Instructions

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Steps To Healthy Legs

Before And After Your Sclerotherapy

Before Your Vein Closure Procedure

After Your Vein Closure Procedure

After Your Microphlebectomy

Steps To Healthy Legs (en Espanol)

After Your Vein Closure (en Espanol)


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Wear Support Hose
The use of compression stockings will reduce the
accumulation of fluid outside the veins in the soft tissues
of the leg (skin, fat and muscles). The hose should be applied
first thing in the morning and worn for as much of the day as
possible. Their use is not required at night. Compression
stockings are available for purchase at Vein Specialists.

Exercise
Routine exercise has multiple beneficial effects. In addition
to maintaining cardiovascular fitness and weight control, it
also improves venous blood return from the legs to the
heart and reduces the risk of progression to more severe
complications.

Elevate Your Legs
Elevation of the legs above heart level for 10 minutes once or
twice daily will help reduce leg swelling and aching. Placement
of a 2X6 block under the legs of the bed at the foot of the
bed will also help drain the fluid out of the legs which has
accumulated over the course of the day due to leaking veins.

Move Your Legs Frequently
Flexing your ankles 10 times each hour will pump the blood
out of your legs similar to the action of walking. Repeat this
every 10 minutes while standing or sitting and try to walk for
at least 2 minutes every half hour.

Maintain a Proper Weight
Even moderate weight loss may reduce aching in the legs
due to varicose veins and diminish the rate at which spider
veins develop.

Avoid High Heels
Wearing shoes with high heels interferes with the normal
pumping action of the muscles which impairs the return
of blood flow that normally occurs with the heel to toe action
or normal walking.

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Before And After Your Sclerotherapy...

Spider veins are commonly seen in patients over the age of
25 and their incidence increases with age. Women are more
commonly affected due the presence of estrogen and their
child bearing status. Spider veins are tiny dilated blood vessels
just under the skin which may occur in large clusters called
telangiectasias. They are usually a cosmetic concern, although
occasionally, spider veins may indicate a deeper vein problem
such as leaking valves. Ultrasound evaluation of the leg veins
may be indicated if a patient has extensive spider veins below
the knee or involving the feet. The presence of varicose veins in
addition to spider veins also suggests a deeper vein problem.
If deeper veins are found to be leaky and directly connected
to the varicose veins or superficial spider veins, the deeper
veins may require treatment prior to treating the varicose
or spider veins.

Sclerotherapy is used to treat spider veins, telangiectasias
and certain types of varicose veins. Sclerotherapy involves the
injection of a special medication into the diseased vein, which
causes the vein to close off and disappear over the course of
4-6 weeks or more. Dr. Magnant uses the compound sodium
tetra-decol sulfate for most of his patients and his results have
been excellent. Other agents are also available if patients have
inadequate results or if they have a sulfa allergy. His technique
includes the use of the smallest needles available, headlight
illumination and loop magnification for accuracy, and gentle,
low pressure infusion of the medicine, all of which make the
procedure almost painless and highly effective.

Rather than spreading smaller treatments out over a longer
period of time, Dr. Magnant enjoys giving his patients generous
sclerotherapy sessions and often will perform the first set of
sessions one week apart, focusing on one leg at a time. This
allows patients to appreciate early changes and resolution of
thetreated veins in comparison to the other untreated leg, giving
them immediate positive reinforcement.

Compression stocking therapy is a very important part of
successful sclerotherapy treatment. Dr. Magnant recommends
at least two weeks of stocking therapy after each injection
sclerotherapy session. Although no guarantee can be given
regarding the results of sclerotherapy, Dr. Magnant’s approach
to veins from the inside out, ensuring all underlying deep vein
problems are fixed first, gives his patients the best chances for
a long lasting result from his sclerotherapy treatments. Please
remember to bring your compression hose with you to each
office visit and please do not apply lotion to the skin of the legs
on the day of your treatments. Dr. Magnant will give you an
accurate estimate of the number of sclerotherapy sessions
required prior to initiating your treatment. Included with your
treatment regimen, Dr. Magnant offers complimentary
follow-up and touch up injections 4-6 weeks after the
final session.

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Before Your Vein Closure Procedure...

First of all, thank you for allowing us to treat your vein problems.
Dr. Magnant wants you to know that he and his staff will treat
you professionally and with compassion. We want to make
your experience as smooth and pain-free as possible. He will
prescribe 2 tablets of Ativan for the day of your procedure.
Please take one pill (1 mg) when you leave the house and
the other upon arrival to the office (30 minutes before your
scheduled procedure time). The medication will help you
relax for the procedure. Although strongly recommended,
using the prescribed medication is optional. However, if you
take the prescribed medication, you MUST have someone to
drive you to and from the appointment. If you do not take the
Ativan we still strongly recommend that you have someone
available to drive you home following the procedure.

