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~Naomi~

Leg Vein Testing?

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I saw a Vascular Surgeon today. I explained POTS and the blood pooling issue and asked if something could be wrong with the veins themselves and if there is a way to look at this. He said the valves in the leg veins can malfunction and there is a test to look at that. And it's done standing.. or at least partly standing? He scheduled me for that and is also going to look more closely with ultrasound at the renal vein for Nutcracker Syndrome. Has anyone had this study done where they look at vein/valve function in the legs?

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Let us know how it goes. My dr mentioned this to me, but he likes to run a lot of tests that I don't think I need. I do have swelling in my right ankle, so I am thinking about it.

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Yes, I have had many ultra sounds of the veins in my legs. Only thing they found is that my greater saphenous vein valves are blown out = varicose veins.

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Hi Naomi. I've never had the leg vein study, however, I had an abdominal CT scan done for something else a few months prior to my POTS diagnosis and the results came back and showed Nutcracker Syndrome. No on acted like it was a big deal!! It was my GI dr who ordered and said this. The CT results explained how my left renal vein was compressed and very narrow and the right was enlarged. I forget what else it said. The other day while researched I saw something about balooning the left compressed vein in Nutcracker syndrome made a POTS patients' symptoms better but to me, that would be a very invasive procedure.

And yes, like Igail says, does he suggest anything if he finds something?

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No, we didn't discuss treatment at all. I'm trying to understand this... if there are valves in the veins that are damaged or not functioning properly (not closing appropriately) could this allow for pooling.... which might cause some of the other symptoms, like tachycardia? Or would that be too easy. Anyway, I explained the whole thing to him and he thought it was a worthwhile test, so whatever, what's one more?

Misstraci - you have to investigate this Nutcracker thing! The way I read the articles is that Nutcracker Syndrome can cause the symptoms of POTS for some people. If I had the severe compression you describe and was officically diagnosed with this, I'd be having at least a discussion with a vascular surgeon.

http://journals.lww.com/jpgn/fulltext/2006/05000/comment_on_gastrointestinal_symptoms_associated.23.aspx

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Damaged/nonfunctional valves in the leg could definitely cause pooling. The valves in the veins are "one way" meaning they allow blood to flow from your feet towards your heart, but if the valves become damaged then blood can pool above them, not get pushed through, etc, which could easily lead to pooling. My first set of compression stockings had a nice diagram of the various types of valve damage and how pooling could result.

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Hi! I had the sonograms on my leg veins. I was told that these superficial veins should have only 1/2 second of reflux, mine had 4 seconds of reflux....meaning that the fluid in the veins should have evacuated in 1/2 second. The Dr. who did the test said that they go inside the veins and collapse them with heat. That way the body by-passes them. He seemed to think that it would help with the pooling issues with POTS. My PCP on the other hand didn't think it would offer much help for the condition because POTS is a problem with the deep veins, not the superficial veins. If anyone has tried the procedure with good results, I'd sure like to hear your story!

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Naomi, I will pursue it further and let you know. After I read your post and started thinking about it, I emailed my Dr. and was asking him questions. I have not heard back yet but now I'm really curious.

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