Vascular Surgery/Horrible leg pain and veins
Hi, I am going to give my history and help you find the questions by numbering them. (I have ADD and a lot of kids so I like to organize lol)
ok past history, I am 38,thin (5'6 115 lbs#. Pretty healthy, I do have POTS which has gotten better since I have been pregnant. I have had 4 kids and I am currently pregnant with the 5th. My legs have gotten considerably worse, with the 4th #3yrs old now# I had a superficial clot behind the right knee and during the ultrasound the lady said they were the worst she had ever seen, not even considering I was one of the youngest. I went to see about getting them fixed last summer and they said, if it's more than a second then insurance would pay and they were over 8 seconds in four large veins. #I made the mistake of thinking I was being polite saying yes, thank you for the stockings, they help me be able to stand at least, so he said no#
So, now. I work just as a lunchlady for insurance #hubby's is horrible# and I am on my feet just over 2 hours, I can sit #I do get up and down# on a stool for the other hours. My left leg looks horrible, it is achy and tired but for some reason my right leg looks ok but it hurts so bad I cringe and find myself holding in the tears throughout the day. It hurts in my calf and esp behind my knee, and it is a different pain from the left. It is a more physical pinpointed pain. I did call my Dr last week and she ordered an ultrasound #I didn't see her# so I got it and they said there was no clot so that made me feel better so I don't think I am worried but #1# do you think I should be worried about anything else? What do you think is causing the pain? Like I said, there are no visible veins popping out and the pain is different from the left leg where the veins are hugely popping out from my thigh to my foot. My stockings do help, there is no way I could work without them and even with them I am hurting very bad. I am only 11 weeks pregnant and I'm worried about making it to the end of the school year when I will be 7 months. #2) Are there any problems or anything to look out for that I should be worried about? Everything I read say that varicose veins while painful and annoying aren't really dangerous but I wanted do make sure there wasn't anything I should be worried about. I think can work through the pain as long as I know I will be ok.
In general, varicose veins are caused by venous insufficiency. Venous insufficiency is diagnosed with an ultrasound that looks for reflux, valves that are working properly, and veins that are distended or swollen and of a certain diameter. The ultrasound should not just be looking for clot.
Each insurance company has a similar set of requires including
pain – that is not relieved by medications,
elevation of the legs, exercise, skin changes – this means discoloration around the ankles, open wounds, scratchy skin, itchy skin. skin thickening,
swelling of the legs
and that the patient has been wearing 20 to 30 mm of compression knee-high, thigh high, pantyhose stockings over a 3 to 6 month period.
The ultrasound combined with your symptoms, is what the insurance company bases its recommendation for treatment on.
The stockings are meant to control the symptoms, prevent the swelling and the skin changes.
If you have been wearing stockings and you continue to have symptoms, this is when insurance companies will generally pay for the VNUS closure procedure
If your doctor says that you can't have your incompetent veins fixed because you're wearing stockings, you need a second opinion.
one of the causes of venous incompetence is pregnancy. One of the things that exacerbate symptoms is standing on your feet all day. Without treatment, you will continue to have pain swelling and skin changes including possible skin ulceration. The stockings are considered a treatment but if they are not eliminating the problem, ask for help. There are so many doctors out there now doing venous procedures you should be able to find one who does this exclusively, and will take your insurance issues for you. I hope this helps Lauri