Deepak Sudheendra, MD, RPVI

A common question that is asked is "what should I do if I have a nickel allergy and need a stent?". It's a challenging question to answer. In this month's issue of the Get Healthy Veins newsletter, Dr. Bruce Brod, a dermatologist at the University of Pennsylvania and the Director of Occupational & Contact Dermatitis, discuss his thoughts on this subject. In my practice, I do not test for nickel allergy nor do routinely I ask about it. While the goal of this post is to provid...e some background on nickel allergies and stents, ultimately you should speak with your physician about what the best course of action is for you. Go to the Get Healthy Veins homepage and subscribe to the newsletter and get up to date information on the complex world of venous disease. https://www.gethealthyveins.com//help-i-need-a-stent-and-/

IMPORTANT ANNOUNCEMENT!!! For the past decade, I have had the privilege of establishing and leading one of the premier DVT and complex venous disease programs in the country at the Hospital of the University of Pennsylvania. It is truly one of the preeminent medical institutions in the world. Working daily with brilliant and amazing physicians as well as wonderful nurses, technologists and staff has made me a better physician. It's also been an honor to teach some of the brig...htest up and coming minds in medicine from med students to residents to fellows. Now it's time for a new and exciting chapter in my career. I recently announced that I will be leaving the University of Pennsylvania. My family and I will be moving to Columbus, OH in the next few months. With patients traveling from all over the globe to see my team, I believe that it's now time for me to establish a vascular practice where I can dedicate 100% of my time to treating patients with complex venous and arterial conditions. Many have called my office at UPenn to learn that I am no longer accepting new patients. Rest assured that this will be short lived and that once my plans are solidified in Ohio, I will be accepting new patients again. If you would like to be notified of when my practice is established and/or if you have found my blog articles informative, please subscribe to my newsletter on the BOTTOM OF THE HOMEPAGE of www.gethealthyveins.com. Wishing you continued good health! Deepak Sudheendra, MD, RPVI, FSIR (aka Dr. Sudi) Founder & Director of DVT & Complex Venous Disease Program Assistant Professor of Clinical Radiology & Surgery Hospital of the University of Pennsylvania - Perelman School of Medicine

As a physician, I am fortunate to have insider access to nearly every specialty in medicine. I can always call another doctor anywhere in the country and get advice. It’s a great privilege that is afforded to me and any physician’s family. Even if we can’t find the exact answer we are looking for, we are at least steered in the right direction. This doctor’s spouse had iliofemoral #DVT in 2001 due to May Thurner syndrome. For 20 yrs, she has had chronic pain, swelling, ven...ous pooling, burning/neuropathy in the legs. She has had access to so many physicians and always been told that nothing can be done except stockings and blood thinners. 6 weeks after my team performed deep venous recanalization, She is nearly back to her old self and is able to do all her activities, play with her kids, and walk on the beach without pain in the legs. If a doctor’s family member has had such a hard time seeking proper treatment, it can be very challenging for the average person to find treatment for this and many other medical conditions. This is why I do what I do to build awareness about #DVT and vascular disease. Dr. Sudi

Although #DVTAwarenessMonth is drawing to an end, it does not mean that our work is done in educating the public and medical community about venous thromboembolism (VTE). Today, I'd like to highlight an aspect of VTE that is seldom discussed -- the emotional toll of #DVT and #pulmonaryembolism. If you subscribed to the Get Healthy Veins newsletter, then you should have already received a link to the latest blog post. Read the article. Does it resonate with you or a loved one...? Share the article and your thoughts. In partnership, Dr. Sudi https://www.gethealthyveins.com//the-emotional-toll-of-dv/

Has your QOL been affected by #DVT? Do you have post thrombotic syndrome (PTS) and have you been told nothing can be done? You are not alone. We all become patients one day and physicians are no exception. This patient is a physician who had been dealing with PTS since 2010. He had an IVC filter that caused complete blockage of his IVC and both legs. He had developed leg ulcers, skin discoloration, shortness of breath, and large varicose veins on his abdomen. He was finding... it increasingly difficult to see patients and stand on his feet for long hours. He had seen several vascular specialists, all of whom told him that it was too late to do anything and to wear stockings and take his blood thinner. He was not a member of FB groups and so it took him 2 yrs to find my team. It has now been 6 months since I treated him by opening up his blocked IVC an leg veins with stents. He has made dramatic improvements and went skiing this winter with no physical complaints at all. His shortness of breath is gone, legs are less swollen and heavy, abdominal varicose veins have significantly improved, and his overall QOL has made a complete turnaround. Now that his deep veins have been opened, the second and final stage will be to perform ablation of his superficial leg veins. This will decrease leg swelling more, prevent future ulcers, improve but not eliminate leg discoloration, and give him the maximum lifelong benefit. Learn more about vein disease at www.gethealthyveins.com

