DVT (Deep Venous Thrombosis) Afflicts American Idol

On Friday, former American Idol contestant Michael Johns suddenly died at age 35, allegedly from a blood clot that formed in his ankle. No official details have been released, but TMZ is reporting that Michael Johns twisted his ankle.  Other celebrities who have made relatively recent headlines for suffering from DVT include Real Housewives of Atlanta star, Nene Leakes, and Tennis Star Serena Williams.  Other well known figures such as

Richard Nixon, Dan Quayle, Dick Cheney and David Bloom have all suffered a potentially fatal deep venous thrombosis (DVT).

Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart, or other area, leading to severe damage.

Blood clots may form when something slows or changes the flow of blood in the veins. Risk factors include:

  • Bedrest
  • Cigarette smoking
  • Family history of blood clots
  • Fractures in the pelvis or legs
  • Giving birth within the last 3 months
  • Heart Failure
  • Obesity
  • Recent surgery (especially hip, knee, or female pelvic surgery)
  • Too many blood cells being made by the bone marrow

You’re also more likely to develop DVT if you have any of the following conditions:

  • Blood that is more likely to clot (hypercoagulability)
  • Cancer
  • Taking estrogens or birth control pills.
  • Long airplane flights: London’s Heathrow Airport reports one passenger death a month from DVT. One nearby hospital recorded thirty passenger deaths from DVT in the past three years including a 28-year-old man. To reduce the risk of DVT during air travel,  passengers are advised to wear compression stockings on flights, frequent moving aroudnt he cabinand pumping the calf muscles, leg elevation and avoidance of sedentary positions for long periods of time without moving.

If you might have a DVT, it is important to see a doctor. Signs of a DVT may be sudden leg pain and swelling. It can be diagnosed by ultrasound imaging. See our other blogs about ultrasound imaging and DVT detection.

What is a Superficial Thrombophlebitis?

A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. There are two main types of thrombophlebitits: deep venous thrombosis (affects deeper, larger veins) and superficial thrombophlebitis (affects veins near the skin surface).  This is often referred to as an STP.

The following symptoms are often associated with thrombophlebitis:

  • Inflammation (swelling) in the part of the body affected
  • Pain in the part of the body affected
  • skin redness (not always present)
  • Warmth and tenderness over the vein

The following increase your chances for thrombophlebitis:

  • Being hospitalized for a major surgery or with a major illness
  • Disorders that make you more likely to develop blood clots
  • Sitting for a long period of time (such as on a long airplane trip)
  • Varicose veins

An STP is common complication of varicose veins. But, it can also indicate an underlying problem with blood clotting.  In some cases, there may also be a concurrent blood clot in other veins, such as the deep veins (DVT) which can be serious. For this reason, a duplex ultrasound examination is used to look at the deep veins and other veins not visible to the naked eye for the presence of blood clots.

If it is localized to a small surface vein, it can usually be treated with  aspirin or other anti-inflammatory medication to reduce pain and inflammation, compression stockings, and cold/warm packs to also reduce inflammation and discomfort. The discomfort is usually improved within 6 weeks but it can take a few months to resolve.

If the superficial thrombophlebitis is extensive or if it appears to be ‘migrating’ up the leg, a blood thinner may be necessary.  You should see your doctor if you develop an STP.


A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. This patient has a superficial thrombophlebitis, which is a blood clot in the superficial, surface veins. You can see redness in the inner thigh of this patient, which is caused by the inflammation and swelling from the blood clot. It can be very painful. You should see your doctor for superficial thrombophlebitis.


Have Tea with the Vein MD August 11th

La Jolla Vein Care is announcing their new ‘Tea with the MD’ series of educational seminars for patients to learn more about varicose veins, what causes them, what’s new in treatment, etc.  Dr. Bunke will be kicking off the first seminar Monday, August 11th.  This is an opportunity to ask the doctor all of your vein related questions in a small group.  Those who are interested are asked to call 858-550-0330 to RSVP as space is limited to keep the discussions quaint.  Light snacks/lunch will be served and parking will be validated. Tea-With-MD-Ad-print

Why Compression Socks?


Olympic champion and Boston Marathon winner, Meb Keflezighi wears CEP compression socks while running. CEP compression socks can be found at compressrx.com.

Graduated compression stockings apply external pressure to your legs reducing venous pressure. Graduated compression stockings are great to use if your want to increase circulation, support you leg veins, and want to reduce uncomfortable leg symptoms such as swelling, tired and achy feeling legs.

They are important in the conservative management of varicose veins to reduce symptoms. They are also used after any type of vein treatment to improve the effectiveness of treatment, to reduce bruising and swelling, and for comfort.

Anyone can benefit from compression stockings. Compression stockings are great for relieving ones symptoms when sitting, standing or moving around for long periods of time. They are also great for professionals such as nurses, hairdressers, desk workers, and everyone in between.

Athletes wear compression stockings too.  There is some evidence that medical compression helps to reduce muscle fatigue and improves muscle recovery.  But, not all compression socks are made equal.  They should be medical graduated compression, like CEP socks by Mediven. These are the socks preferred by Olympic champion and Boston Marathon winner, Meb Keflezighi wears CEP compression socks while running.   Find medical CEP compression socks at compressrx.com.


Varicose Veins vs. Spider Veins

What is the difference between varicose veins and spider veins?  Are they the same thing? Spider veins and varicose veins both refer to dysfunctional, dilated leg veins but the main difference is the size of the veins. Spider veins are small, thread-like veins at the surface of the skin. They often appear in clusters or can have a ‘starburst’ or spider-like pattern. Varicose veins, are larger veins that appear swollen, twisted cordlike veins that ‘bulge’ at the surface.

