Anatomy of Veins in the Lower Extremities | Minnesota

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This blog talks about the anatomy of veins in the legs, the purpose of blog is to educate the patients with varicose veins in the Minneapolis and St. Paul areas.

All of the veins in the body are either part of the superficial venous system or the deep venous system. The superficial veins serve as a conduit to pass blood centrally and eventually into the deep venous system. The principal named superficial veins of the lower extremity are the small saphenous vein (SSV), which usually runs from ankle to knee, and the great saphenous vein (GSV), which usually runs from ankle to groin.

Many superficial collecting veins deliver their blood into the great and small saphenous veins, which deliver most of their blood into the deep system. Superficial veins are also connected to a variable number of perforating veins that pass through openings in the deep fascia to join directly with the deep veins of the calf or thigh.

All venous blood is eventually received by the deep venous system on its way back to the right atrium of the heart. The principal deep venous trunk of the leg is called the popliteal vein from below the knee until it passes upward into the distal thigh, where it is called the femoral vein (FV) for the remainder of its course in the thigh. They are one and the same, and this is the largest and longest deep vein of the lower extremity.

It has been known in Minnesota that varicose veins in the legs are caused by weakening of the veins and valves in the great saphenous veins and/or small saphenous veins. When the valves in these veins do not properly keep blood flowing from the legs up to the heart, blood begins to collect in the legs resulting in the buildup of pressure. The veins become enlarged and knotted and are visible near the surface of the skin.

History of Eugenics Movement with Vasectomy in Minnesota

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Minnesota was one of 32 states that had bills permitting sterilization of insane and feeble minded individuals. The following information on eugenics movement in Minnesota is from the library in Minnesota Historical Society.

In the early 1920s, Charles Fremont Dight, a physician in Minneapolis, launched a crusade to bring the eugenics movement to Minnesota. He combined the moral philosophy of eugenics with socialism and espoused the idea that the state should administer reproduction of mentally handicapped individuals. His main lines of approach included eugenics education, changes in marriage laws, and the segregation and sterilization of what he called “defective” individuals.

Dight organized the Minnesota Eugenics Society in 1923 and began campaigning for a sterilization law. In 1925 the Minnesota legislature passed a law allowing the sterilization of the “feeble–minded” and insane who were resident in the state’s institutions. For the next several legislative sessions Dight fought unsuccessfully for expansion of the law to include sterilization of the “unfit” who lived outside of institutions.

Dight continued his legislative efforts as late as 1935. He spoke and wrote on the subject of eugenics, including over 300 letters to Minneapolis daily newspapers, a 1935 pamphlet on the History and Early Stages of the Organized Eugenics Movement for Human Betterment in Minnesota, and a 1936 book entitled Call for a New Social Order. In 1933 he sent a letter to Adolph Hitler and included with it one of his letters to the editor in which he commended Hitler’s work in Germany.

The Minnesota Eugenics Society became moribund by the early 1930s. Dight died on June 20, 1938, in Minneapolis. He left his estate to the University of Minnesota to found what became the Dight Institute for the promotion of Human Genetics.

History of Eugenics Movement with Vasectomy in America | Minnesota

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Was there a eugenics movement in America? If you haven’t heard of eugenics it is the study or belief in the possibility of improving qualities of the human species or human population by discouraging reproduction by persons having genetic defects or presumed to have inheritable undesired traits (negative eugenics) or encouraging reproduction by persons presumed to have inheritable desirable traits (positive eugenics) Does this sound familiar?

Eugenics was a movement to improve the human species by controlling hereditary factors in mating. The eugenics movement began in the late 1800s in Britain. Francis Galton, an English scientist, coined the term in 1883 and founded the Eugenics Society of Great Britain in 1908. The American Eugenics Society was organized in 1926.

The origin of Eugenics in America started with Albert Ochsner, professor of surgery at the University of Illinois. In 1899 he published, Surgical Treatment of Habitual Criminals. His list of advantages of dealing with criminals using vasectomy was:

1. It would dispense with hereditary criminals from the father’s side.
2. Aside from being sterile the criminal is his normal self.
3. It would protect the community at large while not harming the criminal
4. The same treatment could reasonably be suggested for chronic inebriates, imbeciles, perverts and paupers.

