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Frequently Asked Questions

Read the answers to questions we have been asked by our patients. Please note that the information provided is intended to support patients and is not a substitute for medical advice and treatment. Consultation with a doctor is required for the bond between doctor-patient to be created.

OF GENERAL INTEREST

Whom can I talk to about my medical problem?
When deciding to consult a vascular specialist for your vascular problem, it is essential to have quality face-to-face time with the surgeon who will carry out the treatment. We make sure you get this time.

What will happen at my first consultation and what do I need to do?
It should be useful to bring the following items with you for your initial consultation:

  1. your health insurance card and AMKA (if insured in Greece)
  2. all the medicines you are currently on
  3. any previous medical test results, copies of medical letters and a list of specific questions you may have

After taking your history and examining you, the vascular surgeon will inform you fully and comprehensively about your health condition and will discuss with you to formulate a personalised plan for you. He will also discuss the proposed procedure in detail, recommended anaesthesia, possible risks or complications, what sort of recovery you should expect and the cost.

How should I prepare for my surgery?
The vascular surgeon will provide you with specific guidelines about medications and diet. You may be advised to discontinue certain medications (like the ones that “keep the blood thin” and may increase the risk of bleeding, such as Sintrom and Clopidogrel) for several days before the procedure. Also, please refrain from smoking for a few days at least, before receiving any type of anaesthesia.

ABOUT VENOUS CONDITIONS

What is the best treatment for the spider veins in my legs?
Spider veins are a sign of chronic venous disease, but there may be a more extensive vein problem. The vascular surgeon will assess the situation and formulate the treatment plan for you. Generally, the most successful method of treating spider veins in the legs is sclerotherapy.

When should I see a doctor for the varicose veins in my leg?
Leg varicose veins tend to get worse with time, therefore, do not hesitate to see a vascular specialist even if you are simply concerned about them. If you take certain precautions, you may delay their deterioration.

You need to consult the specialist if you get symptoms like ache, pain, heaviness, burning, itching or swelling; also, if you have developed complications like swelling of a varicose vein which is painful, red or warm to the touch, if a skin eruption has appeared in the lower leg, if there are leg ulcers or if a vein has bled.

The earlier you see the vascular surgeon and start treatment, the greater the benefit with regard to your symptoms and the cosmetic result.

What is the best treatment for my leg varicose veins?
No single general answer can be given to this question based on scientific evidence, because the ideal procedure may vary among various individuals according to the anatomical position of the incompetent valves, and the size and the extent of the varicose veins.

It is important that the appropriate treatment method is selected for the individual patient (treatment individualization), because different veins respond better to different treatment. We perform all types of varicose vein procedures and will present you with a course of action that works best for you. Read more about the procedures to treat varicose veins.

My mother had surgery for varicose veins when she was 30. Will I need such an operation myself?
About 40% of women have varicose veins. Although we know that there is a familial tendency for developing varicose veins, it is not clear whether this condition is hereditary or not.

To find out whether you have a predisposition towards developing varicose veins, you need to consult a vascular surgeon.

I have got varicose veins causing me enough discomfort, but I have had an episode of deep venous thrombosis (DVT) several years ago. Is this a reason to avoid varicose vein surgery?
Not only is this not a reason to avoid varicose vein surgery after an episode of deep vein thrombosis (DVT) with prexisting varices, but you may benefit from surgery since the varicose veins can be a predisposing factor for thrombosis. However, if DVT occurred first and then you developed varicose veins, attention is required.

The vascular surgeon will assess your case and advise you appropriately.

I often travel by airplane. Am I at risk of getting the economy class syndrome?
We have evidence that there is an increased risk of developing deep vein thrombosis (DVT) or pulmonary thromboembolism following a long flight (of over four hours duration). The risk is due to the long period of immobility which may occur when travelling non-stop by aircraft, bus, train or car. We don’t know whether travelling itself is responsible for the thrombosis or whether people affected are at increased risk for other reasons.

