Q: What are varicose veins and how did I get them?

A: There are many factors that contribute to developing varicose veins:  heredity, race, age, gender, posture, height and weight, occupation and hormones (estrogen, progesterone and pregnancy play a distinct role).  With one or more of these factors, damage is done to the valves inside the vein, which under normal circumstances, is responsible for controlling pressure and regulating the flow of blood.  In addition, the diseased vein walls of the superficial venous system lose their elasticity, making it difficult for the blood to travel back to where it belongs.  This results in the blood pooling in the legs, causing the symptoms associated with varicose veins. 

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Q: What do you use to treat varicose veins and how does it work?

A: With great precision, we inject a medication called Sodium Tetradecyl Sulfate (STS) into the diseased vein with the assistance of ultrasound technology. The medication causes irritation to the lining of the vein walls, causing the vessel walls to spasm. This results in inflammation of the vein walls and causes scar tissue to form inside the vein, resulting in closing the diseased vein. Over time, the treated vein is absorbed by the body, and your blood is routed to healthier veins, which helps to decrease your varicose vein symptoms. This process generally takes 4-6 visits for both legs, but most people begin experiencing relief of their symptoms much earlier.

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Q: Does the treatment hurt?

A: The injections themselves can be uncomfortable, but typically not very painful. Everyone’s tolerance for pain is different, so it is difficult to predict how much discomfort a patient might experience. However, most patients tell us they are surprised at how little discomfort there is. You will be able to drive yourself home or go to work after most treatments. The first 24 hours after treatment may be uncomfortable. If necessary, we recommend using Tylenol, elevation, and ice compresses to the leg for treatment of discomfort after Sclerotherapy. Unlike the surgical route, there are no scars to heal.

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Q: How do you know you’re injecting into the right places?

A: We use ultrasound to guide our injections of varicosities. We locate the veins by ultrasound, and actually inject medication into the vein while watching the vein on an ultrasound display. We are able to distinguish veins from arteries by ultrasound as well as the deep venous system from the superficial venous system, which is where varicosities occur.

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Q: Will I be able to work during treatment?

A: For best results, we recommend that you elevate your legs for the first 24 hours after your first treatment of each leg. Following all treatments (except the first), you may continue normal activity with minor exceptions, such as high-impact aerobics, strenuous sports or heavy weight lifting. Low impact exercise is acceptable and encouraged throughout treatment.

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Q: Can I continue taking my usual medications?

A: The only medications that we recommend that you do not take during treatment are over-the-counter medications which may thin your blood, such as Aspirin or Ibuprofen (also called Motrin or Advil). Some prescription medications also have these qualities. Your Phlebologist will review all of your medications at the time of your diagnostic studies and will advise you at that time.

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Q: Why do my veins feel hard and lumpy after treatment?

A: This effect is what causes the vein to eventually close down, and is a normal process with Sclerotherapy. Some patients will notice this temporarily and some patients won’t notice this at all. Over time, the “lumps” diminish and vanish.

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Q: What symptoms will I have after treatment?

A: Often you have discomfort along the vein that was treated, and occasionally you may have redness, bruising, or discoloration of the skin around the injection site. Discomfort will usually subside within 24 hours after your injections are given. Redness normally disappears within 3-4 days, and bruising generally after 7-10 days.

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Q: Will my varicose veins come back?

A: You can always develop new varicose veins after treatment of your current varicose veins, but the same varicose veins will not return after they are treated if our protocol is followed. If you develop symptoms, we recommend an annual follow-up visit after your initial treatment is completed in order to diagnose any new varicose veins that you may have developed.

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Q: How long do varicose veins take to go away after treatment?

A: Once the veins are closed, through the natural healing process, your body will break these down and then absorb them. Absorption can take up to 12 months after treatment is completed, but symptoms of varicose veins usually begin to diminish after the first or second treatment.

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Q: How long do the treatments take?

