DATE

1400H - 1500H
Via Zoom

Empowerment
objective - for
laypeople to have an
VARICOSE
essential
VEINS
understanding of
VARICOSE VEINS in
their health
management.
 DATE
1400H - 1500H
Via Zoom
Welcome all!

MUTE yourself but always

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objective - for Sign in your name, FB

account, or email address in
laypeople to have an
VARICOSE the Chat Box! Include names
essential of companions attending.
VEINS
understanding of Use the Chat Box to ask
VARICOSE VEINS in questions and make
comments while the PEP TALK
their health is on.
management.
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at start and end of PEP TALK –
show your face in video.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
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mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
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Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:
Empowerment FEEDBACK TO THIS
objective - for PEP TALK!
laypeople to have an
VARICOSE
essential Pls. type in your
VEINS feedback in the chat
understanding of
VARICOSE VEINS in box during the open
forum and before we
their health adjourn!
management.
Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
Empowerment TAKING BEFORE WE
START PEP TALK
objective - for
PROPER IN 2
laypeople to have an MINUTES!
VARICOSE
essential
VEINS
understanding of Pls. turn on your
VARICOSE VEINS in video!
their health Show your face!
management.
 ROJoson PEP Talk
Empowerment
objective - for I have a Patient
laypeople to have an Empowerment
VARICOSE
essential Program in which I
VEINS like to empower the
understanding of
VARICOSE VEINS in lay people or
patients to take
their health
control in the
management. management of
their health.
I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.
 My PEP TALK today is
entitled:
Empowerment
objective - for
VARICOSE
laypeople to have an VEINS.
VARICOSE
essential
VEINS
understanding of
VARICOSE VEINS in
their health
management.
 Contents
• What are two general types of blood vessels that can
Disclaimer:
VARICOSE develop abnormal enlargement?
• What are varicose veins?
VEINS • What are the different types of varicose veins?
ROJoson PEP Talk
contains ROJoson’s
• What are causes of varicose veins?
Thoughts, Perceptions,
• How to recognize or diagnose varicose veins?
Opinions and
• What are the different stages of varicose veins?
Recommendations
• How does a physician evaluate varicose veins?
(TPORs) culled from
• What are the common diagnostic tests for varicose veins?
experiences of other
• What are the treatment options for varicose veins?
professionals and
• What is the prognosis (inclusive of recurrence after
ROJoson.
treatment) of varicose veins?
• What are the preventive measures for varicose veins, if
there are?
• What are the myths on varicose veins?
 What are two general types of blood vessels that
can develop abnormal enlargement?
VARICOSE
VEINS
• ARTERIES
• VEINS
 What are two general types of blood vessels that
can develop abnormal enlargement?
VARICOSE
VEINS VEINS – VARICOSE VEINS 
enlarged, bulging, twisted or tortuous

ARTERIES – ANEURSYMS
enlarged = balloon-like bulge
 What are varicose veins?
What are the different types?
VARICOSE
VEINS Per se, VARICOSE VEINS are enlarged, twisted
VEINS.

Most commonly occurring in the lower extremity

(feet, legs, and thighs).

But may form in other parts of the body, such as

• HEMORRHOIDS (in the rectum)
• ESOPHAGEAL VARICES (in the esophagus)
• VARICOCOELES (in the scrotum)
 What are varicose veins?
What are the different types?
VARICOSE
VEINS Per se, VARICOSE VEINS are enlarged, twisted
VEINS.

Most commonly occurring in the lower extremity

(feet, legs, and thighs).

But may form in other parts of the body, such as

• HEMORRHOIDS (in the rectum)
• ESOPHAGEAL VARICES (in the esophagus)
• VARICOCOELES (in the scrotum)
 What are varicose veins?
What are the different types?
VARICOSE
VEINS Per se, VARICOSE VEINS are enlarged, twisted
VEINS.

Most commonly occurring in the lower extremity

(feet, legs, and thighs).

But may form in other parts of the body, such as

• HEMORRHOIDS (in the rectum)
• ESOPHAGEAL VARICES (in the esophagus)
• VARICOCOELES (in the scrotum)
 What are varicose veins?
What are the different types?
VARICOSE
VEINS Per se, VARICOSE VEINS are enlarged, twisted
VEINS.

Most commonly occurring in the lower extremity

(feet, legs, and thighs).

But may form in other parts of the body, such as

• HEMORRHOIDS (in the rectum)
• ESOPHAGEAL VARICES (in the esophagus)
• VARICOCOELES (in the scrotum)
 What are varicose veins?

