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      Puneet Sahgal, M.D., F.A.C.C.
      Diptika Patel, M.D.
FREQUENTLY ASKED QUESTIONS  

GENERAL QUESTIONS

What kind of doctor is Dr. Sahgal?

Dr. Sahgal is a primary care/internal medicine physician, and specializes in cardiology and vein disease, with extensive experience in these fields.


Can Dr. Sahgal be my primary care doctor?

Yes, Dr. Sahgal is Board Certified in Internal Medicine and listed as a PCP (primary care physician) with most of the insurance plans. We provide all Primary Care Services. Our staff will assist you with questions related to your insurance plan.


Can Dr. Sahgal be my Primary Care Doctor as well as my Cardiologist?

Yes, Dr. Sahgal is Board Certified in both Internal Medicine and Cardiology. A large number of patients in our practice have him as their Primary Care Physician and as their Cardiologist.


Can Dr. Sahgal be my Cardiologist while I keep my own Primary Care Physician?

Yes, Dr. Sahgal is Board Certified in Cardiovascular Diseases and is listed as a Cardiologist with almost all of the insurance plans. We provide all major Cardiology Services. Our practice will inform your PCP about your heart related testing and progress.


What is Vein Care?

Veincare involves evaluation, treatment and management of vein diseases and disorders.

Painful varicose veins, spider veins and various other venous disorders are very common and under-recognized and under-treated.

We provide all major Veincare Services and treatments.


What insurance plans to you accept?

We accept most insurance plans. For details please refer to the Insurances tab.


Are you accepting new patients?

Yes, we do accept new patients. You will be able to see the doctor within 24-48 hours.


What hospitals is Dr. Sahgal affiliated with?

  • Raritan Bay Medical Center, Perth Amboy and Old Bridge Divisions
  • Robert Wood Johnson University Hospital
  • JFK Medical Center
  • Bayshore Hospital


Do you have a blood drawing facility in your office?

Yes, we have a phlebotomist in the office at all times.


I am Dr. Sahgalís patient. How can I get my medications refilled?

Your prescriptions will be promptly refilled as long as you are following Dr. Sahgal on a regular basis. Please call the office and we will call your pharmacy.


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ELECTROCARDIOGRAM

What is an Electrocardiogram?

Electrocardiogram is a recording of electric activity of your heart. You will lay on a table. Certain areas of your arms, legs, and chest will be cleaned and may be shaved.

Several electrodes are attached to the skin on each arm and leg and on your chest. These are hooked to a machine that traces your heart activity onto a paper. You will be asked to lay very still and breathe normally during the test.

Sometimes you may be asked to hold your breath. You should not talk during the test.

After the test, the electrode paste is wiped off. Test will take about 5-10 minutes.

EKG is a safe test. The electrodes are used to transfer an image of your heart's electrical activity to the tracing on paper. No electricity passes through your body from the machine, and there is no danger of electrical shock.


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ECHOCARDIOGRAM

What is an Echocardiogram?

An echocardiogram (echo) is a test that uses high frequency sound waves (ultrasound) to make pictures of your heart. The test is also called echocardiography or diagnostic cardiac ultrasound.


Quick Facts

  • An echo uses sound waves to create pictures of your heartís chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart.
  • A probe called a transducer is passed over your chest. The probe produces sound waves that bounce off your heart and ďechoĒ back to the probe. These waves are changed into pictures viewed on a video monitor.
  • An echo canít harm you.

Why do people need an echo test?

Your doctor may use an echo test to look at your heartís structure and check how well your heart functions. The test helps your doctor find out:
  • The size and shape of your heart, and the size, thickness and movement of your heartís walls.
  • How your heart moves.
  • The heartís pumping strength.
  • If the heart valves are working correctly.
  • If blood is leaking backwards through your heart valves (regurgitation).
  • If the heart valves are too narrow (stenosis).
  • If there is a tumor or infectious growth around your heart valves.
The test also will help your doctor find out if there are:
  • Problems with the outer lining of your heart (the pericardium).
  • Problems with the large blood vessels that enter and leave the heart.
  • Blood clots in the chambers of your heart.
  • Abnormal holes between the chambers of the heart.

What are the risks?

  • An echo canít harm you.
  • An echo doesnít hurt and has no side effects.

How do I prepare for the echo?

You donít have to do anything special. You can eat and drink before the test like you usually would.


What happens during the echo?

