What's New from Dr. Lee

2018 LEEF iGala

We are proud to support the Longmeadow Educational Excellence Foundation and hope to see you at their 2018 LEEF iGala on November 3!

Learn more and buy tickets.

By |October 31st, 2018|What's New from Dr. Lee|

5th Annual Western Mass Mom Prom

Hello Mom—Join us on October 26 at the Delaney House to kick up your heels for a great cause! We are proud to support the 5th Annual Western Mass Mom Prom to celebrate breast cancer survivors and support the fight to beat cancer. Tickets are $75 each and include a signature cocktail, gourmet dinner, dancing, a photo booth, raffles and an auction. This year’s theme is a Pink & Black Masquerade. Hope to see you there!

Learn more and get your ticket today!


9 Jobs that May Contribute to Varicose Veins

IS YOUR JOB WORSENING YOUR LEG PAIN?

We see patients from all walks of life who come to us seeking relief from and treatment for varicose veins and other vein conditions. There are several factors that increase the likelihood you will suffer from varicose veins, ranging from genetics to pregnancy to your level of physical activity. However, many people underestimate the role their job plays in developing unsightly and often painful varicose veins.

To explain why, you must understand that the movement of your blood through your body depends on more than just the mechanics of your heart pumping. Especially in the areas that are the furthest from your heart—your legs, ankles and feet—muscle movement helps keep the blood flowing up and back through your heart.

This means that if you have a job for which you spend most of your time stationary—either standing or sitting—your muscles are not helping to move the blood flow from your legs back up to your heart. The effects of gravity also come into play, increasing the likelihood that blood will pool in the veins in your lower extremities, leading to or worsening varicose veins.

JOBS AT INCREASED RISK FOR VARICOSE VEINS

The professions of the people we see the most in our practice for varicose veins include:

  1. Teachers and teacher’s aides
  2. Health care professionals
  3. Law enforcement personnel
  4. Correctional officers
  5. Factory workers
  6. Construction workers
  7. Hair stylists and aestheticians
  8. Office workers
  9. Retail employees

PREVENTION & TREATMENT

If you work in any of these or similar jobs, you can help reduce your risk of developing varicose veins by maintaining a healthy weight, ensuring you get regular, daily physical activity, wearing compression socks, and elevating your legs, especially in the evening if you’ve been on your feet or sitting all day.

If you develop varicose veins, we offer the latest treatments performed in our office under local anesthetic. Best of all, the vast majority of our patients return to their regular activities, including their jobs, soon after treatment, so downtime and missed work are kept to a minimum. 

Contact us today to schedule your appointment for an evaluation and treatment options.


Empty Nest, Fuller Living

DON’T LET VEIN CONDITIONS HOLD YOU BACK

If you recently dropped your youngest off at college or helped furnish their first apartment, you’ve joined an honorable, if bittersweet, club: You are now an empty nester. While we miss our children when they leave the nest and become independent, or relatively independent, adults, it also gives us more time to pursue our own interests and activities.

Perhaps you want to improve your health by increasing your physical activity, maybe taking a dance class or spending time outdoors hiking or biking. But if you suffer from achy, tired legs due to varicose veins, all of this might seem easier said than done. Likewise, if you have unsightly spider veins, you may be reluctant to bare your legs, knees and ankles any more than necessary. Luckily, we can help, and with little to no downtime.

VARICOSE & SPIDER VEINS

Varicose veins are generally a result of venous insufficiency. This happens when veins cannot efficiently circulate blood back to the heart, forcing the blood to pool in the lower veins of the legs, ankles and feet.

Spider veins are smaller, more superficial veins on the surface of the skin. While they are often just a cosmetic concern, they may also be an indication of underlying venous insufficiency and should be evaluated before treatment.

While there can be several reasons an individual develops venous insufficiency, varicose veins are most common in older adults, with women at higher risk of occurrence if they’ve been pregnant. Heredity and obesity also play a major role and, due to simple gravity, prolonged periods of sitting or standing are sure to make the condition worse.

