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DVT or sclerotheraphy

Sent to Health Experts September 18, 2006 2:04 p.m.

I have had an infection, significant swelling and discoloration of the skin in my left foot/ankle and lower leg for 30 days. While I have been on a significant number of IV and oral antibiotics continuously the infection/swelling has not gone down appreciably. I had an xray of that area that disclosed some significant calcification in the arterie and possibly the veins. I then hade an arterial doppler of the lower extremities that indicated normal doppler signals, wave forms and normal ankle brachial indices bilaterally maiking the likelyhood of large vessle PAD low. While toe pressues are diminished bilaterally they cannot exclude small vessel disease. I have been told that the sweeling remains due to an issue with the veins and that is my next stop at the doctors. I dont know if this is sclerotherapy or DVT. Also I am an diabetic and have been for 17 years.

My questions are. Who would do the tests for DVT or sclerotherapy? Which one would be the first step and would my primary care physician, my cardiologist or someone else be the one to direct this care?

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Male , Age: 51

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primary care doctor

Customer (name blocked for privacy)

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Answer
September 19, 2006 12:06 a.m. (10 hours and 2 minutes later)

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Dear Customer (name blocked for privacy),

Your primary doctor should be able to diagnose you with DVT, but if he/she hasn't gone that route, then your cardiologist would be the best bet.

Sclerotherapy is usually done by a plastic surgeon or dermatologist, for treatment of varicose veins or spider veins. You may find that your cardiologist also does sclerotherapy for patients with varicose veins.

Because you mentioned being a diabetic for 17 years, I want to address some issues regarding the feet. Diabetics are at risk for developing sores that escalate to gangrene and eventually amputation. Diabetes impairs circulation and causes neuropathy so yo may have cuts and sores on your feet and not even feel them. As a diabetic it is important to inspect your feet daily to be sure they are intact. Diabetes can also make healing time take longer.

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Reply to AnnlynnRN
Sent September 19, 2006 5:09 a.m. (5 hours and 2 minutes later)

I reralize that schelothraphy for the most part addresses things like spider veins but it also is used for deeper veineous blockage issues, What level of test, and one more indiciative than an IPG and being diabetic would be the best test for one to determine the actual amount of damage or blockage levels in the lower legs and feet. Based on the type of test who would be the best person to evaluate and do the script for? The primary care or cardiologist? Remember this is an HMO we are dealing with.

Customer (name blocked for privacy)

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