Venous Disease - John's Story

John Carrabino, 49, a utility pole lineman, was correcting a break in a client's telephone wire, when he started to feel faint.

"Not again," he muttered to himself, but he knew he'd have to get down from that high telephone pole, no matter how heavy his cleated boots, if he wanted to ensure his safety: his chronic venous insufficiency was acting up again.

This beleaguering condition, in which a patient's veins are chronically unable to properly pump enough oxygen-poor blood back up to the heart, is due to damaged vein valves.

Sometimes referred to as "impaired muscle venous pump," the affliction typically besets utility pole linemen, such as John Carrabino (they have to stand for long hours) and paratroopers or similar men who are likely to get leg injuries.

Commonly, however, the condition usually appears in women who are most prone to have varicose veins. The enlarged veins are more than unsightly: they also cease to function at optimum level...thus, varicose veins venous insufficiency results.

If phlebitis (inflammation of the vein) usually spurred by a wound, and then infection, occurs — the blood flow through these swollen veins turns sluggish and faulty.

An interesting difference exists between deep venous insufficiency and superficial venous insufficiency.

In deep venous insufficiency, (usually a result of deep vein thrombosis, which can be chronic deep vein thrombosis, acute deep vein thrombosis or both) a person's deep vein valves are so horribly damaged, they're far too weak to react in time to prevent deep system reflux.

That, unfortunately, puts tremendous pressure (with its unpleasant side effects of venous stasis and venous edemas) on a person's lower extremities.

Superficial venous insufficiency is more common, though.

In this circumstance, the deep veins function normally, but that important venous blood, instead of continuing merrily along through the deep vein system the way it's supposed to, goes on the lam and breaks all the rules: it flows the wrong way through exhausted, over-dilated superficial veins...and these veins' weak valves simply can't handle the rebellion.

Why, then, do those poor valves go kaput.

Well, as always, congenital reasons may play a part in venous stasis changes. A hard-hitting injury might wreck (at least temporarily) the valves, resulting in venous disorders, or superficial phlebitis could cause the valves to stop working.

Watch out for deep vein thrombosis: it could mean a blood clot's formed in your legs' large veins. The blood clot is a will-it-or-won't-it time bomb. It may float in its area harmlessly, indefinitely, or it might break free — jetting up to your lung artery, which could kill you.

This pulmonary embolism is very difficult to diagnose and treat….all the more reason to keep your veins healthy.

In venous peripheral vascular disease, often seen in diabetics, the arteries get so blocked by waxy plaque that feet and/or legs fester into gangrene. Amputation, severe as it is, is sometimes the only solution to this troubling malady.

Okay, so how do you know you have chronic venous insufficiency or any kind of venous stasis or vascular disease…and not just a set of normally tired legs?

Well, a few nagging symptoms are important to consider.

First, your limbs and skin might itch so furiously, (pruritis) no amount of scratching ever satiates the horrible, prickly agitation. Skin in the affected area turns thick and scaly — sometimes flaking into eczema.

That and hyperpigmentation result from venous stasis skin changes: whatever color your skin is normally, it darkens to startling hues of purple and deep red.

Thank venous stasis dermatitis for the new look.

Also, your legs, besieged by poor circulation, might erupt in a bouquet of indicators: varicose veins, venous stasis ulceration and skin ulcers.

The weepy ulcers, mired in venostasis, easily get infected. If so, they waft out stinky odors. Pus drips from the tender, painful areas. Not a lot of fun.

If that weren't enough, this lower extremity venous disease puffs out the venous veins into lumps of swollen leg edemas…which pock into dimples or pits.

Are the leg ulcers and venous ulcers becoming chronic?

That, too, most likely means that your venous insufficiency and resulting venous stasis ulcer (venous insufficiency's various aliases include postphlebitic syndrome, deep vein thrombosis, and venous reflux disease) isn't just a one-time incident, but a serious condition that needs some close attention.

For one thing, chronic leg ulcers and all venous disease symptoms really exhaust a person. The body needs to keep its essential fluids in. Weeping, oozing ulcers that don't seem as if they'll ever heal are extremely fatiguing — not just physically, but emotionally and mentally.

How, then, can a patient treat his or her chronic venous insufficiency or any sort of vascular diseases of the legs?

And you know the friendly, colloquial expression "take a load off"? It's incredibly apt here. Lying down with your legs elevated facilitates good blood flow back to the heart.

But most basically, your doctor will undoubtedly prescribe compression garments, or compression stockings, typically a knee-high stocking that is of sufficient compressive strength to compress your lower leg so the diseased, leaky valves, that are largely the cause of the problem, will close properly. This is the single most common means to address the underlying cause of chronic venous insufficiency.

What brands are best? Go with the industry's leading manufactures. They are Medi, Jobst and Juzo.

When your doctors tell you to get the stronger compressive strength stockings, meaning 30-40 mmHg, or a class 2, do it! Don't wimp out and get the over-the-counter, 8-15mmHg, or 15-20mmHg. It's not strong enough. They won't close your veins.

If you try them and have trouble getting them on…and off (referred to as donning & doffing), spend a few more dollars and purchase Medi CircAid® Juxta-lite™. This amazing knee-high garment is NEW. The in-elastic material, called Breath-O-Prene®, with Velcro® closures make it is so much easier to manage. And it comes with a compression measuring card that allows to accurately apply the garment to maximize it's effectiveness.

Also, if you have a venous stasis wound, they are covered by Medicare!

Now, many doctors also like their venous stasis patients to use a pneumatic compression device at home on a regular basis – at least one hour a day. The Bio Compression 2004 system is a tremendously helpful adjunct to daily compression stocking wear. These devices increase venous return which really help decrease edema and the all nasty swelling that builds up during the day.

Talk about taking a load off! Get in your recliner, put on your Bio Compression 2004, and feel the pressure in your legs subside.

Then read a book and get some rest…and enjoy tomorrow with healthier legs.