Tired, Aching Legs? Swollen Ankles? Varicose Veins? An informative guide for patients Are You at Risk? Leg problems are widespread throughout the world, but what most people don’t know is that approximately 90% of leg disorders originate within the veins. If you have tired, aching, swollen legs, or if you see the beginning of vari- cose veins, this brochure will help you learn how to improve the health of your venous circulation. Vein problems can progressively worsen over time and can affect your health for the rest of your life. Much can be done to decrease the risk of developing venous disorders. SIGVARIS believes that understanding the cause of venous disease is an important first step. Are you at risk? Please read on... Causes and Risk Factors • Long distance travel • Heredity • Age over 40 • Prolonged sitting or standing • Pregnancy • Obesity • Sedentary lifestyle • Surgery or trauma • Infectious disease • Use of hormone medication Danger signals In most cases, leg problems do not just occur ‘out of the blue.’ There are typical warning signs such as: • Heavy, hot, or tired legs • A feeling of tension, cramps, fatigue or stabbing in calves • Swollen ankles • First signs of small varicose veins The Circulatory System The heart is the main pump of the circulatory system. It is the muscle that pumps oxygen-rich blood through the arter- ies and into tiny capillaries where body cells exchange the oxygen for carbon dioxide. The blood then enters the veins, which carry the blood back to the heart. Circulating blood through the veins can be a challenge. By the time blood enters the veins, the force pushing this blood has weakened. Gravity forces veins to work even harder to return blood to the heart. Arterial: Venous: • Blood flows from heart • Blood returns to heart • Rich with oxygen and • Contains waste and nutrients metabolic residue Venous Return The body has a number of ways to help blood return to the heart. Just as the arterial system uses the power of the heart to drive fresh blood into the tissues, the calf muscle acts as a ‘second heart’ by contracting and relaxing as a person walks. One-way valves in the superficial and deep veins help blood to flow back to the heart. The deep system handles up to 90% of the venous blood volume and is the high pressure system of the venous circulation in the legs. The superficial system handles the other 10% and is the low pressure system. When calf muscles relax, the valves close to prevent blood from flowing backwards into the lower part of the vein. These valves are fragile and can be easily damaged. Other ‘pumps’ help push blood toward the heart, such as the ankle, the foot, and the diaphragm. Muscles in Contracted relaxed state muscles squeezing veins Closed valve prevents blood from Open valve flowing allows blood backwards to flow towards the heart Venous Problems in the Legs Venous insufficiency is a condition in which the valves of the veins fail to function. This interferes with venous return to the heart and causes blood to pool in the vein. Factors leading to venous insufficiency include venous stasis, changes or damage to the vein wall or valve, Venous insufficiency can lead to varicose veins, phlebitis, thrombophlebitis, blood clots, and changes in the skin, including leg ulcers. Descriptions of Venous Problems Normal Normal Incompetent Incompetent Varicose veins are visibly en- larged veins that are often bluish in color and may appear twisted. They are caused by the pooling of blood in a damaged vein and can sometimes Normal Varicose Vein Vein be painful. In the early stages of varicose veins, the legs may feel tired, heavy, achy, or tense. Blood flows one wayBlood flows one way Blood flows both wayBslood flows both ways through normal valvetshrough normal valves through damaged through damaged valves valves Phlebitis is the inflammation of a vein wall, and is the most common problem associated with varicose veins. Symptoms can include swelling, redness, warmth, or pain in the af- fected area. Superficial Thrombophlebitis is the inflammation of a vein caused by a blood clot. Symptoms are similar to phlebitis. Descriptions of Venous Problems A Deep Vein Thrombosis (DVT) is a blood clot in one of the deep veins. About 25% of DVTs move away from the deep veins and travel through the bloodstream into the lungs. This is known as a pulmonary embolism, and can have life- threatening consequences. Symptoms include: • Pain and tenderness in one leg • Swelling in one leg • Increased warmth and redness in one leg • Shortness of breath and fainting • Pain in the chest DVTs can occur with no symptoms. One-way vein valve Deep Vein Thrombosis (DVT) has damaged this vein and valve Description of Venous Problems Chronic Venous Insufficiency (CVI) is a collective term used to describe a long-standing condition involving impaired venous return in varying degrees of severity. Symptoms include: • Edema (swelling) • Feeling of heaviness in the legs • Pain or cramps in the calves • Skin discolorations • Dermatitis (skin problems) • Dry or weeping eczema • Venous leg ulcer A Venous Leg Ulcer is an open wound that usually forms near the ankle and is due to chronic poor circulation. The ulcer has a weeping, raw appearance and the skin sur- rounding the ulcer is dry, itchy, and reddish-brownish in color. Venous leg ulcers are usually slow to heal. ? DID YOU KNOW: Compression therapy is the treatment of choice for CVI. Why Compression Works Compression therapy is the application of external pressure to the limb to reduce venous pressure within the limb. This means wearing socks or stockings that are specially designed to support your veins and increase circulation. To be most effective, the socks or stockings should be put on at the start of your day and removed before you go to bed. Remember that the heart attempts to pump blood against gravity up the veins of the legs. As a person walks, the regular contraction and relaxation of the calf muscles around the veins are necessary to help move blood towards the heart. Some people have an inherited weakness of the vein walls or valves which create additional challenges to venous circulation. Wearing SIGVARIS compression socks or stockings is vital for 20-30% the prevention and treatment of varicose veins and other circulatory problems, especially for individuals who are at risk. 50-80% Compression is greatest at the ankle, gradually decreasing up the leg. 100% Your Doctor Can Help Effective methods for the treatment of venous disorders are readily available. Your physician can provide a diagnosis to correctly assess the course and severity of your condition, and to take appropriate therapeutic measures. When Does a Doctor Prescribe SIGVARIS A doctor prescribes SIGVARIS medical socks or stockings for any active vein disorder of the leg, or as a preventative measure in cases when risk factors are present. They are also prescribed after surgery for patients who are not confined to bed. Filling your prescription is easy. Just go to a certified SIGVARIS dealer, where a trained fitter takes your measurements and can recommend the correct socks or stockings for you based on your physician’s advice. Available in these compressions: • 15-20 mmHg • 20-30 mmHg • 30-40 mmHg • 40-50 mmHg • 50-60 mmHg