EFFECTIVE TREATMENT

We offer the latest, most effective treatments for varicose and spider veins in the comfort of our office. We’ll customize a treatment plan to your specific condition. Procedures are performed under local anesthetic, and there is virtually no recovery period, which means you can get back to doing what you love without delay.

Don’t put off those dance lessons, tennis matches or hiking dates any longer. Contact us today to schedule a consultation.


Varicose Vein Leg Pain Intensifies in Summer

WHY, AND WHAT YOU CAN DO ABOUT IT

While the George Gershwin song may say, “Summertime, and the livin’ is easy,” most of our patients who have varicose veins express a different sentiment, noting that their leg pain increases during the hot summer months.

There are a couple different reasons for this. One is that the increased temperatures result in increased vasodilation, which means that the veins expand and hold more blood, intensifying pain and pressure.

Secondly, many patients are more active in the summer months, and when you spend more time on your feet, gravitational pull works against you, making it harder for blood to move up and out of your legs.

TEMPORARY RELIEF

To provide short-term relief, we advise patients to find regular respite in a cool, air-conditioned location, and to elevate legs to help the blood circulate out of their legs.

For those who must be on their feet or sitting for long periods, we may recommend a combination of the following:

  • Leg exercises, as muscle movement helps to circulate the blood
  • Compression stockings to help keep the blood from pooling in legs, ankles and feet
  • Anti-inflammatory pain medications, such as ibuprofen
  • Weight loss to reduce the restriction on the venous blood flow from the legs
  • Dietary changes, such as reduced sodium intake
  • Not sitting for long periods, or crossing legs while sitting

LONG-TERM SOLUTIONS

We offer a variety of treatment options for varicose veins that can eliminate the pain and swelling, and help you get back to the activities you love.

Depending on the severity of your condition, the veins involved and their location, treatment may include laser ablation, phlebectomy, foam sclerotherapy, or a combination of these options. We’ll explain what will work best for your specific condition, so you know exactly what to expect.

Our highly experienced team has safely performed thousands of these treatments in our office using local anesthetic to reduce discomfort. You’ll be able to return to work and resume most of your regular activities immediately following treatment.

Don’t suffer through another summer with leg pain. Contact us today to schedule your appointment for an evaluation and treatment options.


Dr. Lee Discusses DVT on Western Mass News

Dr. K. Francis Lee appeared on the “Better Western Mass” show yesterday on Western Mass News, WGGB-40 to discuss the prevalence and dangers of deep vein thrombosis in recognition of March as DVT Awareness Month.

Watch it here.

By AVCC | March 20th, 2018

By |March 20th, 2018|What's New from Dr. Lee|

March is DVT (Deep Vein Thrombosis) Awareness Month

Important information about prevalence, risks and treatment

March is Deep Vein Thrombosis (DVT) Awareness Month, also known as Blood Clot Awareness Month. Dr. K. Francis Lee, medical director at Advanced Vein Care Center, one of the premier treatment centers in New England for venous diseases, discussed the importance of deep vein blood clots, noting that increased awareness is needed for the public.

“Deep vein thrombosis is a potentially life-threatening condition that can happen suddenly, and it is much more common than people are aware,” said Dr. Lee. “Its incidence is not exactly known, but it is estimated to affect nearly 1 million people in the U.S. every year. Most commonly, the blood clot occurs in the leg and then may travel to the lungs and be fatal.”

In the U.S., up to 100,000 people each year die of DVT and/or blood clots to the lungs. “In other words,” said Dr. Lee, “every six minutes, someone may die of these conditions.”

Nearly half of the people who develop lower leg DVT further develop a long-term, disabling condition called post-thrombotic syndrome in which they may suffer from swollen, discolored, uncomfortable and thickened lower legs, sometimes with painful, open wounds. One in three people who develops DVT will have recurrence within the following 10 years. Studies show that people with DVT have an 80 percent higher risk of work-related disability than those without DVT.

