Tired of your leaking veins, sick of puffy legs?
Leaking veins usually refer to a condition known as venous insufficiency. When the valves inside the veins are not working properly, blood can leak backward and pool in the veins. This can lead to symptoms such as swelling, varicose veins, pain and ulcers.
There are many treatments for leaking veins, including:
Wearing compression stockings. We usually say to the knee are fine. Medical-grade compression stockings can help improve circulation in the legs and reduce swelling. This is because they help to keep the blood flowing rather than it pooling.
For most conditions keeping to a healthy weight and exercising often is important in self-managing these conditions. It's no different for leaking veins, as this condition also benefits from having a healthy lifestyle. Raising your legs at the end of the day can help improve circulation and reduce symptoms. Propping your legs will help after a day spent standing. And when your legs are swollen and puffy at the end of the day.
When leaking veins - varicose veins – run in your family
If varicose veins run in your family, most likely you will have them, too.
Varicose veins are most commonly visible on the legs and behind the knees. They look ropey and twisty and protrude above the surface.
We treat varicose veins using a medical adhesive to shut off the leaking veins that are no longer working. It is a minimally invasive procedure under local anaesthetic, where you walk in and walk out.
Smaller veins treated with sclerotherapy
Sclerotherapy will mostly be used for treating smaller veins. Just after varicose vein treatment or when a patient returns for a follow-up appointment after varicose vein treatment. A solution injected into the smaller affected veins closes them off and redirects blood flow to healthier veins.
See a vascular specialist for leaking veins, even if you’ve been putting up with them for years. As well, your GP can provide advice on your treatment options.
So, which doctors treat varicose veins in New Zealand?
Which Doctors Treat Varicose Veins in New Zealand?
Many doctors treat varicose veins in New Zealand. These include:
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- Vascular surgeons
- General surgeons
- Interventional radiologists.
- Cosmetic doctors who have an interest in varicose veins. And often in other cosmetic treatments, too. Often called a ‘Phlebologist’ or Vein Specialist
- Other doctors, like emergency doctors, will also treat varicose veins when they have an interest in this area.
All of these doctors can be called vein specialists but there are some differences between them.
Differences in which doctors treat varicose veins
The main difference is in the training and the range of the medical practice they offer.
Vascular Surgeons
General Surgeons
General surgeons are registered specialists in general surgery with the New Zealand Medical Council. They will mostly do surgery such as gastrointestinal, colorectal, hernia and breast surgery. Some general surgeons will also do vascular surgery in hospitals where vascular surgeons may not be available.
Interventional Radiologists
Interventional radiologists are registered specialists with the New Zealand Medical Council. They are specialists in radiology and in a range of image-guided treatments.
Phlebologists or Vein Specialists
These are doctors who have often trained as general practitioners and then branched out to work in the areas of cosmetic and vein treatments. This group of doctors are not registered specialists with the New Zealand Medical Council. Their are appropriately trained in varicose vein treatments but do not offer the full range of vein and artery care.
Other doctors treat varicose veins
There are also some other doctors offering varicose vein treatments in New Zealand. This group may include doctors such as emergency physicians, who might also have an interest in varicose vein treatments. These doctors may work under the guidance of a vascular surgeon. Or they may work independently in a similar capacity to phlebologists, if they have completed appropriate training.
So, which doctor will be best to treat my veins?
Often, the main thing to think about when choosing your varicose vein doctor is their expertise and experience. As well as a low number of complications from their work. And, following on from this, how they manage any complications if they do arise. A registered specialist is more likely to be able to handle these situations. Because they have more training, as well as more experience.
Ask your GP which doctors treat varicose veins
Ask your own GP for advice on who could treat your varicose veins. You might want to think about those doctors who are close to where you live or work. There is a wide range of choice. Making a good choice can be confusing for you.
At the same time, your doctor will talk with you about your symptoms. And may suggest some things you can do, too to help. Like wearing compression stockings. Or raising your legs at the end of the day to help reduce any swelling. Eating a healthy diet, giving up smoking and doing more exercise may also help you, like going on walks. If doing these things doesn’t help with your veins, your doctor may refer you. Or, if you have done your own research, you can refer yourself.
Diabetes and its big risk factor for vascular problems
How Diabetes Increases Vascular Risk: Key Facts to Know
Diabetes and vascular conditions are closely related. People with diabetes have more risk of developing some vascular problems. This is because high blood sugar levels can damage blood vessels over time.
