I requested a copy of my medical records from the first vein clinic. They arrived yesterday and I was a bit embarrassed, after I read them right side up, to find that they actually said "in no acute distress." That's what I get for reading things upside-down...Too bad, since the "acute distress" part made for such a good story!
I had a followup visit today with Dr. W at the second vein clinic. He and the ultrasound tech did a lengthy exam of the veins on both legs, especially the area behind my left knee that developed a blood clot during my last pregnancy. The verdict: he recommended endovenous laser treatment (EVLT) of the greater saphenous vein. He does this right in his office with only local anesthesia along the vein. The varicosities behind my left knee are next to some nerve bundles, so instead of removing those veins via tiny incisions, he would do sclerotherapy injections in that area. He reiterated that while these procedures will permanently fix the affected veins, it's possible that, down the road and especially after more pregnancies, other veins may develop varicosities. He said that if my right leg isn't bothering me that much, it's not worth treating.
At the end of the visit, I asked him if he charged any "cosmetic fees." He looked a bit perplexed. I explained that the first vein specialist I saw charged a "cosmetic fee" of $400 per leg, even for procedures that were medically indicated and that would be reimbursed by insurance. Dr. W asked why he charged this. I said that Dr. F had explained that it was because "we are very meticulous with our work." Dr. W replied, "Well, I guess I'll be very un-meticulous and not charge you an extra $400!" I joked that he should start charging this fee so he could buy fancy office furniture.
I think I'm going to do it, since my leg is really bothering me. Dr. W's office is working on getting a pre-approval letter from my insurance company, and then I can schedule the procedure. I want to get it done before the end of the year, since both Eric and I have had a lot of medical expenses this year (minor knee surgery for him, pregnancy & birth for me) and have hit our deductibles for the year.