Questions on Varicose Vein Surgery
The day after your procedure – the local anaesthetic will have worn off, so don’t be surprised if your bandaged leg are a little more uncomfortable than usual. They will also be slightly more swollen and tender. Patients have different experience in pain; taking regular pain killers (Paracetamol four times a day, Ibuprofen, Cocodamol) is therefore essential for the first few days. They do ease off the pain and make you feel much better.
Most patients recover from Radiofrequency Ablation and Foam Sclerotherapy without any problems. Feeling tightening sensation, cramping, bruising and swelling in your leg after a couple of days is expected, and this may last for a few days (occasionally for 2-4 weeks).
DO: leave your bandage for 24 hours then remove. DON’T remove the stockings for one week (ideally days and nights as they are difficult to apply).
DO: Keep active and run your daily activities. DON’T be overactive, however, and avoid heavy exercises .
DO: Take shower if you wish on the upper part of your body. DON’T shower the stockings!.
DO: contact us or your GP if you have any concerns. DON’T be panic; everything will be fine with good after care.
Yes it is indeed! Surgery to veins, including key hole surgery, treats vessels full of blood. The healing process will be associated with bruise here and there. You might feel feverish as well during the process of absorbing remnant blood. Don’t worry: Once this process finish, you will have much better quality of life and your legs will improve quite well.
You can return to work when you feel comfortable and well enough. We advise taking off work for 2-7 days. For jobs involving prolonged standing or driving, or if you’ve had both legs treated at the same time, you might need to take longer off work but all depends on how you feel in yourself.
Don’t drive for 48 hours after your procedure. You can then drive again when you are free of pain and able to perform an emergency stop comfortably. Please check with your insurance company if you are in doubt. If you are stronger painkillers (such as codeine) then please check with a pharmacist if it is safe for you to drive.
You should avoid flying long haul (any flight over four hours long) for at least few weeks after your procedure as sitting down with the knee bent for long increases the risk of DVT.
The answer is NO! Your treatment has been for symptoms mainly, with additional benefit of improving the overall appearance. The cosmetic result is not guaranteed, however, as it is not the main reason to offer you the treatment.
Please seek help immediately (call 999 or go to A+E) if the following occurs:
• You have difficulty breathing, especially if it gets worse when you take deep breath.
• You have chest pain.
• You have a significant cough, or you cough up blood.
• You are not able to put your foot down due to the pain.
Questions on Hernia Surgery
As with any surgical procedure, there will be some pain during recovery. Your pain will be most severe the first few days following your surgery, and then it should subside gradually. You will be given a prescription for paracetamol+Codeine for the pain – 1 to 2 tablets every 6-8 hours. You should avoid driving while taking Codeine because it can make you drowsy. Once the pain improves, you may substitute the codeine with Paracetamol only.
The intermittent use of an ice pack on the wound for the first 48 hours will also help to reduce the pain and prevent swelling. All the aches and pains associated with a hernia repair will take several weeks to months to fully resolve, but you should see a gradual improvement on a daily basis.
You may shower at any time but no bathing until 2 weeks after surgery. When you shower, you can wash over the dressing with soap and water providing they are water-proof. Please check with nurses.
If you had a standard/open inguinal (groin) repair or umbilical hernia repair (not laparoscopic), you should avoid lifting anything greater than 10 pounds and any form of activity that puts strain on your abdominal muscles for 2-4 weeks.
If you had a laparoscopic inguinal (groin) repair, you should avoid lifting anything greater than 10 pounds and any form of activity that puts strain on your abdominal muscles for 1 week.
DIET: There are no dietary restrictions after surgery. You may become constipated after surgery, so it is best to include fiber (ex. Bran, grains, vegetables) in your diet along with plenty of water. In addition, you should take the some laxatives until your bowel function return to normal. If you do not have a bowel movement in 48 hours, please consult your GP.
DO: contact us or your GP if you have any concerns. DON’T be panic; everything will be fine with good after care.
Patients generally leave the hospital the same day of surgery, but may need an overnight stay depending on their pain and level of discomfort. When you return home, try to return to your normal daily activities as much as possible. As your pain resolves, you may resume regular activities as tolerated. As you increase your activity, your discomfort will undoubtedly increase, but this is not harmful. Simply use common sense. When you start experiencing soreness or pain, it’s time to slow down or stop what you are doing. Walking will be the best form of exercise.
You may begin driving after 48 hours or when you are no longer taking strong pain killers. You can return to work when your pain level allows that, except if your job requires heavy lifting. Typically, patients stay off work for an average of one week, but this is variable of course.
Laparoscopic incisional hernia will not have huge physical activity limitations. Just be sensible when holding heavy objects.
You should avoid flying long haul (any flight over four hours long) for at least 4 weeks after your procedure as sitting down with the knee bent for long increases the risk of DVT.
Please seek help immediately (call 999 or go to A+E) if the following occurs:
• You have difficulty breathing, especially if it gets worse when you take deep breath.
• You have chest pain.
• You have a significant cough, or you cough up blood.
• You have redness around the wound, or discharge from the wound itself.
• You have severe painful swelling in the wound.
Questions on telangiectasia and thread veins
A thorough clinical examination and duplex scan should be done first to ensure there are no underlying vein issues that can be the origin of thread veins or can result in early recurrence after treatment (one-stop clinic).
