pre post procedure instructions

ENDOVENOUS ABLATION

Endovenous thermal ablation is one of the minimally invasive treatments we perform in Boston Vein Care. It involves the insertion of a thin, flexible catheter into a diseased vein and delivers heat energy in a very safe and controlled fashion to seal it shut . Compared with surgical options like ligation and vein stripping, endovenous ablation results in less pain and quicker recovery time.

PRE-ENDOVENOUS THERMAL ABLATION

  • We are delighted to offer six or twelve-month interest-free finance to cover our patient’s out of pocket procedures or co-pays.

  • Avoid caffeine-containing products such as soft drinks, coffee, or tea, it might cause your vein to constrict and make procedure difficult.

  • Shower before your procedure visit, you may not be permitted to shower for up to 48 hours after the procedure. If you can not skip the shower, you will have to buy a plastic leg cover from any local pharmacy).

  • On the day of your procedure have a normal breakfast and/or lunch, again avoiding caffeine products.

  • Your endovenous ablation procedure should not cause you to change your normal dietary activity significantly.

  • Take all your regular medications as prescribed.

  • Your endovenous ablation procedure should not cause you to change your normal dietary activity significantly.

  • Feel free to take 2 over the counter Advil or Aleve tablets, the previous day with dinner, and the morning of the procedure with breakfast, unless contraindicated.

  • Do not apply any type of moisturizer to your leg on the day of the procedure.

  • Wear loose clothes.

  • Be sure you have obtained a pair of prescription strength compression hose & bring them with you for your procedure visit.

  • Do NOT shave your leg within 3 days of the procedure, as it increases the risk of post-procedure skin infection.If advised try to shave leg 3 days before the procedure.

  • Schedule a follow-up appointment within 1 week after the procedure for post ablation visit and limited venous ultrasound (this combined visit will take about 45 minutes).

POST ENDOVENOUS THERMAL ABLATION

  • Leave the compression socks in place for day and night for 48 hours and then use only during day time.

  • Continue using compression stockings for time period advised after a procedure. Duration depends on the size of vein treated and patients acceptance/tolerance with these garments.

  • Stop using compression socks and contact us immediately if they cause numbness, tingling in toes/feet, skin blisters, localized skin discoloration or swelling.

  • There is only anecdotal data that compression stockings help, but there is not strong data that it will hurt a big time or result in loss of benefits of the endovenous procedure by not using them. For that reason if you have any of said symptoms or any other concern, please call us immediately and we are glad to advise.

  • You can drive before and after the procedure if you have not used any strong/sedation containing painkillers or anxiety pills.

  • Do not drive for 24 hours or longer if you required sedation containing medications like painkillers or anxiety medications.

  • Walk around in the office and then around office block after procedure before getting into car.

  • Walk for about 10-20 minutes when you get home then walk for 20-30 minutes every 3 to 4 hours during day time for next two days.

  • Most patients can resume their normal light activities within a couple of hours after the procedure.

  • Again the emphasis is on encouraging mobility. It will reduce a risk of a clot in veins, a clot in lungs and other complications.

  • Take off compression wraps after 48 hours, can take a shower (NOT hot bath or sauna) and put your normal compression stockings.

  • Slowly get back to exercising i.e gentle walk or elliptical without resistance on the procedure with compression hosiery on, intermediate speed running or jogging after a week, high intensity running or weights involving legs directly after two weeks.
  • Take note of your post-procedure follow up and ultrasound visit.

  • You can take Ibuprofen/Motrin 600mg three times a day or Aleve 400mg once a day for post procedure pain. If you are very sensitive to pain, we can occasionally prescribe you with strong painkillers, ask us if you need before you leave as these prescriptions can not be transmitted electronically to pharmacies.
  • After 48 hours use the good moisturizing cream like Eucerin, Aquaphore or Vaseline on your legs especially where you have bruising. It will keep your skin healthy and expedite the process of healing.

  • Post procedure emergencies are very rare. Please call us immediately if you develop leg swelling (localized swelling around the area of treatment is expected & common),fever or bleeding. Please call our emergency line (you will receive after the procedure) for such emergent calls.

  • Please call our office at 978 666 4200 with any other questions or concern.

SCLEROTHERAPY

Sclerotherapy is to treat spider veins and prominent lymphatics. A chemical (sclerosant) is injected into the vessels, which makes them shrink. In our practice sometimes we use this technique even for smaller varicose veins.

