La Jolla Vein Care’s Founder and Medical Director, Dr. Nisha Bunke was honored along with 24 other women, to receive the San Diego Business Journal’s, Business Women of the Year Awards 2018. Read more at the SDBJ website.
image of finalists for 2018 San Diego Business Journal Women of the Year
If you missed Dr. Sarah Lucas, of La Jolla Vein Care on KUSI News, you can see her here on our youtube page.
Dr. Lucas discusses venous insufficiency in pregnancy, how many women it affects and how it affects them.
Pregnancy-Related Varicose Veins, Do Stockings Help?
By Dr. Sarah Lucas
Varicose veins affect up to 30% of pregnant women, and the majority of pregnant women experience some venous insufficiency symptoms such as leg swelling, heaviness, and/or fatigue. Varicose veins most commonly emerge in the first trimester and progress over the course of the pregnancy and subsequent pregnancies. They usually improve after the baby is born, but many women never return to their pre-pregnancy state. This risk of varicose veins increases with each pregnancy, affecting more than 55% of women who have had more than two children.
For this reason, many patients ask what is the best approach to keeping their legs healthy during pregnancy. For the most part, the same guidelines apply to pregnant women as to other patients: keep active, wear compression stockings to control leg swelling and discomfort, and elevate the legs as needed. It is very rare for pregnant women to require surgery for varicose veins. We typically recommend patients wait at least three months postpartum or until breastfeeding is complete to get treatment.
A recent study presented at the European Venous Forum suggests that compression stockings may actually reduce the risk of varicose veins during pregnancy. Women with no history of varicose veins were randomly assigned to wear thigh-high compression stockings or no stockings starting in the first trimester. Among the women who completed the study, varicose veins developed in 12% of those who wore stockings vs. 27% of those who did not. This was a small study (146 patients) but encouraging for women who want to are concerned about onset or worsening of varicose veins during pregnancy.
Ice: Apply ice to tender areas. Ice can reduce swelling and bruising.
Compression: Compression stockings have been shown to reduce bruising after vein stripping surgery in studies.
Homeopathic agents like arnica can help reduce inflammation and bruising. Arnica pellets can be taken prior to treatment as well and Arnica cream or gel should be applied after (not before) treatment.
How to reduce bruising after vein surgery? Picture courtesy of Medicinenet.com
Dr. Bunke’s own creation, Recova Cream is an Arnica-based product, but unlike OTC Arnica preparations, combines other antioxidant, pro-healing compounds to enhance the skin’s ability to repair and recover. It includes menthol, grapeseed extract, and other flavonoids that have been shown to reduce vein-related leg symptoms like leg fatigue and swelling.
RecovaCream.com for more information. Recova Cream can be purchased in-office, on amazon, or at SkinResourceMD.com.
A tinted version of Recova is available after facial procedures such as eyelid surgery, laser treatments, botox, and collagen fillers.
8 years in-a-row! Check out San Diego Magazine, October 2018 issue of the ‘Top Doctors’ and see La Jolla Vein Care Doctors.
Read about Dr. Bunke and her amazing colleagues dedication to the field of venous disease, leading edge treatments and how they are leaders in the industry.
We are Committed to Veteran Care
La Jolla Vein Care is now a provider for The Veterans Choice Program with Triwest. We, at La Jolla Vein Care have a special place in our heart for veterans. Dr. Bunke herself ran the vein clinic at the VA Healthcare system, San Diego for over 5 years. Dr. Bunke’s father was a NAVY SEAL and grandfather also served in the military. Dr. Lucas’ husband currently is a Naval Surgeon. We are pleased to announce that we can provide our specialty care to VA patients if their wait time is longer than 30 days. This is possible due to The Veterans Choice Program with Triwest. To learn more information about how the Veterans Choice Program works please give us a call at 1-858-550-0330
Height may be a genetic risk factor for varicose veins
Tall patients frequently ask if their height contributed to the development of their varicose veins. Now, there may be an answer. A study at Stanford University School of 
Medicine study found a person’s height to be a significant risk factor for developing varicose veins. The exact reason is unknown. Intuitively, one would think the gravitational forces are greater in the leg veins of tall people. (Interesting side note, giraffes would be expected to develop varicose veins but do not: the reason for this is that their skin is firm, providing support like compression stockings). The correlation between varicose veins and height, may not be a structural or gravity-related issue but rather genetic.