VARICOSE When speaking of varicose veins,

VEINS
VARICOSE VEINS commonly refer to the
tortuous and permanently dilated veins
of superficial venous system due to
pooling of blood in the lower extremity
(feet, legs and thighs) seen under the
skin’s surface.
 What are varicose veins? 2 major superficial veins of
lower extremity involved in
VARICOSE Superficial venous system vs deed varicose:
VEINS venous system • Greater/long saphenous vein
• Lesser/short saphenous vein
Superficial veins are below the skin's
surface and deep veins are deep inside,
beneath the layers of tissue and
muscle.
 What are the causes of varicose
veins?
VARICOSE
VEINS WEAK OR DAMAGED VEIN WALLS
AND VALVES
Veins have one-way valves inside
them that open and close to keep
blood flowing toward the heart.

Weak or damaged valves or walls in

the veins can cause blood to pool and
even flow backwards.
 What are the causes of varicose veins?

VARICOSE Weak or damaged vein walls and valves

VEINS
 What are the causes of varicose
veins?
VARICOSE
VEINS Weak or damaged vein walls and
valves
Veins have one-way valves inside
them that open and close to keep
blood flowing toward the heart.

Weak or damaged valves or walls in

the veins can cause blood to pool and
even flow backwards.
 What are the causes of varicose veins?

VARICOSE WEAK OR DAMAGED VEIN WALLS AND VALVES

VEINS
Prolonged increased blood pressure in veins
such as from a tumor compression or
obstruction

Other risk factors:

• Old age
• Sitting or standing for long periods
• Inactive lifestyle (no exercise on leg muscles)
• Positive family history of varicose veins
 How to recognize or diagnose varicose veins?

VARICOSE Just by LOOKING AND SEEING

VEINS
Bulging, tortuous bluish vein or veins on the
lower extremity (feet, legs, and thighs)
 How to recognize or diagnose varicose veins?

VARICOSE Stages of varicose vein development:

VEINS - Spider veins
- Reticular veins
- Varicose veins with no skin damage / ulcer
- Varicose veins with skin damage
- Varicose veins with skin ulcer
 How to recognize or diagnose varicose veins?

VARICOSE - Varicose veins with no skin damage / ulcer

VEINS - Varicose veins with skin damage
- Varicose veins with skin ulcer
 How to recognize or diagnose varicose veins?

VARICOSE - Varicose veins with no skin damage / ulcer

VEINS - Varicose veins with skin damage
- Varicose veins with skin ulcer
 How to recognize or diagnose varicose veins?

VARICOSE Varicose veins with no skin damage / ulcer

VEINS • Different degrees / severity – same / different
persons
 How to recognize or diagnose varicose veins?

VARICOSE Varicose veins with no skin damage / ulcer

VEINS • Different degrees / severity – same / different
persons
 How to recognize or diagnose varicose veins?
How does a physician evaluate varicose veins?
VARICOSE Type of treatment is
VEINS Determine whether there is an external cause dependent on the
such as obstruction or external compression of cause (evident or
the venous systems by a tumor (if there is, probable).
remove the external cause).

Determine whether there are modifiable or

remediable causes such as prolonged standing
and lack of exercise for which measures can be
done to reverse or to prevent progression of
varicose veins.
 How to recognize or diagnose varicose veins?
How does a physician evaluate varicose veins?
VARICOSE Type of treatment is
VEINS Determine whether the varicose veins are dependent on the
caused by weak veins; damaged valves in cause (evident or
superficial, perforators and deep veins; whether probable).
there is problem with the deep vein system.

Determine the severity of the varicose veins.

(spider/reticular; varicose without skin damage
yet; varicose with skin damage / ulcer).
 What are the diagnostic tests being done prior to
treatment for varicose veins?
VARICOSE
VEINS • Physical tests of the legs such as tourniquet
tests
• Ultrasound - Venous Doppler ultrasound of
the leg