PATIENT PRE-SCLEROTHERAPY INSTRUCTIONS

  • Sclerotherapy is an elective and mostly cosmetic procedure and doesn’t require any special preparation.

  • Treatment effects are mostly localized to a treatment site and in people without the history of cardiovascular abnormality should not have many systemic effects.

  • Do not apply tanning lotions or self-tanners to your legs the night before or on the day of your treatment.

  • Bring loose fitting shorts and the long skirt or long loose fitting slacks to wear after treatment.
  • Your treatment will take from 30-45 minutes.

PATIENT POST SCLEROTHERAPY INSTRUCTIONS

  • Immediately after the procedure, put on support hose and walk for 10-30 minutes.

  • Usually not required but we may use cotton balls with or without tape, which generally can be removed within next couple of hours.

  • If you feel you are developing an allergy (itching, rash or redness) to tape, please remove the tape and put on support stocking.

  • You are encouraged to walk as much as you normally and comfortably can and avoid prolonged sitting or period of immobility.

  • Most patients can return to work immediately after the procedure

  • Pigmentation is rare, but avoid sunbathing and UV exposure for 1 week, if you notice any pigmentation after a procedure.

  • If you experience any redness or bump or wound, please contact us immediately. We would like to know sooner than later and recommend appropriate remedies.

  • Light and low impact exercise can be started on the day of the procedure.

  • Intermediate intensity exercise can be started a day after the procedure.

  • High-intensity exercises like weight lifting and intense aerobic exercise can be started 3 days after a procedure.

ULTRASOUND GUIDED SCLEROTHERAPY

Ultrasound helps to visualize veins which can not be seen with naked eyes. We use ultrasound sclerotherapy for intermediate size veins (mostly reticular veins) which are bigger than spider veins but smaller than varicose veins. Injection into arteries and deep veins can have serious consequences. Ultrasound helps to differentiate superficial veins from arteries and deep veins. Other than this visualization procedure is similar to sclerotherapy.

PRE ULTRASOUND ASSISTED SCLEROTHERAPY INSTRUCTIONS

  • Sclerotherapy is an elective and mostly cosmetic procedure and doesn’t require any special preparation.

  • Treatment effects are mostly localized to a treatment site and in people without the history of cardiovascular abnormality should not have many systemic effects.

  • Do not apply tanning lotions or self-tanners to your legs the night before or on the day of your treatment.

  • Bring loose fitting shorts and the long skirt or long loose fitting slacks to wear after treatment.

  • Your treatment will take from 30-45 minutes.

POST ULTRASOUND ASSISTED SCLEROTHERAPY INSTRUCTIONS

  • Immediately after the procedure, put on support hose and walk for 10-30 minutes.

  • Usually not required but we may use cotton balls with or without tape, which generally can be removed within next couple of hours.

  • If you feel you are developing the allergy (itching, rash or redness) to tape, please remove the tape and put on support stocking.

  • You are encouraged to walk as much as you normally and comfortably can and avoid prolonged sitting or period of immobility.

  • Most patients can return to work immediately after the procedure

  • Pigmentation is rare, but avoid sunbathing and UV exposure for 1 week, if you notice any pigmentation after a procedure.

  • If you experience any redness or bump or wound, please contact us immediately. We would like to know sooner than later and recommend appropriate remedies.

  • Light and low impact exercise can be started on the day of the procedure.

  • intermediate intensity exercise can be started a day after the procedure.

  • High-intensity exercises like weight lifting and intense aerobic exercise can be started 3 days after a procedure.

  • Sometimes patient note dark areas along the line of treated vein. It represents trapped blood in treated/closed vein. Please contact us in that case. We might like to drain that clotted blood to avoid dark pigmentation around treated vein.

  • Mostly we use ultrasound guided sclerotherapy for medium sized veins and we advise avoiding flights for about 48 hours after the procedure.

MICROPHLEBECTOMY

Microphlectomy is a medical procedure used to treat medium sized veins after endovenous treatment of varicose veins. In this procedure by using a micro scalpel a small skin incision is made and disease vein is pulled out with a tiny surgical hook.

PRE MICROPHLEBECTOMY INSTRUCTIONS

  • Do not take Aspirin or other blood-thinning drugs (e.g., Vitamin E, Gingko Biloba), ibuprofen, or other nonsteroidal inflammatory drugs (e.g., arthritis medicine) for 2 days before and 2 days after your treatment because these medications can increase bruising.

  • If you take birth control pills or estrogen, inform your teaching team about it.