A treatment of any underlying vein disease should be offered, using endothermal ablation (laser or radiofrequency ablation, both are effective and have low morbidity) under local anaesthetic.
The thread veins can then be treated using injection sclerotherapy, thermavein (electric low current), or laser. The treatment choice depends on a)the size and type of thread veins and b)the skin nature and location of lesion.
This is our protocol:
• Treatment: Thread Vein Removal
• Purpose: To eliminate symptomatic/unsightly thread veins
• How it works: Removes thread veins using dual modality blue-light laser pulses and sclerotherapy with a micro 0.0008″ needle
• Results: Seen in days to weeks
• Note: Individual results may vary
• Technique: Dual modality Blue-light laser and sclerotherapy (available at all clinic sites).
• 2nd Line Technique: Thermavein microwave (available at Runnymede Clinic – Surrey)
• Anesthesia: Special Vibrata device (Simon Ourian’s technique)
Time it takes: 15-45 mins.
• Recovery: Immediate
• Lasts: once injected, most injectable thread veins respond to sclerotherapy and converts into a fibre with no further discolouration. New thread veins can form in time.
• Pain level: Varies, none to mild.
Sclerotherapy for varicose veins has been performed for more than 100 years. Spider veins have been treated for over 50 years. The smallest spider veins have been effectively treated for only the past 10 years, when needles became super small to use in injection.
A sterile sclerosing solution is injected into the veins. This solution chemically removes the inner layer of vein and permanently stop the vein from being a smooth conduit to blood. This occurs within 60 min from injection. Injecting directly into the vein ensures that only the vein is removed.
Laser and electric needle treatments for spider veins can potentially affect the overlying skin (scar, discolouration). The advantage of sclerotherapy is that the needle is placed under the skin directly into the vein. Thus, the likelihood of damaging the skin is greatly reduced.
The injection procedure is generally safe and effective. Complications were more common in the past, but with the use of safer sclerosing agents and lower concentrations, as well as the availability of very fine sterile needles, complications today are quite uncommon.
Possible complications include: infection (need antibiotics if happened), bruising, pigmentation in the skin, small ulcer, and allergic reaction.
Temporary or permanent discoloration may result from sclerotherapy after the veins have disappeared. This discoloration may parallel the course of the treated vein. However, such discoloration is usually less unsightly than the veins.
Scarring and small ulcerations of the skin, although rare, are potential complications. This results from leakage of the solution from the vein into the overlying skin. Such scars are usually very small and are much less obvious than scars that invariably result from surgical vein stripping.
There may be mild discomfort at the site of injection when the procedure is performed. This is caused by the solution and may feel like a stinging or burning sensation. The needle itself is very small so there is minimal, if any, discomfort. Some people develop a muscle cramp in the leg or thigh near the veins that are being treated. This is due to the sodium in the saline solution. If a cramp develops, it subsides within minutes after the injection. We use a special device (VIBRATA) to help reducing the discomfort.
The procedure is done in the outpatient treatment room. After the treatment session you may go back to work or resume normal activities. There is no recuperation period and no need for bed rest.
The number of visits depends on the number of thread veins areas that you have. In many times, only one treatment is needed. However, if there are a great number of veins, several treatment sessions may be required. This can be determined during the initial consultation. You should be seen one month after your first treatment to assess the degree of improvement. At that time, if additional veins are present another treatment may be offered.
Immediately after a treatment, the skin will be red and there my be some bruising. This color usually disappears within a few days. The treated veins may be firm and tender to touch until they are absorbed by the body. This process of absorption can take several weeks to several months depending upon the vein size.
Before leaving the office, the treated leg or thigh is wrapped with stockings.
Once you leave the office, there is usually no discomfort. However the elastic bandage may be bothersome because it fits tightly. It remains on for 3 to 7 days, depending on the vein size and location.
The elastic bandages may be removed to take a bath or shower but should otherwise be kept on, including at bedtime in the first few days. Swelling may be seen below the bandage. This swelling disappears about one day after the bandages are removed. For the ftrst 24 hours after the treatment, it is recommended that no heavy activity take place, such as running or aerobic exercise. After the first day you may resume all types of activity. immediately after sclerotherapy you may perform your usual nonstrenuous activity, such as going to work.
No. You should be able to get along well and can even drive yourself.
Spider veins slowly disappear over several weeks after the treatment. Large varicose veins may take longer to disappear, sometimes several months. While the veins are fading, there may be some faint redness.
It is recommended that you avoid getting much sunlight to the treated site. If you plan on being outdoors within the first month after the elastic bandage is removed. you should apply at least a #25 SPF sunscreen on the skin over the treated veins.
This procedure can be performed any time of the year. However. since there may be a slight bruising and redness to the treated site for a few days to a couple of weeks, you may not want to begin treatment just before taking a vacation or going to the beach.
If you have a history of phlebitis, or blood dot of the legs, this procedure may not be recommended.
Before beginning therapy you should inform us of any medical problems that you have and all of the medications that you take. Although there is no harmful chemical injected with this procedure. we prefer not to treat women who are pregnant or nursing. since varicose and spider veins that worsen during pregnancy often become smaller or resolve after delivery.
This procedure can be performed any time of the year. However. since there may be a slight bruising and redness to the treated site for a few days to a couple of weeks, you may not want to begin treatment just before taking a vacation or going to the beach.