Sclerotherapy before and after: 72 hours post treatment for Varicose Veins in leg

The other day I bit the bullet and finally had treatment for the painful bulging purple veins in my left leg. They ran from behind the bottom of my thigh, down the back of my knee, and then around the outside of my left leg across the front and then down the inside of my shin.

I went to a vascular doctor who specialises in varicose vein treatment and the treatment plan he put in place resulted in having ultrasound guided foam sclerotherapy to fix the problem veins. The surgery went really well. As part of my recovery I need to wear a compression stocking for three weeks – 24 hours a day for the first 3 days (showing with bags to cover the stocking!), then whilst I am awake for the rest of the time.

Last night was the end of the 3 days of continuous compression stocking wear, which gave me my first chance to take a look at the progress my varicose vein treatment has made! Below are some before and after shots of how things are progressing! (apologies for the lighting… took the before photos during the day, and the after photos at night!)

Before Treatment

72 hrs After Treatment

First of all, this is the point of view shot of me looking down at the back of my left leg. You can see the varicose vein clearly in the back of my in the first shot. In the second shot you can see that whilst there is a bit of bruising, the vein has significantly reduced. It is still there, but not bulging and not as visible. The back of my knee still hurts a little bit when I have my leg bent – the compression stocking digs in a little bit – but the bruising certainly isn’t painful to touch.

Before Treatment

72 hrs After Treatment

This second pair of shots is of the outside of my left leg. Again you can see in the first before shot the purple, tortured varicose veins wrapping around to the front of my leg. In the after shot you can see that the vein has significantly reduced!

All in all I am extremely happy with the results so far. Yes there is a little bit of pain every now and then – and I am already very annoyed with my compression stocking – but based on those results I think I can put up with it for another few weeks to ensure a great outcome. No more vein pain!

I just had varicose vein treatment using ultrasound guided foam sclerotherapy

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 and back. 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!

Update: You can now see the sclerotherapy before and after photos in my 72 hours after treatment post.

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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!

3MT: My experience participating in the Three Minute Thesis competition

Last week I posted about how I deconstructed Three Minute Thesis pitches to help craft my own 3MT presentation.  Well, I thought I would share the results with you…

Firstly, here is the slide that I used to support my topic – which explores how technology influences how we all construct the boundary between work and life…

I tried to make it as simple as possible (and not too busy).  I didn’t waste my audience’s attention with my name, my supervisors names, or the title of my thesis.  All I was trying to do was convey exactly what my topic was all about.  Even without me talking about the subject most of the audience would have understood what my topic was about.  The feedback from the judging panel suggests that I hit the nail on the head re: the slide.

When it came to the content and the delivery, again very good feedback, and breaking down the structure of the 3MT presentation into what I discovered when I reviewed winning entries certainly contributed to that.  Starting with a story that everyone could relate to certainly got the attention of the 20 strong audience on the day – lots of eye contact, lots of smiles, lots of nods – was great to see!

But…The dream is over!  Well.  I can’t really complain, I managed to snag a second place (out of seven) in a photo finish during the QUT Business School heat for the 2014 3MT Three Minute Thesis competition.  To be honest the winner was very good and deserved to go through – and her thesis really pulled at the heartstrings!  The feedback from the judges which set my presentation and the winner’s apart came down to one simple thing – she articulated her research question a bit better than I did.

As Maxwell Smart would say… “Missed it, by that much…”

Podcast: My Top 10 non-Excel Microsoft Office tips for Managers

I had the pleasure this week of being a guest on one of the most popular Microsoft Office podcasts in the world – Chandoo.org’s Excel PodCast. (click here to go to episode 17 where I am featured)

Chandoo and I crossed paths online a few weeks ago and as it turns out I have basically found my clone from both a professional, and personal point of view. We spent about 90 minutes on the phone – first discussing how our paths crossed, and then I shared my top 10 no-Excel MS Office tips for Managers and Analysts.

The first 22 minutes is all about:

Then for the last hour we get into the meat of the podcast for – my list of the Top 10 non-Excel MS Office tips for managers or analysts

I would love to hear your feedback (in the comments below) – this is the first time I have appeared as a guest on a podcast (and… um… I like… um realise that I aaagh and um a lot!). If you like Chandoo’s style – make sure you subscribe to his podcast and check out some of his earlier episodes.


Other options to subscribe

3MT: Deconstructing winning Three Minute Thesis entries

 

Next week I am entering the QUT Business School heats of the Three Minute Thesis competition. To help prepare my presentation, I thought I would look at a number of winning entries from within QUT, across Australia, and internationally to see if there were any patterns of success. Thanks to universities around the world publishing the work of their students on YouTube, there are a vast array of speakers from different subject areas to base my analysis on.

As it turns out, after watching 15 or so winning entries, there are four things that appear consistently across almost all high achieving 3MT presentations.

