You’re so vein – homonyms are fun, but it’s not Carly Simon, it’s Medical Matters!

September 21 – When there are problems in your veins, it’s a good idea to get them checked out and fixed.

Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.

One of the issues you can find with your veins is chronic venous insufficiency (CVI). That’s when the veins in the legs are quite literally not working the way they should.

There are tiny valves in the legs that prevent the backflow of blood, but sometimes they can become damaged and no longer work. That makes blood pool in an area of the leg, causing discomfort and damage.

Sommer said, “There’s mild symptoms. You could start to feel tired and achiness in your legs. Your skin becomes kind of itchy. You could see the veins. Your veins start to bulge or you have spider veins and you have more than were there prior, but the biggest issue with chronic venous insufficiency is when you have a non-healing wound.”

That is when you would need to have some corrective action taken to help treat that.

Sommer explained, “It is a valve problem and if you do have an open ulcer, what happens is it’s that non-working vein is preventing the healthy veins to take the pressure away from that wound, preventing it to heal.”

Then there are varicose veins, which affect about one in every three adults, and are twisted or enlarged veins. One in every 50 adults have varicose veins that can develop into chronic venous insufficiency.

Sommer said, “Usually for people over the age of 50. There’s that 50 club.”

If the varicose veins get bigger or bulgier or if the legs are more achy and tired or you can feel pins and needles in the legs, these are red flags. Another symptom is cramping or discolored skin and your provider should be contacted.

Age and a family history can make a person more susceptible to CVI.

Sommer said, “Pregnancy is another issue that a lot of women it can happen during pregnancy. It’s all the pressure, the extra volume that you carry when women are pregnant. It puts a lot of pressure on your legs, on the venous system. So they can develop varicose veins afterwards that later on can turn into chronic venous insufficiency.”

Obesity is another issue that makes a person more susceptible to CVI. It’s important not to be sedentary – get up and move.

Smoking and tobacco use is also on that list.

Sommer said, “Of course if you have a job where you’re sitting and standing for long periods of time – hospitality workers, nurses, doctors, where you find yourself standing. You’re just standing in one spot. So everything just sits kind of still while you’re not moving, increasing the risk for varicose veins and chronic venous insufficiency.”

CVI does have various stages. It goes from stage zero to stage six.

Stage zero is just tired and achy legs.

Sommer said, “Which a lot of times if you are on your feet all the time and if you have a long day, your legs will feel achy and tired. If you start to see more visible blood vessels, like big bulging veins, even spider veins, if they’re coming out more frequency, like you notice oh, I never had that before, that’s a sign that something could be going on in your legs.”

Veins that are larger than three millimeters, edema or swelling in your legs with skin-color change and a non-healing would called an ulcer can all be signs of CVI.

What can be done if you find you have CVI?

Sommer said, “You might start off with a trial compression stocking that they might have you wear for three months. A lot of times, that’s a compliance issue, but it’s also a quality of life issue and being down here in the heat wearing a stocking from your feet up to your thigh is near impossible when it’s 98 degrees.”

Radio frequency ablation is done if you have CVI.

The patient comes in, the leg is prepped. No anesthesia is required – it’s local anesthetic.

Sommer said, “Occasionally we might give you something to calm you down, your nerves, because it is a procedure and people do get nervous and we do understand that.”

An ultrasound is performed and the spot is determined and a needle is inserted into the vein. Then a guide wire is inserted into the vein where the doctor will remove the needle and put in a catheter that will close down and seal that messed up vein with some heat.

Sommer said, “Once the catheter is in place, the physicians will inject some more numbing solution. So it essentially is pretty painless. We try to make it as painless as possible before they turn the heat on. Then once he turns the heat on, it seals the vein and then he removes the catheter.”

The patient will be back to normal activity within two to four weeks.

Sommer said, “There are other vein procedures that we do in the office, cosmetic-wise if you have spider veins, we are able to treat those as well. So come on down if you have any questions about your veins and we will be more than happy to see you.”

For more information on CVI, click here: