faqs
hormone modulation
aesthetics
mesotherapy
sclerotherapy
hormone modulation
What exactly is hormone modulation & how does it work? Hormone modulation is the science of optimizing hormones that are no longer being adequately produced by the body. While genetic programming does many wonderful things, nature's plan brings us to the age of reproduction and nurturing, and then seems to have little use for us. At that point, we begin to fail. In fact, much of aging can be seen as deficiencies in many of the substances that our body once produced in abundance. Regaining and maintaining metabolic and endocrine functions at the upper end of the normal range for your age gives you the best opportunity for a healthy and vigorous life. This optimal range is in the upper third of the normal range for age.
How long before you can actually see results? While this varies with each person, some people feel results within days. Just like beginning an exercise program, you can expect results within three to six months after beginning hormone management. Often the results of proper modulation are manifested by what you don't feel, i.e., sick, tired, moody, etc.
How long do I have to be on these therapies? You should give your program at least six months to see significant benefits. Most patients will experience benefits before three months and continue to see improvement beyond that point. Your body needs that much time to heal and rebuild. You should remain on the program for as long as you want to optimize your health.
What happens if I stop the program? You will have gained time while you were on the program, but if you should elect to stop, you will experience no accelerated aging. Should you stop the program, your body will simply begin to age again at the normal rate. The benefits will fade over time, however you still have benefited.
At what age should a person start such a program? Thirty-five is a good age for the initial baseline evaluation, because that is when deficiencies begin to appear. Around thirty years of age, we lose hormones from 1%-3%. It's never too early for any adult to begin the nutraceutical program. A person does not need to begin hormone modulation therapy, however, until such time as the body begins to lower its hormone production. Our thorough blood tests and assessments help us determine exactly where you may be most deficient and how we can best help you. Every person is different and will have different needs as far as hormone modulation goes.
Will the treatment interfere with my currently prescribed medications? Generally not. In some instances, medications may actually be reduced or no longer needed. Dr.Salmon will be able to advise you best on this and will be happy to work with your own doctor should you so desire.
Will Dr. Salmon be taking over as my doctor? Absolutely not. As a wellness program, Dr. Salmon is happy to communicate with your current health care team, and/or any specialists you may be seeing. You are encouraged to continue your usual visits with your regular doctor.
Why does hGH have to be injected? Human Growth Hormone breaks down if taken orally, so the only truly effective way to obtain its benefits, at this time, is by injection. The nature of the hGH molecule is similar to insulin but the complexity of the hGH molecule is far greater than insulin.
There are no oral, nasal, sublingual, or transdermal growth hormone products including secretagogues and precursors that have any merit whatsoever. Many companies that are promoting "Oral hGH" or "Nasal Spray hGH" that can be purchased from a website or a store without a prescription are under federal investigation. ?Pharmaceutical manufacturers Merck and Pfizer were featured on the front page of the Wall Street Journal in May of 2002 reporting that they have spent approximately $100 million to develop non-injectable hGH products and have failed. The state of evidence-based medical research is overwhelming and compelling that the only way to introduce human growth hormone into the body is by injection. Once pharmaceutical manufacturers are able to deliver insulin orally, hGH will soon follow.
Is this type of program FDA approved? HGH was approved by the FDA for treatment of hormone deficient adults in the summer of 1996. You need to be evaluated to determine if you are deficient.
Isn't it unnatural to inject or ingest hormones? The hGH we use is identical to the human Growth Hormone naturally produced by the body. It is spread to its target organs just as it would be if secreted by the pituitary gland. Supplementing hGH is as natural as supplementing thyroid hormone. It simply returns your body to a state in which it is functioning more optimally.
