About Nisha Bunke

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So far Nisha Bunke has created 107 blog entries.

11, 11, 2021

How We Support Veterans and Military

2021-11-11T08:49:52-08:00

We provide vein care services for all veterans and active military. We provide treatment and diagnosis of varicose veins, chronic venous insufficiency, venous leg ulcers, and deep vein thrombosis.

First off, on this 11th day of November, we honor all who have served and sacrifice. We greatly appreciate our military personnel. Being a military daughter myself, and then working at the VA Healthcare and providing vein care for veteran’s, I continue to be committed to providing vein care services to promote healthy legs for veterans and active military. While military personnel have some of the most fit and healthy legs veteranman-and-woman_web copy

Triwest and VA Champs

La Jolla Vein Care has partnered with Veterans Affairs and Tricare to take care of our veteran’s varicose vein and leg health needs.

amongst all of us, military personnel and even Olympic athletes even can develop vein conditions. Certain occupations are known to increase the risk of developing vein disorders, such as standing occupations. At the VA, I often saw patients who stood guard for many hours on end, or had other risk factors for developing varicose vein disease such as leg trauma, or jumping out of airplanes. The range of vein disease I frequently saw at the VA included chronic venous insufficiency and venous leg ulcers, varicose veins, and venous reflux disease.

Here at La Jolla Vein Care, we accept VA Champs, which allows VA patients to be seen at our clinic and TriCare for active military. If you would like to be seen at our clinic, please contact our Veteran and military new patient coordinator at 858-550-0330 extension 104.

Happy Veteran’s Day.

How We Support Veterans and Military2021-11-11T08:49:52-08:00

18, 9, 2021

New Chula Vista Location Now Open

2021-09-18T17:55:19-07:00

World-class vein care is now available in your own backyard if you live in or near Chula Vista. La Jolla Vein Care has opened a convenient location to serve our San Diego patients who live near Chula Vista, National City, and other cities in the South bay. Our same team, including Dr. Lucas and vascular sonogprahers will go to the Chula Vista location on select days.
The same services as the La Jolla location will be offered including:
Varicose vein treatments, diagnosis and evaluations, physician consultations, ultrasound, and vascular lab services.
*Asclera™ *Endovenous Chemical Ablation *Endovenous Laser Ablation *Foam sclerotherapy *Laser vein ablation *Leg Ulcer treatment *Microphlebectomy *Radiofrequency Ablation *Sclerotherapy *ClariVein® *Spider Vein Treatment *Ultrasound Guided Foam Sclerotherapy *Ultrasound Imaging *Varicose Vein Treatment *Varithena *Vascular Lab Imaging *Venous Ultrasound Imaging
Call now to schedule your appointment at the Chula Vista location: 858-550-0330

New Chula Vista Location Now Open2021-09-18T17:55:19-07:00

14, 6, 2021

Complications of Untreated Varicose Veins

2021-06-14T20:00:18-07:00

Varicose veins and their underlying cause, venous reflux disease can cause a wide array of symptoms, including leg pain, swelling, aching, heaviness, restless legs, and nocturnal leg cramps.

If left untreated, superficial venous reflux disease can progress to cause skin changes and other complications.

Complications of untreated venous disease include:
1. Superficial Thrombophlebitis (STP)
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, warm and tenderness over the vein
Often a ‘hard knot’ or lump can be felt within the vein.

An STP is common complication of varicose veins because blood is pooling and not circulating well. 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.

STP 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.
2. Deep Venous Thrombosis (DVT)
If the blood clot is in a varicose vein near a deep vein or perforator vein, it can extend into the deep system, causing a DVT. For example, a spontaneously thrombosed great saphenous vein, can extend into the common femoral vein and cause a pulmonary embolism (PE). Also, a varicose vein blood clot can extend into a perforator vein and travel to the deep system. It is important to have an ultrasound examination of superficial blood clots to determine a concurrent DVT is present, determine exact location and extent of the superficial clot to make sure it is not near a deep or perforator vein. If it is, a blood thinner may be recommended or serial ultrasounds to monitor the clot may be recommended.
3. Spontaneous Vein Hemorrhage
Untreated varicose veins are at a higher than usual risk of bleeding or spontaneous rupture. Over time, varicose veins become larger, and the vein wall becomes weak and stretched out. These veins, which are already weak are also under high pressure (because of venous reflux, or the ‘backflow’ and pooling of blood in these veins). As a result, the high pressure can cause the veins to spontaneous burst and bleed heavily. Because they are under high pressure, they bleed like an arterial bleed and patients describe the bleeding as ‘blood shooting across the room.’ The varicose veins that are susceptible are veins closest to the surface of the skin

