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Comparing Leg Vein Problems to a House with Leaky Pipes

Veins, acting as “pipes,” have to frequently work against gravity to push blood back towards the heart especially when we sit or stand. These veins have valves that assist in the one-way flow back to the heart. Further, leg muscles especially calf muscles act like a pump much like a sump pump in our basement.

leg veins are like leaky pipes in a houseClick to view large image

Over time, compounded by factors such as genetic predisposition, pregnancies, hormonal changes, prolonged sitting or standing, lifting weights, and age, some veins fail. wrapping pipesUnable to move forward, blood begins to backtrack and pool in the legs causing the familiar symptoms of heaviness, achiness, and tiredness in legs, particularly in the evenings. Increased pressure on the vein walls makes them “gnarly” or varicose. Some veins that are close to the surface of the skin can be seen from the outside as ropy veins or spider veins.

Venous hypertension (increased pressure of the blood in failed veins) predisposes you to profuse bleeding. Elevated pressure causes fluid from veins to leak out into surrounding space much like flooding in our basement when a pipe breaks.

leakage flooding cartoonRemember that the blood in veins is deoxygenated (has “low” oxygen content) and replete with waste products. This blood needs to be sent back to the heart where it can be enriched and put back in circulation. When there is an increased buildup of venous blood in the legs, patients may notice itching, burning, leg cramps (charley horses), and restlessness. Persistent stasis (pooling) causes hyperpigmentation (discoloration of the skin due to deposition of the hemosiderin pigment from the breakdown of red blood cells), cellulitis (skin infection), thrombosis (blood clots), and poorly healing ulcers (sores) in the legs. This is comparable to staining on the walls from leaky pipes, growth of mold, cracks in the walls, and eventually its breakdown.

These unhealthy veins in the legs are unnecessary. In the past, they were removed surgically. Modern treatment options are much easier, safer, and very effective with no downtime. Almost all insurance including Medicare offers coverage for symptomatic varicose veins. Contact Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.

Confidential

Please describe your experience with us:

Front Desk staff:
Very helpful! I appreciate their kindness in helping me with the sign-in process.
Ultrasound Technologist:
Friendly & listens.
Provider/Doctor/Nurse Practitioner:
Great. Couldn't be nicer & explains everything exceptionally well.
Billing/Patient Account Services:
Never a problem.
What made you choose us?
I saw Dr. Gupta on Live-at-Five. When I walked in with leg issues, I was shocked the doctor took time right then to look at my legs. Didn't have to come back at another time..
What symptoms were you experiencing?
Bleeding from small areas where veins had surfaced.
How were you affected by your legs previously? What couldn't you do? How has that changed now?
They were always feeling heavy & aching. There was swelling of the ankles. Terrible restless legs at night. Then I started having the bleeding issues. That was my red flag! To get them treated.
What improvements have you seen in your legs?
No swelling of the ankles, no restless legs, no aching, no bleeding. All around better feeling, especially if I wear my compression hose.
Additional Comments: What did you appreciate? What makes us different than other medical clinics? What could we have done better to exceed your expectations? What changes would you like to see?
I appreciate when you come in for an appointment you don't have to sit in the waiting area. They take you to the room immediately. I love the inspirational videos playing instead of the TV blaring. Even though you play music, it's low enough so it's not irritating. I love your scheduling because you rarely ever see another patient. It's like you are the only one there.

Dad, I want a Charley Horse too!

My 9-year-old daughter recently had a major change in her career plans, from wanting to be a mermaid to being a Physician. I am still trying to find similarities between the two professions to better understand what led to this “slight” change in the career path for her. Some rightly said that children are like mirrors; they reflect all that they see and hear. Perhaps she sees the difference that our work has made in the lives of many including her teachers who came seeking care. I am certain that the stories of numerous patients have impacted her. For instance, hearing that several of my patients have “charley horses”, it was only natural for her to request one… “Dad, I would like one (charley horse) too!”

Although charley horse is a commonly used term for cramps in the leg, typically in the calf muscles, I was curious to learn about the origin of the term. There is a debate about the origin of the nickname. According to one source, there was a lame horse named Charley whose work was to help move things around a baseball park. The picture of the limping horse was so deeply entrenched in memories of the ballplayers that they started referring to each other as “charley horse” if they pulled a leg muscle or developed any minor impairment in their legs. Since the 1880s, the slang word lingered and is now commonly used to describe a sudden tightening or contracting sensation that lasts a few seconds to several hours and can be painful as well as debilitating.

charley horse cartoonThe dreaded charley horse is reported to affect up to 60 percent of adults who have reported the presence of nocturnal leg cramps in the form of a painful spasm, tightening of calf muscles, and twinges. Numerous causes of charley horses have been described in the medical literature including muscle fatigue, dehydration, mineral deficiency, and poor circulation (venous insufficiency).