Echo test is done by specially trained technician. You will have your test done in our office. The test takes about half an hour.
  • You will lie on a table and a technician will place small metal disks (electrodes) on your chest. An EKG keeps track of your heartbeat during your test.
  • The room is dark so that technician can better see the video monitor.
  • Technician will put gel on your chest to help sound waves pass through your skin.
  • Technician may ask you to move or hold your breath briefly to get better pictures.
  • The probe (transducer) is passed across your chest. The probe produces sound waves that bounce off your heart and ďechoĒ back to the probe.
  • The sound waves are changed into pictures and are displayed on a video monitor. The pictures on the video monitor are recorded so our doctor can look at them later.

What happens after the echo?

Echo test is done by specially trained technician. You will have your test done in our office. The test takes about half an hour.
  • Your technician will help you clean the gel from your chest.
  • Your doctor will talk with you after looking at your echo pictures and discuss what the pictures show at your follow up appointment.

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STRESS TESTING

What is an Exercise EKG Stress Test?

A stress test, sometimes called a treadmill test or exercise test, helps a doctor find out how well your heart handles work. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart. It also helps doctors know the kind and level of exercise appropriate for a patient.

A person taking the test...
  • is hooked up to equipment to monitor the heart.
  • walks slowly in place on a treadmill. Then the speed is increased for a faster pace and the treadmill is tilted to produce the effect of going up a small hill.
  • may be asked to breathe into a tube for a couple of minutes.
  • can stop the test at any time if needed.
  • afterwards will sit or lie down to have their heart rate and blood pressure checked. EKG, Blood Pressure, breathing, Heart Rate and how tired you feel are monitored during the test.
Healthy people who take the test are at very little risk. It's about the same as if they walk fast or jog up a big hill. Medical professionals should be present in case something unusual happens during the test.

A physician may recommend an exercise stress test to...
  • Diagnose Coronary artery disease.
  • Diagnose a possible heart-related cause of symptoms such as chest pain, shortness of breath or lightheadedness
  • Determine a safe level of exercise
  • Check the effectiveness of procedures done to improve coronary artery circulation in patients with coronary artery disease
  • Predict risk of dangerous heart-related conditions such as a heart attack.
Depending on the results of the exercise stress test, the physician may recommend more tests such as a nuclear stress test or cardiac catheterization.


What is a Nuclear Stress Test with Exercise?

In this test, the aim is to find out whether any areas of the heart muscle are not receiving enough blood flow during exercise.

A radionuclide, is injected into a vein in the hand or arm. When the radionuclide has circulated through the blood stream, a gamma camera takes pictures of the heart while the patient is lying down. This is known as the "rest scan" of the heart.

The patient then gets up and goes onto a treadmill. The treadmill starts off slowly and gradually picks up speed and incline so that the patient feels he is walking (or running) uphill.

At peak exercise more radionuclide is injected into the patient. When the radionuclide has passed through the blood stream, the gamma camera takes more pictures of the heart. This is known as the "stress scan" of the heart.

Computer system processes the resting and stress images which are then compared to assess for any lack of blood flow to any part of the heart muscle of the pumping chamber of the heart.

The radionuclide helps blocked or partially blocked arteries show up on the scans, because they do not absorb the radionuclide into the heart - they are known as "cold spots".


What is a Chemical Nuclear Stress Test without Exercise?

Some patients, such as those with severe arthritis, are unable to do the physical activity required in a test with exercise. Instead, they are given medications that either speed up the heart rate or dilate the arteries. The body responds in a similar way it would to exercise.

A radionuclide is injected into the patient's arm or hand while he/she is resting. When it has circulated through the bloodstream, a gamma camera takes pictures of the heart - during this process the patient is lying down motionless. As in the test with exercise, this is also known as the "rest scan" of the heart.

The doctor then administers a medication to either speeds up the heart rate or dilates the arteries. When the peak heart rate is reached, the patient is injected again with a radionuclide. As soon as it has circulated throughout the bloodstream the gamma camera takes more pictures. This phase of the procedure is called the "stress scan" of the heart.

Computer system processes the resting and stress images which are then compared to assess for any lack of blood flow to any part of the heart muscle of the pumping chamber of the heart.

As in the stress test with exercise, blocked or partly blocked arteries will show up as "cold spots".


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HOLTER MONITORING

What is a Holter Monitor?

