June 26, 2025 • 44 mins
Ever wondered why those spider veins appear or why your legs feel heavy at the end of the day? Dr. Afshar of the Vein Institute takes us on a fascinating journey through our circulatory system, explaining how veins work using a tree analogy that makes complex medical concepts accessible to everyone.
"Think of veins like a tree," Dr. Afshar explains. "Spider veins are the very top branches, while varicose veins are the deeper branches that become congested when valves don't close properly." This simple yet powerful metaphor helps us understand why one in four people suffer from vein disease and how it impacts our daily comfort and mobility.
The conversation reveals surprising connections between vein health and conditions you might not expect—like restless leg syndrome, which can be caused by either low iron or vein disease. For those concerned about treatment, there's good news: modern vein procedures are virtually painless, can be done during a lunch hour, and most are covered by insurance, including Medicare and Medicaid, when symptoms are present.
Dr. Afshar also shares practical advice for maintaining vein health, explaining why walking is particularly beneficial (your calf muscles are your "second heart" for circulation!) and how compression stockings work to promote proper blood flow. These simple lifestyle adjustments can both prevent new vein issues and complement medical treatments.
Whether you're dealing with visible spider veins, uncomfortable varicose veins, or unexplained leg discomfort, this episode offers valuable insights into treatment options and preventive measures.
Dr. Afshar's book recommendation: E-Squared: Nine Do-It-Yourself Energy Experiments That Prove Your Thoughts Create Your Reality by Pam Grout
More about Dr. Afshar and the Vein Institute
Dr. Alex Afshar is a highly experienced medical doctor with nearly 20 years of expertise in vascular diseases. Previously, he worked at the National Institutes of Health (NIH), focusing on immunotherapy and cancer vaccines, particularly for melanoma. He has contributed to several publications in his field, demonstrating his dedication to advancing medical research and patient care.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
You know you have to think of veins like a tree.
So what you look at on thesurface, if you're looking at
your spider veins, those are thevery top branches of the tree.
When you go further down, tothe branches that connect to the
trunk, those are the ones thatbecome varicose.
(00:20):
And the trunk itself issupposed to have one-way valves
that close and shut in half asecond or less to prevent the
blood from getting sucked backdown towards your feet.
And once these valves becomeincompetent genetics, pregnancy,
(00:41):
occupation, so forth and so onthen these valves don't close
properly and the blood that'sbeen collected from all those
branches into that trunk is onlysupposed to go up towards your
heart and not get sucked backdown towards your feet.
(01:02):
So that's the whole principlebehind vein disease.
Speaker 2 (01:09):
Welcome to the House of Germar podcast where wellness
starts within.
The House of Germar is alifestyle brand, empowering
women to live all in throughinterior design and personal
wellness.
We are a destination for womenready to reimagine what is
possible in their homes andlives and then create it.
We are honored to have you joinus on our mission to empower 1
(01:32):
million women to live all in.
I am your host, Jean Collins,and I invite you to become
inspired by this week's guest.
Welcome to the House of Jarmarpodcast where wellness starts
within.
I'm your host, Jean Collins,and today we are talking veins
everybody.
I am so excited we have DrAshar on as a guest and he lives
(01:56):
locally here in Connecticut,but I wanted to have him on to
talk about his business, theVein Institute, because I think
there's so much education thatwe can all gain from his
knowledge, even if you don'tlive in Connecticut.
So, Dr Ashar, thank you.
Welcome for joining the show.
Thank you for having me Great,Okay.
So first, before we get started, I love to share everyone's
career journeys because we don'tstart out like I said to you
(02:16):
before we started.
At 10 years old, you didn't sitthere on the playground and say
, yes, I want to be a veindoctor.
Yes, I want to be a vein doctor.
So if you wouldn't mind sharingwith everybody a little bit
about your career journey andhow you got into vein health and
, honestly, just a career inhealth in general, Happy to Well
.
Speaker 1 (02:34):
Again, thank you for having me A little bit
unconventional, in the sensethat I did my primary education
in Europe at an English boardingschool, wow yeah.
And after coming to the StatesI attended George Washington
(02:59):
University and at the same timeI was doing a fellowship at NIH
National Cancer Institute andone of the primary focuses of
our project was to cut bloodsupplies to tumor cells, and
(03:21):
that's kind of a summary of theroute that got me into vascular
business.
Speaker 2 (03:28):
Interesting.
So let's talk about the VeinInstitute and first and foremost
talk about vein disease.
And what is that?
Speaker 1 (03:39):
Well, it's very important to first distinguish
the difference between veins andarteries.
There's quite a bit ofdifference, even though commonly
we think of the vascular systemas one system.
But veins in particular, one oftheir major functions is
storage.
That's why pregnant women whohave about 50% extra blood in
(04:04):
their system that's about twoand a half liters of extra blood
they can't store that bloodanywhere, but they're in their
veins.
That's why veins stretch.
That's why after pregnancy yousee more vein conditions than
you would otherwise.
Veins take blood back.
Just simply put, veins takeblood back to the heart.
(04:26):
So veins have this cumbersomework of pulling all the blood
against gravity to make it backto the heart from, let's say,
your feet or your legs.
It's why the veins have tofight gravity.
That's why inside your veinsyou have these one-way valves
(04:47):
that only promote blood going uptowards your heart and not
leaking back down.
But once these valves becomeincompetent age well, actually
most common cause is geneticsThen it's two or more
pregnancies, occupation, femaleand age doesn't help anything,
(05:11):
quite honestly.
Speaker 2 (05:17):
You are so correct, my friend.
Speaker 1 (05:20):
So what happens is the blood that's trying to go up
to make it back to the heartgets sucked back down by gravity
and it pulls to your feet andankles.
That's an overall summary ofwhat a vein condition is.
Speaker 2 (05:36):
That's fascinating.
I had no idea that it workedonly in one direction
interaction.
So is that why this concept ofvaricose veins that many women
have, especially those of usthat have stood a lot for our
careers, happen in our lowerextremities, like I see them in
my legs?
I don't see them in my arms orother places, but I notice them
(05:56):
the most in my legs.
And is that because gravity ispulling it down?
Speaker 1 (06:00):
That's absolutely true.
Yes, that's exactly right, eventhough you can have
varicosities elsewhere, like inthe pelvic region or lower
abdomen or places like that.
But you're absolutely rightMost most common reason is
gravity.
Yes, Avetis.
Speaker 2 (06:26):
So your website?
On your website you mentionedthat one in four people suffer
from vein disease and I waspersonally shocked by how big
that number is.
And so is that any type of veindisease?
Because on your website youtalk about all types of
different things, ranging fromvaricose veins to spider veins
to hemorrhoids I had no ideahemorrhoids fit into that
category To one of my favorites,which I was fascinated by and
(06:48):
want to dig into a little bitrestless leg syndrome.
Wow, so all of those areconsidered vein disease.
Speaker 1 (06:57):
Well, I mean restless leg syndrome is not vein
disease, but it's one of the twocauses that we know of.
One is low iron, the other isvein disease.
So one of its causes is veindisease.
Speaker 2 (07:12):
Yes, Got it Okay, so we're going to dig into that in
a minute.
So all of this in terms oflet's just talk a little bit
about the science behind this,right?
So you talk about how the bloodis flowing down their valves.
So it doesn't flow up, theblood is flowing down.
So I'm assuming gravity is nothelping.
Sorry, the blood's supposed toflow up.
(07:33):
I got that backwards.
The blood's supposed to flow up, not down.
Gravity isn't helping.
Therefore, you end up with I'mgoing to assume and you can
correct me if I'm saying thiswrong blockages in your veins,
which is why, when you havethings like varicose veins and
spider veins, they stick out andyou can see them.
Speaker 1 (07:51):
It's actually the opposite of blockage, it's more
leakage.
Oh yes, because you have tothink of veins like a tree.
So what you look at on thesurface, if you're looking at
(08:11):
your spider veins, those are thevery top branches of the tree.
When you go further down, tothe branches that connect to the
trunk, those are the ones thatbecome varicose.
And the trunk itself issupposed to have one-way valves
that close and shut in half asecond or less to prevent the
blood from getting sucked backdown towards your feet pregnancy
(08:40):
, occupation, so forth and so on.
Then these valves don't closeproperly and the blood that's
been collected from all thosebranches into that trunk is only
supposed to go up towards yourheart and not get sucked back
down towards your feet.
(09:02):
So that's the whole principlebehind vein disease.
Speaker 2 (09:08):
So helpful.
You said it much better than Idid, so thank you for that.
Okay, so what do people doabout this?
