Seek treatment early Small procedure for better quality of life
OUR heart pumps oxygenated blood to the body through arteries and takes the deoxygenated blood back via veins. When the venous walls or valves in the vein are defective, a condition known as chronic venous insufficiency occurs. If this happens in the legs, it leads to the formation of varicose veins.
Dr Tan Kia Lean, consultant vascular surgeon at Ara Damansara Medical Centre, explains that varicose veins generally occur in the legs as the body needs to work harder against gravity to send blood from the legs back up into the heart. “The body uses your calf muscles to pump blood back into the heart. When we move around, the muscles squeeze and relax, slowly pushing the blood upwards. To prevent blood from flowing backwards when the muscles relax, valves are located in various parts of the veins to stop the backward flow of blood.”
However, when the valve malfunctions, blood will leak through the valve. The blood will then accumulate and cause the vein to swell. It becomes a vicious cycle – when the vein swells, the opening of the valves enlarge which exacerbates the issue. If treatment is delayed, the subsequent valves in the vein will slowly become damaged. It can spread to the rest of the leg; for example, from the upper thigh to the middle thigh, calf and then the ankle.
More common than expected
There are many causes for varicose veins – some people may have dilated veins or defective valves from birth, while others may be caused by external injuries that affect the veins. There are cases where the cause is unidentified, too.
Varicose veins is a very prevalent disease. It is two times more prevalent than coronary heart disease, and five times more than peripheral arterial disease, which is where the artery malfunctions. However, because varicose veins do not cause problems for most people, Dr Tan says most people ignore it until the symptoms get worse.
He notes women are prone to varicose veins partially because of the wearing of high heels and pregnancy, which are risk factors. However, the prevalence of varicose veins for both men and women above the age of 70 are equal as they are mostly caused by degenerative changes in the body where tissues become lax and the veins are easily dilated. Prevalence is also almost equal across all ethnicities.
Renewed hope with medical advancements
Varicose veins are generally found in the middle of the thigh or the calf. Nevertheless, Dr Tan states 20% of varicose veins occur in other parts of the body. Potential sites of varicose veins are the perineum, pelvic area, buttocks and many more. He says, “Not every varicose vein can be seen easily, so we will need to identify its source before determining the method of treatment.”
Medical advancements have transformed the way varicose veins are treated now in comparison to two or three decades ago. The advent of minimally invasive surgery has shifted medical recommendations as they are quite easily performed, quick, and painless.
Dr Tan says, “Back then, we did not have such advanced modes of surgery, so you had to wear compression stockings for life to avoid the progression of this condition. With minimally invasive surgery, the outcomes are better and the problem will not recur. Hence, the first line of treatment now is through minimally invasive surgery.” Mainly diagnosed in clinical visits, the diagnosis of varicose veins is now paired with ultrasound to locate the source of the problem and to determine the method of treatment.
To prevent and avoid the progression of varicose veins, Dr Tan advises people to:
• Control your weight – Being overweight adds pressure on your veins • Do light to moderate physical activities – Varicose veins are caused by long hours of standing and walking, so one must strive to be active
• Avoid wearing high heels – High heels restrict blood flow as it keeps your calf muscles contracted
• Have adequate leg rest – After a long day of standing or walking, Dr Tan recommends to rest your legs in a raised position
• Wear compression stockings – If your job requires you to walk or stand for long hours, compression stockings can make your legs feel more comfortable and prevent varicose veins
It is crucial for people to know when to seek medical help should they experience varicose veins symptoms.
Past generations would refrain from treating varicose veins as it is not life-threatening and medical technology was inadequate. However, Dr Tan advises earlier treatment if you suspect you are in the early stages of varicose veins. “Do not wait until symptoms start to cause complications and the condition becomes more difficult to treat. It is also better to practise prevention methods before the issue develops.”
He opines that modern society is no longer similar to the time when people would prioritise supporting the family more than their own health. Instead, quality of life is the main focus for many now.
He gives an example, “If you let your varicose veins fester into ulcers, you will have to constantly bandage your legs, and the smell of ulcers is not pleasant. So, when you go out with your friends, you may feel embarrassed or feel judged when people around you are subject to the sight or smell of your legs. The bandaging and cleaning of your leg is not convenient, either. These can all be corrected and you don’t have to live like that if you get treated earlier.”