Norman Chideckel MD Vein Center
212-993-6133

Welcome to the Vascular Surgery and Vein Center

Welcome to the Vascular Surgery and Vein Center, a comprehensive vascular practice providing state-of-the-art care to patients throughout the tri-state area. Under the direction of board-certified surgeon Dr. Norman Chideckel, we utilize our advanced skills and many years of experience to help patients achieve clear, beautiful and healthy legs.

With our convenient Manhattan location, Dr. Chideckel offers patients a wide range of services to treat varicose and spider veins, deep vein thrombosis, and other vascular conditions, including:

Dedicated to helping patients achieve their desired results through the most effective and minimally invasive treatments available, Dr. Chideckel and his staff take the time to talk with each individual patient and address any concerns or questions they may have before undergoing treatment. Your comfort and satisfaction are among our top priorities.

To learn more about the services provided by Dr. Chideckel, please contact us to schedule an appointment. We always welcome new patients and look forward to meeting you.

Vascular Surgery & Vein Center
108 East 96th Street
Front 1
New York, NY 10128
Call us today at 212-993-6133 to schedule an appointment.

We now offer Telemedicine sessions.  Please call us for more information or to schedule a Telemedicine appointment.

See Our Main Website At www.VeinsDoc.com
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Category Archives: varicose vein doctor nyc

What are Varicose Veins?

The appearance of Varicose veins can make people feel self-conscious about their bodies, especially during the summer, leg baring months. Varicose veins can draw unwanted attention because they stand out with their blue or purple color and often bulge from the surface of the skin. Their bulging appearance is usually larger in diameter than a pencil and look like ropes underneath the surface of your skin. When these veins become swollen or enlarged, some people with experience discomfort and pain in the area of the Varicose Vein.

Why Does This Happen?

The main function of veins is to return blood from the rest of your body back to your heart to recirculate.  Though, when the blood returns to your heart, your veins have to work harder as they working against gravity. Valves, or openings, within the veins allow the blood to circulate through. However, when those valves begin to weaken the backwards flow of blood, back to the heart is stopped (in the effected vein) while the damaged vein collects that uncirculated blood. This process explains why your veins appear as highly visible, swollen, wavy, pathways on your skin.

How Common are Varicose Veins?

Well that is subjective. While they are twice as likely to be found in women, if you are male, you may still suffer from Varicose Veins. This is a common condition and is hereditary for some individuals. If you have signs of varicose veins, there’s a large chance your mother had them as well.  Around 25% of the Caucasian population is projected to have the occurrence of varicose veins. This rate is greater with female hormones and age.

How Serious is This?

Besides being a cosmetic dilemma, there are uncomfortable symptoms of varicose veins. Some of these symptoms can include, a throbbing sensation in the area of the vein, legs feeling heavy or sore, cramping of muscles at night, swollen feet, and itchy skin on infected area. These unwelcome side effects may worsen by the end of the day, especially if you have a job or lifestyle that consist of standing much of the day.

Sometimes Only a Cosmetic Issue

When you suffer from the appearance of varicose veins, though do not have any of the painful side effects, there are still emotional effects to these little nuisances. They often cause people to be reluctant to wear what they want to wear, such as shorts to work out or a swimsuit to the beach. Knowing they are there can cause stress and anxiety when you go out in public or attend outdoor functions during the summer.

If you suffer from varicose veins and want more information, or are interested in treatment from an experienced vein doctor, contact us today to schedule an appointment with Dr. Norman Chideckel.

Are Varicose Veins Dangerous?

If the tissues within the skin are swollen or inflamed for a long period of time, it may cause Lipodermatosclerosis, which is an inflammation of the subcutaneous fat. This usually occurs due to venous insufficiency, which is what varicose veins cause due to insufficient blood flow through the veins. The legs may feel sore and swollen and the tissue will feel hard around the leg. This can cause many other conditions such as edema.

