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Frequently asked questions
What are varicose veins?
Venous disease can cause dilated, or enlarged, varicose veins that look like blue or purple twisted ropes and bulge on the surface of the skin. Varicose veins are equal to or greater than three millimeters in diameter and can be associated with serious chronic venous disease.
What are the signs and symptoms of venous disease?
Venous disease may result in a variety of signs and symptoms including skin irritation (itching or burning), leg swelling, pain and aching, fatigue, heavy or restless legs, and leg cramps. Signs may or may not include abnormal-looking veins, such as varicose veins that bulge on the surface of the skin, loss of hair on the lower legs and ankles, discoloration of the skin, redness, or irritation in the ankle and lower leg. The most severe sign of chronic vein disease is an open sore in the ankle or lower leg area.
My doctor said varicose veins are just a cosmetic problem, is that true?
I had a vein stripping in my leg years ago and now my symptoms are back. What do I do now?
In the past, vein stripping of the saphenous vein was a common procedure for treating varicose veins. It is typical to see varicose veins return after the procedure. An ultrasound examination can show exactly what has been done in the past and can determine which veins are now causing problems. Based on the ultrasound results, Dr. Coates can offer treatment options that best suit your situation.
Don’t I need all of my veins to get blood from my legs back to my heart?
The veins we treat are not providing effective return of blood to the heart. You have many veins in your legs that will function appropriately almost instantly after the diseased veins are closed. Treating the diseased veins and redirecting the blood flow actually improves venous blood flow back to the heart.
What if I need my leg veins for a heart bypass surgery or leg artery bypass surgery?
How long after the procedures do I need to wear compression stockings?
Compression stockings should be worn continuously for the first 48 hours after a radiofrequency ablation procedure and then during the day for the next two weeks.
Do I need to stop my blood thinners or other medications before the procedure?
No. Some patients may have a little more bruising afterward if they are on Aspirin, Plavix, Coumadin, Xarelto or Eliquis. However, many patients on these medicines do not have more bruising. Any other medications can usually be continued.
How long does the radiofrequency ablation procedure take?
Radiofrequency ablation takes about 30-45 minutes to perform. If microphlebectomies are also performed that day, it may add another 30-45 minutes. Including pre-treatment and post-treatment preparations, patients can expect to spend approximately two hours at our facility.
What is the recovery time?
Recovery time depends on the procedure and the patient. However, the procedures performed are all minimally invasive, and patients are able to walk in and walk out. Most patients can return to work or normal activities the very next day.
What do I need to remember the day of my procedure?
On the day of your procedure you will want to dress comfortably, take your normal prescribed and over-the-counter medications, and eat as you normally would. However, do not drink a lot of water, soft drinks, tea or coffee as you will be lying down and not able to get up during the procedure! Remember to bring your prescription stockings to the office; we will apply these after the procedure. Also, you may need to arrange for someone to drive you home.
How often will I need to follow-up with the doctor?
Will my insurance pay for treatment of varicose veins?
Establish Medical Necessity
Compliance with Conservative Therapy
Obtaining Prior Authorization for a Treatment or Predetermination of Medical Necessity
What does “medical necessity” mean?
At the time of your initial visit, Dr. Coates will evaluate your vein problems. Based on your history, and presenting symptoms, he will perform a diagnostic ultrasound if he deems it to be medically necessary to do so. It is with the ultrasound that he is able to see the venous anatomy in your legs and where there may be problems. It is based on the results of the ultrasound that he will be able to discuss with you the treatment options.
What does "conservative therapy" mean?
Insurance companies may require a "trial of conservative therapy" for 1-6 months prior to approving treatment. Usually conservative therapy means participating in regular exercise, elevation of the legs, weight loss attempts, and wearing medical grade compression stockings for 1-6 months. While there is no evidenced based medicine to support this, insurance companies have this requirement, and your compliance is compulsory.
How does one obtain prior approval or get predetermination of medical necessity from the insurance company?
Will Insurance cover “cosmetic treatments”?
We are not aware of any insurance company that will pay for cosmetic treatments. Although spider veins may be uncomfortable or painful, their treatment will not qualify for insurance coverage.