Subtitles will begin at 0:43 I’m so thrilled that Dr. Sonja Stiller has
joined us today. She is with the Center for Advanced Vein Care right here in Mentor, Ohio,
and Dr. Stiller, we’re going to be talking about varicose veins, right?
Exactly. Hi, it’s very good to be here. Well, we’re thrilled to have you. Council
on Aging was involved with the big senior day at the Lake County Fair this summer and
that’s where we got to meet you and find out about your clinic and some of the good
treatments out there. That’s right.
I’ll tell you what, varicose veins, I think psychologically affect people, physically
affect people, and, this is going to be a great learning curve for a lot of our-, not
only myself, but a lot of our listeners today. Right, exactly. I think one of the most commonly
misunderstood medical disorders out there and vein disease. For so long it’s been
thought of as really a cosmetic problem so people tend to wear long pants or long dresses
n the middle of the summer time when it�s really hot. You know, if you’re hot already,
the last thing you want to do is wear a long pair of jeans but when these veins are either
just prominent and bulging out like those spidery or the spidery veins, the red ones
in the side of the legs or the big bulgy ropey veins.
When they’re there, people don’t always want to show their legs. And instead of talking
to a physician about it, and seeing what can be done, they’re often pushed to the side
and said that, “Listen it’s just cosmetic, you know, it’s not impacting anything so,
you know, live with it.” So they tend to try to hide it. And the reality is, is that
varicose veins can cause a lot of problems and over the long run it can affect so many
portions of your life including just simply walking. So, it’s definitely something that’s
misunderstood and we need to delve a little bit more into what’s going on with vein
disease to get the best treatment possible. So, let’s just start right at the very beginning.
What are some of the symptoms of vein disease? I guess is that what you would call it or
vein problems? Yeah, you know it’s funny. Most people when
they come in and I say that they’ve got varicose vein disease. The first thing that they say
is, “Disease? I’ve got a disease. This isn’t a disease this is just ugly looking veins.”
Yeah, what are you talking about? The reality is, what’s happening when you’ve
got varicose veins, is that these veins are broken. Now when I say broken, they’re not
bursting open and bleeding and they’re not causing a lot of bruising or something like
that. Instead, what’s happening is they’re losing their normal function. So the job of
your veins is basically to carry all of our used blood back into our body.
Our heart pumps our healthy blood out to the body through the arteries. So the blood that
goes out to our body has all the oxygen, the vitamins, the nutrients, everything that we
need for metabolism. When your body uses what it needs, it then dumps it’s trash into
the veins. So that trash includes lactic acid, other acetic components of metabolism, less
oxygen because it’s used all of that. So that blood now is sitting inside our veins.
Well, in order for that blood to recirculate, that blood has to get back to our heart. Well
in our legs, that blood has to travel against gravity from the bottom of our feet all the
way up, almost three feet to get to our heart. Well how the heck is that going to happen?
Right. We need two things functioning normally for
that to work. Number one, we need a pump. That pump is our calf muscle. So your calf
muscle is the heart for the veins in your legs. So, the number one most important thing,
and we’ll talk about this later I’m sure, is to keep that muscle pump strong.
When that calf muscle pumps with every movement of our leg or our calf, blood is drawn in
from the vessels on the surface, into our medium and larger vessels, ultimately into
the large vessel. So it’s kind of like a tree branch. The small spider veins you see
on the surface are like the little leaves and the small branches, right? And they dump
in the medium and the larger branches, ultimately to the trunk vein, which is our deep vein
system. That deep vein is what carries our blood up.
Well in between steps, or for sitting or standing, and that calf muscle pump isn’t functioning,
that blood tries to fall back down, because of gravity, right? So to keep that from happening
we have valves inside these vessels. And they�re one-way valves. I always like to use my hand
so it’s really hard to kind of describe this
Especially on radio Exactly. But basically what’s happening,
they’re one-way valves, so when the blood flows in, the valves open, the blood will
flow in and up. And then when the blood starts falling backwards because of gravity it stops
at these valves so it keeps if from falling all the way back down to our feet like it
wants to do because of gravity. Well, that’s how it’s supposed to work. Every time that
calf muscle contracts, blood moves in and up, and then it stops at a valve and waits
for the next contraction to move up kind of like a lock system. Okay.
Gotcha. Right. Well when the veins break — that’s what
we were talking about, broken veins — what’s happening is the veins start getting big.
So those big ropey veins are the veins we’re starting to see. The vessel walls are starting
to stretch. Well when that happens, those valves are attached to the walls. So as the
walls pull apart, the valves are pulled apart. So now when that calf muscle pumps the blood
still goes the right direction, it goes up, but as soon as you stop moving that calf muscle
it starts falling back. And instead of stopping at that valve now it’s leaking past.