“Anyone who has sudden pain and/or swelling in the leg must contact their primary care provider or go to the emergency department,” said Dr. Lee. “There are many medical conditions that can cause leg pain and swelling, but a potentially life-threatening blood clot or DVT must be ruled out with an ultrasound examination.”

DVT Treatment

Dr. Lee explained that not all blood clots are the same, and their degrees of danger vary based on their location and the extent of their involvement and size.

“Those diagnosed with DVT must receive care from a qualified health care provider, including anticoagulation therapy to help thin the blood,” said Dr. Lee. “If the blood clot is serious, they must be evaluated for possibly dissolving or removing the clot emergently.”

Dr. Lee noted that treatment for DVT has evolved significantly in the past decade. “For serious DVT, we no longer just treat with anticoagulation therapy and a ‘wait-and-see’ approach,” he said. “The best time to treat DVT is as soon as it is diagnosed, fully and thoroughly, depending on the nature of the clot. The less clot that remains inside the deep veins after the treatment course, the better the clinical outcome, and the less the chance of long-term risk of disability or death.” 

Provoked and Unprovoked DVT

Sometimes, DVT is “provoked,” which means caused by major physical and physiologic disturbances in the body. For example, Dr. Lee said that blood clots are anticipated to occur in greater frequency after major surgery, traumas involving bone fracture or muscle injury, administration of estrogen (birth control pills, hormone replacement therapy or even pregnancy), or slow blood flow through the veins caused by immobilization (bed confinement, hospitalization, spinal cord paralysis, or prolonged fixed or sitting position such as when driving or flying for long periods).

“When faced with these conditions, patients should discuss appropriate preventative measures with their health care providers,” said Dr. Lee.

DVT can also occur without such conditions, thus considered “unprovoked.” In those cases, Dr. Lee said, “We must consider the possibility of underlying medical conditions previously unknown to the patient.”

One possible, but rare, cause of unprovoked DVT is cancer, including cancer that has not yet been diagnosed. DVT may be the first sign of the disease. Far more common though is a group of conditions known as thrombophilia or hypercoagulability: an increased liklihood to form blood clots, either due to genetic inheritance or an imbalance in the body’s blood clotting system.

The Centers for Disease Control estimates that between 5 to 8 percent of the U.S. population has one of several genetically inherited thrombophilia. “That’s one person out of every 12 to 20 people,” stated Dr. Lee. “That’s a lot of people who are walking around with a higher risk of blood clots and potential risk to their life than they may realize.”

He continued, “I’ve had patients who had lost a parent or siblings at a very young age, like in their 30s or 40s, after a massive heart attack, stroke or blood clot that traveled to their lungs. When we perform blood tests, we find they have a genetic mutation. It is likely that their relative had the same mutation, and had they known about their risk for DVT, might not have died so young.”

To be sure, there will always be unpreventable cases of DVT. Dr. Lee stressed that while the understanding of and treatment for DVT has come a long way, there is still a long way to go. “We know that thrombophilia is a common occurrence. Now we know how to better recognize and reduce the risk of DVT, but that alone is not enough. Greater awareness and understanding is required on the part of the public so they can take steps to prevent its occurrence.”


Choosing the vein care center that’s right for you

Asking the right questions is key

Whether you are simply seeking treatment for unsightly spider veins, or have more serious conditions like venous insufficiency, varicose veins, blood clots in your legs or venous stasis ulcers, it’s important to ask the right questions when deciding where to go for treatment.

Insist on accreditation. Vein procedures should be performed by board certified surgeons and physicians with appropriate accreditation from the Intersocietal Accreditation Commission.

Experience counts. Effectively treating venous insufficiency, varicose veins and spider veins requires thorough knowledge of the vascular system and the skill to perform intricate procedures. Many of the veins we treat are very complex, and some procedures are extremely advanced. Precision is key to success. You should ask how much experience the surgeon has performing your procedure.

Don’t fall for false promises. Ask the surgeon about the expected outcome of your procedure, and how many treatments you may need. In our practice, we work with you to set realistic expectations and not promise more than what it is physiologically possible so you are not disappointed with the results.

