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It was with some hesitation that I finally decided to undergo surgical stripping of the short saphenous vein in my right calf. Although my varicose veins were not severe or painful the faulty and unsightly valves had been growing in size and number over the previous two years. I was also experiencing some swelling in my leg during hot weather and plane flights.
When I first met with my surgeon I was hoping he would suggest injection therapy or laser treatment. These procedures seemed a lot less invasive, however my surgeon explained that injection therapy was far less successful and that patients often had to return for many treatments before a good result was obtained.
Laser therapy was not recommended for this particular vein, because laser treatment involves heat which potentially could damage the common peroneal nerve which lies close to the short saphenous vein.
Surgical stripping, my surgeon explained, was usually a day stay procedure with return to work possible within 1 to 2 weeks.
The surgery would be performed with me lying on my stomach but I would wake up on my back. It would result in a small incision behind the back of my knee where the vein would be tied. I would also have several small incisions in the back of my calf for the removal of each of the faulty valves. The incisions would be closed with dissolving stitches and / or steri strips. Afterwards I could expect some bruising and swelling which would be controlled with bandaging, followed by wearing a surgical stocking continuously for the first 3 days. After this time it was recommended that I wear the stockings during the day for the first 10 to 14 days removing them if required for comfort at night. I was encouraged to massage the leg generally with Hirudoid cream to assist with the resolution of the bruises.
Regular walking would be important the 6 weeks following the surgery in order to re-establish the circulation in my leg. Exercise would help to reduce the swelling and to divert the circulation to alternative veins. My surgeon told me there was a 90 percent chance that the varicose vein would not recur.
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Due to having neck issues I requested the use of a face hole during the procedure, rather than have my head turned to one side. I awoke after the surgery without any pain. Soon I realised that my leg was very numb and that I couldn’t move my toes or foot upwards or outwards. Some numbness was to be expected, however I had complete sensory and motor loss in the distribution of the common peroneal nerve.
The nursing staff were excellent. They released my bandages thinking that they might be too tight. My surgeon visited me and explained that they had injected a local anaesthetic and that this was the probable cause of my foot drop. It would take about 6 hours to wear off.
In actual fact it took almost 24 hours before I began to regain the ability to move my foot normally, so I had to stay in hospital overnight. I walked with a lopsided limp, somewhat like a stroke patient. I was very anxious and already planning my rehabilitation! However it turned out my surgeon was right and complete movement and sensation came back when the anaesthetic wore off.
The rest of my post operative recovery was without further complication, however the bruising was a lot more severe and painful than I expected. I felt this aspect was down played by my surgeon. In retrospect I would not go through this surgery again unless the veins were really painful.
The only instructions I was given were to walk for at least 30 minutes everyday for the first 6 weeks. Once the local anaesthetic wore off, putting any weight on my leg was very painful despite regular analgesia. I was unsure whether to attempt 30 minutes of walking on the day after the surgery. As a physio I was disappointed that more information was not given about post operative exercises.
It made more sense that the exercise should be progressed gradually over the first week. The problems I encountered included severe bruising with large lumps in the calf where the valves had been, marked tightness of my muscles and fascia and a tendency to walk with a limp. As a result I developed an exercise program to help others in the same situation to recover from varicose vein surgery.
It is now five years since I had the varicose vein surgery. There has been no recurrence of the varicose veins and the scars are almost invisible. Overall I’m very happy with the outcome.
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