Dr. Hamilton has devised this checklist of sorts in the form of nine questions for you to use as a “doctor pre-screening” when considering a vein treatment or are experiencing signs of vein disease, including bulging veins.
1. Is the doctor performing the procedure trained in ultrasound?
Diagnostic ultrasound evaluation is critical to determining the underlying source of your vein problem. Ultrasound allows the doctor to see how the vein is functioning and to observe the backward flow of blood (the venous reflux) through the vein.
Interventional radiologists receive extensive ultrasound training and are held to the highest national standards. Registered Vascular Technologists (RVTs) receive less training than an interventional radiologist and are often trained by an interventional radiologist. Many doctors get their RVT certification because their medical training did not include adequate ultrasound training.
Doctors trained and skilled in ultrasound are more adept at image-guided procedures, making for a much smoother procedure experience.
2. Where are the procedures performed? In office, surgery center or hospital?
Physicians skilled in minimally invasive vein treatments will perform almost every procedure in the office, on an outpatient basis, thanks to highly effective, proven technologies that have removed these procedures from the hospital setting and taken them into the comfort and convenience of a physician’s office.
3. Does the doctor treat only veins?
You really want a doctor who specializes in vein treatments exclusively. Someone who understands the complexity of the venous system and is trained and qualified in the latest, most effective procedures. Many different types of doctors dabble in vein treatment. Here you run the risk of exposing yourself to someone whose experience is limited and suboptimal. You do not want a dabbler.
4. What type of anesthesia is used?
A physician who is skilled in vein treatments can comfortably perform procedures in the office with a local anesthetic and, if necessary, oral sedation (Xanax or Valium). IV sedation or general anesthesia is very rarely necessary and only in exceptional cases, i.e. very advanced forms of vein disease.
5. How does the doctor evaluate the veins?
Duplex ultrasound provides the interventional radiologist or RVT with a clear picture of what’s happening with the deeper veins. Is the blood flowing correctly? What is the condition of the vein? Are the valves behaving properly? Only ultrasound can answer these questions with a clear picture that pinpoints the source of the problem.
6. Does the physician use laser or radiofrequency energy to close the veins?
Both are effective at closing veins, but research has shown recovery is faster and far less painful with radiofrequency energy ablation because it is a much more controlled and precise way to heat and close the vein.
7. For the treatment of spider veins, how do they do it?
Sclerotherapy is the gold standard for treating spider veins in the legs. Laser therapy works well in the face, chest and back where the venous pressure is lower.
8. Does the doctor’s office staff understand insurance rules regarding coverage of varicose vein treatments?
As vein disease is a medical condition, Medicare and private insurance cover most vein treatments. However, rules and requirements vary from carrier to carrier. Make sure the office staff is knowledgeable on the subject, specifically with the rules for the conservative treatment period most companies require before treatment.
9. Is there a long-term follow-up plan?
While minimally invasive vein procedures effectively treat specific vein problems, new vein conditions can develop over time. Be sure the vein doctor requires post-procedure follow-ups and has you in for vein wellness check-ups on a regular basis.
People who are educated about a condition, treatment options and who and where to go to for the best treatment experience the best outcomes. Print out this post and keep it handy for your next visit with your doctor. Or better yet, call 281-565-0033 and schedule your vein consultation and screening at Houston’s leading vein treatment center — Hamilton Vein Center. We’ll be more than happy to chat with you on these nine very important points.