• Because of the inaccuracy of the physical tests

(like Trendelenburg; Perthes; tourniquet
tests), usually venous doppler ultrasound is
done.
 What are the diagnostic tests being done prior to
treatment for varicose veins?
VARICOSE
VEINS

https://
www.slideshare.net/
drkdsm/varicose-veins-
92989912
 What are the diagnostic tests being done prior to
treatment for varicose veins?
VARICOSE
VEINS

https://
www.slideshare.net/
drkdsm/varicose-veins-
92989912
 What are the diagnostic tests being done prior to
treatment for varicose veins?
VARICOSE
VEINS Venous Doppler ultrasound of the leg
- a noninvasive test that uses sound waves to
look at blood flow through the valves in the
Doppler ultrasound
veins using a small hand-held device
helps with varicose
(transducer), which is about the size of a bar of
veins detection and
soap, against the skin over the body area being
identifying causes
examined. The transducer transmits images of
and severity. It
the veins in the legs to a monitor, which displays
examines blood
the results.
circulation.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS After reviewing all of the information (history,
physical exam and tests, ultrasound results),
physicians decide and recommend which leg vein
treatment would be most effective.

Sometimes, more than one type of treatment

and more than one session will be
recommended to give the best results and
reduce side effects.
 What are the treatment options for varicose Procedures are often
veins? done as an
VARICOSE outpatient
VEINS Treatment for varicose veins may include self-care procedure, which
measures, compression stockings, and surgeries or means one usually
procedures. goes home on the
same day.
Selection dependent on stages of varicose
development: Some may need
- Spider veins hospital
- Reticular veins confinement such as
- Varicose veins with no skin damage / ulcer when vein stripping
- Varicose veins with skin damage is recommended.
- Varicose veins with skin ulcer
 What are the treatment options for varicose
veins?
VARICOSE
VEINS SELF-CARE
Self-care — such as exercise, raising the legs
when sitting or lying down, avoiding prolonged
standing and sitting, or wearing compression
stockings — can help ease the pain of varicose
veins and might prevent them from getting
worse.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS COMPRESSION STOCKINGS
Wearing compression stockings all day is often
the first approach to try. The stockings squeeze
the legs, helping veins and leg muscles move
blood more efficiently.

Recommended are medical grade especially with

graduated compression stockings.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS Some Procedures for Varicose Veins:

• Sclerotherapy
• Laser treatment
• Catheter-based procedures using
radiofrequency or laser energy
• High ligation and vein stripping
• Ambulatory phlebectomy
 What are the treatment options for varicose
veins?
VARICOSE
VEINS SCLEROTHERAPY
• A solution or foam is injected into the
varicose veins which scars and closes the
veins.
• In a few weeks, treated varicose veins
should fade.
• The same vein might need to be injected Reported Cost: P3,000
more than once. to P4,000 per session
• Sclerotherapy doesn't require anesthesia
and can be done in a clinic.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS SCLEROTHERAPY
A solution or foam is injected into the
varicose veins which scars and closes the
veins.
In a few weeks, treated varicose veins
should fade.
The same vein might need to be injected
more than once.
Sclerotherapy doesn't require anesthesia
and can be done in a clinic.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS LASER TREATMENT
• Laser treatment sends strong bursts of light
onto the vein, which makes the vein slowly
fade and disappear.
• No cuts or needles are used.
• Outpatient procedure.
 What are the treatment options for varicose veins?

VARICOSE CATHETER-BASED PROCEDURES USING

VEINS RADIOFREQUENCY OR LASER ENERGY

• This procedure is the preferred treatment for Reported Cost:

larger varicose veins. P70,000 to
• A thin tube (catheter) is inserted into an enlarged P80,000
vein and the tip of the catheter is heated using
either radiofrequency or laser energy.
• As the catheter is removed, the heat destroys the
vein by causing it to collapse and seal shut.
• Outpatient procedure
 What are the treatment options for varicose veins?

VARICOSE CATHETER-BASED PROCEDURES USING

VEINS RADIOFREQUENCY OR LASER ENERGY

• This procedure is the preferred treatment for

larger varicose veins.
• A thin tube (catheter) is inserted into an enlarged
vein and the tip of the catheter is heated using
either radiofrequency or laser energy.
• As the catheter is removed, the heat destroys the
vein by causing it to collapse and seal shut.
• Outpatient procedure
 What are the treatment options for varicose
veins?
VARICOSE
VEINS
 What are the treatment options for varicose
veins?
VARICOSE
VEINS HIGH LIGATION AND VEIN STRIPPING

This procedure involves tying off a vein before it

joins a deep vein and removing the vein through
small cuts.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS PHLEBECTOMY
• Removing smaller varicose veins through a
series of tiny skin punctures.
• Only the parts of the leg that are being pricked
are numbed in this outpatient procedure.
• Scarring is generally minimal.
 What are the treatment options for varicose
veins?
VARICOSE
VEINS Some Procedures for Varicose Veins:

