Note: This Friday’s post will be delayed until Sunday, August 21!
Last fall when I first met with Dr. Anan Tawil regarding my varicose veins, he said that first would be the laser ablation and then would come the sclerotherapy. The ablation was completed in March, and I had my four-and-a-half month check-up mid-July. Dr. Tawil was very pleased with the results. We decided to go ahead with the sclerotherapy because the ablation did not finish the job. It’s hard to thread a catheter with a laser down a vein that starts to twist, so some of the worst looking veins were still there—not as large but still there. While, the ablation helped with the pain and edema, the sclerotherapy will make my legs feel even better and look good too. I’m all for that!
So, what is sclerotherapy?
It involves injecting the problem vein with a chemical that causes the blood vessel to close up and dissolve. Sclerotherapy is the main treatment for spider veins and is also used for treatment of certain varicose veins, like mine. It is performed in an office visit and causes little to some pain.
How does it work?
Using a very fine needle, the doctor injects a special chemical into the blood vessel. The chemical causes inflammation, which causes the walls of the vessel to stick together. As a result, the treated vessel can no longer hold blood. It shrivels and is eventually absorbed by the body.
How did it work for me?
I arrived in time to apply the prescribed lidocaine cream I was to apply one hour prior to the planned procedure, which was scheduled for 3 p.m. I was there at 1:30 p.m. and was placed in a regular patient visitation room. I had brought my blue paper shorts that I had been given for previous procedures there. I started applying the cream and had it on both legs by 2 p.m. This cream is the only pain deadening I would have during the procedure.
I then started doing a crossword puzzle. I had brought the puzzle book as well as another book to read for my one-hour wait. But before I knew it, Dr. Tawil stopped by to say ‘Hi” and to make sure I knew what we were going to be doing and to go over it briefly. Just as I got going again on the puzzle, the nurse came in to take by vitals and to give me some socks with knubby bottoms for when we walked down the hall to the surgical suite.
They did not wait until 3 p.m. About 2:30 p.m., one of the nurse’s took me to the restroom first and then the surgical suite. I laid down on a special table that could be raised or lowered. The nurse prepared everything that would be needed. Dr. Tawil came in and didn’t waste any time in getting started.
I was wide awake, but I could not see what was happening. However, I could hear everything that was said. Of course, I didn’t understand it all. Apparently, the doctor chooses a vein and decides whether air or CO2 is to be added to the chemical. And since the body can only handle a limited amount of the chemical, he decides how much he can get done within that limit.
Each time, after the the needle was inserted, there was some pain—not bad and it was brief. Then some massaging, or at least that’s what it felt like. Then he would ask the nurse for a flush. Not sure what all was involved with that.
Soon a PA (Physician Assistant) Lauren Jackson came in. Dr. Tawil had told me that she was very good; if he were to have it done on his legs, he would want her to do it. So, I totally trusted both of them. Then the fun began. Comments like, “I want to do that one.” “I’ll do this one.” “Oh, look how nice this one looks already!” “Don’t these look good!”
Every so often, Dr. Tawil would speak to me. “This is the part of the job we enjoy.” “Each time is like the first time.” “You will be so pleased.” He and Lauren were clearly enjoying themselves. I told them that I was really pleased to see them enjoying what they were doing. He kept telling me how well I was doing, and all I was doing was lying there. During the whole procedure, there was a happy vibe!
Since everything was going so smoothly, he asked me if I wanted the veins on my ankle done, and I said yes. Then, he asked if I was up for doing the other leg too. I told him that I was there and ready and why not. So, they did. Even with doing both legs, they were done in about 35 minutes.
After the doctors were finished, two nurses placed gauze and band aids where needed on places that had some bleeding. Then each took a leg and wrapped with gauze and then a stretchy tape that sticks to itself and last a thigh-high compression hose. The compression hose I was to wear for 48 hours. With all that snug bandaging, bending my knee was no longer fun. They were done by 3:30 p.m.
Because no anesthesia was used, I could drive home, and I did with no problem. I got home shortly after 5 p.m. I had a bear claw to eat, one of my favorite foods. Then walked for at least 30 minutes and met two different neighbors where we stood and chatted, so I was outside on my feet for about an hour. Then I came in and lay down and elevated my legs for a half hour.
My directions are to walk at least 30 minutes a day and to elevate legs often. After the 48 hours, I am to remove the compression hose and all dressings and take a shower. And to wear the compression hose every day for two weeks, but not at night. And no baths or swimming or heat or sunlight on the legs during that time. And I’m to take it easy, with no heavy lifting or using abdominal muscles for those two weeks.
Dr. Tawil said it would get worse before it got better. There would be bruising and possible lumps and other discoloration, but within six weeks or so, all the treated sites would look better. By four months even better. With sclerotherapy, it’s not a quick fix. You have to be patient and wait for the results.
In about six weeks, I’ll meet with Dr. Tawil. At that time, we will decide if more sclerotherapy is needed. When I saw him in mid-July, he thought four or five treatments would be needed. But I think they did more this past Wednesday than he thought would get done. So, we’ll see.
Besides the bruising and lumps and other discoloration, there are possible side effects. When you read through them, you’d think no one would ever undergo this treatment. For example, blood clots, skin ulcers, growth of new blood vessels around treated areas, and stroke. Yikes! But these are rare, and I keep telling myself that. So, I’ll wear my compression hose, walk 30 minutes a day, and elevate my legs often. These measures are to help in the healing and to avoid certain side effects.
Since I had such an easy time during the procedure, I won’t call it scare-o-therapy any more—I’ll save that name for the serious side-effects. I have had none and no pain, just the tightness of the bandaging and compression hose, which is annoying.
As far as I’m concerned, so far, so good. But as I write this, it’s only been a little over 24 hours. So, I’ll keep you posted.