  • We recommend not to drink alcoholic beverages and not to smoke for 2 days before and 2 days after your treatment because drinking alcohol and smoking may impair healing.
  • Do not apply any cream, lotion, oil, or self-tanners to your legs the night before or the day of your treatment.

  • Eat a light meal or snack 1½ hours before your appointment.

  • Bring loose fitting shorts or a leotard to wear during the treatment and long skirt or long loose fitting slacks to wear after treatment.

  • It is advised when having treatment of Reticular Veins to postpone flying for 48 hours.

POST MICROPHLEBECTOMY INSTRUCTIONS

  • Immediately after the procedure, you be advised to put on support hose and walk for 10-30 minutes. Please be sure to have loose-fitting slacks/skirt and comfortable walking shoes on the day of the procedure.

  • We will use cotton balls with compression pads with or without tape, which generally can be removed after 24 to 48 hours. If you feel you are developing an allergy (rash/redness) to tape, please remove the tape and put on support stocking.

  • If you remove the tape, remember and try to put support hose at least for 24 hours after the procedure.

  • You are encouraged to walk as much as you normally and comfortably can and avoid prolonged standing.

  • Avoid strenuous activities like weight lifting and high impact activities like aerobics and running for first 48-72 hours.

  • Avoid hot baths for 2 weeks after sclerotherapy and cool your legs with cold water after each shower.

  • Avoid sunbathing and UV exposure for 1 week after the procedure.

  • Avoid blood thinning medications like Aspirin and other non-steroidal anti-inflammatory drugs like Motrin, Aleve etc for 24-48 hours if you can. For cardiac patients sometimes they do not have the option of stopping Aspirin, Plavix, Coumadin and alike. Please ask your doctor if you can stop these drugs safely or not. Our doctors can also help to answer few of these questions when you come for your procedure.

  • If you experience any redness or bump or in a less likely scenario of open area, please contact us immediately. We would like to know sooner than later and recommend appropriate remedies.

  • Generally, we advise avoiding flights for about 48 hours after the procedure.

LASER SPIDER VEIN REMOVAL

A laser is one of the treatment we offer to treat spider veins. We use 3 different wavelengths depending on skin type/color in our practice. Instructions will vary somewhat depending on the wavelength we are going use but the following can be used as the general guideline.

BEFORE LASER SPIDER VEIN REMOVAL

  • Avoid any unprotected sun exposure for 4 weeks prior to treatment if you are Caucasian.

  • Avoid unprotected sun exposure for 2 weekS prior to treatment if you have brown or black skin.

  • Please download brief medical history questionnaire, complete and fax or bring it with you at the time of your consultation. I will save you time and we are able to proceed with your treatment soon after you arrive for your appointment.

  • Do not apply any cream, lotion, oil, or self-tanners to an area of treatment on a day before and on the day of treatment.

  • Isotretinoin (Accutane) should be stopped 6 months before laser spider vein removal or laser hair reduction treatments.

  • Please inform us if you have any of following conditions, pregnancy, seizure disorder triggered by light, photosensitivity, lupus, keloid formation, history of poor wound healing, noticed any pigmented lesion, have permanent makeup or receiving gold therapy, on immunosuppressants or anticoagulants like Coumadin/Warfarin.

  • If you develop the fever or other illness before appointment you must reschedule.

POST LASER SPIDER VEIN REMOVAL

  • It is of utmost importance to avoid sun exposure after any skin laser treatment including laser spider vein removal.

  • We advise strongly to use sunblock every couple of hours, when out and about to minimize ultraviolet-related skin burns. Skin is extra sensitive after laser treatments.

  • Do not take blood-thinning drugs (e.g., Vitamin E, Gingko Biloba), ibuprofen, or other nonsteroidal inflammatory drugs (e.g., arthritis medicine) for 2 days before and 2 days after your treatment because these medications can increase bruising.

  • If you take birth control pills or estrogen, inform our office about it.
  • We recommend not to drink alcoholic beverages and not to smoke for 2 days before and 2 days after your treatment because drinking alcohol and smoking may impair healing.

  • Bring & use loose fitting shorts or a leotard during the treatment and long skirt or long loose fitting slacks to wear after treatment.

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boston vein care

Boston Vein Care is a comprehensive vein center, wound carer & vascular medicine practice offering the full spectrum of vein, wound & vascular diagnostic & treatments. We also provide health screening from offices in Wellesley, MA & Chelmsford, MA.