By Joseph G. Magnant, MD, FACS, RPVI

What Do Varicose Veins, High Blood Pressure, High Cholesterol and Diabetes Have in Common?If you have been told by your doctor that your varicose veins are just cosmetic and present no immediate threat to your health or that your swollen achy legs are just something you are going to have to live with, you might want to reconsider your options. Several patients have presented to our practice with complications of their varicose veins in the past few months. These included clotting of the veins (thrombosis) with progression to DVT (deep vein thrombosis) or with external bleeding from their varicose veins. One patient bled on the pool deck, another bled on the floor in Walmart, and a third bled in her bathtub. What all these patients shared is the fact that until their complication occurred, they had not previously experienced pain or disability related to their varicose veins. Most of them did complain of swollen or achy legs, itching, heaviness, throbbing and heat around the varicose veins, however, none had actual “pain”. Most of their physicians knew about their vein problems but had not made any specific recommendations other than conservative therapy until complications occurred. With the modern diagnostic technique of ultrasound and minimally invasive treatment options of endovenous ablation available for the past 20 years (since 2000) it is time to change the way we approach venous insufficiency. Rather than reacting to complications of vein disease, it is time to take a more proactive approach to avoid future complications.

So why compare venous disease to other medical problems?
Hypertension has earned the nick name of “the silent killer” since many patients with high blood pressure are unaware of their condition until a screening blood pressure reveals a high reading or until they have a heart attack or stroke or worse.

Untreated high blood pressure may lead to premature heart attack, kidney failure, stroke and death. Similarly, proactive treatment of high cholesterol through weight loss, dietary modification, exercise and medication, when appropriate, has been shown to reduce the risk of stroke, heart attack and death related to hardening of the arteries. Screening blood tests for high cholesterol are routinely performed as part of an annual medical evaluation after the age of 40.

Physicians are not likely to advise their patients with high cholesterol to wait until their first heart attack or stroke before considering active therapy. The same can be said for the treatment of diabetes. Tighter blood sugar control with dietary modification, increased physical activity and
medications when appropriate, has been shown to slow the progression of a variety of complications of diabetes.

Patients may have been told by their primary care physicians that if their varicose veins, or swollen, discolored legs don’t hurt they should leave them alone. Over the past decade, our understanding of venous insufficiency has been greatly improved as endovenous ablation has been applied with excellent results to patients with some of the more advanced stages of venous insufficiency.

Modern ultrasound evaluation of the venous system accurately identifies which veins are insufficient (leaking) and determines the severity of reflux. Ultrasound directed sealing of the abnormal veins with endovenous ablation under local anesthesia has yielded far superior results than the antiquated practices of vein ligation or stripping. The result has been relief for millions of patients worldwide and for hundreds of thousands of patients in the USA. Ulcers are being healed in record time, stasis dermatitis changes are being reversed and both leg swelling and pain are resolving in thousands of patients who were once thought to be “untreatable”.

So, the questions are:

1) When to consider getting your vein problems evaluated.

2) Whether it is wise to leave varicose veins alone until complications occur. The next time someone tells you to wait for your varicose veins to “bother” you to
consider having a vein evaluation or treatment, think back on the proactive measures taken towards the treatment of patients with other medical diseases such as high blood pressure, high cholesterol and diabetes. It is preferable to avoid complications rather than to react to complications. The common goal is prevention
of long-term complications, not necessarily relief of “pain”. It has been 20 years since endovenous ablation has become the gold standard treatment for patients with symptomatic venous insufficiency, and from time to time it is appropriate to shed light on this safe, effective, and minimally invasive treatment for the many patients still suffering needlessly from the various signs and symptoms of venous disease.

If you or a loved one has any signs or symptoms of venous insufficiency such as varicose veins, leg swelling, fatigue, achiness, cramps or restless legs, leg skin discoloration or venous leg ulcers, please consider visiting our website at for more information or call (239) 694-8346 to schedule an appointment today in either the Fort Myers or Bonita Springs office.

Trust your leg vein care to Dr. Joseph G. Magnant & the Vein Specialists team.

1500 Royal Palm Square Blvd., Suite 104, Fort Myers, Florida | 3359 Woods Edge Circle, Suite 102, Bonita Springs, Florida

(239) 694-8346