There are vascular conditions linked to diabetes
Diabetes can lead to narrowing and hardening of the arteries in the legs, known as Peripheral Artery Disease or PAD. This can mean less blood flow to the legs and feet, causing pain, cramping and wounds to not heal well. Worse cases can lead to gangrene and having limbs removed.
Atherosclerosis, is a build up of fat spots (plaque) in the blood. People with diabetes are at a higher risk of developing these, which can affect many blood vessels, including those in the heart (coronary artery disease, see below), brain (stroke) and legs (PAD, see above).
There is also more risk of blood clots and plaque in the blood vessels in the brain, bringing with it more risk of stroke.
Diabetes is a big risk factor for Coronary Artery Disease (CAD) or narrowing of the coronary arteries. This can lead to angina (chest pain) or heart attacks.
High blood pressure also poses a risk, because high blood pressure can mean more risk of vascular issues. As well, diabetes may damage the blood vessels in the retina, called Diabetic retinopathy. Following, this can lead to eye problems and blindness if left.
Blood vessels in the kidneys may also be at risk of damage or kidney failure. Nerve damage may also be caused by diabetes. Meaning poor blood flow, especially in the feet and lower legs.
Management is key
Managing diabetes and vascular conditions means keeping blood glucose within target ranges.
Eating healthy food and keeping blood pressure and cholesterol under control are all key for managing vascular risks. So, too, is doing regular exercise and not smoking or vaping.
Your vascular specialist or doctor may advise on medicine to control blood pressure or lower cholesterol, as well as medicine to help stop blood clots. People with diabetes need lots of checkins with their healthcare team to help reduce the risk of vascular problems.
More on carotid artery disease, is there a concern?
The carotid arteries are two major blood vessels either side of the neck that supply blood to the brain, head and neck. The right carotid artery and the left carotid artery. These arteries are vital for delivering oxygen-rich blood to the brain, allowing it to function properly. Strokes happen when there is a reduced blood flow to a part of the brain. Strokes can be caused by many factors. One common cause is the narrowing or blockage of the carotid arteries. This condition is known as carotid artery stenosis or carotid artery disease.
How carotid artery disease leads to strokes
The most common cause of carotid artery disease is the build up of fatty deposits (plaque) on the inner walls of the arteries. Over time, this plaque can narrow these arteries and therefore reduce blood flow to the brain.
Sometimes, the plaque in the carotid arteries can break apart. When this happens, it can cause blood clots. These blood clots can then travel through the bloodstream until they get stuck in smaller blood vessels within the brain. This will block blood flow and may cause a stroke. This type of stroke is called an embolic stroke.
Even if there aren't blood clots, narrowing of the carotid arteries can lead to reduced blood flow to the brain. If this blood flow is restricted, it can mean oxygen and nutrients may struggle to get to the brain cells. This may cause cell damage or death. This type of stroke is called an ischemic stroke.
Stroke symptoms and carotid arteries
When a stroke occurs due to carotid artery stenosis, the symptoms can vary. Symptoms may include sudden weakness or numbness on one side of the body, the person may have trouble with their speech or vision. Severe headaches and a loss of coordination may happen too. Following on from this, urgent medical help is vital if stroke symptoms are present.
Your vascular surgeon is an expert on carotid artery stenosis. To help prevent strokes caused by carotid artery stenosis, they may recommend lifestyle changes and medicines to manage risk factors. Risk factors include high blood pressure and high cholesterol. In some cases, surgery such as carotid endarterectomy to remove plaque or widen the narrowed artery or arteries will be needed.
Regular check-ups and monitoring by your vascular surgeon can help manage carotid artery disease and the risk of stroke. This may also include having regular ultrasound scans.
Seek medical help straight away if you suspect you or someone else is having a stroke, because quick intervention can help reduce brain damage for better outcomes.
Hyperhidrosis - sweat excessively? What you need to know.
Excessive sweating is called hyperhidrosis. It's more than what you would class as 'normal' sweating. People with hyperhidrosis sweat excessively even when they're not doing the things that would normally make you sweat, like exercise or being in hot or stressful conditions. This excessive sweating can occur in many parts of the body, including the hands, feet, armpits and face. While most can deal with it, for those with significant issues, it can impact their quality of life. From not wanting to shake hands, not being able to hold a pen in their hand, to having drenched clothes. All cause discomfort, embarrassment and then, sometimes, isolation.