If you are currently taking Coumadin, please consult with
Dr. Magnant for directions on discontinuing use prior to the
procedure. Generally, we recommend discontinuing use of
Coumadin 3 days before your procedure. If you are diabetic,
please bring a snack. You ARE permitted to eat, drink and
take your normal medications (with the exception of Coumadin)
in the hours prior to having your procedure performed. Please
wear loose fitting clothing and shoes that are easily slipped
on and off, as your leg will be dressed with a thigh length
compression stocking at the completion of your procedure.
If you have a thigh length stocking please bring it with you
to your procedure. Inexpensive thigh length stockings
may also be purchased at Vein Specialists the day of
your procedure.

Please do not apply lotion to your legs the day of your procedure.
We recommend that you wear your compression hose in the
weeks prior to your procedure in order to become accustomed
to wearing them. Continue wearing your hose for two weeks
following your procedure. You do not need to sleep or shower
in the compression hose.

Please be advised that some insurance companies do not
provide a Pre-Determination of benefits review and thus
will not give us a guarantee of payment. Therefore, if it is
determined that your insurance company is one of these,
a $500.00 deposit will be required at the time of service.
Your insurance will be billed after the procedure and you
will be reimbursed accordingly once insurance has paid.
Insurance companies that do not provide Pre-Determination
review include (but are not limited to) BCBS Blue Choice,
BCBS Blue Options, and BCBS Federal.

If your insurance provides Pre-Determination reviews you will
be responsible for your co-pay and deductible, as well as any
outstanding balance at time of service. Your insurance will
be billed after your procedure and you will be notified of any
additional responsibility once your insurance company has
remitted payment to Vein Specialists.

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After Your Closure Procedure...

The local anesthesia will last for approximately 1 hour after
the procedure is over. Please start taking an Ibuprofen
equivalent (Motrin or Advil) 600-800 mg immediately after
your procedure and then 3-4 times a day with food for 5-7
days. This will help relieve some of the pain associated
with your procedure. If you feel as though you need stronger
pain medication, please let us know during working hours
and we will call this in to your pharmacy. You should expect
discomfort over the course of the closed vein and this may
progress over the first couple of days and then should slowly
start to improve. This time schedule may vary from patient
to patient. The discomfort is often greatest along the inner
and upper thigh region, as this is the location where more
of the energy was applied and is one of the more sensitive
areas in the leg.

You will be asked to walk in the office for a few minutes before
leaving to make sure you have your “sea legs”. Please rest
after you return home and allow the Ativan to wear off. If it is
necessary for you to travel for an hour or more, please stop
every 30 minutes and walk around for 10 minutes. Walking
will help exercise your calf muscle pump to help keep your
venous blood circulating. It will also help dissipate any
discomfort you may have and reduce the risk of complications.

Please leave the compression stocking in place for 24 hours.
You may remove the bandage and shower after 24 hours but
please wear your compression hose thereafter except at
bedtime. If you have stitches, showering is OK but please
do not swim or take baths until they are removed (10days).

Moderate bruising is common after the procedure, primarily
along the inner thigh area, so please do not be alarmed if this
occurs 1-3 days after your procedure. You will have a follow-up ultrasound 3-5 days after your procedure and Dr. Magnant will
see you two weeks after your procedure.

Avoid strenuous exercise such as aerobics, weight training,
bicycling, or running for the first week, and then resume your
normal exercise regimen as tolerated. You are encouraged
to walk progressively more each day. Avoid prolonged standing
for the first week and elevate your leg(s) at least 3 times a day
for 5-10 minutes. Normal work activity may be resumed within
1-2 weeks depending on your comfort level. We will be happy
to provide you with any documentation necessary for
your workplace.

We will be happy to answer any questions that come up after
your procedure and we are available from 8:00 am until 5:00pm
M-F at 694-8346. However if you feel as though you have a
procedure-related emergency outside of these hours please
call our after hours cell phone at 297-7837.

