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Gray hair and occasional memory loss may be a normal part of aging, but is living in pain also part of getting older?  I have often wondered if this topic has been researched adequately.  I see many patients who report aches and pains that they have come to accept just because of getting older.

It is true that wear and tear of our joints in the knees, hips, and feet can lead to occasional aches and pains. This is different from chronic pain that is defined as pain experienced daily for over six months.  Yet, according to the National Institute of Health (NIH), fifty percent of seniors who live at home say they suffer from chronic pain. The Center for Disease Control and Prevention (CDC) reported that three-fifths of adults, 65 years and older, have pain that has lasted one year or longer.

A recent patient of mine, Pam, has lived with swelling, pain, and restlessness in her legs for several years. She loves to spend time with her three grandchildren including her beautiful 16-month-old granddaughter, Adeline.  She reported that her legs hurt at different times throughout the day and her ankles would swell up.  She would take breaks to elevate her legs and move them “back and forth” to alleviate the discomfort that was both debilitating and disruptive.   It turns out that Pam had varicose veins that were causing the pooling of blood in her legs.  A simple office-based procedure using laser restored function and eliminated the chronic pain in her legs. There was no downtime or restrictions, so she returned to caring for her grandchildren immediately following her one-hour procedure.

Modern science and medicine have enabled countless seniors to live free from disease and chronic pain while also prolonging their lives.  However, research has demonstrated that factors such as socializing and relationships are equally important factors for longevity and quality of life.  A small town in Southern London put this finding to test and combined one of the largest retirement homes with a nursery school. This project not only helped bridge the age divide but also infused a new wave of energy, with improved levels of functioning in the elderly who had advanced stages of dementia and physical limitations.

Life expectancy is higher than ever before and an estimated 10,000 people turn 65 each day. While love, family, and our relationships are essential parts of life, chronic pain does not have to be part of our beautiful journey on this planet. Call Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.

Sam Gupta, M.D.

Blood Clots & Varicose Veins - 5X Higher Risk

• VEIN DISEASE - OVERVIEW
• Varicose Veins
• Chronic Venous Insufficiency
• Blood Clots
• Spider Veins
• Restless Leg Syndrome
• Edema (swelling)
• Infection / Leg Ulcers
• Neuropathy

Read More about Potentially Deadly Blood Clots

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Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

New research published in the New England Journal of Medicine shows that the respiratory virus SARS-CoV-2, which causes COVID-19, is also responsible for severe damage to blood vessels increasing the risk of blood clots. One Amsterdam study found that almost one-third of patients hospitalized with severe COVID-19 demonstrated complications from blood clots.

A blood clot is a clump of blood formed when blood changes from a liquid to a thicker gel-like state. Ordinarily, this can be a life-saving mechanism to help stop bleeding; however, when the clot breaks off, it can travel through the bloodstream choking the supply of blood to essential organs such as the lungs (causing a Pulmonary Embolism) or the brain (causing a stroke).

Patients admitted to the hospital are more likely to have blood clots in the blood vessels of the legs due to immobility while hospitalized. Staying active, use of compression stockings, sequential compression devices, and, in select cases, the use of blood thinner can help lower the risk of clots.

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COVID-19 Blood Clots

There are also reports of blood clots in patients with COVID-19 who are at home and staying active. Swelling in the legs is the most common sign of blood clots. Some patients with COVID-19 develop a condition called “Covid toes” – red, swollen toes that may be due to small clots in the blood vessels of the feet.

If you have leg swelling, pain in the legs, or any other sign of a blood clot, please call us at 816-396-0245 to have a duplex ultrasound screening test for blood clots. This is performed in the comfort of the office setting at Alsara Vein Clinic.

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Alsara Vein Clinic - St. Joseph, MO

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.

The 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.

There 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).

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.

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Leg Pain and/or Restless Legs Syndrome is a very common symptom of deeper vein problems. We've helped thousands achieve relief.