Right. It eventually will hit a normal valve. Over
time that one’s going to break, so, it’s like, kind of like a domino effect. With every
valve breaking it puts more pressure on the next one, and it keeps breaking all the way
So when we’re dealing with a disease process what’s happening is, it’s something that
isn’t a onetime thing. It’s a continuously worsening process. And that’s what’s happening
with varicose veins as well. So when a person starts to see a little bit
of the spider veins, the markings, is that the symptom that triggers them to know, “Oh
this disease could be happening?” Or, I mean what are the symptoms?
Right. Well the symptoms are a little different. When you see spider veins? That can very well
be kind of like the tip on an iceberg. All right? When you see a spider vein it’s the
part that’s showing on the surface, but it can be telling you that there’s more
going on underneath. That still is an appearance. It’s something that we see. It isn’t necessarily
something that we feel. So when we talk about symptoms, those symptoms are more the sensations
that we’re feeling associated with the disease process. Some of those symptoms can include
things like achy painful legs. Now we tend to blame that on a lot of other
things, like what we’ve done during the course of our day. But if you notice that your legs
are getting more painful and more achy towards the end of the day in particular or if you’ve
been standing for awhile, or sitting for a while. Both of those things are things that
affect the gravity on our legs, right? Then it may very well be related to veins. Other
symptoms can be heaviness or tiredness, fatigue, that feeling like, “I just don’t want
to walk up another fight of stairs,” you know? Or, “I come home from work, I sit
down and I just have to put my feet up, because it makes such a big difference.”
Wow. Okay this is starting to sound a lot like what we just had — one of our guests
on the arthritis foundation where a person feels fatigued, they just don’t want to
do anything or maybe they’ve been working in the garden. So is there a correlation or
sometimes people think they have arthritis, but it’s the vein disease , or?
Absolutely. Absolutely. A lot of the symptoms that go along with varicose veins also are
associated with other disease processes. And another interesting thing is because the process
that’s happening with varicose veins is an inflammatory process. Something has broken.
And anytime something in your body breaks, you get an inflammation. So with arthritis,
it’s not a truly broken part. But it’s an inflamed joint. Well with veins that are
inflamed if they’re sitting anywhere near that joint, you’re going to start noticing
increased inflammation. And they basically play together. So it’s almost a double sensation.
Right. So if you have achy, painful legs, it may
be arthritis, it may be some other process going on, but it also may be the veins and
sometimes as you treat the veins other symptoms-, or those symptoms will improve even if you’ve
got another process going on. Right. Or it might be you were just dancing
the funky chicken too much last night? Right? [Laughs] You never know.
I don’t ever do that, no. So is there one segment of our population
who is at risk for developing vein problems more than another segment?
Well varicose veins and vein-disease is predominantly hereditary. So about 95% of the time we can
blame it on somebody else; our mom, our dad, grandma, grandpa, aunts and uncles. And
remember if they wore long pants and you never got to see their legs there’s a possibility
that they may have had varicose veins and they just weren’t showing them. So often it’s
hereditary. But as, there are several other factors that play a role in the development
of varicose veins. So, for example, women have the hereditary
component but they can also have hormonal changes and that’s cumulative over the years.
So even when their cycles are all done and there’s no longer that hormonal change that
has added up over the years. And then for every pregnancy, they’re at higher risk.
Aging is a big key. Over the age of 50, 40-50% of Americans, both males and females, have
some aspect of vein disease that are playing a role in their symptoms.
Wow. We’re speaking with Dr. Sonja Stiller who joins us today and we’re talking about
varicose veins. She is with The Center for Advanced Vein Care. When we come back we’re
going to talk a little bit about treatment options, perhaps medications – that type of
thing, and more about The Center as well, okay?
Sounds good. So, all right thank you for tuning in. There’s
more to come on Our Aging World, on Integrity Radio, WINT 1330 AM. Commercial Break – Music We’re back with our final portion here of Our Aging World here on WINT 1330 AM. This
is Joey Tomsick with you from the Lake County Council on Aging. We are thrilled to have
Dr. Sonja Stiller who is joining us from The Center for Advanced Vein Care. Where is the
center located? It’s at 7200 Mentor Avenue, so right near
South Point Plaza at 306 at Route 20. There’s a GFS and we’re right next to that GFS.
And it used to be an old carpet building. And actually I think many of the folks listening
probably received, in their mail just last week, a circular that has a pretty interesting
interview and description of the center. Right. We were in the MIMI magazine on the
cover and did an article in there that I think provides some pretty good information about
varicose veins and symptoms that you should be looking for to consider coming in for an
evaluation. We do have free screenings going on right now too.
Oh really? Yeah. So if you have any-, if you’re concerned
or you’re thinking, “Hey maybe my swelling is related to veins.” But you’re not certain,
then please give us a call, come on in and we can take a quick screen to see if that’s
part of the issue. So really, don’t be afraid to make that
call. No absolutely not.
What is a good phone number for folks to reach you? All right. Our phone number is (440) 710-1140. So, Dr. Stiller, do you really have to take
more medication to get leg swelling under control? You know that’s an interesting question. Because often I will get referral doctors
sending in patients because they’ve just added another diuretic or water pill to help control
the swelling. And oftentimes what’s happening is the patient has venous insufficiency, which
is when the veins are broken and the blood�s flowing the wrong direction. The inflammation
caused by all that trash in that vein can cause swelling.
