Tuesday, November 17, 2009


Endovenous Laser Treatment of the Saphenous Vein (EVLT).

My new worst enemy. I can admit that I feel completely deceived. Completely blindsided. Maybe it's just a momentary/minute amount of pain and suffering to be endured for the long haul. Maybe not.

See, the reality, the varicose veins of mine, weren't painful. Ugly, yes. Painful, no.

I could have never imagined the procedure or the aftermath of the brief procedure. My first recommendation for anyone considering treatment DO NOT SCHEDULE DURING THE SUMMER (and fortunately for me, I didn't - mere coincidence). Second suggestion, DO NOT PLAN ANYTHING FOR SEVERAL DAYS TO A WEEK AFTERWARD (unless of course you have like to walk around with a tight ace bandage on your leg and sport a stocking for the week after - again fortunately I'm Ok with nothing in the schedule and that I can wear pants!).

The procedure was very quick. As described in my written material, "Endovenous laser treatment is a minimally invasive option for treating the saphenous vein reflux (leaky valves). The first stage of your procedure will involve numbing the skin and then inserting a thin catheter (plastic tube fed up your diseased saphenous vein, (the superficial vein along the inside of your calf and/or thigh)."...More numbing..."The laser catheter is then slowly pulled back while delivering energy to the vein wall, causing it to heat, collapse and seal shut."

Long story short, the numbing process took the longest of the procedure, with the actual laser treatment lasting about 90 seconds. From the time I checked in at the desk to walking out, it was less than 25 minutes. I'm not a fan of needles, so I was fortunate that I couldn't see the IV, which the doctor claimed would be the most painful part. He lied.

Then when numbing the upper thigh, he informed me that I would feel a slight series of pokes. He lied again. I thought of RUR and his smile and pushed hard on my rib cage with each extreme jab that repetitively went into the thigh down to the knee. Poke my...! Maybe it was more painful for me due to the muscles in my thigh. Who knows, but it hurt.

Then there was the use of the laser. He warned that I may smell or taste something. MAY? He lied, yet again.

Smell or taste was the clearly under exaggerated! He did joke that it would only last a few weeks, which it did subside shortly after the laser treatment was complete. The smell...burning rubber.

The taste? I have never in my life smoked a cigarette. When I was young, I wanted to. I would sit in my mom's car when she ran into the store and push in the push lighter. I would burn her cigarettes that were in the ashtray. I would hold them in my hands. I would lift the partial cigarettes toward my lips, never coming closer than my chin. I couldn't do it. I wouldn't do it. I don't know why. Now, I despise the smell of cigarettes. I can't stand the smell of smoke lingering in my hair and my clothes and my being from going out on the town. I hate that I wreak of an ashtray after home calls of smokers. I'm glad that I've never tried a cigarette. So the taste you ask? Cigarette ashes.

I can't tell you how or why I know this. For those brief minutes of reality, which seemed like thousands of seconds of hell, in the back of my throat, I tasted cigarette ash. I felt like I was licking the ashes from an ashtray. It was disgusting and appalling and anything but surreal.

After the doctor was done, I was informed that I have to wear the ace bandage for five days. If it happens to fall off (maybe with some assistance of my own) in three or four days, that's OK. Then I have to wear my "chap stocking" for a week to prevent blood clots. Ibuprofen was recommended (400-600mg) for pain, especially since day 2-3 can be the most severe.

I used to think that I had a high pain tolerance. I was wrong. I've been popping ibuprofen like candy every 5-6 hours at 1000mg each. My upper thigh is beyond swollen and I feel like I'm a 500# sumo wrestler. The pain is more intense than the feeling of a "slight muscle pull" that I might feel.

If nothing else, I want the truth. I can handle it. But what I hate the most, deceit. Tell me that if I want to be varicose vein free it will hurt like hell for up to two weeks. Tell me that I'll taste cigarette ash for longer than I ever want to admit. Tell me that I can't workout for a week and showering will be a challenge. Tell me that I'll be in discomfort and that while I can work, I won't want to. Tell me that my inner thigh will feel worse than bad razor burn and a pulled muscle combined. Tell me that vanity may be painful. Then and only then would I expect the worse and understand what I'm walking into. Don't sugarcoat the truth.

Would I do this again? My answer today, NO.


Anonymous said...


Anonymous said...

Keep on you check ups. I had the EVLT done on both legs. A couple of years later the veins on both legs reopened. Now I have new bigger veins in my thighs and permanent bruising. This is more than just a cosmetic procedure. Hopefully the discomfort of your procedure is well worth it in the long run.

Anonymous said...

Thanks for writing about this. I've heard about 90% of good things about this procedure, and have to admit that these are the first few bad responses I've heard about. Good to know though. I didn't know about the possibility of the vein re-opening, and being even LARGER. Do you have to go back and have the procedure redone? That's just so much money.