Is Growth Hormone safe? Will it make things "grow"? Human Growth Hormone is safe in physiologic doses. Among its many functions is that of repairing and regrowing tissue. When a person reaches maturity, Growth Hormone is important for cell revitalization and repair. Cells cannot repair, maintain, and heal properly in its absence. While hGH is sometimes used to help stimulate height in children who are pituitary dwarfs, it does not make an adult grow taller. There has been absolutely no correlation between physiologic dosages of hGH, such as those given in our programs, and cancer of any kind. Quite the contrary. HGH has proven to be extremely helpful in strengthening the immune system, increasing mental acuity and focus, and preventing the onset of diseases usually associated with aging. Growth Hormone is only prescribed for adult growth hormone deficiency.
There's been a lot of negative press recently about HRT for women. What do you think about that? Most women over thirty-five years of age need some form of hormone supplementation, which can include testosterone, human growth hormone, thyroid, and possibly others. This applies to women that have reached menopause as well as premenopausal women. Menopause is clearly a hormone deficiency condition. We believe it is absolutely crucial to the health and well being of every woman to replace these lost hormones with natural bioidentical hormones in order to maintain quality of life and prevent unnecessary suffering. Synthetic means the molecule is not natural to the human body. Bioidentical hormones are natural hormones whose molecules are identical to those made by humans.
What about the scandal involving athletes using growth hormone and steroids? Why is the use of growth hormone being questioned when there are so many benefits? There exists a significant difference between physiologic optimization and abuse. Generally athletes are young and vigorous and already performing at a very high level. These athletes do not have any partial hormonal deficiencies, so they take hormones to go way beyond the optimal physiologic range. Whether athletes take a testosterone derivative or growth hormone, there is a short-term benefit for performance, but the long-term detriment to their body exceeds the benefits.
Are you ever too old to start? Age is not a barrier. Many of the older people, including those over 60 years, will ask this question thinking it is too late to begin a program. The answer is quite the opposite. Older people have greater deficiencies or partial deficiencies, therefore the response to hormone modulation and supplementation is excellent and almost immediate. It is important to note that early intervention can reduce rapid advancement of diseases, such as osteoporosis and Alzheimer's. Less progress is to be expected when conditions such as these are advanced.
Does your office accept health insurance? Our office does not accept insurance for payment. However, this does not rule out the possibility of reimbursement by your insurance provider. We will be glad to provide you with properly coded invoices that you may submit for reimbursement. Many insurance plans will cover a portion the cost of office visits according to their out-of-network provider schedule. You may be subject to an annual deductible and a co-pay, depending on your coverage. Please contact your provider for more details on coverage.
Will my insurance cover the cost of prescriptions? Most insurance companies do not cover the cost of compounded medications. For this reason, our pharmacy partner does not accept insurance for direct payment. However, we can arrange to provide you with properly coded invoices that you may submit to your insurance carrier for reimbursement.
Will my insurance cover the cost of lab tests? Insurance plans will sometimes cover the cost of lab tests. Speak with your insurance carrier for more details. The list of tests we perform can be found here .
Will my FSA cover your treatment? Many employers offer a Flexible Spending Account (FSA) to their employees. These arrangements permit the employee to stow a portion of their pre-tax earnings in a special account for use on health-related expenses NOT covered by primary health insurance. Depending on the type of FSA, these arrangements may cover the portion of your treatment not covered by your primary health insurance, including medications, office visits, co-pays, program fees, vitamins & supplements. Ask your employer or visit the IRS FSA site .
How are the hormones administered? How often? Hormones are self-administered once or twice per day via transdermal creams (estrogen, progesterone, testosterone), oral capsules (progesterone, DHEA, pregnenolone, melatonin), or subcutaneous injections (HGH, HCG). Injections are relatively painless, using ultra-fine (#31 gauge, 5/16") insulin needles.
What are the hormones made from? The bioidentical estradiol, progesterone and testosterone hormones we prescribe are derived from soy or yam. These molecules are then modified to exact replicas of the hormones currently in your body. HCG hormone is human-derived, and HGH is produced using recombinant DNA technology. In every case, they fit the receptors in exactly the same way as the hormones in your body today.
