Physicians Consultation

Consult with Dr. Clovis Manley

To learn more about varicose veins, leg pain and vein treatment

The treatment of superficial venous disease (varicose veins) is very complex and no two patients are the same. Each patient must have an individual, detailed history of their vein problems documented, a comprehensive ultrasound mapping of the deep and superficial venous systems performed, and a careful physical examination of the legs by your physician before a treatment plan can be discussed. Our physician will explain in detail the findings of our evaluation and go over your case in a private, personal consultation and he will prepare an individual treatment just for you.

An exception to the above policy is a patient with “spider veins” and absolutely no symptoms or signs of underlying venous disease. We can treat these patients with “cosmetic” visual sclerotherapy and no ultrasound vein mapping is necessary. These treatments are not covered by insurance and will be the patient’s responsibility on the day of service.

The four modalities of treatment that are most commonly used in the treatment of venous disease are EVLT if the saphenous veins are failing, microphlebectomy if bulging veins need to be removed, ultrasound-guided foam sclerotherapy for dilated veins under the skin that are not visible externally, and visual sclerotherapy for reticular and telangiectatic veins (“spider veins”) visible on the skin surface. Each case is unique and a patient may get any combination of treatments on each leg, depending on our findings. During the consultation the risks, benefits and alternatives to each modality of treatment will be discussed to the satisfaction of the patient.

 

During the consultation we will also discuss the policy of your individual insurance company regarding the treatment of varicose veins since each company has their own procedures. Most insurance companies, with the exception of United Health Care, require patients to wear compression hose for a length of time before they will consider any actual treatment. This is what insurance companies call “supervised conservative management” and is usually six weeks or three months in duration. This means that the sooner a patient starts wearing their prescription hose under their doctor’s supervision, the sooner they can get treatment.

 

Patients are encouraged to bring their spouse, a family member or a friend to the consultation. We will cover a lot of material. We will also provide written explanations of all procedures for your review at home. When you leave the physician consultation you will have a personal, written plan of care to take home and review.

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