A Holter monitor is a battery-operated portable device that measures and tape records your heartís activity EKG continuously for 24 to 48 hours or longer depending on the type of monitoring used. The device is the size of a small camera. It has wires with silver dollar-sized electrodes that attach to your skin. The Holter monitor and other devices that record your ECG as you go about your daily activities are called ambulatory electrocardiograms.

Quick facts:
  • You may be asked to wear a Holter monitor to see if you have a slow, fast or irregular (uneven) heartbeat. Or, your doctor may use it to see how well your medicines are working to treat these problems. If you have a pacemaker and feel dizzy, your doctor may use a Holter monitor to find out if your pacemaker is working properly.
  • This monitor has no risks and wearing it isnít painful.
  • The results of wearing a Holter monitor will help you and your doctor decide if you need more tests or medicines for your heart, or if you need a pacemaker or a cardioversion procedure to restore a regular heart rhythm.

Why do people wear Holter Monitors?

Regular electrocardiograms (ECGs or EKGs) let your doctor look at your heartís activity at one point in time during your ECG test. But abnormal heart rhythms and cardiac symptoms may come and go. Thatís why your doctor may want to evaluate your heartbeat over time while you go about your normal activities. You may be asked to wear a Holter monitor if you have fast, slow or irregular heartbeats called arrhythmias.


What will wearing the monitor tell my doctor?

  • If your medicines are working.
  • Why you have symptoms such as dizziness, or faintness or the feeling that your heart is racing or skipping a beat.
  • If your heart is getting enough oxygen to meet its needs.

What are the risks of Holter Monitors?

Wearing a Holter monitor has no risks and causes no pain. Holter monitors have wires that connect to small discs (electrodes) attached to your chest to record the electrocardiogram. Because the electrodes are attached with tape or adhesives, they may cause mild skin irritation. Tell the technician if you are allergic to any tapes or adhesives.


What should I expect with the Holter Monitor?

A specially trained technician will attach the Holter monitor and instruct you how to record your symptoms while wearing it.
  • The technician first attaches the electrodes to your chest. If you have a hairy chest, he or she may shave some hair off to attach the electrodes firmly.
  • Once the electrodes are in place, the technician helps you put the Holter monitor on and explains how to take care of it.
  • You can carry the monitor in a pocket or pouch, slung across your shoulders and neck like a purse or camera, or attach it to your waist.
  • Do your usual activities while you wear the monitor with these exceptions:
    • Donít bathe, shower or swim while wearing the monitor.
    • Donít have X-rays while wearing the monitor.
    • Stay away from high-voltage areas, metal detectors or large magnets.
  • The technician will show you how to keep a diary of your activities and symptoms during the test. Itís important to keep an accurate diary. If you feel symptoms such as chest pain, shortness of breath, uneven heartbeats or dizziness, note in your diary the time of day they began and what you were doing. Your diary will be compared to the changes in your ECG recorded by the Holter monitor.

What happens after wearing a Holter Monitor?

After the test period, return the monitor to the technician. He or she will process the record of your heart activity and prepare a report for your doctor. This will include the notes in your diary. You should get the results of the test in one or two weeks.


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CARDIAC CATHETERIZATION / ANGIOPLASTY / STENT

What is Cardiac Catheterization?

Cardiac catheterization is a procedure to examine how well your heart is working. A thin, hollow tube called a catheter is inserted into a large blood vessel that leads to your heart.

Quick facts:
  • Cardiac cath is performed to find out if you have disease of the heart muscle, valves or coronary (heart) arteries.
  • During the procedure, the pressure and blood flow in your heart can be measured.
  • Coronary angiography is done during cardiac catheterization. A contrast dye visible in X-rays is injected through the catheter. X-ray images show the dye as it flows through the heart arteries. This shows where arteries are blocked.
  • The chances that problems will develop during cardiac cath are low.

Why do people have cardiac catheterization?

A cardiac cath provides information on how well your heart works, identifies problems and allows for procedures to open blocked arteries. For example, during cardiac cath your doctor may:



  • Take X-Rays using contrast dye injected through the catheter to look for narrowed or blocked coronary arteries. This is called coronary angiography or coronary arteriography.
  • Perform a percutaneous coronary intervention, such as coronary angioplasty with stenting to open up narrowed or blocked segments of a coronary artery.
  • Check the pressure in the four chambers of your heart.
  • Take samples of blood to measure the oxygen content in the four chambers of your heart.
  • Evaluate the ability of the pumping chambers to contract.
  • Look for defects in the valves or chambers of your heart.

