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Tag: varicose veins
My Experience of Varicose Veins Surgery
My Experience of Varicose Veins Surgery – by Jodie Krantz
Deciding on a procedure
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.
What my surgeon told me
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.
CLICK HERE if you are looking for an Exercise Programme following Varicose Vein Surgery
My experience of varicose vein surgery
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.
Beginning my rehabilitation exercises
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.
Five years later – very happy with the outcome
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.
Read more about Exercise following Varicose Vein Surgery
Exercise Programme following Varicose Veins Surgery
Exercise Programme Following Varicose Veins Surgery
Exercise safely after your varicose vein surgery with advice from an experienced physiotherapist. Jodie Krantz from Perth in Western Australia went through this surgery herself and writes with 30 years experience in her profession.
This article is a step by step guide that takes you through the days and weeks immediately following your surgery. It will give you the confidence to help yourself recover as quickly as possible.
Please note: the following is a general guid only guide only and may not apply to everybody. Always take the advice of your surgeon and other medical personnel. Read our disclaimer
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Day 1
As soon as you wake up after the surgery begin the following bed exercises at least once an hour:
Ankle exercises
Move your feet and toes and down rhythmically. Circle them 10 times in each direction. The purpose of this help maintain your circulation and prevent the rare but serious complication of a deep vein thrombosis.
Knee and hip exercises
Bend and straighten your knee slowly and gently 5 times by sliding your foot along the bed. This helps to prevent stiffness and also keeps your circulation going.
Walking
You should be allowed to get out of bed and walk soon after you have eaten your first meal. Walk to and from the bathroom on the first day and if possible a little further.
Analgesia
Take your pain medication as advised by your doctor. Pain relief will help you perform your exercises better and therefore improve your recovery.
Comfort
Elevating your affected leg on a soft pillow may assist your circulation and reduce swelling. Check with your medical staff first.
Applying Surgical Stockings
Before putting on your surgical stockings turn the stocking inside out down to the heel. Slide your foot into the stocking up to the heel then ease it up over your leg – it will hurt! Surgical stockings with a cutout toe hole are easier to put on. Place a plastic bag on the end of your foot then slide the stocking on over the plastic bag. Remove the bag through the toe hole.
Day 2
The pain may be a bit worse on the second day as the local anaesthetic wears off. Take your prescribed or over the counter analgesic medications so you can get yourself moving.Â
Bed exercises
Continue your bed exercises as above on an hourly basis.
Walking
Extend the duration of your walking to periods of up to 10 minutes if possible. Try to get up and walk at least once every 2 hours.
Analgesia
Continue to take pain medication as required. It will help you do your exercises so you can recover more quickly.
Day 2 to 5
In place of the bed exercises get out of bed and walk every hour during the day for a short period. Walk continuously for at least 15 minutes twice a day on flat ground. You may find the walking is quite painful to begin with however the longer you walk, the less pain you should experience.
When walking, try to put your full weight on the affected leg and minimise limping as much as possible. Do not rush the weight bearing phase on your affected leg and try to use the muscles of this leg normally. Always wear your surgical stockings when walking. Avoid prolonged sitting or standing and elevate your leg when lying down.
Day 6 onwards
By now the pain should be starting to decrease, though you will likely still feel very tight and stiff. Even if it’s still really uncomfortable it’s important to keep moving and to try to gradually increase the duration of your walking.
Walking
Continue your walking programme for at least 30 minutes everyday. Include some hills. Start each walk slowly and try to put even weight on both legs. Gradually lengthen your stride and increase your speed as you start to feel more comfortable. Ensure that your stride length is the same on both legs.
Using a pedometer may help to encourage you with your walking. I recommend the fitbit which i found incredibly motivating. It logs the number of steps you have taken each day, the distance covered and the calories you’ve burned. Little flashing lights on your wrist band show your progress and give you positive feedback. The fitbit also monitors your sleep quality at night.
Stretches
The muscles and fascia of the calf and / or inner thigh are likely to become very tight following your surgery. These stretches should be performed gently. Listen to your body and do not push into pain. Remember, everyone responds differently to exercises. If you are experiencing any difficulties please ask your doctor or physio for advice.