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After your Microphlebectomy (varicose vein excision)

The local anesthesia will last for an hour or two after the
procedure is over. You can improve the likelihood of a
smooth recovery by taking it easy for the first day or two
after your procedure. Elevation of the legs above the heart
alternating with short walks will also help speed your
recovery. Most patients require little more than ibuprofen
for post procedure discomfort. You will be asked to walk
at the office for a few minutes before leaving. If it is
necessary for you to travel for an hour or more, please stop
every 30 minutes home and walk for 10 minutes. After your
procedure, you will have a compression stocking applied
to your leg which should be left in place for 24-48 hours.
Minimize vigorous walking or working out for the first 48 hours.
Avoid strenuous exercise such as aerobics, weight training,
bicycling or running for 1-2 weeks, although you may resume
all your pre-procedure activities, including work, as soon as
you feel up to it.

In the unlikely event that you notice drainage through the
dressing, do not become alarmed. This is usually a minor
problem and is easily controlled by elevating your leg,
removing the dressing and applying direct pressure over
the site for 10 minutes, followed by an ace bandage. Elevation
and compression are the most important maneuvers. After
you have performed these steps, apply a fresh gauze pad and
an ace bandage. Please call the office for further instructions
if you notice continued drainage. There is no need to become
alarmed or rush to an emergency room. We believe education
of our patients is critical in ensuring a smooth postoperative
course.

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Cómo mejorar sus piernas

Ejercítelas regularmente
Para reducir dolores y cansancio en sus piernas, camine,
corra, practique ejercicios aeróbicos, use escaleras
mecánicas, máquinas de movimientos elípticos, nade,
o ande en bicicleta por 30 minutos 5 - 7 días a la semana.

Alzarlas
Elevar las piernas por sobre el nivel del corazón por unos
10 minutos una o dos veces al día puede ayudar a disminuir
el dolor y la inflamación.

Moverlas con frecuencia
Flexionar los tobillos 10 minutos hará bajar la sangre
de sus piernas como lo hace el caminar. Repita este
ejercicio cada 10 minutos estando de pie o sentado y
trate de caminar por lo menos 2 minutos cada media hora.

Evitar el uso de tacos altos
El uso de tacos altos interfiere con el movimiento normal
de la sangre en las piernas lo que puede causar dolor y
calambres.

Mantener un peso adecuado
Aunque pequeña, una pérdida de peso puede ayudar a
reducir el dolor en las piernas causado por várices y disminuir
la cantidad de las llamadas "spider veins."

Uso de medias elásticas
Disponibles en la clínica "Vein Specialists" de Royal Palm
Square y otros departamentos de útiles médicos. Medias
de menos elasticidad pueden encontrarse en otros negocios.
Sin embargo, es mejor usar medias de sello "Graduated"
porque estas son de mejor beneficio para sus piernas.

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Después su Tratamiento Cerrado Intravenoso

El efecto de la anestesia local durará alrededor de una hora
después de efectuado el procedimiento. Comience a tomar
pastillas ante-inflamatorias (Motrim o Advil 600-800 Mg) con
alimentos, tres veces al día durante 7 a 14 días. Las píldoras
ante-inflamatorias aliviarán el dolor causado por inflamación
y reducirán el uso de calmantes de mayor potencia mas tarde.
El Doctor le dio una receta para comprar calmantes más
fuertes. Use estos calmantes solamente si el dolor fuera
muy fuerte. Es posible que el dolor aumente en intensidad
después de 3-5 días del tratamiento para luego comenzar
a disminuir, esta condición varía de paciente a paciente.

No se alarme si nota moretones después del tratamiento,
esto es normal. Después de 3-5 días del tratamiento se le
hará un nuevo examen médico y ultrasónico.

Antes de marcharse, se le hará caminar brevemente por la
oficina. Si debiese manejar por mas de una hora después
del tratamiento, deténgase por el camino cada 30 minutos y
camine unos 10 minutos. Caminar disipa cualquier malestar
que pueda sentir y ejercita su pierna, lo que ayuda a mantener
buena circulación.

Después de la intervención se le vendará la pierna. Mantenga
seco el vendaje las primeras 24 horas. Después, puede ya
bañarse diariamente y usar sus medias elásticas.

Evite ejercicios exhaustivos, como aeróbicos, ciclismo,
levantamiento de pesas o trote, la primera semana después
del tratamiento. Resuma su régimen de ejercicios lentamente
hasta llegar a su estado normal nuevamente. Se recomienda
caminar progresivamente todos los días. Evite mantenerse
de pie por períodos de tiempo prolongados la primera
semana y eleve la pierna (s) unas tres veces al día por
unos 3 a 10 minutos.

Puede resumir toda actividad normal dentro de una o dos
semanas, dependiendo de cómo se sienta. Tendremos
mucho gusto en proporcionarle cualquier documento que
su empleador requiera.

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