| Q. |
What happens in the vein orientation? |
| A. |
Your initial visit to our office may take as long as 1 ½ to 2 hours. First, after completing general office information, you will be part of a small informal class to learn the details of sclerotherapy. One of our nurses will explain how our different treatment plans work. Then the insurance portion will be explained by one of our billing staff. You will have an opportunity to ask questions, see "before and after" pictures and obtain more information about our office.
If you are unable to arrive at your scheduled time please call ahead of time to notify us. If you are late for your appointment, it may be necessary to reschedule your visit, as we are unable to delay the class for the other scheduled patients.
If by the end of our class you decide that our treatment program does not meet your needs, you are under no obligation to remain for the physician consultation. There will be no charge if you choose to leave prior to your consultation.
After class you will meet individually with the doctor. The diagnosis of a leg vein problem may be as simple as a look at the leg, or may involve the use of ultrasound studies to make a complete evaluation. The physician will discuss with you the severity of your varicose vein problem, whether any diagnostic testing is necessary, the likelihood of any surgery and will outline an appropriate course of treatment. He will also be able to render an opinion as the approximate number of treatments and the likely outcome of those treatments.
For your benefit, as well as the benefit of others, we ask that you please refrain from bringing children to the consultation and your sclerotherapy visits.
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| Q. |
Why do I have to do a predetermination for varicose vein treatment and how long does it take? |
| A. |
Our predetermination process takes approximately eight weeks for prior approval. This gives us and your insurance company enough time to prepare and review our treatment plan for medical necessity. The majority of insurance companies consider varicose vein treatment to be cosmetic and have to review our records against their criteria. As soon as we hear back from the insurance company you will get a letter in the mail with instructions and a timeframe for the treatment plan. Medicare is one of the few insurance plans that does not require any prior approval.
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| Q. |
Do you participate with many insurance companies? |
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We are providers with most insurance companies.
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| Q. |
Where do I check in for my arteriogram? |
| A. |
If you are arriving at 6 AM check in at the Saint Joseph's Hospital of Atlanta Emergency Room.
If you are scheduled to arrive after that time, check in at Harold Harrison Pavilion, formerly known as Stella Maris.
If your arteriogram is scheduled at Northside Hospital, check in at admissions.
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| Q. |
Where do I check in for my other surgeries? |
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If you are having a procedure at Saint Joseph's Hospital of Atlanta check in at Harold Harrison Pavilion, formerly known as Stella Maris.
If your procedure is scheduled at Northside Hospital, check in at admissions.
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| Q. |
When will I get my ultrasound test results? |
| A. |
Patients that were referred by one of our doctors, will receive their results and follow up recommendations via telephone within ten business days. Test results will not be available prior to this time.
If you are a patient wanting ultrasound test results for varicose vein procedures such as EVLT, high ligation or sclerotherapy you will receive your test results and further instructions via letter within 3-4 weeks.
If you were referred for testing by a physician other than our doctors, please follow up with your physician for test results and follow up recommendations.
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| Q. |
What are the post-op instructions for venous closure, the EVLT? |
| A. |
Return to normal activities
Refrain from strenuous activities for 10 days
Compression stockings for 10 days
Ambulation instructions for 60 minutes a day for 10 days
For Pain medication use Tylenol or Motrin, no aspirin; Rx medication if needed
Thigh high hose are to be worn only during the day. Use an Ace wrap at night for the first three nights.
You will be expected to walk immediately after the procedure for at least 20 minutes here at our office. Normal activity can be resumed immediately, but strenuous exercise can cause the vein to reopen. Also, avoid hot baths.
Recovery from EVLT is usually trouble-free. It is normal to experience some tenderness and possibly bruising along the areas where local anesthesia was administered. It is also normal to feel a "tightening" sensation in your leg after 5 to 7 days. Keep in mind this "tightening" may last approximately a week. This discomfort can generally be managed with over-the-counter analgesics like Tylenol or Motrin, but avoid aspirin-based products unless otherwise recommended or prescribed. The benefit with compliance will be a reduction in bruising, swelling and pain.
Call your physician immediately at (404) 255-3252, after 5PM call (404) 256-0404 if you experience any of the following:
- Fever of more than 100 F
- Numbness in your foot or toes
- Prolonged tenderness, redness, or warmth along the treated segment
- Moderate to severe pain preventing return to normal activities
- Shortness of breath
- Swelling in the treated limb
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| Q. |
Is this normal after sclerotherapy? |
| A. |
If your leg has a compression wrap applied after treatment, keep this on for the number of days your doctor has indicated. This is to stay on and must not become wet.