Deep Vein Thrombosis (DVT)

This is the most severe condition caused by varicose veins, hence why they should be treated. Many patients complaining of a “pulling sensation” in their leg and this is caused by a blood clot due to the build-up of blood in the vein. If this blood clot travels up further in the body, especially to the heart, lungs or brain, it can cause life-threatening injuries, as insufficient oxygen is delivered.

Hyperpigmentation

When varicose veins are left untreated for a long period of time, it can cause excess blood to leak into the tissues of the affected area. This will cause painful inflammation and swelling of the tissue and the skin can become discolored and dark. Once hyperpigmentation occurs on the skin, it can be hard to get rid of. Although usually medically harmless to the body, it can cause body confidence issues for many people.

Superficial Thrombophlebitis

Superficial Thrombophlebitis is another inflammatory condition caused by a blood clot in the veins beneath the skin. This affects the vein more than the surface of the skin, although the skin may become red around the affected area. The vein may feel very sensitive to touch, which can cause ongoing discomfort. Left untreated, this can cause other complications such as cellulitis, which is a skin infection caused by bacteria.

Leaving varicose veins untreated can cause many other problems within the veins and surrounding tissues. Many problems that occur are very similar and it can be hard to know which one you are suffering from.

Call us today at 212-993-6133 to schedule an appointment with the best Varicose vein treatment doctor in New York City.

Can Stress Cause Varicose Veins?

We are living in a world that is getting more stressful with the passage of time. Although technology has made life easier in numerous ways, it has increased our stress levels due to various reasons. For example, having a smartphone makes you available 24/7. In case you are needed, you will be called at any hour of the night, no matter how inconvenient, and sometimes even on your vacation. It is hard to ignore that flashing light indicating new work emails when you get up. Moreover, people usually have the tendency of being very impatient and expect prompt responses to text messages.

This need to stay available all the time creates stress, which in the long run can be detrimental to your health. High stress levels can significantly impact your vascular system, causing a spike in blood pressure, heart diseases and sometimes varicose veins. A surge in blood pressure can impair vein walls causing varicose veins to appear.

Stress places a huge burden on your cardiovascular health. Therefore, it is vital for patients running a risk of venous diseases, to keep their stress levels in control. A stressful lifestyle often leads to lack of exercise, poor diet and alcohol or drug abuse, all of these undesirable habits can trigger or exacerbate vein diseases such as varicose veins, spider veins and deep vein thrombosis.

Long-term or chronic stress places excessive pressure on your veins, which may make it hard for the veins to pump blood back up to the heart, this blood will pool and cause the weak veins to swell.

People experiencing stress tend to care less for their bodies; this often leads to stress eating or too much pressure leaves little or no time for exercise. Any or both of these situations can cause people to put on weight, which adds extra pressure on their veins and weakens the venous walls. Stress-eating usually involves high intake of salty foods which can lead to high blood pressure. For people who are already vulnerable to varicose veins, this can have an adverse affect on vein health.

A majority of people resort to smoking as a coping mechanism to deal with stress. While it may offer a quick fix to stress relief, in the long run smoking greatly raises the chances of contracting a vein disease, not to mention the slew of other health problems that can ensue.

For people who have a family history of varicose veins, not a lot can be done to avoid this medical condition and varicose veins will usually appear irrespective of stress levels. That being said, there are several means of minimizing the chances of the appearance and severity of varicose veins.

The effective management of vein health in stressful circumstances usually entails treating your inner self. Begin by setting aside a few minutes every day for meditation or take frequent small walking breaks to raise the flow of blood and cognitive function. The next thing you can do is incorporate a relaxation activity like yoga, painting or reading in your daily activities.

You may find it extremely helpful to include an exercise program in your schedule; this will not only cut down stress but also boost your cardiovascular health and mitigate or prevent the development of varicose veins.

Call us today at 212-993-6133 to schedule an appointment with the best Varicose vein treatment doctor in New York City.

The Most Common Symptoms of Varicose Veins

Definition and Overview

You may not have heard this term before, but this condition is quite common. The term varicose veins, is used to refer to a medical condition where your veins become dilated, enlarged or overfilled with blood. Although any vein in your body can become varicose, the veins in your feet and legs are most prone to this condition. That is due to walking and standing upright, which increases the amount of pressure in the veins that are located in the lower parts of the body.