During the initial stages, it is a good idea to gently massage the affected areas and use over-the-counter pain medication such as ibuprofen.

confuciusThere are some easy ways to help prevent charley horses including staying hydrated, eating a balanced diet, avoiding excessive sugars and caffeine, and avoiding overexertion.

There are numerous old wives’ tales about home remedies from drinking pickle juice, using quinine, to the use of a bar of soap under the bedsheet to fend off charley horses. There is scarce scientific data to back these claims. One Harvard study described an ion channel called TRPV1 that activates the spinal column and inhibits the firing of nerves to dull the pain of cramps. It is possible that the protons in pickle juice use this mechanism to help alleviate the discomfort. Remember that a mere 2 ounce shot of the juice may contain a few hundred milligrams of sodium, so anyone with heart disease, hypertension, or renal insufficiency should exercise caution. Quinine has potential side effects such as severe bleeding and heart arrhythmias. There does not seem to be any harm from using a bar of nice smelling soap if you have a strong urge to try it under your bedsheet. If nothing else, it will help your bed smell nice!

Having a magnesium, potassium, or calcium deficiency can contribute to leg cramps, however, your medical history must be taken into account before you consider using any over-the-counter supplements. It is always better to discuss with your Primary Care Provider to avoid any adverse interactions.

Although infrequent incidences of muscle spasms may not be anything to worry about, they are signs that the spasms might be more than a run-of-the-mill charley horse. Studies have shown that leg cramps at night are a very common manifestation of venous disease in the legs. Our veins are responsible for collecting de-oxygenated blood from the tissues and returning it to the heart and lungs, where the blood is replenished with oxygen and nutrients. Veins in the legs tend to fail more easily due to risk factors such as genetic predisposition, prolonged sitting or standing, pregnancies, and age. When some veins fail, the blood cannot flow through them effectively and starts pooling in the legs. In face of compromised blood flow, calf muscles are not able to function appropriately and cause cramps (charley horses) and restlessness (Restless Leg Syndrome).

CHARLEY HORSE

WHAT IS IT?

WHO GETS THEM?

A "charley horse" is another term for a muscle spasm or cramp in the leg. While cramps can happen in any muscle, charley horse is most commonly noted in calf muscles and feet.

Anyone can develop a charley horse, however, according to the National Institute on Aging, not drinking enough water, poor muscle conditioning, and certain medications are factors that make people more susceptible to getting a charley horse as they age.

WHAT TO DO?

There are a few ways you can ease the pain from your charley horse. Drinking electrolytes and stretching can help to keep your muscles loose, as well as trying to take breaks from sitting for long periods of time. Applying an ice pack for 10-15 minutes following strenuous exercise can also calm down muscle tension.

If you are experiencing muscle cramps regularly, it may be a sign of blood flow in your legs due to veins that have failed. Call us for a free consultation. Your Vein Specialist will ask you some questions and likely check the blood flow using ultrasound.

Remember that vein problems in the legs affect more than half of adults. In addition to leg cramps, you may notice heaviness in your legs, tiredness, itching, burning, restlessness, or leg swelling. The affected veins are typically deep inside the legs, hence you may not see them on the skin surface.

Left untreated, blood flow in the legs continues to worsen. Varicose veins and venous insufficiency may lead to blood clots, discoloration of the skin, sores that do not heal well, bleeding veins, and frequent skin infections.

Modern treatments are minimally invasive with minimal to no pain, no downtime, and almost all insurance companies offer coverage for symptomatic venous problems.

I cannot emphasize enough the seriousness of repetitive muscle cramps. One of our patients, Sandra Dyer, has graciously shared her story. She and her husband came to us looking for answers after three visits to the hospital for severe leg cramps.

Like most chronic conditions, left untreated, the diseased (varicose) veins continue to worsen and may cause other complications such as swelling, skin discoloration, blood clots, poorly healing sores, infection, or bleeding.

