Update on my Endovenous Laser Surgery and Stab Phlebectomy

It has been one week today since I had Mr. Nasty plucked out of me, and his cause, Mr. Saphenous, shut down by laser. All I can say is, "It still hurts!"

The day of the "procedure" (I guess it wasn't technically a "surgery", it was called a "procedure"), I was a bit nervous. I'm not overly fond of pain. But extremity pain is more bearable to me than internal pain. I'd rather have veins ripped out of my legs than my appendix ripped out of my abdomen, kwim?

The first thing they did when I got there was to start medicating me. I was given liquid Versed, 2 Valium, and a Cipro (anti-biotic) for good measure. I was told to sit in a comfy chair for 20 mins to let the meds start working. The doc came in about 10 mins later with a sharpie. I felt like I was going to have plastic surgery. He proceeded to mark all the spots on my leg where he planned to jab into me. Lovely! He also decided at that point that I needed more Versed. The nurse seemed surprised as she said "Really?" when he asked her to give me more. I must have a high tolerance for narcotics (hmm, my past coming back to haunt me?), maybe I wasn't as messed up as he thought I should be. So I drank another cup of the liquid versed. BTW, it is some nasty tasting stuff.

About 10 mins later I remember being walked into the "procedure" room. I do remember laying on the table. I remember him jabbing into my knee (to get to Mr. Saphenous with the laser) and it really hurt. I know I asked some questions, but can no longer remember the questions or the answers. I do remember asking to see my vein, (I am morbid that way) and the nurse did show it to me. It looked much smaller than I thought it would. (Although it could have been in pieces). It also wasn't bloody which I thought it would be. I suppose when they take it out, there isn't blood in it anymore (duh) so that explains that!

The whole thing seemed to go by rather quickly, but it really took over an hour. What I found out later was that Versed, as well as being a major sedative, is also an amnesiac, meaning it is supposed to promote memory loss of the event. The intent is that you don't remember a lot of what went on. So it seems that it worked a bit in me. I do remember bits and pieces, but I don't remember the entire procedure. Oh well, it was probably pretty fascinating and I might have been able to learn something if I had been more coherent. I am sure that some of the questions I asked had to pertain to what they were doing. They were probably happy to not have to answer me. I am also happy to not have felt much pain during what was probably at least a slightly painful procedure.

When it was all over, they wrapped me up. I do remember most of the wrapping up (my drugs must have been wearing off). I had about 5 layers , starting with gauze and ending with huge ace bandages. And it was tight. So tight my toes kept getting tingly and I couldn't bend my knee. The bandages went from toes to upper thigh. I was not to remove any bandages until Thursday morning ( the procedure was Monday). That was also supposed to be the first time I was allowed to shower. Well, I wasn't going 3 days without a shower. I managed to get a really big lawn and leaf bag around my entire leg. I tied it off with the drawstring from some sweatpants. Then I wrapped a towel around the end for good measure. Luckily my toilet is very close to the shower, because I managed to rest my leg on the closed toilet lid, and take a sideways shower with the curtain open. It was a little difficult, but I did it. And I felt so much better being able to shower. People should know better than to tell me I can't do something......when there's a will, there's a way!

Here's a picture of what my leg looked like after taking off the bandages......this was day 3 post "procedure"

So, now it's Monday again, one week later. It's not as bruised, it's all fading to a lovely yellowish green right now. But it still really hurts. I am still wearing my super tight surgical support hose, and have to for another week. I'm still not supposed to stand still for longer than 5 mins or so at a time, although walking is good. I'm not supposed to lift anything or do anything "strenuous" for at least another week. After next Monday, supposedly, I will be almost cured, and can slowly ease back into normal activity. I'm kind of looking forward to that. I'm looking forward to it not hurting when I walk, or when I don't have my legs up. I'm looking forward to being able to sleep on my right side again. (It's my right leg).

Of course the best news was when I went back for my post "procedure" visit on Thursday. After telling me everything looked pretty good, he informed me that while he was taking care of my right leg, he decided to ultrasound the saphenous vein in my left leg, (he uses ultrasound during the procedure, so he just happened to have it there) as I have a small (very small) varicose vein on the front of my lower calf). It seems Mr. Saphenous in my left leg is shot too. He told me to let him know when I wanted to to have the left leg done! I think I'll wait a while : )

Endovenous Laser Surgery with a Stab Phlebectomy on the side

That's what I am having done to me on Monday.

