I had ELA & sclerotherapy on 4 saph veins same day. After a couple of weeks I started experiencing lots of varied burning, pain, pressure tingling, numbness, and throbbing in my legs/feet. The doctor doesn't have answers for me. Why am I worse off and what should I do?
You are probably feeling the effects of the treated veins either closing or opening back up. Keep in mind that your veins have a lot of branches feeding off of them. Not all of these branches close with the laser or with sclero. Because your complaints started 2 weeks later, my guess is that some of these treated veins closed and now the venous structure in your leg has started to adjust to the closures. During this adjustment phase, you can develop new refluxing channels, new feeders try to pump into these treated veins or even trapped blood. All of these can cause the pain you are reporting. Unfortunately, your doc is probably someone who only does vein treatments on the side. A doc who only does veins would know this. Go find yourself a an accredited person who only does vein treatments.
Published on Jul 11, 2012
Usually, endovenous laser ablation is done on only 1 saphenous vein at a time to prevent unnecessary pain afterwards. There are nerves that run along those saphenous veins that can be irritated or damaged during treatment, and may take a few months to completely heal. Did the physician perform a follow-up ultrasound? The ultrasound is done to ensure the treatment was successful. Make sure your physician is accredited by the American College of Phlebology.
Published on Jul 11, 2012
After treatment, patients often experience a pulling sensation, which is the result of the vein hardening. Sclerotherapy, by definition, means hardening the vein. Also, post-EVLT the hardened vein pulls on the skin and can cause pain. Some edema, bruising and swelling may occur, and this is common. These symptoms may cause discomfort but should go away with Arnica, anti-inflammatories, and compression stockings. The most important complication would be nerve damage and blood clot. I always recommend to follow up with your physician ASAP if these present. If you have any concern, you are more than welcome to ask more questions. I would be more than happy to answer any other questions you might have.
Published on Jul 11, 2012
Thermal ablation may irritate nearby nerves, which could be painful for some time. If your doctor can't tell you why you have this problem I would seek another opinion to make sure everything is OK. When seeking a second opinion, be sure to find a vein specialist who is board certified and has years of experience treating veins with a variety of modalities.
Published on Jul 11, 2012
See a different vein specialist.
Published on Jul 11, 2012
Your symptoms are not unexpected. There is a healing process that needs to occur. The best you can do is to wear compression stockings daily, try to do walking exercises and use anti-inflammatory medications. It should began to subside after 1-2 more weeks.
Published on Jul 11, 2012
First of all, your doctor should understand that they blocked all main superficial venous exit routes for the blood in your legs at one time. With that understood, they should tell you that it will take some time for your perforator veins to adjust, since they will now convey the venous blood into the deep veins directly. Establishing such drastic alterations in circulation takes time and you will have to be patient as these changes adjust. They might also suggest wearing properly fitted gradient support stockings to reduce your
discomfort.
Published on Jul 11, 2012
In my practice we will only seal one saphenous vein at a time. If you are not getting support from your treating physician you should seek an opinion from a board-certified vascular surgeon who specializes in treating superficial vein disease. This is not a normal outcome. You may be referred to a neurologist to assess possible nerve involvement.
Published on Jul 11, 2012
Needs to be evaluated.
Published on Jul 11, 2012
It sounds as if you may have some nerve irritation following the laser ablation. The nerves most commonly affected are the saphenous nerve, which runs along the medial leg to the ankle and the sural nerve, which runs close to the small saphenous vein. It would be most unusual for all the nerves to be affected. Fortunately, most nerve issues improve over time. For now, I would try NSAID'S and possible topical heat treatments to the areas affected. I would also get a second opinion from a vein specialist.
Published on Jul 11, 2012
Find another MD if he cannot answer your questions.
Published on Jul 11, 2012