So, you got over your inertia, and you got over your trepidation, and you finally came to see us about your varicose veins. Dr. G saw you and told you that you need a procedure to get rid of them. And now it’s hurry up and wait. Because the medical assistant is fitting you for compression hose and tells you that you need another appointment in three months to decide whether you’re going to get your procedure. What gives? Your legs are hurting you now. Why wait three months?
Let me say upfront that it’s not our fault. Insurance companies don’t want to pay for procedures. They put roadblocks in the way. In this case the roadblock is “conservative therapy.” Most insurance companies demand that you fail “a trial of conservative therapy” (six weeks to three months) before they will pay for the procedure that you really need. United Healthcare and Medicare are exceptions. You can have your procedure the same week that we evaluate you.
What is “conservative therapy?” The first component is compression hose. You know, those tight stockings that we fit you for at the office. Their tightness exerts pressure on the veins causing them to flatten. The problem is that the minute you take them off (and to comply with “conservative therapy” you have to wear them from when you wake up to when you go to sleep) the veins bounce right back. The compression hose doesn’t take care of the underlying problem.
The second component is elevation of the legs. If you’ve been on your legs for a long time or your legs hurt you, then you sit down and put your legs up. Elevating your legs aids in drainage of the blood from the varicose veins back to your heart. So, you feel better. Just like with the compression hose, leg elevation doesn’t take care of the underlying problem in your veins. It makes you feel better while they’re elevated, but the effect is only temporary.
The third component is anti-inflammatory drugs like Naprosyn. Again, this may give some pain relief but does nothing for the problem in your veins.
As you can see, I am not very enthusiastic about “conservative therapy.” It does nothing to address the underlying vein problem. The minute that you stop it, the problem comes right back. If I had it my way, none of the insurance companies would require it. But, as I said they like to throw up roadblocks on the way to definitive treatment.
This delay means that you can’t get your legs looking beautiful again right away. You have to wait three months, and then there’s the time after the treatment that you have to wear compression hose. If you come to see us in May your legs won’t be ready for the summer. Now is the right time to think about getting your legs treated. Just give us a call at (860) 761-6666 and schedule your appointment.
– Dr. Greenwald