Two main types of hyperhidrosis:
Primary hyperhidrosis: This is the most common type and may start in childhood; affects 0-5-1% of people. It's not linked with a medical condition and may run in families; affects the palms, soles, underarms and face.
Secondary hyperhidrosis: This type is usually because of a medical condition or from taking a medicine. It can occur suddenly and can affect more parts of the body. Some causes might be from the thyroid, hormones, diabetes, some medicine or infections.
How do you treat it?
Botox/Dysport injections, (botulinum toxin) can be given to help block the nerves that make the sweat glands work. Most often used for underarm sweating but also for other areas, like the hands. These injections have become the mainstay for people with more severe. symptoms. Because they are well tolerated, results can be seen in about a week. Often they will last for an average of six months.
Drying agents – aluminium salts can be used in the area. These seem to help stop the sweat glands but may cause irritation for some. Lasts up to 48 hours.
Topical antiperspirants: prescription antiperspirants that have aluminium chloride in them can be used. These help to temporarily block the sweat glands.
Oral medicines, like anticholinergics – can help reduce sweating. But have many have side effects and are not well tolerated.
Surgery – there is surgery like thoracoscopic sympathectomy (cutting or clamping of the sympathetic nerves that cause the sweating). However, as with any procedure, there are risks. But some people do choose this as a more permanent option. Normally for those where other treatments do not work.
Lifestyle changes – avoiding things that make you sweat, like spicy foods, caffeine and alcohol can help some people with their sweating; especially if caused by hormones. For example, for women in menopause. Wearing clothing made from natural fibres, like cotton, may help.
It's important to see a medical professional to find out what will be best for you. They can help with what type of hyperhidrosis you have and then recommend what's best for you.
Is Raynaud's disease the cause of cold, throbbing fingers?
Raynaud's disease affects the blood vessels, particularly the small arteries in the extremities, such as fingers and toes. It is characterised by episodes of vasospasm, where the blood vessels constrict, leading to reduced blood flow to the affected areas. This can result in colour changes in the skin, usually causing the fingers or toes to turn white, then blue and finally red when blood flow returns.
Patients have difficulty holding objects and describe a throbbing sensation as their fingers and or toes return to normal. Sometimes returning to normal may be in patches where parts of the fingers or toes are white and others look normal.
What causes Raynaud's disease?
The exact cause of Raynaud's disease is unknown but it is believed to involve an exaggerated response of the blood vessels to cold temperatures or emotional stress. It can occur on its own, known as primary Raynaud's disease, or as a secondary condition, known as secondary Raynaud’s disease or Raynaud’s Syndrome, linked with other underlying medical conditions such as autoimmune diseases (eg, lupus, scleroderma as part of CREST syndrome), vascular diseases or with some medications.
Treatment for Raynaud's disease aims to reduce the frequency and severity of attacks, relieve symptoms and prevent complications. Patients may go long periods without flare ups.
What are some common treatments?
Common approaches include:
- Lifestyle modifications: Avoiding triggers such as cold temperatures and stress is important. Keep the body warm by wearing layered clothing. Hand warmers or heated gloves may be useful and avoiding exposure to cold water can all help.
- Medications: Medications may help improve blood flow and reduce vasospasm. Examples include calcium channel blockers (eg, Nifedipine), oral vasodilators (eg, Pentoxyfilline and Sildenafil aka Viagra), intravenous prostaglandins (eg, Iloprost) and alpha-blockers.
- Biofeedback: This technique helps individuals learn to control their body temperature and blood flow by providing real-time feedback. It can be useful for some people with Raynaud's disease.
- Avoiding vasoconstrictive substances: Certain substances, such as nicotine in tobacco, can worsen symptoms. Avoiding smoking and exposure to secondhand smoke is beneficial.
- Stress management: Learning how to reduce stress, such as relaxation exercises and meditation, may help prevent or minimise attacks that result from stress.
- Surgery: In severe cases or when complications such as ulcer and gangrene arise, surgical intervention may be considered. Sympathetic nerve surgery aims to disrupt the nerve signals that trigger vasospasm. They may be benefit those with severe secondary Raynaud’s Syndrome.
It is important to consult a medical professional for an accurate diagnosis. They will describe the most appropriate treatment plan based on individual circumstances.
