Vericose Vein Procedures – not for the faint of heart

January 5, 2011

Back in November I decided I was gonna get the veins in my legs examined a little closer. I was beginning to experience more pain and pressure from them than I felt normal. Not to mention they weren’t the prettiest sight to behold either. I had one vein sticking out above my calf and another purple cluster of veins and/or blood pooling at the base of my right ankle. I felt since I was only 33 that I needed to get them taken care of before they became more debilitating than they already were. I went to the Intermountain Vein Clinic in Provo, UT and got a consult. I ended up coming out of there with more anxiety than I imagined possible.

I was hoping it would involve a simple one-step procedure but that was not the case. Instead I came out of there with a 4 step process that would total over $10,000 worth of medical bills (of course that is before insurance kicks in its portion). Thankfully this isn’t considered cosmetic surgery due to the amount of pain I am having in my legs or else we wouldn’t even consider the procedure(s). The outlined steps were:

1) First appointment, laser my Greater Saphenous Vein
2) Second appointment, laser my Small Saphenous Vein
3) Third appointment, do a phlebectomy (slit skin and remove veins) on a couple painful visual veins
4) Fourth appointment, Schlerotherapy (inject a poison into my perforater veins and pelvic veins). Schelortherapy is often used for spider veins but this isn’t the procedure I am doing. I can deal with my few spider veins, they are painless. This the only way to treat smaller, more hidden veins the laser cannot reach.

I set and appointment in early December to have my first appointment on January 4th. I tried not to think about it but lets be honest, it was on my mind nearly every day. It consumed me. I was scared. There are side effects associated with this surgery. I began doing lots of research and calling everyone I knew that had possibly done a similar surgery. I spoke with three people whom I knew. I was hoping this would ease some of my fears.

One friend said her first laser treatment was fairly painless, other than the needle injections in her leg, but she went on to tell me her second laser treatment was terrible and extremely painful. She said it felt like she was being burned from the inside. Another friend said she didn’t feel much of anything with either vein. The third person I spoke with only did one vein and said it was the most horrifying pain she had ever felt in her life. At this point I wasn’t feeling any better. For those of you that don’t know, all of these procedures are done while you are awake. You can take a valium beforehand, but overall you are very much aware of what is happening. Honestly, I think I would prefer to have been put to sleep. I have always considered myself tough and have felt I have a high pain tolerance, but this still really scared me.

The week prior to the surgery, I found myself imagining the worst case scenerio happening to me. I couldn’t sleep well and I even think I gave myself an upset stomach (either that or it was perfect timing for the stomach flu). I was embarrassed. How could I be so scared? It is pretty simple really. The problem is it isn’t something commonly discussed. I rarely hear about people who have done it and those who have don’t really mention it. I just wish I could have had more reassurance. Some side effects are numbness, permanent bruising, blood clots (which can lead to a pulmonary embolism), and more. Worst case scenarios were locked in my mind. Because this surgery was optional I knew it was ultimately up to me. I didn’t have to do it, but I wanted to do it. I was sick of going through the discomfort these veins caused when riding my bike or running. I didn’t want to have a huge gross painful vein in my calf that hurt every time I played with my kids. Heck, I am 34 and I shouldn’t have to deal with stuff like that yet. So I did it. I went through with it. In all fairness to me, once I finally made the decision to have it done, I had a very peaceful feeling come over me. I felt like everything would be okay.

I had a blessing from Seth the night before the appointment which gave me some rest and much needed comfort. The morning before my first appointment, I got up, showered, ate, and headed in to the office. When I was called back I looked back at Seth and just walked in. I was incredibly nervous. I don’t even know why but I was about to lose it. The thought passed through my mind to run back out. Thankfully I didn’t. That would have been really embarrassing. 🙂 The assistant had me put on some huge shorts they have and turned on some of my favorite music. The ultrasound technician came in and began prepping my leg. She sterilized it with soapy water and whatever else might have been in it. Note to self, don’t shave your legs the morning before. The soap really made my leg sting and I am pretty sure it was because I had shaved. I am grateful for the technician because she graciously answered my questions which helped put me at ease, well a little. The offered me and ibuprofen and a valium. I took them. Then she said I would have to chew the valium so it would kick in fast enough for the surgery. Not only was it putrid and made me gag a ton but it never really kicked in at all, well until after the procedure and then it mostly just made me a little drowsy.