Most patients describe that it occurs during or after a warm shower (warm water causes veins to relax and dilate, allowing more blood to pool within the veins) or during sleep. It is painless and patients report that they notice it because they feel something wet in bed. Patients who are on blood thinners can lose large amounts of blood, especially if it occurs while they are sleeping. Some people have required blood transfusions. The small blue spider veins around the ankle are equally at risk of rupture as are the larger bulging veins.If someone you know has experienced bleeding from their varicose veins, they should be seen by a doctor. Treatment will prevent the veins from bursting again. This is a common condition that we see at La Jolla Vein Care.

4. Venous Leg Ulcer
A leg ulceration is the most severe form of chronic venous insufficiency. This is referred to as a ‘venous leg ulcer.’ Venous leg ulcers make up 70% of all chronic leg wounds. Therefore, the venous leg ulcer is much more common than a diabetic or arterial ulcer. It is caused from long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination. Venous reflux is the most common cause for a venous leg ulcer. The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest). The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually the skin will break open. The leg wound can be healed by treating the underlying vein condition.

5. Venous stasis and venous eczema
Venous stasis skin changes refers to darkening around the skin. It is associated with itching often, due to inflammation of the skin. It indicates long standing venous disease, called chronic venous insufficiency. Progression can lead to ulceration.
Venous leg ulcers can also be prevented by early intervention with non-invasive procedures. If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

Complications of Untreated Varicose Veins2021-06-14T20:00:18-07:00

How Laser Vein Ablation Works to Treat Varicose Veins

2021-06-07T13:47:35-07:00

The VenaCure EVLT procedure is minimally-invasive and can be performed in a doctor’s office. It addresses both the cosmetic and medical issues associated with varicose veins.

A laser light emitted through a thin fiber inserted into the damaged vein delivers just a small amount of energy, causing the malfunctioning vein to close and seal shut.
Veins that are treatable with the VenaCure EVLT system are superficial veins. Laser therapy with the VenaCure EVLT system is indicated for varicose veins and varicosities with superficial reflux of the Greater Saphenous Vein, and in the treatment of incompetent refluxing veins in the superficial venous system in the lower limb.
After the VenaCure EVLT procedure, your body will naturally route blood flow to other veins.
Bulging and pain in the damaged and now-sealed vein will subside after the procedure.
Because VenaCure EVLT vein treatment eliminates varicose veins where they start, the results can be obvious right away.

Before undergoing any treatment, it is important to discuss with your physician the risks, benefits and alternatives to the procedure.
Complications with vein treatments are rare, but you should be aware of Potential Complications:

Potential complications include, but are not limited to the following: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, skin pigmentation alteration, neovascularization, paresthesia due to thermal damage of adjacent sensory nerves, anesthetic tumescence, non-target irradiation, hemorrhage, necrosis, DEHP exposure, skin burns and pain.

To read more about the VenaCure EVLT procedure that we perform at La Jolla Vein Care, click here. To schedule a consultation or telemedicine visit with one of our physicians to further discuss laser treatment and alternatives to laser, call us at 858-550-0330.

How Laser Vein Ablation Works to Treat Varicose Veins2021-06-07T13:47:35-07:00

1, 5, 2021

How Ultrasound Can Detect Hidden Dangers in Leg Veins

2021-05-01T01:06:15-07:00

The Duplex Ultrasound examination allows us to visualize the blood vessels that are not visible to the naked eye, even blood vessels that are deep within the muscles. Ultrasound looks at deep and superficial veins in the legs to check for venous-valvular incompetence (the underlying condition that causes varicose veins). The ultrasound examination is used to both identify the veins that have faulty valves and to map the anatomy of the veins, creating a ‘road map.’ This is necessary to make an accurate assessment of the cause and extent of the varicose veins, as well as to formulate the best treatment plan. This should be done for any individual being evaluated for varicose veins, leg swelling, skin changes, patients who have failed prior treatment, patients who are symptomatic and in some patients with certain anatomic patterns of spider veins.

