Q: My father is 71 years old. He has developed several varicosities in the Great Saphenous Vein (GSV) of the right leg. The GSV is thrombosed. Surgery is one of the solutions, but is a risk because of his age. He also has other problems like high blood pressure and he takes one amlong A everyday. He also has blood sugar and takes one glyciphage everyday along with the problem of gout for which he takes one colcicindon everyday. All these problems are under control with medication presently. He has been given antibiotics - augmentin 675 and deflon 500 mg (twice) and has developed acidity. He also had ulcer problem 25 years back. My grandfather had varicose veins, and that has been inherited. My father is still working part time and needs to sit up for about half a day on the chair. He had these clots in the leg along with inflammation which is now under control. The pain and redness has reduced. Is doing away with surgery a permanent solution? Should he wear stockings all the time? Blood tests were taken and his RBC is low (12), his platelet count is low and the conclusion has been thrombocytopaenia. The chest X-ray shows a calcified right aorta. Can deflon be taken indefinitely? He occasionally gets choked whilst eating and cannot gulp down the food, nor spit it out. What else could be wrong? For acidity he has started polycrol gel and ocid tablets. Could there again be some ulcer problem? Now 1 glyciphage has been asked to be replaced with 1 glyciphage SR. No blood reports showed any abnormal sugar levels. Kindly advise.

A:The patient being old and suffering from diabetes should have a thorough assessment and then only he should be subjected to surgery. I am of the opinion that purely thrombosis of the GSV should not produce enough trouble needing surgery. In case that surgery is decided then one has to make sure that his deep veins are patent as at this age, the deep veins are vulnerable and one should not do surgery in that case as it will be counterproductive. This really means that he not only needs the physicians assessment, but also vascular surgeons consultation. In the interim period he should have graduated compression stocking and some anti-inflammatory drugs. He could continue with the daflon if this is giving him relief.