Eugenics was accepted and procedures were carried out without any legal authority in the United Stated. The first state to introduce a compulsory sterilization bill was Michigan in 1897, and Indiana became the first state to enact sterilization legislation in 1907. In time 32 states had eugenics programs permitting sterilization of insane and feeble minded individuals and 12 states included sterilization of criminals. While California had the highest number of sterilizations, North Carolina’s eugenics program was the most aggressive of the those states. Over 60000 men were sterilized with vasectomy in the United States from 1909-1924. By the 1960’s, the eugenic sterilizations slowed to a trickle and eventually stopped as many state statues were overturned due to legal challenges.

Varicose Vein Symptoms|Minnesota

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Varicose veins are relatively easy to identify and can be a cosmetic nuisance for many people in Minnesota. The common symptoms list in the following

• No symptoms in some people with mainly a cosmetic problem.
• Protrude or bulge from under the skin and feel ropey
• Leg aching and heaviness in the standing
• Leg cramping at night
• Leg skin itching with discoloration
• Leg skin firmness
• Blood clots without the inflammation
• Tenderness with local swelling
• Leg ulceration and infection
• Developing painful superficial thrombophlebitis, which is a blood clot along with inflammation of a superficial segment of vein.
• Worse in the afternoon or long standing
• Worse during menstruation or pregnancy

Superficial thrombophlebitis is not to be confused with a deep vein thrombosis, which is a blood clot in a deep vein. Deep vein thrombosis (DVT) is more serious because of the clot’s potential to travel toward the heart and lodge in the lung (pulmonary embolism). This condition requires emergent admission to the hospital for treatment with blood thinning medications.

Some symptoms of varicose veins can be relieved or prevented by wearing the compression stocking every day. If you are clinically diagnosed to have the varicose veins, the next step is to have the duplex ultrasound exam do a complete vein evaluation. The definitive treatment of varicose veins in Minneapolis and St Paul includes endovenous laser ablation (EVLA), sclerotherapy, and phlebectomy.

Recovery from No Scalpel Vasectomy | Minnesota

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The recovery from no scalpel vasectomy can be uneventful if the patient reads and fully understands the post procedure instructions. You are encouraged to ask for clarification if you have any questions on the post vasectomy care. You are usually allowed to drive yourself home after surgery if you don’t need to take any sedatives, but you have to arrange for transportation if you will be sedated. The trauma from no scalpel vasectomy is so small that patients rarely need any sedation.

The post-operative discomfort is quite mild after a no scalpel vasectomy. Local anesthesia given during the surgery will begin to wear off about an hour after the procedure. You may take Tylenol or Ibuprofen for pain control, but narcotics are rarely needed. Many patients who had no scalpel vasectomy in my clinic don’t take any pain medications. Pain and swelling can be minimized by elevating your legs, staying off your feet and applying ice packs to the scrotal area after surgery.

Antibiotic ointment, gauze and an athletic supporter will be placed over the wound immediately following the vasectomy procedure. Continue to apply the antibiotic ointment daily until the skin puncture site is completely healed. The athletic supporter should be worn for at least 2 days.

Once you return home after the vasectomy surgery, relax and rest. It is not practical to apply ice pack in the first day because you have high stack of gauze under the athletic supporter. You may apply the ice packs intermittently for the first 48 hours to reduce swelling in the scrotum after the gauze is removed. Overall, Applying ice packs are no longer critical for no-scalpel vasectomy since the trauma is so minimal.

Patients in the Minneapolis and St. Paul areas often notice scrotal swelling in the first week following the surgery. The swelling often increases with activity, and may be relieved by wearing the athletic supporter and resting.

You may shower and spend more time walking on the second day. Soaking in a warm bath is allowed once the incision has scabbed and can be soothed and beneficial to healing. Heavy lifting or vigorous physical activity should be avoided for 1 to 2 weeks.

A small amount of bleeding is normal but active bleeding is not. Call the physician if you experience a significant amount of bleeding or swelling from the incision site or within the scrotum.

Infection is very uncommon following the no scalpel vasectomy procedure in Minnesota. Contact your physician if you notice excessive redness, tenderness, warmth or drainage from your surgical site.

Bruising over the scrotal skin is common following vasectomy. Call the physician if the scrotal sac is severely bruised and/or expanding in size.

