George Burns, that wise philosopher, said it best: “You can’t help getting older, but you don’t have to get old.” There’s no denying biology, but when a patient enters his or her golden years, attitude and lifestyle become more relevant to good health than ever.
Dr. Bruce Bates, D.O., FACOFP, CMD has been practicing medicine since 1975. He is the former Associate Dean for Clinical Services at the University Of New England College of Osteopathic Medicine and was the first-ever Chair of the Department of Geriatric Medicine.
Dr. Bates believes that the biggest obstacle when caring for older patients is ageism—on the part of the doctor and the patient. “What do you expect? I’m old,” is a commonly held attitude.
“The acceptance of decreased functionality as normal is a detriment to healthy and successful aging,” said Dr. Bates, who was an administrator and part-time physician for MatureCare, a Maine practice specializing in caring for the elderly in live-in facilities or at home.
Veins and aging
Paying attention to venous health is one aspect of successful aging. Venous insufficiency occurs when healthy veins become damaged and allow the backward flow of blood into the lower extremities. This pooling of blood can lead to a feeling of heaviness, aching, and can cause skin changes, such as spider veins or a brown, woody appearance of the lower legs.
To better understand how veins work, watch this short video with Dr. Cindy Asbjornsen, a vein specialist at Vein Healthcare Center in South Portland, Maine.
The veins of an older person
Older people’s veins respond differently to everyday stress compared to that of a younger person’s because vein walls are primarily made of collagen. As the body ages, a decrease in the production of collagen causes the veins to become more brittle and the valves more likely to fail, especially in the superficial veins. Thus, there is a higher incidence of varicose veins in the elderly population.
Additionally, the skin begins to lose its elasticity and doesn’t respond to stress the way it once did. And because skin is the “end organ” of venous disease, ulcers and bleeding varicosities can occur as a result of damaged veins.
Many older people think varicose veins and venous stasis ulcers are a normal part of aging, but what they may not know is that they need not suffer with symptoms. Even those who experience an aching or heaviness in their legs can receive treatment and relief. Treating the symptoms also stops the progression of the disease.
One barrier to treatment is that, in the past, treatment options were limited. “Vein stripping” was the go-to procedure for many years. Treatment of venous disease today, however, is vastly different. Breakthroughs in phlebology and new approaches to treatment involve less time and less pain, and they are overwhelmingly successful over the long term when performed by an experienced specialist. The risk-benefit ratio makes vein treatment an ideal option for seniors.
A trained phlebologist will locate and treat a vein problem at its source, leaving no skin openings other than that of a typical IV access site. Considering the person’s overall health prior to treatment is essential. It’s important to take into account any other ongoing health issues.
Common problems and solutions
As discussed earlier, varicose veins are a frequent problem for older people. Deep vein thrombosis (DVT) is also quite common. DVT occurs when a blood clot forms in one of the large veins—usually one of the lower limbs, such as the thigh or calf—leading to either partially or completely blocked venous return.
The incidence of DVT is higher in older people because of something called Virchow’s triad: 1) endothelium damage, including trauma to any blood vessel due to surgery, or even bumping into something, 2) stasis, a decreased blood flow due to immobility, and 3) hypercoaguability, an abnormal tendency toward blood clotting, due to heredity, an acquired medical condition or a medication.
As people age, some tend to be less active because of other medical conditions, such as arthritis or a respiratory issue that makes them less likely to walk or exercise. Walking causes the rhythmic contraction of calf muscles and, like a pump, forces all the blood into the deep veins and helps promote blood flow to the heart. Amazingly, walking just 30 minutes a day, even in three-minute increments, can improve vein (and overall) health.
Compression therapy is also common in venous care, especially for older people. If you tried compression stockings years ago, there are newer designs and devices to help pull them on, and wearing them is much more tolerable. What’s also important to know is that there is a difference between graduated compression stockings and T.E.D. hose; they should never be used interchangeably.
Treatments and attitudes
No matter what your risk or your age, there are modern treatment options and techniques, such as endovenous ablation or ultrasound-guided sclerotherapy that offer effective solutions for the majority of vein problems. They are minimally invasive, highly successful, and are not reserved for the young.
Back to the issue of ageism as it relates to the health of your veins. If you think about aging in a functional, positive way, rather than a declining, dysfunctional way it leads to one conclusion: Prevention is key. In venous care, early, high-quality treatment can be the best form of prevention.
This blog post was adapted from an article featured in Vein Health News, a publication founded by Dr. Cindy Asbjornsen to educate medical professionals and patients about vein health.