Typically your first appointment will be as follows:
- You will be asked to fill in the registration form which will include your details, some questions about your veins complaint to help assess the severity of your disease. It will also include questions about relevant medical conditions that may need to be considered when planning your treatment.
- Dr Nicola will have a brief history from you and going through the registration form as well as the referral from your Practitioner to ascertain the extent of the condition.
- Your veins will be examined by Dr Nicola who will also conduct any relevant examination to determine the extent of the disease and the suitability of the various treatment options available.
- As a part of the initial examination, Dr Nicola will examine your veins using a Doppler Ultrasound to gain more detailed information about the distribution of the incompetent veins that need treatment.
- Dr Nicola will then sit down with you to explain his findings, go through the possible options to manage the condition highlighting the pros and cons of each. In most instances, he will be also able then to structure a treatment plan including the exact number and frequency of treatment and review sessions. You will be also presented with a detailed costing plan together with any expected Medicare rebate you might be entitled to if applicable.
- You will be given ample time to ask any questions you might have and Dr Nicola will endeavour to answer them all. You will be also given written information summarising the condition, the available treatment modes and the relevant potential side effects as well as the costs of your treatment. You are always encouraged to review these documents and can return back to discuss any questions that may arise from you reading them as many times as you need before that start of your treatment.
Following the first appointment, most likely you will be booked to have a detailed venous examination at the clinic called venous map which will act as a road map to follow when conducting the treatment agreed on.
What to bring?
Generally speaking, in your first appointment you are required to bring:
- Referral letter from your referring doctor (unless this has been forwarded directly to us by your doctor)
- Current Medicare card, veteran’s affairs card and any concession card if applicable.
- Any previous relevant investigations you may have had in the past such as ultrasound examinations, Xrays, CT scans etc…
What is varicose vein disease?
Normal veins have valves (partitioning like protrusions within the wall of the vein) at certain intervals. Their function is to prevent the blood from falling backwards through the effect of gravity when we stand up. Varicose veins happen when the diameter of a vein increases. This leads to malfunction of the valves resulting in the blood falling backwards in the opposite direction. This leads to a further size increase in the vein wall which then accommodates more blood. The affected vein eventually becomes tortuous. This is called incompetent vein. The incompetent segment increases in length and affects other connected veins leading to the spread of the disease.
What causes varicose veins?
The most common causes for veins to become incompetent are; inherited (genetic) weakness of the vein wall and prolonged standing, such as in certain employment situations. Advancing age, obesity, the use of oral contraceptive pills, hormone replacement therapy (HRT) and pregnancy are other risk factors in the development of incompetent veins.
What are the most common symptoms varicose veins?
Apart from the unsightly appearance of bulging lumpy veins in the legs, there are symptoms such as pain, aching, heaviness and cramping. Sometimes, the presentation is for swelling of the ankles and legs, stinging, burning, itchiness or restless legs. Advanced vein disease can cause a permanent red rash of the lower legs associated with thickening and tightening of the skin (a condition called lipodermatosclerosis – LDS). Ultimately the skin breaks, causing an ulcer which can persist for a long time, with the ongoing risk of secondary infection until the underlying incompetent vein is treated to induce healing of the ulcer.
What can happen if I don’t do anything about varicose veins?
Progression of the varicose vein disease happens slowly but surely. Worrying complications include; clotting in the superficial system (also called superficial thrombophlebitis – STP) and clotting within the deep system (deep venous thrombosis – DVT) – a potentially life threatening condition which if not treated may lead to clots spreading to the lungs (called pulmonary embolism – PE).
Is there any downtime after the treatment?
No. All the procedures performed at the Bondi Vein Clinic are performed with no downtime. No time off from work or normal activities is needed.
Is the treatment painful?
Pain perception is variable among people. Generally speaking, you can feel a sting as the medicine is injected and sets off the intended reaction within the vein lining to produce the desired results. This lasts only for a few seconds. In Endovenous Laser Ablation EVLA the administration of anaesthetic solution around the vein means minimal discomfort is felt.
Why do I have to wear stockings after the treatment?
You will be fitted with a medical stocking immediately after the treatment to wear during the day. The number of days you will be required to use the stocking for is dependent on the type of procedure and Dr Nicola will advise you about that prior to the treatment. The use of medical grade class II compression stockings following the treatment has been shown to help to effectively close the treated varicose veins, prevent deep venous thrombosis, reduce any discomfort following the treatment and help improve the venous and lymphatic blood flow.
How much does the treatment cost?
Management and treatment modalities offered by the Bondi Vein Clinic are charged at set fees. After your assessment, Dr Nicola will give you a written quote for your treatment. This will stipulate the total cost, the number of visits, the amount you’ll be able to claim from Medicare (if applicable) and the likely out of pocket costs.
Does Medicare cover these treatments?
Yes. In general, Medicare can provide rebate towards the cost of consolations, evaluation and treatment of the varicose veins for medical purposes. However, purely cosmetic treatments for only unsightly spider veins are not rebatable under Medicare. The staff at the Bondi Vein Clinic will be able to advise you of your anticipated Medicare rebate (if applicable) and out of pocket cost.
Can I claim the treatment on my private health insurance?
As the treatments in the Bondi Vein Clinic are provided as office-based, they are not claimable under the private health insurance. However, the cost of medical stockings used as part of the treatment may be claimable under the private health insurance.