Vascular Medicine Appointment

Hello everyone

I have been referred to vascular medicine as a result of bad Doppler test results taken because of a wound I have being slow to heal.

I have the first appointment end of February and would love to read your experiences of what it could be like What questions do they ask and what further tests do they do?..Its another new specialism for me. You were very helpful about dermatology so I thought I'd ask again .

Hope your all as well as possible

Many thanks , looking forward to reading great replies.

MistyX

55 Replies

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  • Hi Misty,

    I used to be a district nurse so can let you know a bit about what to expect but I've never actually been in an appointment.

    You have been referred because you have an ulcer that won't heal. The doppler shows a high reading which indicates arterial problems which affects circulation going down the leg.

    I would imagine that they will want a history from you and symptoms. They should look at the wound and then maybe do further tests/scans to see where the problem is.

    Sometimes people later have a stent or bypass to allow the blood flow to be better which would hopefully heal an ulcer.

    Hope I have helped in some way,

    HC

  • Hello happy chicken

    Thank you for your very helpful reply. I'm feeling particularly bothered about this appointment so understanding about it better helps a lot!. My wound is shrinking now thanks to honey dressing.

    Hope your feeling well. X

  • That's great. Honey is a great dressing....One of the best out there.....really good for wounds

    Let us know how you get on at your appointment

    HC

  • Thank you happy chicken I will. Love your name. X

  • Hi Misty. I've had one appointment to date in a vascular department to rule or out a TIA or stroke in 2015. I had an EEG and a Carotid Duplex (ultrasound of my Carotid arteries) both ordered by my neurologist at the time.

    My EEG was normal but the Carotid Duplex showed mildly diseased carotid arteries (up each side of my kneck) with plaque or mildly diseased on all. Also the woman who conducted this investigation seemed to think I must have diabetes and asked me twice because of the amount of hardening. I don't have diabetes although my dad did and I do have family history of atherosclerosis. So I arrived back at the neurologist's office in a state of high anxiety.

    But he just shrugged and said it was normal for my age and to just avoid fatty foods and get some weight off. Which I do try to do and so did my mum, who was also quite thin!

    It has worried me quite a lot in relation to my worsening peripheral symptoms, so my new gp has referred me for stress tests and further investigations as she agrees this needs clarrification. Not heard a date yet but I will watch for your experience and hope it goes really smoothly and well. Nothing I experienced was invasive at all. X

  • Hi twitchy

    Thank you for sharing your experience. Sorry you've had that extra worry and hope you don't have to wait too long for these further tests!. Our family, medical history can be such a worry never mind our own!. Glad you didn't have anything invasive as that's my biggest fear for this!. X

  • As far as I know - vascular don't do invasive. Xx

  • The installing of stents etc can be really iffy...dreadful stuff can result sometimes...causing chronic debilitating life altering pain syndromes and other baddies....I've witnessed this ...invasive procedures all involve risk... and vascular med investigations can segue that direction πŸ™πŸ€πŸ˜˜

  • Oh okay - thanks for putting me right BC. I was only thinking about the investigations at this still early stage (for Misty) really. Of course putting in stents is an invasive procedure. What was I thinking? - sorry.

    But then they can also save lives - if my mum had these she would probably still be here today to see her grandchildren flourishing etc. X

  • So true...my father 's early cardiac disease too 😏...I sometimes wonder how we have the nerve to undergo our treatments & procedures...I guess it's a triumph of hope, experience & faith in human skill...so often things DO go really well πŸ€πŸ˜˜πŸ€πŸ˜˜πŸ€πŸ˜˜

  • As one who has had several invasive procedures (root canal, lumbar puncture, gallbladder removal) all go wrong I completely relate to the idea that, despite this we still need to have faith in those who do these procedures all the time - usually without misshap. I always tell myself and others that my bad experiences were the exception not the norm. This must be true because I know so many who have had them done uneventfully with positive outcomes. X

  • Exactly: I tell myself this, like a mantra. And your voice + those of so many others here sing the same chorus:helps me keep it together πŸ‘­πŸ‘­πŸ‘«πŸ‘¬πŸ‘­πŸ‘­πŸ‘«β€πŸ€

  • That's made me feel so much better Barnclown. X

  • Hi twitchy

    They can do invasive. Have a look at happychicken's reply. X

  • Oh heck yeah so they can, sorry😳? My folks never got as far as invasive unfortunately 😒. Invasive has to be seen as a necessary evil sometimes I guess.