Kidney stones - are they the cause of your pain?
Kidney stones, also known as renal calculi, are hard deposits that form in the kidneys and can cause significant pain and discomfort. The symptoms and treatments for kidney stones can vary depending on the size, location and number of stones present. Read on for an overview:
Symptoms of kidney stones
Symptoms include:
- Severe pain: The most common symptom is intense pain in the side or back, below the ribs. The pain can radiate to the lower abdomen and groin.
- Hematuria: Blood in the urine, often visible as pink, red or brown discoloration.
- Frequent urination: The urge to urinate more frequently than usual, accompanied by minimal urine production.
- Cloudy or foul-smelling urine.
- Nausea and vomiting.
- Fever and chills (if you have an infection).
And, so what are the treatments?
Treatment depends on how bad your stones are and whether you have had them diagnosed, including:
- Drinking plenty of fluids: Increasing fluid intake, especially water, helps flush out small kidney stones. You should aim to drink at least two to three litres of water per day.
- Pain management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain. Stronger prescription pain medications may be necessary for severe pain.
- Medical therapy: Dending on the type of kidney stone, medications can be prescribed to help dissolve or prevent the formation of stones in the first place. More commonly used for certain types of stones like uric acid stones.
- Extracorporeal shock wave lithotripsy (ESWL): Sound waves are used in this non-invasive procedure, where kidney stones are broken into smaller pieces that can be passed more easily in the urine.
- Ureteroscopy: A thin tube inserted through the urethra and bladder to reach the stone in the ureter or kidney. The stone can then be removed or broken into smaller pieces using laser or ultrasound.
- Percutaneous nephrolithotomy (PCNL): Surgical procedure for larger stones or when other treatments are not feasible. A small cut is made in the back and a tube is inserted to remove or break up the stone or stones.
- Natural passage: Small stones (usually less than 5mm) may pass naturally through the urinary tract with increased fluid intake and pain management. This process can take from several days to a few weeks.
It is important to consult with a healthcare professional if you suspect you have kidney stones. They can evaluate your symptoms, order diagnostic tests such as imaging or urine analysis and recommend appropriate treatment based on the size and location of the stones.
Kidney Disease Causes and Treatments
The kidneys play a key role in maintaining our overall health. Kidney disease is a common and serious condition that affects millions of people worldwide.
Understanding kidney disease
Kidney disease, also known as renal disease, refers to the gradual loss of kidney function over time. The kidneys have essential functions, such as filtering waste products and excess fluids from the blood. They regulate blood pressure, produce hormones and balance electrolyte levels. When the kidneys are damaged, they cannot do these functions as well, leading to a build up of toxins and waste in the body.
Causes
- Diabetes: Diabetes is one of the leading causes of kidney disease. High blood sugar levels can damage the blood vessels in the kidneys, making it hard for them to filter waste and fluids.
- High Blood Pressure: Uncontrolled or poorly managed high blood pressure can also damage the blood vessels in the kidneys, affecting their ability to filter waste and fluids effectively.
- Chronic Glomerulonephritis: This is a group of kidney diseases characterised by inflammation and damage to the tiny filters in the kidneys.
- Polycystic Kidney Disease (PKD): PKD is a genetic disorder that causes cysts to develop in the kidneys, which leads to kidney damage.
- Urinary Tract Infections (UTIs): Recurrent or untreated UTIs can spread to the kidneys and cause infections that may cause kidney damage.
Symptoms
Following on from this, early on the symptoms may not be that noticeable. However, as the condition progresses, people may have the following signs and symptoms:
- Fatigue and weakness.
- Swelling in the legs, ankles, feet or on the face.
- Decreased urine output or changes in patterns.
- Blood in urine or foamy urine.
- Persistent itching.
- Loss of appetite and unintended weight loss.
- Nausea and vomiting.
- Difficulty concentrating and mental fog.
-Muscle cramps and twitches.
Treatment options
Treatment does depend on the cause and the stage the patient is at. Following on from this, here are some common approaches:
- Medications: Medications may manage conditions, such as diabetes and high blood pressure.
- Lifestyle Changes: Adopting a healthy lifestyle can help slow progression of the disease. This includes maintaining a balanced diet, limiting salt intake, giving up smoking, exercising regularly and managing stress.
- Dialysis: Dialysis may be needed in the later stages of this disease. This is when the kidneys cannot function properly. Dialysis removes waste products and excess fluid from the blood using a machine.
