Dr. Nirman Tulsyan is Board Certified vascular surgeon with 15+ years of experience.
He has been a practicing Attending Vascular Surgeon since 2007. He has vast experience in complex aortic reconstruction, carotid artery disease, lower extremity arterial and venous pathology, and management of dialysis access for patients with end-stage renal disease. He is also prolific writer, having authored over 20 research articles published in peer-reviewed journals, as well as 2 book chapters on Vascular Surgery. Among his many service awards include “Patient’s Choice”, “Compassionate Doctor”, and “On-Time Doctor”.
Dr. Aziz' practice accepts most major insurance plans, and he speaks English, French, Spanish and Arabic.
Varicose veins also know as varicoses or varicosities, are enlarged veins often on the thighs, the backs and fronts of the calves, or the inside of the legs near the ankles and feet. Varicose Veins affect approximately 25% of adults, affecting women more than men. During pregnancy, varicose veins can happen around the inner thigh, lower pelvic area, and buttocks.
If you are symptomatic, your legs may feel heavy or ache. Your symptoms may get worse after sitting or standing for long periods of time and can improve after resting and elevating your legs. Larger varicose veins may cause aching, throbbing, and discomfort. Varicose veins can also be responsible for ulcers that form on the skin near varicose veins.
Varicose Veins Symptoms
The following factors increase your risk of developing varicose veins:
Causes
Changing hormone levels may affect your symptoms. Because of this, you may notice more symptoms during certain times in your menstrual cycle or during pregnancy or menopause.
Muscle contractions in your lower legs help blood return to your heart. Tiny valves in your veins open as blood flows up towards your heart, then close to stop blood from flowing back down. If these valves are weak or damaged, blood can flow backward and pool in the vein, causing the veins to stretch or twist. Over time, more blood gets stuck in the vein, building pressure that weakens the walls of the vein, which causes the vein to grow larger.
Risk factors
The following factors increase your risk of developing varicose veins:
Self-Assessment
Ask your self the following questions: more YES answers indicate a greater likelihood of Varicose Veins.
Diagnosis
Initially we conduct a visual examination where we look at your legs while you're standing or sitting with your legs dangling and ask about any symptoms you might be experiencing or any pain.
Next we often use ultrasound to check blood flow in your veins and to look for blood clots. This noninvasive test uses high-frequency sound waves, which allows us to see the flow of blood through your veins. During this test, a handheld device will be placed on your body and passed back and forth over the affected area. The device sends and receives sound waves. A computer converts the sound waves into an image of the blood flow in your arteries and veins. A venogram which is an X-ray is performed using a special dye, which allows us to see the flow of blood in your veins, may also be used in your diagnosis.
Tests such as ultrasounds or venograms help ensure that another disorder like a blood clot or a blockage isn’t causing the pain and swelling in your legs.
“Dr Tulsyan is a very nice person and treats the elderly very well. My mom who is 89 thinks the world of him. He speaks to the patient and does procedures only if absolutely needed. I recommend him highly. I think he has a great attitude and most of all he listens to the patients needs.”
~ Thanks, Margaret M.
“Very caring, great bedside manner.”
~ John C.