Question:
I am at 35 year old male who has had trouble with varicose veins in my legs for years and ignored it. I am beginning to think something has to be done, but am unsure where to turn. I am not sure of the cause of my veins, but they are common on my mother's side of the family. I am not overweight, but was up to my teens. Since my early 20's I have been at the correct weight for my height and workout daily. I have very muscular legs from my workouts. While my legs are hairy like most men and that covers the appearance of most of the veins, I noticed a year or two ago that sometimes at night I was feel a light aching in my calf off and on and then it would ago away. It took me a while to realize this aching was coming from the same calf where my varicose veins are. I am unsure if it's related. It will come, then go for months and then return for a day or two. In any event, this week I finally look a good look at my calfs and it's not pretty. I have a very large mess of varicose veins on the inside of my right calf, a few more varicose veins near my ankle and a smaller, almost spider vein near the side of my knee on the same let. My left calf have some smaller varicose veins, but I'd swear that calf didn't have any a few years ago so I assume this sitution is worsening and need to take action. I had read about laser vein removal and saw a local doctor a few months ago who looked at my legs and said the veins were too large for lazer methods to me used. He then told me I need to find a "vascular surgeon" but couldn't name any to refer me to. I am left with two questions. I want these veins gone, I am a healthy man in very good shape otherwise and I believe the ache I feel may be related to the veins. I feel I have to do something before things get worse. My questions are: 1. Is removel of varicose veins normally covered my health insurance? This is not just a cosmetic issue and I just can't shell out the cost of removal out of my pocket. 2. Where do I find a vascular surgeon? I looked in my large book of providers given to me by my health insurance company but can't even find a listing for that type of doctor. I keep putting this off because I don't know how to proceed and want to take action. I'd like to have this done and over with before summer when I am wearing shorts again.

Answer: -Long saphenous vein (LSV) stripping is the most common surgical procedure in patients affected by varicose disease of the lower limbs. Reactive oxygen metabolites (ROM) generation plays a crucial role in chronic venous insufficiency (CVI). The aim of this study was to investigate whether ROM generation is increased in patients affected by varicose disease versus healthy controls and whether LSV stripping has a positive effect on the local production of ROM. The local production of ROM was assessed measuring hydroperoxides in the blood collected from the leg of 30 patients consecutively undergoing LSV stripping and 30 controls. In both the patient group and the control group, the test was repeated 30 days later. We found that ROM levels before surgery are higher in varicose vein patients than in controls ( p <.0001) and that ROM are significantly reduced 30 days after LSV stripping ( p <.0001). At that time point, no significant differences between patients and controls was found. We also found that sex and age do not affect ROM concentration in patients and controls, either before or after surgery. In conclusion, our data indicate that CVI is characterized by significant oxidative stress and that LSV stripping is able to normalize local production of ROM in patients with varicose disease of the lower limbs. We suggest that measurement of ROM might be useful to test the positive effects of LSV stripping in these patients. -You may find a vascular surgeon that would operate on your varicose veins, but generally it's more common to find that it's a procedure that is done by general surgeons.