- Kidney Transplant: In cases of end-stage kidney disease, a kidney transplant may be the best option. This involves surgically replacing a damaged kidney with a healthy one from a donor.
- Supportive Care: Managing symptoms and complications, such as anaemia, bone disease and cardiovascular issues, is essential in providing care for people with kidney disease.
Kidney disease is a serious condition that can significantly impact a person's health and quality of life. Understanding its causes, recognising the symptoms and seeking medical advice are crucial steps. By addressing underlying causes, making lifestyle changes and following the recommended treatment options, people can slow the progression of the disease and improve their overall wellbeing. If you suspect kidney disease or experience some of the symptoms above, it is important to talk to a healthcare professional, such as a vascular surgeon.
Lipoedema in Men
Lipoedema in Men: Causes, Symptoms and Treatment Options
Abnormal accumulation of fat in the legs and thighs characterises lipoedema. While more common in women, this chronic condition is increasingly also being seen in men.
What are the symptoms?
Lipoedema typically presents as symmetric swelling and enlargement of the legs, often accompanied by a feeling of heaviness and discomfort. As well, characteristic ‘orange peel’ appearance on the skin may be due to the presence of fibrous tissue. Abnormal accumulation of lymphatic fluid in the tissues characterises lymphoedema, which often accompanies the condition.
While exact causes of lipoedema are not well documented, it is thought to be related to hormonal and genetic factors. Often underdiagnosed and misdiagnosed as obesity, it can have a significant impact on a person’s quality of life.
What are the treatment options for lipoedema in men?
Treatment for lipoedema typically involves a combination of approaches, including compression therapy, manual lymphatic drainage, and liposuction. Compression therapy involves the use of special compression stockings or compression garments to help reduce swelling and improve circulation. Manual lymphatic drainage is a massage technique that helps to reduce the accumulation of lymphatic fluid in the tissues. Liposuction is a surgical procedure that removes excess fat from the affected areas.
Seeing a health professional is the first step
Lastly, men being aware that lipoedema is not just a women’s issue is a good first step. If you have symptoms of lipoedema, it is important to see a healthcare professional who can properly diagnose and treat the condition. With the right treatment, it is possible to reduce the symptoms of lipoedema and improve quality of life.
For more information see our earlier blog: Is fat in the legs lipoedema or obesity? where we talk about how misdiagnosis of lipoedema for obesity, oedema or lymphoedema is common. And as a result of this, sufferers may embark on an incorrect treatment pathway, such as weight loss surgery. While all of these conditions may be present at the same time to differing degrees, it is recognised as a distinct condition, with its own set of specific treatments.
Varicose veins can cause skin eczema
Varicose veins are a common condition that can cause a variety of symptoms, including skin eczema. Eczema is a skin condition characterised by red, itchy and scaly patches of skin. It can occur in individuals who have varicose veins due to a number of different factors.
Why varicose veins can cause skin eczema
Increased pressure on the blood vessels in the legs is one of the main reasons varicose veins can cause eczema. When the valves in the veins become weak or damaged, blood can pool in the legs. This puts extra pressure on the surrounding skin. This increased pressure can cause inflammation and irritation, leading to eczema.
Lymphatic fluid in the legs a contributing factor
Another factor that can contribute to eczema is the accumulation of lymphatic fluid in the legs. Lymphatic fluid is a clear, fluid normally transported through the lymphatic vessels. It helps to remove waste products from the body. When the lymphatic vessels become blocked, lymphatic fluid can accumulate in the legs, causing swelling and inflammation.
Stress can also contribute
In addition, varicose veins can also cause eczema because of the psychological stress and anxiety that can accompany the condition. People with varicose veins may experience feelings of self-consciousness or embarrassment about the appearance of their legs. This can lead to stress and anxiety. This psychological stress can then manifest as eczema.
What are the treatment options?
To treat eczema caused by varicose veins, it is important to address the underlying condition thereby treating the varicose veins. An ultrasound scan can diagnose varicose veins. Self-care measures, such as wearing compression stockings, elevating the legs and exercising regularly can help. Minimally invasive procedures like sclerotherapy or Venaseal can help treat varicose veins. Additionally, using a therapeutic moisturiser, such as fatty cream, and avoiding irritants that can worsen eczema, symptoms can be helpful.