    Anyway what I meant was that there was nothing invasive or horrifying on view when I was in vascular department a few years ago. No one crying or looking like they were in hell. Unlike the neuro day room from where I had been sent - which was awful to be honest. But probably just a matter of timing.X

  • Ps that's great news about the honey and healing though! X

  • Many thanks Twitchy, it is a big relief about the healing. It's three months now. x

  • I know - what a nightmare it's been for you. X

  • Hello misty πŸ‘‹πŸ‘‹πŸ‘‹πŸ‘‹

    Am so glad that the system is pulling out all the stops for you: these slow-healing wounds need serious attention....especially in our lower limbs. You have been vvvvv brave all these months while conscientiously working with your gp surgery doing everything recommended to aid healing. this can only be a great concern.

    Am hugely relieved you've had the Doppler and been referred to vascular med. on the other hand, if you're anything like me, this referral may be a cause of anxiety...no matter how experienced a patient I am, or how many referrals to various depts I've benefitted from over the decades, these referrals always make me feel "on edge" 😏. And issues with my vascular system especially spook me. And leg wounds are a particular worry. So, am vvvv much feeling for you, even though I know you're one of the best informed patients here and have coped courageously & successfully with a great deal for many years

    you've had these tip top replies from happychicken & twitchy...and I'm looking forward to following as more replies come in. Am so glad you've posted...this is a subject I need to learn more about.....and, seems to me, there hasn't been much about it on forum over the years, other than discussions about raynauds etc ...so: thanks πŸ‘πŸ‘πŸ‘

    I know you're taking care, dear misty, but I'll say it anyway πŸ˜‰: Take Care

    πŸ€πŸ˜˜πŸ€πŸ˜˜πŸ€πŸ˜˜ coco

  • Hello dear Barnclown

    Thank you for your wonderful reply.Your encouragement helps me no end. I'm with you re this particular referral spooking me as wounds and vascular are my extra worry too!. I particularly don't want anything invasive because of what has happened in the past. It's good in a way that it's quick as less worry time but then we worry when it is quick don't we?. Ha. You'd think the number of referrals you and I have had , we'd be a dab hand at it but I never feel confident when seeing a new Consultant !. You?. Always a worrier I guess!. Any vascular breakthrough for you at your GP?.

    Did see the nurse yesterday and wound is shrinking. Hurrah for honey!.

    Hope your recovering after your infusion and appointment last Friday. X

  • Well Said! πŸ‘πŸ‘πŸ‘πŸ‘πŸŒŸπŸŒŸπŸŒŸπŸŒŸ

    HURRAH for honey is right! I'm on it daily for my lower GI these days...

    Thanks so much: am just about "over" the flu-y reaction to the infusion. Am grateful to πŸ¦‰ you & my osteoporosis nurse for helping me get the hang of this: a week on lots of paracetamol & hydration & 😴 is cracking this for me, No Worries πŸ˜‰

    β€πŸŒˆπŸ•ŠπŸ€

  • Hello

    I have no personal experience but my mum has. She's had a slow healing ( or rather, non healing) ulcer on her leg for over 10 years now. In all the time she's been at vascular they've done nothing more invasive than scans and doppler to check the vessels and help her with dressing the wound etc.

    She doesn't have any autoimmune problems but she had a condition called factor 5 Leiden which has a stong link to non healing ulcers and the doctors say now it's unlikely it will ever heal. I'm not suggesting this is the case with you at all but just throwing that info in there!

  • Hi 1985 Mum

    Thank you for your great reply, sorry your Mum has had such a big problem with a non-healing ulcer. Must be awful!. Do hope it does heal. Has she tried manuka honey?. How did your test go?.

    I hope they just do scans with me, you've given me hope as seven years ago I had an emergency op with them that has given me nerve pain and I don't want the same for my other leg which is why I'm so bothered!.

    Hope your feeling better.x

  • Oh not nice that you've already had bad experience with them. I hope it's all straight forward for you once you get there!

    My mum has tried everything. Absolutely EVERYTHING that could possibly be used to heal an ulcer!! Manuka honey was one of the first ones.

    I'm not so good at the moment but I have my next appt in a fortnight so waiting to see if I can get some treatment.

  • Hi 1985mum

    That's awful about your mum's ulcer, she must be so FED UP with it!.

