As a practicing physician in the ER (playfully referred to as my “day job”, I mean, “night/weekend/holiday job”), I’m used to seeing the ugliest presentations of diseases in the body, when patients are super sick, or in dire need. As odd as this may sound, I was looking for that with vein disease. I needed to know why I felt compelled to study and immerse myself in the practice of venous medicine over two years ago. Is there something about it that, like other diseases such as diabetes, high blood pressure, or heart disease compel me to encourage and educate my patients, my family and friends about the importance of primary care, getting checkups and improving our lifestyle?
And that leads me to Honduras. I had never been to a third world country. In fact, I was pretty nervous about traveling alone, spending a week with people I’d never met, and treating patients without even the most limited resources (like clean water and electricity). The clinic I was assigned to felt like a scene out of MASH, inside a small room where sheets were hung to act as curtains for eight, tiny treatment rooms. Instead of injured soldiers rushed in by helicopters, there stood hundreds of people, who traveled for days to be seen. And there it was, the purpose for this journey. The worst venous wounds and ulcers I have ever seen, not even in textbooks. My first patient said she was told she would lose her leg if she didn’t get treatment. She had been covering the wounds with banana peels and cleaning the wounds with the only water she had – dirty water. My portable ultrasound revealed terrible back flow of the veins underneath that caused too much pressure to the skin and foot. I treated her with the most basic of venous treatments we had, counseled her on wound care, and applied donated compression stockings and dressings. I still think of her when I talk to the community and my patients about venous disease and how, when left ignored, progress to advanced stages that profoundly impact one’s life. Over the course of one week, our clinic treated over 1,000 patients. We could only treat one leg so we could get through all the patients waiting to be seen. Many had been there one year before to get their other leg treated. Many brought their mothers, grandmothers, and siblings. We saw patients in their 20s up to their 80s.
Many times, my patients diminish their symptoms or are embarrassed to even tell their doctor they are getting vein treatments. Some patients tell me they feel it’s simply vanity and they know third world problems are much worse than theirs. I’m here to tell you is that vein disease is a real medical condition. It starts as small spidery type veins, progresses to bigger bulging veins, swelling, or skin discoloration. It’s important to treat it just like other medical problems, and treat it early.