Leg vein issues due to obesity...
Hello guys,
It is great to have a men’s forum to discuss WLS issues, thanks to all of you for the support. I have a co-mortem related health question for all of you. Prior to my WLS six months ago my left leg, to a greater extent then my right leg, was swollen below the knee. My skin was also discolored with a reddish-tan patchiness on both legs like larger irregular shaped freckles. This discoloration began 6-7 years ago mostly at my angles and spread up to my knees over those years. The swelling in my left leg became much more pronounce 3-4 years ago. I had all kinds of tests ultrasonically up and down my legs by my PCP and by orthopedics (my lower back was also consistently sore during those years as well, but it turned out not to be related it the leg swelling).
Just after my WLS, I stopped in at a vein specialist and had another round of ultrasound testing, this time by some one who seemed to know what they were doing, and eventually found out that my morbid obesity was causing my main leg veins to swell, and as a result the internal back-flow valves within the veins designed to help drain the leg of used blood were not working efficiently. The swelling was a resulting pooling of blood in my lower legs due to the poor back flow, and the reddish-tan freckles were the result of the iron leaching in to my skin layers like the ink of a tattoo. There were no signs of spider veins or other vein varicose vine issues going on.
I was prescribed to wear 20-30 mm Hg support hose, preferably the ones that full leg length, but I also were just knee length ones as well. The swelling has gone down in both my legs and the level of reddish-tan freckles has been reduced to about half of what was their prior to wearing the support hose. I was told to wear the support hose for six months particularly early in the day and then to be reevaluated as to how much my vein swelling has been reduced. I was told to also avoid hot soaking bathes, take colder showers, not to stand or sit for long period of time without exercising my legs every two hours by walking or stair climbing, and to elevate my legs with a stool or foot rest when sitting at my desk, because I am a desk jockey for most of the workday. I have worn mostly knee length support hose everyday for at least 10-12 hours per day since I found our what was happening.
At the six month point, I was told that the doctor would look at how mush smaller the vein had closed down with the ultrasound evaluation and then determine if the swollen vein would need to be treated with a laser through a fiber optic tube that would burn the leaky veins and leave scar tissue that would effectively closed down the veins. I was told that there are many other veins in my legs that would take over the role that the scarred veins were doing and that it would not be an issue to have this done.
I have noticed that on the weekends if I do not put my support hose on by 10:00 a.m. these seems to be a return of a slight level of swelling in legs with a greater extent in my left leg, but it goes away if put my support hose on. The support hose are not that bad, and make my legs feel comfortable, though as it has started warming up in temperature here in the south, I have noticed that they are getting more uncomfortable due to heat and they do not let my legs breath. I could go on wearing the support hose indefinitely, but I am concerned if the doctor does recommend having the laser scaring on my veins in July when I return for my follow up visit.
My question is, after such a long post, has any one else had a similar issue, or have had a laser vein treatment? What is it like to loose a vein in your legs? Does the laser scarring and lose of a vein lead to other issues? And when I loose my final 100 pounds over the next 6 months, will the leg swelling and the reaming discoloration be permanent whether I do or do not have the laser treatment or continue to war the support hose?
Thanks for the help and I apologize for such a long post.
Herb, Your story sounds similar to mine. When I was about 30 I started to get varicose veins with the left leg being much worse (why is it usually the left leg?). It didn’t bother me except occasionally at night when I would wake up with a Charlie horse in my calf. I would get up and walk it off and it usually went a way within a minute. Then one night the cramp was particularly severe and it hurt like hell. Walking it off didn’t work. It felt like I had been hit on the back of the calf with a baseball bat. In the morning my leg was swollen and my entire calf was black & blue. It scared me bad enough that I went to the doctor. He looked at it and told me my vein had thrombosed. I asked what I could do and he said, “Nothing, it’s too late.” He checked my other veins and recommended that I wear compression hose to bed and try to lose some weight. I tried the compression hose and they drove me crazy so I didn’t use them. The thrombosis healed but left my leg discolored and swollen due to the poor circulation. It was so swollen that I needed to buy larger shoes because my left foot was a size bigger than my right. The back of my calf became rock hard and it itched a lot. I had a pretty ugly left leg. I lived with it for the next ten plus years. Since losing weight it has gotten much better, but it took a while. I didn’t really notice much improvement until after six or eight months. Now the swelling is all but gone and my skin color is almost normal. My calf muscle is no longer hard, although I can still feel the scare tissue. The swelling in my ankle has gone down considerably and I can lace up boots to the top again. I might even wear shorts in public again.
