I’m a vein doctor…Phlebologist, to be more precise…with a clinic devoted to treating patients with varicose veins and spider veins in the Chicago area.
Patients often come to see me in consultation as a “second opinion”. There are plenty (too many?!) other vein clinics around and, being the curious sort of person I am, I tend to ask people why in particular they decided to seek an alternative.
In many cases, people didn’t feel comfortable with the experience because they felt more like a “faceless pair of legs” than a person. They feel like they were rushed through a visit and didn’t have a good understanding of the rationale for the treatments that were recommended.
That is PRECISELY why I designed my practice the way I did. Each new patient consultation is scheduled for a one-hour-long appointment slot with me. We spend a great deal of time going over a patient’s past medical history, including family medical issues, too. At my vein clinic, you are more than a pair of legs. Getting to know the whole you can make a whole lot of difference.
Here’s a great example of just how much of a difference taking a holistic approach can make in the life of a patient:
Recently I saw a patient with pretty typical presenting problems: varicose and spider veins. They were seen at another clinic a few years prior where, after a brief consultation, it was suggested that they have endovenous laser ablation followed by sclerotherapy treatments. The patient didn’t feel comfortable taking the next step at that time and deferred any treatments.
During my consultation visit, we learned that the patient has a brother who developed a blood clot in his deep veins of the legs that traveled to the lungs. This is known as a pulmonary embolism (PE) and can be life-threatening. Deep vein thrombosis (DVT’s) and PE’s may happen for a variety of reasons and can be provoked by a number of situations such as prolonged immobility, surgery, critical illness, etc.
Things get a lot more interesting when DVT’s and PE’s develop unprovoked and out of the blue. It turns out that this patient’s brother had an unprovoked DVT/PE at age 48.
The patient herself had no history of DVT nor PE. She had a few unremarkable pregnancies and no miscarriages. Nevertheless, unprovoked venous thromboembolic disease (VTE) in the family makes me pay attention and be suspicious for potentially inheritable blood-clotting disorders (thrombophilias, hypercoagulable disorders).
So…instead of recommending moving forward with treatments for her varicose veins and spider veins, I recommended that the patient be tested for known thrombophilias. This involves a series of blood tests. While the patient was a bit disappointed that we couldn’t get after those annoying veins immediately, she appreciated my concerns and understood that learning about a previously undetected hypercoagulable disorder may potentially save her from serious troubles in the future.
As it turns out, we ended up discovering that the patient had a disorder called Factor V (roman numeral 5) Leiden. Patients with this disorder have a decreased ability to STOP blood from clotting…which, in turn, leads to a higher tendency to make clots…anywhere from 8-80 times the usual risk!
About 5% of Caucasian Americans have Factor V Leiden; it’s less frequently found in Latinx, which was the background of my patient. Though it seems like an infrequent thing, it turns out that up to 30% of patients with a DVT or PE have Factor V Leiden mutation!
Making a “pick up” in medicine is great not only because you feel like your med school tuition dollars were well spent…but, arguably way more importantly…because you can make a huge…no, YUGE…impact on a patient’s life after diagnosis.
If a patient is found to have a particular thrombophilia, it can impact the way doctors approach the patient for the rest of their life…making suggestions that would decrease the risk of blood clots from occurring. For instance, possibly putting the patient on blood thinners proactively before procedures, long flights, during pregnancies, etc. If we never learn about such underlying clotting disorders in a given patient, they may develop serious complications if ignored.
I often tell my patients (to the chagrin of my accountant) that even if we never perform a procedure on their varicose or spider veins…but we prevent them, or their family members from getting a DVT/PE in the future…then I will have done my job as a physician…and will have upheld our most sacred credo: Primum non nocere…first, do no harm.
Fortunately (says my accountant), epidemiology being what it is, the vast majority of my patients in the Chicago area have no underlying thrombophilia. For them, the only thing getting in the way of finally dealing with their chronic varicose veins and spider veins is THEMSELVES.
They Say: “I heard that treating varicose veins involves surgery and I don’t want that!”
I Say: False! All of the procedures I offer my patients are NON-SURGICAL. They are minimally-invasive, maximally comfortable and performed in my comfortable office.
They Say: “I lead a busy life; I don’t have time for downtime!”
I Say: False! There is no downtime after such procedures. You can drive yourself to your visits and drive yourself home. Afterwards, I encourage patients to be active!
They Say: “This stuff is all just ‘cosmetic’; insurance will never cover this!”
I Say: FALSE! Many procedures may be covered by commercial insurance (BCBS, Humana, Aetna, United Health Care, to name a few) and Medicare. Coverage depends on a patient’s particular condition and insurance policy. My assistant Maria and I help our patients to get the coverage they deserve; we do all the “leg work” (pun intended) for you! Be aware that getting coverage can often take months to achieve. Schedule your consultation now to ensure that you can get your coverable treatments during this calendar deductible year.
So…what are you waiting for?! Whether you’ve seen “the other guys” and were skittish…or if you were just waiting for the right time and place…the time is now and the place is conveniently located!
Call 847-272-8346 now and schedule your initial consultation appointment. I look forward to meeting you…the whole you…and helping your legs to feel and look better than they have in years!