In general, the risk of suffering a DVT during a flight is very small, unless you have risk factors, like previous DVT, malignant disease or underlying thrombophilia. In such cases, consult your doctor before a flight of over three hours duration. Also, avoid travelling for three months following total arthroplasty surgery of a knee or a hip.

ABOUR OTHER CONDITIONS

Does the fact that I am a diabetic mean that I have a diabetic foot?
Not necessarily. Diabetic foot may present as (a) neuropathic arthropathy, (b) foot ulcer or (c) foot infection. The underlying damage takes some time to develop if diabetes in not well controlled.

What is the percentage of narrowing (stenosis) of the carotid artery which requires an operation?
There is no clear-cut answer to the question (with a precise degree of stenosis).

Certain factors should be taken into consideration before deciding whether an operation of the carotid artery is expected to be beneficial to the patient. Such factors are: (i) whether an ischaemic stroke has occurred or not, (ii) the degree of stenosis (generally speaking the tighter the stenosis, the greater the benefit of the operation), (iii) the life expectancy of the patient and (iv) the coexistence of risk factors for atherosclerosis which are not well controlled (e.g. current smoking, uncontrolled high blood pressure, uncontrolled diabetes mellitus).

I have heard that alcoholic drinks are good for blood circulation. Is this true?
There are studies showing that drinking up to two units of alcoholic drinks per day can reduce the risk for stroke or other vascular events by about half. More alcohol than this may increase that risk and also cause liver disease, accidents etc.

If you drink, we recommend no more than two drinks a day, but, if you don’t drink, don’t start!

Can I reduce my ‘bad’ cholesterol levels by diet only or do I need to take medications?
Many people do not know that the major part of cholesterol in our blood is produced by our body itself and this is genetically determined, while only a small part comes certain foods, like those of animal origin (e.g. fat, cheese, red meat) or fried foods.

To improve your cholesterol levels you need to exercise more, to quit smoking and to have a healthy diet. If you cannot reach the targets your doctor has set for you, then you may need cholesterol-lowering medications.

I often get cramps in my legs at night. Is it likely that I have a problem with my circulation?
Night cramps are commoner in people with vascular conditions, such as peripheral occlusive arterial disease or venous problems like varicose veins. Cramps occur more frequently in older ages and in people with reduced physical activity.

Initially, your physician will rule out that your cramps may be related to certain medications (diuretics, Nifedipine, Salbutamol etc), excessive alcohol consumption, electrolyte disorders, thyroid disease etc. Also, bear in mind that cramps are quite common in pregnancy.

Is there any treatment for night cramps?
Night cramps may settle down if their cause is found and corrected. Usually, however, no cause can be found. In general, increase in physical activity and regular excercise is recommended. There is no specific medication for cramps. In some countries, quinine sulphate may be prescribed, while in others – like Greece – you may be recommended to take a magnesium salt.

When I am in bed at night, I have annoying jerking movements in my legs. Is it likely that I suffer from the restless leg syndrome?
Restless legs syndrome (RLS) is a neurologic disorder affecting 10% of adults. There is no specific test to diagnose RLS. Diagnosis can be suspected from the history, when the individual feels uncomfortable sensations in his/her legs while sitting or lying down, accompanied by an irresistible urge to move the affected limb(s). Symptoms are worse at night and are absent in the morning and may cause sleep disturbance, anxiety or depression.

In most cases the cause of RLS is unknown, while – in certain cases – it is familial and passes on as an autosomal dominant trait. More rarely, it may be related to another condition, such as low levels of iron or peripheral polyneuropathy (which may occur in people with diabetes mellitus, chronic kidney failure, rheumatoid arthritis etc). We do not know exactly what lifestyle changes may reduce symptoms. However, symptoms seem to be relieved with movement, massaging of the limb(s) or a programme of moderate activity.

If medical treatment is required, as your physician will advise, there are medications that help. Common drugs prescribed include: agents largely used in Parkinson’s disease, like dopaminergic agents (Pramipexole [Mirapexin]) or Sinemet, the anticonvulsant Gabapentin [Neurontin], opioids and benzodiazepines.

 Last modified 10/10/2015