    I hope your appointment goes well and you get the treatment you need. Keep us posted. You've given me great hope that this can be tested non invasively, thank you. Take CareXπŸ’πŸ˜Š

  • Can't add anything helpful as I haven't been down this path yet, but just wishing you all the best and sending love and hugs. Xxx

  • Many thanks Musicteach, appreciate your good wishes. How are you doing?. Much better I hope. x

  • Thanks, Misty...am just about fully recovered from the pneumonia and back to some teaching, which is good. Will see what the cardio says about the absent pulse, which comes and goes...just as well, or I would be a ghost! Pretty good, on the whole...and hopefully all of my lupie friends will have good times ahead. Xx

  • Hi Musicteach

    Great your back teaching again, you must have been greatly missed!. Sorry your having to go to a cardiologist. When is that?. There's always something for us to worry about with these illnesses!. Good luck. X

  • Hi misty, you say your Doppler reading was bad is that bad as in high or low bad?.

    Doppler ultrasound on the legs are done to determine how well the blood is flowing in your lower extremities so if you have a wound that is slow to heal they need to figure out if the underlying cause is to do with blood flow, if the Doppler reading is low then it can indicate arterial insufficiency meaning there's not enough blood getting through the arteries and smaller vessels to nourish the tissues to enable healing and if the Doppler is higher than normal then there could be venous incompetence meaning the valves in the veins aren't working as well as they should and the blood isn't flowing back upwards as well as it should (this is what happens when you have varicose veins which is very common in many people) this in turn can also cause slow wound healing. It's really important for the vascular team to find out how well the blood flow is as arterial ulcers and venous ulcers can have different treatments for example if you have venous incompetence they may want you to wear compression stockings which are a bit like flight socks that you'd wear on a flight to help the blood flow in your legs but you wouldn't wear compression if you had an arterial ulcer because that would compress the arteries and compromise the blood flow and cause more problems so finding out if the blood flow (arterial or venous) is an underlying cause is really important but if your wound is showing signs of healing now then that's a really good signπŸ‘πŸΌ. Unless your arteries are severely compromised or you have really bad varicose veins I doubt they would do anything very invasive.

    They'll probably check your Bp weight and urine and do another Doppler test and look at your wound, the dr should examine you and feel the pulses in your feet behind your knees and in your groin and take a full medical history.

    Try not to worry (stupid thing to say I know, easier said than done!)

    I hope this helps a little, let us know how you get on.

    Diane🌺Xxx

    Ps I worked in a busy vascular clinic for many years up until 6 years ago!

  • Thank you Diane for such a helpful , detailed reply. Ironic that you've worked in health and become so poorly yourself, must be hard!. I don't know which way the reading results were, only that they weren't good hence the referral. I'm seeing my GP on Tuesday about it so thanks to you I know what to ask. There's a particular reason why I'm bothered about this. Seven years ago I had an emergency vascular op that has given me nerve damage in my right leg. I don't want a matching pair as the wound is on my other leg!. I may have the beginnings of varicose veins. Trouble is I now look at my legs and wonder what's going on but know blood flow is an issue as I have Raynauds!. Always something for us to worry about isn't there?. How did your test go?. Are you feeling better?. Thanks for telling me about first clinic visit, so helpful.

    Take Care

    Love HelenX

  • Hi Helen,

    Yes it is ironic and it was hard giving up my job as I loved it.😞 And now I'm on the other side of things, never thought I would be, Still it is what it is and have to deal with what's thrown at us somehow don't we!

    I'm so sorry to hear about the nerve damage to your leg that's grim for you and I can see why you don't want problems with your other leg, fingers crossed they can help you and find out what's going on to prevent any other problems and get your wound fully healed.

    As for my tummy thank you for asking, that's sweet of you, it's still not right, it's still painful, it seems to ease a lot if I don't eat, I've been living on chicken broth this week and when I start to eat a bit more I start getting the pain! My diet is getting very boring but I've lost some weight which isn't a bad thing! I had the scan for my ovaries but haven't had the result although the radiographer said there wasn't anything obvious to see but still had to examine it to do the report. Apparently my lymphocytes were down a little and my crp and esr was raised so I think there must've been some infection going on. I've been referred to a gastroenterologist so I'm hoping it won't be long before I get seen, I've been having loads of heartburn too.

    I got my follow up rheum. Appt for the end of June, I was not happy about this as in Dec he said he wanted to see me in two months so I called and ended up speaking to his secretary and the next thing I knew my rheumatologist called me back himself to apologise and said he needed to see me before then and he would get me an appointment for March.....HOW AMAZING was that that he actually called me himself! He is such a nice Dr, I can't quite believe I have found someone who is interested and is taking me seriously and knows what he is talking about, is compassionate and professional. He's also referring me to a Neurologist because my MRI brain showed multiple white matter lesions, he also said my bloods had changed since last March, my ANA has shot up from 1:640 to 1:2560 which is not good!