Diagnosis determines treatment. Ask how the surgeon will confirm your specific condition before recommending treatment. Proper diagnosis should include an initial consultation to identify cosmetic (spider veins) versus medically necessary conditions (varicose veins and/or venous insufficiency).

If there is a medical concern, the initial evaluation is generally followed by a venous physiology ultrasound study, which should be performed by a sonographer or clinician credentialed as a registered vascular technologist. This determines how severe your condition is, what your diagnosis entails, and what treatment options are available. Following these steps will help you meet your care goals efficiently and effectively.

Technology drives results. A key component in effectively diagnosing and treating vein conditions is the technology we use. We can now detect the root cause of your venous problem more accurately thanks to duplex ultrasound.

Advances in laser technology also drive success during endovenous laser treatments, a procedure used to treat venous insufficiency. A skilled surgical team can safely perform even complex procedures on an outpatient basis. Most patients feel better and resume their daily activities within a very short period of time. Excellent technology used by highly trained specialists offers you the best possible results, with the least amount of discomfort and recovery time.

We are truly committed to performing with excellence and aim to reach the best results for patients who visit our state-of-the-art vein center. If you have any questions, give our office a call at 413.732.4242.

By |September 25th, 2017|What's New from Dr. Lee|

The Harm of Sitting

For some, a livelihood can be made from the strength of their bodies. Serena Williams. Michael Phelps. Usain Bolt. They worship their bodies with exercise, high-quality food, massages, and sleep. These athletes forge their bodies and skillsets into art; and we, the awe-inspired, wonder at them.

Yet for most of us, the body is not beauty, but utility.

We may pay homage to our bodies occasionally—a light jog, a weekend morning raking leaves, a walk along the beach—but these relished moments are pittances, when predominantly, we abuse our body to make ends meet.

Consider, it is Sunday night—10:30 p.m. You have indulged in apple pie à la mode, and are filing taxes. While your liver works industriously to convert excess sugar into long-term storage (fat and glycogen), the pineal gland in your brain begins to release melatonin (sleep-inducing hormone). Eyelids droop. You turn the intensity of lights up, thereby activating cells in the retina that inhibit melatonin secretion. Your body interprets that there is a reason to be awake, some danger to overcome. Cortisol (stress response hormone) is secreted, allowing you to nibble the crust of the apple pie and persevere.

Indeed, there is a certain beauty to the body’s industry, but also there are certain limits. Each day, we push these limits until the body pushes back. While prolonged standing can lead to venous dysfunctions as I’ve discussed previously, there is a danger at the other end of the spectrum: prolonged sitting.

“We have created for ourselves a modern way of living that clashes with the way we’re meant to be,” wrote Dr. James Levine,[i] the Director of the Mayo Clinic-Arizona State University Obesity Solutions Initiative, and author of “Get Up!”

The phrase has taken hold: “Sitting is the new smoking.” The National Institute of Health has launched an initiative aimed to address this problem, cities have increased the number of bike share options, and companies have even begun to install treadmill desks and promote active work environments. Why? Because even when defined by utility, the body is most productive when healthy, i.e. active.

Studies validate the need to be active, showing that sedentary lifestyle is a risk factor for obesity, diabetes, hypertension, cardiovascular disease, age-related frailty and cancer.[ii] Unfortunately, I also treat the effects of inactive lifestyle each day in my practice, since sedentary lifestyle puts people at risk for chronic venous insufficiency (CVI)[iii] [iv], peripheral vascular disease[v] [vi], vascular blot clots[vii] [viii], and other diseases. While inactivity puts individuals at risk, exercise can help in the treatment of these same venous disorders.[ix] [x]

Physical activity is crucial because the muscular and circulatory systems work cooperatively. Case in point: the calf-muscle pump. Did you know, that while arteries pump oxygenated blood away from the heart at relatively high pressures (120/80 mmHg), veins collect and transport de-oxygenated blood back to the heart at relatively low pressure (5-15 mmHg)—and as such, the calf muscle plays a crucial role in pumping the blood from our feet and legs at ground-level upwards to the heart some four feet above.