Varicose veins are a quite common condition that affects women more than men. About a quarter of all adults suffer from this condition.

For a lot of individuals, varicose veins are only a cosmetic concern. However, others are not so lucky and for them this condition can lead to severe discomfort and pain. In some situations varicose veins can have more grave implications. They are also indicative of a greater risk of circulatory issues. Treating varicose veins may entail self-care measures or specific procedures that your physician can use to remove or close the veins.

Most Common Symptoms

There are a significant number of people who exhibit no symptoms due to their varicose veins, other than the noticeable appearance, which could be embarrassing. Apart from cosmetic embarrassment, the most common and frequent symptoms of this condition are aching legs, heaviness and discomfort in legs, which worsen as the day progresses. At times your ankles may swell as well. These symptoms don’t tend to be medically serious; in case they become substantially problematic treatment options are available.

Although varicose veins have the tendency of getting worse as the years progress, this is a very slow and gradual process. If you are one of those unfortunate people who have high pressure in their veins, it may end up damaging the skin located near the ankle; the skin in the area will turn brown in color, and in some situations will get scarred with white areas. At times a red rash can appear which is called Eczema.

If for some reason you allow these skin changes to progress, or your skin gets injured, there is a likelihood that an ulcer may build up. Changes to your skin condition are a good reason for you to see a doctor so that he may refer you to a skin specialist.

Below is a list of symptoms for easy reference.

    • Veins that have a blue or dark purple color
    • Veins that seem bulging or twisted; giving the impression that a cord is sticking to your leg
    • Painful varicose veins have the following symptoms:
    • A feeling of aching or heaviness in your legs
    • Swelling, burning sensation, muscle cramping and throbbing in your legs
    • Worsening of pain following standing or sitting for long periods
    • Itching in your veins
    • Bleeding varicose veins
    • Hardening of your veins, color changes, skin inflammation or ulcers near the ankles

In case you or your loved ones are suffering from varicose veins, don’t worry as we have got you covered. Just call us right away to schedule an appointment with our team of experienced and qualified physicians in New York City and get instant relief.

Call us today at 212-993-6133 to schedule an appointment with the best Varicose vein treatment doctor in New York City.

Are Varicose Veins Dangerous?

Many people want to treat varicose veins due to cosmetic reasons, but there are many more reasons apart from their unsightly appearance to treat these blemishes on your skin. Varicose veins that are left untreated can cause mild to severe symptoms, depending on the person, and can even become life-threatening.

Lipodermatosclerosis

If the tissues within the skin are swollen or inflamed for a long period of time, it may cause Lipodermatosclerosis, which is an inflammation of the subcutaneous fat. This usually occurs due to venous insufficiency, which is what varicose veins cause due to insufficient blood flow through the veins. The legs may feel sore and swollen and the tissue will feel hard around the leg. This can cause many other conditions such as edema.

Deep Vein Thrombosis (DVT)

This is the most severe condition caused by varicose veins, hence why they should be treated. Many patients complaining of a “pulling sensation” in their leg and this is caused by a blood clot due to the build-up of blood in the vein. If this blood clot travels up further in the body, especially to the heart, lungs or brain, it can cause life-threatening injuries, as insufficient oxygen is delivered.

Hyperpigmentation

When varicose veins are left untreated for a long period of time, it can cause excess blood to leak into the tissues of the affected area. This will cause painful inflammation and swelling of the tissue and the skin can become discolored and dark. Once hyperpigmentation occurs on the skin, it can be hard to get rid of. Although usually medically harmless to the body, it can cause body confidence issues for many people.

Superficial Thrombophlebitis

Superficial Thrombophlebitis is another inflammatory condition caused by a blood clot in the veins beneath the skin. This affects the vein more than the surface of the skin, although the skin may become red around the affected area. The vein may feel very sensitive to touch, which can cause ongoing discomfort. Left untreated, this can cause other complications such as cellulitis, which is a skin infection caused by bacteria.

