Miller Vein named official Ambassador of the COVID-19 Workplace Safety Program

Miller Vein is proud to announce its status as an official Ambassador of the Covid-19 Workplace Safety Program through MIOSHA. We are thankful to our teammates for their diligent efforts and attention to detail in maintaining the highest level of patient safety.

To ensure the safety of our friends, families, coworkers and patients, we will continue to adhere to the CDC & Michigan Health guidelines as we navigate through these turbulent times.

I Need Hip (or Knee) Surgery and Vein Treatment. Which Should I get Treated First?

Every day we see patients with varicose veins, and these same individuals are often suffering from osteoarthritis (degenerative joint disease).  This should come as no surprise, since aging is a significant risk factor for both vein and joint disease.  As most people know, wear and tear eventually will weaken bones, joints, and the cartilage in between. Eventually, the pain caused by this degenerative process leads patients to a hip or knee replacement.

Many patients will ask us, “which problem should get treated first, my hip/knee or my veins?”  So, you may ask yourself, does the order really matter? Short answer is yes. Why?  The sequence of treatment may affect your risk for developing a blood clot!  Research has shown that untreated varicose veins are associated with an increased risk of deep venous thrombosis (DVT) after total hip replacement (also known as total hip arthroplasty or THA) or knee replacement (also known as total knee arthroplasty or TKA).  In fact, it has been demonstrated that treating vein disease decreases the chance of post-operative DVT by 50%.

Speaking of knee surgery, we have had the occasional patient with knee pain, thought to be arthritis actually turn out venous disease. For example, a 40-year-old female came to our office with varicose veins in both thighs extending to her lower legs. She had received two negative knee arthroscopes to assess her knee pain. This discomfort was bad enough that she had trouble playing with her young daughters. After we treated her veins, she was thrilled! She could play with her kids again. Also, she had the answer that had eluded her for years. Her knee pain was related to her veins.

Summary

Varicose veins are more than a cosmetic concern. Not only do they cause pain, aching, swelling and other lower extremity symptoms but they are a risk factor for blood clots after hip or knee surgery. Thus, it’s useful to receive appropriate vein treatment prior to these orthopedic surgeries.

Ref:

Prophylactic GSV surgery in elderly candidates for hip or knee arthroplasty

Open Med (Wars). 2016; 11(1): 471–476.  Gennaro Quarto, Bruno Amato, Giacomo Benassai, Marco Apperti, Antonio Sellitti, Luigi Sivero, and Ermenegildo Furino

Does Previous Varicose Vein Surgery Alter Deep Vein Thrombosis Risk after Lower Limb Arthroplasty? Orthopaedic Surgery2012; 4:222–226 • DOI: 10.1111/os.12003

Anahita Dua, MD, Santiago Neiva, Alasdair Sutherland, MD(Hons), FRCSEd(Tr&Orth)

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Imagine Your Great Legs

“I’ve had a less than perfect experience with other doctors with regard to my vein treatment. But Miller Vein and their staff was perfect! Thank you!” – Steve

“I had ropey, ugly, and painful varicose veins. I suffered from prolonged throbbing in my left leg… The procedure was pain-free… My legs look so much better now. My family and co-workers were quite amazed that one week after surgery I was dancing the night away in Las Vegas!” – Susan

CALL TODAY FOR YOUR FREE VEIN EVALUATION

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Can an Octogenarian Safely Receive Vein Treatment?

Varicose veins in the United States are a common problem. In fact, it is estimated that approximately 30% of the adult population have these irritating veins. Unfortunately, many physicians believe that these are only a cosmetic problem, especially when they care for an elderly patient. Nothing could be further from the truth!

Varicose veins are frequently associated with significant symptoms that cause many “functional” limitations. In other words, people have a problem carrying out their typical activities of daily living. It becomes difficult to do yard work, housework, or even to go shopping!

Furthermore, quality of life studies reveals that people with varicose veins often have scores (how they rate their quality of life) that are similar to those who have had prior heart attack, stroke, or a fractured hip. It’s a serious problem.


With this in mind, there was an interesting study that looked at how octogenarians did after vein ablation (closing a vein down) and compared them to younger patients. Of note, those who were over the age of 80 typically had far more cardiovascular co-morbidities (heart and vascular conditions). They also usually had more severe vein disease compared to their younger buddies.


So how did the octogenarians fare? Drum roll please… They did just as well as the youngsters. It was shown that vein ablation is both safe and effective in the elderly. Thus, age should not be used as a factor to deny these patients the care they deserve.


Ref:
Safety and efficacy of venous ablation in octogenarians. Aurshina et al.
Journal of Vascular Surgery: Venous and Lymphatic Disorders, September 2019; p 685-692

What Science Says about Healing a Leg Ulcer

The most common cause of a leg ulcer is a faulty vein(s) that allows blood to leak or travel the wrong way in your lower extremity. A useful analogy to how of these leg ulcers form is to think of your vein as a leaking pipe and your skin is dry wall. Now imagine the leaking pipe is causing the dry wall to get wet and eventually rot. The damaged dry wall will crumble and maybe even develop an open hole.  This open hole is the venous ulcer.

While patching the dry wall may make your wall look okay, with time the wall will get wet again and you will be left with another hole! So before patching the wall, it’s really important to fix the leaking pipe. Similarly, if you want your leg ulcer to heal, you need to have the underlying “pipe” or vein, treated.

