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How to examine your own legs What you can do for yourself If your veins are not working efficiently you may then experience skin changes and other signs Useful exercises to help improve your circulation that indicate what is going on under the surface of your skin. Ticking the boxes below may show that you have problems with the veins in your lower legs. They may not be working as efficiently as they did. TAKING CARE Do you regularly have any of the following symptoms?: reddish/brown staining above the ankle OF YOUR LEGS sores that appear within the stained skin Sitting & lying Sitting & lying Standing itchy patches above the ankle (flexing the foot) (rotating the ankle) (moving up & down) wounds or knocks that are slow to heal visible and painful varicose veins tired, throbbing and/or swollen legs With all this going on, the skin above the ankle will be very vulnerable. If the above symptoms Do... Don’t.. are not attended to then the risk of developing leg ulcers is high. The provision of compression hosiery or socks will reduce the risk of the above by helping the blood return up the leg. ...regularly moisturise your legs ...cross your legs for long periods What should I do next? ...walk and exercise regularly ...stand still for long periods If you have any concerns about the condition of your legs, even if you don’t have exactly the same symptoms as described in this leaflet, it may be appropriate for your legs to be ...eat a balanced diet and watch ...have very hot baths professionally assessed. In the first instance you should speak to your GP or Practice Nurse, your weight who may give you a more thorough examination. This may include a full health check and a ...ignore any sores or irritations review of your circulation in your lower legs. They will ascertain whether your veins are ...put your feet up working efficiently or not. If your veins have a problem then they may prescribe compression ...assume that your leg will just get therapy in the form of hosiery or bandages that will treat your existing problem and prevent ...check your legs and feet regularly better by itself further complications. ...get treatment for any knocks or sores ...smoke How compression therapy works if around the ankle, particularly if you Compression hosiery and bandages work by applying a firm, continuous, graduated pressure suffer from diabetes ...remain inactive for extended to the muscles and veins in your legs. When your calf muscle contracts e.g. during walking, periods, eg long journeys your hosiery for example will “give” and then return to its original position. By doing this your ...act on advice from a trained hosiery is able to assist your body’s own natural mechanism for returning your blood back to healthcare professional your heart. What should I do if I’m advised to wear compression hosiery? The educational campaign is supported by If you are advised to wear compression hosiery or socks, it is important that you continue to This leaflet has been sponsored by wear them! Activa Compression Hosiery Modern compression hosiery uses lightweight, comfortable yarns virtually indistinguishable and co-written with from regular hosiery! In fact, the woman on the left of the front cover photo is wearing compression tights. The Association of Tissue Viability Nurse Specialists (South) Self Help Guide If they are not comfortable or are difficult to get on, please speak to your nurse or advisor. Written by 1 Lancaster Park, Newborough Road, Needwood, It is important that you get the correct fit and that you know how to put them on easily. Burton on Trent, Staffs. DE13 9PD. The Association of The compression hosiery will help the venous blood return up the leg, thereby Tissue Viability Nurse Specialists (South) Customer Care Line: 08450 606707 • reducing the chances of venous disease Visit our website at: www.activahealthcare.co.uk • reducing the swelling and aching in the leg Activa is a registered trademark of Activa Healthcare Ltd. • reduce the skin irritation and staining M048 V1.3 Why you need to read this leaflet Varicose Veins Arterial Ulcers This leaflet has been produced to help make you aware of some of the common leg A varicose vein occurs when the valves within the vessel become ineffective Fatty deposits that collect in your arteries can cause them to become complaints which, if diagnosed early enough, can be helped or eliminated by the use (or incompetent), and allow a slight backflow of blood. Eventually the vein narrow, resulting in reduced blood flow to your lower legs. This often of compression therapy. becomes permanently elongated, dilated and tortuous in appearance and causes you to feel that your legs are cold and painful especially when pain results. your legs are elevated. When the blood flow is reduced ulceration It has been estimated that around 50% of the western population are likely to get some form can occur. of venous disease during their lifetime. This can range from spider veins to more serious Varicose veins are usually thought to be an hereditary condition and this is said to be so in 75% of cases. complaints such as leg ulcers. This is due to the fact that we have evolved to walk upright which means that gravity is constantly forcing blood away from the heart and back into your legs. Diabetes There are two basic causes of Varicose Veins: Foot complications are one of the most common reasons for someone with diabetes being If normal bloodflow, through the valves within the deep veins in your legs, becomes ineffective 1. An insufficient number of valves within the vessel admitted to hospital. through injury or inactivity the blood may be redirected to the superficial veins. These are situated Deep Vein near the surface of the skin, causing various complaints such as varicose veins and leg ulcers. 