It is normal to experience lumpiness and a bruised appearance over a vein that was treated. This may last for a month or more until the vein is absorbed by the body. The injection site marks usually heal in 1 1/2 to 2 weeks. Nothing needs to be done to these areas. If your legs are uncomfortable after treatment, walking and Tylenol may be helpful.
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| Q. |
What are the restrictions for sclerotherapy? |
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No sun tanning on the treated areas for one month
No high impact activity (tennis, running, etc.) or leg/abdominal weights for one week
Do not soak in a hot tub or get a massage on the legs until the veins have resolved
We do not advise taking a lengthy car trip or plane flight within a few days following treatment
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| Q. |
Do I need to bring my compression hose with me to my sclerotherapy appointments? |
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Yes. If you do not there will be a fee for the wrap.
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| Q. |
What causes varicose veins? |
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The most important factor predisposing to varicose veins is a strong history of similar problems occurring in other blood relatives, such as mothers and aunts. With such a family history, individuals presumably inherit weakened valves in the superficial veins of their legs and under the right set of conditions, the veins become tortuous and dilated. Typically, factors that seem to predispose to the development of varicose veins include jobs which require prolonged standing or conditions which result in increased pressure within the abdomen, such as pregnancy or recurrent constipation. |
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| Q. |
What is an aneurysm and how do they form? |
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When the wall of an artery becomes weakened, the pressure within the vessel can cause the wall to bulge out forming a localized dilation, or aneurysm. Although a small percentage of such cases are due to inherited factors, the vast majority appear to represent a variant of atherosclerosis and like atherosclerosis, they tend to occur in a limited number of locations. Most aneurysm seems to occur in the abdominal aorta, the main artery lying in the center of the abdomen. Other common sites include the groin and the vessels behind the knee. |
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| Q. |
What is a stroke? |
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When circulation to a part of the brain is interrupted for more than a few minutes, the brain cells in that region may die or malfunction and the patient will demonstrate loss of some bodily function such as vision, speech, movement of a body part or sensation. When the underlying disease process is temporary, the symptoms may be similarly temporary and the episode is known as a "transient ischemic attack" or TIA. Some people also refer to these as "mini-strokes." |
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| Q. |
Who are vascular surgeons? |
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Vascular surgeons are physicians who care for patients with diseases that affect the arteries and veins throughout the body. This medical specialty first emerged in the early 1950s as a hybrid between general and cardiac surgery. However, unlike most other surgical specialties, no parallel medical discipline evolved to treat these patients and vascular surgeons were left to manage the full spectrum of vascular disease. Over the next three decades, pioneers in this specialty expanded our knowledge of the disease processes that affect blood vessels and helped to develop many of the diagnostic modalities and treatments that we use today. |
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| Q. |
What is peripheral vascular disease? |
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Peripheral vascular disease refers to diseases of blood vessels outside the heart and brain. It's often a narrowing of the vessels that carry blood to leg and arm muscles. There are two types of these circulation disorders:
- Functional peripheral vascular diseases don't have an organic cause and don't involve defects in blood vessels' structure. They're usually short-term effects and can come and go. Raynaud's disease (or Raynaud's phenomenon) is an example. It can be triggered by cold temperatures, emotional stress, working with vibrating machinery or smoking.
- Organic peripheral vascular diseases are caused by structural changes in the blood vessels (such inflammation and tissue damage). Peripheral artery disease is an example. It's caused by atherosclerosis.
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| Q. |
How can I pay my bill? |
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You can send in your payment when you receive your statement. You can pay with Visa or Mastercard by writing your card number on the back of your payment stub and mailing it to our main office. You can also call our office at (404) 256-0404 and ask for Jessica at extension 228 or Cindy at extension 224 to make a credit card payment over the phone for our Atlanta and Lake Oconee locations. For a credit card payment over the phone for our Roswell location, please call (678) 242-1193. |
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| Q. |
Will I have to pay a copay for just an ultrasound? |
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Some insurance companies require a copay for ultrasound only appointments. We will not collect the copay on that day, but will bill you if your insurance company processes your claim that way. |
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| Q. |
What if I need to give my medication list to a nurse for my upcoming surgery and the office is closed? |
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You can fax your list to us at (404) 847-0423. Please make sure to put the name of your nurse on the copy. Or you can go to the question or comment area on this page and give us your list. If it is during business hours you can call our office at (404) 256-0404. If you are having surgery with Dr. Clark or H'Doubler, you can ask for Christy at extension 235. If you are having surgery with Dr. Mittenthal or Rheudasil you can ask for Denise at extension 234. If they do not answer you can leave them a voicemail. |
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