I developed this big old nasty varicose vein (herein called Mr. Nasty V.) 13 years ago while pregnant with my eldest daughter. I was always conscious of it, it's ugly. It's in my right inner thigh. So if I wore longer shorts, or kept my legs together, : ) it wasn't very visible. But if I was on my feet all day, I knew it was there without needing to see it. It would hurt. It would bulge, and get hot. Ewwww! But then if I spent some time with my legs up, the pain would go away. So I ignored it all these years. Until January of this year. My leg had been bugging me more than usual. The Christmas season had been busy, I was on my legs a lot, I chalked it up to that. But one day in the shower, while shaving said leg, it hurt when I got near Mr. Nasty V. I looked at it and realized it was pretty red and also had two very prominent red lumps in the vein, that were painful and hot to the touch. Hmmm, that doesn't seem good. So off to the doctor I went.

Seems I had some blood clots in Mr Nasty V. I had an ultrasound. The blood clots were contained in Mr. Nasty V., so "supposedly" it wasn't too serious and I "shouldn't" worry about anything breaking off and killing me! Don't they know me? Worry is my middle name!

I went to see a Vascular surgeon. He specializes in Laser removal of Mr. Nasty V's, not surgical stripping. That's a good thing. He checks me out, and tell me all sorts of things about the veins in my legs that I never learned in high school. See that would've been good information for a woman with a genetic pre-disposition to Mr. Nasty V.'s to have learned.

Anyway, it seems you have a big old Femoral Artery that runs down your leg. The next biggest vein that shoots off the Femoral is the Saphenous vein. It appears my Saphenous vein is shot. Doesn't work anymore. At the top of my leg where the Saphenous meets the Femoral, the diameter of the vein has blown open. It's something like 3x the size it's supposed to be. (Can't remember how small the opening is supposed to be, mine is not small enough). Also, there are little valves in your leg veins that are supposed to close after the blood gets pushed up. My valves weren't even visible, which means they have either been blown open or somehow disappeared. So, basically, I need my Saphenous vein shut down. BTW, my varicose isn't in my Saphenous vein, it is an off shoot of the Saphenous vein. The bad Saphenous vein, (you know, the blood running back down my leg because it had no help getting back up my leg since my valves went AWOL) caused the varicose vein to develop. So, not only do we have to do something with the Saphenous vein, I will need another procedure as well to take care of Mr. Nasty V.

This is why on Monday I am having Endovenous Laser Surgery (to take care of Mr. Saphenous) and a Stab Phlebectomy (to take car of Mr. Nasty V.) Basically I will go in to his office and first he will give me a nice cocktail of pain killers and sedatives so hopefully I don't feel anything during the procedure. I will not be asleep, but should be "happy" as he liked to put it. Then he will begin to numb my leg from groin to knee with a SERIES of injections. (I don't know how many a SERIES is, but I don't like the sound of it.) After I am numb, he will use a needle to poke into my Saphenous at the knee. Once in, he will thread a small laser into the vein and up to the top of my leg where the Saphenous meets the Femoral. Once there he will begin to pulse the laser, slowly pulling it down the vein while he pulses. The heat from the laser will shut down the vein. It will close behind the laser as he pulls it down. (I REALLY hope I can't feel that). "Supposedly" my body will just absorb the closed down vein over time. (Wonder where it goes?) "Supposedly" the blood that used to run through that vein will be re-routed elsewhere. (Can you tell I am hesitant to believe everything I am told)? That part of the procedure should take 30-45 mins.

After he is done closing down Mr. Saphenous, he will move on to removing Mr. Nasty V. That requires him to make a SERIES (there's that word again) of stabs along the length of Mr. Nasty V. (Mr. Nasty V. is about 6 inches long btw). After he makes these "stabs", he will use a crochet hook like thing (their words, not mine) and pull the vein up out of the stab holes and remove it. I am guessing he will have to cut it at some point, although he never used the word "cut" while explaining it to me. This part should take about 20 mins. After that they will wrap my leg in a giant ace bandage from toe to groin, and I cannot remove it for 48 hours. So no shower for me........ewww once again. The only plus to all this is that I get to lay around for those 48 hours. I am supposed to keep my leg elevated as much as possible although walking is good for me. I can walk to the bathroom (and the refirgerator : ) Standing is a no-no, so no standing in front of the stove to cook or sink to wash dishes or ironing board to iron clothes. Awww shucks!

I will go back and see him on day 3. If all looks well, I will need to wear my super tight surgical hose for the next 2 weeks around the clock. I can resume normal activities after the first 3 to 5 days, but nothing strenuous. (Aren't cooking, cleaning and laundry strenuous activities?)

While I am not looking forward to Monday, I will be happy to see Mr. Nasty V. go bye bye. I will once again be able to go to a carnival or walk around a mall or take a hike with my girls without my leg killing me at the end of the day. I will no longer need to wear long shorts or be embarrassed in my swimsuit. (Aside from the fact that I don't have great legs anyway and don't look too hot in a swimsuit either : )

I'll let you know how it all went after the fact. Hopefully I won't have any horror stories to tell.

(Click below for the after procedure update)

http://randomthoughtsofafierywoman.blogspot.com/2008/05/update-on-my-vein-procedures.html