What are the risks of cardiac catheterization?

Cardiac cath is usually very safe. A small number of people have minor problems. Some develop bruises where the catheter had been inserted (puncture site). The contrast dye that makes the arteries show up on X-rays causes some people to feel sick to their stomachs, get itchy or develop hives.


How do I prepare for cardiac catheterization?

  • You will be given instructions about what to eat and drink during the 24 hours before the test.
  • Usually, you will be asked not to eat or drink anything for six to eight hours before the cath procedure.
  • Tell your doctor about any medicines (including over-the-counter, herbs and vitamins) you take. The doctor may ask you not to take them before your cath procedure. Donít stop taking your medicine until your doctor tells you to.
  • Tell your doctor or nurse if you are allergic to anything, especially iodine, shellfish, latex or rubber products, medicines like penicillin, or X-ray dye.
  • Arrange to have someone drive you home after your procedure.
  • If you usually wear a hearing aid, wear it during your procedure. If you wear glasses, bring them to your appointment.

What happens during cardiac catheterization?

A doctor with special training performs the procedure with a team of nurses and technicians. The procedure is done in a hospital cardiac catheterization (cath) lab.
  • Before the cath procedure, a nurse will put an IV (intravenous) line into a vein in your arm so you can get medicine (sedative) to help you relax, but youíll be awake and able to follow instructions during the procedure.
  • The nurse will clean and shave the area where the doctor will be working. This is usually in the groin area.
  • A local anesthetic is usually given to numb the needle puncture site.
  • The doctor will make a needle puncture through your skin and into a large blood vessel. A small straw-sized tube (called a sheath) will be inserted into the vessel. The doctor will gently guide a catheter (a long, thin tube) into your vessel through the sheath. A video screen will show the position of the catheter as it is threaded through the major blood vessels and to the heart. You may feel some pressure in your groin, but you shouldnít feel any pain.
  • Various instruments may be placed at the tip of the catheter. They include instruments to measure the pressure of blood in each heart chamber and in blood vessels connected to the heart, view the interior of blood vessels, take blood samples from different parts of the heart, or remove a tissue sample (biopsy) from inside the heart.
  • When a catheter is used to inject a dye that can be seen on X-rays, the procedure is called angiography.
  • When a catheter is used to clear a narrowed or blocked artery, the procedure is called angioplasty or a percutaneous coronary intervention (PCI).
  • The doctor will remove the catheters and the sheath. Your nurse will put pressure on the site to prevent bleeding. Sometimes a special closure device is used. The procedure lasts about an hour.

What happens after cardiac catheterization?

You will go to a recovery room for a few hours. During this time, you have to lie flat.
  • Pressure will be applied to the puncture site to stop the bleeding.
  • You will be asked to keep your leg straight and will not be able to get out of bed.
  • Your heartbeat and other vital signs (pulse and blood pressure) will be checked during your recovery.
  • Report any swelling, pain or bleeding at the puncture site, or if you have chest pain.
  • Before you leave the hospital, you will receive written instructions about what to do at home.

What happens after I get home?

Be sure to carefully follow all instructions. It is important to take your medications as directed by your healthcare provider and to make follow up appointments before leaving the hospital. Most people can return to their normal activities the day after the procedure depending on whether any additional interventions were done during the cardiac cath. A small bruise at the puncture site is normal. If the site starts to bleed, lie flat and press firmly on top of it for a few minutes. Then, recheck to see if the bleeding has stopped.


Call your doctor if:
  • Your leg with the puncture becomes numb or tingles, or your foot feels cold or turns blue.
  • The area around the puncture site looks more bruised.
  • The puncture site swells or fluids drain from it.

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SCLEROTHERAPY

Sclerotherapy is a medical procedure used to eliminate spider veins. Sclerotherapy involves an injection of a solution (generally polidocanol) directly into the vein. The solution irritates the lining of the vein, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view.


Am I a candidate for Sclerotherapy?

Prior to sclerotherapy, you will have an initial consultation with Dr Sahgal to decide if you're a good candidate for the procedure.

Your eligibility will be decided on an individual basis, and will depend on the overall health of the area needing treatment.


How is Sclerotherapy Done?

In most cases of sclerotherapy, the medication solution is injected through a very fine needle directly into the vein. At this point, you may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected. The procedure itself takes approximately 15 to 30 minutes.