• Sclerotherapy
• Laser treatment
• Catheter-based procedures using
radiofrequency or laser energy
• High ligation and vein stripping
• Ambulatory phlebectomy

OUTCOMES OF TREATMENT
 What is the prognosis (inclusive of recurrence
after treatment) of varicose veins?
VARICOSE
VEINS
 What is the prognosis (inclusive of recurrence
after treatment) of varicose veins?
VARICOSE
VEINS Usually, varicose veins aren't dangerous and don't
cause long-term health problems. Most people
with the condition are concerned with the way
varicose veins look. They may experience
discomfort but don't develop complications.

Varicose veins tend to get worse over time.

Common consequences: Skin damage and skin
ulcer
Rare – worst scenario: blood clots
 What is the prognosis (inclusive of recurrence
after treatment) of varicose veins?
VARICOSE
VEINS There is no cure for varicose veins. Even after
surgical removal, recurrences may occur.
 What are the preventive measures against
varicose veins, if there are?
VARICOSE
VEINS
 What are the preventive measures against
varicose veins, if there are? Some recommended
VARICOSE exercises for varicose
VEINS • Keeping a healthy weight. veins:
• Exercising regularly. - Walking
• Avoid prolonged standing. - Bicycling
• Avoid prolonged sitting still. (stationary biking)
• Putting your feet up while sitting. - Leg lifting
• Not wearing tight clothing. - Lunges
- Rocking the feet
- Calf-muscle
exercise (calf-
raising)
 Some recommended exercises for varicose veins:
LEG LIFTING
VARICOSE
VEINS
 Some recommended exercises for varicose veins:
LUNGES
VARICOSE
VEINS
 Some recommended exercises for varicose veins:
ROCKING THE FEET
VARICOSE
VEINS While sitting or standing, rock
feet back and forth from heel
to toe. 
 Some recommended exercises for varicose veins:
STAND-UP CALF-RAISING
VARICOSE
VEINS
 Myths on varicose veins:

VARICOSE Myth #1: If you cross your legs, you’ll get

VEINS varicose veins.

Varicose veins are a result of weakened or

damaged valves. Crossing your legs does not
lead to weakened or damaged valves.
 Myths on varicose veins:

VARICOSE Myth #2: Exercise will make varicose veins

VEINS worse.
Exercise is not only good for your overall health,
but it is also good for your veins. Walking or
running causes your calf muscles to pump more
blood to your heart, which gives your circulation
a great boost.
 Myths on varicose veins:

VARICOSE Myth#3: Varicose veins are treated with drugs

VEINS and herbal medicines.

Drugs and medications can relieve pain and

inflammation but not the varicose veins that are
caused by weakened veins and damaged valves.
 Contents Summary
• What are two general types of blood vessels that can
develop abnormal enlargement? Take Away
VARICOSE
• What are varicose veins?
VEINS • What are the different types of varicose veins? Disclaimer:
• What are causes of varicose veins?
• How to recognize or diagnose varicose veins? ROJoson PEP Talk
• What are the different stages of varicose veins? contains ROJoson’s
• How does a physician evaluate varicose veins? Thoughts, Perceptions,
• What are the common diagnostic tests for varicose veins? Opinions and
• What are the treatment options for varicose veins? Recommendations
• What is the prognosis (inclusive of recurrence after (TPORs) culled from
treatment) of varicose veins? experiences of other
• What are the preventive measures for varicose veins, if professionals and
there are? ROJoson.
• What are the myths on varicose veins?
 Be always in touch with reliable medical Take Away in
information on VARICOSE VEINS. relation to
VARICOSE
VEINS Patient
Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions /
make better decisions on VARICOSE VEINS
in your health management.
 Empowerment
objective - for
laypeople to have an
VARICOSE
essential
VEINS
understanding of
VARICOSE VEINS in
their health
management.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:
Empowerment FEEDBACK TO THIS
objective - for PEP TALK!
laypeople to have an
VARICOSE
essential Pls. type in your
VEINS feedback in the chat
understanding of
VARICOSE VEINS in box during the open
forum and before we
their health adjourn!
management.
Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
Empowerment TAKING BEFORE WE
START Q&A AND
objective - for
INTERACTIONS!
laypeople to have an
VARICOSE
essential Pls. turn on your
VEINS
understanding of video!
VARICOSE VEINS in Show your face!
their health
management.