Excerpts from a testimonial of one of our patients, Marlene, who suffered from a non-healing leg ulcer sums up the experience of many people:

My personal experience with Miller Vein was finally my journey to healing. I had a venous leg ulcer. (Prior to Miller Vein) I probably had close to 40 visits altogether. The (prior) wound care clinic treated the ulcer with topicals, debriding and wraps… My lucky day (was when my) doctor handed me a Miller Vein card. My husband and I contacted them immediately. I had two office procedures. The wound proceeded to heal…

Notice that prior to definitive treatment, Marlene visited her wound care clinic up to 40 times. We hear stories like this all of the time. Instead of fixing the pipe, they had their dry wall worked on. But does science agree with this concept? I would say YES

In a trial conducted at 20 centers in the United Kingdom, 450 patients with venous leg ulcers were randomly assigned to either undergo early endovenous ablation of superficial venous reflux (closing down an unhealthy vein) or not. Both groups received compression treatment as part of their care. The results? Early endovenous ablation of superficial venous reflux resulted in faster healing of venous leg ulcers and more time free from ulcers.

The take home message is that veins are the most common cause of leg ulcers and when this is the case, early treatment will result in faster/longer lasting healing.


Ref: A Randomized Trial of Early Endovenous Ablation in Venous Ulceration  

The NEW ENGLAND JOURNAL of MEDICINE 

Manjit S. Gohel, M.D. et al. published on April 24, 2018, at NEJM.org.

Another Reason to Appreciate Health Care Workers: Vein Disease

Since the COVID-19 pandemic, the public in general has appreciated health care workers more than ever. Yard signs are still scattered about thanking these frontline caregivers. A recent study demonstrated that chronic vein disease is very common in these workers. This is in spite of the fact that they don’t have other cardiovascular comorbidities (i.e. heart or vascular conditions).

A large screening study of health care workers found that most hospital employees (a whopping 69%!) had signs and symptoms of chronic venous insufficiency (CVI). This means that they complained of leg swelling and also potentially had pain, aching, heaviness, or skin changes of their lower extremities.

CVI accounts for a loss of approximately 2 million workdays per year and almost 12% of healthcare workers seek early retirement because of symptoms.

Left untreated, CVI can progress to a leg ulcer. The annual cost of venous ulcer care is estimated to be $3 billion.

Ultrasound screening on these employees revealed that 82% had venous reflux (blood going the wrong direction in their legs). Also, up to 14% were noted to have increased risk for blood clot!

Long story short…We really need to take care of our frontline health care workers and institute appropriate preventative strategies.

Miller Vein First to Perform FDA-Approved VenaSeal™ Treatment in Southeast Michigan, A Nonsurgical Solution to Treat Varicose Veins

venasealMiller Vein, Metro-Detroit’s primary vein clinic, now offers patients VenaSeal™ as a treatment option for varicose veins. Jeffrey H. Miller, MD and his staff performed the first treatment in Southeast Michigan on Thursday, February 11, 2016. The VenaSeal™ closure system uses a “medical-superglue” to close diseased veins in patients with venous reflux disease.

VenaSeal™ is a variation of procedures already performed at Miller Vein. The benefits of VenaSeal™ is there is only one numbing injection, no compression stockings are needed after the procedure, and patients are able to exercise immediately.

While the underlying cause of varicose veins, venous insufficiency is considered medical; this new form of treatment is currently not covered by insurance.

The VenaSeal™ closure system is the only non-tumescent, non-thermal, non-sclerosant procedure that uses an exclusive medical adhesive delivered endovenously to close the vein. This unique approach eliminates the risk of nerve injury when treating the diseased vein, which is a risk sometimes associated with certain thermal-based procedures. Clinical studies have demonstrated that the procedure is safe and effective. The procedure is administered without the use of local anesthesia, avoiding patient discomfort associated with multiple needle sticks.

Click here to see VenaSeal™ featured on “The Dr. Oz Show”.

Miller Vein Billing Team Achieves ICD-10 Certification

August 18, 2015 – The AAPC (American Academy for Professional Coders) will require all those with a certified professional coder (CPC) credential to pass an ICD-10 proficiency exam to keep their certification by October 1, 2015.

The Miller Vein billing team successfully implemented the code set in the practice, tested with the carriers and are ready for the switch to ICD-10.

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. ICD-10-CM will replace International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) diagnosis codes in all health care settings for diagnosis reporting with dates of service, or dates of discharge for inpatients, that occur on or
after October 1, 2015.

The AAPC requires all those with a CPC credential (Certified Professional Coder) to take an ICD-10 proficiency exam to keep their certification. Miller Vein’s billers, Carrie Fillar, CPC and Sharon Tierney, CPC have both passed the exam and obtained their ICD-10 certification.

See more at: http://blogs.hcpro.com/icd-10/2009/04/aapc-icd-10-proficiency-exam/#sthash.50pYRDGo.dpuf

Miller Vein Receives Vascular Testing Reaccreditation by the IAC

August 5, 2015 – Miller Vein has been granted a three-year term of reaccreditation in Vascular Testing in the areas of Peripheral Venous Testing by the Intersocietal Accreditation Commission (IAC). Miller Vein has proudly remained an accredited vein clinic since 2012.

Health care organizations are held to high levels of accountability. Patients should remain cautious in making sure that their procedures are performed within accredited facilities, because for many facilities it remains a voluntary process. The IAC is widely respected within the medical community and ensures patients receive quality care.

Accreditation by the IAC means that Miller Vein has undergone a thorough review of its operational and technical components by a panel of experts. The IAC grants accreditation only to those facilities that are found to be providing quality patient care, in compliance with national standards through a comprehensive application process including detailed case study review. Through the accreditation process, facilities assess every aspect of daily operation and its impact on the quality of health care provided to patients.

IAC accreditation is a “seal of approval” that patients can rely on as an indication that the facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of Vascular Testing. When scheduled for a Vascular Testing procedure, patients are encouraged to inquire as to the accreditation status of the facility where their examination will be performed and can learn more by visiting www.intersocietal.org/vascular/main/patients.htm