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Advancing Care - 2024 | Issue 5

Uwe Fischer, MD

When Should You Worry About Varicose Veins?

Varicose veins. They’re visible and often unsightly. You may be resigned to just covering them up. But do they pose a health risk? Should you worry about varicose veins?

What are varicose veins?

Varicose veins appear as swollen or raised leg veins and are often blue or dark red in color. They result from a weakness in the vein walls. They almost always occur in the legs (because gravity makes it harder for blood to flow upward), but they can show up anywhere on the body. A milder version of varicose veins usually seen in the legs is often called “spider veins,” which are typically smaller and thinner.

While the condition sounds scary, it’s very common – especially as we get older, according to Uwe Fischer, MD, a vascular surgeon with Yale New Haven Hospital and assistant professor of vascular surgery at Yale School of Medicine who treats patients in Old Saybrook as part of the multidisciplinary team at the Heart and Vascular Center.

“Approximately 30 percent of adults have varicose veins, and they rarely lead to significant health problems,” he said. “However, in the most severe cases, varicose veins can cause pain, aching, heaviness, swelling and even ulcers. They can also bleed if damaged.”

Risk factors for varicose veins

Varicose veins develop for various reasons. The most common risk factors include age, family history, pregnancy, menopause, obesity, tobacco use and prolonged sitting or standing.

Females are particularly prone to varicose veins because of changes in hormone levels. Many females develop varicose veins during pregnancy because of hormonal effects on the vein walls. “If they don’t develop during pregnancy, women who have had children are still more vulnerable to varicose veins later on, because the additional stress of pregnancy has weakened the veins,” he said. 

When should I see a doctor?

While varicose veins usually are not dangerous, an increase in swelling or pain in your legs may be a sign of a more serious problem, said Dr. Fischer. Other signs of worsening symptoms include skin discoloration, ulceration or if the skin feels hot to the touch.

“If you are concerned, make an appointment to get clarity and peace of mind. We conduct a physical exam and look at everything,” Dr. Fischer said. “Every patient who comes in gets an ultrasound test to ensure there are no underlying concerns, such as blood clots. This can also give us additional information about the veins in your legs.”

Treatment options

According to Dr. Fischer, the first step in treating varicose veins is what vascular surgeons refer to as conservative management.

“We begin with having patients wear special compression socks or stockings that can help the blood flow to your heart. They also decrease swelling,” he said. Additional lifestyle changes such as exercise and diet are also recommended.

If lifestyle changes aren’t working, or if your varicose veins are causing a lot of pain or damaging your overall health, other treatment options are available. The recommended treatment depends on your symptoms and the size and location of the varicose vein. These options may include:

  • Sclerotherapy, which involves injecting a solution into the vein. The solution irritates the vein, causing the walls to collapse. The vein closes off and harmlessly remains in the body.
  • Ambulatory phlebectomy, a mini-surgical technique that involves removing varicose veins through multiple, small (less than 2 mm) slits made in the skin overlaying the vein.
  • Endovenous laser ablation therapy (EVLT), which uses light energy to collapse a vein.
  • Radiofrequency ablation (RFA), which relies on heat and radiofrequency waves to close off a vein. 

“All of these treatments are minimally invasive and very well tolerated, and can be performed right in our office,” Dr. Fischer.

Can I prevent varicose veins?

Some of the risk factors — such as family history or age — are obviously impossible to avoid. While you may not be able to prevent them, Dr. Fischer recommends several steps you can take to keep them from becoming worse:

  • Avoid standing or sitting for long periods of time. Take frequent breaks to stretch and walk around, especially if you have a job that requires you to be on your feet. 
  • Lose weight or maintain a healthy weight. Getting rid of extra weight helps reduce pressure inside your veins.
  • Drink water throughout the day. Proper hydration helps with healthy blood circulation
  • Exercise to improve your circulation. Walking, cycling, swimming and yoga are good options.  
  • Wear compression socks or stockings. 
  • Elevate your legs. Whenever you're resting, put your feet up.

YNHHS uses the terms "female" and "male" to reflect biological status typically assigned at birth, and "women" and "men" when referring to gender. According to the Human Rights Campaign, a doctor or midwife assigns a child's sex as male, female or intersex at birth based on their external anatomy. Gender identity is one's innermost identification of self as male, female, a blend of both or neither. Gender identification may differ from birth sex. 

