About an hour ago I walked out of my local leg vein treatment clinic after having the varicose veins that have ached and sometimes been quite painful.. treated. Whilst I get use to the compression stocking on my left leg which will be my friend over the coming weeks, I wanted to make sure I captured what happened and publish my story – simply because when I was looking to find a way to reduce the tiredness, the pain, the restless legs caused by my torturous varicose veins… there were not many patient stories out there to read about. I figure there are people out there just like me that will benefit from my perspective.
Before I get into it – I am not a doctor – please don't take this as medical advice or hold my word re: the procedure or the pain levels I felt (or didn't feel as is the case). Your mileage may (and probably will vary). Make sure you talk to your GP, local specialist or vascular surgeon to figure out your best course of action. To be honest now that I have gone through with the treatment… I wish I did it years ago!!!
So just how bad were my varicose veins?
I noticed that I had visible veins in my leg probably 10-12 years ago. There was a purple patch on the front of my shin – I just assumed it was a sporting injury from playing too much soccer without my shin pads on. But about 8 years ago I started to notice that my left leg in particular got quite tired and achy when I was pushing a shopping trolley around the supermarket. It was mild at first, but after 6-12 months without fail every time I went shopping, or went for a long walk, or was on my feet for a long time – there would be pain radiating from the back of my knee. Further to that sometimes I would get a strange pins and needles feeling – almost like ants crawling inside my left… down the front of my shin.
I brushed it off for the longest time, until one night at the dinner table my leg really started to ache. So much so that I couldn't bear to sit at the table any more. We called the afterhours doctor to take a look at it as I thought something serious was wrong (like a Deep Vein Thrombosis – DVT). Thankfully the pain went away… and it wasn't DVT… but he suggested I get in touch with a vein center and talk to a varicose veins specialist to see if something could be done. Being stupid – I waited another 12 months until I actually made the call!
Excuse the hairy legs… but here is what it looked like. This first shot is my point of view looking down at the back of my knee and down my calf. You can see that there is a very visible, very tortured varicose vein running from the back of the bottom of my thigh, down through the back of my knee, and then around to the left hand side of my left calf.
The vein actually wraps around the side of my calf to the front as you can see in the second picture
… and you can make out the bluish and purple – almost bruise like appearance on the front of my shin where the blood is pooling in my veins.
So it looked pretty awful to be honest. But this treatment wasn't about cosmetics. I needed to get rid of the aches, the pains, the strange sensations running down my leg. So I finally called a vein clinic to see what my options were!
The first consultation with the varicose vein specialist
This was only a 30 minute appointment. This was a pretty uneventful session. At a high level after providing some basic medical history to the receptionist (filling in a form on a clip board) I sat with the Doctor and he asked me a few questions about my purple veins – for example, how long have you noticed it, what is the pain like, does this run in your family etc etc. Then using the ultrasound machine he had in his room, he mapped out the varicose veins in my left leg. This took about 20 minutes and he talked me through was he was seeing on the ultrasound screen which was good. To make it nice and easy for me to understand, he drew the varicose vein on a template he had of the left leg – illustrating where the deficiency was, and then talking through why the vein had started to bulge, twist, and ultimately cause issues. He also highlighted why I may be getting those crawling ant style pins and needle sensations – as the vein was pushing against a key nerve that runs behind the knee. Because of this alternative traditional vein stripping or laser ablation / surgery options were not the best approach to my treatment as there was a higher risk of vein damage. Basically the only way to approach the treatment in his opinion was to do ultrasound guided foam sclero
So armed with all that information… there was only one more question…
How much is this going to cost?!?!?!?
"Good question" the friendly Phlebologist says J
Not sure about the rest of the world, but here in Australia varicose vein treatment using ultrasound guided foam sclerotherapy isn't covered by Medicare or by private health insurance. Despite my varicose veins being quite painful, it is considered elective and therefore there is very little Medicare rebate. I think I get a portion of the compression stocking back from the government, but apart from that it is up to me to fund. The doctor said that the treatment will take about 60-90 minutes… I will need to walk continuously for 30 minutes straight after (he said I could actually go back to work if I wanted!) and the procedure, plus a handful of follow up appointments over the next 12 months, with the compression stocking will cost just over $1500 Australian Dollars. To be honest I was surprised that it was that cheap, and considering the pain that I had been through it was a no-brainer to go ahead with the varicose vein surgery. The next question in my head was when to treat my bulging varicose veins – so once I had cleared the credit card to cover the cost of the surgery… I booked in the next available appointment I could make!
