Women are more likely to have vein issues than men

Pain in legsDid you know that venous disease issues like varicose vein and spider veins are twice as likely to occur in women than men? For women with this issue, the problem can cause significant emotional distress. Women are more likely to show off their legs in their everyday lives. So dealing with unsightly varicose or spider veins can make women self-conscious and embarrassed.

Vein issues like varicose veins and spider veins occur because the vein walls begin to weaken over time. This weakening causes small clots to form as the blood pools in the lower part of the vessel instead of moving through the vein back to the heart. The more the blood pools, the more pressure is placed on the vein wall, which compounds the problem.

Women experience this issue more than men because of a few risk factors, including:

  • Pregnancy. When a woman is pregnant, her average blood flow increases. This extra blood causes veins to swell, which can result in varicose veins and spider vein issues.
  • Estrogen. This hormone weakens vein valves. Women on birth control containing estrogen may face an increased risk of developing varicose and spider veins.

Treating vein issues starts with lifestyle changes. Making sure you are healthy, and your weight is under control can help. A diet low in sodium and rich in potassium can help reduce water retention in the body, which is good for your veins. Regular exercise improves circulation and blood flow. But these changes are sometimes not enough to fight back against vein issues.

At Precision Vein Therapeutics, we offer leading treatments to help remove troublesome vein issues. Dr. Michael and Polly Anna Barlow have trained with some of the best vein specialists to provide our patients to find the relief that they want. Our goal is to help you feel your best by using minimally invasive procedures that remove vein issues.

The symptoms of vein disease are more than just uncomfortable. Achy, swollen legs are not fun for anyone. But large varicose and spider vein bundles can be unsightly and cause significant emotional distress. We’ve seen patients who are afraid to show their legs in public out of fear of being ridiculed. You don’t have to feel this way. You should feel confident to wear a skirt, go to the beach, or show off your legs without fear or judgment. Check out our before and after photos on our website. They speak for themselves. We want to help you get the same results. Call to book your appointment today.

Five ways to make the most of your vein treatment recovery

40871244_MCongratulations! You’ve chosen to seek treatment for your vein issues. At Precision Vein Therapeutics, we do our best to ensure a positive treatment experience for our patients. We keep wait times short, and we can answer any questions you may have about your treatment. One of the major concerns our patients often have is how long it will take to recover from a procedure. We make sure to thoroughly provide all the answers our patients need to prepare them for the recovery process.

Recovering from vein treatment typically doesn’t take long. Depending on the type of treatment you receive, it may even be just a few days. Our doctors will always do their best to ensure that you have all the proper aftercare instructions, and our office will be in touch to follow up on how you are feeling after treatment. Even though recovery is fast, it can still be uncomfortable, so we encourage our patients to do their best to relax and allow their bodies to heal. Here are five ways to ease the recovery process.

  1. Bring someone with you. After many of our treatments, you wouldn’t be able to drive for a day, at least. If you’ve had sedation, you may also feel nauseous or dizzy. Ask a friend or loved one to drive you to the clinic and stay with you after the procedure.
  2. Put your feet up. The best thing you can do to speed up the healing process is to rest your legs. Watch some movies, take a nap, and stay off your feet.
  3. Wear compression stockings. Compression stockings will help your body to heal faster. Wear them as much as possible, even at night if you can. Your doctor will outline the recommended wearing guidelines for your specific case.
  4. Make sure to stretch. Maintaining flexibility and blood flow will be a crucial part of your recovery process. Add light stretching, yoga, or other flexibility exercises to your workout in between treatments to keep your blood flowing.
  5. Stick with your treatment schedule. Many varicose and spider vein issues require multiple treatments. Your doctor will outline a treatment plan that will help you get the best results. Stick with your timeline, and you’ll see results in no time.

Recovering from a medical procedure is often uncomfortable, but that shouldn’t be a reason to put off treatment. Vein treatment has a speedy recovery time, especially if you follow aftercare instructions correctly. We want to help you feel and look your best, even during recovery. If you have any questions, ask us. We are here to help!

Compression hose can reduce the likelihood and severity of varicose veins

mother and daughter walking in the forestTrying to prevent spider and varicose veins? Ask us about the benefits of wearing compression hose. Compression hose can help you better manage venous insufficiency, a condition that can lead to a spectrum of vein-related issues, from spider veins to varicose veins to at worst, venous ulceration. That’s when a vein issue results in red and irritated skin and can progress to an open wound.

