General

What should I bring with me when I come for a scheduled office appointment

• It is NOT necessary to have a referral to attend the clinic and this does not interfere with obtaining Medicare rebates for procedures. If your doctor does give you a referral, please bring it so we can get the doctors details and communicate with the doctor (only if you wish us to, that is)
• Medicare card
• Please print out any quote from the Alia Vein Clinic that you have received over the internet. This helps Dr Roberts to give you an accurate costing

Are my medical records kept private and confidential?

Your medical file is handled with the utmost respect for your privacy. Our staff are bound by strict confidentiality requirements as a condition of employment regarding your medical records.

Do I need a referral to make an appointment?

No, this is NOT necessary, even for procedures that give Medicare and Medicare Safety Net rebates.

What should I expect during first visit?

During your initial consultation, Dr Owen Roberts  will take about 30 mins to explain  which vein treatment is best for you and will go over any risks. He will examine your legs  and will ask you a few questions.

Dr Roberts will explain in detail what causes vein problems and may recommend an ultrasound mapping of your legs. This takes about 30 minutes and is performed by a qualified sonographer. This ultrasound will determine where the problems are, which veins are not working properly and whether you are suitable for endovenous laser ablation (usually for big, ropey veins).

Once the mapping is completed, Dr Roberts will be able to advise you of the best options to treat your legs. Come prepared with your questions too. It is a good idea to write them out, so nothing is forgotten.

At the end of the consultation you should feel that all your queries have been answered, you should have a clear understanding of all the costs and be in a position to make a decision about proceeding. Dr Roberts will give you his contact number so you can contact him with any further questions.

Many people make bookings for procedures at the time of the consultation so if you know your work schedule before you come you can make your treatment appointments at the time of consultation. Some people may want to begin treatment immediately, especially people from out of town. This can be accommodated at time of consultation.

What do I need to do after the treatment?

Specially designed compression stockings need to be worn on the treated leg following each session. This is fitted at the time you have the first treatment.

A Grade 2 compression stocking is worn for 1 week following the treatment of spider veins. For larger veins, a Grade 2 compression stocking is worn for 2 weeks after the last treatment session. The stocking helps to compress the vein walls so they stick together, and it also helps to minimise any blood trapped within the vein. It also reduces the chance of skin pigmentation (looks like a bruise) as the vein breaks down. The risk of inflammation to the vein is also reduced.

Walking is important right after each treatment session and also between the treatment sessions – about 30 minutes after each session and 1 hour each day wearing the stocking for the two week period. You will need to avoid any strenuous exercise, including aerobics and yoga. This can increase the pressure in the treated veins and disrupt the healing process, so some minor lifestyle adjustments must be made to get the best from your treatment.

Does Medicare cover some of the cost of procedures?

There are medicare rebates for both endovenous laser and ultrasound guided sclerotherapy also for microsclerotherapy for spider veins. All these procedures do contribute small amount to the medicare safety net. Medicare does not cover all the costs.
If you would like more information about the Medicare Safety Net, please go to the Medicare website www.medicareaustralia.gov.au

Is there parking nearby?

Yes, there is free 2 hour parking in a multi storey car park just down from the Alia Vein Clinic in Hume Street.

How long does the procedure take?

30 mins for ultrasound guided sclerotherapy, 45 mins for laser and 30 mins for spider veins per session. After each treatment you will need to go for a 30 minute walk before you drive home/ work.

How many treatments would I need?

This varies due to the amount of veins and the size of the veins each person has. On average it is 2 treatments per leg, then a check-up at one month, 2 months and sometimes at 6 months after the treatments. These check-ups are covered by medicare. Treatments can be done on consecutive days so one leg can be completed in 2 days . You can also contact Dr Roberts at any time on his mobile phone.

Most problem veins on one leg can be treated in just 2 sessions of Ultrasound guided Sclerotherapy. One leg is treated at a time, so both legs are usually completed within 4 treatment sessions – sometimes fewer. An ultrasound assessment of the veins is conducted at the beginning of each treatment session. This is to check how the last treatment has gone and also to locate any small tributary vessels that could cause a recurrence. These veins are treated straightaway so that the best long-term outcomes can be achieved. The treatments can be done over two consecutive days to streamline the process and minimise the time you will need to wear special hosiery. If spider veins and reticular veins also need to be treated, then 1-2 additional sessions may be required.