Some men develop a small, tender nodule where the vas was cut. These sperm granulomas can produce discomfort, but almost always resolve spontaneously. You can have the site re-examined if you are concerned.

Semen examinations should be performed to document the success of the vasectomy. Another form of contraception (such as condoms) should be used until you have been notified by your physician that you have had one or two negative semen checks documented. During the first week after surgery, there should be no sex and/or ejaculation. It is important to note that the patient will not be considered sterile for several months after vasectomy. It is important to resume ejaculation because it takes up to 20 ejaculations for any remaining sperm to be released. A semen sample will be examined about 12 weeks or 20 ejaculations after surgery to determine if sperm is still present.

Factors that Aggravate the Varicose Veins | Minnesota

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In the previous blog, we discussed the mechanism of varicose veins in Minnesotan patients. Correct functioning of the venous system depends on a complex series of valves. Varicose veins develop slowly when the frail valves of veins are dysfunctional.

There are many factors that aggravate the varicose veins. Most of them are reversible, meaning the varicose veins won’t develop or improve if we avoid these aggravating factors.

We can’t stop the aging process. Generally, most elderly individuals show some degree of varicose vein occurrence.

Prolonged standing can be avoided. If your job requires prolonged standing, you may want to consider wearing compression stockings.

Pregnancy can aggravate varicose veins through 3 mechanisms. 1. Pressure on the veins by the weight of the growing uterus; 2. Increased blood volume; 3. The relaxation effects of the hormones estrogen and progesterone on the vein walls.

Obesity is another reversible factor; loss of weight may help to improve varicose veins.

Straining due to chronic medical problems such as chronic constipation aggravates varicose veins. Actively managing the constipation may improve varicose veins, so is hemorrhoid.

If you just start developing the varicose vein and spider veins, especially you have symptoms such as pain and discomfort, you should wear compression stocking every day. In the meantime, you should seek the consultation with vein specialist and medical treatments as early as possible.

Psychological Effects of Vasectomy | Minnesota

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Men have been surveyed about their vasectomy satisfaction since the mid 1970’s. The goal was to find out whether they were happy over all with their decision to have a vasectomy based on their sexual satisfaction and happiness. 90% agreed that their sexual desires and satisfaction levels were the same or better than before they had their vasectomy. 7-10% of men surveyed regretted their decision. The first surveys being done were just asking whether men were satisfied or dis-satisfied with their procedure. It did not ask about how they were feeling about it.

When the men were interviewed about their feelings and the psychological aspect was looked at, it was found there were valid reasons for men regretting their decision. Some were feeling bullied by their wife into having the procedure done. Others felt good about their decision but major changes in their life made them feel regretful. Life changes such as divorce and re-marrying or re-partnering with someone have a big impact on men especially if their new spouse or partner wants to have children. Up to 5% of men have a vasectomy reversal. A higher percentage would probably have a reversal done if it wasn’t for the cost and low success rates. Men who are typically younger when they have a vasectomy tend to have more regrets down the road.

Dr. Steven Shu performs no scalpel vasectomy in Minneapolis & St Paul, and he always requires a consultation and likes to make sure that both partners are in agreement before doing a vasectomy. It is important to have both couples on the same page in order to maintain high satisfaction levels in the emotional and sexual relationship.

Pathophysiology of Varicose Veins in Minnesota Residents

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In Minnesota alone, about 19% of men and 36% of women have varicose veins. It most often occurs in the veins in the legs and thighs. Varicose veins tend to be inherited, and become more prominent as a person ages.

Veins returns blood from the periphery of the body back to the heart and lungs. Unlike arteries with thick walls, most veins are very thin and easily dilatable, so the peripheral venous system also functions as a reservoir to hold extra blood. You could say that the venous system is almost magical in its function when you are told that the entire cardiac output volume of 5–10 L/min is received into periphery venous system for eventual delivery back to the heart and lungs.

There are two types of veins, deep and superficial. The superficial veins and their branches are close to the skin; the deep veins are encased by muscle and connective tissue, which help to pump the blood in the veins and back to the heart. Generally, blood travels from the superficial veins to the deep veins. The communicator or perforator veins connect the superficial veins with the deep veins.