Chronic venous insufficiency occurs when the valves in your leg veins don’t permit blood to properly flow back up to your heart. This can cause blood to pool in your legs. By steadily squeezing your legs, compression stockings are designed to help your veins move blood more effectively.

It’s important to not only purchase quality compression hose, but to make sure you’re measured for the hose by someone trained in proper fit. Low-quality compression hose and hose that doesn’t fit properly can be difficult to wear, wear out quickly and/or not be as effective as quality hose. Don’t like the idea of wearing compression hose? Compression hose has come a long way in the last decades, and is not only more effective but easier and more pleasant to wear than ever before. If you receive treatment for vein problems, wearing compression hose after treatment as you’re instructed can make all the difference. They can help make your treatment more successful over the long term and can help prevent new issues from emerging.

Learn more about us and our treatment options by visiting our website: Questions about compression hose? Give us a call: (205) 258-0998

You’re So Vein

You probably think this blog is about you.  Don’t you? Don’t you?  And you would be absolutely right.  Okay I’m sure I’m not the first vein doctor to use Carly’s perfectly written breakup song about Warren Beatty for purposes of encouraging patients to get their varicose veins treated.  If you are old enough (like I am) to remember vividly when this song was released (1972) then you are also in the age group of the population with the highest incidence of venous disease of the legs.  These are problems that can affect both young and older people, but we know the incidence definitely increases with age.

I spend lots of time educating patients about what the symptoms of lower extremity venous disease are and how important it is to seek treatment for varicose and spider veins.   I grew up listening to Paul Harvey on the radio.    “The rest of the story” was always something different and deeper than what you were expecting.   Venous disease in the legs usually progresses and gets worse, involving more and more areas of the leg in the path of whatever vein has gone bad.  Early intervention is what I preach.

The rest of the story with venous disease is that there is such a wide variation in just how a patient will develop problems.  Most patients will have typical symptoms of aching, fatigued feeling legs that feel heavy towards the end of the day, usually with a bulging vein here or there.  Swelling that seems to go away overnight, only to return in the calves and ankles by quitting time is pretty typical.   Changes in the appearance of the skin over time are a big tip off.  This usually includes darkening, or an increase in pigmentation in the lower legs, a reddish itching rash on the skin of the lower calves and ankles, thickening or hardening of the skin in these areas, and the most advanced skin change is the appearance of a non-healing skin ulceration, a venous ulcer.  There are patients who will only have bulging veins or a covering of spider veins and no symptoms at all.   Wide variation.

Right lower calf venous ulceration before and after treatment.

The trick is heading all of this off at the pass.  Getting treatment for venous disease is more important than ever.  Bulging veins at the skin are at risk for lots of bad things.  Superficial blood clots can form in these surface veins that can progress to deep vein thrombosis (DVT).   Bulging veins just under the skin are often in vulnerable areas of the legs that are at risk for rupture and significant bleeding with even minor injuries.   Even more concerning is the tendency of these veins for spontaneous rupture due to the high pressures that develop from underlying veins that are allowing reverse blood flow into them.

The good news for most people is that treatment is not anything like it used to be.  There is an entire generation of people that still believe that “vein stripping” is still the only treatment.  This was invariably a very painful procedure that had a very long recovery period with serious risks.   Today, highly effective treatments are performed in an office-based setting in my clinic, extremely well tolerated under local anesthesia and mild sedation.   There is minimal down time with patients able to return to work on the second day and pain is easily managed typically with over the counter medications.

Don’t wait a minute longer.  Don’t daydream about getting something done.  Don’t be naive like Carly.  She had some dreams but apparently, they were clouds in her coffee.   Gulp that coffee down, grab your phone and give us a call at Precision Vein Therapeutics 205-710-3800 for an evaluation.  Two years after she released “You’re so Vein” she released my favorite song of all time, “I Haven’t Got Time for the Vein.”   You don’t either.

Michael R. Barlow MD, RPhS

All content copyright 2019


The Big Picture on Vein Disease and Leg Swelling

Vein Screening Form


“Why are my legs swollen?”  In this blurb I’m going to hopefully give you the big picture on a very common complaint, leg swelling (edema) that tends to go right along with venous disease.

When I give talks on venous disease of the legs, I emphasize that I believe one of the most important things I am trying to accomplish is educating patients on the importance of recognizing signs and symptoms of problems early when treatment can produce rapid recovery and return to function.  Doing this can prevent progression to advanced stages when recovery and improvement can be lengthy.   In addition to explaining the possible health consequences that could result from ignoring serious signs of developing vein disease in their legs, I like to focus on just how effective, well tolerated and elegant that modern vein procedures really are.

