Sharen Gardner - Early warning signs of lower limb problems

Hi, I'm Sharon Gardner and I'm a clinical specialist for HR Healthcare, and we are an industry partner of the Lindsay Led Club. What I want to talk about today is recognizing the early signs of chronic venous insufficiency, so the early signs that the circulation in your legs perhaps isn't working as well as it used to. We know that chronic venous insufficiency occurs when the valves in your leg veins fail to work properly. Your leg veins have a difficult task of carrying blood in your legs, and to do the job effectively they need help from muscle movement, so your calf muscle pushes the blood along, opens up those one-way valves, and then closes again so that the blood can't flow back in the wrong direction. If there's some malformation of those valves, then we start entering into problems. It's really important to think about the early signs of venous insufficiency, that those valves maybe aren't working or there's some problem with the circulation, because sometimes we don't always recognize these signs as a big problem, and we don't always recognize that these are the early warning signs. If we acted on them early enough, we may be able to make a difference to the outcome of our leg health in the future.

Some of the early signs we can look out for — and this is not an exhaustive list, just some of the early signs that maybe you'd consider thinking about your leg health and your circulatory health in your legs. One of the things is varicose veins. Varicose veins don't generally cause any problems; they can be painful, they can cause dullness or heaviness in the legs, they can be worse at certain parts of the day depending on what activities you've done, but they do tend to be seen as more of a cosmetic problem rather than a medical problem. Actually, these can be one of the really early signs that there's something going on with the circulation in your leg, so there's some venous hypertension, some backflow through a faulty vein, or some form of venous insufficiency in your legs. If you are noticing that you are developing varicose veins, your risk of developing a clot in your leg, a deep vein thrombosis, is really highly increased.

Some of the other symptoms — and again, these symptoms could be associated with other medical or lifestyle problems, but they are one of the early signs of venous problems. So leg pain that gets worse or changing leg sensation when you stand still for an extended time, but it feels better when you put your legs up. This is a characteristic of chronic venous insufficiency, and if you notice this type of pain, it's a sign you should come in and get someone to have a look at your legs or assess your blood supply in your legs. Another one, which again we can associate with other problems — I certainly know myself, particularly if I've been on a plane, which unfortunately I haven't been for a while, but if I've flown and I've come home, sat in that compressed air pressure in one position with my legs down for a long period of time, I do get increased leg swelling. I find that my feet and my ankles are more swollen than they would be normally, and that's due to the pressure increasing. That can cause you to develop swelling in your lower leg, ankle, and or foot. That type of swelling often increases throughout the day because of that gravity aspect of being on your feet all day or sitting with your feet down, and it can cause fluid to build up in the tissue in the feet and the legs. When you press the area on your skin, you get a little bit of an indentation, and that's just increased fluid in the tissues.

You may notice changes in your skin, so you may notice some hair loss — maybe you're losing hair at the bottom where your sock area might be. We might notice some changes in the color of the skin or the texture of the skin. Changes in the skin aren't one of the earliest things that we would notice when we're seeing changes in our leg health, but they are definitely important signs. If something is changing with the texture, the feel, or the appearance of your skin in your legs, then that could be an early warning sign of a problem with your leg health. As I said at the beginning, that's not an exhaustive list, and there will be other changes to your legs in terms of their appearance, their sensation, your ability to walk and move, that may be other early warning signs. But it was just to point out a few of the most common changes that patients may see before they then go on to develop more significant problems in terms of leg health and circulatory problems. Thank you very much for listening to my podcast.