A: The actual treatment sessions take about 20-30 minutes, depending on the severity of the varicose veins being treated.

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Q: How many treatments will I need?

A: It is difficult to predict how many treatments you will need until we are able to complete the diagnostic study and see how you respond to your first treatment. The average person would need 2-3 visits per leg with 4-6 injections per visit. Visits are scheduled one week apart.

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Q: Can I have Sclerotherapy during pregnancy?

A: We do not perform Sclerotherapy during pregnancy, because there have not been sufficient or adequate studies done. You may have Sclerotherapy treatment 6 weeks post-partum or when you stop breastfeeding.

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Q: Am I too old for this procedure?

A: There are no age limits for undergoing this non-surgical procedure. Many of our “mature” patients have commented that mobility and quality of life have greatly increased after treatment.

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Q: Do I need to wear compression hose after treatment?

A: We highly recommend wearing compression hose as we have found that they not only help accelerate the treatment process, but also help to decrease some of the side effects of treatment, such as the temporary “lumpiness” as described earlier.

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Q: Do I need someone to drive me home after treatment?
You will not be sedated during the procedure, so you are free to drive yourself home. However, if you must travel for a significant distance (an hour or more), you should arrange for someone to drive you home after the first treatment on each leg. More specific questions should be directed to your Phlebologist at the time of your consult.

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Q: What is the normal schedule for appointments?

A: We begin with a FREE consultation. The next appointment is the diagnostic study, also called a mapping. At this appointment, we measure your veins, take ultrasound pictures, conduct Doppler flow studies to pinpoint diseased valves, and conduct a physical where we review your symptoms and overall health. After your mapping, it generally takes an average of 4-6 weeks to receive authorization from your insurance company. Once we receive approval from your insurance company, we can begin treatment.

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Q: What is the long-term effectiveness of this procedure?

A: Once varicose veins have been treated effectively, the same vein cannot become varicosed again. However, new varicose veins can develop in areas where you didn’t have them before. Should symptoms return well after treatment is completed, we recommend follow-up visits to evaluate you for development of new varicosities.

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Q: Does Decatur Vein Clinic follow HIPAA regulations?

A: Patient privacy is of the utmost importance to us. All our team members have been trained in HIPAA regulations and requirements, and we are HIPAA compliant. You can feel comfortable that your medical records and treatment will be treated confidentially.

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Q: What is your billing policy?

A: We will accept what your insurance company allows for payment. Your responsibility is determined by the terms of your insurance policy, which typically requires your payment of unmet deductible, co-pays & co-insurance. Our billing staff will estimate your level of benefits with your insurance company and provide you with a written estimate before you incur any personal expenses.

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Q: Will insurance cover this procedure?

A: This is determined by the scope of your policy, and each policy differs from person to person. You will be assigned a representative from our billing department, who will prepare an estimate of your out-of-pocket expenses after they have researched your benefit level with your insurance company. DVC prides itself on partnering with you in working with your insurance company. We have a dedicated pre-determinations staff that works diligently to cut through the insurance red tape to hopefully gain approval from your insurance company.

Once approval for treatment has been received from your insurance company, our full-service billing department handles filing all the appropriate paperwork directly with your insurance company. Insurance does not cover treatment of spider veins because they are considered cosmetic.

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Q: How are my insurance benefits determined?

A: Our pre-determinations team will be your advocate as we seek to gain approval from your insurance company. We’ll prepare and send all the necessary information on your behalf for review by your insurance company. Knowing how confusing insurance requirements can be, we try to make this process as simple as possible for our patients. We encourage you to also contact your insurance company regarding the status of the request for approval and to emphasize that you wish to undergo this treatment.

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Q: Should I make an appointment with Decatur Vein Clinic?

A: Yes, absolutely. Decatur Vein Clinic is accepting new patients and offers a FREE consultation. Get to know our professional staff and learn more about our non-surgical approach to treating varicose and spider veins.

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