Both spider veins and varicose veins can cause pain and other symptoms like burning, aching and throbbing. Both can be treated without surgery.

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This image describes the difference between spider veins and varicose veins. Both are manifestations of unhealthy veins. Spider veins are essentially, tiny varicose veins.

How is Venous Reflux Diagnosed?


Venous duplex imaging uses ultrasound waves to create pictures.  La Jolla Vein Care utilizes state-of-the-art ultrasound scanners to image the veins beneath the surface of the skin, not visible to the naked eye. Duplex ultrasound imaging can identify if the vein is healthy, or if it is refluxing, or if there are any blood clots in the vein.

Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound shows how blood is flowing through your vessels and measures the speed of the flow of blood. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel.  Conventional ultrasound uses painless sound waves higher than the human ear can detect that bounce off of blood vessels. A computer converts the sound waves into two-dimensional, black and white moving pictures called B-mode images.

Doppler ultrasound measures how sound waves reflect off of moving objects. A wand bounces short bursts of sound waves off of red blood cells and sends the information to a computer. When performing duplex ultrasound, your ultrasound technologist or physician uses the two forms of ultrasound together. The conventional ultrasound shows the structure of your blood vessels and the Doppler ultrasound shows the movement of your red blood cells through the vessels. Duplex ultrasound produces images that can be color coded to show physicians where your blood flow is severely blocked as well as the speed and direction of blood flow.  Venous reflux refers to back flow of blood across dysfunctional vein valves.  The direction of blood flow is detected by ultrasound.  This is measured in seconds.


La Jolla Vein Care image that shows reflux in the great saphenous vein. Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels.

Foam Treatment of Venous Malformations

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Venous malformation of the lateral leg before treatment. Venous malformations appear like abnormally dilated bluish vessels near the surface of the skin. They appear in clusters and look different than typical varicose veins. They often appear during childhood, as opposed to varicose veins.

Venous malformations comprise either superficial or deep veins that are abnormally formed and dilated.  Although they usually are present at birth, they may not be seen until years later into adolescence or even adulthood. The natural history of a venous malformation is slow, steady enlargement. However, events such as surgery, trauma, infection, or hormonal changes associated with puberty, pregnancy or menopause may cause rapid expansion.

At La Jolla Vein Care, we frequently evaluate and treat superficial venous malformations of the legs. Prior to treatment, it is important to have thorough diagnostic imaging, such as an ultrasound examination to ensure an accurate diagnosis of a pure venous malformation.  If an arterial connection (arterial venous malformation) is suspected on ultrasound evaluation, further imaging with CT or MR arteriogram may be necessary. Venous malformations can also occur in other syndromes, such as Klippel -Trenaunay syndrome and may involve the abnormal development of the deep veins.

Pure venous malformations can be treated without surgery. Foam sclerotherapy is a common treatment type.  Foam sclerotherapy uses a technique to inject a foamed sclerosing solution into the cluster of varicose veins, which will cause them to collapse and eventually dissolve.


Venous malformation after treatment with ultrasound guided foam sclerotherapy at La Jolla Vein Care. Treatment can reduce the symptoms associated with venous malformations such as leg pain, aching and throbbing.

8 Warning Signs of Vein Disease: #4 Swollen Ankles


Ankle swelling related to varicose veins and venous insufficiency may be subtle, leaving indentations from socks.

Swollen Ankles at Night

Thick, swollen ankles are signs that blood or other fluid is congested in the leg and / or leg veins. Over time, damaged vein walls can become even more stretched out and permeable, allowing fluid and protein to filter from the veins into surrounding leg tissue. When you lie down at night, the pressure from gravity is equalized across your leg. Usually, vein related swelling (venous edema) becomes apparent later in the day or worse throughout the day and improved with leg elevation or overnight during sleep.  Often in the morning, there may be no swelling. But, as the day progresses gravity causes poo

Pooling of blood around the ankle in incompetent veins. Venous insufficiency is one of the most common causes of ankle swelling that worsens throughout the day. Sometimes, the swelling can be subtle, leaving indentations from sock lines. Or, it may cause the skin to feel firm, shiny, or puffy by the end of the day.

If you have swelling, you should discuss it with your healthcare provider. Venous insufficiency can be diagnosed with a venous duplex sonogram, which is a non-invasive study of the leg veins.

8 Warning Signs of Vein Disease: #3 Open Sores or Ulcers on the Lower Leg


Venous leg ulcers are the result of chronic venous insufficiency and venous hypertension, which causes the skin to break down.

When chronic venous insufficiency reaches its most serious point, ulcers may appear on the lower leg. These open ulcers are the result of blood leaking into the leg tissue and damaging the skin. Open sores need to be treated by a doctor immediately.

New Product: The Scat Belt Becoming a Favorite Exercise Companion

Exercise is an important component of good vein health.  Exercise empties the veins of the legs and is beneficial to the cardiovascular system.  As a result, regular exercise, even a walking routine is beneficial to the leg veins and can help reduce leg symptoms.  A new product was developed that keeps you safe during outdoor exercise, such as going on evening walks or hiking in areas that are less populated. The Scat Urban Belt, allows you to carry pepper spray, a super loud alarm, a smarthphone and even a bottle of water!  For more information, go to scatbelt.com.


The SCAT URBAN Belt is lightweight, comfortable and provides peace of mind because you’re prepared and protected. The Urban comes in three great colors and two adjustable sizes for optimal fit.

Access pepper spray, an ear-piercing personal alarm and smartphone within seconds – also carry a bottle of water.