How To Protect Yourself from Mosquito-Borne Illnesses

They’re pesky and annoying. Whether you’ve been hiking in the woods or relaxing in your backyard, you’re likely aware that it’s that time of year: mosquito season. But mosquitos are not just a pain in the neck (or arm or leg) -- they can also carry serious diseases.

Learn about precautions you can take to protect yourself from mosquito-borne illnesses

YNHH Named as a Best Regional Hospital for Equitable Access

Yale New Haven Hospital (YNHH) has been named by U.S. News & World Report as a “Best Regional Hospital for Equitable Access.” This designation recognizes YNHH for its success as a high performing hospital providing excellent care to patients in underserved communities.

“We are very proud and pleased to be recognized by U.S. News & World Report in their inaugural listing of the best regional hospitals for equitable access,” said Katherine Heilpern, MD, president, Yale New Haven Hospital. “Yale New Haven Hospital has always been at the forefront of groundbreaking initiatives with a national healthcare reputation as an industry leader, delivering quality medical care for all patients regardless of race, ethnicity, religion or gender. We strive every day to make high-quality healthcare accessible to all populations.”

The 53 hospitals that received a Best Regional Hospital designation had to meet at least two of the following criteria:

  • had 40 percent or more of its patients from a community of greater socioeconomic deprivation (according to the Area Deprivation Index))
  • served 20 percent or more racial/ethnic minority patients or was in the highest tier in at least 1 of 5 measures of racial and ethnic patient representation
  • served 20 percent or more Medicaid patients or was in the highest tier in the measure of low-income patient representation

U.S. News' recognition of the Best Regional Hospitals for Equitable Access highlights the important and necessary work hospitals are doing to improve care for underserved communities,” said Tavia Binger, senior health data analyst at U.S. News. “This recognition also underscores the need for continued focus on prioritizing health care among vulnerable populations who may face numerous social and economic challenges in receiving care.”

Smilow “Beyond Beauty Program” Workshop on Aug. 21

The Beyond Beauty Program is a free service for Smilow Cancer Hospital patients, provided by our licensed cosmetologists, certified hair and wig specialists and The Cingari Family Boutique. It is created for current Smilow patients who are undergoing chemotherapy and radiation treatment and experiencing temporary visual changes to their hair, skin and nails.

If you are a current Smilow patient, you may register for an interactive workshop held on Aug. 21 from 2 - 4 pm at Smilow Cancer Hospital – Derby, 350 Seymour Av., Derby. You must pre-register to receive your makeup toolkit on the day of the class. Class size is limited. Sign up for the Beyond Beauty Program by calling the Cingari Family Boutique at 203-200-2273 (CARE) or by sending an email to [email protected].

Ride With Us and Get Closer to Free!

The 14th Annual Closer to Free Ride rolls off the starting line on Sept. 7, and you’re invited to ride along with us! The Closer to Free Ride fuels research and care at Smilow Cancer Hospital and Yale Cancer Center. Riders of all levels have the chance to experience five professionally-designed and fully-supported routes ranging from 10 to 100 miles long. If you’re not in the New Haven area, you can join as a Remote Rider and complete your own route wherever you may be.

You may also consider sharing your energy and enthusiasm with the Closer to Free community as a volunteer. Volunteer opportunities are available to support the pre-ride check-in, at the start/finish line and on the ride route as a member of the Road Crew.

Register as a rider or volunteer

Can’t ride with us this year? Make a donation to a specific rider or team.

Take a Walk and Chat with YNHH Doctors

Take a walk and chat with local doctors as part of Yale New Haven Health’s Get Healthy Walk ‘N’ Talk with a Doc. Walks are each Saturday through September along the Farmington Canal Greenway Trail in New Haven. Please arrive by 8:45 am. Walks begin at the entrance on the corner of Shelton Avenue and Starr Street and last approximately one hour. Parking is available at New Freedom Missionary Baptist Church, 280 Starr St., New Haven. For more information, email Andy Orefice or call 203-688-5671.

MyChart Gives Patients Access to Their YNHHS Imaging Studies

YNHHS patients with a MyChart account can now view and download their YNHHS imaging studies. Links to imaging for downloading or viewing can be found on the Results page on MyChart. Links to studies can also be created and emailed to the patient’s other providers. MyChart, a free and secure online service, offers patients access to portions of their medical records and health management tools. If you don’t have a MyChart account, sign up online.

Find a Provider at YNHH

Are you looking for a physician? Call 888-700-6543 or visit our Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience.

Billing Questions?

Yale New Haven Health offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.