Varicose veins - treatment seems odd?

[Batty]

I have had a few small purple blotches around my ankles for 20-odd years. They have never got better, or worse. It runs in the family, and I am the youngest of six. All of my elders have had them for years, without anything getting worse.

 

Over the last few years, I have developed bulging veins in both legs. Again, two of my elders have had the same issue for years, and none of them have been operated on or anything. My mother had it also and had the veins 'pulled out like spaghetti' when she was around 50 years old, which is my current age.

 

It's obviously an issue, and the fact that none of my elders have had a serious problem with it should not serve as a deterrent from my getting them sorted. So, I found a clinic in Udon Thani who specialises in this kind of thing.

 

The doctor there spoke amazing English and seemed very much on the ball. He is a doctor at the local army hospital and works this clinic evenings and weekends.

 

He diagnosed varicose veins instantly, without even touching my legs, and said it could be dangerous in the future. I don't doubt that. He said I could lose a leg in the future (I think he said 10 years or so upwards) and am currently 'mid-range seriousness'. He said the procedure is a chemical injection directly into each problem vein. This would cause or prevent (I forget which) thrombosis, effectively blocking the vein and stopping blood flow within it. That, he said, is the cure.

 

All good so far, in terms of consultation. But my spider senses kicked-off a little because he seemed to switch to sales mode. He wasn't hard selling, but I just got a general sense that he was keen to close me, and get me on the procedure table right there and then for my first couple of injections. Hard to explain, really, but it just felt more like a beauty clinic environment where they are keen to do business, as opposed to treat patients, if that makes sense. The word 'special price' and 'great offer' was thrown around quite a bit. 

 

Each injection, apparently, is one vial. He said I may need up to 12 vials total, at a 'special promo price' of 65,000 baht for all 12 injections/vials. One being, one vial, kinda thing.  He said we should do the most potentially dangerous 2 or 3 veins first, then I can have the others done over a month or two, at my own leisure, until we have used all 12 vials. 

 

I asked him if I might have a DVT, or if there is any chance of having one. I never have pains in my legs, apart from a tiny, almost insignificant feeling of discomfort in one of the veins, on my calf. He said there is no chance of having a DVT as I don't present with the symptoms. He also said they can not check for DVT at this clinic, which made me wonder if that was his motivation for being so certain that I do not have one.
 

I told him I would go home, think about it, and come back to him. In fairness, there was no charge for the consultation - although I made it clear that I would be back to pay the 65,000 soon just so I could wrap things up and get out of there.

 

By the way, I also asked him (candidly, I guess) if I could have it done at the army hospital he works at. No, he said. "they not have this special injection there". Hmm. Seemed a bit odd. 

 

Sorry about the long-winded post, but I have a few questions about all of this:

1) Is this the correct procedure for varicose veins? An injection directly into the vein? What is the general approach by a regular hospital?

2) Does the price sound about right? 65,000 for 12 vials/injections?

 

3) I did previously think I had a DVT, as I had a pain in my left calf a couple years ago for around one month months. At one point, I was limping for a week or so. I was told by a different local clinic that I had a DVT - but then got a scan at a hospital later, and was told I didn't. The pain vanished, and never returned. Maybe it was something else, I have no idea. However, how can the doctor at this clinic I just visited be so sure I don't have one, just by glancing at my leg? I thought DVTs were invisible to the naked eye?

Whatever you guys thing I should so, basically. Would I be better off going to a local hospital, maybe? 

 

 

 

 

 

 

[Sheryl]

There are various treatments for varicose veins: surgery, radiofrequency ablation, laser, sclerotherapy  (the injections this doctor proposed). The choice of method depends in part on the size of the veins.

 

I can't say re usual cost for sclerotherapy vials. Nor can I comment on the recommended number of vials though does sound like a lot. 

 

What most concerns me is:

 

1. The lack of physical exam

 

2. The high sales pressure

 

3. The scare tactics. To say you might lose the leg in 10 years is quite a leap and not justified. It would take a whole series of events for that to occur and usually it does not.