So, oftentimes if we get that venous insufficiency under control, we actually can eliminate not
just one, but sometimes you can get rid of all of the diuretics, or at least one of them.
You know, the idea, of course is we don’t want more medications. We want to try to get
rid of the cause of the problem and if we can do that and eliminate medications, it’s
ideal. You know, it doesn’t mean we’ll be able to get rid of all of it but it does sometimes
help quite a bit. Right. Is there a correlation to — to what
they call the restless leg syndrome? Yes. Absolutely.
So people go to sleep, right, and they can’t sleep because those legs are just like, they
want to keep going. Exactly. Right. They feel like their legs
have to keep moving or like, sometimes I’ll get the description that there’s bugs crawling
under the skin or that sensation of something just making you feel like you have to move
your legs. And, you know, restless legs can be so disturbing. It interrupts sleep, it
makes it difficult to fall asleep, makes it difficult to stay asleep.
You tend to wake up in the middle of the night. And the fact is, is that often restless legs
and vein disease are correlated. If you have varicose veins and you have restless leg syndrome,
you need to treat those varicose veins, because treating them alone can get you off medications
and get you a better night’s sleep. Wow. And, let’s talk about treatment. What
are some of the treatment options for vein problems?
All right. If you could, you know, comment a little bit
about that. Absolutely. There’s actually a spectrum
of treatment out there. We can start with things that are fairly simple — exercises
to strengthen the calf muscle are key. Oh yes, when you started out you told us the
calf muscle has to be — Keep moving. Keep that calf muscle moving.
It’s like the heart. Exactly. And what you have to understand as
soon as you stop moving, as soon as you stop stop walking, all of your health issues start kicking
in. So, we’ve got to keep you moving. So if you come in and you’re not moving that much,
one of the first things I’m going to do is teach you some calf muscle exercises to
strengthen that calf muscle. Walking is very important. You don’t need to do anything
more extensive than that. Even just a simple walk around the block several times a day
is really very good. So exercising you legs is key and I’m going to push that.
Wow The other thing is wearing compression. Now
compression doesn’t have to be your grandma stockings anymore. I mean it used to be that
we’d talk about grandma’s peg legs with those stockings right? We still use those
stockings because when we’re doing treatments we often need to have the tight ones and nobody
wants to wear those all the time. But the fact is, is I wear compression stockings on
a regular basis and I’m a professional and I want to look good.
So there’s so many different styles from tie-dye stockings to sheer, different color
stockings to black. They have sport socks that look like you were just going to the
gym and they’re exercise socks. So we’re not stuck with that same old grandma stocking
anymore. But wearing compression is really important. I just recently put my mother on
compression stockings because she has leg cramps and wearing the compression stockings
alone during the course of the day has significantly improved the leg cramps. So, and I hear that
all the time. Now if we want to move on with further treatment then we do an evaluation
to look at exactly where the problem in the veins is.
I see. Because it can be in a lot of different areas
So, I’m going to stop you — just put the pause button on right there, because I think
a lot of people listening are surprised that the first words out of your mouth was not
about surgery. You’re talking about exercise. You’re talking about compression stockings
— all these other things that really do matter and that really could help.
Exactly. That is so very important. Just keep moving.
So you’ll take a look at all those items first.
Absolutely. And you know and if we get to the point where we’ve done exercises and your
compression stockings are working and you don’t need anything else, that’s good.
Then that’s all we need to do. For some people, they’re happy with just doing that.
If we want to move on, we certainly can and there’s so many different options.
It used to be that the only treatment for varicose veins was striping surgery, where
literally, we would go in, do surgery and pull them out. And for so many reasons it’s
a very difficult procedure to deal with. So now we do some minimally invasive procedures
where you’re in without a hospitalization. You come into the office. Everything is done
with a needle, so it’s not incisions and it’s not a long recovery time. And you’re
up and moving immediately afterwards. There’s laser treatments, heat ablation, schlerotherapy
– a lot of options, which we can talk about in more detail if we wanted to go into that.
Dr. Sonja Stiller, you mentioned a little bit earlier you’re having free screenings
this month. This month into next month as well.
Okay, and if someone thinks that they may have a vein problem but they don’t know
for sure. Can they just kind of pop in for-? Absolutely, you can stop by the office again.
Like the veins pop out you have them pop in. Exactly. We’d rather them pop in.
Yes, okay We are located at 7200 Mentor Avenue. Our
phone number is (440) 710-1140. Or you could check us out online. There’s a lot more
information at our website and that’s http://www.YourHealthyVeins.com. Wow, very good. Dr. Stiller, I sure appreciate
you coming today and filling us in on this subject.
Absolutely. Maybe we can get you back and maybe do some
live calls – that type of thing in some future show?
That would be excellent. I’d be happy to. All right. Perfect. You’ve been listening
to Our Aging World here on WINT. This is Joey Tomsick with you from the Lake County Council