ovarian vein. While every blood clot left untreated over a long period of time is potentially life-threatening, the proximity of the ovarian vein to the heart makes OVT especially dangerous, due to the likelihood it will block blood flow to the heart.

Despite her history with varicose veins, Sarah had no idea other veins in her body could also be affected by varicosities — nor that they could be life-threatening.

What Are Varicose Veins?

In order to understand how varicose veins develop, you need to start with the circulatory system, which consists of many veins and arteries; blood vessels with two different functions. Arteries bring oxygenated blood (blood that contains oxygen) from the heart to the rest of the body, and veins transport deoxygenated blood (blood from which most of the oxygen has been removed) back to the heart.

Women with a hereditary predisposition to varicose veins should start wearing graduated compression stockings early in the pregnancy — all the time.

Healthy muscles squeeze the deep veins, pushing deoxygenated blood back to the heart. At the same time, one-way valves keep that blood flowing in the right direction. When the muscles relax, valves inside the veins close, preventing the backward flow of deoxygenated blood.

In the legs specifically — the most common place for varicose veins to develop — there are three types of veins: superficial veins, which lie close to the skin; deep veins, which lie in or beneath the muscles; and perforating veins, which connect the superficial to the deep veins.

With varicose veins, the valves are typically an issue. “Most patients with varicose veins have abnormal valve function of the great and/or small saphenous veins, the main superficial veins of the legs,” explains Dr. Gary Nackman, MD, FACS, clinical associate professor of surgery at UMDNJ-Robert Wood Johnson Medical School and practitioner at NJ Vein Care and Aesthetics Center in Clifton, New Jersey.

“If blood doesn’t move through deep veins, pressure increases in the vein, and a condition called deep venous thrombosis may arise. If the valves in the superficial system of veins are not working properly, the condition is called superficial venous insufficiency.”

The resultant dark-blue crisscrossing veins can cause a sensation of heaviness, burning, aches and pain in the legs, and lead to blood clots and ulcers.

In Sarah’s case, the vein dysfunction extended past her legs to the ovarian vein. In fact, when she’d visited the vascular surgeon during her pregnancy, an ultrasound had revealed how far up it had traveled. However, the doctor hadn’t realized how worrying that was until her post-pregnancy test revealed the clot that formed due to deoxygenated blood sticking to the lining of the vein walls.

Once diagnosed, Sarah was put on blood thinners to prevent further clotting until she was ready to treat her varicose veins.

An Ounce of Prevention

Although women can take steps to prevent and control varicose veins, often the busy lives we lead often aren’t very conducive to preventive self-care.

“People think they’ll live with the varicose veins, or that if they don’t think about them, they won’t bother them,” says Devorah Schwartz, proprietor of The Surgical Sock Shop with locations in Monsey, Monroe, Brooklyn, and Lakewood. “That isn’t the case — if you don’t take care of them, they get progressively worse.”

Wearing compression stockings all day is probably the most common approach to prevent the worsening of varicose veins. However, it’s important to be fitted by someone qualified; that ensures maximum comfort and effectiveness. (Excerpted from Family First, Issue 564)

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