Consultations from home

So many people from around Ireland, Northern Ireland and the UK are looking for consultations with our Clinical Director/Advanced nurse specialist Claudia McGloin. 

We understand the difficulty for some to travel to Sligo which is the main clinic so, we have come up with a way for you to have advice and information without travelling. 

You can now avail of a consultation from the comfort of your own home via telephone or Skype at a time that suits you. We can offer help, advice and discuss conditions while advising you on a way forward to get the investigations and treatment that’s right for you. 

The New You Clinic recently rebranded from the Claudia McGloin Clinic and is now a dedicated Women’s Health Clinic in addition to Medical Aesthetics. We are now covering aspects such as HRT, Menopause, Osteoporosis, Melasma, Varicose Veins, Thread Veins, Stress Urinary Incontinence, Sexual Dysfunction, Vaginal Dryness and painful intercourse. 

Our phone consultations include:

* Pelvic Congestion Syndrome

* May Thurners Syndrome

* Menopause 

To book a consultation, you will need to call the clinic direct on 0719140728 and book a time that suits you. The consultation cost is €50 and must be paid at the time of booking the appointment. A text confirming your appointment will be sent to you.

T&C’s Apply. 

Leg Ulcers

What are Leg Ulcers?

Leg Ulcers can be either Venous or Arterial. A Venous Leg Ulcer is a Chronic Non Healing Wound that has been present for at least 6 weeks with Broken Layers of Skin and Exposed Tissue. Venous Leg Ulcers are usually found on the inside of the leg just above the ankle. They can be painful especially when they are infected.

What causes Leg Ulcers?

A Venous Leg Ulcer is caused by Poor Blood Circulation due to damaged veins in your legs.

There are two main types of blood vessel:

• Arteries – oxygen rich blood is pumped from your heart through your arteries to the rest of your body.
• Veins – blood is returned to the heart through the veins once the oxygen has been removed.

Vein problems occur when the valves inside the veins stop working properly.

In a healthy vein, blood flows towards the heart. Blood is prevented from flowing backwards by a series of valves that open and close to let blood through. If the valves weaken or are damaged, for example, following a Deep Vein Thrombosis (DVT) the blood can flow backwards.

This may cause Varicose Veins visible on the surface of the leg or the damage may lie in the deep veins hidden from view. Pressure inside these veins is increased and this can damage the Skin.

The constant high blood pressure in your legs causes fluid to leak from the veins. The fluid causes swelling and damages the skin which becomes hard and inflamed leading to a Leg Ulcer.

Symptoms of a Leg Ulcer

• Swollen Ankles filled with fluid that temporarily hold the imprint of your finger when pressed (Oedema)
• Discolouration and Darkening of your skin around the Ulcer (Haemosiderosis)
• Hardened Skin around the Ulcer (Lipodermatosclerosis)
• Small, Smooth areas of White Skin which may have tiny Red Spots (Atrophie Blanche)

The associated symptoms of a Venous Leg Ulcer are caused by blood not flowing properly through your veins. This is known as Venous Insufficiency and can cause the following:

• Leg Pain
• Heavy feeling in the affected leg
• Aching
• Itching
• Swelling
• Varicose Eczema (Itchy, Irritated Skin associated with Varicose Veins)

Diagnosis of a Leg Ulcer

If you have the above symptoms then you need to see a Medical Professional. You may well have a Doppler and a Duplex Ultrasound Scan. A referral to a Consultant Vascular Surgeon is next to determine the next stage and treatment for the Leg Ulcer.

Treatment for Leg Ulcers

Treatment for Leg Ulcers should start with the UNDERLYING vein problems.

• Assessment by a ConsultantVascular Surgeon
• Duplex Ultrasound Scan
• Surgery (approx 60% of patients)
• Long term Compression (40% of patients)

What should be avoided at all costs?

