We routinely hear stories from our patients that they have been told that the leg pain they have with their varicose veins was not related to their veins, as varicose veins do not cause symptoms. Some medical professionals still profess that varicose veins do not cause symptoms, and it is likely due to well published research that failed to be significant. In 1999, a study was published titled, “What are the symptoms of varicose veins?” This study looked at over 1500 patients with physical inspection of vein disease, and questionnaire about leg symptoms. There was no correlation between visual/physical presence of veins and symptoms of leg pain, etc., and this was propagated as the study that proves varicose veins are merely cosmetic concerns.

One year later the same population was evaluated with ultrasound where correlation between ultrasound findings, physical findings and symptoms was identified. In a subsequent study of over 40,000 patients in Poland, there is a high degree of correlation between physical findings and symptoms in patients with varicose veins. The most common symptoms are pain (82%), heaviness (79%), intensification of symptoms with standing or warm environments (71%) and leg cramping (63%). Varicose veins can and often do cause symptoms.

To really understand the reasons why this could happen, and why it shouldn’t, we must understand a little more about varicose veins. What causes varicose veins? The primary causes are genetics (80%) and hormonal influences/pregnancy (15%). Other contributing factors are obesity, gravity and occupations involving prolonged sitting or standing. We literally have miles of vein network in each leg, so if we developed varicose veins with the genetic and hormonal influences, those influences are still present after your veins have been successfully treated.

Varicose veins are a reflection of a chronic disease state triggered by factors out of our ability to control. One change in varicose vein management involves the recognition of this chronicity. Patients with symptomatic varices should have periodic ultrasound evaluations to identify new disease before it becomes problematic. Compare this to high blood pressure or diabetes; they are similar to managing varicose veins in that one treatment cannot provide sustained control or a cure.

When varicose veins are managed properly, they will not come back. Periodic ultrasound evaluations over years will allow newly diseased veins to become identified before they are able to cause any problems.

This is generally false. Insurers do not wish to pay for cosmetic procedures, but if you have pain, swelling, heaviness, leg cramping or complications of vein disease, you will generally be eligible for benefits from your insurer.

We have tremendous experience in helping patients acquire benefits from their insurers, the first step is simply setting up your consultation and determining the extent of your varicose vein disease. From there, our team will verify your benefits and discuss the various treatment options you may have for YOUR condition.

Varicose veins are dilated and their walls are weak. They are not suitable for arterial surgery if they are diseased because they cannot handle the high pressures of arterial circulation, as with by-pass surgery. The good news is that we have miles of vein network and a few arterial sources that can safely be used even after treatment for varicose veins.

We each have an abundance of blood vessels that return blood to the heart. When varicose veins develop, that venous circulation becomes a short circuit as blood travels up a deep vein in the leg then spills back down into a diseased vessel. This short circuit actually impairs your circulation and does nothing to promote normal circulation.

The reality is that any diseased saphenous vein may be safely treated without concern for adversely affecting normal circulation. We have miles of normal veins in the legs at any given time so there is more than ample carrying capacity for normal flow back to the heart.

As recent as twenty years ago, this was a fair statement. In the past decade alone, the advances in treatment for varicose veins have nearly rendered varicose vein stripping as obsolete. Depending on the extent of your varicose veins, you may have many treatment options available to you. Advances in managing large varicose veins include catheter based procedures that deliver heat to shrink the vessel, improvements in sclerotherapy (chemical ablation) using foamed sclerosants and enhancements in lesser invasive surgical procedures, e.g. microphlebectomy.

Advances in managing the small surface vessels of the lower extremity and above the nipple line include broadband light therapy, transilluminated sclerotherapy allowing the provider to see more disease than can be seen with the naked eye. The more advanced procedures enable quicker recovery times, better symptom control and ultimately better cosmetic outcomes. Bottom line is that there are far more treatment options available today, and far less invasive options than surgical stripping and ligation.

There are first generation lasers and second generation lasers. First generation lasers relied upon blood in the vessel to be successful, generated far greater temperatures, and delivered energy that perforated the vein wall often leading to extensive post-procedural pain and bruising. Contrasted with 1st generation lasers, the 2nd generation lasers depend on water in the cells of the vein wall, deliver over 700 degrees less heat energy, and do not perforate the vein wall. Second Generation lasers deliver scientifically proven results with statistically less pain and bruising.

Dr. Schul and the Lafayette Regional Vein Center utilizes the latest in endovenous thermal technology (Sciton Pro-V) and has experience with both 1st and 2nd generation lasers. Having used both laser technologies, Dr. Schul has witnessed too many improvements in how is patients’ legs feel and look, and could not recommend the original laser unless pain and bruising are not important.

This may be true given a medical license and a desire to help people with varicose veins. The reality is that the complexities of varicose veins and knowledge of ultrasound mandate that to be successful, a provider should have extensive training in the anatomy and pathophysiology of varicose veins and offer these services as a sole service to his/her patients.

Treatment outcomes are not the same between providers, in fact, training may have involved a weekend seminar for some. Dr. Schul transitioned from a successful career in Emergency Medicine to become a Phlebologist. During a 4 month immersion fellowship with Vein Clinics of America, Dr. Schul was mentored to become a competent and successful Phlebologist with an understanding of Duplex ultrasonography, and venous pathology to help patients anywhere in the spectrum of varicose vein concerns. His training involved comprehensive knowledge of sclerotherapy, and extensive exposure to endovenous thermal ablation procedures, and he performed or directed over 8000 procedures before establishing the Lafayette Regional Vein Center.

Dr. Schul is so passionate about this field of Phlebology, that he spearheaded the recognition of Phlebology by the Indiana State Medical Society and was the first Phlebologist to be recognized by the Indiana State Medical Association and the American Medical Association in Indiana.