“We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be causing varicose veins.”
Another recent study in Russia, showed a particular gene in ethnic Russians, that was associated with the development of varicose veins, was also responsible for other traits such as rheumatoid arthritis and has a negative impact on human height, an opposite finding from the Stanford study.
To read more about the Stanford study, click here.
La Jolla Vein Care’s Founder, Dr. Nisha Bunke is Named an Industry Leader Finalist by San Diego MAGAZINE. This award recognizes an individual who is a dynamic and passionate leader who has a positive influence on others and works tirelessly for causes near and dear to her heart. Dr. Bunke’s contribution to the field of venous medicine, mentoring and advancing women in the health care field, and creating Recova, an innovative post-surgery cream.
Nisha Bunke, MD, FACPh, RPhS
Dr. Nisha Bunke Named Industry Leader Finalist by San Diego MAGAZINE 2018
As the first American physician to hold a fellowship in venous and lymphatic medicine, Dr. Bunke is renowned in her field, having coedited The Vein Book, medicine’s leading resource on venous disease; opened San Diego’s first vein clinic certified by the prestigious Intersocietal Accreditation Commission; and invented RECOVA, the first all-natural postsurgical bruise remedy. Driven by a passion for medicine, a dedication to improving patients’ quality of life, a commitment to collaboration in and outside her field, and a goal of growing her practice and advancing her field, Dr. Bunke also prides herself on developing the careers of her all-female staff.
“A colleague called me a ‘career developer.’ I like that,” she says. “I have a staff of ten motivated women. I enjoy supporting them to grow through training, conferences and by encouraging participation in clinical research and patient education.”
9850 Genesee Ave., Ste. 410, La Jolla, CA 92037 | 858.550.0330
San Diego’s First Accredited Dedicated Vein Center
La Jolla Vein Care is the only dedicated vein center in San Diego that is accredited by the Intersocietal Accreditation Commission (IAC). IAC accreditation is a “seal of approval” that patients can rely on as an indication that the facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of Vascular Testing and as a Vein Center.
How to Reduce Your Risk of DVT During Air Travel
woman passenger in terminal
There is a known correlation between air travel and deep venous thrombosis (DVT), which is a potentially fatal blood clot that forms in the veins of the legs. Blood clots in the leg veins occur in 1% of airline passengers on flights longer than 8 hours. The longer the flight, the higher the risk of DVT. There are a number of factors that contribute to the development of DVT during air travel. Prolonged sitting and non-movement of the legs cause blood to pool in the leg veins, making blood more susceptible to forming clots. This in combination with other factors such as potential hypoxia in the airplane cabin (Gavish) and dehydration may increase the risk of air travel related DVT. Individual risk factors include age over 40 years, gender (female), women who use oral contraceptives, varicose veins in lower limbs, obesity, pregnancy and genetic thrombophilia.
Deep venous thrombosis is when a blood clot forms within the leg veins
The term ‘economy class syndrome‘ has been used to refer to DVTs in passengers sitting in economy class- where there is limited leg room to extend the legs. People who have these risk factors are predisposed to hypercoagulability and are more susceptible to suffer venous thromboembolism during air travel.
Tips to reduce your risk of travel-related DVT and keep blood circulating in the leg veins.
#1) Move: Every 45 minutes, walk about the cabin when possible
If you are unable to walk, use your calf muscle pump by flexing and extending your feet.
#2) Wear graduated elastic compression stockings.
#3) Stay hydrated. People tend to drink less on-the-go. Drink frequently. Drink a glass of water for every alcoholic beverage you drink.
#4) Wear loose, non-restrictive clothing
#5) Elevate your legs. If your seat lacks a foot rest, use a backpack to prop your legs up.
#6) Talk to your doctor if you have a known risk factor for forming blood clots, if you are pregnant or have recently given birth; use birth control or other hormone therapies or have an active cancer. When necessary, a blood-thinning medicine can be prescribed on the days of air travel to reduce the risk of DVT.
Reference:
1: Gavish I, Brenner B. Air travel and the risk of thromboembolism. Intern Emerg
Med. 2011 Apr;6(2):113-6.
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