A common question patients ask is "what kind of doctor should I see for vascular disease?" Should they see a vascular surgeon? An interventional radiologist? A cardiologist? Why did their PCP refer to one over the other? Every specialty has its strengths and weaknesses. Every specialty brings unique skills to the table. However, what's more important than the field is your physician's knowledge, background, and experience when it comes to treating the condition you have. Jus...t because someone treats vascular disease does not necessarily mean they have experience with all types of vascular disease. Last wknd, I had the distinct privilege of meeting Dr. Kurtis Kim over lunch at El Vez in Philly. Dr. Kim is a #vascularsurgeon at Mercy Medical Center, Baltimore, MD who specializes in both arterial and venous disease. I had never met him before but had read his very insightful comments to people in FB groups. Dr. Kim was visiting Philly and called me up and asked if I wanted to meet. Dr. Kim and I had a great mtg over lunch. We talked about family, our professional backgrounds and our shared passion for vascular disease, both venous and arterial. There were no politics, no turf wars -- just 2 docs mtg to learn from one another about how we can improve care to our patients. The networking and relationships that I have developed from all over the world is the best aspect of social media! Dr. Sudi

Many patients are on blood thinners or antiplatelet medications or both after having a DVT, thrombectomy procedure, or a stent placed. While each patient's situation is unique, a common question patients ask is whether antiplatelet medications such as aspirin or Plavix is the same as an blood thinner or anticoagulant (ie warfarin, Xarelto, Eliquis). Only your doctor will know what is the best treatment option for you and not everyone's medication regimen will be the same. While the end result of both types of medications is the same -- prolonged bleeding -- there is a distinct difference between the two types of medications and it is important to know these differences. Read my latest blog article on the differences between antiplatelet therapy and anticoagulation. http://bit.ly/36MPvcs

May Thurner Syndrome (MTS) is commonly known to be associated with left leg #DVT & unexplained left leg swelling. But did you know that MTS can also cause RIGHT leg swelling in addition to low #backpain and #pelvicpain? It's a presentation that confuses many vascular specialists. http://bit.ly/395JZDq

Have you had any of the following? - extensive/recurrent LEFT leg #DVT - unexplained LEFT leg swelling or #lymphedema - chronic #pelvicpain or #backpain... If so, learn more about a vascular condition called May Thurner Syndrome. https://www.gethealthyveins.com//may-thurner-syndrome-an-/

Happy New Year! With a new year comes new beginnings. I'm excited to announce the launch of my new blog www.GetHealthyVeins.com. The goal of the site is to serve as an educational resource so that you and your physician can make better informed choices about your venous health. Vein disease is poorly understood and this site will help you navigate the ever changing landscape of venous disease. Sincerely,... Dr. Sudi See more

A patient in her twenties presented to an outside hospital with sudden onset bilateral leg swelling, pain, and shortness of breath. She was found to have extensive #DVT up thru her IVC and pulmonary embolism. She underwent thrombolysis and open surgical thrombectomy (clot removal) that was successful in the short term. She reclotted within 1 month and was told that she had IVC agenesis (absence of the IVC) of the upper 1/2 of the IVC (from the mid abdomen to the heart). Her d...octors were only able to get the clot out from her legs and the lower half of the IVC. During her follow up visit, she was told that the only potential treatment was open IVC bypass surgery. A major surgery requiring a massive incision in the abdomen. She was told that IVC reconstruction with stenting was not possible and that anyone who told them that it was possible was not being up front with them. Well this patient now has a new IVC with a total of 5 stents in the IVC and iliac veins. She had 3 small skin punctures and is doing fabulous. Lesson: For complex venous reconstruction, there is rarely a role for traditional open surgery, which has extremely poor results. If a doctor is unable to offer or perform an endovascular (minimally invasive) procedure to open up a blocked vein, consider a second or third opinion. If your doctor has already tried to do an endovascular procedure and it was unsuccessful, get another opinion. While there will always be cases that are just too difficult even at the most experienced centers, endovascular treatment can often be done successfully. This patient came to us for a 2nd opinion....I’m glad she did. Dr. Sudi