The Case Against Compression Stockings

Many patients hesitate to have their spider veins treated during the summer months.  Summer heat makes the idea of wearing  compression stockings unpleasant.

veins compression hose dog play 

After years of experience, I offer the following guidelines on the subject:

veins compression hose closeup polkadots


 The use of compression stockings after sclerotherapy is somewhat controversial.  Recommendations vary and a case can be made for both wearing and not wearing compression stockings.

Some doctors feel that studies show that you don’t need to wear compression stockings at all.  This is the accepted standard of care in France:  the recommendation in France being NOT to wear compression stockings for treatment of spider veins.   Yet, other doctors insist on compression hose.

I come down somewhere in between both views.  Every case is, after all, different.   Patients who have larger spider veins and reticular veins need to be treated differently from those who have smaller spider veins.  So, some  patients will do well  without wearing compression stockings and there are others whose veins need to have some compression for a short period of time to prevent refilling of the treated veins.

Don’t put off treatment or evaluation because you assume you will have to wear compression hose.   At your initial appointment, when we are able to look at your veins, we will  make a personalized  evaluation of what you can anticipate.  You may be pleasantly surprised!

veins compression hose colors




This post was written by Vein and Skin Laser Center | July 9, 2015



It has been a happy season, seeing spring come and go and settling into summer and July 4.

We enjoyed seeing our grandson wave the stars and stripes!


This is what I woke up to early one morning.


It’s not all work and no play for the doctor!  Well deserved time off for a family vacation at the beach with all the kids and grandkids.

David at beach with kids

In the midst of the good times, we recognize those who experience life a lot differently.  The life of a doctor includes seeing a lot of pain and suffering, here and abroad.   His life is an attempt to ease the hardships that inevitably come.


More next month on doctors’ wife activities, but this month, salute to America and my husband as he tries to do his part!  I love you, Dr Fern!

Dr Fern’s Favorite: Carrot Cake

1-1/4 cups Wesson oil

2 cups sugar

4 whole eggs

2 cups White Lily flour

2 teaspoons cinnamon

2 teaspoons soda

2 teaspoons baking powder

1 teaspoon salt

3 cups shredded carrots



1 8 oz block cream cheese

1 cup pecans, broken

1 stick butter

1 box powdered sugar

2 teaspoons vanilla

Beat together oil and sugar.  Add eggs, one at a time, beating well after each.  Sift together  flour, cinnamon, soda, salt and baking powder  2 or 3 times.  Add to egg, sugar and oil mixture.    Last, add the grated carrots.

Turn into three greased and floured cake pans.  In addition, I line mine with wax paper .

Bake in  a 350 oven for about 30 minutes.  Cool 10 minutes or so before turning out of pans.  Cool on wire racks.

Ice with cream cheese frosting.


Beat all ingredients except nuts together until fluffy.

Add nuts.

Spread frosting between layers and on sides and top of cake.




This post was written by Vein and Skin Laser Center | July 8, 2015




Patients sometimes wonder if having varicose vein treatment is a smart move.  They think they might need those leg veins (great saphenous veins) if they need bypass surgery in the future.

This is a good question!  Because in the past there was concern among physicians to preserve this vein.  The great saphenous vein was  often used as a replacement for an artery in heart bypass surgery.     IMG_0497

Now, many cardiac surgeons prefer the radial artery from the forearm or the left internal mammary artery from inside the chest as a conduit for coronary arterial bypass procedures.

 Things have changed!  Doctors now believe there is no reason not to treat the great saphenous vein in the leg if needed.  If the vein is badly damaged, it will not work as a vein graft anyway.  Truth is, refluxing varicose veins (which have broken valves allowing the blood to flow back)  are unsuitable for use in these situations.  They are not healthy, functioning veins.

When  bypass surgery is needed,  heart surgeons  want the best veins possible for a good outcome that would last for many years to come.  And diseased veins would not be the best choice. There are several arteries that can be used as grafts for bypass surgery, but the most common is the left internal mammary artery (LIMA). The right internal mammary artery (RIMA) may also be used as a graft. These arteries are accessed thru the same chest incision used to access the heart. Occasionally, the radial (in the arm) or the gastroepiploic (near the stomach) arteries may be used, each accessed thru separate incisions.

Because we have many substitutes that can be used for the saphenous vein it makes it easy to recommend having the veins treated by thermal ablation.  In this way the patient’s symptoms and lifestyle can be improved without having to worry about needing this damaged and inferior vein for later bypass cardiac procedures.


This post was written by Vein and Skin Laser Center | July 7, 2015