Speaker 1 (09:16):
It's good to review a little bit of history when it
comes to this condition, and thehistory of treating vein
disease was that we used to tellpatients to just deal with it
over compression stockings, evenif you were in Houston, texas,
scars on your legs, lots ofpost-operative pain afterwards,
(09:36):
until the beauty of laser andradio frequency and all this
good stuff on the light spectrumcame about, which really really
is all about thermal energy.
So what we do is we advance acatheter which is kind of doing
(10:18):
that is a little bit more thangiving blood at the blood
station.
We advance a catheter into thesection of the vein which has no
pain fiber, so it's painless tothe section that we want to
close, which is mostly the trunk, and thermal energy under local
(10:40):
anesthesia will close thatsection shut.
You pull out the catheter, youput a band-aid on, you put
compression stockings on andit's done and can be, really can
be done during a lunch hourthese days With a competent
surgeon.
(11:00):
It can be done during people'slunch hour.
Imagine it can be done duringpeople's lunch hour.
One thing that is interesting isthat we hear laser and radio
frequency and infrared light andall these fancy names, but it's
all about thermal energy.
We use thermal energy.
(11:22):
That's what they do in ourfield.
Laser emits thermal energy.
That's why we use it forablation, whether it's your leg
veins or your heart, and radiofrequency does the same thing.
When you apply thermal energyto a vessel that's made of
(11:43):
protein, the proteins break downand the vein collapses.
Speaker 2 (11:46):
That's what happens, Got it.
So through that process thatvein is no longer a working vein
.
Am I correct in that that's?
Speaker 1 (11:56):
correct, and one of the common questions that we get
asked is oh, don't I need thatvein.
You really do need everythingthat's in your body, otherwise
you wouldn't be there in thefirst place.
But with veins we have quite abit of liberty, to the point
(12:17):
where we can remove all theveins on somebody's hand just
for beautification purposes, andnothing happens, because
ablating a leg vein that'sincompetent is like closing an
exit off of a long highway.
Speaker 2 (12:33):
Okay, so the blood is still going, just in a
different way.
Speaker 1 (12:37):
It's just using a different, so many different
veins.
Speaker 2 (12:40):
Right, different paths to get there, correct, yes
, wow, okay, so let's talk aboutthe different types of services
that you would offer.
And so you're talking spiderveins, which you talked about,
which are on the surface,varicose veins.
What's the difference between?
A varicose vein is just deeper.
Is it larger?
Is it when we see those larger,really raised bumpy veins on
(13:05):
our skin?
Is it when we see those?
Speaker 1 (13:06):
larger, really raised bumpy veins on our skin.
So if we think of that treethat we discussed earlier,
spider veins are like.
It's like looking at the treefrom the top.
Spider veins are the very topbranches.
Those are spider veins.
Then when you go down you getto a larger vein.
(13:27):
Those are called reticularveins and those are those
greenish, bluish veins thatdon't bulge, but you see them on
your leg.
Okay, Yep.
Quite unsightly.
But they're not alwayspathological.
They could be normal, could bethe color of your skin.
Pathological they could benormal, could be the color of
your skin.
And then, past that, you get tothe final branch, before you
(13:51):
get to the trunk of that tree.
Those final branches, they getcongested, just like during
pregnancy.
They get congested with bloodbecause all the blood is not
draining from them to go back toyour heart.
Some of it is leaking back downby force of gravity.
And then they bulge out andbecome ropey and you see them on
(14:12):
your legs.
Those are varicose veins.
Speaker 2 (14:16):
Got it.
I had no idea the differencebetween all three.
That's so helpful.
So then you okay, so we havethose services.
Then you also have the conceptof cosmetic veins.
So talk to me a little bitabout why someone would come to
you for help cosmetically withveins.
Speaker 1 (14:33):
Well, you know spider veins, even though they are
part of that tree network thatwe just discussed, all of our
treatments are covered byinsurance, including government
insurance, including Medicareand Medicaid and all the major
insurance companies.
The spider veins, though, areconsidered cosmetic, so if
(14:54):
somebody comes to us for justcosmetic, they're coming just
for spider vein treatments.
They have no symptoms likeheavy legs, cramping, swelling,
restless leg syndrome, as youmentioned.
Like I had a patient here theother day with an ankle ulcer.
Most common cause of ankleulcers are vein-related, so they
(15:17):
don't have any of those stuff,they just see some unsightly
purplish veins on their legs,and that's what they want
treated.
Speaker 2 (15:26):
Got it.
So I was shocked to find outthat much of your vein treatment
is covered by insurance, as youjust said.
I was amazed at that and Iwould think a lot of people
don't realize that it is coveredby insurance, even though in my
mind it's elective whetheryou're choosing to deal with
this or not, because noteverybody does, but if the
(15:48):
statistics are that one in fourof us have this issue, I think
that's pretty amazing thatinsurance does cover that type
of service.
Speaker 1 (15:56):
If you have symptoms that relate to vein condition.
They don't have to be likethey're not going to make you
take time off work because yourlegs hurt so bad.
Your legs just feel heavy atthe end of the day and most of
us think that's kind of normal,is because we work so hard all
(16:18):
day.
Right, whether we have or not,that is a different matter.
But you know, legs feel heavy,they feel tired, they feel you
get cramping, mostly during theday, not at night.
You have, you know again,restless legs, swelling.
If you have those kinds ofsymptoms then and your condition
(16:43):
, after doing a simpleultrasound of your legs, is
confirmed to be potentially fromvein disease, then that's all
covered by insurance.
The only part that's notcovered are the, the spider
veins so talk to me about how.
Speaker 2 (16:59):
What's it like if someone signs up to go to your
practice?
What happens?
How do you identify what mightbe causing these symptoms that
people have?
And we can even use me as anexample, because I do have
restless leg and I do havespider veins, but I don't think
I have varicose veins.
But I definitely have restlessleg and it is hereditary and
(17:19):
other members of my family haveit as well.
So how do you go aboutidentifying if that's a cause of
vein disease is what'scontributing to the restless leg
?
Speaker 1 (17:29):
Okay, so, first of all, because the restless leg is
such a common and really,really disabling condition
because it doesn't let you sleepat night, the first thing that
anybody should do before evenseeing a doctor is improve their
(17:49):
iron intake.
So, even if your blood work iscompletely normal, you know we
look at hemoglobin andhematocrit and then we look at
other indices to see whetherit's iron-related, b12-related,
folate-related.
So, regardless, if you improveyour iron intake in your diet
(18:10):
especially if you've had heavymenstrual cycle in the past, if
you've been anemic in the pastor if you've not and your iron
has been on the lower side ofnormal, that should improve
things by itself.
Interesting Independently.
Speaker 2 (18:26):
No one's ever told me that.
And I've had by itselfInteresting Independently no
one's ever told me that and I'vehad restless leg for a really
long time.
Magnesium I take magnesium, butiron no one's ever told me
about iron.
Speaker 1 (18:40):
Very, very common problem.
Just like cramping, just likeswelling.
And then what happens issomebody makes an appointment.
(19:00):
They come in not forgettingthat the diagnosis should be
made by the physician and thepatient, not by imaging studies.
Imaging studies are supposed tobe something I learned at the
National Institute of HealthI'll never forget.
Imaging studies are supposed toconfirm your diagnosis, not
make it Got it.
So when they come in, signs andsymptoms, Symptoms are what you
feel, all right, Again, goingthrough the list cramping,
(19:24):
heaviness, tired legs, swelling,all the things, even
discoloration around your lowerlegs from your ankle up.
That's a big sign, Ulcers, ofcourse.
So, based on that, then weexamine the legs, just physical
(19:47):
examination.
Once we see that the signs arethe things that we see, the
symptoms are the things that wehear, and all the comorbidities
if somebody has one, you don'thave to have one if they have
diabetes, but most of thepatients we actually see are
(20:08):
perfectly healthy Then we say,okay, I think this could be a
vein condition that can betreated.
Then we do a simple no radiationagain covered by all insurances
ultrasound Everybody's had oneand take a look at how these
(20:32):
one-way valves open and close,shut, and does it take them half
a second to open and close shut, or does it take those valves
five seconds or 10 seconds toclose and open?
Shut those valves five secondsor 10 seconds to close an open
shot?
If the valves are incompetentand they take much longer to
(20:53):
close or don't close at all,then we move on to get
pre-approval from insurancecompanies.
We have to do some conservativemanagement, kind of a little
bit waste of time, but it has tobe done, it's worth it.
It's worth it, yeah.