Using modern technology, we are now able to easily seal the diseased veins with help of endovenous laser ablation, allowing you to return to normal activities, without any downtime. Treatment of symptomatic venous disease is typically covered by most insurance companies including Medicare and Medicaid.

If “charley horses” are visiting you at night, call 816-396-0245 to get back in the saddle or schedule a Consultation today.

venous anatomy of the legsClick to view large image

Signs and Symptoms

Signs and Symptoms

During the initial stages of varicose veins, patients usually have mild symptoms, which are experienced more toward the end of the day. The onset of symptoms is often very subtle, so much so that many people forget how their legs felt before they had problems. As the condition worsens, symptoms become more noticeable.

The initial signs and symptoms may include:

  • Aching
  • Burning or numbness
  • Cramping or 'Charley horse'
  • Heaviness
  • Itching
  • Leg pain
  • Restlessness in legs
  • Tiredness
  • Swelling in feet ankles and calves

  • Left untreated, may result in skin discoloration, bleeding veins, sores that heal poorly, and blood clots.

Over time, the symptoms will worsen and could result in skin discoloration, sores, blood clots, frequent skin infections, and bleeding.

It might be surprising to learn that restless leg syndrome, leg cramps, swollen ankles, ulcers, varicose veins, and spider veins could all be symptoms of vein disease. We've helped thousands achieve relief with in-office treatments.

Schedule your Consultation today with Alsara Vein Clinic.

Iceberg Phenomenon of Varicose Veins

Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

Signs & Symptoms Menu

Varicose Veins in Men

– and bikini contests!


Where did summer go? It seems like only yesterday the snow had finally melted, after a prolonged winter, and here I am talking about fall. In fairness, this summer was an extraordinarily busy time for us at Alsara Vein Clinic. We saw more new patients in July than any other month in the past. Every one of my staff members worked extra, long hours to ensure each patient received top-notch care, even in the face of increased patient volume and the numerous urgent requests to see a patient the same day.

happy old man cartoon 2I am humbled by both the confidence that numerous referring providers have in our care and the trust of patients who refer family and friends. For example, Jim*, a 76-year-old gentleman, came to Alsara Vein Clinic after exhausting all options at hospitals and other clinics in the area. With a tracheostomy collar in place, he was unable to talk and breathe at the same time, yet he had much to discuss. After providing his medical history, he cleared his “airway trash”, drew a deep breath, and concluded by saying, “I am hanging by the last straw. My neighbor across the street advised me to come to you. You took care of him when he had no hope that anything could be done.” Since then, the topic of his conversation has been anything but medical. Taking swift breaks to inhale, he seemed more interested in talking about his friends, family and his many aspirations although, as he politely stated, “I realize that I won’t be able to participate in a bikini contest anytime soon!”

Later that week I saw Tom**, a 58-year-old, who had avoided seeking care as he was sure that leg amputation was going to be the only option available, given the advanced stage of chronic venous insufficiency in his leg. It seems that every clinic day has its fair share of patients with swelling, severe leg cramps, and restlessness. We also see many male patients with clots, bleeding, and poorly healing sores in their legs, all of which are features of advanced, chronic venous insufficiency.

A detailed duplex ultrasound scan (Mapping) provides us with a “road map” of all the key veins in the legs. The goal of every treatment modality is to get rid of the underlying varicose veins and restore proper blood flow by routing blood to the healthy veins. The new, modern, minimally invasive treatments allow us the opportunity to eliminate the diseased veins safely and effectively with very little downtime; these are also much safer than surgeries used in the past. Over the last 10 years, further advancements have occurred in our understanding of venous diseases and the options available to treat them. For instance, the latest 1470 nm laser used at Alsara Vein Clinic offers a 40-fold improvement in energy absorption, compared to older generation lasers, resulting in even less bruising and discomfort. All treatments including Endovenous Laser Ablation and Ultrasound Guided Sclerotherapy are performed in the comfort of the office setting and patients can resume normal activities immediately.

I feel very fortunate for the technology and scientific knowledge backed by the experience of successfully treating thousands of patients over the past decade. Although participating in a bikini contest is not completely ruled out for Jim*, I suspect that he will put his legs to much greater use in the years ahead!

Concerns about your legs? Call Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.

sam gupta signature

Sam Gupta, MD, MPH

* Jim is an actual patient of Alsara Clinic and has graciously given permission to use his quotes, story and images.
** Tom – his name changed to protect confidentiality.