Studies of Ultrasound Guided Sclerotherapy on leg veins show excellent long-term results. A short follow-up ultrasound is performed 1 month and 2 months after your treatment finishes to ensure closure of the veins. Always bring your stockings with you on every visit so we can do any touch up injections. You wear the compression stockings for a few days with these top up injections not the full 2 weeks again.

What is the difference between surgical stripping and endovenous laser/ ultrasound guided sclerotherapy?

The recurrence of varicose veins is much less with laser and ultrasound sclerotherapy than with stripping. There is no hospitalisation, no general anaesthetic, no down time- you just carry on with normal activities compared with stripping where you are off work for weeks and in considerable pain.

Don’t I need these veins?

Varicose veins are veins that are not working anymore, other veins have already taken over their function. If  left untreated they will only get bigger and may cause problems such as aching legs, itchy legs, skin discolouration and could lead to leg ulcers.

I had my spider veins injected before and they came back

If spider veins come back it could be due to an underlying problem of varicose veins. Spider veins can be supplied by a feeder vein from a vessel deeper in the leg like a varicose vein. These spider veins come back due to the pressure from below forcing the spider veins to open again and refill with blood.

You need to map the veins using ultrasound to make sure there are no varicose veins below the spider vein so you can get the best result possible. Spider veins also are under hormonal control in their growth so it is unrealistic to expect to get rid of 100%. A realistic result would be a 75% improvement.

Does it hurt to treat the veins?

For ultrasound guided sclerotherapy we use ultra fine needles to inject the fluid or sclerosant. Using ultrasound we see exactly where the needle is going so it is very accurate. This ensures the injection is placed quickly and with minimal discomfort. With microsclerotherapy an even finer needle is used so any discomfort it is easily managed.

With Laser we inject a local anaesthetic so you don’t feel any pain during the laser. For people who just find the thought of a needle makes them uneasy we offer the use of a nitrous oxide gas that makes you feel very relaxed. You just breath it in at your own pace and it wears off quickly before you leave the surgery. It is not recommended you drive after nitrous oxide use so catch the train/ bus or have someone drive you.

How long before my legs get better?

After the treatments the veins will be tender to touch for 6-8 weeks. The treated veins will go hard  and lumpy. The veins don’t increase in size but you  will notice them when you shower or touch your legs.

After 6 weeks your body starts to dissolve them until they disappear. The larger the veins the longer it takes to shrivel away. While this process is going on you carry on with your normal life such as work, family, exercise etc.

One of the first  things to improve after treatment is if your legs ache or you suffer other leg vein related symptoms such as  tiredness legs, heaviness, throbbing, itching, and restless legs, this is due to the pressure being turned off at the top of the leg. After  Laser treatment these improvements are often instant as the varicose vein has been closed immediately.

How long do I wear compression stockings?

1 week for spider veins and you can take them off at night to shower and sleep. 2 weeks for varicose veins, the first 3 days you don’t take them off, you shower and sleep in the stockings (they are designed for it), then for the remaining 11 days for can take them off to shower and sleep. You wear them throughout the day for 2 weeks.

The stockings we use are fitted to your shape of leg, there is no size of  leg we can’t fit. The stocking are a stay-ups  and they come up high to the top of the leg and your toes are free. A lot of people choose to wear them longer as they are very comfortable especially if they have jobs were they are standing a lot e.g. chefs, teachers, hairdressers, retail workers and nurses.

Is there pain after the treatments?

For both Endovenous Laser and Sclerotherapy (injecting the veins)  the veins will be tender but easily managed by nurofen or panadol. After two days most people don’t need pain relief. Walking also makes the legs more comfortable. About 20% of people don’t need pain relief at all.

How long will the results last?

Some people can have a single session or sessions of sclerotherapy and will not need further treatment ever again. Usually the veins that have been treated will go completely, but others can form with time, as sclerotherapy does not fix faulty valves and vein walls.

For large problem veins, Endovenous Laser and Ultrasound Guided Sclerotherapy delivers excellent long-term results. The research stipulates that there is an 85% chance of no regrowth in 5 years allowing 15% chance of a varicose vein forming within 5 yrs. If this occurs it is usually only one small vein and it is easily treated.

For smaller spider veins, up to 75 % improvement can be expected following a single treatment course. You can have another treatment course, if necessary, after a two-month waiting period to improve the remaining 25%. You cannot get rid of 100% of spider veins but you can improve on them significantly.