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Courtesy : Subhadra Nambudiri Foundation

Not sprains but could be problematic veins

Rub it and forget it seems to be the instant mantra these days when one suffers from a self-diagnosed "sprain". Influenced attractive advertisements, the normal tendency is to go for the pain reliever balm from the friendly neighbourhood chemist, apply it on the affected part and forget it...Ooh..Ah...Ouch.

But Doctors say things are not that simple. Watch out if you have been suffering from ankle ache and swelling that disappear at night when the legs are elevated. If so, then it's high time you act fast, as this could be a serious problem related to veins, they warn.

Symptoms

•  Leg ankle swelling and ache towards the end of the day but disappears when the legs are elevated.
•  Discoloration just above the ankle that slowly will lead to distressing weeping ulcer which is not only very uncomfortable but needs daily dressing.

According to Dr. Jaisom Chopra Senior consultant with Batra Hospital "Should some injury take place over the dilated veins , they bleed like a tap, and scare the patient, who lands up in the casualty. In such cases, one must immediately contact a vascular surgeon."

Causes When we stand the ankles take all our weight . In a normal person, on standing, the weight of blood is transmitted to the ankle but the valves break the column of blood into small compartments and reduce the pressure at the ankle , However when the valves are spoilt, the weight of the entire blood column is transmitted to the ankle. (which is increased more than 10 fold) This leads to distressing complications like profuse bleeding, discoloration and ulcers.

Diagnosis A bed side ultrasound is conducted by the vascular surgeon to know if the cause is due to weakness of the valves in the veins or is it the weakness of the vein wall that is responsible for these ugly looking veins. "Only after establishing the basic cause the vascular Surgeon will advise you the treatment." says Dr. Chopra.

Treatment

The basic treatment of Varicose Veins is to reduce the abnormally high pressure at the ankle. There are three forms of universally accepted treatment available . q To wear stockings q Injection treatment in to the veins- sclerotherapy q Operative treatment

Out of all the three options wearing stockings appears the best option for the patient as it avoids surgery. It reduces the pressure at the ankle, but have to be worn life long despite the seasonal variation, even during the hot Indian summer. They also delay the ulcers but don't prevent them.

Injection therapy is very commonly conducted in the OPDs (Outpatient Department) . This does not need admission and involves multiple needle pricks over the dilated veins using a sclerosing agent. This has its limitations as it may not succeed in cases with strong reflux. It may be used in aged and non-surgical candidates.

Surgery is commonly advised , in cases with venous reflux, as it is effective. Surgery is conducted by making legs numb by an injection in the back. Hospital admission is for 48 hours and no bed rest is needed after surgery. This is most commonly followed method all over the world as it is effective.

According to Dr. Chopra , " Varicose veins are a common problem all over the world and are neglected as complications take years to present, most people wait for the distressing stage."

One can make life comfortable by getting it treated early when the results of the surgery are better and you are permanently cured .Chances of recurrence is minimal says Dr. Chopra.

from SUNITA GOVIND