How? As the calf muscle flexes, it forces blood against gravity up along the course of the veins, which are lined with one-way valves that catch the blood as it travels, preventing it from flowing backwards. A normal, efficient calf muscle will force 70% of blood out of the calf as we walk.[xi]

The relationship is evident: the more efficient the muscles, the more efficient the blood flow, and vice versa. For people with venous insufficiency, healthy musculature is crucial, and physical activity can help without the need to start any onerous workout regime. As the ice and early dusk of winter settles into the Pioneer Valley, I encourage readers to incorporate simple movement into their daily habits.

The simple act of getting up to walk to the water cooler can engage your leg muscles, loosen back muscles, as well as promote blood flow that increases concentration and work productivity. In-chair exercises can also be helpful. One study investigated ten in-chair exercises most commonly recommended by airlines, and found that exercises requiring the heel to be raised caused the greatest calf-muscle pump activation (see below images).[xii] In the end, while scientific studies can validate, individuals must motivate themselves to be proactive, beginning with understanding the harm of inactivity, and the preventative and therapeutic benefits of physical activity.

        AVCC Blog PIc

Figure (taken from O’Donovan, et al., 2006) showing that heel raising exercises 1, 4, 6, 7, and 8 significantly activated the calf-muscle pump.

 

References:

[i] As quoted in Los Angeles Times: http://www.latimes.com/science/sciencenow/la-sci-sn-get-up-20140731-story.html

[ii] Bouchard C, Blair SN, Katzmarzyk PT. Less Sitting, More Physical Activity, or Higher Fitness? Mayo Clin Proc. 2015 Nov;90(11):1533-40. doi: 10.1016/j.mayocp.2015.08.005. Epub 2015 Oct 5. Review. PubMed PMID: 26422244.

[iii] Medline Plus website: https://www.nlm.nih.gov/medlineplus/ency/article/000203.htm

[iv] New York Presbyterian website: http://nyp.org/services/venous-insufficiency-ulcers.html

[v] MD Guidelines website: http://www.mdguidelines.com/peripheral-vascular-disease

[vi] Cleveland Clinic website: http://my.clevelandclinic.org/services/heart/disorders/pad

[vii] Healy B, Levin E, Perrin K, Weatherall M, Beasley R. Prolonged work- and computer-related seated immobility and risk of venous thromboembolism. J R Soc Med. 2010 Nov;103(11):447-54. doi: 10.1258/jrsm.2010.100155. PubMed PMID: 21037335; PubMed Central PMCID: PMC2966881.

[viii] Suadicani P, Hannerz H, Bach E, Gyntelberg F. Jobs encompassing prolonged sitting in cramped positions and risk of venous thromboembolism: cohort study. JRSM Short Rep. 2012 Feb;3(2):8. doi: 10.1258/shorts.2011.011121. Epub 2012 Feb 14. PubMed PMID: 22393469; PubMed Central PMCID: PMC3291423.

[ix] Klyscz T, Jünger M, Jünger I, Hahn M, Steins A, Zuder D, Rassner G. [Vascular sports in ambulatory therapy of venous circulatory disorders of the legs. Diagnostic, therapeutic and prognostic aspects]. Hautarzt. 1997 Jun;48(6):384-90. German. PubMed PMID: 9333613.

[x] Partsch H, Blättler W. Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg. 2000 Nov;32(5):861-9. PubMed PMID: 11054217.