2. Weakness in the wall of the vessel Peripheral Neuropathy It’s this extra pressure in your veins that may lead to problems in later life. Peripheral Neuropathy is a condition whereby you may lose the feelings in your feet and toes. It is safe to say that anyone possessing either of these two weaknesses is a likely candidate for varicose veins. However, these two basic Many people with diabetes are not even aware that they have this condition as it usually If you are having problems with your legs, you may have noticed that the skin has become involves losing the ability to feel pain and other sensations over a period of time. If this occurs weaknesses alone are not sufficient to cause the development or discoloured and you may also experience itchiness in the lower part. and you were to knock and damage your skin a sore may result. If this is not dealt with quickly the condition. and professionally the sore can become an ulcer over time with very serious consequences. The veins may also start to bulge and become sore. The pain may be worse at the end of the Because they are weak, any additional strain or pressure on the vessel Calf Incompetent Muscle day when you have been standing for long periods. may result in the formation of varicose veins. There are six common ‘predisposing’ cases of varicose veins, but these will effect the vein only Valve Peripheral Vascular Disease These problems are usually more common where there is a family history of varicose veins if one or the other of the two basic weaknesses are present. Peripheral Vascular Disease is a condition whereby the flow of blood within your blood vessels or leg ulcers. Damaged is reduced, usually resulting in cold and painful feet. If left untreated your ability to fight Valve in • Pregnancy • Obesity Deep Vein infections and heal any wounds that you might get, is severely reduced. • Injury • Occupational All people who have diabetes should take special care with their legs and feet and should not What are the most common leg problems? • Constriction • Constipation wear compression products without taking advice from their GP or practice nurse. In addition we would recommend that you should also visit a chiropodist on a regular basis. General skin changes Deep Vein Thrombosis Our skin naturally changes as we get older, for example our skin Deep Vein Thrombosis is a condition in which a small blood clot forms mainly in the deep veins of the legs as a result of venous stasis. Lymphoedema may lose its softness, elasticity and smoothness over time. Lymphoedema is swelling in your legs* as a result of an infection However, you may notice more unusual changes such as your legs or damage to the lymphatic system. The lymphatic system has become drier, scaly and discoloured brown staining over time. Recently there has been a lot of coverage in newspapers of people developing DVT during travel and one of the ways of helping to reduce the risk is by the wearing of Class 1 medical been compared to the overflow system of a swimming pool, This might be as a result of leakage of substances from your blood which serves to recycle and filter water (blood) back to the pool vessels into your surrounding skin. compression hosiery which is only available through pharmacies. (blood in the legs) therefore helping to maintain the correct level of blood and nutrients to keep your legs healthy. Swollen ankles and legs Venous Leg Ulcers * lymphoedema can occur anywhere in the body but will be discussed in relation to the legs for the purpose of this leaflet. Oedema occurs as a result of an increase in fluid in your legs. Oedema can be a very painful A venous leg ulcer is an area of damage on your skin, normally below your and distressing condition that can occur for a number of reasons, some of which are more knee or on your foot that fails to heal even after several weeks. • Your skin may become thickened, preventing you from pinching the folds of your skin serious than others. If there is an ulcer present then you may be advised to use a compression • You may notice pronounced skin creases or folds bandaging system or hosiery treatment kit which will be applied over several • Constriction from clothing • Lack of mobility during a long journey weeks to allow your ulcer to heal. • Your legs and ankles may become swollen • Eczema • Contact dermatitis • Leg Ulcers • Poor circulation • You may get regular bouts of cellulitis, which is a skin infection and can become painful, If there is no ulcer (sore) present, you will be advised to wear compression hosiery to prevent • Lymphoedema bright red and lumpy the ulcer from occurring or reoccurring. Compression hosiery and bandages provide support to your veins to encourage the blood to flow back up the legs to the heart, therefore reducing the blood pressure in your veins.
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