You will need:
- A carpeted floor space or exercise mat
- A strap with a loop (for example resistance tubing, yoga strap or dressing gown cord)
This stretch sequence has 3 parts all done in the same position. Remember, the leg that’s not moving remains bent with the foot on the floor. This helps you stabalize the pelvis and protects your lower back from injury.
- Hamstrings:
- Lie on your back with knees bent, feet flat on the floor
- Put the loop of your strap around your foot of the operated leg
- Hold the strap with both hands
- Lift your foot up high and try to straighten the knee
- Keep the other foot standing on the floor
- Slowly lower your leg towards the floor, keeping pelvis stable
- Raise and lower your leg like this 10 times, breathing fully
2. Calf muscles:
- Keep your leg up as high as possible, knee straight
- Having your foot up helps reduce swelling in the calf
- Gentle flex and extend your ankle 10 times, keeping the knee straight
- Circle your ankle 5 times in each direction
3. Inner thigh muscles (hip adductors)
- Do these exercises extra slowly for the maximum benefit
- Keeping a stretch on the back of your thigh and the knee straight slowly lower your leg out to the side
- Consciously allow the muscles of the inner thigh to let go
- You can allow the bent knee (non-operated leg) to move outwards slightly to counterbalance
- Keep the pelvis as stable as possible – this will help with core strength
- Bring the leg back to the vertical and repeat 5 times
It’s also fine to do all the above exercises on the non-operated leg.
Massage
Soft tissue massage can be helpful for relieving congestion and breaking down scar tissue, while improving comfort and mobility. Refer to the advice of your surgeon as there are situations in which massage could be inadvisable or dangerous (especially infection or deep vein thrombosis).
You will need to start extremely gently for your safety and comfort. Begin by lightly rubbing in the Hirudoid cream, working it in an upward direction (towards the groin). Don’t use excessive pressure or you will only worsen the brusing.
From approximately 4 weeks after the surgery you can begin to use a bit more pressure and include small circular movements over the lumps in your calf or thigh.
Beyond 6 weeks
See your surgeon for a post operative check. Continue all your exercises until you have no further symptoms. If you’re not normally someone who exercises regularly, consider making a 30 minute walk part of your daily routine for the rest if you’re life.
As little as 2.5 hours of moderate activity every week (ideally as 30 minutes minimum every day) can reduce the chance of your veins recurring as well as improve your general and physical health. You are likely to live both a longer and happier life if you make this simple lifestyle change. If you need motivation go with a friend, join a walking group or buy a fitbit, smart watch or pedometer.
If there are still lumps in your thigh or calf after 6 weeks, use a foam roller to massage the soft tissue daily. A professional massage can really help. It always seems to take twice as long as you think to recover from surgery. I still had some lumps remaining after 4 months. One year after the surgery I still had scars. However in time they all disappeared. I hope you also have a great outcome.
Good luck!
Joint Hypermobility Frequently Asked Questions
Joint Hypermobility Frequently Asked Questions
What is Joint Hypermobility?
Joint Hypermobility is a condition in which joints can be moved beyond the normal or expected range of movement – sometimes referred to as being double jointed. When Joint Hypermobility affects multiple joints in the body, it may be due to a systemic condition causing excessive mobility of the connective tissues which bind the body together, including ligaments, tendons, muscles, skin, blood vessels and the gastrointestinal tract.
Does Joint Hypermobility cause pain?
The condition does not necessarily cause pain in and of itself, in fact it may be an advantage to have extra flexibility, for example, many dancers and gymnasts are hypermobile. However the disadvantage is that extra flexibility may result in poorer stability, a difficulty in sensing the position of joints (reduced proprioception) and a susceptibility to injuries such as joint sprains or dislocations along with slower recovery.
What is Joint Hypermobility Syndrome (JHS)?
Joint Hypermobility Syndrome, sometimes called Benign Joint Hypermobility Syndrome (BJHS), refers to a group of conditions in which Hypermobility occurs along with chronic pain (pain lasting more than 3 months) and affects multiple joints. It has been recognised condition since 1967.
