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.
- 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: all the medicines you are on, any previous medical tests, your insurance not and AMKA (if insured in Greece) 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.
- I have spider veins in my legs and I would like to have them removed. What is the best treatment?
- 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.
- 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.
- 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 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.
- Does the fact that I am a diabetic mean that I have a diabetic foot?
- Not necessarily. Diabetic foot may present as neuropathic arthropathy, foot ulcer or foot infection. The underlying damage takes some time to develop if diabetes in not well controlled.
- 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 and occur more frequently in older ages.
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. 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 hes/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. Symptoms are relieved with movement, massaging of the limb(s) or a programme of moderate activity.
In most cases the cause of RLS is unknown, while more rarely it may be related to low levels of iron, kidney failure or the use of certain medications. We do not know exactly what lifestyle changes may reduce symptoms.
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 08/08/2012