What are the side-effects? Side-effects are often minimal and manageable when restoring hormones to youthful levels. Some patients report breast tenderness or swollen joints when first starting bioidentical hormone replacement therapy; these and other adverse reactions can be remedied by reducing the dosage. None of our patients have reported long-term side effects.
Do you do saliva testing? Whereas saliva testing may be accurate for hormones that circulate in high concentrations, such as progesterone, not all hormones can be accurately assessed using saliva. For instance, estradiol is typically present in picograms (trillionths of a gram!) Since we require extensive blood testing for each consultation, there is no need to collect saliva samples as well. All the hormones we assess can be accurately measured using the blood samples that will be collected already.
What if I had a hysterectomy? Bioidentical hormone replacement is perfectly safe after a hysterectomy. In fact, since the ovaries produce much of the testosterone in the female body, replacing this hormone is even more important.
How long do I need to stay on the program? You should continue treatment as long as you wish to see results or resolution of symptoms.
What happens if I stop the program? Will my body stop producing hormones on its own? Will my hormone levels decrease? Will I lose my gains? In general, supplementation by exogenous (external) hormones will result in decreased endogenous (internal) production. However, the body tends to restore hormones to pre-treatment levels after cessation of treatment. If your own hormone production was low before treatment, it will most likely return to the same levels after treatment. As a result, most of the physical changes enabled by the program will gradually revert back to "normal".
Will my testes shrink on testosterone replacement therapy? We currently restore testosterone using transdermal testosterone cream and HCG, human chorionic gonadotropin. Using the cream, the testes will likely slow production of testosterone in response to (perceived) high levels. This condition also may result in minor atrophy or shrinking of the testes. HCG emulates luteinizing hormone, which stimulates the testes to produce their own testosterone, thereby preserving their function and size. This product is injected each morning by the patient using an insulin syringe. HCG can be prescribed in lieu of or in addition to transdermal testosterone cream.
Will I continue to get my period? The answer to the question of whether to cycle or not to cycle when undergoing bioidentical HRT (bHRT) is complex and depends upon many factors specific to each woman. It also entails a long discussion of the evidence for and against it at this time. Briefly, our current interpretation of available data is that while cycling may turn out to have benefits with regard to breast cancer risk, there is not enough clinical trial data to mandate it for all patients, particularly those with a low risk of breast cancer and who have difficulty tolerating the fluctuation of hormones that cycling entails.
Have you had any success in treating fibromyalgia? We are treating several patients with fibromyalgia and/or chronic fatigue, all with significant improvement in energy, level of pain, and frequency of exacerbation of symptoms. None have encountered a negative response. This does not assure similar response in all patients with fibromyalgia, but to date the response to therapy has been more effective than prior therapies. Although our program is not specifically designed to attack the underlying cause of fibromyalgia, it does restore function and strength of the immune system, restore efficiency of mitochondrial production of energy with cells, and improves the bodies natural anti-inflammatory capacity. If you are interested in pursuing treatment, contact the office to schedule a set of laboratory blood tests prior to coming in for consultation. With the test results we will be better able to discuss possible benefits of our treatment specific to your current condition.
When should I start thinking about bioidentical hormones? My doctor wants me to wait until I reach menopause. The menopause is defined as a single day--12 months after your last period. Your physician's suggestion that you wait until you have passed this milestone reflects an antiquated view of a woman's transition from the premenopause to menopause. The majority of women experience their most severe symptoms in the months to years leading up to this milestone. To wait for this single day would be to subject women to a year or more of unnecessary hot flushes, night sweats, mental fogginess, and bone loss. Our approach is to start addressing these symptoms as soon as they appear. They often begin a year or two before the final menstrual period, a time called the perimenopause. By so doing, we can avoid all the havoc that fluctuating hormone levels can wreak on a woman. Our approach is to smooth the transition from normal cycling through the menopause rather than to wait for a somewhat arbitrarily defined date.