Even if you cannot see any visible or bulging varicose veins, your ongoing leg pain and/or restless legs syndrome may still be due to venous insufficiency. Other symptoms may include heavy legs, aching legs, tired legs, burning sensation in legs, itching, leg cramps or "charley horse", leg inflammation, swelling feet or ankles, skin discoloration, sores that heal poorly, skin ulcers, bleeding, even blood clots.

An estimated 60% of women and men suffer from vein disease.

How can I know if this is my problem?

We offer Consultations with a Board Certified Provider. They will visually examine your legs, evaluate your symptoms, answer any questions you may have, and determine whether an ultrasound "mapping" of your leg veins is necessary.

Ultrasound scanning is done in the office, is pain-free, and the results are available immediately. The Phlebologist (leg vein specialist) will perform a detailed examination, make a diagnosis, and then will discuss with you the best treatment options. Treatment is designed for each patient based on the results of the examination and ultrasound scan. Every patient is different, so an individualized treatment plan is essential.

How are varicose veins treated?

Fortunately, the days of painful vein stripping are over. Now, the treatments available are much safer, more effective, and patients are able to resume activities right away. We offer several minimally invasive, non-surgical, in-office procedures to ensure immediate and long-term results, including EVLA (Endovenous Laser Ablation), USGS (Ultrasound Guided Sclerotherapy), VenaSeal Closure System, and Microphlebectomy.

Leg problems don't wait – why should you?

If you're concerned about leg pain, endure leg pain or restless legs at night, or just wonder what is causing your lower leg pain or restless legs, claim your Free Consultation today and/or request an emailed informational brochure.

About Alsara Vein Clinic and Dr. Sam Gupta

Your Vein Specialist, Sam Gupta, M.D., M.P.H. completed his medical training at the Mayo Clinic and Masters in Public Health from Harvard University. He is one of the 795 Vein Specialists in the nation certified by The American Board of Venous & Lymphatic Medicine. He has devoted his career solely to the diagnosis and management of the entire spectrum of vein disorders. Alsara Vein Clinic is focused on varicose vein treatment and serves the greater northwest Missouri area. Many patients who have come to us with symptoms of leg pain and restless legs have found lasting relief with our virtually pain-free in-office varicose veins treatment. We offer Consultations, no referral necessary.

Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

Veins are all we do, all day, every day. We've treated over 12,000 patients, many of whom sought relief from leg pain and/or restless legs and had no idea what was causing it.

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Neuropathy in Legs? – Could be due to failed veins

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Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

• VEIN DISEASE - Overview
• Varicose Veins
• Chronic Venous Insufficiency
• Blood Clots
• Spider Veins
• Restless Leg Syndrome
• Edema (swelling)
• Infection / Leg Ulcers
• Neuropathy

President Donald Trump was recently diagnosed with Chronic Venous Insufficiency (CVI). His diagnosis has sparked renewed interest in this common yet often overlooked condition. Many patients are now asking important questions: What is CVI? Is it serious? Who gets it? How is it treated? Let’s dive right in.

What is CVI?

Chronic Venous Insufficiency (CVI) is a medical condition in which the veins in the legs don’t function properly, making it difficult to pump blood back to the heart. This leads to circulation problems and a variety of leg symptoms.

In the early stages, symptoms may be subtle such as heaviness, fatigue, aching, throbbing, itching, or burning in the legs. As the condition progresses, due to inadequate blood flow to calf muscles patients may experience leg cramps (often called “Charley horses”) or restlessness at night (Restless Leg Syndrome).

Without treatment, CVI can worsen and lead to leg swelling, skin discoloration, bleeding varicose veins, recurrent skin infections, blood clots and poorly healing sores (ulcers)

How Common is CVI?

CVI is extremely common, affecting 10–35% of adults in the U.S. Both men and women are at risk, but women often develop symptoms earlier due to pregnancies and hormonal changes. In fact, nearly 40% of women over age 50 have some degree of CVI.