Leaving varicose veins untreated can cause many other problems within the veins and surrounding tissues. Many problems that occur are very similar and it can be hard to know which one you are suffering from.

Getting treated for varicose veins is always the safest option, so schedule an appointment with the best varicose vein doctor in NYC today.

Call us today at 212-993-6133 to schedule an appointment with the best Varicose vein treatment doctor in New York City.

Management of Lymphedema

Compression stockings are the mainstay of management of lymphedema. The importance of its daily use cannot be stressed enough, as without its there will be progression and worsening of the lymphedema.

The stockings are gradual gradient compression stockings, measured in mm Hg (millimeters of mercury) pressure, with the greatest pressure at the level of the ankle, and progressive diminution in the pressure up to the level of the knee. Compression hose function to aid the muscles of the forefoot and the calf; also known “the muscle pumps”, return fluid back towards the heart. As these “muscle pumps” only exist in the muscles of the forefoot and calf, there is generally no need for use of stockings above the level of the knee.

The appropriate compression grade is decided by the degree of swelling, and the integrity of the skin, e.g. dry skin, or skin color changes. The goal is to use the lowest compression grade that will appropriately treat the lymphedema, and prevent its progression. Also the appropriate placement of the stocking is key to success; remembering when lying flat no stocking is necessary, as the legs and the heart are on the same plane. However, when standing there is a “hill” to climb, so placing the stocking prior to the leg being dependent is crucial to it successful In situations where the stocking alone is inadequately treating the underlying process, adjunctive measures can be added to the treatment protocol. One of these is manual lymphatic decompression (MLD), a technique of massaging the lower extremity from the periphery to the center, in order to stimulate “collateral” lymph drainage. This enables the lymph channels to work more effectively, by increasing the size of these “collateral channels”, and this increased diameter increases the amount of fluid return, thus reducing the swelling of the lower extremity. MLD is performed by specialist trained in this technique, either physiatrists, physical therapist, or lymphedema specialists. There is an online resource to search for an appropriate therapist that performs this technique.

Alternatively there is another adjunctive option–lymphedema pump. This entails placing a plastic sleeve on the forefoot and on the calf which is then connected by a tube to a power source, and sequential compression occurs which helps in recirculating the lymphatic fluid. There are also available wearable mobile device with an internal battery pack the can also be used in the same fashion. Use of the pump several times per day is important to help reduction of the lymphedema

Whether using either the MLD, or the lymphedema pump as adjunctive measures, continued use of a compression hose with daily activity still necessary, as when the leg is dependent there is the possibility of accumulation of lymph fluid. Lymphedema is chronic lifelong condition. Attention to detail is crucial in the prevention of worsening of this condition; it is imperative to make sure that the compression stocking that you are using does not wear out. As the stocking is made of material including spandex, over time the elasticity and compressibility of the stocking deteriorates. Also it is important to adequately moisturize the skin to maintain skin integrity, and if possible whenever sitting to elevate the leg.

Be aware of the early signs of potential deterioration in the condition of the extremity, and seek medical care earlier rather than later, to prevent serious consequences.

Finally, be active in your care, and try to learn as much as possible about this condition, so that you can prevent consequences. There is much information on the Internet that is readily available to the public, including lymphedema societies that are directed towards patient needs.

Skin Care During Winter Months

In a recent blog posting, I addressed the issue of bleeding from spider veins, and the association with dry skin.  The question is what can you do to prevent dryness of the skin.

Skin Care in Colder Weather

During the winter, colder weather months, there is a constant change occurring to or skin.  When out in the cold the skin contracts, and upon reentry into a warm indoor environment the skin will reexpand.  These temperature changes lead to dryness of the skin, and as result the skin may crack and predispose bleeding from spider veins on the surface of the skin.  In order to protect the skin from these constant changes, it is important to moisturize the skin several times a day.  In the morning, especially after a hot shower, and again at the end of daily activities. Any of the commercial available moisturizing creams or lotions is fine, and you may want to experiment to find the one that is best for you.