So then we move on toconservative management, which
is walking, exercising andwearing compression stockings
(21:17):
for a few weeks Some say sixweeks, some say 12 weeks and
then after that we can schedulethe patient to get their
treatments done, and thetreatment is done from the trunk
up to the top branches, butspider veins are not covered by
(21:37):
insurance?
Speaker 2 (21:37):
Not part of it.
Got it.
Okay, that makes perfect sense.
Is treatment like you said?
You can do it over lunch?
Is it really a one time?
You come in once and thenyou're wearing I'm assuming
compression socks.
I don't know, you tell usafterwards for a little while.
Or is it a repetitive treatmentthat you have to go back again
and again?
Speaker 1 (21:57):
That's an excellent question and the answer to that
is it's never once.
But if insurance is notinvolved which insurance often
is for most of us if insuranceis not involved, things can be
bundled.
Okay, so we can do two, threesections at once.
(22:20):
When insurance gets involved,then we can only do one section
of a vein at a time.
And because of that, thinkabout, if you've got four trees
that are incompetent, then youhave to do four trunks, then you
have to do four trees, branches, then you have to do the
injections, and so it willbecome multiple, multiple visits
(22:44):
, and so it will become multiple, multiple visits, but for none
of them one needs to go home,rest, elevate or anything like
that.
Speaker 2 (22:59):
You go back to your normal activities, right off the
table.
Speaker 1 (23:01):
So that's one advantage.
Speaker 2 (23:02):
so much, and have you seen that since you started,
because you've been doing thisfor 20 years.
So have you seen the technologychange a lot over let's even
say the last five years.
Speaker 1 (23:14):
Absolutely, absolutely.
There was a time that we used alower wavelength laser, a lower
wavelength laser A lowerwavelength laser targeted
hemoglobin to close the veinshots.
When you target blood cells toclose the vein shots, you injure
(23:37):
the blood cells.
That's painful, right.
So patients would have somepain for a couple of days, not
longer yeah since then.
Now the new lasers use, as theyuse, a higher wavelength, which
targets water in the vein wallyeah, so it's completely
(23:59):
pain-free.
That is amazing, that's.
That was a big advancement.
Speaker 2 (24:05):
That is amazing.
Wow, how do you stay on top ofall the new technology?
Running a practice, being busy?
How do you stay on top of itall?
Speaker 1 (24:14):
We just ask the reps to bring lots of lunch and teach
us what to do.
No, I mean, you know it'smedicine, medicine.
You really can never be caughtup, but you know, fortunately.
Fortunately I am a big fan oftechnology, for at least our
(24:36):
field, because fortunately,these days, as soon as something
new comes up, you get emailsfrom your society and you get
emails from American MedicalAssociation, and you get.
So the articles just get fed toyou.
All you have to do is read them, and that's the hard part.
Speaker 2 (24:56):
Make the time make the time to find that.
Yes, that is fascinating.
So just for the people who livein Connecticut, let's talk
about the location of yourpractices.
Where are your practiceslocated, we kind?
Speaker 1 (25:09):
of have researched areas that there was a need.
And we have our new town officewhich serves all the greater
Danbury area and new towns andsurrounding towns.
Then we have Shelton, whichit's become.
(25:31):
Shelton has exploded in termsof restaurants and because it's
a great town, another great townto live in.
And then we have Fairfield,which we've been for a very long
time, at least I.
I want to say 12 years or more,actually 15 years or more.
(25:51):
And then our newest office isin Milford.
Speaker 2 (25:56):
Oh, ok, so you cover a big geography.
Speaker 1 (26:00):
Cover a big geography ?
Yeah, fortunately Connecticutis not that big, so it's easy to
cover.
Speaker 2 (26:08):
That is true.
You can cover a big geography,so that's a lot.
It's a big job to be a doctorand to manage four offices.
So how do you find time in yourlife for wellness for you?
Because I feel like anyonewho's in the medical field
wellness, you know.
You never want to walk in andsee a doctor who's huffing and
puffing and really fat andoverweight and looks like they
(26:28):
don't take care of themselves.
So it's not a good sign.
So I feel like everyone I'veever met in the medical field is
very interested in their ownpersonal wellness.
So if you wouldn't mind if weprobe a little into you and your
life?
How do you make a priority forthat?
Because, just like many of thepeople who listen to my show,
many of them are entrepreneursand it doesn't matter what
business you're in.
(26:49):
This is a struggle to run abusiness and make time for
yourself.
So if you wouldn't mind sharing, how do you make personal
wellness a priority?
And what do you know?
I do this kind of podcast andthings to help educate people.
Speaker 1 (27:10):
You know, a few times a year at least, and your
questions are excellent.
Absolutely All the questions Ihear from patients these are
questions from medical studentsthat we teach and things like
that.
So that is super.
Now, when I started close to 20years ago, you know I came in
(27:34):
strong.
I wasn't all in veins.
I had one of the largestprimary care offices, actually
the largest primary care officein Newtown, and unfortunately,
you know, the thing with SandyHook happened also, so it wasn't
, but regardless.
You know I went in as a youngdoctor to change the world,
(27:55):
right, sure, and you know I wasthere first thing and you know,
back then again because of thetechnology wasn't there, we
would have to sit down at theend of our shift or end of last
patient.
We would see and sit down andwrite charts and calling
medications and call patientswho had abnormal blood work that
were kind of dangerous andneeded to know right away.
(28:19):
And I did all of that and Ilooked in the mirror and what I
saw was somebody who would notbe able to help anybody very
soon it literally that's exactlywhat I saw.
I was like, well, you know, youmay be doing a good job, but it
(28:39):
won't be for long.
So exercising, you know, health, health in general has to be
priority, right.
Otherwise, whenever I've said,oh, ok, I'll do this and then I
exercise, maybe I'll do that andthen I exercise, more often
(29:00):
than not it doesn't happen.
So what I did was I made sureat first I got a trainer at our
local gym yeah, so I'maccountable.
Yes, so I'm accountable.
And then, once I was on a roll,my schedule always includes
(29:21):
exercising when I'm not having abig ribeye steak.
A healthy diet, a nice healthydiet.
Unfortunately, these days youcan have tasty healthy diet.
When I was very young, to eathealthy was kind of what is that
?
What's healthy?
(29:42):
You had a salad with your steak.
You didn't have a salad as ameat, you know.
So I made it priority, really,really, and it changes things.
It changes the way you think,it changes the way you feel.
It changes the way you enjoylife, you're able to perform.
Speaker 2 (30:05):
It changes absolutely everything I agree.
Couldn't agree more.
And I did have one of thosemornings where I was like, okay,
after I do this little workproject, I'm then going to go
work out.
And before I knew it the timewas over and I was like note to
after I do this little workproject, I'm then going to go
work out.
And before I knew it the timewas over and I was like note to
self, I know better.
I should have worked out first.
Speaker 1 (30:22):
Always.
Speaker 2 (30:23):
Always, always, always.
It's normally on my calendarfirst thing in the morning and
if I don't, you know at leastnow in Connecticut the sun is
out and it's light later, so youknow we can at least get out
later.
But still, I'm with you if youdon't do it first thing in the
morning, and I think for all ofyour patients, since, based on
some of the protocol that youmentioned for insurance, it's
like ensuring that they do getexercise, that they do get
(30:46):
movement, so their blood flow ismoving, and that's really an
important part of helping in thecure is making sure that your
clients are moving and thathelps our vascular health in
general, especially for yourlegs.
Speaker 1 (31:00):
It helps everything.
It helps everything, Jean.
Yeah, it really does.
Actually, one of the thingsthat we do tell our patients is
they must walk every day.
We actually have them walk 30to 40 minutes a day, which is,
(31:21):
yeah, I mean, one of thequestions.
I'm glad you brought this up.
One of the common questionsthat we get is what can I do to
prevent new veins after I gettreatments?
Or you know, since it's, yousee, vein condition has
treatments.
Yeah, so it's like diabetes ithas treatments.
(31:46):
It's like hypertension it hastreatments, but none of those
chronic conditions have a cure,Right?
So you cannot cure diabetes,but you can keep it in check.
You cannot cure hypertension,but you can keep it in check.
That's the definition of achronic disease that it may or
(32:08):
may not have treatments, butit's not curable yet.
So, to prevent further veinsfrom popping up, keep your
weight in check, which meansexercise, especially walking.
Biking, ellipticals and thingslike that are great forms of
(32:31):
exercise, but they don't doanything for your veins because
they don't cause calfcompression.
Speaker 2 (32:37):
Wow, I didn't know that.
Yes, okay, wow, all right, allthe more reason to keep walking.
I do have a walking desk.
