Tag Archives: spider veins

My uses for Hypertonic Saline

Normal Saline was invented in 1896 by Mr. Hartog Hamburger in Holland. Yes, this was at one point called Hamburger’s solution. Normal saline is a close approximation to the osmolarity of blood – thus there are tons of uses for normal saline. So how about HYPERTONIC Saline? What are the uses of something that has a higher osmolarity of blood? There are multiple uses but in my career it has been used for reducing brain swelling in trauma patients (more specifically to lower intracranial pressure, where maintenance of cerebral perfusion is key as it relies on blood pressure being high enough above intracranial pressure.)

The other use of HYPERTONIC Saline is in the COSMETIC treatment of spider veins. Now it’s less popular for this indication because POLIDOCANOL has been shown to be a superior product for spider vein treatment (and more expensive), but safety and superiority trumps cost for the most part. We use Polidocanol at Surgical Artistry, in Modesto, CA.

How soon after vein procedure do I see results?

Vein Treatment Center in Modesto, CA

I got this question today and I thought I’d try to answer this question.

How soon after vein procedure do I see results?

It’s actually not an easy question to answer because the results vary and everyone starts with a different starting point.  But even after I see a patient, I still have somewhat of a hard time predicting the point where “results” are seen.  First let me define results as “I’m happy to show off my legs.”  or I can word the question a little differently:

How long after I START vein procedures will I be happy with the BEST reasonable results?

Reasonable results = 90% improvement from baseline.

It might be 6 months later after starting vein treatments and about 3-4 sessions of sclerotherapy (vein injections) and vein laser mixed in, and about $1500 spent. And after sclerotherapy, I don’t want patients to experience vigorous exercise for about 9 days after the procedure.  Stockings after sclerotherapy is a must for those 9 days as well.  But after vein procedures, the after care is easier: no stockings needed, and minimal restrictions on the exercise.

Most patients do fewer than the 3-4 to get the greatest results in 6 months.  Many take their time and do 3-4 procedures over 2 years.  But after each procedure, there may be about a 2-3 month recovery time depending on several factors.  And after each session, I’m hoping for 30-50% improvement.

Cosmetic Vein Procedures and Medical Vein Procedures are different

I perform an ultrasound with duplex to see if there is reflux in some of the slightly deeper veins.  If these veins have reflux, I consider the surface veins as a possible side effect of these veins on the inside.  Most of the time, I believe that insurance covers the treatment of the refluxing veins.  This is usually done via endovenous ablation with laser or radio frequency in the office/surgicenter setting or it can be done with vein stripping at a hospital setting.  I have done laser ablation in my office; however, I’ve stopped taking insurances and if our ultrasound test shows that you have what I called a “medical vein issue” then I’ll make some recommendations for practitioners who take insurance, and after these veins are taken care of.  We can deal with the cosmetic vein issues.  However, about 30-60% of the time, I’ve seen much of the cosmetic vein problems subside after the medical vein problems have been solved or improved upon.

What do we do at Surgical Artistry?

 

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I get this question a good deal.  I think it’s probably somewhat confusing as to what we do and we offer a lot of procedures and products.  Basically we are a two surgeon medical group offering services in Veins, Acupuncture, Plastic Surgery, and General Surgery.  That can be quite a lot.  But even with that said, it’s somewhat confusing as to what each of these items involves.  So I thought I’d make a list which doesn’t include everything, but covers most of what we do:

DR. TAMMY WU PROCEDURES:

DR. CALVIN LEE COSMETIC and BOTOX PROCEDURES:

  • Botox for cosmetic
  • Botox for headaches
  • Botox for hand and axillary sweating
  • Botox for TMJ (jaw pain)
  • Fillers (ie. Juvederm)
  • Lip Augmentation with Juvederm or other injectable fillers
  • Vein Laser
  • Vein Injections (ie. with Asclera)
  • Face Vein treatment
  • Acne Consultation
  • Skin Care Consultation
  • Cosmetic Mole Removal
  • Microdermabrasion
  • Chemical peels (ie. Obagi Blue Peel Radiance and Obagi Blue Peel)

DR. CALVIN LEE ACUPUNCTURE PROCEDURES:

  • Acupuncture trigger point deactivation for muscle pain
  • Acupuncture for back pain / neck pain
  • Acupuncture for buttock pain (ie. pyriformis syndrome)
  • Acupuncture for IT band pain (side of thighs wrapping to below knee)
  • Acupuncture for fertility
  • Acupuncture for TMJ (jaw pain)
  • Acupuncture for stress / anxiety
  • Acupuncture for allergies
  • Acupuncture for fibromyalgia
  • Acupuncture for depression
  • Acupuncture for hormones (hot flashes, acne, menstrual cycle)
  • Acupuncture for facial rejuvenation (cosmetic)
  • Acupuncture to boost the immune system
  • General wellness Acupuncture
  • Anti-nausea acupuncture for those undergoing chemotherapy or pregnancy

  SKIN CARE PRODUCTS:

  • Obagi Line
  • NIA 24 Line
  • Various Skinceuticals

 GRADUATED COMPRESSION SOCKS:

To recover faster from workouts, prevent varicose veins, and prevent injuries

  • Calf sleeves from Sigvaris and CEP brands
  • Full calf sleeves from Sigvaris and CEP brands
  • Dress socks from Sigvaris
  • Thigh high and Pantyhose compression from Sigvaris.

 Contact Us:

Surgical Artistry - Calvin Lee, MD / Tammy Wu, MD

 

Metronidazole Topical for Rosacea?

This is a note-taking blog for purposes of education – not for specific directed medical advice.

Metronidazole is a treatment available for Rosacea

  • Topical application of Metronidazole (meanning applied to the skin surface)
  • Metronidazole also comes as a pill form but this isn’t usually needed or indicated for Rosacea
  • Metronidazole is an antibiotic
  • Flagyl is the name a brand of metronidazole in pill form
  • As an antibiotic, Metronidazole is effective against anaerobic bacteria and protozoa.  It is a drug used for treating clostridium difficile infection (c. diff).
  • Topically, it comes as cream or gel
  • Metrogel is a brand (Metrogel 1%) as is Rozex.  And there are generics available for metronidazole gel or cream.
  • Many patients use metronidazole topical twice a day
  • Many patients of ours at Surgical Artistry, Modesto, report some dryness with the product and use it with a moisturizer.

Other uses of Metronidazole

  • Orally it has been used in Crohn’s disease
  • And orally, it has been used as part of the treatment for peptic ulcer disease

Obagi Rosaclear

  • a system designed by Obagi Medical for treatment of Rosacea
  • Metronidazole topical is part of the kit,
  • available as part of the rosaclear kit is a cleanser, toner, and a special tinted sunblock

What is Rosacea?

  • Some forms of it seems to be a skin infection which is related to blood vessel dilation and redness
  • Central facial redness, burning and stinging
  • visible red veins
  • bumps or blemishes
  • tight or itchy facial skin which may swell
  • Cause is unknown

What can our office in Modesto, do for Rosacea?

There are many treatments available for Roscea

  • We have Rosaclear available from Obagi
  • We have many Rosclear Sunscreen – tinted specially to hide and blend in the redness.
  • We have a vascular laser (Dornier 940, Germany) which is good for targeting the red vessels.
  • For some patients we can also prescribe clindamycin topical for rosacea