    I feel overwhelmed with all the appointments and different Drs but just happy they're taking notice after so long!

    I have raynauds in my feet as well as my hands so I know what a worry it is especially when you have a wound that won't heal well but yes honey makes a great dressing, there are so many dressings out there to help with healing.

    Good luck with your gp too on Tuesday

    Hugs

    Diane🌺Xxx

  • Hello. I've been following this post out of curiousity and I think we've chatted about your MRI findings before, as I too have bilateral frontal white matter on my MRI which the report said could be due to migraine but I have wondered about a vascular link. Would you mind please letting me know the outcome of your appt with Neurology? I've seen neurosurgeon re my syrinx cyst but not neurology. Thank you. Wendy x

  • Hi Wendy we did chat about it in another post and yes of course I shall let you know as soon as, although it may be a while before I actually get an appointment, you know how it goes!!

    My MRI showed that ' there are multiple white matter lesions with the most notable lesion being within the left parital lobe adjacent to the left occipital horn of the lateral ventrical ' there's a whole load more but it's pretty much gobbledegook medical lingo that all looks ok, the main concern being the lesions.

    The rheumatologist asked me if I was still having migraines and I asked him if these lesions could be responsible for this horrible Visio/ spacial problems and he agreed that they could well be so it will be very interesting to hear what a neurologist has to say.

    Hopefully won't be too long to wait.

    Diane🌺Xxx

  • Thought we might have. My memory is shocking and getting worse. Thanks for your reply. X

  • Yep I know that feeling all too well Wendy. 😱

    Take care xx

  • Hi Diane

    So sorry your very poorly but great news you will see your Rheumy in March. He sounds fab and I really think you will get answers and help now in view of your test results. So sorry your going to a lot of Consultants. It can be overwhelming when we collect so many!i juggle three regular ones and then panic a bit when I have to add others like at the moment!. . It must seem strange to be on the other side of the fence but I dearly hope you don't wait too long to see a Gastro!. Digestive problems can be very lowering and hard to live with!.

    The nurses did want to do compression but the Doppler ruled it out so looks like it's arterial. I shall know on Tuesday when I see my GP whose back from a months leave having climbed a mountain!. Thank you for all your help, now know what to ask.

    Fingers crossed for you, keep us posted too. XπŸ’πŸ˜Š

  • Will do, thank you Helen.

    Oow what I'd give to climb a mountain although it does feel a bit like that everyday! I hope you have a good GP that looks after you.

    Yes sometimes you can have mixed aetiology so a bit of arterial insuffiency and a bit of venous incompetence. The vascular team should suss it out and advise the right treatment for you. I really hope you get some answers to put your mind at rest.

    Take care 🌺Xxx

  • Wonderful discussion: am so glad you joined in diane...this subject has been on my mind a long time. I've witnessed friends managing terrible leg ulcers for years...forced into amputation etc. And consultants have warned me I'm at risk + simultaneous raynauds & erythromelalgia make me a tricky customer. Your level headed advice is helping me a lot

    Am so glad you're seeing Rheumatology sooner!!!!!

    Take care...and please do keep us posted on as much of your experiences as poss...am thinking of you

    πŸ€πŸ˜˜πŸ€πŸ˜˜

  • Thank you so much Coco. Yes leg ulcers can be pretty distressing to cope with and it is very sad when it ends up with amputation, but with knowledge and care we can try and prevent them if possible, looking after skin, keeping warm or cool! eating sensibly , trying to avoid knocks and bumps and bites is important as that's often how they can start, keeping mobile etc ( not always easy though!) but sometimes the skin can just breakdown! I remember often people would say their ulcer started by being bashed in the leg with a shopping trolley!!

    I'm so sorry you're at risk, it's not a nice prospect along with everything else going on, but here's hoping and praying that you won't get one.

    I'm happy to help if I can in anyway, it's nice to be able to as I'm learning so much from you all on here πŸ‘πŸΌ

    Take care too Coco

    Big hugs 🌺😘🌻🌸xx

  • Hi Diane

    The possibility of having mixed aetiology sounds just like me!. I usually come up with the quirks which makes it harder!.

    I have a very supportive GP!. Hope you do too. It makes all the difference. Agree about us climbing a mountain every day!. Will update when I know something.

    TAKE CARE. XπŸ’πŸ˜Š

  • Yes I have a good GP Helen and like you say it makes all the difference only trouble is she only works one and half days a week!

