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.
Detailed scan for Deep Vein Thrombosis (DVT) as well as Superficial Vein Thrombosis (SVT)
The best test currently available for thrombosis (clot) in the legs is a color flow duplex ultrasound. At Alsara Vein Clinic, we utilize very high-resolution ultrasound capable of diagnosing clots in even the smaller deep veins in the calf.
Dr. Gupta is certified by the American Board of Venous and Lymphatic Medicine. All clinical staff has specialized education and training for the management of venous diseases including all types of blood clots. Urgent Care centers, Primary Care Providers, Patients, and their relatives routinely call us for same-day appointments.
At Alsara Vein Clinic, we treat vein problems all day, every day. Unlike duplex ultrasound performed at an Emergency Room that focuses only on deep vein thrombosis (DVT), we check for DVT and SVT. Do not let yourself or your loved one be another victim of an undiagnosed dangerous blood clot.
Superficial Thrombophlebitis and Deep Vein Thrombosis (blood clots) are other potential complications from varicose veins.
Varicose veins are prone to developing Superficial Thrombophlebitis (SVT) as well as Deep Vein Thrombosis (DVT). Superficial Thrombophlebitis is characterized by redness of the skin, tenderness, and pain along the affected superficial vein just below the skin surface. As opposed to deep veins, blood clots in the superficial veins are less severe and generally do not break off and go to the lungs.
Deep Vein Thrombosis or DVT on the other hand is a more severe condition. The vein in the leg still becomes inflamed and forms a blood clot. However, Deep Vein Thrombosis has the potential to cause a “pulmonary embolism” – a potentially life-threatening condition – if the clot breaks loose and travels to the right side of the heart and eventually migrates to the lungs.
Embolism: a blood clot that travels from the site where it was formed
Thrombus: a blood clot that forms in a vessel
Deep Vein Thrombosis (DVT): 5 X higher risk of DVT in people with Varicose Veins
Pulmonary Embolism (PE): blood clot travels through the heart and blocks a blood vessel in the lung
Peripheral Arterial Disease (PAD): 1.7 X higher risk of Pulmonary Embolism (PE)
A landmark study was published in JAMA, a very reputable medical journal, that demonstrated how people who have varicose veins have five times (5X) higher risk for clots in the deep veins that can be potentially fatal. Those blood clotscan take off and get lost in areas like the lungs and cause conditions like Pulmonary Embolism.
In the initial stages of varicose veins, people may only see some spider veins or ropey veins, and sometimes there are no visible veins. You may have pain, heaviness, tiredness, restless legs, leg cramps, etc. More advanced stages are when you have skin changes, discoloration, bleeding, ulcers that are slow to heal, and blood clots.
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.
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.
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.
Over time, compounded by factors such as genetic predisposition, pregnancies, hormonal changes, prolonged sitting or standing, lifting weights, and age, some veins fail. Unable 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.
Remember 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.
Veins are “pipes” that are responsible for returning blood to the heart. Varicose Veins are damaged, swollen, enlarged veins that do not work properly allowing blood to pool in legs.
Veins in the legs are far from the heart and must work against the force of gravity to pump blood back towards the heart. Heredity is a common risk factor making veins prone to weakness and failure. Other risk factors include age, pregnancies, prolonged sitting or standing, and history of trauma or clots in legs.
Complications of Untreated Varicose Veins
Blood Clot
Compromised blood flow and inflammation can cause superficial thrombophlebitis. Patients may experience redness of the skin, increased tenderness and swelling.
Spontaneous Bleeding
Varicose veins cause increased pressure of blood in the veins and fragile skin over time. Terminal branches of veins are pushed closer to the skin surface. This is a perfect setup for spontaneous bleeding. Even a slight scratch can lead to profuse bleeding that is usually painless. Patients may lose a significant amount of blood very quickly.
Hyperpigmentation
Left untreated, varicose veins cause increased pressure of pooled blood in leg veins. Fluid leaks out of these veins and may result in painful swelling and discoloration of skin known as hyperpigmentation. Inflammation of skin may cause severe itching, burning and redness.