The veins have one-way valves to prevent them from backward flow. The correct functioning of the venous system depends on a complex series of valves. Varicose veins develop slowly and become abnormally thick, twisting or dilated over the time when the frail valves of veins are dysfunctional.

It is not clear what exactly causes the venous valves to work less efficiently. Some theories suggest inherited valve problems or abnormalities of the vein wall, causing some patients to have too few valves or have the valves that do not function properly. The result is that when a person with poorly functioning valves stands up, the valves leak and blood flow actually reverses.

Varicose vein treatment in Minnesota include the sclerotherapy (injection), mini vein stripping, and laser treatment, known as endovenous laser ablation (EVLA); fine spider veins can be treated with an external laser. Procedure Clinic offers one stop vein care with the above treatment options for the people living in the Minneapolis and St Paul areas.

Doctor in UK performs a DYI vasectomy

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So far in Minnesota, we haven’t had any doctors reporting a DYI surgery but in the UK they have a brave doctor who gave it a try. Dr. Jonathan Heatley of Horsham, West Sussex in the UK, performed 3 vasectomies and decided that he should be number 4 that day. He and his wife already have 3 boys who are ages, 12, 14, and 16 and he knew at some point he wanted to get a vasectomy. He called in his nurse and his wife who works with him as the practice manager. The doctor, who admittedly was a little nervous, gave himself a local anesthetic. His main concern was making sure that the area was numb before he started his procedure. His nurse and wife were standing by to help and everything went smoothly. He had his wife stepping on the foot pedal of the apparatus as needed for the DYI surgery. The procedure he performed on himself only took 20 minutes. Then he went home, relaxed and read a book. The next day he was back to work and just a couple days later was out riding his bike around town. Here is proof that a vasectomy is relatively pain free and nothing to be afraid of.

Rejuvevein Supplement to prevent Varicose Veins in Minnesota

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There is probably nothing more frustrating than unsightly varicose veins nowadays. More and more men and women in Minnesota are concerned with venous diseases, such as varicose veins, spider veins and hemorrhoids. Females are three times more likely to suffer from varicose veins than men since one of the biggest risk factors is pregnancy.

We are able to identify many risk factors related to varicose veins, but we don’t know the exact mechanism of varicose vein diseases. Hereditary, along with the pregnancy, aging, lack of exercise, long standing and overweight are common risk factors in Minneapolis and St. Paul areas.

Humans have valves inside our veins that help blood toward the heart. In varicose veins, the valves do not work correctly, and some of the blood does not leave the veins. The blood builds up inside of the veins and causes the veins to become enlarged. Research showed that nearly half of all varicose veins contain the exact same kind of bacteria that causes teeth (periodontal) disease. These bacteria can damage the valves and cause them to lose their seal-making ability across the vein.

The treatment of varicose veins include endovenous laser ablation (EVLA), sclerotherapy, and mini phlebectomy. Spider veins can be removed with sclerotherapy and external lasers.

Endovenous laser ablation uses a laser fiber to insert through the skin directly into the vein. The laser heats up the lining of the vein causing it to shrink and fade away. Sclerotherapy is a procedure that uses tiny needles to inject the veins with a chemical sclerant to harden the veins and help them fade away. Mini phlebectomy may be used in conjunction with other therapies to treat varicose veins. Tiny incisions are made into the skin and superficial veins are removed using vein hooks.

Rejuvevein Supplement
We recommend our Rejuvevein supplement from Procedure Clinic to help with any sort of venous disease. The supplement contains well-researched, citrus-based flavonoids in a unique micronized form for enhanced absorption and bioavailability. Research suggests that these compounds support healthy veins, capillaries, and blood flow; promote healthy lymphatic drainage; and enhance antioxidant activity and the body’s normal response to inflammation. It is a great product for those with spider veins, varicose veins, hemorrhoids or those who want to help prevent these conditions. More recent research supports a role for the components of Rejuvevein in maintaining blood glucose levels already within the normal range and, as a result, healthy kidney structure and function.

• Great for those with or want to prevent varicose veins, spider veins, and hemorrhoids,
• Supports Veins, Capillaries, and Circulation
• Helps Promote Normal Lymphatic Drainage
• Supports Antioxidant Activity and the Body’s Normal Response to Inflammation
• Supports Blood Glucose Levels Already Within the Normal Range

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