I'm 32 and about to have this done, but am reading all I can about it. I have a few blue veins, and my legs feel sore when I sit, but I was told it will only get worse with time. My fear is the future. I thought having it done before kids would be good, since child-bearing brings it on hard core.


Ms. Independent said...

I was 35. I still can't say that I will jump on board to do it again. The veins are not visibly any different and would need touch up if I wanted to clear up the spiders.

For me it was just a matter of not being truly informed. However, what I was told was that if I planned on having more children, TO WAIT - as it can bring it on hard core, but it could make treatment more futile and likely need to be done again. Personally, once was more than enough!

Best of luck!

Anonymous said...

You are spot on !! I just finished up the fifth of what I was told six treatments..(now I find out eight) and you are right on the mark with your comments.. I told my sister I know what licking an ashtray would taste like. The pain is very annoying and I wish they told me it lasts for weeks. My lower left leg is numb in parts which I hope goes away...

Anonymous said...

I'm as cynical as all of you since having my treatment 3 weeks ago - I had bulging veins in my right calf and quite thick spider veins behind my left knee. I had EVLT on my right leg and foam sclerotherapy on my left. I was left limping for a few days after the EVLT, which, might I add, was a MILLION times more painful and just gross than the leaflets suggested. The feeling of tightness they describe that might appear on the 5th day lasted for 2 and a half weeks and really hurt - I haven't felt able to exercise since.

My varicose veins as yet still look the same, except they don't bulge as much. There's no sign of them fading away on their own, and I've noticed a long vein not far under the skin down the front of my thigh that wasn't there before and I'm worried that it's going to turn into a varicose vein as the veins left over struggle to cope with the sudden burden of carrying blood that the old vein used to carry. Also, the vein on the other leg I had the foam sclerotherapy injection on actually looks worse before it gets better - which I've read happens as the vein gets tough and gets reabsorbed, but it just looks like other veins in the leg are looking more prominent, like the sclerotherapy has somehow irritated other veins which are now starting to appear and branch out. Anyone else had a similar experience? I'm a bit worried about veins reopening or growing back in other places...

Anonymous said...

I am a 44 yr old female. I had EVLT of the saphenous vein and ambulatory phlebectomy (removal of varicose veins. I went in for a consult on 6/1 and got booked for 6/17. I was told I would be fine for our beach vacation on 6/26. They had a scheduling issue so I needed to push it up to 6/9. Thank goodness! My leg has about 20 little scabs from the vein removal, and where I had the EVLT I just had the stitches removed and a huge about 5 x 7 bruise - that is fading but still there. But starting yesterday it really started to hurt in my inner thigh. I don't want to take the prescription stuff - I have 2 kids and it makes me goofy. Ibuprofin and Tylenol don't seem to do help much though. I sure hope this pain goes away soon. It hurts with every step I take. I also agree that the procedure was more painful and unpleasant than I was told. Plus, he said my anatomy was wierd and he had trouble finding my saphenous vein (he's been doing this 30 years, so he is definately experienced). Not sure how much poking and needling he did to me looking for it. Anyway - I agree w/ Ms. Independent NOT to do it in the summer, and don't do it if you have a vacation or event coming up anytime soon. I hope and pray that in the end my leg will look better/normal...but for now it looks worse than it did with the veins. Had I known it would look and feel this bad, I would have waited until the fall to do this. We are having a huge swim party next month - I just hope the brusing, scabs, incisions, etc. are all gone by then, but most of all I hope the pain is gone!!!

Anonymous said...

I just had this done...and I also am experiencing a lot of pain...i just had it done from under my knee to my ankle....the big varicose vein still shows. I am having pain too...it hurts something awful. I wonder if this is something the doctors all want to experiment with and we're all their victims in a way. I hope this is safe long-term. Mine took an hour, it hurt like hell I was in tears although they didn't know that since I was face down. I wonder too about the newer veins I already see forming. SIgh.

Anonymous said...

My dr. said "think of this procedure as being like a trip to the dentist." Yeah...maybe if you're talking about getting your wisdom teeth ripped out. I was NOT prepared for the pain of the 20+ injections to get my numb. My dr. made me feel like I shouldn't be hurting. I have had four children, so I think my pain tolerance is pretty high. This procedure hurt like heck! I'm on the second week post-procedure and my leg is green and black and blue. I have scabs all over, plus a nice hole where one refuses to scab properly. I walk with a limp b/c it hurts so much. I start working in two weeks. I can only hope it will be much better by then. I will not be doing this procedure on the other leg!!

Anonymous said...

I had this treatment back in march as i read that it was less invasive, you can return to work rhe next day, minimal scarring and virtually painless. Well none of the above were true! I had vein stripping a few years ago and that was far less painful than this! I had to have 2 weeks off work, i now have very visible scarring and my veins are still very visible with a few extra ones.
A complete waste of time!

Benenden Hospital said...

Its great that you've highlighted some of the myth's and facts about Varicose Veins. These kinds of articles provide fantastic initial ideas surrounding an often overlooked condition, and can lead to an initial almost self diagnosis that, if nothing else, may prompt the individual to seek further professional medical advice.