Stocking for Varicose Veins

If you have underlying varicose veins of any degree, then the use of a support/compression stocking will be of benefit to prevent swelling of the lower extremity.  Appropriate placement of these stockings is crucial-placing them on the leg before they are dependent will give the maximum benefit.  For the best outcomes, it would be recommended to put the stockings on before getting out of bed in the varicose vein treatment legsmorning.  However, being cognizant that this would not be doable for most people, it would be effective to elevate the legs for several minutes prior to placing the stocking.  Also moisturization of the skin prior to placement of the stocking would be beneficial.  So in practical terms, after showering, moisturize the skin, sit down and elevate the legs on a chair, and after several minutes when the moisture has had time to seep into the skin, put on the stockings.

If you do not have varicose veins, use of a support/compression hose may not be necessary.  However if your job requires prolonged standing—doorman, hairdresser, chef or similar occupations, then support hose would be helpful to prevent swelling of the legs, and will also energize your legs during daily activities.

Bleeding Varicose Veins

One of the scariest varicose vein related issues is the sudden onset of bleeding.  The bleeding episode may be the result of a local trauma, or more often than not it may occur spontaneously.  It is very dramatic as the bleeding is profuse and pressurized to the extent that some patients have described it as “a geyser eruption”.

Spider Veins

The most common location is at the area of the ankle, where the venous pressure is at its maximum.  Veins return blood flow, and it is at the level of the ankle that the process begins.

Bleeding Varicose VeinsIt is usually the “spider veins” that bleed, as the top layer of these veins is right under the surface of the skin.  Dryness of the surrounding skin will predispose to a bleeding episode, so moisturization of the skin is of great benefit.  In the colder months there is a greater potential due to the frequent temperature changes, from being outdoors in colder temperatures, to indoors in warmer temperatures with higher humidity causing increased dryness of the skin.  Yet, even in the warmer months, the increased humidity may course dryness of the skin, and again the potential for bleeding from these varices.  Very often people report that the bleeding occurred while showering or bathing, or even after exiting a swimming pool.

Larger, bulging varicose veins, rarely bleed externally, as the outer layer of the vein is deep to the skin, and therefore protected.  These veins main complication is potential for blood clots or thrombophlebitis.

What to do if the vein bleeds

  • Try not to panic – easier said than done.
  • Firstly, elevate the leg to reduce the venous pressure and gravity.
  • Secondly, apply local pressure to the area to control the bleeding.

VV3These measures will usually control most episodes of bleeding.  But, if after several minutes, the bleeding continues, please call 911 or any emergency medical system, as rarely the bleeding can be so excessive to potentially cause you to go into shock.  At the emergency room or urgent care center a compression bandage most likely be applied, or often times a suture may need to be used to control the bleeding, at least temporarily.

Evaluation of the venous circulation will be the next appropriate step.  If there is underlying varicose vein problems then that would need to be addressed, perhaps with an ablation procedure (this has been addressed in a previous blog).  If there is no evidence of underlying venous abnormalities, then local care-sclerotherapy-to seal the surrounding veins would be of benefit.  Even in those patients who have an underlying varicose vein problem, local sclerotherapy to temporize, until more definitive therapy is done, would be of benefit.

If it is recommended to you to wear a compression stocking, remember to place the stocking on the leg before it is dependent, and place a Band-Aid over the area of the bleed, to protect the formed scab, from being irritated by the stocking.  It would also be advisable to maintain a Band-Aid over the area of the scab while sleeping, so that bedsheets do not irritate the area.  As mother use to say “don’t pick at the scab”, because doing so will start the whole healing process all over again.

What Stockings Should I Wear?

Support Or Compression

Support or compression hose aid in vein blood flow return from the lower extremities.  They also prevent swelling of the lower extremities, and energize the legs during daily activities.  The questions often asked are which stocking are appropriate for me, and what is the difference between these stockings.

