Many years ago I had a blood clot (DVT) in my left leg. My leg on that side has always been a little swollen since then. More recently the skin around the ankle has developed small veins, feels thicker, and is getting dark in color. Are these changes related to varicose veins?
Q : I have a family member who had vein stripping years ago. I don't want that surgery.
A : Years ago vein stripping was one of the few surgical options for varicose veins. Fortunately, vein stripping is rarely needed with today’s modern varicose vein treatments. The vast majority of vein treatments are done in our office and do not require general anesthesia. Afterwards, most patients are pleasantly surprised at how comfortable they are throughout the treatment and can immediately resume normal activities.
Q : Will my insurance cover varicose vein treatments?
A : Most insurance policies do have coverage for varicose vein treatments, but it does depend on the patient and the insurance company. During your initial visit we will document your varicose vein history and perform a physical exam relevant to your varicose veins. In most cases we will obtain an ultrasound exam of your legs to identify veins that are not functioning correctly. We then contact your insurance company to obtain pre-authorization for any planned treatment. We have extensive experience and are familiar with the most common insurance companies in Montana. Before any treatment you will know what is covered by your insurance.
Q : What can be done about my spider veins?
A : Traditionally, sclerotherapy (vein injections) is used to treat spider veins. In some cases a laser or pulsed light treatment is also an option. During your initial visit we will determine if your spider veins represent a local problem or if they might be related to other veins that are not functioning appropriately. Following that we can develop a treatment plan specifically for your veins.
Q : Isn’t varicose vein treatment considered cosmetic?
A : Not necessarily. It is common to get symptoms of leg discomfort from varicose veins. In addition, varicose veins generally get bigger and more numerous over time. Less commonly, complications can happen because of untreated varicose veins (superficial blood clots and skin inflammation or ulcers). And while most people appreciate the improvement in the appearance of their legs after treatment, many people seek treatment for relief of symptoms. This is different than having treatment solely to improve the appearance of your legs.
Q : I’ve heard that after vein treatment that my veins will just come back.
A : It is true that there is no ‘cure’ for varicose veins. However, current varicose vein treatments are more effective than ever. The use of ultrasound to identify veins under the skin and the minimally invasive laser technique are two examples of newer technology that makes today's vein treatments superior to the larger vein operations which were common years ago. After treatment, regular use of graduated compression stockings is another way to help prevent against the formation of new varicose veins. Other recommendations for healthy legs include regular exercise (at least 30 minutes a day, 5 times a week) and maintaining a proper weight.
Q : Is treatment painful? Do I need anesthesia?
A : Nearly all treatments are performed in our office and require only local anesthesia. Local anesthesia is medicine which numbs an area so you do not feel pain. It is given only at the site of the procedure. Many patients are anxious about the discomfort they might experience, but most are pleasantly surprised at how little pain they feel. In fact, we have even had some patients fall asleep during the treatment! General anesthesia (bring completely asleep for a procedure) was necessary for older vein stripping operations, but is not necessary with today’s minimally invasive outpatient vein treatments.
Q : What is it like after treatment?
A : In general, discomfort after treatment is minimal. Some people describe soreness in treated areas that feels like a bruise. It is uncommon to need anything stronger than over the counter pain relievers. If discomfort occurs it can last for a few days to a week. Walking, low impact exercises, and stretching are encouraged starting the day of treatment and help people get better faster. Strenuous activities should be avoided for two weeks, but after that there are no restrictions.
Q : Do I need a referral? How much will the initial evaluation cost?
A : The Montana Vein Clinic does not require a referral for evaluation of your varicose veins and, in most cases, insurance companies do not require a referral from a primary care provider. Your cost for the initial evaluation will depend on your insurance plan, your co-pay, and the deductible. Please feel free to call us for more information about costs and charges.
Q : Do you offer free consultations?
A : Montana Vein Clinic does not offer free consultations. However, for those who would like more information about varicose vein treatment or leg health in general an informal discussion with one of our experienced nurses can be done over the phone. We are happy to answer questions regarding compression stockings, go into greater detail about the usual steps required before and after treatment, and to address financial or insurance concerns. Please call (406) 414-5037 for more information.
Q : How do I schedule an appointment?
A : Its easy – call (406) 414-5037 and ask to schedule an appointment with Dr. Grace at Montana Vein Clinic. This is the central office number for both Montana Vein Clinic and Montana Surgical Clinic, where all his appointments are coordinated.
Q :I had vein surgery at a clinic several years ago and now my veins are coming back. Can you do anything?
A : In most cases the answer is yes, but it does depend on what has been done and what the veins look like now. A thorough ultrasound exam is especially important in people who have had prior vein surgery or procedures. Ultrasound allows for evaluation of previously treated veins, looks for new veins that may have developed, and provides the roadmap for any additional treatment.
Q : Many years ago I had a blood clot (DVT) in my left leg. My leg on that side has always been a little swollen since then. More recently the skin is around the ankle has developed small veins, feels thicker, and is getting dark in color. Are these changes related to varicose veins?
A : Leg swelling and skin changes after a blood clot in the leg can represent a significant underlying problem with the vein circulation. Even if the blood clot was a long time ago the damage to the veins persists and problems can manifest years later. If untreated, skin changes from underlying venous insufficiency can progress to skin ulcers. Evaluation is warranted, preferably at a vein treatment center that can perform advanced venous imaging and has the ability, if necessary, to perform interventional procedures on the deeper veins of the leg. Hospital affiliated vein clinics are most likely to have these capabilities. Free-standing vein clinics, especially those limited to just ultrasound for diagnosis, often cannot thoroughly evaluate or treat this type of advanced venous disease.