While not common (up to 10% in some reported studies), long haul flights ie. those over four hours, can increase any individual’s risk of developing a DVT. This is particularly so if someone is over 60 years of age, has significant medical problems, is pregnant, is using oestrogen containing medications or has varicose vein disease.
Articles in Category: Vein Treatments
Patients coming to Palm Clinic regarding their varicose veins are often concerned that they may develop a venous leg ulcer.
They recall an older relative "who used to have awful legs with ulcers, and I do not want that".
This patient had a varicose ulcer for 4-5 months prior to treatment. Varicose ulcers are generally treated by compression hosiery and regular dressings but very often they do not heal until the underlying varicose vein has been treated. This then improves venous circulation which in turn reduces oedema in the tissues and clears tissue toxins more effectively.
The photos show complete resolution of the varicose ulcer.
Sitting and DVT
Prevention of DVT (deep vein thrombosis) mainly involves using the foot pump and calf muscle pump to stimulate blood flow through the deep veins.
Blood is taken down to the feet through arteries and taken back to the lungs and heart via veins. About 90% of the venous blood is returned via the deep veins which are situated inside the calf and thigh muscles.
The foot pump involves squeezing of blood through a complicated venous plexus in the foot and the blood is then further squeezed towards the heart via calf and thigh muscle action on the deep veins.
When we sit for long periods the foot pump and calf muscle pump are inactive and this can lead to pooling of the blood (venous stasis) which in turn can cause a DVT. In a worst case scenario a piece of the blood clot (thrombus) can break off and block the main arteries to the lungs causing a pulmonary embolus (PE). A small PE may not even be noticed but a large PE can cause dramatic symptoms of severe chest pain, shortness of breath or coughing blood. In these circumstances a PE could be fatal so you need to get urgent attention by dialling 111.
Although small DVT's are quite common and usually don't cause symptoms, larger DVT's can cause calf or thigh pain and swelling of the leg. These symptoms should always be checked by ultrasound.
DVT's are more likely if you have long periods of sitting eg long car travel or long flights over 4 hours duration or if you have had recent surgery or a prolonged illness requiring bed rest. If you have had a DVT before or a superficial thrombophlebitis you may be at greater risk of a further DVT. It is worth having a thrombophilia screen if your doctor is concerned about a strong family history of DVT.
Prevention of DVT's can include:
1. wearing class 1 or 2 compression hosiery.
2. working the foot and calf to stimulate venous return.
3. getting up and walking around regularly if you are sitting for long periods.
4. keeping well hydrated on flights and avoid alcohol on flights.
5. the foot pump works better in people who do not have flat feet or high arches. If you suffer from these problems a good orthotic device will improve venous return.
6. varicose veins may increase the liklihood of DVT so having your varicose veins treated may be a good long term solution.
7. there is no evidence that aspirin reduces the risk of DVT
Palm Clinic has been an affiliated provider for Southern Cross Healthcare since 2002 for varicose veins treatment where medical necessity criteria apply.
Palm Clinic is now an Affiliated Provider to Southern Cross Health Society for skin cancer treatment, skin biopsies, and skin cancer surgery. Medical necessity criteria apply.
Any suspicious lesions detected by dermatoscopy will be biopsied. Actinic keratoses or irritated seborrhoeic keratoses will be treated with liquid nitrogen or in the case of AK's with Efudix or equivalent skin creams.
Why wear them?
Endovenous laser ablation (EVLA) is the latest treatment for varicose veins. It uses a laser fibre inside the abnormal varicose vein to cauterise and close the vein down instead of stripping the vein out surgically. Endovenous laser treatment is performed under local anaesthetic only so you don't need a general anaesthetic to treat your varicose veins and you can return to work the same day.
Dr John Barrett inaugural Chairman
Dr John Barrett of Palm Clinic was appointed the inaugural Chairman of the New Zealand Faculty of the Australasian College of Phlebology at the last ACP meeting.
Dr Barrett will be responsible for ensuring the training programme for NZ trainees meets their requirements and the high standards of the ACP.
Restless legs can be really distressing.
They usually happen in the evening and can make sleeping really difficult. It feels like you don't know where to put the legs and they can be associated with a twitchy feeling so that the legs need to be moved frequently. The cause is not known and is probably multi factorial. Magnesium deficiency can be relevant for some people.