About Varicose Veins
Varicose veins are abnormally dilated, tortuous, bulging veins in your legs. They are often caused by failing valves (incompetent) in your veins, leading to back pressure, which results in the dilated veins you can see on your legs. Apart from looking ugly, Varicose veins can cause aches and discomfort when standing, or venous pain in women prior to their menstrual periods. Other symptoms include itching and eczema, ankle swelling, fluid retention, hot sensations, leg fatigue after work and standing long periods. More sinister symptoms include; severe bleeding from minor trauma, superficial ‘blood clots’ (superficial thrombophlebitis), venous ulcers and a brown indurated woody painful skin condition called Lipodermatosclerosis. Medical treatment includes leg elevation and wearing compression stockings which is often difficult in hot climates.
Endovenous Radiofrequency Ablation
Previously, surgical treatments were known as “cutting and stripping veins” which often frightened patients into avoiding surgical treatment.
Dr Gett is vastly experienced in minimally invasive key hole surgery known as Endovenous Radiofrequency Ablation of Varicose Veins. The procedure involves using advanced radio frequency waves to seal abnormal veins and valves which cause your varicose veins. It uses no synthetic glues or foreign elements to seal the vein, it is just your own natural vein wall’s response to radio frequency waves. This technique requires no stitches and you will experience minimal discomfort often only requiring an occasional Panadol or no medication at all. Returning to work or driving a car can occur the day after your discharged from hospital depending on your circumstances.
Dr Gett recommends that you ensure that you are seeing a registered specialist Vascular Surgeon for your treatment of varicose veins and spider veins. Beware as many ‘Vein Clinics’ are only GP practitioners, they are not registered vascular specialists with the Medical Board of Australia and thus you cannot access your private medical insurance for reimbursement. If you do not require a referral to see the practitioner then it is unlikely to be a specialist surgeon.
Dr Gett is a specialist Vascular and Endovascular Surgeon registered with the Medical Board of Australia and thus requires a referral from your GP to see him. Dr Gett sees both privately insured and uninsured varicose vein patients.
Not all varicose veins and spider veins require surgery. Injection Sclerotherapy is a technique where Dr Gett will inject your varicose veins or spider veins with medication, making the vein wall shrivel and shrink preventing visible blood flow through the vein. Initially the vein and surrounding area will look bruised and discoloured before eventually returning to normal, this usually occurs after a number of months. In a small number of patients the discolouration may not resolve and this is something Dr Gett will discuss with you more in your consultation. This procedure may allow the vein to fade from view over time.
Injection sclerotherapy is performed by Dr Gett and not by an assistant or nurse. The procedure is performed in the rooms, requires no anaesthetic and you can drive home or return to work immediately after the procedure.
About Spider Veins
Spider veins are like varicose veins but are much smaller and closer to the surface of the skin, often with a red or a blue-black appearance. They either appear in clumps or like fine spider webs which look ugly, presenting themselves sometimes like bruises or blue black lines on your legs. They occur more commonly in women but still occur frequently in men. Spider veins are often hereditary. In women they are often associated with changes in hormonal levels and thus bursts appear during puberty, pregnancy, menopause and in elderly patients.
Apart from looking ugly cosmetically, spider veins can be itchy, feel hot and painful. Spider veins, especially in the elderly, can cause major painless bleeding often after scratching unwittingly, after a hot shower or after minor trauma.
Dr Gett has vast experience in treating your spider veins to achieve the best cosmetic result and treat unwanted symptoms. Most of these procedures can be performed in the rooms and do not require surgery.
About Excessive Sweating
Hyperhidrosis is the medical term for excessive spontaneous abnormal sweating. This condition is often embarrassing for patients and can be functionally disabling, as the sweating can inhibit many daily functions such as using a smartphone, writing on paper, holding a steering wheel, typing on keyboards, shaking and holding hands etc. The excessive unwanted sweating can often damage and stain clothes as well as shoes. The condition often commences in childhood or puberty and persists throughout all adult life unless treated. The sweating can occur spontaneously or be exacerbated by heat and normal anxious situations, like giving a presentation or meeting new people. Medical treatment with anti deodorants, medications or electrical water baths (iontopheresis) is often prescribed as first line management of the disease however sometimes these treatments are not enough. Dr Gett offers minimally invasive surgical procedures which can alleviate excessive sweating especially in hands, armpit region, face and hair. Treatment for hand sweating has a 98% success rate requiring no ongoing medications or treatments.
Circulation & Claudication
‘Blocked arteries’ or peripheral vascular disease is a common problem. The major blood vessels often supplying your legs become blocked by a disease process of atherosclerosis 'hardening of the arteries’. Calcium and cholesterol plaques occlude your blood supply to organs or your legs. This is commonly caused by multiple factors such as age, diabetes, smoking, high cholesterol, hypertension and also genetics (family history).