I have a treadmill under mydesk, anything that?
Speaker 1 (32:48):
causes calf movement.
So like pressing the gas pedalin the car, that causes calf
movement, that kind of amovement, because we actually
call your calf muscles yoursecond heart.
Because, it's the second mostimportant muscle for your
(33:09):
circulation.
Speaker 2 (33:11):
All your veins sit inside your calf muscles, so
that's why, when you walk on aplane and you don't get a clot,
is because your calf muscles aresqueezing your leg veins.
Ah, all the more reason to getout and get your steps.
Speaker 1 (33:30):
Walk run, walk run, yes, but you know, be careful
with your knees If you're alittle bit older, you know.
Walk on a you know comfortablesurface, soft surface,
comfortable shoes, of course.
And then when you travel longdistances on the plane or by car
, if you can wear a, you know,even over the counter is better
(33:52):
than nothing.
Compression stockings, even ifthey're knee highs, that helps
as well.
Hydration helps Exercisingwalking hydration.
So those things prevent newones from popping up so quickly.
Speaker 2 (34:08):
I love that.
Now do people have to walk intheir compression socks, or not
necessarily from your clientperspective.
Speaker 1 (34:26):
It's better if they do, but the principle behind.
Speaker 2 (34:27):
They call them gradient compression stockings
because they're tighter aroundyour ankle and lighter
compression as they go up theleg.
Speaker 1 (34:34):
That promotes blood flow going towards your heart.
Okay, so that's the wholeprinciple behind compression
socks.
Speaker 2 (34:45):
That's fascinating, I will say.
I've used compression sockswhen I used to fly from New York
to California on a prettyregular basis and I definitely
wore them on the plane and I didnotice a difference.
Speaker 1 (34:57):
And some people just naturally their feet and legs
swell after a flight and thatprevents that.
Speaker 2 (35:05):
Yes, very much.
So.
Yes, I definitely noticed adifference.
I haven't worn them in a while,so you're reminding me I need
to get them out for someupcoming trips.
I have but, and they're notnecessarily fashion forward, but
that is okay.
Speaker 1 (35:21):
Actually that's not true anymore.
You can really get fashionablecompression socks nowadays.
I don't know if you can getfishnets, but you can get
fashionable and comfortable andinexpensive.
Quite honestly.
You know, back in the day youcould only get those.
(35:41):
I had a patient once who saidher son was walking on the beach
and somebody had compressionstockings on and her son told
her oh, mom, mommy, look at thatguy, he's got prosthetic legs.
Wow, compression stockingsdon't work that way anymore.
They're much more fashionablenowadays.
Speaker 2 (36:02):
They're much better.
Oh, I love that Well, and justthe form of treatment sounds
like it's much better.
Anyone who, as a doctor, saysthey have a treatment for
something where there isn't paininvolved or a lot of pain
involved, is definitely a signme up.
That sounds incredible.
So question for you what's onyour bucket list professionally?
What would you like to do thatyou haven't done yet?
Speaker 1 (36:24):
That's an excellent question.
One of the things, actually,that has always a passion of
mine was longevity, which isbeing studied extensively, but
that's still at its very infancy, so I'm kind of just learning
about it and studying it.
But professionally, we're justgoing to continue to expand and
(36:48):
help as many people who needhelp in areas that they can't.
So that would be the nextbucket list.
Next on the bucket list yeah.
Speaker 2 (36:58):
Yeah, longevity is fascinating the things that
happen in blue zones and thingslike that, I think is actually
very, very, very interestingbecause it's a lifestyle.
I think, from the little bitthat I know, it is all about
really adapting a lifestyle andI am a huge proponent of getting
listeners of this podcast tounderstand that everything I do
and I talk about and the guestsI bring on, we all do different
(37:20):
things and provide differentservices, but this is a
lifestyle and it's a lifestyleand a commitment to wellness.
It's not a one and done.
We never talk about just takinga pill and it's over.
Everything is about a lifestyle100%.
Speaker 1 (37:33):
I couldn't agree more .
And I think one of the thingsthat we mustn't forget about is,
you know, we get out there, werun and we get on the treadmill,
we run, and then we lift someweights and we stretch, and then
, you know, we put our music onand get to work.
We forget about activity forour minds and our brains, which
(37:55):
also, you know, brain is also atype of muscle.
It needs to grow, it needs tobe healthy, it needs to, it
needs exercising, meditation,yoga, things like that.
Speaker 2 (38:10):
I'm a huge proponent of all of those things and
continual learning, which is whyI think it's always interesting
to have entrepreneurs on andask them what's on their bucket
list, because you can see howthey aspire to learn new things.
Most people, without meprompting, have things they want
to learn as entrepreneurs,because entrepreneurs just
innately are curious people.
So what is on your bucket listpersonally?
(38:33):
It's always nice to get alittle peek at someone
personally.
So what's on your bucket listpersonally?
Speaker 1 (38:37):
One of them is kind of boring because everybody
wants to travel, right, butcurrently I am trying to improve
my kite surfing.
Oh wow, good for you.
I'm kind of a big wakeboarderin summertime.
That's what I am kind of.
I try to improve a little bitevery year.
Speaker 2 (38:59):
You can't possibly be doing that here in Connecticut.
We don't have enough waves.
Speaker 1 (39:03):
No.
Speaker 2 (39:05):
Where are you going?
Speaker 1 (39:06):
to do that.
We have the wind.
Speaker 2 (39:08):
Right, we have plenty of wind, but we don't have
waves.
It's not real ocean here, sowhere do you go to do that?
Speaker 1 (39:16):
Actually, the best place I have found to do that
because the water is clear, warm, shallow and the wind is not
crazy for a beginner like me isTurks and Caicos.
Speaker 2 (39:27):
Oh well, hey, that's a great reason to go there.
I love that.
Thank you for sharing.
All right, so before we go, twolast questions for you.
One is there anything that Ididn't ask you that you want to
make sure you communicate to thelisteners and to the viewers on
?
Speaker 1 (39:43):
YouTube.
Just have to get a consultationby a reputable physician or a
surgeon.
You get an ultrasound done thatwill confirm everything that's
been discussed.
The treatment is covered byinsurance.
(40:05):
The time to get treated becauseof insurance criteria could be
long, but overall the resultsare fantastic.
Removing varicosities has morethan 98% improvement and that's
a national average, so that'sreally good in medicine.
You know back to your normalactivities, covered by all
(40:28):
insurances, so I don't think youmissed anything at all that's
wonderful.
Speaker 2 (40:33):
Well, I will definitely be coming to you guys
for my restless leg situation,because I had no idea that that
could be dealing with my veinsmight be a way to help that.
So thank you for sharing that.
Okay, last question for you.
I love to ask all my guests torecommend a book that has
impacted them either personallyor professionally that they
would like to recommend to theaudience.
I am a huge proponent thatbooks change lives, so what book
(40:54):
would you like to recommend?
Or books?
Audience?
I am a huge proponent thatbooks change lives, so what book
would you like to recommend?
Or books?
You can recommend more than one.
Speaker 1 (41:00):
There is a book that I am reading as we speak, and
that book is called E-Squared.
The reason I look down becauseI'm trying to find the name of
the author.
Speaker 2 (41:12):
That's okay.
I'll link it in the show notesso you don't even need to.
Speaker 1 (41:16):
You know, when you say it's about quantum physics,
then people just switch off itis, but it's not.
You know, it's one of thosethings that I certainly wasn't
listening to in class when theytaught it, but it's about
improving your mindset.
(41:36):
So you see the things that youwant to see, instead of the
things that you don't want yourbrain to see Negativity.
Speaker 2 (41:47):
Oh, my goodness, I have to read that.
I'm all about mindset, so Ihave to read that one.
Speaker 1 (41:54):
It's short and, to prove its concept, it has
exercises, very simple exercises, and, like we discussed a few
minutes ago, I think exercisingour brain muscle is just as
important as exercising ourbiceps.
(42:15):
So that's what this book is for.
Speaker 2 (42:19):
Oh, I agree.
Thank you so much for sharingthat.
I am absolutely going to gocheck that out.
I love everything to do withmindset and, as a mindset coach,
anything that taps into that Ifind fascinating.
So thank you so much, dr Afshar.
It's been such a pleasure tomeet you.
Thank you for taking time outof your very busy schedule to be
on the show to share yourwisdom, to share your knowledge.
It was a pleasure to meet youand I personally will be coming
(42:41):
to your clinic for someassistance.
So thank you.
I hope you have a beautiful day.
Speaker 1 (42:45):
Thank you so much.
It's been an honor to see youand treat you if needed be.
