The symptoms of chronic venous insufficiency and the proper management of simple to complex disease have not been taught to physicians in the past, regardless of specialty. For instance, neurologists still prescribe Lyrica and Requip for restless legs. However, restless legs syndrome is cured in fifty percent of patients with saphenous vein closure by radiofrequency or laser. Nocturnal cramps seem to be ameliorated in all cases, with a virtual cure in a large percentage of cases. The latter condition seems to be ignored by many primary physicians, regardless of severity.
The patients that will have positive saphenous vein studies for reflux and dilatation will virtually always present with some externals stigmata including telangiectasia and/or spider veins or blue reticular veins. Most will not have varicose veins.
With the proper education of physicians and nurse practitioners, these patients that have symptoms that interfere with rest at night and daytime activities can get appropriate care and either complete relief or symptoms significantly improved.
If your physician, does not suggest referral to a dedicated vein center, consider self referral. At a dedicated center, the phlebologist(vein specialist) sees only vein patients and only works in the venous outpatient setting. All of his continuing medical education and practice are exclusively related to venous disease evaluation and management.