• Patients with Leg Ulcers being condemned to dressings and compression bandages/stockings without assessment by a Specialist Vascular Surgeon (unless patient is immobile, has poor ankle movement, is very unwell for any other reason or has a very short life expectancy).
• Patients with skin changes at the ankle being given creams (particularly steroid creams) before venous causes have been excluded by a Specialist Vascular Surgeon
• Patients with Varicose Veins being told that it is a cosmetic problem only and to "wait until there is a problem before having anything done".
• Patients with skin changes at the ankle or Varicose Veins being given long term support stockings without a cause being found and the possibility of a cure being offered.

(The College of Phlebology)

Vulval Varicose Veins

What are Vulval Varicose Veins?

Vulval Varicose Veins are found on the Vulva and Vagina. They develop during pregnancy. Women may not have had any symptoms of reflux prior to getting pregnant and had no visible Varicose Veins and were therefore unaware that they had any problems. During pregnancy the veins in the pelvis dilate further causing Varicose Veins in the Vagina, Vulva and then they become visible Varicose Veins on the legs. Out of embarrassment, women rarely mention Vulvar Veins but these veins can be treated.

Diagnosis of Vulval Varicose Veins

The diagnosis for Vulval Varicose Veins is the obvious Varicose Veins on the Vulva and Vagina. A Duplex Ultrasound Scan is required prior to treatment.

Furthermore, a new grading system for Vulval Varicose Veins was published by The whiteley Clinic in 2012 to help Medical Professionals to classify the severity of Vulval Varicose Veins.

	Description	Frequency seen at present
Grade 0	Normal – no varicosities nor venous reflux in vulva	Usual
Grade 1	No visible varicosities in vulva, but ultrasound proven reflux in vulval veins usually with para-vulval varicose veins seen on inner thigh	Common – 1 in 7 females presenting with leg varicose veins (1 in 5 of those post vaginal delivery)
Grade 2	Visible varicosities seen through mucosa of inner labia and lower vagina and ultrasound proven reflux in vulval veins.	Uncommon
Grade 3	Isolated varicosities seen on standing through skin of outer labia majora without a distortion of the general anatomy of the area	Very uncommon
Grade 4	Extensive varicosities of the labia, distorting skin and distorting the gross anatomy of the area on standing	Rare

The Whiteley Clinic 2012

Treatment for Vulval Varicose veins

Treatment is available for Vulval Varicose Veins. If you have any of the symptoms then see a Medical Professional and get the required investigations and treatment required.

MYTHS about Varicose Veins

Common MYTHS about Varicose Veins

• Women get Varicose Veins more often than men
• Pregnancy causes Varicose Veins
• You should wait until you've had your family before getting your Varicose Veins fixed
• Varicose Veins are only cosmetic and can safely be left alone
• There's no point in operating on Varicose Veins as they always come back
• Standing for long periods of time causes Varicose Veins

(The College of Phlebology)

Varicose Veins

What are Varicose Veins?

Varicose Veins are dilated Veins which you can often see as bulges on the Legs however, you can still have Varicose Veins that have no visible signs on the Legs. These are called 'Hidden' Varicose Veins. This occurs when the valves in these Veins which stop the blood from flowing back down your legs fail and the blood flows back the wrong way down your leg, which causes the Vein to start dilating or bulging. These Veins can become unsightly as time goes on.

While some people with Varicose Veins have absolutely no problems at all others have symptoms such as aching Legs, bulging Veins and swelling. It is important at this point to see a Medical Professional and have investigations such as Doppler, Venous Duplex Ultrasound Scan to determine if you have Varicose or 'Hidden' Varicose Veins.

Diagnosing Varicose Veins

A Venous Duplex Ultrasound Scan is the ONLY way to accurately diagnose Varicose Veins as this Non Invasive Scan can tell which vein is incompetent and where it is.

Some clinics, hospitals and GP's will only offer a Doppler Ultrasound Scan but this is will not be as accurate as the Duplex Scan.