I've really really enjoyed ourtime together today.
Thank you need it be.
Speaker 2 (42:56):
I've really, really enjoyed our time together today.
Thank you, perfect.
Thank you have a great day.
Thank you for joining us foranother episode of the House of
Jermar podcast, where wellnessstarts within.
We appreciate you being a partof our community and hope you
felt inspired and motivated byour guest.
If you enjoyed this episode,please write us a review and
(43:16):
share it with friends.
Building our reach on YouTubeand Apple Podcasts will help us
get closer to our mission toempower 1 million women to live
all in.
You can also follow us onInstagram at House of Jermar and
sign up to be a part of ourmonthly inspiration newsletter
through our website,houseofjermarcom.
If you or someone you knowwould be a good guest on the
(43:38):
show, please reach out to us atpodcast at houseofgermarcom.
This has been a House of Germarproduction with your host, jean
Collins.
Thank you for joining our house.
You know you have to think of veins like a tree.
So what you look at on thesurface, if you're looking at
your spider veins, those are thevery top branches of the tree.
When you go further down, tothe branches that connect to the
trunk, those are the ones thatbecome varicose.
(00:20):
And the trunk itself issupposed to have one-way valves
that close and shut in half asecond or less to prevent the
blood from getting sucked backdown towards your feet.
And once these valves becomeincompetent genetics, pregnancy,
(00:41):
occupation, so forth and so onthen these valves don't close
properly and the blood that'sbeen collected from all those
branches into that trunk is onlysupposed to go up towards your
heart and not get sucked backdown towards your feet.
(01:02):
So that's the whole principlebehind vein disease.
Speaker 2 (01:09):
Welcome to the House of Germar podcast where wellness
starts within.
The House of Germar is alifestyle brand, empowering
women to live all in throughinterior design and personal
wellness.
We are a destination for womenready to reimagine what is
possible in their homes andlives and then create it.
We are honored to have you joinus on our mission to empower 1
(01:32):
million women to live all in.
I am your host, Jean Collins,and I invite you to become
inspired by this week's guest.
Welcome to the House of Jarmarpodcast where wellness starts
within.
I'm your host, Jean Collins,and today we are talking veins
everybody.
I am so excited we have DrAshar on as a guest and he lives
(01:56):
locally here in Connecticut,but I wanted to have him on to
talk about his business, theVein Institute, because I think
there's so much education thatwe can all gain from his
knowledge, even if you don'tlive in Connecticut.
So, Dr Ashar, thank you.
Welcome for joining the show.
Thank you for having me Great,Okay.
So first, before we get started, I love to share everyone's
career journeys because we don'tstart out like I said to you
(02:16):
before we started.
At 10 years old, you didn't sitthere on the playground and say
, yes, I want to be a veindoctor.
Yes, I want to be a vein doctor.
So if you wouldn't mind sharingwith everybody a little bit
about your career journey andhow you got into vein health and
, honestly, just a career inhealth in general, Happy to Well
.
Speaker 1 (02:34):
Again, thank you for having me A little bit
unconventional, in the sensethat I did my primary education
in Europe at an English boardingschool, wow yeah.
And after coming to the StatesI attended George Washington
(02:59):
University and at the same timeI was doing a fellowship at NIH
National Cancer Institute andone of the primary focuses of
our project was to cut bloodsupplies to tumor cells, and
(03:21):
that's kind of a summary of theroute that got me into vascular
business.
Speaker 2 (03:28):
Interesting.
So let's talk about the VeinInstitute and first and foremost
talk about vein disease.
And what is that?
Speaker 1 (03:39):
Well, it's very important to first distinguish
the difference between veins andarteries.
There's quite a bit ofdifference, even though commonly
we think of the vascular systemas one system.
But veins in particular, one oftheir major functions is
storage.
That's why pregnant women whohave about 50% extra blood in
(04:04):
their system that's about twoand a half liters of extra blood
they can't store that bloodanywhere, but they're in their
veins.
That's why veins stretch.
That's why after pregnancy yousee more vein conditions than
you would otherwise.
Veins take blood back.
Just simply put, veins takeblood back to the heart.
(04:26):
So veins have this cumbersomework of pulling all the blood
against gravity to make it backto the heart from, let's say,
your feet or your legs.
It's why the veins have tofight gravity.
That's why inside your veinsyou have these one-way valves
(04:47):
that only promote blood going uptowards your heart and not
leaking back down.
But once these valves becomeincompetent age well, actually
most common cause is geneticsThen it's two or more
pregnancies, occupation, femaleand age doesn't help anything,
(05:11):
quite honestly.
Speaker 2 (05:17):
You are so correct, my friend.
Speaker 1 (05:20):
So what happens is the blood that's trying to go up
to make it back to the heartgets sucked back down by gravity
and it pulls to your feet andankles.
That's an overall summary ofwhat a vein condition is.
Speaker 2 (05:36):
That's fascinating.
I had no idea that it workedonly in one direction
interaction.
So is that why this concept ofvaricose veins that many women
have, especially those of usthat have stood a lot for our
careers, happen in our lowerextremities, like I see them in
my legs?
I don't see them in my arms orother places, but I notice them
(05:56):
the most in my legs.
And is that because gravity ispulling it down?
Speaker 1 (06:00):
That's absolutely true.
Yes, that's exactly right, eventhough you can have
varicosities elsewhere, like inthe pelvic region or lower
abdomen or places like that.
But you're absolutely rightMost most common reason is
gravity.
Yes, Avetis.
Speaker 2 (06:26):
So your website?
On your website you mentionedthat one in four people suffer
from vein disease and I waspersonally shocked by how big
that number is.
And so is that any type of veindisease?
Because on your website youtalk about all types of
different things, ranging fromvaricose veins to spider veins
to hemorrhoids I had no ideahemorrhoids fit into that
category To one of my favorites,which I was fascinated by and
(06:48):
want to dig into a little bitrestless leg syndrome.
Wow, so all of those areconsidered vein disease.
Speaker 1 (06:57):
Well, I mean restless leg syndrome is not vein
disease, but it's one of the twocauses that we know of.
One is low iron, the other isvein disease.
So one of its causes is veindisease.
Speaker 2 (07:12):
Yes, Got it Okay, so we're going to dig into that in
a minute.
So all of this in terms oflet's just talk a little bit
about the science behind this,right?
So you talk about how the bloodis flowing down their valves.
So it doesn't flow up, theblood is flowing down.
So I'm assuming gravity is nothelping.
Sorry, the blood's supposed toflow up.
(07:33):
I got that backwards.
The blood's supposed to flow up, not down.
Gravity isn't helping.
Therefore, you end up with I'mgoing to assume and you can
correct me if I'm saying thiswrong blockages in your veins,
which is why, when you havethings like varicose veins and
spider veins, they stick out andyou can see them.
Speaker 1 (07:51):
It's actually the opposite of blockage, it's more
leakage.
Oh yes, because you have tothink of veins like a tree.
So what you look at on thesurface, if you're looking at
(08:11):
your spider veins, those are thevery top branches of the tree.
When you go further down, tothe branches that connect to the
trunk, those are the ones thatbecome varicose.
And the trunk itself issupposed to have one-way valves
that close and shut in half asecond or less to prevent the
blood from getting sucked backdown towards your feet pregnancy
(08:40):
, occupation, so forth and so on.
Then these valves don't closeproperly and the blood that's
been collected from all thosebranches into that trunk is only
supposed to go up towards yourheart and not get sucked back
down towards your feet.
(09:02):
So that's the whole principlebehind vein disease.
Speaker 2 (09:08):
So helpful.
You said it much better than Idid, so thank you for that.
Okay, so what do people doabout this?
Speaker 1 (09:16):
It's good to review a little bit of history when it
comes to this condition, and thehistory of treating vein
disease was that we used to tellpatients to just deal with it
over compression stockings, evenif you were in Houston, texas,
scars on your legs, lots ofpost-operative pain afterwards,
(09:36):
until the beauty of laser andradio frequency and all this
good stuff on the light spectrumcame about, which really really
is all about thermal energy.
So what we do is we advance acatheter which is kind of doing
(10:18):
that is a little bit more thangiving blood at the blood
station.
We advance a catheter into thesection of the vein which has no
pain fiber, so it's painless tothe section that we want to
close, which is mostly the trunk, and thermal energy under local
(10:40):
anesthesia will close thatsection shut.
You pull out the catheter, youput a band-aid on, you put
compression stockings on andit's done and can be, really can
be done during a lunch hourthese days With a competent
surgeon.
(11:00):
It can be done during people'slunch hour.