The number of veins injected in one session depends on the size and location of the veins, as well as the general medical condition of the patient.

Sclerotherapy is performed in our office by Dr Sahgal and requires that you do not do any aerobic activity for a few days after the procedure.


What to Do Before Sclerotherapy?

Prior to sclerotherapy, you should avoid certain anti inflammatory medications, such as Advil, Motrin, alleeve. Tylenol, however, should not affect this procedure. No lotion should be applied to the legs before the procedure.


What are the side effects of Sclerotherapy

You may experience certain side effects after sclerotherapy. There are milder effects, such as itching which can last for one or two days after the procedure. Also, you may experience raised, red areas at the injection site. These should disappear within a few days. Bruising may also occur around the injection site and can last several days or weeks.


Are there any other side effects of Sclerotherapy

  • Larger veins that have been injected may become lumpy and hard and may require several months to dissolve and fade.
  • Brown lines or spots may appear at the vein site. In most cases, they disappear within three to six months, but they may also last indefinitely.
  • Neovascularization -- the development of new, tiny blood vessels -- may occur at the site of sclerotherapy treatment. These tiny veins can appear days or weeks after the procedure, but should fade within three to twelve months without further treatment.
Should any of the following side effects occur, contact your doctor immediately. These include:
  • Inflammation within five inches of the groin
  • A sudden onset of a swollen leg
  • Formation of small ulcers at the injection site
Allergic reactions to the fluid that's injected may occur at the time of the injection and are rarely serious.


What happens after Sclerotherapy?

After sclerotherapy you will be able to drive yourself home and resume your regular daily activities. Walking is encouraged.

You will be instructed to wear support hosiery to "compress" the treated vessels. If you have compression hosiery from previous treatments, you are encouraged to bring them with you to be certain they still have adequate compression. Following the injections, avoid aspirin, ibuprofen, or other anti-inflammatory drugs for at least 48 hours. Tylenol may be used if needed.

Also, you should avoid the following for 48 hours after treatment:
  • Hot baths
  • Hot compresses
  • Whirlpools or saunas
  • Direct exposure to sunlight
Showers are permitted, but the water should be cooler than usual. The injection sites may be washed with a mild soap and tepid water.


How effective is Sclerotherapy?

Studies have shown that as many as 50%-80% of injected veins may be eliminated with each session of sclerotherapy. Less than 10% of the people who have sclerotherapy do not respond to the injections at all. In these instances, different solutions can be tried. Although this procedure works for most patients, there are no guarantees for success.

In general, spider veins respond in three to six weeks, and larger veins respond in three to four months. If the veins respond to the treatment, they will not reappear. However, new veins may appear at the same rate as before. If needed, you may return for injections.


Will my insurance cover Sclerotherapy?

If your veins are causing medical problems such as pain or chronic swelling, your insurance may offer reimbursement. If sclerotherapy is being done for cosmetic purposes only, your carrier most likely will not provide coverage. If you have questions, call your insurance company, which may request a letter from us concerning the nature of your treatment and medical necessity.


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VENEFIT (VNUS CLOSURE) PROCEDURE

What is an Venefit (VNUS Closure) Procedure?

The Venefit procedure, previously known as the VNUS Closure Procedure, offers patients an efficient, non-surgical alternative for treating varicose veins to improve the skinís appearance and to reduce health risks related to large varicose veins. The Venefit Procedure utilizes radiofrequency (RF) energy to heat and contract the collagen found inside the vein walls, causing the vein to collapse and seal shut.


What are the advantages and benefits of the Venefit/VNUS Closure Procedure?

  • Outpatient procedure
  • Very little downtime; normal activity can be resumed within 1-2 days
  • Minimally-invasive; not an open surgical procedure
  • Little to no scarring
  • Long lasting relief from symptoms
Extensive clinical tests involving thousands of patients throughout the United States and Europe demonstrated that the Venefit Procedure is effective at occluding (closing) veins and reducing patient symptoms. Published studies have shown that at 12 and 24 months following the Venefit Procedure, over 90% of treated veins remained reflux free.



Before and After Venefit Closure Procedure


Using ultrasound, your physician will position the Venefit catheter into the diseased vein through a small opening in the skin. The tiny radiofrequency powered catheter delivers heat to the vein wall. After sealing the vein, blood flow redirects to healthy veins, thus reducing or eliminating the appearance of enlarged, diseased veins. The Venefit procedure is performed on an outpatient basis and typically takes about 30 minutes. Local anesthesia is used for patient comfort. In some cases, this procedure is performed in conjunction with Ultrasound Guided Sclerotherapy or Ambulatory phlebectomy.