Treatment for Varicose Veins

If Varicose Veins are present then the Consultant Vascular Surgeon will decide on the appropriate treatment required. Treatments available for Varicose Veins include:

•             Endovenous Laser Ablation (EVLA)

•             Radiofrequency Ablation (RFA)

•             Ultrasound Guided Foam Sclerotherapy (UGFS)

•             Ambulatory Phlebectomy

•             Transluminal Occlusion of Perforators (TRLOP)

•             Coil Embolisation of Pelvic Veins

Vein Stripping should not be a treatment option for Varicose Veins as it has been researched that Varicose Veins can grow back and cause more Thread Veins on the legs.

Common MYTHS about Varicose Veins

• Women get Varicose Veins more often than men
• Pregnancy causes Varicose Veins
• You should wait until you've had your family before getting your Varicose Veins fixed
• Varicose Veins are only cosmetic and can safely be left alone
• There's no point in operating on Varicose Veins as they always come back
• Standing for long periods of time causes Varicose Veins

(The College of Phlebology)

Microsclerotherapy

What is Microsclerotherapy?

Microsclerotherapy is a technique of injecting Thread Veins with a substance through a very small needle. Using a large magnifying light, a chemical called a "Sclerosant" is injected into the Veins. This destroys the Vein making the walls of the Veins fibrose (''stick'') together. After treatment on the Legs, you will need to wear compression stockings for 2 weeks day and night.

As Microsclerotherapy closes the Veins by inflammation of the wall, most patients get a patch of inflamed skin over the site of the injection which lasts for up to two weeks. This inflammation is actually very good - it is the body’s way of removing the dead Vein. The area then settles down but the full benefit can take up to 12 weeks to be seen. After that you will find that the Veins often continue to improve for up to a year after the treatment. Depending on the number of Thread Veins on the Legs, several sessions may be needed to get the required results, but usually two will be enough.

How effective is Microsclerotherapy?

Compared with other treatments, Microsclerotherapy gives the best results. It is the Gold Standard for treatment of Thread Veins, with 95% of patients seeing an improvement with a good or very good result.

Some clinics use Laser, Intense Pulsed Light (IPL) or Electrolysis type treatment of Thread Veins on the Legs. Laser and Intense Pulsed Light (IPL) are more likely to damage the skin. This does not happen on the face where the skin is more resilient to radiation. As far as the needle-type treatments such as Electrolysis that are used that heat the Vein and destroy it, this is very slow and laborious compared to Microsclerotherapy. In addition, one injection of Microsclerotherapy not only takes away a whole patch of Thread Veins but also treats lots of little Thread Veins that are hidden under the skin that may well be feeding into this patch. Using one of the techniques that employ heat being transferred to the Vein via a needle, each visible vein has to be treated individually every couple of millimetres along its whole length and any Vein that is deep enough to not be visible from the surface cannot be treated.

In a very few cases, Thread Veins of the Legs are too small for treatment by Microsclerotherapy. An alternative is to leave the Veins for six months in which case they often get large enough to treat with Microsclerotherapy.

The Vein Clinic Ireland do NOT use laser treatments for the removal of Thread Veins from the LEGS.

Are there any side effects to Microsclerotherapy?

As with any medical procedure, there are some risks involved, but complications with Microsclerotherapy are very rare and are generally of a very minor nature.

Some 4-5% of people can get brown marks – usually very mild and usually fading over several weeks or months. Very occasionally the brown stains can be dark. At the Claudia McGloin Clinic we check anyone who has brown stains as many can be improved by releasing any trapped blood in the Veins that were treated.

Approximately 1% (1 in 100) people can get a little break down of the skin. This is called a Chemical Ulcer. This can be very tender for a few weeks and then usually heals with a small scar. This scar can be permanent but such a small scar is usually better then the Thread Veins that were there before the treatment. This is rare. Allergies are often quoted as a problem but they are exceptionally rare.

Contact the Claudia McGloin Clinic for further details on Thread Veins and procedures available.