Imagine it can be done duringpeople's lunch hour.
One thing that is interesting isthat we hear laser and radio
frequency and infrared light andall these fancy names, but it's
all about thermal energy.
We use thermal energy.
(11:22):
That's what they do in ourfield.
Laser emits thermal energy.
That's why we use it forablation, whether it's your leg
veins or your heart, and radiofrequency does the same thing.
When you apply thermal energyto a vessel that's made of
(11:43):
protein, the proteins break downand the vein collapses.
Speaker 2 (11:46):
That's what happens, Got it.
So through that process thatvein is no longer a working vein
.
Am I correct in that that's?
Speaker 1 (11:56):
correct, and one of the common questions that we get
asked is oh, don't I need thatvein.
You really do need everythingthat's in your body, otherwise
you wouldn't be there in thefirst place.
But with veins we have quite abit of liberty, to the point
(12:17):
where we can remove all theveins on somebody's hand just
for beautification purposes, andnothing happens, because
ablating a leg vein that'sincompetent is like closing an
exit off of a long highway.
Speaker 2 (12:33):
Okay, so the blood is still going, just in a
different way.
Speaker 1 (12:37):
It's just using a different, so many different
veins.
Speaker 2 (12:40):
Right, different paths to get there, correct, yes
, wow, okay, so let's talk aboutthe different types of services
that you would offer.
And so you're talking spiderveins, which you talked about,
which are on the surface,varicose veins.
What's the difference between?
A varicose vein is just deeper.
Is it larger?
Is it when we see those larger,really raised bumpy veins on
(13:05):
our skin?
Is it when we see those?
Speaker 1 (13:06):
larger, really raised bumpy veins on our skin.
So if we think of that treethat we discussed earlier,
spider veins are like.
It's like looking at the treefrom the top.
Spider veins are the very topbranches.
Those are spider veins.
Then when you go down you getto a larger vein.
(13:27):
Those are called reticularveins and those are those
greenish, bluish veins thatdon't bulge, but you see them on
your leg.
Okay, Yep.
Quite unsightly.
But they're not alwayspathological.
They could be normal, could bethe color of your skin.
Pathological they could benormal, could be the color of
your skin.
And then, past that, you get tothe final branch, before you
(13:51):
get to the trunk of that tree.
Those final branches, they getcongested, just like during
pregnancy.
They get congested with bloodbecause all the blood is not
draining from them to go back toyour heart.
Some of it is leaking back downby force of gravity.
And then they bulge out andbecome ropey and you see them on
(14:12):
your legs.
Those are varicose veins.
Speaker 2 (14:16):
Got it.
I had no idea the differencebetween all three.
That's so helpful.
So then you okay, so we havethose services.
Then you also have the conceptof cosmetic veins.
So talk to me a little bitabout why someone would come to
you for help cosmetically withveins.
Speaker 1 (14:33):
Well, you know spider veins, even though they are
part of that tree network thatwe just discussed, all of our
treatments are covered byinsurance, including government
insurance, including Medicareand Medicaid and all the major
insurance companies.
The spider veins, though, areconsidered cosmetic, so if
(14:54):
somebody comes to us for justcosmetic, they're coming just
for spider vein treatments.
They have no symptoms likeheavy legs, cramping, swelling,
restless leg syndrome, as youmentioned.
Like I had a patient here theother day with an ankle ulcer.
Most common cause of ankleulcers are vein-related, so they
(15:17):
don't have any of those stuff,they just see some unsightly
purplish veins on their legs,and that's what they want
treated.
Speaker 2 (15:26):
Got it.
So I was shocked to find outthat much of your vein treatment
is covered by insurance, as youjust said.
I was amazed at that and Iwould think a lot of people
don't realize that it is coveredby insurance, even though in my
mind it's elective whetheryou're choosing to deal with
this or not, because noteverybody does, but if the
(15:48):
statistics are that one in fourof us have this issue, I think
that's pretty amazing thatinsurance does cover that type
of service.
Speaker 1 (15:56):
If you have symptoms that relate to vein condition.
They don't have to be likethey're not going to make you
take time off work because yourlegs hurt so bad.
Your legs just feel heavy atthe end of the day and most of
us think that's kind of normal,is because we work so hard all
(16:18):
day.
Right, whether we have or not,that is a different matter.
But you know, legs feel heavy,they feel tired, they feel you
get cramping, mostly during theday, not at night.
You have, you know again,restless legs, swelling.
If you have those kinds ofsymptoms then and your condition
(16:43):
, after doing a simpleultrasound of your legs, is
confirmed to be potentially fromvein disease, then that's all
covered by insurance.
The only part that's notcovered are the, the spider
veins so talk to me about how.
Speaker 2 (16:59):
What's it like if someone signs up to go to your
practice?
What happens?
How do you identify what mightbe causing these symptoms that
people have?
And we can even use me as anexample, because I do have
restless leg and I do havespider veins, but I don't think
I have varicose veins.
But I definitely have restlessleg and it is hereditary and
(17:19):
other members of my family haveit as well.
So how do you go aboutidentifying if that's a cause of
vein disease is what'scontributing to the restless leg
?
Speaker 1 (17:29):
Okay, so, first of all, because the restless leg is
such a common and really,really disabling condition
because it doesn't let you sleepat night, the first thing that
anybody should do before evenseeing a doctor is improve their
(17:49):
iron intake.
So, even if your blood work iscompletely normal, you know we
look at hemoglobin andhematocrit and then we look at
other indices to see whetherit's iron-related, b12-related,
folate-related.
So, regardless, if you improveyour iron intake in your diet
(18:10):
especially if you've had heavymenstrual cycle in the past, if
you've been anemic in the pastor if you've not and your iron
has been on the lower side ofnormal, that should improve
things by itself.
Interesting Independently.
Speaker 2 (18:26):
No one's ever told me that.
And I've had by itselfInteresting Independently no
one's ever told me that and I'vehad restless leg for a really
long time.
Magnesium I take magnesium, butiron no one's ever told me
about iron.
Speaker 1 (18:40):
Very, very common problem.
Just like cramping, just likeswelling.
And then what happens issomebody makes an appointment.
(19:00):
They come in not forgettingthat the diagnosis should be
made by the physician and thepatient, not by imaging studies.
Imaging studies are supposed tobe something I learned at the
National Institute of HealthI'll never forget.
Imaging studies are supposed toconfirm your diagnosis, not
make it Got it.
So when they come in, signs andsymptoms, Symptoms are what you
feel, all right, Again, goingthrough the list cramping,
(19:24):
heaviness, tired legs, swelling,all the things, even
discoloration around your lowerlegs from your ankle up.
That's a big sign, Ulcers, ofcourse.
So, based on that, then weexamine the legs, just physical
(19:47):
examination.
Once we see that the signs arethe things that we see, the
symptoms are the things that wehear, and all the comorbidities
if somebody has one, you don'thave to have one if they have
diabetes, but most of thepatients we actually see are
(20:08):
perfectly healthy Then we say,okay, I think this could be a
vein condition that can betreated.
Then we do a simple no radiationagain covered by all insurances
ultrasound Everybody's had oneand take a look at how these
(20:32):
one-way valves open and close,shut, and does it take them half
a second to open and close shut, or does it take those valves
five seconds or 10 seconds toclose and open?
Shut those valves five secondsor 10 seconds to close an open
shot?
If the valves are incompetentand they take much longer to
(20:53):
close or don't close at all,then we move on to get
pre-approval from insurancecompanies.
We have to do some conservativemanagement, kind of a little
bit waste of time, but it has tobe done, it's worth it.
It's worth it, yeah.
So then we move on toconservative management, which
is walking, exercising andwearing compression stockings
(21:17):
for a few weeks Some say sixweeks, some say 12 weeks and
then after that we can schedulethe patient to get their
treatments done, and thetreatment is done from the trunk
up to the top branches, butspider veins are not covered by
(21:37):
insurance?
Speaker 2 (21:37):
Not part of it.
Got it.
Okay, that makes perfect sense.
Is treatment like you said?
You can do it over lunch?
Is it really a one time?
You come in once and thenyou're wearing I'm assuming
compression socks.
I don't know, you tell usafterwards for a little while.
Or is it a repetitive treatmentthat you have to go back again
and again?
Speaker 1 (21:57):
That's an excellent question and the answer to that
is it's never once.
But if insurance is notinvolved which insurance often
is for most of us if insuranceis not involved, things can be
bundled.
Okay, so we can do two, threesections at once.
(22:20):
When insurance gets involved,then we can only do one section
of a vein at a time.
