Why Do I Have Varicose Veins and What Can I Do About It?

The live chat had a good turnout and is now available online.

Apr 4 2017, 11:57 AM
EmoryHealthcare: We are starting the live chat in 4 min Are you, guys, ready with your questions?

Apr 4 2017, 12:00 PM
EmoryHealthcare: Welcome, everyone! Thanks for joining us today for our web chat “Why do I have varicose veins and what can I do about it?” with Dr. Rheudasil of Emory Vein Center.

Apr 4 2017, 12:00 PM
EmoryHealthcare: Dr. Rheudasil is a Fellow of the American College of Surgeons and a member of the Society for Vascular Surgery and the American Venous Forum. He is also a member the Southern Association for Vascular Surgery and is a past President of the Georgia Vascular Society and the Atlanta Vascular Society.

Apr 4 2017, 12:01 PM
EmoryHealthcare: We’ll get started in just a minute. Dr. Rheudasil is here to answer all of your questions! Ask away

Apr 4 2017, 12:01 PM
EmoryHealthcare: Please note that all questions are moderated before appearing in the stream, so you may not see yours appear right away, just give it a moment Dr. Rheudasil is answering every question live right now. By the way, have you already shared our live chat with your friends on Facebook and Twitter? Invite them to join now The more the merrier

Apr 4 2017, 12:02 PM
EmoryHealthcare: We received some questions that were submitted in advance through our website and Facebook at https://www.facebook.com/emoryhealthcare/ so we’ll get started by answering a few of those first.

Apr 4 2017, 12:03 PM
EmoryHealthcare: Freida asked: “If I have a surgery, will the veins return and will I have to take time off work?”

Apr 4 2017, 12:03 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Freida, it is possible for new or recurrent veins to occur following vein treatment. These veins are usually less severe but may require additional treatment. Our treatment plans typically can take up to 6 six months to complete. The treatment plans will involve the primary vein ablation procedure followed by 1 or more sclerotherapy sessions. After the initial treatment, we will be evaluating your legs and determining if additional sclerotherapy is needed along the way.

Apr 4 2017, 12:04 PM
EmoryHealthcare: @Freida, over time, your veins will begin to improve. Typically, patients are able to return to work the following day after their ablation procedure. There is no time away from work when you are having sclerotherapy.

Apr 4 2017, 12:05 PM
EmoryHealthcare: Julie asked: “Should I wait until I lose weight to have spider veins removed? Or will having it done prevent them from getting worse? Difference in going to a “Vein-R-Us” type place to have this done and going to an Emory doc?”

Apr 4 2017, 12:05 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Julie, weight loss will help with vein treatment since any additional weight will cause an increase in pressure in the legs causing the vein to bulge abnormally. Generally, I would recommend veins be treated prior to weight loss to address the current problem and to alleviate future worsening.

Apr 4 2017, 12:06 PM
EmoryHealthcare: @Julie, the difference between a Vein-R-Us facility & the Emory Vein Center is that any physician can be employed to perform these procedures at those types of places, that means a dermatologist, an anesthesiologist, OBGYN primary care, etc can perform procedures on your veins. At the Emory Vein Center, only certified vascular surgeons who are trained in venous disorders are evaluating and treating your veins based on their expertise and training.

Apr 4 2017, 12:07 PM
EmoryHealthcare: Jean asked: “I used to be VERY heavy.
Over 8 years of losing & keeping the weight off – I have spider veins & some varicose I suspect – pinch & burn & hurt now and then.
Never had that issue when I was heavy. Is this unusual?”

Apr 4 2017, 12:08 PM
EmoryHealthcare: Dr. Rheudasil’s answer is coming but we also want to encourage YOU to ask your questions here What’s on your mind today about the topic?

Apr 4 2017, 12:09 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Jean, these veins may not have much to do with your weight changes”

Apr 4 2017, 12:10 PM
Guest1023 (Guest): Mainly the left lower leg – with spider veins at ankles n top of feet on both / Jean

Apr 4 2017, 12:11 PM
EmoryHealthcare: @Jean, did we answer your question? Thanks for details.