Finally the doctor arrived and shook my hand. He asked me how I was doing and I replied that I was really nervous. He asked me why I was nervous. I told him that the thought of feeling a burning laser really frightened me. He reassured me that the least painful part would be the laser. He said most people don’t even feel it and if I did to let him know and he would increase the liquid around the catheter. He then explained what would take place during the procedure. He said that they would be inserting a needle into the vein. It can’t be numbed because it would cause the vein to collapse. Once the needle was in they would insert a catheter up the vein. Next they would inject fluid around the catheter to avoid the burn of the laser being felt. He said the injection up my thigh would be uncomfortable because that skin is tender. He also injected some numbing medicine to help with the pain. And so he began.The initial needle hurt, but not terribly bad. Needles don’t really bother me. I also felt each needle poke as he went up my leg. There were probably a total of 8 or maybe a few more. It was uncomfortable but I didn’t feel the need to cry or scream. I mostly just coped with it just as I learned to cope with pain when I had my kidney stone. Before I knew it, we were all putting on our protective eye glasses and the laser began. It was over within a minute or two and I never felt a thing after it. The doctor told me that rarely do you feel the laser and if you do, he will numb it more. He said most complaints come from the shots.

Then I was done, wrapped in gauze and placed in a compression stocking. I have to leave the stocking on for 48 hours and then I can take it off to shower and then I have to keep it on during the day for seven days. So far the pain has been bearable. There is discomfort but nothing I can’t handle. I see some good bruising at the top of my thigh but I can’t see anything else until tomorrow. They have me taking 800 mg of ibuprofen three times a day (not for pain, but mostly for swelling). So far so good. I am not looking forward to going back next Thursday but I will admit that I am not dreading it nearly as much as I did this first one. It helps so much to know what to expect.

Picture right after surgery (can’t see much…just wrapped in compression stocking)

Picture after 48 hours

Picture after 72 hours

Picture after one week

I thought most of the pain and bruising would be gone by now, but it isn’t. The bruising is better and seems to be lessening each day but I still have a painful pull in my leg when I walk (kind of like a rubber band). Supposedly that is normal and could take up to three weeks to disappear.

January 13, 2011

Good new for me today! I went in for my follow-up appointment and looked great. Even better news is my smaller Saphenous Vein has adjusted to the closing of my greater Saphenous Vein and is no longer pooling blood in that area. This means I don’t have to have it lasered after all. Instead we went to steps 3 and 4. They did a phlebectomy on my vein that had ballooned out in my calf. They numbed me good so I didn’t really feel any pain, but it was a very odd sensation having the doctor tug and yank on my vein. It wasn’t like he gently pulled it out. It was literally a strong, manly yank until it snapped. He made five small incisions (called nicks) and pulled out the vein segments with what looked like a crochet hook and then tugged until it snapped. It still gives me the heepie jeebies when I think about.

Next they did the sclerotherapy. Basically the doctor just injected the agent into the veins that he couldn’t access with the laser. The agent then causes the vein to collapse and close off. It didn’t really hurt but it was a really strange feeling. It stung very mildly and my calf felt like it was blowing up like a balloon. It has been about four hours and I haven’t had much discomfort yet, but I am sure that is still to come. I get to wear my compression stockings non-stop for 3 days after which I have seven more days of wearing them during the day.

My next appointment is Wednesday the 19th. I will do my follow-up and get my final sclero injections. I am a little nervous because they are in my pelvic area and I have heard they are pretty painful. I guess I will find out soon enough.

Here is a pic of my leg 48 hours after the sclero and phlebectomy:

January, 19, 2011

Well, the good news isn’t I didn’t have to do my final injections. The bad news is they found a DVT (deep vein thrombosis, aka blood clot) in my lower leg. Thankfully it is below the knee in my calf and the doctor believes that taking one aspirin a day for two weeks will take care of the problem. I won’t pretend I am not a little scared about this. It is unlikely that it would break off and even more unlikely that if it did, it would do any damage, but for whatever reason it freaks me out. I am pretty shook-up. That was my biggest fear of doing this and sure enough, I was one of the rare cases it happened to.

The doctor said it occurred because the sclero injected in my calf seeped out one of my large perforater veins and went into my deep vein. He said most perforater veins are small so it doesn’t happen but mine was stretched out. The only thing I can do at this point is wait. He is going to put off the other injections for at least a month while we wait for this clot to clear up. Plus, we are going to Disneyland in February and he doesn’t want to do anything before a big trip since I will spend hours sitting in a car (which increases the chances of more clots). I was hoping I followed the majority and avoided getting any clots from the procedures. Unfortunately this wasn’t the case. It will be at least one month before I get any further procedures so I decided to go ahead and make a post about this. When all my procedures are complete I will make a before and after post. For now though, here is my leg two weeks post laser surgery and one week post schlero and phlebectomy. Not pretty but getting better. For those of you that believe in prayer feel free to drop a few my way. I really don’t want this to get any more serious than it is. Thanks.