Ellie Lindsay OBE. The Importance of Lower Limb Care

Hello, I'm Ellie Lindsay and I'm delighted to be here today speaking to you at this fantastic World Event Vein Week, kindly hosted and brought together by Professor Sergio Giancini. He has gathered a world of experts to raise public awareness of the importance of vascular and lymphatic lower limb problems that we're all aware of today. We're trying to make it even more a global awareness. So what does venous disease mean for me? Well it means prevention. Prevention is the key. The internet is a wonderful dynamic interactive medium that's become established source of health information for the public. As new digital technology becomes an increasingly important part of health information it will enable you the individual to make a choice and decision about your health care and how you want to go forward because if we don't prevent today we are more than likely to have problems for tomorrow, especially as 50% of us are likely to have some form of venous disease during our lifetime. Most importantly for me, I cannot explain it enough, but you really should get to know your legs. Every day we see our face and our hair and we know and would know immediately if a problem was starting to occur, but unless we get to know what our legs look like today we won't be aware of problems and potentials for tomorrow. Now I'm going to go through a lot of questions I'm hopefully can answer that people have asked me. So what is venous disease and is it serious? Well initially it isn't apart from getting leg pain and swelling but if left untreated can lead to varicose veins eczema and unfortunately venous ulceration in later life. When you see this chart you can see immediately problems, elder age, deep vein thrombosis, surgery for example, hernia, even simple surgeries, a motorbike accident with pin and plates put in, a family history of venous problems, injury and of course limited mobility and when we look at our lifestyle today we're very sedentary, we sit for hours in front of a computer or if you've got long-distance professional work related i.e. lorry drivers, train drivers, bus drivers all sit in there and that can lead to potential problems. Another question I'm often asked is well what causes venous disease? Well the blood flows around the body and it's vital to our health and legs play a vital role in that process as the calf muscle pump is instrumental in helping that blood flow that comes out of the heart, comes down, reaches our foot and then has to go all the way back up. So, it has to go against gravity and that's where the calf muscle pump is the engineer, the enabler to get that blood back up to the heart and that's where your foot is vital. It's no good saying, oh well I'll rotate my ankle, no, it has to be the initiation from the foot. what are we going to do about it? And each time we breathe in and it's very, if you think of a toothpaste, every morning we have to squeeze it and every night just to get a little toothpaste out because we're fighting against gravity and that's exactly what your foot is doing, it's initiating that squeeze of the muscle pump. Threadveiners are a classic sign and so many people say but I've got perfect legs until they go and understand and then look around their ankle area but for me all that is going on the skin above the ankle will be vulnerable. If the above symptoms occur you should seek medical advice from your local leg club or general practice surgery because we really want to know what's going on underneath and if appropriate then of course you'll get referred. But that's where you need to know your legs and good skin hygiene is vital. Also weight loss if you've got rather excess around the stomach area is all pressure on your legs and walking of course and any exercise of the lower limb will improve blood flow. So what are we going to look for? And this is where again I reiterate you must look at your legs and get to know your legs. Have you got little dry areas of skin? And do you know what a varicose vein looks like? The photo at the top here you can see early symptoms and yet the gentleman I spoke to was adamant and said but my legs are perfect I don't have varicose veins and when I asked him well what do you think varicose veins are he promptly said oh those little bunch of grapes I see you know on some people but no these are all early signs broken veins, red patches invariably between the knee and the ankle but also a very major alert signal for you is if you're getting pain on walking and it stops at rest. Also cramps, numbness, all of these are big problems and you know seek advice if in doubt shout and you can see that it is the underlying problems is the blood getting back to your heart so you do need to look at this and following an assessment by your general practitioner he will refer you to a vascular service if he feels that there is further investigations needed because he wants to look at prevention of any progression of disease. Another question I'm often asked is what can I do to help my legs? Well again it comes back to raising your knowledge and awareness of problems, potential problems. We know that compression therapy is a gold standard treatment of choice because it acts as an enabler just above your ankle where the graduation is tightened and it goes up so it's aiding the blood flow back to your heart it acts as really a preventative and you can see lifestyle again is a big issue and wearing compression hosiery will absolutely change your life but you need to get information and don't be hesitant to approach leaflets that are available whether they're on the internet or in a surgery or a chemist or whatever you see them pick them up read about it again get to know what's normal for your legs and the early warning signs of what's not normal. Another question I'm often asked with horror is well what is compression hosiery? Well as I've said compression is the gold standard and by wearing compression I'm not talking about flight socks I'm talking about medicated compression hosiery and that applies a continuous graduated pressure to the muscle and veins in your legs and it enables that calf muscle pump and the blood flow back to your heart and also look after your skin and by avoiding high extreme temperatures avoid scratching and damage because scratching if you've got venous disease we have a big bacterial carrier under our nails where we scratch away and we all know we've had an insect bite we're desperate to scratch it but it does cause potential problems leading to else's. I think for me getting over the image of compression hosiery is the biggest challenge for younger age groups. We've moved on a long way from the Nora Batys of yesterday. The The manufacturers today really are state-of-the-art. The socks and the stockings are designed to improve, but many, many people wear them just to alleviate the tiredness at the end of the day, the aching feet and legs, and they are designed to be aesthetically pleasing. So all age groups can wear them, the colours are phenomenal and they go from black to magenta to greens to orange, fantastic colours and we all know that once you start wearing them you'll remain wearing them for life because it really does change your quality of life. So take action today and prevent for tomorrow because tomorrow you could have potential problems. So I am absolutely adamant that you must, you must prevent today by getting to know your legs and looking after them because you're going to need them as one gets older. If you do have dexterity problems with your hands there are aids that will help you to put stockings on but also you need to be measured accurately and that's where your clinician comes into the important role or the pharmacist and you need a regular review and remeasure of your limb and most hosiery lasts at least three months or six months depending on the manufacturers and what you use. So as I close my story remains the same, prevention is better than cure and I know a lot of us don't like what our legs look like and we're suddenly aware now that we have got venous disease if we tick all the boxes that I went through with you just recently. So it is important to go and get help and advice. Please don't wait until the problems occur, deal with them now, get them preempted and avoid long standing and encourage your mobility, exercise and leg elevation on rest, especially if you've got some fluid accumulating around your ankles by the end of the day. But remember use of compression hosiery when there are early signs of venous insufficiency can help to prevent the development of ulcers in later life. So on that note, as I say goodbye, please remember, Bain Week. Support it and enjoy it and learn from it and most importantly of all, know your legs. Bain Week.