By Dr Irineu Antao Pereira
Mangaluru, Mar 4: Our legs stand up for us and help us achieve our goals. But are we doing enough to stand up for our legs?
Our legs can suffer from multiple problems related to various diseases, be it of bones, joints, muscles, arteries, veins, nerves and so forth. The early signs and symptoms unfortunately do not get the attention they deserve; and the patient presents to the doctor at a stage where even aggressive treatment may not prevent continued suffering and even an amputation of the leg.
While pain in the legs on walking or at rest, swelling of the legs or joints can be due to a disease of blood supply to the legs (due to a disease in the arteries) or improper blood drainage (due to a disease of the veins) or could be a disease of the joints; non-healing leg wounds and blackening of the toes could be due to a blockage in the blood supply of the leg or due to varicose veins and not diabetes alone. Diabetes usually complicates arterial or venous disease.
What are the reasons behind delayed treatments and higher complications in untreated varicose veins and arterial blockages?
Treatments for venous diseases get delayed because patients feel it is a problem of cosmesis, the veins simply look ugly. Varicose veins are not a cosmetic problem alone and can produce life-threatening complications like thrombosis and bleeding.
Treatment may also be delayed by carrying out local home remedies beyond a particular level. Varicose veins are due to vein valve ‘leaking' – just like a water-tap leaking at home. It is a mechanical problem in need of a mechanical solution. So if the reflux is severe or complications have occurred, valve closure is important.
Treatment is also delayed by anecdotal stories of poor results of relatives and friends, from earlier treatment methods or inappropriate treatment. Treatments and new set of skills have evolved and deliver great results such as day care 1470nm radial laser procedures done under local anaesthesia and intravenous sedation. You are on your feet within an hour and are back home on the same day.
Treatment is also delayed – especially in varicose veins as we may find it not troubling enough to visit a doctor. But we need to treat early for better results, as earlier diagnosis may avoid the need for more invasive treatments!
How can you diagnose problem of blood drainage and varicose veins at home?
Cramps early in the morning, swelling of the legs in the evening which decreases overnight during sleep, bulging leg veins and black pigmentation in the legs are the common symptoms. One of your parents may have been a patient of varicose veins or piles. Or among women, the problem may have commenced or worsened during pregnancy.
To confirm valve reflux (blood flow from the groin to the leg instead of being from the leg up towards the heart) just do simple test. Lie down on your bed and lift your leg up. You will notice that the bulging veins are gone or decreased and soft. Now stand up and cough a couple of times. You will notice that the veins bulge again. And they will become firm or hard – depending on the amount of blood flowing back in the reverse direction.
You then need a Colour Doppler Ultrasound for confirmation and a guide to the appropriate treatment which may be a combination of treatments such as medication, medical compression stockings, surgery, sclerotherapy or endovenous laser or similar treatments.
How can you diagnose a block in blood supply to your legs at home?
What you experience – let’s take for example, pain in the legs on walking but which is relieved by rest in the legs. This may suggest an arterial blockage. The level of the pain in toes, legs, thighs or the waist, would suggest the level of the blockage; and the distance you are able to walk before the pain begins, would suggest the severity of the blockage. This may be in addition to loss of hair on the legs, shiny skin. All you then need to do is to see a vascular surgeon, get a Colour Doppler Ultrasound Scan and have either medical or interventional treatment. All treatments highlight a need for lifestyle changes like quitting smoking, avoiding oily food, regular exercise. There are no short-cuts to any great result.
About Dr Irineu Antao Pereira
Dr Irineu Antao Pereira is a Senior Cardiothoracic and Vascular Surgeon with a special interest in Vascular Diseases. Patients desiring to know more are requested to visit www.irineupereira.com or email him at dr.irineu.pereira@gmail.com or WhatsApp 7744880022. He is available for consultations in Panaji, Goa, Mangaluru in Dakshina Kannada and Payyanur in Kannur, Kerala. Appointments can be booked online on the website, on email or on WhatsApp.
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Dr Irineu Antao Pereira
MBBS, DNB (Gen.Surg), MCh(CTVS), DNB(CTVS), MBA(Healthcare Management)
Cardiothoracic & Vascular Surgeon