Varicose veins are enlarged, twisting veins that are typically blue or dark purple in appearance. While for many patients they are a major cosmetic concern, they can also result in uncomfortable symptoms including pain, itching, skin discoloration, and heavy limbs. Varicose veins are usually the result of malfunctioning vein valves. When the valves do not work, blood is flowing backwards, resulting in increased pressure and dilation of the veins.
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This is a non-invasive physical examination that gives a better idea of your specific vein issues and concerns. We will also educate you on the different treatment options available and make recommendations on which are best suited for you. Multiple treatments will then be scheduled depending on the severity of your veins.
Ultrasound guided foam sclerotherapy
Ultrasound guided sclerotherapy or echosclerotherapy is a vein treatment where the use of an ultrasound helps to guide a needle into the abnormal vein deep inside the leg. A ‘sclerosing agent’ is mixed with a physiological gas (CO2) to create a sclerosing foam. The foam is then injected directly into the vein which over time destroys the inner lining of the vein and seals it shut. Your body then metabolizes the treated vein and your blood is re-routed to other surrounding healthy veins.
Liquid sclerotherapy for spider veins
Liquid sclerotherapy treatment is a minimally invasive, non-surgical method of removing the appearance of varicose and spider veins using injections of a chemical solution known as a ‘sclerosing agent'. This treatment is injected into smaller, more superficial veins closer to the surface of the skin. Typically, one sclerotherapy treatment takes 30 minutes and as many veins are treated as possible in this duration of time. Multiple treatments are needed to all spider veins. Expect 3-5 treatments spaced one month apart.
1064nm Nd YAG Laser for small veins
Nd YAG is an acronym for neodymium-doped yttrium aluminum garnet. This is a fancy name for a laser that emits light with a wavelength of 1064 nm that is used to treat smaller veins. The 1064nm Nd YAG is used to treat smaller vessels if injections are not the preferred method. Typically used to treat facial spider veins, leg veins, venous lake, cherry angiomas, the Nd: YAG delivers a deeper penetration of lower absorbed light. The haemoglobin in the blood absorbs the wavelength of the laser with variable pulse duration to adjust to different vessel diameters, high fluences, and optimal cooling systems to avoid pain or burning.
At the Skin and Vein Centre we offer medical grade, prescription compression therapy stockings. One of our certified stocking fitters will measure and consult you on the various types of stockings that we have to offer. Fittings are scheduled by appointment and stockings are special ordered.
We offer direct billing to Blue Cross as well as Maple leaf.
Post Treatment Instructions for Foam Sclerotherapy
Within 30 minutes of leaving The Skin & Vein Centre after your foam sclerotherapy treatment, you must walk briskly for 30-45 consecutive minutes. For the next 2 weeks, you must exercise your legs for a minimum of 30 minutes every day. (brisk walk, cycling, etc.)
When you leave the clinic after your procedure, you may have a dressing on your leg which consists of a 1”x 1” rectangular piece of foam taped to your leg to help apply extra pressure and compression to the treated vein. You will wear the compression stocking and the dressing on your leg overnight for the first night and then remove the dressing the next morning. You can then have a quick shower and immediately don (put on) your stocking again. Some people opt to wear the stocking in the shower so they can have a longer shower and then remove the wet one and put on a dry, clean one when they get out of the shower.
You must wear your 30-40mmHg compression stockings during the day from the time you get up until the time you go to bed for the next 13 days.
During the first week after your treatment, you must avoid vigorous activities such as heaving lifting (over 10lbs), and extensive gym workouts. You must also avoid extreme heat such as hot tubs, saunas and hot yoga.
Any leg discomfort over the following weeks usually responds well to elevation of the leg, ice, compression, and ibuprofen (Advil). If you have localized tenderness, apply ice for 15 minutes four times a day. If you develop tender or discolored lumps near the injection site two weeks after your treatment, this can be a little bit of trapped blood which is normal. Dr. Kelleher or her designated nurse will remove the trapped blood at your next scheduled appointment.
If you have any extreme redness, excessive swelling, extreme pain, or areas that are hot to touch, please contact our clinic at 204-727-1920 or your family doctor.
Compression Stocking Washing and Care Instructions
Stockings are final sale. Cannot be replaced when user error occurs (holes, catches/snags, runs). Must be taken care of extremely carefully.