Apr 4 2017, 12:12 PM
EmoryHealthcare: Amanda asked: “Does pregnancy increase varicose veins?”

Apr 4 2017, 12:12 PM
EmoryHealthcare: @Amanda, the answer is on its way

Apr 4 2017, 12:13 PM
Guest1023 (Guest): Yes – I’m the jean who submitted the one you just answered.

Apr 4 2017, 12:13 PM
EmoryHealthcare: @Jean, we know it Glad to help

Apr 4 2017, 12:13 PM
EmoryHealthcare: @Amanda, here’s Dr. Rheudasil’s answer for you: “Dear Amanda, yes, pregnancy is a common risk factor for varicose veins and will almost always make pre-existing veins worse. Just like any weight gain, you’re adding additional pressure to the legs, which increases pressure on the valves in the veins and that in turn can cause the valves to malfunction causing venous insufficiency.”

Apr 4 2017, 12:14 PM
Guest1037 (Guest): Do you have to do the vein mapping first? Standing in place for 45 minutes is difficult and made me sick. I did not use that clinic as they could not answer questions I was asking

Apr 4 2017, 12:15 PM
EmoryHealthcare: @Guest1037, great question! Dr. Rheudasil’s answer is on its way

Apr 4 2017, 12:15 PM
EmoryHealthcare: Have you, guys, checked out Dr. Rheudasil’s online profile at https://www.emoryhealthcare.org/physicians/r/rheudasil-j-mark.html

Apr 4 2017, 12:17 PM
EmoryHealthcare: @Guest1037, most studies can be performed without the patient needing to stand. Our vascular lab uses the reversed Trendelenburg position for the venous testing which means they put the patient in a foot down position for the majority of the examination. Depending on your clinical evaluation with the physician, you may not need ultrasound testing. For example, spider veins alone may not require diagnostic testing. Each treatment plan is individualized to meet each patient’s need.

Apr 4 2017, 12:18 PM
Guest1319 (Guest): It’s hard for me to get to Clifton Rd. can I receive treatment at any other Emory locations?

Apr 4 2017, 12:20 PM
EmoryHealthcare: @Guest1319, absolutely!

Apr 4 2017, 12:21 PM
EmoryHealthcare: @Guest1319, the Emory physicians provide vein treatment at many other locations. We see patients on the Emory Saint Joseph’s campus as well as have offices in Roswell, Johns Creek and Buckhead. You can call our office at 404-778-VEIN to speak with our call center agents and they can assist you with an appointment at the location of your choice.

Apr 4 2017, 12:22 PM
Mark97 (Guest): Is the process or treatments to get varicose veins removed the same for men? I’d like to have this done.

Apr 4 2017, 12:23 PM
EmoryHealthcare: @Mark97, yes, the evaluation and treatment for varicose veins is exactly the same for males as it is for females.

Apr 4 2017, 12:25 PM
EmoryHealthcare: Jeannine asked: “My mom has varicose veins. Does that mean I will too?”

Apr 4 2017, 12:26 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Jeannine, no, but heredity is a common risk factor and you will have a higher likelihood of varicose veins than the general population.”

Apr 4 2017, 12:26 PM
michasims (Guest): How painful is sclerotherapy? Mild or scream your head off painful?

Apr 4 2017, 12:26 PM
Guest1037 (Guest): Is this procedure painful?

Apr 4 2017, 12:28 PM
EmoryHealthcare: @michasims and @Guest1037, here’s Dr. Rheudasil’s answer for you: “It has been almost 3 weeks since I have had a patient run screaming out of the room. Just kidding! Sclerotherapy involves multiple needle sticks that are described sometimes as a mosquito bite. We also have numbing cream available for patients to purchase who are extra sensitive. ”

Apr 4 2017, 12:29 PM
EmoryHealthcare: Jacqueline asked “Can you remove swollen veins that show?”

