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Bad circulation in legs can be painful but treatable
APATIENT I'll call Mrs. Jones has the most common cardiovascular disorder in our society. But she doesn't get chest pain or shortness of breath. She hasn't had a heart attack or a stroke. She hasn't needed heart surgery or stenting of her coronary arteries.
While she is a little overweight, Mrs. Jones, 55, is not a smoker. She can walk a mile without much difficulty, and she's generally healthy. In other words, she does not fit the typical profile of a person with a cardiovascular problem.
So what's wrong with her? Mrs. Jones has a venous ulcer, a common but seldom-discussed vascular ailment.
Venous ulcers are open wounds, usually in the lower legs, that develop when the leg veins don't return blood to the heart as efficiently as they should. They can cause a significant amount of pain.
Mrs. Jones has a small opening in her skin at the level of her ankle. It's been there for a year and is somewhat painful.
Her problems began several years ago when she suffered a blood clot--deep vein thrombosis--in her leg. Since then, she has had chronic leg swelling and discoloration in her lower leg.
Then, about a year ago, she developed an area of dry skin which ultimately turned into an open sore. The sore is about 3
Mrs. Jones, a teacher, said her condition worsens after long periods of standing on her feet. By the end of the day, she just wants to put her feet up and relax.
She hasn't told many people about her condition. She's somewhat embarrassed by the swelling and discoloration in her legs, and she rarely shows her legs in public.
Fortunately for people suffering venous ulcers, there are ways to lessen the pain and ultimately heal the wounds. But treatment can take time.
A VALVE PROBLEM
Venous insufficiency is the term used to describe
unilateral leg swelling
varicose veins--the most common kind of venous insufficiency
venous stasis dermatitis, which involves leg discoloration and dryness
lipodermatosclerosis, which is a combination of color changes and scarring
If you need surgery or other expertise on vein problems, here are some things to consider:
Look for a surgeon who has experience performing newer venous ablation techniques and who received formal training in vein surgery.
When getting an ultrasound, be sure it's done in
If you need surgery for varicose veins, your surgeon should be involved in treating all types of venous problems, not just varicose veins.
If you have a leg ulcer, you may need to go to a wound care center. Learn more about the Rappahannock Wound Healing Center at marywash ingtonhealthcare.com/ser vices/wound-healing-services.
--Dr. Victor D'Addio
These symptoms indicate that you have a problem with your leg veins properly returning blood back toward your heart:
history of leg vein clots (deep vein thrombosis)
family history of varicose veins
unilateral leg swelling
skin discoloration in the ankle area
non-healing sores/wounds around the ankle
leg pain, burning, itching, heaviness after long periods of standing.
Dr. Victor D'Addio is a vascular surgeon with Virginia Interventional and Vascular Associates in Fredericksburg. He also is medical director for the Rappahannock Wound Healing Center.