I have Factor V Leiden but don't know if I have one or two gene mutations. I have pain in my calves often and horrible varicose veins. I only wear compression stockings when flying and I fly often. I'm 53 years old and not overweight. I'm devastated to learn about my condition and think it is related to the knot-type varicose veins in my feet and ankles. What should I do? Should I be wearing compression stockings all the time? Treatment?
You should see a vein specialist for a full venous evaluation and a venous reflux ultrasound. You can easily be assessed for homo or heterozygous Leiden Factor, and this evaluation, together with a venous exam, will help to decide the best way to treat this. In the interim, you should wear 20-30 mmHg knee-high compression stockings during the day and remove them at night.
Published on Jul 11, 2012
Extended air travel is a risk factor for venous thromboembolism and that risk is increased in patients with Factor V Leiden. Therefore, use of compression stocking, remaining well hydrated and activating the calf pump (try drawing the alphabet with your feet) is highly recommended. Otherwise, wearing compression stockings as much as tolerated is recommended. The varicose veins in your feet and ankles are likely treatable. Start with an ultrasound to ensure patency of the deep venous system and appropriate outflow. If the varicose veins are from superficial venous insufficiency, they can be treated safely. Specific treatments such as vein ablation, phlebectomy or sclerotherapy depend on your anatomy.
Published on Jul 11, 2012
Yes, compression stockings are a good idea, especially when flying or sitting for longer periods. The best option for the varices is to have them treated by an experienced vein specialist.
Published on Jul 11, 2012
Factor V Leiden is a clotting disorder. It is neither the cause of your vein issues nor the source of any of your symptoms. The compression stockings are great for you on the planes (thigh high stockings is preferred), but are only a potential source of symptomatic relief when you are up and running around. Unfortunately, they are also not the cause of your knot-like varicose veins at your feet/ankles. Vein disease is inherited for most people. What or which veins ultimately go bad is genetically determined and not related again to your clotting disorder. Where your clotting issue plays a role is in your relative risk of developing blood clot in one of your varicose veins, which causes your venous blood to not flow correctly. This in turn puts you at greater risk of clotting in those vessels (stagnant blood tends to clot). Having your veins treated will not get rid of your Factor V issue but can help to decrease the amount of blood that is stagnant in your venous system. Thus decreasing your relative clotting risk. You should also try to find out whether you are homozygous or heterozygous for the Factor V trait. It could affect whether you ever need to be on chronic blood thinners.
Published on Jul 11, 2012
The best course of action is to treat your varicose veins. This will eliminate a major source of thrombosis and relieve your symptoms. Find out
whether you have one or two Factor V mutations (heterozygous or homozygous); one is common and by itself and represents a minor issue, but
two is major and requires a more aggressive approach. Meanwhile, compression stockings should reduce your chances of thrombosis.The more
risk factors for thrombosis you have the more likely it can occur.
Published on Jul 11, 2012
There are many possible benefits of compression stocking for selected individuals. With your medical history you would certainly receive benefit from wearing them most every day.
Published on Jul 11, 2012
Great question. Firstly you should have an ultrasound examination by a board certified vascular surgeon who specializes in treating varicose veins. You should also be screened for a blood clot and this is urgent. Also the ultrasound will determine the cause of your varicosites which most commonly is saphenous reflux. If saphenous reflux is present this can be treated minimally invasive laser ablation with clotting precautions before and after surgery. Your Factor V is an inherited condition and not caused by varicosities. I would recommend that you wear a medical grade compression thigh length stocking which is professionally measured and fitted.
Published on Jul 11, 2012
You need to address the varicose veins by seeing a vein doctor.
Published on Jul 11, 2012
Whether you have one copy or two, you should wear your stockings daily. Even though you are at higher risk for blood clots, you may still be a candidate for treatment. If your symptoms are moderate to severe, treatment is warranted. In high risk patients, short term blood thinners are always an option to prevent blood clots around the time of treatment.
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PATIENT QUESTION
ID:35901
Question: I have Factor V Leiden, calf pain and horrible varicose veins, should I be wearing compression stockings all the time?
Procedure: Compression Stockings
Question Detail: I have Factor V Leiden but don't know if I have one or two gene mutations. I have pain in my calves often and horrible varicose veins. I only wear compression stockings when flying and I fly often. I'm 53 years old and not overweight. I'm devastated to learn about my condition and think it is related to the knot-type varicose veins in my feet and ankles. What should I do? Should I be wearing compression stockings all the time? Treatment?
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Published on Jul 11, 2012
You should wear stockings routinely. See a vascular specialist.
Published on Jul 11, 2012