Frequently Asked Questions

Q. I've been diagnosed with Raynaud's phenomenon and my doctor has recommended a sympathectomy. Will this provide me any relief, and what are the benefits and future problems that can occur with this test?
A. Sympathectomy is a procedure which uses surgical or minimally invasive tools to remove or interrupt the nerve supply to an extremity. Sympathectomy is generally reserved for only the most severe cases of Raynaud's phenomenon, especially those cases which have not responded to conservative measures, such as a trial of vasodilator medications or some newer medical therapies that have been studied within the past five years. This is a procedure of last resort for patients who have severe disease, including ulcers of the fingers, and have not had relief with other treatments. Sympathectomy procedures may be performed on nerve roots to the arms, legs, or even the small nerve fibers of the fingers (digital sympathectomy). The nature of the procedure, including the nerves which are to be targeted and the technique to be used, deter mines the potential side effects. If you have not done so already, you may wish to obtain a second opinion from a vascular specialist regarding your Raynaud's phenomenon.

Q. I suffered a DVT a few months ago in my right leg and have now been experiencing the same sort of symptoms in my left leg. Is it possible for DVT to travel from one leg to another?
A. It is unlikely that a DVT will travel from one leg to the other. People who have one DVT episode are certainly at higher risk for future episodes. These can occur in either leg. Development of new symptoms should prompt an immediate visit to your health-care provider.

Q. I developed DVT after knee surgery over three years ago and still get swelling and occasional flare-ups if I'm on my feet or sitting for too long. I've been told that the blood is slower due to scar tissue in the vein caused by DVT. Should I be concerned about this, and is there something I can do to reduce the daily swelling and prevent flare-ups?
A. About half of all DVT patients develop long-term symptoms similar to yours. This is called post-thrombotic syndrome (PTS). Many patients may benefit from prescription graduated compression stockings. These help decrease swelling in the leg and come in a variety of colors and materials. Some other helpful things are swimming or walking. In both of these activities, you flex your foot and activate the calf muscle pump (see article on chronic venous insufficiency). Periodic leg elevation may also be helpful (remember to keep "your toes higher than your nose"). Beyond these measures, PTS is difficult to treat once it has developed. Very carefully selected patients who have extensive blockage of the vein in the groin and pelvis can sometimes be treated with advanced catheter-based procedures such as stent placement. Ask your health-care provider about whether you have PTS, or consult a vascular expert.