The most common symptom is pain in the major muscle groups (calf, thigh or buttock muscles) of your legs when you walk. Calf muscle pain occurs after walking a fixed distance and is relieved within a few minutes of rest, but recurs again after walking the same fixed distance again. Thus walking becomes a stop, start and stop again affair. This symptom is called claudication. When an artery is blocked or narrowed, insufficient blood supply reaches the muscles with exercise and can cause muscle ache and pain; only relieved with rest. If the blood supply remains severely insufficient gangrene and painful ulcers can occur leading to amputation.
Dr Gett uses minimally invasive ‘key hole’ techniques to treat this problem, often requiring only an overnight hospital stay. This endovascular surgery passes a small wire though an atherosclerotic blockage in the artery. A ‘balloon angioplasty’ is performed in which a tiny balloon opens the occluded blood vessel where, on some occasions, a metallic ‘stent’ is placed to hold the blood vessel open. The ‘stent’ or the ‘balloon angioplasty’ can be coated with a special drug which inhibits regrowth of the atherosclerosis. After the procedure ‘blood thinning drugs, aspirin or aspirin like drugs are used to help prevent further blockages.
The procedure is generally performed under a local anaesthetic with analgesia, so you are awake but experience no pain. X ray guidance is used to undertake the surgery and find the blocked arteries.
Dr Gett has undertaken thousands of these procedures and will discuss with you, how this procedure can improve your walking and eliminate the muscle pain with exercise.
Occasionally minimally invasive ‘key hole’ surgery is not possible, as some blood vessels have long hardened occlusions which wires, balloons and stents can not pass through and re open. In these cases vascular surgical bypass surgery is employed to restore blood supply to the leg or organ. A bypass graft using your own spare veins is produced to create a detour around the blocked artery. This surgery is usually performed under a general anaesthetic and may require a week in hospital to recover.
If you have further questions regarding Bypass Surgery, do not hesitate to ask and Dr Gett will discuss these with you.
About Aortic Aneurysms
Arteries can become diseased, dilated, enlarged and can subsequently rupture causing death. Arterial Aneurysms are the term given to dilated ballooned arteries, these most commonly occur in the Aorta, the largest blood vessel in the body arising from the heart. Arterial Aneurysms grow slowly, often develop in people over 65 years of age and sometimes run in families. The most common artery involved is the Abdominal Aorta but also can occur in the Thoracic Aorta, Femoral and Popliteal arteries.
Dr Gett can treat your aortic aneurysm with either Endovascular Surgery or Open Vascular Surgery.
Minimally invasive ‘key hole’ surgery is a technique used to treat aortic aneurysms. A metallic stent graft, covered in non porous material, is placed in the diseased arterial aneurysm to exclude the blood vessel from the circulation, relining the artery and preventing the aneurysm from rupturing and causing death. This endovascular surgery can be performed with minimally invasive techniques enabling for a faster recovery and mobilisation, typically only 2 or 3 days in hospital. The procedure is performed under a general anaesthetic in a hybrid surgical operating X-ray catheter suite, using the latest 3 dimensional angiography techniques.
Dr Gett has extensive experience in performing advanced endovascular techniques to treat complex arterial aneurysms so you can have confidence your artery will not rupture.
Due to some anatomical considerations, a small number of arterial aneurysms cannot be treated by endovascular surgery. Major Vascular surgery is then required to surgically replace the diseased arterial aneurysm. This surgery is performed under general anaesthetic and may take 2- 4 hours. After your surgery, medical care in an intensive care unit often for 24 hours and a hospital stay of 7 -10 days is required.
Dr Gett is very experienced with excellent results in treating these forms of major vascular aneurysm reconstructions
About Dialysis Access
Renal failure is when the kidneys fail to remove many blood toxins and waste products from the blood. This results in a build up of toxic chemicals and metabolites in the blood stream making you sick. Removal of these toxins can be performed by a dialysis machine. Like a “washing machine”, dialysis washes and removes the blood of toxins, returning “clean” blood to you.
In order to process large amounts of blood for “washing”, an Arterio-Venous Fistula (AV Fistula) is formed. This is created by a Vascular Surgical operation connecting an arm artery to a vein. This allows a large volume of high flowing blood to pass into an arm vein which can then be accessed easily for dialysis.
Dr Gett has extensive experience in creating and maintaining AV Fistula’s for both the Greenslopes Private Dialysis Unit and The Mater Hospital Renal Unit. Critical in the care and maintenance of these fistulas is the use of duplex ultrasound scanning done by Precision Vascular Imaging.
Important in the care of your AV Fistula is the avoidance of blood tests, blood pressure cuffs or IV drips in your planned fistula arm. If you are unsure, please ask your kidney specialist, dialysis staff or Dr Gett for advice.