Risk factors include family history of vein disease, age and prolonged standing or sitting

Treatment of CVI

In the past, treatment for CVI often required invasive vein stripping surgery in a hospital, followed by a long and painful recovery. Thankfully, modern medicine has transformed vein care.

Today, CVI can be treated in the comfort of an office setting with minimally invasive procedures. Diseased veins are safely closed, restoring healthy circulation. Patients typically return to normal activities immediately with no downtime, and minimal discomfort. Many notice improvements in their legs as soon as the next day.

A quick, painless duplex ultrasound can diagnose CVI, and your vein specialist will review personalized treatment options. Almost all insurance plans including Medicare cover treatment of symptomatic vein disease.

Call Alsara Vein Clinic today at 816-396-0245 for a Consultation. We offer same-day appointments.

Restless Leg Syndrome

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Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

• VEIN DISEASE - OVERVIEW
• Varicose Veins
• Chronic Venous Insufficiency
• Blood Clots
• Spider Veins
• Restless Leg Syndrome
• Edema (swelling)
• Infection / Leg Ulcers
• Neuropathy

Many patients now recognize that varicose veins may not be visible from the outside. Most of our patients report experiencing tiredness, cramping (charley horse), restlessness, or swelling in the legs. Those whose condition has not reached one of the advanced stages often wonder if they are at increased risk of anything that could be limb or life-threatening.

Click to Play Video

At least one-third of our patients clearly have signs of advanced venous insufficiency – when varicose veins have progressed to a point where the chronic pooling of blood (stasis) in the legs causes skin changes. They may notice skin discoloration, thickening or hardening of the skin, recurrent skin infections, bleeding that can be profuse, and poorly healing sores in the legs. In addition, varicose veins may be an early warning sign of potentially deadly blood clots.

We routinely see patients with blood clots. Some are referred by their primary care providers and others present themselves with concerns about blood clots. Yet there are many patients who are surprised to find that they have a blood clot when we examine them using duplex ultrasound.

Introduction

Restless Leg Syndrome (RLS) is characterized by an irresistible urge to move the legs to alleviate discomfort, ranging from aching and throbbing to itching and crawling sensations.² Articulating these sensations can be challenging for some patients.

Who gets it?

Initially documented in 1945, RLS, also known as Willis-Ekbom disease³, was reported to affect around 5% of the population. Recent studies, however, indicate a prevalence ranging from 3% to 15%. It tends to occur more frequently in women, with a nearly 2:1 female-to-male ratio. As age advances, there is a positive correlation with RLS prevalence. Genetics plays a role, as up to 25% of first-degree relatives of individuals with RLS report similar symptoms.⁴

Connecting Varicose Veins and RLS

Even in the 1940s, when Restless Leg Syndrome (RLS) was first identified, Dr. Ekbom suggested that venous disease could be a potential cause. However, it took around fifty years to firmly establish this connection. A groundbreaking 1995 study published in the Journal of Dermatologic Surgery treated 113 individuals with restless legs and ultrasound-confirmed vein disease using sclerotherapy.⁵ Surprisingly, 98% of participants reported immediate relief. Subsequent studies have consistently supported this link, uncovering RLS symptoms in individuals with primary and recurrent varicose veins¹. Addressing superficial venous insufficiency has proven effective in alleviating RLS symptoms for most patients. Nonetheless, it's essential to acknowledge that certain conditions, including iron deficiency anemia, pregnancy, kidney failure, various neurological conditions, and specific medications, can also contribute to RLS symptoms.

Explaining the connection

Impaired venous blood return in the legs, particularly in chronic venous insufficiency (CVI), may drive the subconscious urge to move the legs (RLS), forcing you to use your muscles that help pump blood back to the heart. Inflammation associated with CVI could lead to overactive nerves, intensifying the situation. Nighttime leg cramps and pain, often linked to varicose veins, can further disrupt sleep, aggravating leg restlessness.

