Nurse Susan Rutledge Kemp discusses how to deal with spider and varicose veins

__ABOUT SUSAN__

Job title: Clinical resource nurse with the Saint Francis Vein and Laser Center

Hometown and city of residence: Cape Girardeau

Education: I have an associate of arts degree in nursing from Southeast Missouri State University.

Give us an overview of what you do at the Vein and Laser Center. What do you enjoy about the job?

I coordinate the care we give at the V&L Center. I verify each patient's benefits for varicose vein treatment and seek prior approval for procedures whenever possible. I also assist with procedures, although that usually consists of visiting with the patient while Dr. Wiggans and our sonographer, Michelle Hardin, do the actual work! My nursing background has been critical care-oriented, so the slower pace and the time I get to spend talking to patients is wonderful. I also enjoy the people I work with very much.

Why do varicose veins develop?

What we usually refer to as varicose veins are large, bulging veins on the surface of the skin. There are also several categories of smaller abnormal surface veins, including spider veins. These veins can sometimes be painful. In addition, a patient can have symptoms of pain, swelling, fatigue in the legs and heaviness. To properly diagnose, a specialized ultrasound should be done to identify a condition called reflux, or blood going backward for several seconds at a time in leg veins. It is thought that this condition, venous insufficiency, is usually hereditary and made worse by prolonged standing, pregnancy, obesity and lack of exercise. Women have this condition more than men, but a surprising number of men have come to us for treatment.

Is there any way to prevent varicose veins? Once we have them, how can we control the symptoms?

I don't know if one can prevent varicose veins, but you can try several things to control the symptoms. Sitting or lying with your legs elevated above heart level for 30 minutes three or four times per day; regular exercise that includes the calf muscles; weight loss; and over-the-counter anti-inflammatory agents can help. Compression garments (usually stockings) that are fitted to the patient are also very useful. If one has tried all of these methods and still has symptoms that interfere with their abilty to get their daily activities done, then it is time to seek treatment.

Who is your typical client, and what treatments are most common?

Our clients are usually over age 40, although we have seen people with pretty bad veins in their 20s. As venous insufficiency can result in skin ulcers that won't heal, we treat this type of patient frequently. It seems that most of the time, the patient has been suffering with pain and whatever other symptoms they have for a long time, and finally can't take it anymore. I cringe when a patient tells me they've been told in the past that "there is nothing to do about your veins; just live with it."

Our center offers a treatment called endovenous laser ablation of veins that reflux. We also do injections of sclerosing solutions to close problem veins (this is how we treat spider veins and other cosmetic problems). If a patient has large, bulging veins, we remove these through a tiny incision. All of our procedures are outpatient and last one to three hours. We usually advise patient to go out and eat and maybe shop a little after we get through with them!

How do we know when it's time to seek treatment for problem veins?

The decision will lie with the patient, as a patient may decide they would rather live with the bad veins than have them treated. Myself, I would at least get them looked at if I am suffering from them, or if I had skin changes on the lower legs that point to vein disease. This would be darkening and/or thickening of the skin on the lower legs. Most insurances cover varicose vein treatment if it is deemed medically necessary. Medical necessity is proven by an ultrasound that is positive for reflux, and the patient having symptoms that interfere with their activities of daily living. I am more than happy to discuss this with anyone who calls our office, and no referral is needed to make an appointment with Dr. Wiggans.

What's your best overall health advice for women?

Don't listen if anyone tells you that you "just have to put up with it." Also, drink lots of water and get plenty of sleep!