And because of that, thinkabout, if you've got four trees
that are incompetent, then youhave to do four trunks, then you
have to do four trees, branches, then you have to do the
injections, and so it willbecome multiple, multiple visits
(22:44):
, and so it will become multiple, multiple visits, but for none
of them one needs to go home,rest, elevate or anything like
that.
Speaker 2 (22:59):
You go back to your normal activities, right off the
table.
Speaker 1 (23:01):
So that's one advantage.
Speaker 2 (23:02):
so much, and have you seen that since you started,
because you've been doing thisfor 20 years.
So have you seen the technologychange a lot over let's even
say the last five years.
Speaker 1 (23:14):
Absolutely, absolutely.
There was a time that we used alower wavelength laser, a lower
wavelength laser A lowerwavelength laser targeted
hemoglobin to close the veinshots.
When you target blood cells toclose the vein shots, you injure
(23:37):
the blood cells.
That's painful, right.
So patients would have somepain for a couple of days, not
longer yeah since then.
Now the new lasers use, as theyuse, a higher wavelength, which
targets water in the vein wallyeah, so it's completely
(23:59):
pain-free.
That is amazing, that's.
That was a big advancement.
Speaker 2 (24:05):
That is amazing.
Wow, how do you stay on top ofall the new technology?
Running a practice, being busy?
How do you stay on top of itall?
Speaker 1 (24:14):
We just ask the reps to bring lots of lunch and teach
us what to do.
No, I mean, you know it'smedicine, medicine.
You really can never be caughtup, but you know, fortunately.
Fortunately I am a big fan oftechnology, for at least our
(24:36):
field, because fortunately,these days, as soon as something
new comes up, you get emailsfrom your society and you get
emails from American MedicalAssociation, and you get.
So the articles just get fed toyou.
All you have to do is read them, and that's the hard part.
Speaker 2 (24:56):
Make the time make the time to find that.
Yes, that is fascinating.
So just for the people who livein Connecticut, let's talk
about the location of yourpractices.
Where are your practiceslocated, we kind?
Speaker 1 (25:09):
of have researched areas that there was a need.
And we have our new town officewhich serves all the greater
Danbury area and new towns andsurrounding towns.
Then we have Shelton, whichit's become.
(25:31):
Shelton has exploded in termsof restaurants and because it's
a great town, another great townto live in.
And then we have Fairfield,which we've been for a very long
time, at least I.
I want to say 12 years or more,actually 15 years or more.
(25:51):
And then our newest office isin Milford.
Speaker 2 (25:56):
Oh, ok, so you cover a big geography.
Speaker 1 (26:00):
Cover a big geography ?
Yeah, fortunately Connecticutis not that big, so it's easy to
cover.
Speaker 2 (26:08):
That is true.
You can cover a big geography,so that's a lot.
It's a big job to be a doctorand to manage four offices.
So how do you find time in yourlife for wellness for you?
Because I feel like anyonewho's in the medical field
wellness, you know.
You never want to walk in andsee a doctor who's huffing and
puffing and really fat andoverweight and looks like they
(26:28):
don't take care of themselves.
So it's not a good sign.
So I feel like everyone I'veever met in the medical field is
very interested in their ownpersonal wellness.
So if you wouldn't mind if weprobe a little into you and your
life?
How do you make a priority forthat?
Because, just like many of thepeople who listen to my show,
many of them are entrepreneursand it doesn't matter what
business you're in.
(26:49):
This is a struggle to run abusiness and make time for
yourself.
So if you wouldn't mind sharing, how do you make personal
wellness a priority?
And what do you know?
I do this kind of podcast andthings to help educate people.
Speaker 1 (27:10):
You know, a few times a year at least, and your
questions are excellent.
Absolutely All the questions Ihear from patients these are
questions from medical studentsthat we teach and things like
that.
So that is super.
Now, when I started close to 20years ago, you know I came in
(27:34):
strong.
I wasn't all in veins.
I had one of the largestprimary care offices, actually
the largest primary care officein Newtown, and unfortunately,
you know, the thing with SandyHook happened also, so it wasn't
, but regardless.
You know I went in as a youngdoctor to change the world,
(27:55):
right, sure, and you know I wasthere first thing and you know,
back then again because of thetechnology wasn't there, we
would have to sit down at theend of our shift or end of last
patient.
We would see and sit down andwrite charts and calling
medications and call patientswho had abnormal blood work that
were kind of dangerous andneeded to know right away.
(28:19):
And I did all of that and Ilooked in the mirror and what I
saw was somebody who would notbe able to help anybody very
soon it literally that's exactlywhat I saw.
I was like, well, you know, youmay be doing a good job, but it
(28:39):
won't be for long.
So exercising, you know, health, health in general has to be
priority, right.
Otherwise, whenever I've said,oh, ok, I'll do this and then I
exercise, maybe I'll do that andthen I exercise, more often
(29:00):
than not it doesn't happen.
So what I did was I made sureat first I got a trainer at our
local gym yeah, so I'maccountable.
Yes, so I'm accountable.
And then, once I was on a roll,my schedule always includes
(29:21):
exercising when I'm not having abig ribeye steak.
A healthy diet, a nice healthydiet.
Unfortunately, these days youcan have tasty healthy diet.
When I was very young, to eathealthy was kind of what is that
?
What's healthy?
(29:42):
You had a salad with your steak.
You didn't have a salad as ameat, you know.
So I made it priority, really,really, and it changes things.
It changes the way you think,it changes the way you feel.
It changes the way you enjoylife, you're able to perform.
Speaker 2 (30:05):
It changes absolutely everything I agree.
Couldn't agree more.
And I did have one of thosemornings where I was like, okay,
after I do this little workproject, I'm then going to go
work out.
And before I knew it the timewas over and I was like note to
after I do this little workproject, I'm then going to go
work out.
And before I knew it the timewas over and I was like note to
self, I know better.
I should have worked out first.
Speaker 1 (30:22):
Always.
Speaker 2 (30:23):
Always, always, always.
It's normally on my calendarfirst thing in the morning and
if I don't, you know at leastnow in Connecticut the sun is
out and it's light later, so youknow we can at least get out
later.
But still, I'm with you if youdon't do it first thing in the
morning, and I think for all ofyour patients, since, based on
some of the protocol that youmentioned for insurance, it's
like ensuring that they do getexercise, that they do get
(30:46):
movement, so their blood flow ismoving, and that's really an
important part of helping in thecure is making sure that your
clients are moving and thathelps our vascular health in
general, especially for yourlegs.
Speaker 1 (31:00):
It helps everything.
It helps everything, Jean.
Yeah, it really does.
Actually, one of the thingsthat we do tell our patients is
they must walk every day.
We actually have them walk 30to 40 minutes a day, which is,
(31:21):
yeah, I mean, one of thequestions.
I'm glad you brought this up.
One of the common questionsthat we get is what can I do to
prevent new veins after I gettreatments?
Or you know, since it's, yousee, vein condition has
treatments.
Yeah, so it's like diabetes ithas treatments.
(31:46):
It's like hypertension it hastreatments, but none of those
chronic conditions have a cure,Right?
So you cannot cure diabetes,but you can keep it in check.
You cannot cure hypertension,but you can keep it in check.
That's the definition of achronic disease that it may or
(32:08):
may not have treatments, butit's not curable yet.
So, to prevent further veinsfrom popping up, keep your
weight in check, which meansexercise, especially walking.
Biking, ellipticals and thingslike that are great forms of
(32:31):
exercise, but they don't doanything for your veins because
they don't cause calfcompression.
Speaker 2 (32:37):
Wow, I didn't know that.
Yes, okay, wow, all right, allthe more reason to keep walking.
I do have a walking desk.
I have a treadmill under mydesk, anything that?
Speaker 1 (32:48):
causes calf movement.
So like pressing the gas pedalin the car, that causes calf
movement, that kind of amovement, because we actually
call your calf muscles yoursecond heart.
Because, it's the second mostimportant muscle for your
(33:09):
circulation.
Speaker 2 (33:11):
All your veins sit inside your calf muscles, so
that's why, when you walk on aplane and you don't get a clot,
is because your calf muscles aresqueezing your leg veins.
Ah, all the more reason to getout and get your steps.
Speaker 1 (33:30):
Walk run, walk run, yes, but you know, be careful
with your knees If you're alittle bit older, you know.
Walk on a you know comfortablesurface, soft surface,
comfortable shoes, of course.
And then when you travel longdistances on the plane or by car
, if you can wear a, you know,even over the counter is better
(33:52):
than nothing.
Compression stockings, even ifthey're knee highs, that helps
as well.
