I spent a long time getting my medical training. Since my background is pretty broad…back-to-back residencies in Internal Medicine & Emergency Medicine…and then doing MORE training in the specialty devoted to treating vein disease called Phlebology…I learned a whole lot about a whole lot of things. Some of the most important things relate to being clear about the risks of vein treatments.
Probably the two most important general concepts I learned were:
1. When to decisively, definitively treat someone.
2. When NOT to treat…or at least strongly consider advising the patient to delay definitive treatment in favor of conservative management. I’m certain that this is the more important of the two.
It turns out that the allopathic medical world is skewed a bit more towards #1 vs #2. It’s only with breadth of knowledge and experience that one gains
the insight required to “know when to say no”.
“Could” do something doesn’t mean you necessarily “should” do something when it comes to vein treatments.
Part of the reason why I spend 1 hour with all of my new patients is to learn all about their past and current medical issues. I also inquire about issues that may run in their family. I want to know about medications, surgeries, pregnancies, occupation…and more.
While it may seem at first glance that a lot of these issues may have little to do with spider veins/varicose veins…in fact, all of those bits of info help me calculate the potential risks that may occur with procedures.
Fortunately the risks of signficant side effects with any procedure I do are VERY VERY LOW. I keep the risks even lower by doing a number of things, but first and foremost is PATIENT SELECTION.
Patients who make the best candidates for procedures have the following characteristics:
- Active and mobile. Not only is there no down time after the state-of-the-art vein procedures I provide, patients are safer if they are more mobile and active.
- No recent (significant) surgeries
- No other signficant, ongoing medical issues that need to be addressed first: cancer, heart disease, peripheral arterial disease, uncontrolled hypertension or diabetes…to name a few
- If a patient recently delivered a baby, she must be at least 3 months post partum. Nursing isn’t an issue, though I tell nursing moms to store up some extra breast milk in the freezer and then “pump and dump” for a few days after any sclerotherapy session.
- No plans for (especially long) flights within a short period of time. While there is no standardized period of time, I am conservative in my approach and use 1 month as my cutoff.
- No known or suggested underlying blood clotting/bleeding disorders. This goes for the patients themselves as well as blood relatives.
- Not on medications that may increase the risks of blood clots: tamoxifen, birth control hormones,etc.
The above isn’t meant to be an exhaustive list, but it gives you a taste of some of the things that any careful, thorough doc should consider before recommending a treatment course.
Recommending against treatments isn’t a fun thing to do…who wants to be a party-pooper?!…but if you care about patients and give them recommendations as if they are friends or family [and by the way I LIKE my family!]…
it’s better to be right and safe than it is to be “popular”.
Just because I recommend against certain treatment options doesn’t mean there are NO options. Sometimes patients have to weigh the risks and benefits of being on blood-thinning medication before/during/after treatments. Other times patients feel better…both physically and emotionally…knowing that conservative measures such as compression stockings can help their symptoms and mitigate risks such as deep vein clots.
I often tell patients that even if I never do a single vein treatment for them, if I have helped identify a potential underlying risk factor for developing blood clots…information that could help other doctors decide when and how to do other critical medical treatments for them in the safest way possible…I will have done my duty as a physician.
When you come to Rosen Vein Care, feel comfortable in knowing that I recognize that you are more than just your leg veins.
The word “Care” is on the door for a reason.
to learn more about the Rosen Vein Care Difference.
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