Getting the varicose vein treatment
The actual procedure was a lot better than I thought it would be. I arrived about 10 minutes early for my appointment, and the receptionist has a clip board with a quick information sheet talking about the potential complications of the procedure. Nothing out of the ordinary here. So after a quick read I signed the form and handed it back to the assistant. About five minutes later the Vein Doctor that I had the initial consultation with invited me into his room.
After taking my shoes, socks and shorts off… he took a number of "before" photos – so we could compare before and after the treatment. He then sat me down on a surgical bed and talked me through the procedure so I knew what was going on. He mentioned that my treatment is a little more complex than others, and involves the use of a number of cannulas to push the sclero foam through the vein – in fact most of the procedure is actually setting up to pump the foam in, and not the injection of the foam into the varicose vein itself. I lay down on my stomach… and after a quick check of the vein again using the ultrasound machine, and a practice of the roll over onto my side I needed to do half way through the procedure, we were good to go
The doctor had set up table with at least 20 different needles, cannulas, bottles of sclero (not in its foam form yet) and saline solution. He started with a local anaesthetic which I felt go into my thigh just above the back of my knee – it was a small sting but nothing too bad. After a few minutes he started placing cannulas into my veins – specifically where the venous deficiency was occurring (above the back of my knee). The first one I didn't even feel – that is how good the anaesthetic was. But to be honest it was probably just very close to where the anaesthetic went in, as the following cannulas and needles went in I did feel some pain – again not much but enough to notice. The Dr was using the ultrasound to guide the needles into the right place… if I turned my head I could watch on the ultrasound screen which was pretty cool.
About 30 minutes passed he had finished the set up – at which stage I turned my head to look back at my leg where I could see a number of cannulas handing out of my thigh, and what looked like a few drainage punctures in the top of my calf (or it could have been where he had injected some saline previously – I am not too sure). Then I heard the noise of him making the sclerotherapy foam. It is pretty interesting how the make it – basically two syringes set 90 degrees apart with a valve between them. The Dr pushes each syringe in and out passing the sclero solution through the valve turning it into a foamier consistency every time. Once he had the first batch of foam created he injected it into the cannulas sticking out of my thigh. He repeated this process at least four times, pushing more and more foam into my varicose vein. At this stage he checked around the back and the side of my leg to see how far the foam had progressed using the ultrasound.
I rolled onto my side, and then onto my back where he used "direct sclerotherapy injections" as opposed to a cannula to finish off the job and get the smaller veins on the front of my shin. This involved about 4 further injections guided by the ultrasound… and 3 or 4 which he did using the naked eye. Again each one hurt a little, but I wouldn't say it was overly painful.
After whipping down my leg to clean up the ultrasound gel and the little bit of blood… it was time to put on the Compression Stocking. The assistant brought in the size four stocking and the Dr pulled the full length stocking up left leg… leaving the last 10cm at the top of the thigh for me to do J
He said I need to wear it continuously for the next 72 hours, and then when I am awake for the next 3 weeks. Here is a picture of the stocking I took as I walked out of the leg vein clinic…
Straight after the treatment – it is time for a walk
The leg vein specialist said that (after I fix up the bill and book my follow up appointment for about three weeks' time with the reception desk) I needed to walk continuously for 30 minutes before going anywhere. I walked about 3km down to the local shops close to that big cheap car insurance
company. To be honest it felt really good as I started walking, but as soon as I stopped at a set of traffic lights, and started walking again – I could really feel the pressure of the foam down near my shin. Also I have noticed that as the local anaesthetic has worn off… the back of my knee in particular has a dull aching pain – ironically worse than the varicose veins, but it should settle down overnight.
The results? Too soon to tell
It is now four hours after my treatment was completed (taken a while between things to finish off this post) and yes it still hurts a bit, and no I can't see if the veins have gone. It does look like the bulging has gone down if I look at the compression stocking. I will post an update once the stocking if off in another 72 hours!
You can now see the sclerotherapy before and after photos
in my 72 hours after treatment post.
The reason I wanted to post this article is to help those who are suffering from the aches and pains associated with varicose veins make a more informed decision about how to get treatment. I am not a doctor, and as I mentioned at the start of this article you really need to talk to your own GP, or varicose vein surgeon. I am glad (so far) that I got the treatment done, and look forward to no pain (and no more subtle limping)… and the pleasant side effect of no ugly bulging purple varicose veins in my leg anymore!