Hydration helps Exercisingwalking hydration.
So those things prevent newones from popping up so quickly.
Speaker 2 (34:08):
I love that.
Now do people have to walk intheir compression socks, or not
necessarily from your clientperspective.
Speaker 1 (34:26):
It's better if they do, but the principle behind.
Speaker 2 (34:27):
They call them gradient compression stockings
because they're tighter aroundyour ankle and lighter
compression as they go up theleg.
Speaker 1 (34:34):
That promotes blood flow going towards your heart.
Okay, so that's the wholeprinciple behind compression
socks.
Speaker 2 (34:45):
That's fascinating, I will say.
I've used compression sockswhen I used to fly from New York
to California on a prettyregular basis and I definitely
wore them on the plane and I didnotice a difference.
Speaker 1 (34:57):
And some people just naturally their feet and legs
swell after a flight and thatprevents that.
Speaker 2 (35:05):
Yes, very much.
So.
Yes, I definitely noticed adifference.
I haven't worn them in a while,so you're reminding me I need
to get them out for someupcoming trips.
I have but, and they're notnecessarily fashion forward, but
that is okay.
Speaker 1 (35:21):
Actually that's not true anymore.
You can really get fashionablecompression socks nowadays.
I don't know if you can getfishnets, but you can get
fashionable and comfortable andinexpensive.
Quite honestly.
You know, back in the day youcould only get those.
(35:41):
I had a patient once who saidher son was walking on the beach
and somebody had compressionstockings on and her son told
her oh, mom, mommy, look at thatguy, he's got prosthetic legs.
Wow, compression stockingsdon't work that way anymore.
They're much more fashionablenowadays.
Speaker 2 (36:02):
They're much better.
Oh, I love that Well, and justthe form of treatment sounds
like it's much better.
Anyone who, as a doctor, saysthey have a treatment for
something where there isn't paininvolved or a lot of pain
involved, is definitely a signme up.
That sounds incredible.
So question for you what's onyour bucket list professionally?
What would you like to do thatyou haven't done yet?
Speaker 1 (36:24):
That's an excellent question.
One of the things, actually,that has always a passion of
mine was longevity, which isbeing studied extensively, but
that's still at its very infancy, so I'm kind of just learning
about it and studying it.
But professionally, we're justgoing to continue to expand and
(36:48):
help as many people who needhelp in areas that they can't.
So that would be the nextbucket list.
Next on the bucket list yeah.
Speaker 2 (36:58):
Yeah, longevity is fascinating the things that
happen in blue zones and thingslike that, I think is actually
very, very, very interestingbecause it's a lifestyle.
I think, from the little bitthat I know, it is all about
really adapting a lifestyle andI am a huge proponent of getting
listeners of this podcast tounderstand that everything I do
and I talk about and the guestsI bring on, we all do different
(37:20):
things and provide differentservices, but this is a
lifestyle and it's a lifestyleand a commitment to wellness.
It's not a one and done.
We never talk about just takinga pill and it's over.
Everything is about a lifestyle100%.
Speaker 1 (37:33):
I couldn't agree more .
And I think one of the thingsthat we mustn't forget about is,
you know, we get out there, werun and we get on the treadmill,
we run, and then we lift someweights and we stretch, and then
, you know, we put our music onand get to work.
We forget about activity forour minds and our brains, which
(37:55):
also, you know, brain is also atype of muscle.
It needs to grow, it needs tobe healthy, it needs to, it
needs exercising, meditation,yoga, things like that.
Speaker 2 (38:10):
I'm a huge proponent of all of those things and
continual learning, which is whyI think it's always interesting
to have entrepreneurs on andask them what's on their bucket
list, because you can see howthey aspire to learn new things.
Most people, without meprompting, have things they want
to learn as entrepreneurs,because entrepreneurs just
innately are curious people.
So what is on your bucket listpersonally?
(38:33):
It's always nice to get alittle peek at someone
personally.
So what's on your bucket listpersonally?
Speaker 1 (38:37):
One of them is kind of boring because everybody
wants to travel, right, butcurrently I am trying to improve
my kite surfing.
Oh wow, good for you.
I'm kind of a big wakeboarderin summertime.
That's what I am kind of.
I try to improve a little bitevery year.
Speaker 2 (38:59):
You can't possibly be doing that here in Connecticut.
We don't have enough waves.
Speaker 1 (39:03):
No.
Speaker 2 (39:05):
Where are you going?
Speaker 1 (39:06):
to do that.
We have the wind.
Speaker 2 (39:08):
Right, we have plenty of wind, but we don't have
waves.
It's not real ocean here, sowhere do you go to do that?
Speaker 1 (39:16):
Actually, the best place I have found to do that
because the water is clear, warm, shallow and the wind is not
crazy for a beginner like me isTurks and Caicos.
Speaker 2 (39:27):
Oh well, hey, that's a great reason to go there.
I love that.
Thank you for sharing.
All right, so before we go, twolast questions for you.
One is there anything that Ididn't ask you that you want to
make sure you communicate to thelisteners and to the viewers on
?
Speaker 1 (39:43):
YouTube.
Just have to get a consultationby a reputable physician or a
surgeon.
You get an ultrasound done thatwill confirm everything that's
been discussed.
The treatment is covered byinsurance.
(40:05):
The time to get treated becauseof insurance criteria could be
long, but overall the resultsare fantastic.
Removing varicosities has morethan 98% improvement and that's
a national average, so that'sreally good in medicine.
You know back to your normalactivities, covered by all
(40:28):
insurances, so I don't think youmissed anything at all that's
wonderful.
Speaker 2 (40:33):
Well, I will definitely be coming to you guys
for my restless leg situation,because I had no idea that that
could be dealing with my veinsmight be a way to help that.
So thank you for sharing that.
Okay, last question for you.
I love to ask all my guests torecommend a book that has
impacted them either personallyor professionally that they
would like to recommend to theaudience.
I am a huge proponent thatbooks change lives, so what book
(40:54):
would you like to recommend?
Or books?
Audience?
I am a huge proponent thatbooks change lives, so what book
would you like to recommend?
Or books?
You can recommend more than one.
Speaker 1 (41:00):
There is a book that I am reading as we speak, and
that book is called E-Squared.
The reason I look down becauseI'm trying to find the name of
the author.
Speaker 2 (41:12):
That's okay.
I'll link it in the show notesso you don't even need to.
Speaker 1 (41:16):
You know, when you say it's about quantum physics,
then people just switch off itis, but it's not.
You know, it's one of thosethings that I certainly wasn't
listening to in class when theytaught it, but it's about
improving your mindset.
(41:36):
So you see the things that youwant to see, instead of the
things that you don't want yourbrain to see Negativity.
Speaker 2 (41:47):
Oh, my goodness, I have to read that.
I'm all about mindset, so Ihave to read that one.
Speaker 1 (41:54):
It's short and, to prove its concept, it has
exercises, very simple exercises, and, like we discussed a few
minutes ago, I think exercisingour brain muscle is just as
important as exercising ourbiceps.
(42:15):
So that's what this book is for.
Speaker 2 (42:19):
Oh, I agree.
Thank you so much for sharingthat.
I am absolutely going to gocheck that out.
I love everything to do withmindset and, as a mindset coach,
anything that taps into that Ifind fascinating.
So thank you so much, dr Afshar.
It's been such a pleasure tomeet you.
Thank you for taking time outof your very busy schedule to be
on the show to share yourwisdom, to share your knowledge.
It was a pleasure to meet youand I personally will be coming
(42:41):
to your clinic for someassistance.
So thank you.
I hope you have a beautiful day.
Speaker 1 (42:45):
Thank you so much.
It's been an honor to see youand treat you if needed be.
I've really really enjoyed ourtime together today.
Thank you need it be.
Speaker 2 (42:56):
I've really, really enjoyed our time together today.
Thank you, perfect.
Thank you have a great day.
Thank you for joining us foranother episode of the House of
Jermar podcast, where wellnessstarts within.
We appreciate you being a partof our community and hope you
felt inspired and motivated byour guest.
If you enjoyed this episode,please write us a review and
(43:16):
share it with friends.
Building our reach on YouTubeand Apple Podcasts will help us
get closer to our mission toempower 1 million women to live
all in.
You can also follow us onInstagram at House of Jermar and
sign up to be a part of ourmonthly inspiration newsletter
through our website,houseofjermarcom.
If you or someone you knowwould be a good guest on the
(43:38):
show, please reach out to us atpodcast at houseofgermarcom.
This has been a House of Germarproduction with your host, jean
Collins.
Thank you for joining our house.
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