Why does it take so long to arrive at a diagnosis of JHS?
Joint Hypermobility Syndrome has been under recognised and under treated by health professionals and the medical establishment, though awareness of the condition is growing. Because people with JHS may exhibit a good range of movement even when they are in severe pain, their pain may have been ignored or trivialized at times. It may even have been implied that they are exaggerating or imagining the pain or that they are just suffering from anxiety.
What are the Causes?
Joint Hypermobility is often hereditary, so if you have very flexible joints, it’s likely that one or both of your parents do also. It’s more common in women and in children and adolescents.
Problems with proprioception and sometimes coordination can lead to frequent injury. Recovery from injury is often prolonged, due to recurrent re-injury of the healing tissues. Re-injury may occur without the person realising that it’s happening at the time, such as during periods of prolonged poor posture. A person with hypermobility usually has greater than average spinal movement for example, so can slouch even more fully than someone who is relatively stiff, putting the spinal discs under great pressure.
More serious causes of Joint Hypermobility include several genetic conditions such as Ehrlers Danlos Syndrome (which may cause fragile skin, easy bruising, heart, vascular and lung disorders) and Marfan Syndrome (which may cause skeletal abnormalities, eye, vascular, heart and lung problems). For this reason, people with Joint Hypermobility who have other symptoms are advised to consult a knowledgeable physician for a thorough medical assessment.
Why do people with JHS feel stiff?
Lack of joint stability may result in having to work harder in the muscles to hold yourself up against gravity, so people with Joint Hypermobility may find prolonged sitting and standing extremely difficult. This can lead to slouching along with painful overuse of the superficial muscles, along with limited activation of the deeper ‘core’ muscles that would normally assist with balance and stability. The result can be feeling tight and stiff all over, however stretching (for example yoga classes) may exacerbate the problem by increasing joint mobility.
What other problems may be associated with Joint Hypermobility?
Varicose veins, hernias, pelvic organ prolapse, irritable bowel syndrome, stretch marks and scarring, snapping or clicking joints, scoliosis, fibromyalgia, osteoarthritis, pronated feet, fatigue, anxiety and depression are conditions which may be related to and co-exist with Joint Hypermobility. Conditions which affect the autonomic nervous system, including palpitations, dizziness, fainting and excessive sweating are also more common in people with JHS.
Is it better to rest or exercise with JHS?
Regular physical activity, especially during the teenage years when the body is growing quickly, assists the development of a strong and healthy musculo-skeletal system that is resistant to injury. However with JHS pain can cause avoidance of exercise and physical de-conditioning. In the long term this can result in more pain. Although rest may be required at times to assist with tissue healing following injury, staying active and improving cardio-vascular fitness, strength, core stability, balance and posture and keystones in the management of JHS.
Recommended exercises include Clinical Pilates, the Feldenkrais Method, swimming, hydrotherapy and Tai Chi. Contact sports and any forms of exercise with a high risk of injury are not advisable for most people with hypermobile joints. The important thing is to find a balance and exercise that is right for the individual. Advice from a Physiotherapist with an understanding of JHS can be very valuable.
Connect with others
There is a is a great new blog site where you can get information and support. Visit Hypermobility Connect.
How We Can Help
The Feldenkrais Method is very useful when someone has moderate or severe pain. People with JHS frequently report that they don’t feel pain during physical activity, they only feel it afterwards, when it is too late to change the way in which they move.
Feldenkrais helps you become more aware of small discomforts, before they develop into pain, so that you can stop and change the way you are doing something. Because it is so gentle even people with severe pain can participate in one-to-one Feldenkrais sessions, with view to progressing to classes, where they can gain greater independence and freedom from pain. Through gentle movement lessons, participants clarify their ‘self image’ – the detailed map of the body, which everyone has in their brain. Improved body awareness and proprioception reduces the frequency and severity of re-injury, allowing the body to repair the damaged tissues.
Clinical Pilates can assist teenagers and adults with JHS and mild to moderate pain to safely improve their body awareness, posture and strength, promoting a return to more vigorous forms of physical exercise. Individual assessment is essential prior to commencing our programmes.