Before your test:

This study does not require any preparation. You should not wear your compression stockings the same day as the examination. Make sure to be hydrated.

How Ultrasound Can Detect Hidden Dangers in Leg Veins2021-05-01T01:06:15-07:00

28, 4, 2021

Vein Care’s Dr. Foghi Interviewed in San Diego Voyager

2021-04-28T00:28:48-07:00

We would like to share with you our very own Dr. Armin Foghi’s interview in San Diego Voyager Magazine. Dr. Foghi discusses his career path, obstacles and what makes him happy. This read gives you a personal take on one of San Diego’s best vein specialists- dedicated to the diagnosis and treatment of vein disorders.
You can find the link to the interview here

Vein Care’s Dr. Foghi Interviewed in San Diego Voyager2021-04-28T00:28:48-07:00

Medi-Cal Coverage for Varicose Veins and Leg Ulcers in San Diego

2021-04-25T00:47:37-07:00

Medi-Cal Coverage for Varicose Veins and Leg Ulcers in San Diego
La Jolla Vein Care is pleased to announce that we’ve recently enrolled with Medi-Cal. This means that more people in San Diego and Southern California have access to world-class vein treatments. Most patients with Medi-Cal can now be seen by our award-winning vein experts, have a diagnostic ultrasound and help with:
-painful varicose veins, that interfere with work and lifestyle
-leg ulcers that do not heal
-leg swelling
-lymphedema
-phlebitis
-leg pain
-superficial thrombophlebitis
-blood clots

Does Medi-Cal pay for varicose vein treatment? Does Medi-Cal pay for leg vein treatments?
There are different types of Medi-Cal health coverage.
If you have Medi-Cal and would like to make an appointment, we recommend to call or text our office. We can take your insurance information and verify if the visit would be covered with your specific plan. Call us at 858-550-0330 or text us at 858-283-4099. You can also find more information about Medi-Cal insurance here.

Medi-Cal Coverage for Varicose Veins and Leg Ulcers in San Diego2021-04-25T00:47:37-07:00

Proudly Serving Veterans and Active Military for Vein Care Needs

2021-11-03T23:25:26-07:00

Many veterans experience some form of venous disease in their live including leg pain, night cramps, Leg fatigue, Leg swelling, Skin discoloration, leg ulcers, and varicose veins. La Jolla Vein Care is proud to be partnered with Veterans Affairs to offer its vein treatment services to current and past members of the military and their families. A person may be eligible for CHAMPVA when they are no longer eligible for Tricare. Family members may also qualify. Read eligibility criteria here. La Jolla Vein Care offers a full range of diagnostic, minimally invasive and conservative options for venous disorders. Serving veterans is dear to our heart, as Medical Director, Dr. Nisha Bunke treated vein patients at La Jolla’s VA Health Care System for years. Most of our staff have spouses, parents or relatives to have served our country. We are proud to give back and serve San Diego’s Veterans.

Proudly Serving Veterans and Active Military for Vein Care Needs: When your VA facility cannot provide specialized medical services, including vascular care, in a timely manner, the Veterans Choice Program (VCP) allows U.S. veterans the opportunity to seek medical treatment outside of their regular VA clinic. La Jolla Vein Care gladly accepts Veterans Choice insurance as part of this program. We also are partnered with Tricare for active military.
Read more about insurance types accepted.

Many veterans experience some form of venous disease in their lives. Some common symptoms of vascular disease are:
Pain, cramping or discomfort in the legs including night cramps
Leg fatigue, that prevents long periods of standing
Need for leg elevation
Leg swelling
Skin discoloration around the ankles
Varicose Veins

Read more about our services: what is vein disease?
How is it diagnosed?
What are the treatments?