Lipodermatosclerosis
Continued inflammation of the skin over time causes the skin to become firm and leathery. Patients feel increased tenderness of the skin. The stiffening and hardening of the skin is known as Lipodermatosclerosis.
Venous Leg Ulcer
Long-standing venous hypertension causes damage to the skin which eventually breaks down to form an ulcer. These ulcers do not heal well and may cause itching, bleeding and infection. In rare cases, infection could lead to serious conditions such as osteomyelitis (infection of the bone) or sepsis (blood poisoning).
Varicose veins are typically located deep inside the leg and may not be visible from the outside. Initially, the symptoms include leg pain, tiredness, heaviness, itching, throbbing, or burning sensation in the legs. These symptoms are usually worse at the end of the day after a person has been sitting or standing for long periods of time and are usually better upon first getting out of bed. The recurrent increased pressure of blood in leg veins allows leakage which can cause swelling in the legs. The build-up of deoxygenated toxin-rich blood in muscles makes them prone to cramping and restlessness in legs. There is a higher risk of clot formation and bleeding that can be profuse.
Continued increased pressure of blood in the leg veins causes changes to the skin that are typically noticed in the mid-calf to the ankle area. This condition, known as stasis dermatitis, is characterized by severe itching and redness of the skin followed by hyperpigmentation (discoloration of the skin due to deposition of iron pigments). This is followed by induration (thickening of the skin) and dermal fibrosis (scar tissue): a condition known as Lipodermatosclerosis. There may be atrophie blanche (smooth, ivory-white plaques surrounded by hyperpigmentation). The final stages of chronic venous insufficiency are related to the breakdown of skin and the formation of poorly healing leg ulcers (sores). There is a higher risk of local skin infection (cellulitis), sepsis (blood poisoning), and osteomyelitis (infection of the bone).
Over the past few decades, extensive research has allowed us a much better understanding of the causes of leg ulcers. We now know that majority of ulcers in the legs are venous (varicose veins). Venous leg ulcers account for about 80% of all leg ulcers. These ulcers are typically painless unless there is an infection on top of the leg ulcer or physical irritation that can cause pain. Fortunately, we also have technology such as laser (Endovenous Laser Ablation) that allow us to treat the underlying problem at its source in a minimally invasive manner.
Vein treatments are safe, effective, virtually painless, and do not require any downtime. Your Vein Specialist at Alsara Vein Clinic has performed over 25,000 treatments and helped countless patients some of whom came with prior failed treatments or no hope that anything could be done. Call for a Consultation at 816-396-0245.
Dona is an "active" female who came to us in a wheelchair. She has lived with ulcers in both of her legs for several years. She has received wound care for numerous years without long-term relief; ulcers and skin infections became recurrent problems for her. She has also lived with substantial leg swelling, leg cramps and extreme sensitivity to touch. She has restless leg syndrome and was prescribed medications, such as Requip. Still, the discomfort in her legs (at night) remained.
She received endovenous laser ablation of the "leaky" (refluxing) axial veins in both legs at Alsara Vein Clinic in Spring 2018. By the start of Summer 2018, the ulcers in her legs had completely healed. The swelling is almost nonexistent and, for the first time in several years, she can enjoy pain-free legs both during the day and at night.
Another Smile Restored!
What made you choose us?
A nurse practitioner's recommendation.
What symptoms were you experiencing?
Swelling in lower legs, wounds that would not heal.
How were you affected by your legs previously?
Legs had been swollen for years, couldn’t walk much; skin so tight I couldn’t move knees or ankles.
What has changed after treatment?
Swelling & sores gone, wounds healed, able to bend knees & flex ankles – walking better.
Additional Comments: What did you appreciate?
Everyone at Alsara Vein Clinic put us at ease from the start, very helpful. We loved the casual professionalism and witty banter because we knew/felt deep down you really wanted to help.
What makes us different than other medical clinics?
No stuffy robotic atmosphere. You treated us like people, not numbers.