Determining if Varicose Veins might be responsible for Restless Legs

A straightforward and noninvasive duplex ultrasound in your Vein Specialist’s office can identify any underlying venous issues. The Vein Specialist will review a treatment strategy if venous insufficiency is found. Typically, the affected veins are closed using one of the FDA-approved treatment modalities to reroute blood flow through healthier veins.⁶

Conclusion

Restless Leg Syndrome (RLS) is a common issue often linked to varicose veins. You might also be encountering other symptoms of varicose veins and associated venous insufficiency, including sensations of heaviness, fatigue, aching, cramping, and swelling in the legs. If left untreated, the condition can worsen, leading to potential complications such as blood clots, bleeding, frequent skin infections, and slow-healing sores. Medications for RLS, such as Ropinirole and Pramipexole, may mask the symptoms without addressing the underlying problem. Reach out to Alsara Vein Clinic at 816-396-0245 for a complimentary Consultation.

Take the initial step towards relief and an improved quality of life.

1. Restless legs syndrome symptoms in primary care: a prevalence study. Nichols DA, Allen RP, Grauke JH, et al. Arch Intern Med. 2003;163:2323–2329
2. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology:Sleep Med. 2003;4:101–119. 
3. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria Sleep Med. 2014;15:860–873. [
4. Treatment of Leg Veins for Restless Leg Syndrome: A Retrospective Review, Swaminathan et al, Cureus 2019
5. The effect of sclerotherapy on restless legs syndrome Dermatol Surg 1995 April 21 
6. The effect of endovenous laser ablation on restless legs syndrome Hayes et al Phlebology June 2008

Sclerotherapy Treatments

Varicose Veins Treatment using Varithena^®

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• VEIN TREATMENT - OVERVIEW
• Varicose Vein Treatments
• – Laser
• – VenaSeal
• Sclerotherapy
• – Varithena
• Spider Vein Treatments
• Microphlebectomy

Many patients now recognize that varicose veins may not be visible from the outside. Most of our patients report experiencing tiredness, cramping (charley horse), restlessness, or swelling in the legs. Those whose condition has not reached one of the advanced stages often wonder if they are at increased risk of anything that could be limb or life-threatening.

At least one-third of our patients clearly have signs of advanced venous insufficiency – when varicose veins have progressed to a point where the chronic pooling of blood (stasis) in the legs causes skin changes. They may notice skin discoloration, thickening or hardening of the skin, recurrent skin infections, bleeding that can be profuse, and poorly healing sores in the legs. In addition, varicose veins may be an early warning sign of potentially deadly blood clots.

We routinely see patients with blood clots. Some are referred by their primary care providers and others present themselves with concerns about blood clots. Yet there are many patients who are surprised to find that they have a blood clot when we examine them using duplex ultrasound.

Blood clots are far more common than most people think. Serena Williams and Hillary Clinton are among the dozens of celebrities who have suffered consequences due to blood clots. James “Jimmy” Stewart from the movie It’s a Wonderful Life and NBC journalist David Bloom lost their lives from blood clots. David Bloom’s wife, Melonie Bloom, has devoted her life to raising awareness of thrombosis.

The association between varicose veins and deep vein thrombosis (DVT) was demonstrated in a landmark Taiwanese study published in JAMA (Journal of the American Medical Association). Reviewing the health records of over 425,000 adults, the study found a higher rate of pulmonary embolism (when a blood clot in the leg breaks off and travels to the lung) and peripheral artery disease in patients with varicose veins.

• Varicose veins increase the risk of deep vein thrombosis (DVT) by five times
• DVT is a clot in the legs, which can lead to amputation or even death
• Varicose veins make people twice as likely to develop a pulmonary embolism
• Varicose veins double the risk of peripheral artery disease, which reduces blood flow

Varicose veins are veins with weakened walls that fail and cause pooling of blood in the legs. Patients with varicose veins are known to have increased levels of inflammatory and pro-thrombotic markers. These patients have a considerably high risk of forming blood clots in their legs.