- Proper washing and don and doffing (putting on and taking off) are essential to keeping your stockings in optimal condition.
- Hand wash with mild soap.
- Lay flat to dry. NEVER let them go through the dryer or compression will be ruined.
- Always wear rubber gloves to don and doff as you can risk putting your finger through the compression.
- Keep toenails trimmed without rough edges and keep your heels moisturized/as smooth as possible.
- Wear slippers or socks over them at home to protect from snags/holes/catches from occurring.
- Compression is good for 6 months if worn every single day.
Q: How do I get an appointment to see Dr. Kelleher regarding my varicose veins?
A: We require a doctor’s referral for varicose vein treatments. Once this referral is received, we will contact you with a consultation date. If they are only small spider veins, you do not need a referral letter and we will schedule you a consultation with our nurse injector.
Q: Are my vein treatments covered by Manitoba health?
A: Yes and no. Varicose vein treatments are covered by Manitoba health, but spider vein treatments are not. Manitoba health also does not cover the use of the ultrasound machine that Dr. Kelleher needs to use throughout the treatments. You may have had a previous ultrasound of your veins in a hospital, but this is not the same. Dr. Kelleher uses the ultrasound machine initially to map the veins and again during your treatments to watch what she is doing as she injects the veins deep inside the legs.
Q: How long does a treatment take?
A: The treatment only takes about 20-30 minutes. If you are having echosclerotherapy with Dr. Kelleher and you live more than one hour outside of Brandon, we require you to have a driver take you home so that you can ride home with your leg elevated in the back seat of the car.
Q: How long do I need to wear my compression stockings after my treatment?
A: After a foam echosclerotherapy treatment you must wear your stockings and dressing continuously for 48 hours. You can remove the dressing after the 48-hours, but you must continue to wear the stocking on the treated leg during the day from the moment you get out of bed until you get back into bed for the night for the next 12 days. The stocking can come off to have a quick shower but must be put on right after. Some people opt to shower with their stocking on as it dries quite quickly with a blow dryer or can be changed to a dry one after you shower.
After a spider vein treatment, you must immediately walk for ten minutes and wear your compression daily for 3 days. A daily half hour walk each day is also mandatory.
Q: What do I need to do to prepare for my appointment?
A: We recommend that you shave or clip any long hairs in the upper inner thigh to the groin to help the tape and dressings adhere to your leg post treatment.
We ask that you bring a pair of loose-fitting shorts with you that are loose enough for Dr. Kelleher to access your entire leg right up to the groin region.
You will need to bring your 30-40mmHg thigh high compression stockings with you to your appointment. If you do not have any, we are able to provide them to you at a charge of $160 per pair.
For spider vein treatments, we ask that you bring a pair of loose-fitting shorts, and some 20-30 mmHg stockings. If you do not have any stockings, they can be purchased for $120 per pair.
Stockings are prescription strength and covered by most insurance plans.
Q: What do I need to do after my foam echosclerotherapy (varicose vein) appointment?
A: After your foam echosclerotherapy treatment, you must go directly home and elevate your legs 12-16 inches for a period of 4 hours. During the 4 hours of elevation you must get up once every hour to go for a walk for 10 minutes and then relax back down and continue elevating. Once the 4 hours of elevating and walking are over, exercise your legs for 30 minutes. i.e.: a brisk walk or cycling and then you can continue about your day as usual.
If you live further than one hour away from our clinic, we ask that you have a driver to take you home as you must elevate your leg on the ride home.
Q: What do I need to do after my liquid sclerotherapy (spider vein) appointment?
A: You will need to wear 20-30mmHg thigh high compression stockings immediately after your treatment and daily for a minimum of 3-5 days post treatment. You will need to go for a brisk walk for 10 minutes immediately following your treatment. You can remove any dressings and cotton balls after 2 hours. Elevate your legs for 15 minutes 3 times daily for 3 days. We ask that you avoid strenuous activity for 3-5 days.
Q: Can I go swimming after my treatments?
A: If the dressing is still on, you cannot get it wet. Once the dressing is removed, you are can go swimming as long as you are wearing your compression stocking. Hot tubs and Jacuzzis are discouraged until after the 12 days of recovery.