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Legs Leaflet qxd Page


									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      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:
• 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.
                                                                                                        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
                                                                                                                                                                                                                 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.
                            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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