Not all clots are serious, but they often tell us about an underlying problem such as impaired blood flow that can lead to greater problems down the road. As Dr. Chang, the lead author of the Taiwanese study stated, “varicose veins deserve careful monitoring and early evaluation”.

Call us at 816-396-0245. We are here for you.

Unhealthy veins are like weeds in a garden

Left untreated, they continue to worsen and turn into a serious problem.

Maybe you’ve seen the blue or purple squiggly veins on your legs that look like lines on a roadmap and wondered how to get rid of them. Maybe you are experiencing pain, cramps, restlessness, or have sores on your legs, and you were told by your Primary Care Provider that you have varicose veins. Perhaps you wondered “What the heck are varicose veins anyway” and “How do I get rid of them?”

What is a Varicose Vein (and CVI)?

In simplest terms, varicose veins are faulty blood vessels that have become overstretched and swollen with blood.

When your heart beats, it pumps blood through arteries to every part of your body carrying oxygen and essential nutrients. Since you have a limited amount of blood (about 5 liters in an adult), the deoxygenated blood returns to the heart via countless veins in your body. The veins in your legs are farthest from the heart and must work against gravity to push blood back to the heart. Compounded by other risk factors, some veins wear out over time and become “varicose”. The pooling of blood in varicose veins may cause symptoms such as heaviness, tiredness, itching, burning, cramping, restlessness and pain. Left untreated, the increased pressure of blood in the leg veins can leak out, causing problems such as edema, skin discoloration, sores in legs that heal poorly, and frequent skin infections. This condition is called Chronic Venous Insufficiency (CVI).

Who gets them?

Although varicose veins affect both men and women, they are slightly more common in women who tend to have them at an earlier age. This may also have to do with the fact that men are less inclined to seek timely medical care. Hence, it is not a surprise that men have more advanced stages of varicose veins and CVI by the time they see a vein specialist compared to women. People in general are more likely to get them as they get older.

Frequently there is a genetic predisposition to vein problems. That means that if your mom or your sister has them, you are more likely to also have them. Things that put pressure on your legs and feet — like being overweight or standing for a long time, every day, without exercise — can also cause varicose veins. Pregnancies also make veins worse due to increased pressure of the uterus and the extra blood volume.

Do I need these veins?  How do I get rid of them?

Once a vein is varicose, it is a diseased blood vessel much like a “weed” in your yard. Just like weeds compete for space and nutrients in your yard (and are formidable competitors!), varicose veins have weakened walls that facilitate easy entry of blood but instead of pushing the blood back in circulation, the blood tends to pool in them causing a wide variety of problems including life-threatening blood clots.

In the past, varicose veins were “stripped” much like pulling weeds from the yard. This was a painful, imprecise, and invasive surgery with significant downtime, scarring, and risk of complications. Even worse, many patients required additional treatment due to other veins rapidly becoming varicose.

In the last 15 to 20 years, our increased understanding of venous disease, modern tools available for accurate diagnosis, and minimally invasive treatments have revolutionized how we treat vein problems in legs. After your vein specialist has performed a detailed ultrasound scan of your legs, he/she will create a “road map”. Then, using tools such as Endovenous Laser Ablation (EVLA), your Vein Specialist can seal the underlying varicose veins at their source, much like closing the large root of weeds from the inside. Any smaller, persistent veins can then be treated using injection sclerotherapy that is analogous to using a weed killer in your yard. Some unsightly varicose veins are removed by microphlebectomy, the careful removal of unwanted veins through tiny openings using very fine instruments without the need for sutures or risk of scarring.

Current treatments are very safe, effective, and provide long-lasting relief without any downtime or painful recovery. Since varicose veins and CVI are serious problems, almost all health insurance companies, including Medicare and Medicaid, offer coverage for necessary scans and treatments.

Contact Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.