I was at the doctor’s office and I’d seen something about “veins,” and you’re like ‘Really? Veins can have a… ?” You know, you just don’t think that there’s an issue. And the more I read, then I asked my doctor, and she sent me here to you guys [Alsara Vein Clinic].
[It was] a relief, a sigh of relief. In fact, I think I even cried when [Dr. Gupta] was actually talking to me, because, it’s like, here’s a doctor that is literally talking to you. And he didn’t speak jargon. He laid it on the line. He spoke in a way that I could understand. And it was just like, to hear somebody give you an answer that they may be able to help you, was just like… I think… I know I cried. I know I cried because – oh my gosh – there’s somebody talking to me; not at me but talking to me.
The treatments were technically painless. I didn’t have any issues with pain or discomfort. I liked the way that he walked me through it, what he was going to do, how he did it. Love his helper, Kati. And they explained everything. And they even said if you want to watch, you can watch, which I did. It was just fascinating to see. Oh my gosh, I didn’t know that this was this, and that was that. He let me ask questions. Yeah, most places don’t let you ask questions.
I haven’t flown for a long time. I really haven’t done anything out of the ordinary for a long time because it was just… walking through an airport, ah, it was just the heaviness of the legs… sitting in a car didn’t work very well. As I said, unless you’ve been through it, just… you feel heaviness in your body, and you don’t really know why. And it’s like a constant discomfort, and [in] a plane; even more so. I mean, you never would have dreamed that that was an issue.
It is a godsend. It has been a godsend. I mean, when you look back to where I was a year ago or so to where I am present day, there had to have been a difference that was made that most people don’t think about. So it’s like, haaaaah [exhales]. Oh my gosh, I did this, I did that. I’m moving. I’m standing a little bit longer. So, shy of a miracle.
Treatment of ropey varicose veins may require one or more combinations of the following: Endovenous Laser Ablation, VenaSeal Closure System, Injection Sclerotherapy (including Ultrasound Guided Sclerotherapy and Catheter Assisted Sclerotherapy), and Microphlebectomy.
Large bulging veins that appear on the skin surface as ropey veins are frequently a major branch of a deeper (inside the leg) saphenous vein, such as the Great Saphenous Vein, which is often, but not always, involved. Ultrasound testing is frequently necessary to determine the level of involvement. If the saphenous vein is involved, it would likely need to be sealed first using Endovenous Laser Ablation (EVLA) or VenaSeal Closure System. This step in itself is sometimes enough to “shrink” the bulging vein. Any remaining unsightly veins may be either closed with sclerotherapy (using medication to seal the vein) or sections of the bulging veins may be removed by microphlebectomy. Unlike vein stripping, microphlebectomy is a simple, out-patient procedure performed under local anesthesia. Using very fine instruments, sections of unwanted veins are carefully removed through tiny openings without the need for sutures and with minimal risk of scarring. Vein treatments may be staged (occur on separate days) or a combination of treatments may be performed on the same day if recommended by your Phlebologist (Vein Specialist).
Now you may be able to get rid of the unsightly ropey varicose veins during your lunch break (and start looking for that pair of shorts you thought you could never wear!).
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.
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.
Dr. Gupta is certified by the American Board of Venous and Lymphatic Medicine. All clinical staff has specialized education and training for the management of venous diseases including all types of blood clots. Urgent Care centers, Primary Care Providers, Patients, and their relatives routinely call us for same-day appointments.
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 “
Click to view large image
Unable 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.
Remember 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.
What made you choose us?
I was at the doctor’s office and I’d seen something about “veins,” and you’re like ‘Really? Veins can have a… ?” You know, you just don’t think that there’s an issue. And the more I read, then I asked my doctor, and she sent me here to you guys [Alsara Vein Clinic].
Treatment of ropey varicose veins may require one or more combinations of the following: Endovenous Laser Ablation, VenaSeal Closure System, Injection Sclerotherapy (including Ultrasound Guided Sclerotherapy and Catheter Assisted Sclerotherapy), and Microphlebectomy.
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).