    If you have mixed aetiology they can still help with treatments . Good luck with it πŸ‘πŸΌFingers crossed🀞

    Look after yourself.

    Big Hugs🌺🌻🌸xx

  • Hi Diane

    Hope you had a good weekend and your coping!. I'm glad you have such a supportive GP too but tough she works so part time!. Our illnesses don't always get the timing right!. I'm so relieved mine is now back. It looks like my Doppler results indicate a possible blocked artery in my leg hence the referral. He told me to tell them of what happened with my other leg as a possible test they might do can be done less invasively. Die injected into arm like a blood test. Thanks to you and him I feel more empowered for the appointment on 28th , know what to ask and I've just got to be brave and face it. No choice!. That's happened a lot for me , I bet it has for you too. Thank you for all your valuable help and good luck for your appointments. XπŸ’πŸ˜Š

  • You're welcome Helen, I'm very pleased to have helped in some way, it's great to have so much info, help and reassurance on here and that feeling of not being alone in our battle for wellness is so important. So when you go for your appt think of us thinking of youπŸ™‚ I know what you mean about being brave and having no choice I'm feeling a tad anxious about the gastro appt and what they might have to do😱!!

    Today has actually been a better day...YaYπŸ‘

    Good luck with your appt too and hope it goes well for you, keep us posted.

    Hugs πŸŒΊπŸ•ŠπŸŒ»xx

  • Hi Diane.

    I certainly will think of you all on forum, egging me on!. When is your Gastro appointment?.I can help you there because I've had the main tests and it's a speciality I've had to stay with!. You think of us all as well and I hope it goes well. Glad you've had a better day. Fingers crossed you get more. XπŸ’πŸ˜Š

  • Thanks Helen, I haven't got my appointmentyet but I called them and they said I should get it soon maybe in a few weeks, it wasn't an urgent referral. The pain is much better but it's still there and I can't eat normally yet, now I've got rib pain, crikey it never ends, I wonder what delights tomorrow will bring😫

    You take care now with those legs.

    Big hugs xxxπŸ’•πŸŒΊπŸ¦‹

  • Hi Diane. There's always something with us Lupies!. Fingers crossed you get that Gastro and Rheumy appt soon. Take care with that rib pain, can be very painful. Is it better to elevate leg and walk rather than sit?.

    Hugs HelenπŸ’πŸ˜Š

  • It's difficult to say Helen without knowing what's actually is going on, if it's venous it's better to have your legs up high when you're sitting down and when standing don't stand on the spot for too long and keep moving your legs and ankles but if it's arterial then walking is good as it opens up little vessels called the 'collateral circulation' that can help bypass the blockage or narrowing of the artery that's affected which in turn helps to nourish the tissues, and try to avoid sitting with your legs crossed and no wearingπŸ‘ πŸ‘ high heels 😟. Big Hugs🌺🌸xx

  • Thanks so much Diane, I will walk as much as I can. Luckily I don't wear high heels, never have or sit crossed legged. Seems so crazy why it's happened as don't fit lifestyle either. You ask me anything you want to and good luck for next few days. Hugs helenXπŸ˜ŠπŸ’πŸ‘ŒπŸ»

  • Thanks Helen I appreciate thatπŸ‘πŸΌ Will do.

    I know what you mean, I try hard to stay healthy and do all the right things but.....!

    Take care, more hugsπŸ˜˜πŸ¦‹xx

  • Just want to say a BIG thank you for this GRRRRREAT discussion dear Helen!

    I hope you're now feeling well prepared to face vascular medicine and get the best possible help there

    Please let us know how this goes. Every detail shared here is invaluable....so many of us live with the sort of predispositions that can make eventual referral to vascular medicine inevitable.

    πŸ€πŸ˜˜πŸ€πŸ˜˜πŸ€πŸ˜˜

  • Thank you for a lovely reply Barnclown. I do feel better prepared for my appointment thanks to you all on forum. First step is Tuesday with my GP. Think it will be helpful. X

  • Was a terrific discussion....I've just started the day and felt soooo low , πŸ˜ͺperversely I suppose...am feeling brighter now knowing there are wonderful sensible and supportive people out there who are battling but giving so much with their myriad of problems. Bravo πŸ‘πŸΌ all of you.

    Stay strong πŸ’ͺ🏼.

    Hugs πŸ€— to all

    PM 🌼🌼🌼

  • Hi Penelope Mary

    Thank you for such wonderful comments. You be strong too and be as well as possible. X

  • πŸ¦‹πŸ’›πŸ¦‹, thank you misty xx

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