If you are preparing to meet with a vascular surgeon for the first time, these are the questions we recommend you asking. This will help both you and your doctor establish the best course of treatment and results! Of course any additional questions you have for your vein doctor should be brought up, and remember questions are extremely encouraged!
What is the cause of my varicose veins and why do some people have large bulging veins and other people only have spider veins?
Bulging veins are frequently caused by valvular insufficiency. Valves act as one-way shutters to keep the blood moving back toward the heart. Patients may also have a large amount of swelling if they have a component of obstruction or blockage. Some of the smaller vessel dilatation is due to hormones while larger bulging veins are most often due to valvular dysfunction. Some patients have a decreased number of valves and some patients have decreased function of the valves.
Why do I have swelling at the end of the day?
Swelling at the end of the day may be caused by fluid leaking outside of the veins and into the soft tissues. Initially this will come and go and resolve with elevation and rest overnight. However, eventually there will be a buildup of fluid and protein in the soft tissues causing darkening of the skin and loss of shape, which then may become irreversible. Compression stockings can help to delay and slow down this progression. Weight loss and exercise are also helpful.
What can be done for my bulging veins and also what can be done for my spider veins?
You can injure the vein by using laser or radiofrequency causing heat injury, or you can inject them with foam or sclerotherapy which causes chemical injury to the cells lining the veins. Each of these treatment options will have different benefits and risks as well as recurrence and recovery periods. It is important to clarify with your doctor what the treatment plan is and what the recovery and restrictions will be.
Will insurance pay for my varicose vein treatment? What is fee splitting and how does the determination for the medically necessary and cosmetic portions work?
The answer is critically important for everyone, as the answer is variable. It’s important to work closely with the staff to determine what is and isn’t covered by your insurance.
What are my post treatment restrictions and limitations? How active can I be? Is this going to be done in the office or in the hospital? What type of sedation or anesthesia will be required? Will I need more than one treatment?
The answers to these questions are varied. All of these questions need to be answered. Make sure your expectations are realistic.