Apr 4 2017, 12:30 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Jacqueline, yes, treatment will often require closing or removing large veins. Venous ablation is our primary procedure that is performed to close the abnormal vein. You can see some before and after pictures here: https://www.emoryhealthcare.org/centers-programs/vein-center/treatments.html

Apr 4 2017, 12:30 PM
EmoryHealthcare: @Jacqueline, after the first treatment, we will need to evaluate how your vessel reacts. There is a possibility that the vein will not close in all desired locations. However, that is why we follow up with sclerotherapy to close the remaining vessels, which you can also read about on that page I just shared with you.

Apr 4 2017, 12:30 PM
Guest5075 (Guest): Can I be treated the same day or will I need to come back?

Apr 4 2017, 12:33 PM
EmoryHealthcare: @Guest5075, the answer is on its way right now.

Apr 4 2017, 12:34 PM
EmoryHealthcare: You all are asking great questions! Remember to invite your friends to join the live chat, so we can also help answer their questions. We have 26 minutes together still So, invite them

Apr 4 2017, 12:35 PM
EmoryHealthcare: @Guest5075, the process will start with an evaluation with the physician. During this time your medical history will be discussed as well as getting an understanding of your venous concerns and what your expectations are. In most cases, an ultrasound is needed to develop a treatment plan and insurance approval for vein treatment often takes several weeks. Vein treatment is a process that often requires a number of vein visits over time.

Apr 4 2017, 12:36 PM
EmoryHealthcare: Susan asked “I have spider veins after chemo and radiation treatment. Can you help?”

Apr 4 2017, 12:36 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Susan, yes, absolutely we can treat spider veins with injection sclerotherapy. The fact that these vessels occurred after chemotherapy will not change or affect the treatment plan.”

Apr 4 2017, 12:36 PM
EmoryHealthcare: Nancy asked “Does weight play a role in addition to heredity?”

Apr 4 2017, 12:36 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Nancy, yes, being overweight is a risk factor for varicose veins, as is a family history.”

Apr 4 2017, 12:37 PM
Guest1037 (Guest): Where does blood go after vein is removed?

Apr 4 2017, 12:38 PM
EmoryHealthcare: @Guest1037, the blood is redirected into other veins. Does this help answer your question?

Apr 4 2017, 12:38 PM
gigi (Guest): hi there! i’m scheduled to have my spider veins treated next week and am flying to dubai 2 days later. is it safe to fly?

Apr 4 2017, 12:38 PM
Guest1037 (Guest): Does initial cost include follow ups?

Apr 4 2017, 12:39 PM
EmoryHealthcare: @GiGi, here’s Dr. Rheudasil’s answer for you: “Hi Gigi! I would reschedule one of those appointments! Air travel is generally prohibited 7-10 days after vein treatment. This recommendation is to reduce the potential risk of clot formation”

Apr 4 2017, 12:42 PM
EmoryHealthcare: @Guest1037, unfortunately, no. Each visit / treatment will involve a separate charge. However; treatments are often covered by your insurance.

Apr 4 2017, 12:43 PM
EmoryHealthcare: Busch asked “What happens to blood that goes thru veins destroyed?”

Apr 4 2017, 12:43 PM
EmoryHealthcare: Dr. Rheudasil’s answer: “Dear Busch, the body is amazing, your blood will reroute into other veins by taking the path of least resistance.”

Apr 4 2017, 12:45 PM
EmoryHealthcare: These questions have been great, guys! We have time now for just 2-3 more question. Any remaining questions will be answered by Dr. Rheudasil in the post-chat Q&A.

Apr 4 2017, 12:46 PM
Guest1037 (Guest): I have so many veins was a bit nervous that I would have issues removing

Apr 4 2017, 12:46 PM
EmoryHealthcare: @Guest1037, what issues are you afraid of?

Apr 4 2017, 12:47 PM
gigi (Guest): this has been very informative. thanks Emory!

