What is chronic venous disease?
Published:Wednesday | September 13, 2023 | 12:07 AM
Keisha Hill/Senior Gleaner Writer
CHRONIC VENOUS insufficiency occurs when your leg veins do not allow blood to flow back up to your heart. Normally, the valves in your veins make sure that blood flows toward your heart, but when these valves do not work well, blood can also flow backwards. This can cause blood to collect in your legs.
Legs and feet are parts of the human body where malfunction of veins is a frequent cause of illness and other threats to quality of life in senior years across the world.
“Individuals with venous hypertension often seek treatment advice only when the condition reaches advanced stage of chronic venous insufficiency,” said Dr Madhurt Gore, concerning the situation in India, writing in the Indian Journal of Surgery.
However, is there a silent crisis of chronic venous disease in Jamaica too? Close to 500,00 people in Jamaica might be dealing with quality-of-life issues, ranging from moderate to pressing, due to failure of their leg veins to properly return blood to their hearts.
The variety of diseases involved tend to become progressively worse for those who delay seeking help with their problem.
If this condition is not treated, you may have pain, swelling, cramps, skin changes, varicose veins, and leg ulcers. Intermittent pain, which may feel like cramps, muscle fatigue or heaviness, usually in the legs, worsening pain during exercise, usually in the legs, coldness of the affected body part, numbness, pins and needles, muscular weakness, blue or purple tinge to the skin, wounds that won’t heal, blackened areas of skin or skin loss.
Chronic venous insufficiency initially is not a serious health threat, but it can be painful and disabling. You are more likely to have this condition if you are overweight, are pregnant, have a family history of the problem, had damage to your leg due to injury, surgery, or previous blood clots, and illustration of the circulation system of the legs.
Other causes of chronic venous insufficiency include high blood pressure in the leg veins over time, due to sitting or standing for long periods, lack of exercise, smoking, a blood clot in a deep vein, often in the calf or thigh, swelling and inflammation of a vein close to the skin, and often in the legs.
Varicose veins merit special attention because their appearance is claimed among experts to be an early warning of much more serious conditions if there is a prolonged delay in attending to them.
The collection of these diseases poses a significant, if not major, threat to quality of life as you get older, and this may include swelling, chronic pain, various degrees of difficulty in walking which can be as serious as requiring wheelchair support or even amputation in severe cases related to diabetes.
On June 9, the UK All-Party Parliamentary Group on Vascular and Venous Disease published a report that highlights the challenges in treating the large number of patients with leg ulcers. Treating venous disease is a field in which UK expenditures rise into the billions of pounds per year.
The burden of vascular diseases goes beyond lives lost and changed. There is also a fiscal toll. Costs in the UK for vascular-related complications in patients is $20 billion per year. Healthcare costs for venous thromboembolism are $7.5 billion.
Eight years earlier, in a presidential address to the American Heart Association, the burden of venous diseases was characterised as representing a silent crisis in the nation. In medical journal articles there are estimates that close to 30 per cent of the adult population in various countries are under some stress from diseases caused by failure in some aspect of blood flow involving their leg veins.
In order to treat chronic venous disease, your doctor will take your medical history and give you an examination. You may also have an imaging test called a Duplex ultrasound that looks at blood flow and the structure of your leg veins. The test also checks the speed and direction of blood flow in the blood vessel.
Vein Centers of Jamaica has two clinics in Jamaica, that are located in Montego Bay and Kingston. Their vascular medicine specialists are Dr Bart Muns and Dr Hilary Brown, both vascular surgeons.
SOURCE: Bridget Lawrence, chief executive officer of Footcare Academy based in Toronto, Canada and Ardinel Davis of Riviera Wellness Ltd (Jam). For more information contact: bridgemick@gmail.com or rivierawellness@outlook.com
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TREATMENT FOR CHRONIC VENOUS DISEASE MAY INCLUDE:
• Improving blood flow in your leg veins: Keeping your legs raised (elevated) can reduce swelling and help increase blood flow. Wearing compression stockings may also help. Regular exercise can also improve blood flow.
• Medicine: Medicines that increase blood flow through the vessels may be used along with compression therapy to help heal leg ulcers. Aspirin can also be used to help ulcers heal. Medicines that draw excess fluid from the body through the kidneys (diuretics) are not often used. But they may be used if other conditions such as heart failure or kidney disease are also linked to the swelling.
• Endovenous laser ablation or radiofrequency ablation (RFA): This is a minimally invasive procedure. A tube (catheter) puts heat right into the affected vein. This closes the vein. Once the vein is closed, less blood pools in the leg. Overall blood flow is improved.
• Sclerotherapy: This may be used if your case is more serious. A chemical is injected into the affected veins. The chemical causes scarring in the veins so that they can no longer carry blood. Blood then returns to the heart through other veins. The body absorbs the scarred veins.
• Surgery: This is done in severe cases. Ligation is a type of surgery that may be used. The affected vein is tied off so that blood no longer flows through it. If the vein or its valves are heavily damaged, the vein will be removed. This is called vein stripping.