The appropriate grade level of stocking

Firstly, the stockings are graduated gradient stockings, meaning that the pressure is higher at the ankle, and lower at the level of the calf just below the knee.  The pressure in the stocking is measured in mmHg, with support hose at 8–15 mmHg, and compression hose in various pressures depending on the grade (15–20, 20–30, 30–40, and 40–50mmHg).  The appropriate grade level of stocking is determined by symptoms, and physical exam findings.  The goal is to use the lowest degree of pressure that will be of benefit.  The sizing of a compression stocking is determined by measuring the circumference of the ankle, and of the mid-calf.  With support stockings, the size is usually determined based on shoe size.Compression Stocking

These stockings function by a squeezing of the “muscle pumps” of the calf, which are the muscles of the forefoot and calf.  This prevents blood flow and fluid from pooling at the area of the ankle.  As such there is no generalized benefit in wearing a stocking above the level of the knee.  There are exceptions though to this rule, for example – a woman who is pregnant would benefit from pantyhose, to reduce the pressure on the lower extremities by the enlarging uterus.  Another exception would be in someone who has varicose veins of the calf and lower thigh, such that the upper portion of the calf high stocking may cause an irritation to these veins, and they would be benefited by wearing a thigh-high stocking.

I have been often asked-don’t these stockings stop my circulation?  Of course the answer is that they do not, but people may notice an impression on the skin from the elastic band at the top of stocking.  To prevent this and also to obtain the maximum benefit from the stocking, I recommend placing stocking on the legs when they are elevated.  The ideal situation would be to put the stockings on before getting out of bed, but this is impractical, and it would be fine to put them on after showering, but first sit down and elevate the leg.  Some people notice that their legs feel uncomfortable with the stocking, and this most likely occurs because they put the stocking on after the legs have been dependent for a good period of time.  Another potential problem of placing stocking on after the leg is been dependent is that swelling may start to occur, and the stocking may then cause skin irritation.

Lastly, placing the appropriate stocking on the leg may pose a challenge, as the higher degree pressured stockings are more difficult to place.  This is an issue in the elderly or people with limited mobility due to arthritic changes.  In these situations, insisting on the appropriate pressure to manage an issue may not be doable, and as such the stocking will not be used leading to potential problems.  It is best in these cases to use a lesser degree of pressure, following the adage “something is better than nothing at all”.

Varicose Veins of the Face

Telangiectasia

Varicose veins of the face, most commonly spider veins, also known as telangiectasia, are small dilated blood vessels, 0.5-1 mm in diameter. These will occur near the surface of the skin, and are often seen on the face, around the nose, cheek, and chin. They will most often be red or pink in color. These do not pose a health risk, but may reflect an underlying medical issue, but most of the time these are just a cosmetic nuisance.Varicose Veins of the Face

The causes of these spider veins may be due to congenital or acquired factors. Of the congenital causes the list would include a port wine stain, hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome), as well as others that are beyond the scope of this blog. Of the acquired causes, the more common reasons are acne rosacea, environmental damage caused by prolonged sun or cold exposure, pregnancy, or perhaps an underlying liver abnormality.

Treatment

Treatment of spider veins of the face, is most often accomplished with localized treatment, and can be accomplished with the use of thermocoagulation with Vein-Gogh (ohmic thermolysis), using a very fine needle to deliver radiofrequency current into the vein thus sealing the vein. Use of lasers, most commonly IPL is also a viable treatment option. Sclerotherapy, the most common treatment option for spider veins of the lower extremities, is not recommended in the area of the face.

Any of the treatment options listed above will be successful in the treatment of the spider veins; however, they will not prevent the development of new spider veins in the area. To prevent new vein development, using SPF creams prior to prolonged sun or cold exposure would be of great benefit. Perhaps, as mentioned in a previous blog, increasing flavonoid intake in the diet may be of benefit to strengthen blood vessel walls. If there is an underlying medical condition as the source of these veins, that issue should be addressed under the care of your medical doctor.

If you suffer from varicose veins of the face call the top varicose vein doctor in NYC, Dr. Chideckel today!