Dr Dale Maharaj
MBBS FRCS FICS FICA CWS FACS
Specialist General & Vascular Surgeon
Board Certified Wound Specialist

Mr. Joseph, 45, came to the Clinic complaining about heaviness in his lower limbs. After a long day at his office, his legs throbbed and he would only find relief when he lay down, or elevated them at night. He was worried because his sister had developed a clot in her leg that travelled to her lung, nearly resulting in death. His mother had a “life ulcer,” which he described as a sore in her ankle for 20 years.

His is the story of a young male who has developed varicose veins or chronic venous insufficiency. Generally, males are less affected than females—20 per cent vs 30 per cent of the adult population. Normally, the veins in your legs, which are meant to carry blood upward, have one-way valves that prevent the backflow of blood due to gravity. In people with Chronic Venous Insufficiency (CVI) the veins are inflamed, with weak valves that allow blood to flow downwards, causing “snake-like” cords, with pooling in the feet and ankles. It is a common misconception that all patients with CVI have bulging veins. This is not necessarily the case, as we see with our patient.

As the lead surgeon at Caribbean Vascular and Vein Clinic (CVVCL) in St. Clair, I can confirm that this common condition is a true medical issue; not just a trivial, cosmetic one. If left untreated, venous disease can progress to more severe medical problems. Heaviness in the legs, Achiness, Swelling, Throbbing, and Itching, referred to as HASTI, are the more common symptoms. As the disease advances, the ankles become darker, developing a leathery texture. This usually heralds the formation of ulcers which can be difficult to treat. Another devastating complication of CVI is Deep Venous Thrombosis (DVT), or clots in the legs. These clots can travel from the leg to the lung, leading to Pulmonary Embolism (PE) and sudden death. During this COVID-19 pandemic we have seen the incidence of DVTs more than triple, not because of the virus itself, and definitely not due to vaccination, but because of the necessary lockdown, leading to weight gain and sedentarism.