Call to schedule an appointment: 858-550-0330

Proudly Serving Veterans and Active Military for Vein Care Needs2021-11-03T23:25:26-07:00

COVID Vaccine Concerns and Blood Clots

2021-11-05T11:31:24-07:00

Johnson & Johnson Vaccine Blood Clot Concerns: What is a Deep Vein Thrombosis (DVT)?

Blood clots associated with the Johnson & Johnson vaccine have caused pause and concern. As a result, the United States is recommending a pause on administering the single-dose Johnson & Johnson coronavirus (COVID-19) vaccine after reports of six women experiencing blood clots within three weeks after their inoculation, according to the CDC. Specifically, six women between the ages of 18 and 48 developed unusual blood clots in combination with low platelets, 6 to 13 days after vaccination.  There have been no reports of blood clots related to the Johnson & Johnson vaccine in San Diego County (out of nearly 60,000 doses given). It is unclear if the rare blood clotting disorder is related to the vaccine administration or not, as 7 million people have received the vaccine.

A deep vein thrombosis (DVT) is a blood clot in one of the veins in the deep venous system. There are 2 types of veins in the legs, deep and superficial. Deep veins are deep within the muscle and are responsible for 90% of the blood return from the legs to the lungs and heart. These veins are necessary for life. Superficial veins are in the subcutaneous tissue and lie outside of the muscle, closer to the skin. Blood clots located in a deep vein, most commonly occur in a leg or arm.

Johnson and Johnson Vaccine and Deep Venous Thrombosis (DVT) blood clots

Johnson and Johnson Vaccine and Deep Venous Thrombosis. Deep venous thrombosis is when a blood clot forms within the leg veins

Blood clots occur when the blood thickens and sticks together. A blood clot in the deep veins can break off and travel up through the bloodstream, becoming an embolism. The most serious and immediate concern is a pulmonary embolism (PE), which is when the blood clot travels to an artery in the lungs and blocks blood flow.  This can cause damage to the lungs or other organs and can cause death. A blood clot in the thigh is more likely to break off than a clot in the lower legs. DVT and PE are also known as VTE (venous thromboembolism). In general, VTE affects as many as 900,000 Americans each year.

What are the signs and symptoms of a blood clot?

Many people with DVT have no symptoms at all. Symptoms depend on the size of the clot and the veins affected. But here are the most common symptoms that occur from a DVT in the legs:

  • Swelling (typically in the leg. Blood clots in the arm can cause arm swelling)
  • Leg Pain (especially with walking)
  • Tenderness
  • Redness of the skin
  • PE Symptoms
  • Difficulty breathing
  • Faster than a normal or irregular heartbeat
  • Chest pain or discomfort, which usually worsens with a deep breath or coughing
  • Coughing up blood
  • Very low blood pressure, lightheadedness, or fainting
Johnson & Johnson Vaccine Blood Clot Concerns. A Deep Vein Thrombosis (DVT) blood clot in the leg

Johnson & Johnson Vaccine Blood Clot Concerns. A Deep Vein Thrombosis (DVT) blood clot in the leg can cause pain and swelling.

How is a deep vein thrombosis (DVT) diagnosed? A DVT is diagnosed by a venous ultrasound of the leg. A physician will decide if a blood thinner is needed for the treatment of the blood clot based on a variety of factors. If a blood clot is suspected, an ultrasound is necessary immediately and a physician should be notified. Read more about venous ultrasound imaging at La Jolla Vein Care to detect blood clots. 

 

COVID Vaccine Concerns and Blood Clots2021-11-05T11:31:24-07:00

Dr. Bunke interviewed by Modeliste Magazine!

2021-04-11T23:28:39-07:00

 

Tell us about La Jolla Vein Care and what makes it so unique and such a leader in vein treatments.

La Jolla Vein Care is unique because we exclusively specialize in vein disorders. This means we are able to perform all ultrasound diagnostics in-office and offer all treatment options for vein conditions vs.a one-size-fits-all approach based on more limited treatment availability. Since we are skilled in all modern treatment modalities, we can truly customize a treatment plan to the unique needs of the patient. Our leading edge treatments are able to treat most vein conditions, including large varicose veins without surgery, using endovenous techniques.

Read the full interview on our media page
To see the full magazine online

Dr. Bunke interviewed by Modeliste Magazine!2021-04-11T23:28:39-07:00
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