[xi] Chapter 11 of Physiology of Venous Insufficiency, by Kevin G. Burnand and Ashar Wadoodi, Abstracted by Teresa L. Carman

[xii] K.J. O’Donovan, T. Bajd, P.A. Grace, D.T. O’Keeffe, G.M. Lyons, Preliminary Evaluation of Recommended Airline Exercises for Optimal Calf Muscle Pump Activity, EJVES Extra, Volume 12, Issue 1, July 2006, Pages 1-5

 

By |December 11th, 2015|What's New from Dr. Lee|

The Nightmare of Leg Cramps—Chronic Pain Awareness Month

Have you ever woken at night to the debilitating, piercing pain of a leg cramp? If so, you are not alone. It’s been shown that 33.6% of the general public experience night-time muscle cramps, and as high as 50% among those with chronic venous insufficiency.1

Across the nation, the same scenario occurs each night. A calf muscle suddenly seizes. The stricken individual jolts awake and screams aloud. The disoriented spouse frantically begins to massage the muscle, as the pained individual finds a way to get up and walk around, begging the cramp to subside. Sometimes they find themselves standing on the cold tile of the bathroom as the cold sensation on the feet can sometimes coax the pain away. This nightmare occurs more than 3 times a week for 40% of vascular patients (occurring every night for 6%), according to one study.2

Night-time muscle cramps are not only common; they are complicated. There are several different causes: such as vascular diseases, over-excitable neurons, irregular endocrine or metabolic function, genetic disorders, and nutrition deficiencies. For this reason, a myriad of treatments exist, ranging from the robustly-studied neuron-stabilizing quinone, to the more holistic “spoonful of mustard” before bedtime. This complexity unfortunately means that sleep-deprived individuals with muscle cramps do not know where to turn.

One fact is clear. If you experience leg cramps and also have varicose veins, spider veins or other signs of venous insufficiency, your first step should be to seek consultation from a vein specialist.

In the past ten years, I have performed over 10,000 venous procedures for patients with a diagnosis of venous insufficiency.” My patients are often afflicted with night-time leg cramps, which reflects the established knowledge that venous disease places individuals at risk for night-time leg cramps.3 While very few diseases in the field of medicine can be fully “cured,” the occurrence of leg cramps almost always improves significantly, or goes away entirely when the underlying venous insufficiency is treated.

In fact, the reduction of nocturnal leg cramps following treatment is so reliable in my experience that it can be used as a measure for post-operative evaluation. For instance, a patient may come to me with both joint pain and venous pain. They will describe symptoms of a whole array of leg and joint symptoms. If after the venous treatment, their leg cramps have disappeared while the other less obvious pain symptoms remain, it becomes clear that the treatments have effectively addressed the venous condition and what remain are symptoms associated with other causes, such as arthritis, fibromyalgia, or neuropathy.

As we become increasingly aware of the roll chronic pain can play in our lives, it is important to be aware of the relationship between leg cramps at night and chronic venous insuffiency. If you have ever experienced leg cramps at night, ask yourself a simple question: do you have any varicose veins, spider veins or other venous problems? If so, your leg cramps may be treatable, even curable. It is among the most satisfying things in my daily life – to hear my patients say afterward, “I haven’t had any cramps since I last saw you.” Sometimes, it’s the spouse who thanks me more. They’re not awoken by their loved one’s scream at night.


References:

[1] Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FG. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg. 2002 Sep;36(3):520-5. PubMed PMID: 12218976.

[2] Monderer RS, Wu WP, Thorpy MJ. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010 Jan;10(1):53-9. doi: 10.1007/s11910-009-0079-5. Review. PubMed PMID: 20425227.

[3] Hirai M. Prevalence and characteristics of muscle cramps in patients with varicose veins. Vasa. 2000 Nov;29(4):269-73. PubMed PMID: 11141650.

By |October 7th, 2015|What's New from Dr. Lee|

Contact Us

Advanced Vein Care is happy to provide more information. Call our Springfield, MA office at (413) 732-4242 or fill out the form below.



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2018 LEEF iGala

  • October 31st, 2018

We are proud to support the Longmeadow Educational Excellence Foundation and hope to see you at their 2018 LEEF iGala on November 3!

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Suzanne from Middlefield, MA   

I can wear skirts now, and I am pain free. More attention should be paid to making sure the patient has the correct stockings. Also, I feel that more medication should be suggested for phlebectomy.

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