What to Expect at the Vein Doctor
Many people with vein disorders, such as varicose veins or venous ulcers, have never been to a phlebologist, or vein specialist. Proper treatment of insufficient veins starts with a consultation and complete evaluation. Every part of the evaluation is critical to effective vein treatment, as the best specialists treat the whole patient, not just his or her legs.
Here are some things first-time patients can expect from an evaluation by a Board certified phlebologist:
1) Health history – Patients are asked to describe the current state of their veins, what makes their veins feel better, and how their quality of life is affected. Board certified phlebologists don’t just stop at the legs but rather review all of the patient’s systems from head to toe. Past medical, family, and surgical histories are also taken into account, as well as a social history.
2) Details about lifestyle — whether or not a patient smokes, runs marathons, or stands for his/her job all day, for example—are all relevant to good venous care.
3) Physical exam – The specialist will take a patient’s vital signs, then look closely at the patient’s legs and feet. The doctor will rate the patient’s level of disease and health on universal standardized scales. Vein specialists use the “CEAP classification,” which helps us categorize disease. (CEAP stands for: clinical severity, etiology or cause, anatomy, and pathophysiology.)
4) Ultrasound mapping – The veins of the lower legs are evaluated using ultrasound waves to see which veins have flow going in which direction. A healthy vein will only allow flow from the feet towards the heart. Faulty veins are often connected, and finding the “source” of the problem is a complicated, but critical step in establishing the site where treatment should start.
Consultations generally take between 45 to 90 minutes, depending upon the extent of the problem and whether or not an ultrasound occurs in the same visit. Most offices allow new patients to prepare for their first consultation by filling out any required paperwork ahead of time (filling paperwork out at the office may delay the appointment and, consequently, other patients too).
It’s also helpful for patients to drink water before the exam; hydration can cause the veins to bulge, making it easier to see the problem. Patients should also know that they will be asked to wear a short garment and to take off socks and shoes. Doctors need to visually inspect the patient’s legs and feet, so they must be adequately exposed.
Once the evaluation is complete, the specialist should take the whole picture into account before determining the best treatment for the patient. The doctor will present the patient with all of the potential options, including conservative treatments. In the end, the patient decides how he/she wants to proceed.
While full consultations are not free, they are partially or completely covered by most insurance companies, especially if the policy covers specialist visits. Those with Medicare and supplemental coverage usually pay no out-of-pocket expenses.
Taking the first step toward understanding more about your vein health is something you do for yourself. The vein specialist’s goals are to learn about your condition, help you understand how your vein health affects your overall health, and provide you with the best information about treatment options.
Dr. Cindy Asbjornsen is the founder of the Vein Healthcare Center in South Portland, Maine. Certified by the American Board of Venous and Lymphatic Medicine, she cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers. Dr. Asbjornsen is the only vein specialist in Maine to be named a Fellow by the American College of Phlebology. You can contact Dr. Asbjornsen at 207-221-7799 or [email protected].
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