May Your Lantern Burn Bright,
Paul
Due to poor genetics and my obesity, I’ve needed vein surgery on both of my legs. Actually, my legs were a big reason that I decided to pursue WLS. I figured I had to get the excess weight off first before taking any action or else my problems would either continue or get worse.
I had seen a vascular specialist 10 to fifteen years earlier when I started to suffer with ulcers on the inside of both of my ankles. I couldn’t figure out what was going on and I couldn’t get them to heal. The specialist diagnosed me with varicose veins and told me to wear compression stockings. I knew I have vein problems in my thighs and around my knees, but didn’t realize they would cause this type of problem with my lower legs. After these areas healed, there was some scaring and dark rusty discoloration due to the iron from my blood staining the surrounding tissues.
In 2005 I heard about EVLT, endovenous laser treatment. In 2006, after I was about 6 months out from WLS, I went to a local specialist who practices this technique to see if it would work for me as I had heard how painful the old "stripping" method was. He was quite surprised to see how bad my legs were and told me I was one of the most advanced cases he had seen. That didn’t exactly make my day. Because of the size of some of my veins, he said the laser would not be able to close them and recommended that I have my left leg surgically stripped. This is where they make incisions in the groin and knee, pass a fine wire up through the vein to the groin, attach it to the vein and then pull the vein out through the incision by the knee. This was outpatient surgery. They also do some micro surgery where they go after some of the smaller veins that branch from the larger vein being stripped with a small instrument that somewhat resembles a crochet hook. I had a number of holes from that initially, but you can’t see them now. Recovery from the stripping surgery was a little painful for a few days, but that’s what they make Vicodin for! It wasn’t too bad. I would do it again for the benefits I’ve received. I had to wear a thigh high compression stocking for a week and had some areas packed for additional pressure for three or four days. I couldn’t run or exert myself for a month to allow the leg to heal. Walking and biking were encouraged, so I did a lot of walking.
After my left leg healed, I did have EVLT on my right leg. This was performed in his office. I was supposed to have gotten a dose of Valium to take to make me less anxious during the procedure. I believe he forgot to give me the script at the visit before the procedure as I was under the impression I would receive it at his office. So, I had it done with only local anesthetic and again, it wasn’t too bad. I think the Valium might have sent me to a little happier place for a while, but I got through it. The laser only treated the vein in my thigh. He again did the micro surgery on some of the branching veins. I didn’t take as much Vicodin with the EVLT, but this surgery is a bit strange. My leg didn’t bother me much the day of surgery or the second day, but the third day was very painful. The doc told me this was normal. As I’m sure most of us have heard, burns are pretty painful. That is essentially what is happening with the laser. I guess it takes a few days for the nerves to recover to start sending that signal to our brains.
After both surgeries, I went back for follow up procedures. Another method of treating smaller varicose veins is sclerotherapy. This method uses an injection of a solution into the vein to make the walls of the vein "sticky" and with use of compression stockings collapses the vein onto itself so it closes off. I had a few done with this method with no problems.
As your legs heal from any of these methods you may notice some localized swelling and discomfort. I had a few areas that swelled like there was one-third to one-half of a golf ball under the skin and it was painful to touch. This occurs because the circulation to the area has been disrupted and your body must rebuild a way to restore the circulation. I had some tender areas for a couple of months. I still have a couple of "knots" that have been around almost six months now, but are slowing fading away.
Would I do it again! Yes, most definitely! It has made a big difference. I can only baring see a couple of scars and the discoloration in my ankles is lightening to a medium tan at this time. I still wear compression stockings. Partly because they still feel good, and I still get a little swelling if I just wear regular socks. The best place I found to buy nice dress socks that hold up forever (3 years or more) is Ames Walker Hosiery at http://www.ameswalker.com/rxfitstyl103.html.
Hope that helps,
Matt
