Q: I am 42 years old and had varicose veins stripped from my left leg eight years ago. I had it done because the veins were aching and uncomfortable. It was a strip taken from my kneecap up into the thigh. The last couple of years it has been getting uncomfortable. The pain increases when I walk or get on my knees, or if I am on my feet a lot.
The leg also feels numb and heavy, but my legs do not swell. The only way to get relief is with a hot water bottle, a painkiller and elevating the leg. Someone told me later that I should have worn a compression stocking after the surgery, but I wasn’t told that at the time. Is it necessary for me to wear a compression stocking now?
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A: Patients undergoing varicose vein surgery (stripping) can develop the same complications as any other form of surgery, such as infection, bleeding or swelling. There is also a risk from the general anesthetic and embolisms, which are small blood clots that can travel through the body, causing trouble where they land.
Some complications are unique to this particular operation. Stripping the greater and lesser saphenous vein, which are the main surface veins in the leg, can injure nerves in the area. This results in tingling or burning pain around the ankle. The pain usually disappears gradually within a year, and there is less chance of it happening if the stripping is only above the knee.
Another problem is fluid buildup known as a seroma, which develops as the result of liquefaction of fat or division of the lymph channels. These usually occur in the groin area and may have to be drained by the surgeon.
Another complication of varicose vein stripping is leg swelling, although you say your leg only feels as though it is swollen. Perhaps it really is, but you can only tell if you measure the calf with a tape measure at the same point at different times. The fact that the pain goes away after you elevate the leg suggests that there is some fluid buildup, since gravity will cause swelling when you are vertical. It is rare for this to last more than three weeks after the procedure, but it can become permanent and require the person to wear a compression stocking and elevate the leg as often as possible. This may be what has happened in your case. Or possibly, there is another varicose vein that is bothering you. To find out if this is the case, your doctor could arrange for you to have a venogram or Doppler test.
According to researchers at the American Stroke Association annual meeting, a three-step test could improve stroke detection rates and help get victims to hospital sooner. This is important because the quicker a clot busting injection is administered, the less chance there is of permanent paralysis or death.
The test involves asking the person to smile, raise both arms and keep them up and to speak a simple sentence clearly.
If the patient smiles in a lopsided way, or raises one arm higher than the other or cannot lift one arm at all, and speech is impaired, an ambulance should be called immediately.
If more people were aware of this test, fewer might end up in long-term care.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
