A true Coronavirus story. Laurel (not her real name) is a patient of mine with varicose veins. She was sheltering-in-place due to Coronavirus. As with many of us, her days were very sedentary. She spent most of her time in one chair with her legs bent. Though we prescribed compression hose for her, she felt lethargic and listless and just couldn’t muster the energy to put on the stockings.
About a week into the quarantine, she developed pain in her left leg. With the office closed, I did a telemedicine conference with her. I told her that I thought she had a clot in her varicose veins. Since venous thrombosis (the technical name for a clot in the leg) can send clots to the lung, it is potentially life-threatening. In the absence of anywhere else to send her, I sent her to the emergency room. She had an ultrasound of her leg and, sure enough, had a clot. She was put on blood thinners and discharged.
P.S. A week later, she developed symptoms of COVID-19. She called the Coronavirus hotline and went for drive-through testing. Yes, she had COVID-19. She probably caught it at the hospital. Luckily, it wasn’t a severe case. She’s in self-quarantine in her house, so she doesn’t infect her other family members. She’s lonelier than ever. Luckily, she didn’t require hospitalization.
Coronavirus can represent a real challenge for you if you have varicose veins. If you don’t go to work during this time (like the majority of us), then you probably spend a lot of time sitting, maybe even hours in a row.
In varicose vein disease, the primary problem is the pooling of blood in the leg. When you walk, the muscles in your leg contract and press on the veins. The muscles act like a pump moving the blood up from your legs and ultimately back to the heart. If you’re sitting all the time, the muscular pump doesn’t work and the blood pools in your leg. This stagnant blood is a breeding ground for blood clots.
Things are even made worse by the way everybody sits – with their legs bent at the knees. This bend kinks off the veins in your leg and makes it doubly hard for blood to get from your lower leg to your body. The stagnation of blood is made even worse. This situation is worse if you cross one leg over the other, bending it at the knee.
Odds are, if you’ve seen me in the office for varicose veins, you have compression hose. Compression hose exerts even pressure along your leg. They force blood out of your leg and into your body. But the compression hose doesn’t work if you don’t wear them. They don’t do anything in your dresser drawer. I know that it’s hard to put them on. It’s a tussle and requires a fair amount of energy. But if you’re going to be sedentary, they are absolutely essential.
So, there are two things you can do to prevent complications of varicose veins during this extraordinary time.
- Don’t sit for more than two hours. Get up. Walk around the house for fifteen minutes. Walk outside. Any movement will get the muscular pump working and reduce the stagnation of blood in your leg.
- Wear your compression hose. It’s difficult during these plague months to not be more sedentary than usual. The compression hose will push the blood out of your leg, and that will help to prevent clots.
Oh, by the way, Laurel’s going to be just fine. The clot has stabilized, and she doesn’t have to worry about life-threatening complications. Her case of COVID-19 was mild, and Laurel’s over all her symptoms. She can’t wait to get out of quarantine and back to her family.
Stay safe, everyone. I anticipate that we will be back in the office in May. I can’t wait to see all of you.