In most advertising for vein clinics (mine included!), you will see some version of “leg swelling?” being asked.   The typical pattern of swelling that is associated with what I treat (venous insufficiency) usually begins around the ankle and progresses up the leg.  Usually, this swelling tends to increase during the work day and decreases overnight or with simple maneuvers such as leg elevation.  Over time, swelling is noted to occur on top of the foot as well.

From here, keeping an eye on the big picture is challenging to say the least.  Figuring out the cause of swollen legs can be a complicated affair and frustrating for patients and physicians.   It’s very much like that scary forest right outside the Emerald City on the Wizard of Oz.  The second you walk into the trees it gets dark.  And thick.  So off we go.

First of all, when I see a patient for evaluation of a swollen leg, it is usually after studies searching for urgent situations such as acute deep venous thrombosis (DVT) have already been performed.  This is not always the case however.   Sudden swelling that occurs over hours to days is termed “acute” and if from a venous cause, is usually due to either a DVT in the leg or other obstruction higher up the venous circulation in the abdomen or pelvis.  These problems are usually managed in the hospital setting.

Leg swelling that occurs over a longer period of time, weeks to months, is termed “chronic” and when a patient comes for treatment, early investigation should start.  The most important thing to remember is that the longer swelling is allowed to continue without treatment, the more likely it will potentially become permanent.

My focus at Precision Vein Therapeutics is sorting out whether or not a swollen leg is the result of a vein that is not doing its job.  I perform a thorough venous ultrasound of both deep and superficial leg veins to determine this.  This exam is noninvasive and done right in our clinic on Watermelon Road.   The amount of information about the venous circulation that can be obtained from this elegant test is truly amazing.

In the setting of saphenous vein reflux, which I detail on the vein disorders and treatment pages of this website, mild to moderate swelling that follows the pattern I mentioned above, (gets better overnight), after treatment with endovenous laser ablation, typically resolves.  Longer standing or more extensive swelling that tends to remain unchanged over night on average may improve after correction of saphenous reflux, but in a percentage of patients, will need further management to deal with.   This is where the woods get dark and deep.   In medicine, we like to blame a set of conditions on one cause.  The swollen leg is a big ugly example of the situation where there can be multiple contributing causes.   It’s very important in cases of severe edema and venous insufficiency to help patients set realistic expectations.

The lymphatic system of the body is an extremely important little machine and it doesn’t get much air play.   For all practical purposes, it is microscopic, but it is the hardest working system in the body for its’ size.  It is responsible for collecting the plasma portion of the blood that is filtered out between arteries and veins at the cellular level.  Okay, there it is, we just lost the sun.  Walk with me in the dark for just a second.

There are many different medical and structural issues that can affect the load on the lymphatic system’s fluid transport ability and when it can’t keep up, you guessed it, edema happens.  The lymphatic system itself can have abnormalities that affect its ability to function correctly.  There’s even a little roundworm that is transmitted to humans by mosquitos mostly in tropical countries that has an appetite for human lymphatic vessels and basically destroys them.  Outside of developed countries, this is the #1 cause of lymphedema in the world.  120 million people have this.  120 million.  There are effective treatments but I’d still take some Deep Woods Off if you plan to go down there.  Here’s a classic example.




In developed countries, the #1 cause of lymphedema is obesity.   There are even some medications that can cause lymphedema.

I mention all of this mainly because of what I mentioned earlier.  Expectations. There is no question that venous insufficiency can cause or contribute to leg edema.  If I’m asking in my advertising if you have swollen legs then you might have venous disease, I better know what your next stop needs to be if you don’t.

The good news is that for patients clinically diagnosed with lymphedema, there are treatments available to help manage the disease.   There are lymphedema clinics that specialize in this very issue.

This brings us right back around to what I mentioned at the beginning of this.  Job #1 for me is providing education and awareness of the resource that Precision Vein Therapeutics can offer patients in terms of thorough evaluation for the presence of treatable venous disease, and then offering those definitive, effective outpatient treatments in the same office-based setting.  For those patients with a family history of venous disease, living with chronic leg and ankle edema, thinking it is just a sign of aging, working too hard or it’s something that just “runs in my family”, understand that waiting can be a very bad thing.   Make an appointment and get treatment.

That’s the big picture.

Michael R. Barlow MD, RPhS

Precision Vein Therapeutics

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