Varicose Vein Surgery

So this post is NFTFOF (not-for-the-faint-of-heart).

Varicose veins, in the doctor’s office, are put into two categories: cosmetic and medical. Cosmetic veins means that while bulging veins may be present typical, non-threatening vein function is still occurring. Medical varicose veins means that atypical functions are occurring and have negative potential for the person who has them. I had the latter. An ultrasound of the vein in question can confirm the vein to be performing typically or atypically. A typical vein has blood flowing in one direction. An atypical vein has dual blood flow – not good.

Varicose veins have the potential to form in any part of the body but are more likely to form in the areas that have the greatest length or room to expand i.e. legs and arms.

SYMPTOMS

The standard symptoms for varicose veins includes excess fluid or swelling (also causing a “heavy” sensation in the appendage), a throbbing sensation where the problem vein is located, a generalized and localized discomfort, skin discoloration, itchy patches of skin on and around the problem vein, and of course, the number one concern: blood clots. Interesting fact, varisoce veins do not necessarily mirror in dysfunction. I had damaged veins in my right leg but none in my left.

HOW DO THEY FORM?

There are lots of ways that varicose veins can form.
1. Genetics – can’t think of a person over the age of 40 in my family that doesn’t have them.

2. Standing too much and sitting too much – exactly the kind of lifestyle modern society has us engaged in.

3. Pregnancy.

4. Being a woman – I’m not even making that up. Being a woman is an actual reason listed. Rapid hormone fluctuation, or having a healthy female body that’s undergone puberty and general aging, can trigger varicose veins.

5. Being born with defective valves.

6. And the number one: being grossly overweight.

MY BACKGROUND
As I’ve noted in previous blogs, I know what it is to be grossly overweight. Not once in my lifetime, but twice!

The first  time was simply to do with being raised to eat through my emotions. Feelings were never encouraged in my family, more like actively discouraged. As a kid, whenever I was anxious (always) or feeling bad about school (often – I was the weird kid that was always reading and never playing) I was encouraged to eat a treat and then I would feel better. I wasn’t allowed to feel, but I was allowed to eat. It was my only known coping mechanism as a kid. I take full responsibility for my weight, though. I don’t blame my parents. They may have provided the foundation, but I knowingly built the house on which the foundation stood. As some point in my childhood, I learned what I wasn’t meant to eat, or the quantities in which I was eating, but I did not change my habits. I kept at being overweight until at some point I reached my zenith of 310lbs.

I was 26 years old when I was given my a pre-diabetes diagnosis. I decided right there and then, leaving the doctor’s office, that I was done with the weight. I spent the next 18 months shedding the fat and dropped down to 150 lbs. It was relatively easy as I recall. I loved running and core training. I was a broke college student so I could only afford vegetables and cheap cuts of chicken. No flour-based carbs. I exercised five days a week and stayed active as I worked, interned, and went to classes for my masters degree. That was my life for 18 months. At 150lbs I saw the first of what was the very tiny bumps on the back of my right leg, barely visible so no big deal.

Fast forward four years later, age 32, my thyroid (already temperamental) breaks completely under the stress of pregnancy, and I shoot back up to 280lbs. It takes nearly two years to adjust my thyroid medications and the weight loss, this time, is painfully sloooooowwwwww. All that precious 20-something energy is gone. Slowly but surely, I shed the weight.

The veins aren’t small bumps on the back of my leg anymore. They are gnarly, unsightly monsters but I’m used to it. The veins are gross but I figure they don’t hurt so who cares? It just means I gained a lot of weight, then lost a lot of weight. They’re a testament to my hard work. I figure I’m okay. Come November 2017, my right leg starts throbbing.

20180731_081053
My varicose veins on a good day. Started at the upper back thigh and ended at the inner ankle. On a busier day, the veins would be twice that size. You can see the swelling in my feet from the extra fluid.

Day – night – there’s no rhyme or reason to the throbbing, it just happens erratically. Then the itching started. As it turns out, the atypical blood flow was agitating the surrounding tissue causing the itching sensation. On a few occasions, I scratched so hard I bled. I had also joined 24Hour Fitness around November and while I always loved running and cardio in general, my right leg just seemed to take extra effort to move. I bought athletic compression socks and that seemed to help for awhile, but eventually the socks have to come off.

The sensations got worse as the real Texas heat rolled out. Around late June, I had contacted my insurance company and was advised to get an ultrasound. If the vein was determined to be medical and not cosmetic, then any surgical procedures should be covered. I got checked out by Dr. Friedmann of Westlake Dermatology.

At the appointment, I was ready to assume the worst when it came to insurance coverage so I asked Dr. Friendmann straightaway, not yet having an ultrasound done, what his opinion was of the vein – did it look medical or cosmetic? I remember his eyebrows popping up when he took in the extent of the vein and said, “I can tell you right now it’s medical – not at all cosmetic. We just need an ultrasound to prove it for insurance reasons.”

I got approved!

THE PROCEDURES

1. Ablation – lasering the vein to shut it down. It took about 45 minutes. My leg was numbed locally and I didn’t feel a thing. There was recovery pain as the aesthetic wore off. I could feel the post-procedure burning effect for about two hours but nothing an Aleve tablet and a glass of wine couldn’t cure. I wore a medical compression stocking day and night for exactly seven days and resumed all normal activities during that week except for running.

20180808_170438-e1535044344596.jpg
Exactly one week post-ablation. The vein was shut down at its extreme ends to stop all functions. It was now dead tissue. I was surprised. I expected to see lumps for weeks afterwards but my skin smoothed down almost completely.

2. Phlebectomy – sometimes referred to as “hook and pull”. Crocheting is one of my many hobbies so I was familiar with the idea of the procedure from the beginning. The now dead vein was pulled up and out at several incision points throughout my leg and then cut out. Dr. Friedmann was at my leg, extracting the vein longer than planned. My procedure was slated for an hour but it took a little over 90 minutes. He said I had some of the strongest connective tissue he’s ever encountered. I was swearing at several points as time went on, so was Dr. Friendmann and I don’t blame him. It felt like we were on the same team trying to get this massive vein out. Numbed up or not, you know when your leg is taking a beating. My leg felt like a big piece of rubber that was just getting pummeled.

 

The picture below is of my leg 24 hours after the phlebectomy. I was back in the medical stocking for another 72 hours, but I took the stocking off long enough to remove the dried, bloody bandages.

 

And finally, here is my right leg exactly nine days after the phlebectomy procedure.

20180823_084855
The bruising is already in the “yellowing” phase. Dr. Friedmann told me I was a fast healer. Still some post-procedural swelling present.

To say I’m pleased is an understatement. The pain is 100% gone. No throbbing. No itching. No heavy-with-excess-fluid sensation. The general varicose vein pain stopped immediately after the ablation, removing the dead vein was just tidying things up.

There is a possibility for a third procedure called, “foam sclero”  (a foam injection that kills off any smaller, remaining veins that the laser can’t get to) that I was approved for but Dr. Friedmann decided to hold off as the main problem vein was so large that removing it may in turn kill off the smaller veins.

I will update this blog later with full recovery pics. I can’t wait – August 2018.

UPDATE PHOTOS – November 2018 – 3 months later.

Here it is! My right leg is completely smooth. There is, however, a slight recess in the inner leg, mid-calf. A lot of tissue was extracted (see above photo) so I’m not terribly surprised by the recess. The pain from the faulty vein was gone within the first week of the first procedure and has stayed gone. I would do this again.

 

 

Cheers,
ArmedWithCoffee.com
Austin, Texas
@gnrmuggle

 

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