Dr. Dietzek recently visited The Doctors to discuss venous disease and it’s treatment.
Luke: I don’t think that’s supposed to happen. That is a varicose vein that popped and it didn’t stop bleeding. Okay, got to do something now.
Host: The man behind that home video and exploding vein Luke is in our audience along with board certified vascular surgeon and founder of the vein and vascular institute, Dr. Charles Dietzek.
Dr. Rachel: Luke, I don’t know what was more engaging.
Dr. Ordon: Professionally, that’s what we call a squirter.
Dr. Rachel: Was it the squirting that got me. or the calmness about how you just handled it like, oh my goodness!
Luke: That was the second time that happened.
Dr. Rachel: Second time.
Luke: It happened a couple of days before that and it was actually three times worse.
Dr. Rachel: Wow!
Luke: I actually happened to have my phone in the bathroom with me at that time and I was like, okay this would be, make a great video so I could show the doctor exactly what happened.
Dr. Rachel: Yes.
Host: Well, that’s actually smart in that sense, luckily you also then knew the minute you put the phone down to apply direct pressure, right?
Host: So you knew what you had to do to stop the bleeding so you wouldn’t bleed out.
Dr. Rachel: So doc, can you comment a little bit on how often this happens because a woman, I know at some point I’ll probably get some varicosities of some sort, you know because as we get a little older, or as we get pregnant, it increases our risk of developing these basic veins. So talk a little bit about how often does this happen, that someone shows up with blood squirting out of their leg.
Host: From a varicose vein in this case.
Dr. Rachel: Yes.
Dr. Dietzek: There’s about 25 million people that have venous insufficiency and some severity of venous insufficiency. Luke had a more advanced case, and there are different things that you can see as the disease progresses. This is just one of them. You could see discoloration of the skin, hardness of the skin, you could see ulceration, large ulcers that are quite dramatic and sometimes these ulcers won’t heal for months but it’s all because of venous insufficiency. Luke had the situation of a ruptured varicose vein and this time of the year where the weather is a little bit dryer, skin tends to crack a little bit easier. You see more of these.
Host: So for most people, that venous blood, you walk around, it goes back up to your heart and gets pumped back through but in venous insufficiency it’s pooling in the legs. There’s a lot of pressure down there, so what do you do in a case like this where Luke’s had numerous instances where these varicose veins are literally exploding and bleeding, how do you fix that?
Dr. Dietzek: First thing is you have to evaluate him and see what exactly is the reason why he has this. And so the first step is to get an ultrasound. An ultrasound study is going to allow us to evaluate the entire venous system and determine whether there is valvular insufficiency. There are valves inside the veins that are supposed to be unidirectional allow the blood to go back towards the heart and what Luke had was valves that were not working in a particular vein. Subsequently, when he would stand, the pressure would go down the vein and then would go into branches and over time these branches got larger, and larger to the point that the skin overlying them was very thin. Subsequently one rupture resulting in that dramatic video.
Host: An animation here of the first step that you used to help treat this, can you walk us through it?
Dr. Dietzek: Sure, Well, this is the Venefit Procedure. This catheter is inserted into the vein that is not functioning properly and it’s passed up the thigh up to the groin area. Then the catheter is turned on and it actually heats the inside of the vein, destroying the inside of the vein and it does that over a seven centimeter length, and then you pull the catheter to the next section and then destroy that vein that’s not functioning. This procedure takes about three to four minutes. The actual heating and sealing of the vein, and it’s done in the office with the patient awake. So this is an outpatient procedure where you come right in the office, have this done and out the office by yourself.
Host: Because this is an accessory vein, Luke doesn’t need this vein, so you’re essentially creating a process here where this vein no longer is going to have this blood backed up in it.
Dr. Dietzek: Correct.
Host: And then you have a second step that I think we also have some, some footage of. What are you doing here?
Dr. Dietzek: Once I took care of the underlying problem, then I had to address the more superficial problem of the bleeding vein. So here what I’m doing is injecting veins that are at the skin surface using a sclerotherapy agent to destroy the vein which then happens over a period of weeks. Here you see the vein disappearing immediately because it’s being filled with that solution but then the actual process of it sealing will take a few weeks for that to occur.
Dr. Ordon: Dr. Dietzek, I mean you mentioned how many millions of people have this. I think a lot of people don’t realize there’s a much better way now to treat it. The old days you had to do vein stripping, larger incisions, tie things off, pull the veins out. Now with this radio frequency therapy, that offers a huge innovation for people.
Dr. Dietzek: Oh, it’s dramatic.
Dr. Ordon: Typically you think of varicose veins more in women than men, why in this particular case do you think he was set up to get this?
Dr. Dietzek: This is a genetically predisposed disease and there are certain things that will accentuate that predisposition. Luke has a job where he stands for long hours of the day and this just potentiated his venous conditions such that he ended up getting these large varicose veins.
Dr. Rachael: Can you speak a little bit then because it is genetic and we all know family members and you can look and say oh my God, I hope my legs don’t look like that when I grow up, so what are some tips that we can do on our daily basis to just kind of minimize our risk of developing severe varicosities?
Dr. Dietzek: Well, with regards to genetics you can’t run away from that.
Dr. Rachael: I know, I know.
Dr. Dietzek: But as far as the other things that you can do, is avoid long periods of standing, wear compression stockings if you’re predisposed, when you’re not standing elevate your legs. Other things that you can do is eat a healthy diet. Make sure you’re high in fiber so that you avoid constipation.
Dr. Rachael: Because constipation if you’re straining on the toilet, you can increase your varicosity.
Dr. Dietzek: Correct.
Host: And the important question, Luke, how are you now, my friend?
Luke: I’m doing much better. I don’t have to worry about my leg bleeding out anymore.
Host: Dr. Dietzek, we appreciate you joining us. The good news here as Dr. Ordon mentioned, superior treatments now for those suffering from varicose veins but prevention, boy that is the best treatment of all if you can do so.
Dr. Rachael: Yes.