Q: I have a problem in my left leg. The doctor says that the vein in the thigh region has a small block, which is preventing the upward flow of blood from the leg. My left leg swells up everyday. The vein in the foot, near the ankle is very prominent and it bulges out suggesting that blood is getting stagnant there. As a result the skin on the lower part of my left leg is going bad. The last doppler test showed that the block is getting opened slightly. I have consulted a lot of doctors but nothing satisfactory has been done. I rest my leg against a wall at night for about 20 minutes before sleeping so that the blood flows due to gravity, which has really helped. Please help me regarding the treatment as it is very embarrassing to have a swollen foot with a bad skin on it.

A:I have noted the contents of the mail and have following advice to give. The patient should get further investigations done to confirm or exclude the possibility of Anti Phospholipid Syndrome. These are blood tests and are designed to plan the long term prognosis and treatment. It is obvious from the details that he has had Deep Venous Thrombosis with Chronic venous insufficiency. If the episode is one in isolation then one has to only treat the swelling. This can be done by using a flowtron and graduated compression stocking which have to be worn for long time. In case the anti phospholipid syndrome is present then that has to be addressed and this can mean treatment over and above the treatment for the swelling and could mean anti-coagulants for life. If the person is not sure with the advice then I suggest that a vascular surgeon may be consulted.