2015 02 24

I got up and walked out…on my own two feet after my varicose vein surgery

Vascular Diseases, Varicose Veins

Po venu operacijos atsikeliau ir isejau... savo kojomis

“It seems like it never happened like there was no pain at night,” 52–year-old businessman Daivas Remeikis can hardly contain his delight. He doesn’t even want to remember his heavy numb legs and the fear of having to give up his favourite sport of tennis eventually. “Now I wouldn’t think twice before having surgery on the second leg,” the businessman sounds confident. His determination was inspired by a short and completely painless varicose vein surgery which was performed by vascular surgeon Nerijus Bičkauskas at the Vilnius Medical Diagnostic and Treatment Centre.

Remeikis noticed the first signs of varicose veins in his adolescence. The veins on one leg were more prominent than on the other. “Now I know that the condition is inherited. My father had surgery on his leg at the age of forty, and my daughter had to have the operation at twenty-four,” says Mr. Remeikis.

Dr N. Bičkauskas who has twenty-six years of experience in the field of vascular surgery agrees that varicose veins are hereditary. “If this condition runs in your family, make sure you have a closer look at your legs,” advises Dr Bičkauskas and notes that prominent veins are concern free only at the beginning. However, even if you have developed varices, your life can still seem unaffected. “Men wear trousers; besides, the problem is often concealed by the hairs on their legs,”  the doctor tries to explain the patients’ perspective. “Men do not care about beauty and only come to the doctor’s office when their legs become achy, when they feel numb at night and when the condition starts interfering with their active lifestyle. However, we should know that blood clots may form in the affected parts of the veins, in which case tomorrow may never come.”

“At the beginning, I rubbed my aching legs with creams. But they didn’t help at all! Five years ago I had my leg examined in Kaunas. The doctor said that the leg should be operated on but if I could still bear it, it could wait. This year I could no longer bear it. When Dr Nerijus Bičkauskas saw my leg, he just said, “Oh dear, this is not a joke, we have to operate immediately.” I had the consultation on Tuesday, and on Thursday my leg was post-surgery.”

Remeikis admits to being quite anxious before the surgery. He was wondering how he would deal with the anaesthetics, and how he would get out of bed following the surgery. He now knows that his worries were unfounded.

“Nowadays the traditional surgical methods for varicose veins are less and less frequently used in the world, and in Lithuania,” says vascular surgeon N. Bičkauskas. “The incision and long post-operative period make healing difficult, and the patient has to stay away from work for a long time. Endovascular methods are more advanced and laser treatment is suitable for the majority of sufferers. This is the most universal method which also allows the inconvenience to patients to be minimized. Varices visible underneath the skin are the consequence. Damage to the stem of the vein is at the root of this condition, and it must be treated. All methods, including open surgery and laser, are used depending on the individual situation. We are the only centre in Lithuania offering the latest treatment method – the varicose vein glue.”

Previously it was common for the entire vein to be removed during the surgery. The vein was pulled out through an incision in the groin. For this operation patient had to be put to sleep. “However, normally the condition does not affect the entire veinoweHpowHo. The laser enables us to aim the impact exactly at the area in the blood vessel that has been damaged, and we only have to anesthetise the spot where the catheter is inserted. The surgery takes 45 minutes, and then the patient gets up and walks home on his own two feet,” explains Dr N. Bičkauskas. 

The doctor who has continued his professional development in the US and many European countries, confidently claims that success of the surgery depends not only on the power and precision of the laser but also on the diagnostic equipment which has greatly improved. At the Medical Diagnostic and Treatment Centre, we use the duplex ultrasound scanner which enables accurate detection of damage in the vein. “The disease can be contained if we treat the insufficient stem of the vein, but most patients prioritize the perfect appearance of their legs. In that case, the sclerotherapy method is generally used; it consists of injecting special medicine into the unwanted blood vessel, which seals it. Sclerotherapy often needs to be repeated several times, but the method is very effective for treating spider veins and burst capillaries, and it causes no inconvenience,” says Dr N. Bičkauskas.

“The surgery went on for about an hour. I did not feel any pain and the doctor kept talking to me throughout, asking me whether it was hurting. Whenever I felt something, they gave me an injection. An hour later I got up, put on my clothes, said goodbye and left. I could have gone back to work on the same day, but I decided to have a rest because my anxiety had far exceeded the pain or inconvenience suffered,” remembers Remeikis.

It should also be mentioned that three weeks later the big tennis fan gradually eased back into playing his game again. A month later he removed the compression stocking which had to be worn day and night during the first week after surgery, and then only during the day.

Doctor Bičkauskas’ advice is to keep moving after this type of surgery. He says that slow walking aids the healing process while staying in bed or sitting in the armchair with your legs stretched out is the worst thing that you can do.

“A short plane journey is not forbidden, but we explain that patients must wear a compression stocking and recommend taking some anticoagulants before the flight,” says the doctor who has had quite a few patients from abroad lately. They do not wish to stay in Vilnius longer than necessary and return home by plane.

The VenaCure 1470 laser is used to treat varicose veins at the Medical Diagnostic and Treatment Centre. The same laser is used by the most advanced clinics worldwide. Lithuanian residents who are covered by compulsory health insurance get the basic price of the surgery compensated by the National Health Insurance Fund.

“Another step forward is the vein glue treatment – a brand new method which is becoming very popular worldwide but is still not that frequently used in Lithuania,” Dr N. Bičkauskas introduces the simple and efficient procedure for varicose veins  used at the Centre.” After injecting a small amount of glue into the insufficient vein, the vein is sealed. The walls of the vein get stuck together, and the blood travels up toward the heart along the nearby healthy veins. Once the pressure is removed from inside the damaged veins, they stop dilating.”

The treatment is quick and pain-free. No bandages or compression stockings are required following the procedure, and patients can return to their daily activities right away. “This type of surgery is very popular in Latvia. My colleagues have told us that children often give varicose vein glue treatment as a present to their elderly parents, as it is not associated with any negative experiences. Nevertheless, our patients prefer laser treatment, which is also considerably cheaper than vein glue,” says Dr N. Bičkauskas.

From the recent conference in Paris, Dr N. Bičkauskas brought news about the 1920 nm laser which is currently being tested by the Americans. It will make varicose vein surgery even more precise.  “It is important to start acting right after noticing the first worrying signs,” advises the vascular surgeon. “We work with excellent equipment and offer all globally available treatment methods. The sooner you conquer the condition, the sooner you can get your life back.“

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