Great stuff.

Candy shop said...

I just had EVLA, which is the same as EVLT. The actual procedure was very painful and I clinched my fists and passed out after a few minutes of moaning in a pool of sweat and crying in pain. I've delivered 5 babies, two of them at home and this pain was almost as bad as a childbirth. I even took a Valium beforehand to calm my nerves. Then you taste and smell smoke as they are burning your veins. It feels like they are pouring warm water on your legs as the needle comes out but that's actually your blood being spilt. I probably lost 1/2 pint, which is far less than the 2.5 gallons I lost in my last labor and delivery!

For recovery, I'm taking very high doses of oral arnica 1M then I will switch to Arnica 200c in a few days. The arnica helps tremendously with the bruising. I dont have that much bruising on day 3, even though my doctor said i had a very large varicose vein with 2 branches that were almost to ulcer. I was injected about 30 times and a couple WAY up in my groin that hit nerves and made me jump on the operating table.

The arnica lotion is much lower in dose than the oral Arnica so I'm not using the lotion. I'm also taking ibuprofen 400mg with breakfast, lunch and dinner. It is supposed to help with the inflammation. I took ibuprophen with a back injury and it actually helped reduce the swelling. Surprising how it does that.

I'm also walking 20 minutes twice a day. It hurts so much to walk and move and I'm limping around like an old woman. But I'm doing it anyways. I just take a few extra ibuprophen before I walk. I hear it is supposed to help with recovery and prevent blood clots. My first 20 minute walk was two houses away and back. I was that slow walking!

PonderPatter said...

reading these comments I feel a lot better. It is one week today since my procedure. I had EVLT. I must say the procedure itself was pain free because of light sedation I was given. However, I didn't expect the level of pain I experienced and am continuing to experience on day 7. Lots of bruising ranging from light mustard to dark eggplant, which I can deal with, but extreme pain on inner thigh both inky muscles and topically (as others have said like razor burn) is really bringing me down. My doctor said my reaction is unusual and most feel onlly minor discomfort . Funny because I'm in excellent health and exercise routinely. Inhope to be able to return soon to biking, tennis and dancing. Anynadvice? I take advice about 4 x a day and use hot compresses. Walking is painful but I force myself

Anonymous said...

OMG! Its two weeks today from the first of the eight veins I had EVLT and sclero done! I am so exhausted! I am still very uncomfortable. I am told that all bruising and discoloration willl be gone by vacation 12/13! We will see! I went in for cosmetic sclero and US showed reflux and so on... I wish I was informed. I wish I would of seen this blog! All other info was positive, minimal pain etc. Any questions? I will be honest... I will check frequent. :) I will survive!!!

Anonymous said...

I'm 6 days post EVLT. I had to do it as on bad days, I could barely walk due to the pain and heaviness of my leg. The procedure was easy and quick. They gave me Xanax so I was a little out of it. The first few days I felt very sore. Yesterday I walked for 15 minutes on the treadmill at the gym, and today.. OH MY today the pain is ten times worse. I'm taking 3 motrin, then tylenol a few hours later, then 3 motrin to take the edge off. I really hope this gets better and is successful. I am too young to be hobbling around like an old lady.

Anonymous said...

I had mine done last Thursday and today is Monday. I can honestly say I have felt no pain or discomfort post surgery. Yes, I am bruised from mid-calf to mid-thigh but on a pain level from 1 tp 10 I would say i am at 1.

I came home from the surgery in a huge bandage but had that removed the following day and I wore support stockings for two days after that.

As far as I can tell my bulging veins have disappeared although I will reserve judgement on the outcome until all signs of brusing has gone.

Research your surgeon well. Mine was recommended through a friend and I would definately recommend him again.

Anonymous said...

I have recently had EVLT.My first leg last month, no complications and relatively pain-free. Second one last week, similar experience however after 1 week half of my foot became numb. This is worrying me. Anyone out there had the same? Did the feeling come back completely?

PS I found that wearing good support stockings helped with the recovery.

Anonymous said...

Well, I am day 6 post EVLT. I needed to have it done because I had a clot in one of my veins . Cosmetically, my legs don't look that bad. My saphenous vein was totally shot, valves werenot working. I work in an office that does the EVLT. Procedure. I am so glad that I read all the comments because I thought I was being a big baby. Last night was horrible. I don't know what I did because I was in pain. The Advil is killing my stomach so I tried not to take it but had to in order to sleep. The end of a work day takes it's toll. I do think that they down play the post treatment issues. My follow up is tomorrow and I will voice my post op opinion. If I have the leg done, I will plan better, shorter work days.

Anonymous said...

I had EVLT in both legs and it has been 8 weeks. My knee is swollen, it's difficult to walk, and at night I feel like someone is pulling my hamstrings as hard as they can. I had very little pain at first. The misery is 7-8weeks later. My dr. acted like this would be a walk in the park. I beg to differ.