 

I recommend you get a second opinion at a hospital with a vascular surgery clinic  such as 

https://wattanahospital.net/patient_services/vascular-surgery-clinic/

[msbkk]

I also do have spiderveins and lots of enlarged veins at my lower legs as well as some purple spots. I went to a large hospital in Bangkok to consult with a vascular surgeon. My idea was also to get some injections.

 

The surgeon did a physical exam and used a device at my legs  called Doppler ultrasound and I was diagnosed with venous insuffiency.

Doctor prescribed long compression socks. His advice was to do a lot of walking and keep my legs high when seated. All other treatments can have serious side effects according to him and he advised not to do injections.

This might of course be different from case to case.

[GammaGlobulin]

If I were you, I would wait until AI has improved...for about another 18 months.

 

Still, the state of the art treatment at Harvard Medical School, according to the AI of today....

 

Is this:

 

 

[Batty]

On 12/8/2024 at 9:04 PM, Sheryl said:

There are various treatments for varicose veins: surgery, radiofrequency ablation, laser, sclerotherapy  (the injections this doctor proposed). The choice of method depends in part on the size of the veins.

 

I can't say re usual cost for sclerotherapy vials. Nor can I comment on the recommended number of vials though does sound like a lot. 

 

What most concerns me is:

 

1. The lack of physical exam

 

2. The high sales pressure

 

3. The scare tactics. To say you might lose the leg in 10 years is quite a leap and not justified. It would take a whole series of events for that to occur and usually it does not.

 

I recommend you get a second opinion at a hospital with a vascular surgery clinic  such as 

https://wattanahospital.net/patient_services/vascular-surgery-clinic/

Thanks so much, Sheryl. I did go to Wattana hospital and ask the 'international staff' (English speaking girls) if they had a doctor about my veins that they said they did not have a department for that and referred me to a clinic in the town - a clinic that turned out to be useless (the doctor is never there, and let me down with two appointments because he was busy at the public hospital).

 

I'll try again at Wattana. Maybe I didn't explain myself correctly to the staff. 

 

Appreciate the advice!

[Batty]

On 12/8/2024 at 9:40 PM, msbkk said:

I also do have spiderveins and lots of enlarged veins at my lower legs as well as some purple spots. I went to a large hospital in Bangkok to consult with a vascular surgeon. My idea was also to get some injections.

 

The surgeon did a physical exam and used a device at my legs  called Doppler ultrasound and I was diagnosed with venous insuffiency.

Doctor prescribed long compression socks. His advice was to do a lot of walking and keep my legs high when seated. All other treatments can have serious side effects according to him and he advised not to do injections.

This might of course be different from case to case.

 

Thanks. My situation sounds very similar to yours, actually. It sounds like you had a great doctor there, offering honest impartial advice. 

 

I'll see if I can locate the same type of doc!

 

 

[Batty]

On 12/8/2024 at 9:44 PM, GammaGlobulin said:

If I were you, I would wait until AI has improved...for about another 18 months.

 

Still, the state of the art treatment at Harvard Medical School, according to the AI of today....

 

Is this:

 

 

Thanks, appreciate it - I should have done the same research, in hindsight. 

[Sheryl]

23 minutes ago, Batty said:

Thanks so much, Sheryl. I did go to Wattana hospital and ask the 'international staff' (English speaking girls) if they had a doctor about my veins that they said they did not have a department for that and referred me to a clinic in the town - a clinic that turned out to be useless (the doctor is never there, and let me down with two appointments because he was busy at the public hospital).

 

I'll try again at Wattana. Maybe I didn't explain myself correctly to the staff. 

 

Appreciate the advice!

The term you want is "vascular surgeon". 

 

There is one at Bangkok Hospital Udon, Dr. Anucha 

https://bududon.com/en/doctorprofile.php///doctorprofile.php?cntype=CN0008