The Opening

Setting the scene is really important. Instead of diving straight into the student’s thesis and all the gory detail, most presenters started with a general problem that everyone in the audience could relate to in some way. Not only did they state the problem, but most very succinctly then demonstrated the consequences of that problem – this paints a very vivid picture to:

  1. Provides a clear “signpost” as to what the research is all about;
  2. Ensures everyone in the audience understands the importance of the research
  3. Now that they know it is a problem, keeps the audience intrigued as to how you solved it/answered the question

Sharon Savage from the University of New South Wales does this within just 10 seconds of starting her 3MT presentation. Clear, concise, to the point… and made the research relevant to EVERYONE in the room!

 

The Details

Very few students used technical research language to describe their study. For example, no one talked about “sampling strategy”. Instead the speakers used simple language to describe at a high level what they did. For example Matthew Thompson from the University of Queensland (Winner 2011) talked about “working with fingerprint examiners in Brisbane, Sydney, Melbourne.. etc” something that we can all understand.

(Matthew Thompson – University of Queensland on stage at the Australasian finals of the 2011 Three Minute Thesis Competition presenting “Suspects, Science and CSI” – my favourite 3MT presentation from my quick and dirty analysis)

Beyond using simple language, the speakers didn’t share their data – they shared the story of their data. The took complex results and boiled them down to simple statements which were consumable by the audience. Matthew Thompson summarised most of his PhD results in just one of sentence – “Generally fingerprint examiners were very accurate, however there were a few mistakes”. It laid the perfect signpost to segue to…

The Significance

Almost all speakers did a great job of tightly articulating why their research was of real practical significance. Not just “adding to the body of knowledge” – but passionately sharing the specific impact the research is already having, or will have in the world we live. The best students took this one step further, and ensured that the significance of the research was relevant to the audience. For example, Emily Milne from the University of Waterloo took her specific topic and then articulated how it was a social challenge that all Canadians need to care about.

(Emily Milne – University of Waterloo (2013) makes it crystal clear at the end of her 3MT as to the impact of her study on one of the most critical social challenges for Canadians)

 

The delivery

Ultimately everyone delivered very engaging presentations which took their audience on a journey. Passion, emphasis where it was required, subtle but effective hand movement, and confident delivery ensured that the audience understood the key points the speakers were making. The best example of this I found was Megan Pozzi from QUT discussing her research on teenage girls and social media identity. It is also very clear that all top speakers were well rehearsed – all had memorised their presentations – all didn’t need to refer to their slide for guidance – they knew their stuff!

(Megan Pozzi – the Three Minute Thesis 2013 winner from QUT – the most dynamic speaker from the bunch)

 

Now I know that watching 15 YouTube videos, with no theoretical framework to guide my analysis isn’t overly scientific – but hopefully my observations and tips will help you when preparing your Three Minute Thesis presentation. Good luck!

Tracking sleep with my FitBit: the awakening

I have almost religiously worn my FitBit Flex for the past 11 months or so. At first it was all about the steps. How many steps could I do each day. How often could I get that 10k steps badge? How many days in a row could I get the 10k steps badge? What is the highest steps badge I could get? As soon as I managed to get 30,000 steps in one very long day – the drive to get the little black band to do it’s light and vibration dance slowly wore off. Instead my focus switched to another interesting part of the device. The sleep tracker.

One of the other drivers for me to start looking even closer at the sleep tracker was that people in the office almost consistently every morning when I get to work say “hey looks like you had a rough night”, “looks like you need to go back to bed”, “man you look tired”. I know what you are thinking – surely that alone should drive you to sleep more – but with a young family, and lots of work and study commitments… sometimes you need more convincing J

That being said… you know what I realised pretty quickly once I started looking more closely at the sleep tracker? I am not sleeping anywhere near as much as all the doctors/magazines/blog articles suggest (and everyone in the office is right!). Let’s take a look at the last 7 days on the FitBit dashboard…

  • Last night:     5hrs 55mins
  • Thursday    7hrs 19mins
  • Wednesday    6hrs 34mins
  • Tuesday    6hrs 56mins
  • Monday    6hrs 07mins
  • Sunday        6hrs 17mins
  • Saturday    6hrs 47mins

Not only do almost all of those sleep durations start with a 6… the average for the week was just 6hrs 34mins of sleep each night! Well below the 7 or 8 hours recommended. (by the way, if you ever want to calculate your average sleep duration across a week, month or year – check out this article which describes how to average time in Excel).

So – we have a heap of data here from multiple sources (primary data from the FitBit which shows I not only have short sleep durations, but also inconsistent bed and awakening times – and the observations of my colleagues) suggesting I have a problem. What can we do about it?

Stop going to bed at 12:30pm?

I am a bit of a night owl and some of my best thinking happens late at night – I would hate to lose that

Start sleeping in after 7am?

Difficult with a young family to sleep through the noise (and then the associated guilt) of the breakfast/get out the door to kindy routine

Nap?

Again difficult, although I could go for a rest in the car at work during my lunch break

Eat a spoon full of cement and harden up?

Hmm have been doing that for the past few years and I think it may be impacting on my health and well-being just a little bit

I think out of all of the above options the easiest to implement will be to shift my usual’ish bedtime from 12pm (+/- 30 mins) to 11pm (+/-30 minutes). I wonder what impact one extra hour per night will have over time – first things first – let’s see what impact it will have over the next week. I will report in with my findings in 7 days J