Apr 4 2017, 12:48 PM
EmoryHealthcare: @GiGi, you’re welcome!

Apr 4 2017, 12:48 PM
Guest4028 (Guest): Should I wait until I have lost weight to have my spider veins removed? Or will removing them now prevent new spider veins from being created, or worsening?

Apr 4 2017, 12:48 PM
EmoryHealthcare: @Guest4028, here’s Dr. Rheudasil’s answer for you: “We recommend treating spider veins when they are bothersome enough to the patient. Weight loss is not necessary to begin treatment. Unfortunately, spider vein treatment does not reduce the risk of future spider vein formation.”

Apr 4 2017, 12:49 PM
EmoryHealthcare: @Guest1037, BTW, extensive vein treatment is quite common and you will not “run out of veins

Apr 4 2017, 12:50 PM
EmoryHealthcare: We have 10 min left

Apr 4 2017, 12:51 PM
EmoryHealthcare: Your questions have been wonderful, thank you for your engagement. We want to hear 2 last questions. As away!

Apr 4 2017, 12:51 PM
Guest4028 (Guest): Do spider veins grow up to become varicose veins, or are they two different problems?

Apr 4 2017, 12:52 PM
EmoryHealthcare: @Guest4028, the answer for you is on its way Thanks for the great question!

Apr 4 2017, 12:53 PM
EmoryHealthcare: We can probably take 1 more question now. As away!

Apr 4 2017, 12:54 PM
EmoryHealthcare: @Guest4028, here’s Dr. Rheudasil’s answer for you: “Dear Guest4028, no, spider veins never grow up, they are two separate conditions. Many patients have a combination of both spider and varicose veins. Spider veins are small thread-like veins that are a cosmetic problem only and varicose veins are larger veins that protrude from the skins service and are more likely to cause symptoms”

Apr 4 2017, 12:54 PM
gigi (Guest): good to know air travel isn’t smart after getting treatment. thanks!

Apr 4 2017, 12:55 PM
EmoryHealthcare: @GiGi, we want you to have time to heal so you can enjoy being healthy later You’re welcome Safe travels!

Apr 4 2017, 12:56 PM
Guest4028 (Guest): Does insurance cover spider veins, varicose veins, or both? I’ve heard insurance treats spider veins as a cosmetic only issue – but mine hurt!

Apr 4 2017, 12:56 PM
EmoryHealthcare: @Guest4028, thank you for your question. We are about to answer. We have 4 min left

Apr 4 2017, 12:58 PM
EmoryHealthcare: Just wanted to remind everyone that we have a web page with FAQ you can bookmark right now at http://bit.ly/2nTIEXh

Apr 4 2017, 12:59 PM
EmoryHealthcare: We share videos there that are full of great information, so make sure you check it out and share with friends http://bit.ly/2nTIEXh

Apr 4 2017, 1:00 PM
EmoryHealthcare: @Guest4028, here’s Dr. Rheudasil’s answer for you: “Dear Guest4028, Spider veins seldom cause symptoms and treatment is not usually covered by insurance. Patients that have larger varicose veins are more likely to have symptoms and treatment is often covered by insurance.”

Apr 4 2017, 1:00 PM
Guest4028 (Guest): How many veins can be treated at one session? What is the average number of sessions required for moderate spider veins?

Apr 4 2017, 1:01 PM
EmoryHealthcare: We ran out of time and will continue answering your questions on this page in a few days. We will post all responses here, so come back often, or, even better, bookmark this page right now.

Apr 4 2017, 1:01 PM
EmoryHealthcare: Thanks, everyone, for joining today, have a great day!

Learn More At Emory Vein Center 

About Dr. Rheudasil

Mark Rheudasil, MD, graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia and also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the Society for Vascular Surgery and the American Venous Forum. He is also a member the Southern Association for Vascular Surgery and is a past President of the Georgia Vascular Society and the Atlanta Vascular Society.