Following the procedure, a simple bandage is placed over the insertion site, and additional compression may be provided to aid healing. Your doctor may encourage you to walk, and to refrain from extended standing and strenuous activities for a period of time. Patients who undergo the Venefit procedure typically resume normal activities within a day.


How is the Venefit Procedure different from vein stripping?

Vein stripping is an invasive surgical procedure that requires removing the vein through an incision during surgery. Vein stripping is typically performed in the operating room under full anesthesia. The Venefit Procedure, on the other hand, does not require surgery nor the removal of the vein. Instead, the vein is left in place and is closed using a special catheter inserted through a very small puncture.


Instructions after your VNUS closure Procedure

  1. Appointments:
    1. Please keep your 48 hour post procedure appointment with Dr Sahgal, and your Mandatory first one week Doppler appointment with our office.
    2. You are NOT ALLOWED to fly until you have had your FIRST post Procedure Doppler.
    3. Please schedule and keep your 1 month and 3-4 month Doppler appointments.
  2. Activity:
    1. You can walk and go up and down the stairs. Avoid sitting or standing in one position for prolonged periods of time (greater than 2 hours).
    2. You may shower the second day after your procedure, but avoid tub baths or swimming until the puncture wound is healed (approx. 2 weeks).
    3. Avoid ALL exercise that causes you to work up a sweat for two (2) weeks.
  3. Bandage / Compression Stockings:
    1. The Ace wrap around your thigh should remain in place for 48 hours. It should be snug, but not too tight. If the Ace wrap feels too tight, remove it and re-apply it starting at the knee and working your way towards the groin.
    2. Continue to wear compression stockings after surgery.
  4. Medications:
    1. If you have some mild discomfort, you may take Ibuprofen or Tylenol as needed.
    2. You may continue your regular medications including Aspirin, Coumadin & Plavix.
  5. Bruising / Bleeding:
    1. It is likely that you will have some bruising of your thigh, this will resolve with time.
    2. If you experience any bleeding, lay down and apply firm pressure over the site for 20 minutes with a clean towel. This will stop the bleeding.
  6. Call our office should you have any of the following problems:
    1. Fever over 101.5 degree F .
    2. Severe pain .
    3. Abrupt swelling of the treated leg .
    4. Bleeding that lasts longer than 20 minutes despite direct pressure.

What you may expect after your VNUS Closure Procedure:

VNUS Closure procedure is a minimally invasive technique leaving almost no evidence of trauma or scaring at the skin surface, however there is a modest amount of trauma to the veins beneath the skin surface. The procedure works by heating the inner lining of the vein to just over the boiling point of water, causing the vein to coagulate and begin the process of slowly digesting away. You will experience no pain from this because the area is numbed by the local anesthesia.

Over next 3-6 hours, you should expect to begin to feel slight discomfort as anesthesia wears off. Most patients will feel better with over the counter pain medications (such as Ibuprophen). However, if you need something stronger, our office will call in a prescription for a stronger pain reliever. Most patients can return to normal activity within 24 to 48 hours with minimal discomfort. Although the pain is different, it is usually less than what you have long suffered with your venous disease which should begin to diminish almost immediately.

Over the next several days, you will begin to notice some swelling and minor tenderness along the course of the Ďclosed veiní. It is mildly tender to the touch and sometimes slightly bruised. Patients sometimes complain that it feels like something is pulling or stretching inside. This is entirely normal. The tenderness may take a month or more to fully resolve however the firm cord will take 4-6 months to slowly shrink and disappear. There may also be some mild numbness of the skin in the area of treatment. It too will almost always resolve itself, and may take up to a year.

If you have also had ultrasound or Veinlite guided injection sclerotherapy, this same phenomenon will occur although the firm Ďlumpsí will be more prominent because they are closer to the skin.

If you had phlebectomies, there will be small butterfly tapes over these small wounds. They may fall off in a few days. If not you can gently remove them if they remain on after 5 days.

Healing process that begins the day of the procedure, unfolds over a series of months. The relief of your original Ďvenous painí occurs quickly and is usually dramatic. The healing process from the Ďcoagulationí of the vein(s) however takes longer time. Any discomfort you may suffer will be very minor, and you should be back to full activities within a few days.


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