Got a question we didn't answer? Email us!
aesthetics
How do Restylane, Restylane Fine Lines, Perlane, and Juvederm work? These products are all based on a hyaluronic acid gel that is injected into the skin in order to fill in wrinkles or add volume to lips and other tissues.
What is hyaluronic acid? Hyaluronic acid is a natural substance that is found throughout the body. For example, it adds volume to the skin, lubricates the joints, and gives the eye its shape.
How do Restylane/Perlane and Juvederm differ from other dermal fillers? Restylane/Perlane and Juvederm are non-animal forms of hyaluronic acid. These products have many advantages over similar products used for dermal enhancement. No sensitivity testing is required prior to administration and no allergic reactions have been reported. Additionally, the results of these treatments last much longer than many of the alternatives.
What exactly is BOTOX ® Cosmetic? ?BOTOX ® Cosmetic is a purified protein produced by the Clostridium botulinum bacterium. It is a nonsurgical, physician-administered treatment that can temporarily reduce moderate to severe frown lines between the brows in people 18 to 65 years of age. During treatment, very low doses of BOTOX ® Cosmetic are administered via a few tiny injections directly into the muscles that cause those stubborn lines. The treatment is usually done in about 10 minutes, and no recovery time is needed. Within days, you may see an improvement that can last up to 4 months. Results may vary.
How does BOTOX ® Cosmetic work? ?Those moderate to severe frown lines between your brows form over time as the result of muscle activity. BOTOX ® Cosmetic is injected directly into the muscles between your brows. It works by blocking the transmission of nerve impulses to the injected muscles; this reduces the activity of the muscles that cause those persistent lines to form.
When will I see results from a BOTOX ® Cosmetic treatment? ?Within days, you may see a marked improvement in the moderate to severe frown lines between your brows. Lines continue to improve for up to a month, and results can last for up to 4 months. In clinical trials, nearly 90% of men and women rated the improvement in their appearance as moderate to better 1 month after treatment. Results may vary.
How long does BOTOX ® Cosmetic last? ?Results from treatment with BOTOX ® Cosmetic can last for up to 4 months. If you discontinue treatment, the frown lines between your brows gradually will look like they did before treatment.
Is treatment with BOTOX ® Cosmetic painful? ?Discomfort is usually minimal and brief. Prior to injecting, you may choose to numb the area with a cold pack or anesthetic cream. The entire procedure takes approximately 10 minutes. Many people are in and out of the office without downtime following BOTOX ® Cosmetic treatment.
Who should not use BOTOX ® Cosmetic? ?BOTOX ® Cosmetic should not be used in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any ingredient in the formulation. Patients with neuromuscular disorders such as ALS, myasthenia gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects.
Will I experience any side effects? ?The most common side effects following injection include temporary eyelid droop and nausea. Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection. Patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk of serious side effects.
Will my facial expressions continue to look natural? ?Although the results are visible, a treatment with BOTOX ® Cosmetic will not radically change your facial appearance or make you look as if you "had work done." The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.
Is BOTOX ® Cosmetic affordable? ?When considering your facial aesthetic options, BOTOX ® Cosmetic is quite affordable. According to an American Society for Aesthetic Plastic Surgery survey, BOTOX ® Cosmetic is one of the low-entry-cost facial aesthetic procedures in the United States . Like other appearance-related investments, such as hair coloring and cuts, teeth whitening, and chemical peels, the cost must be weighed relative to your expectations. Consult your doctor for further information.
mesotherapy
What is Mesotherapy? Mesotherapy is an aesthetic medical specialty, which involves injecting microscopic quantities of pharmaceutical agents, natural plant extracts, homeopathic agents, and vitamins into the skin. The Physician selects a custom formula to treat your condition. Mesotherapy can be effectively used to treat cellulite, body sculpting, weight loss, and rejuvenation of the skin. Meso pain management is evaluated on an individual basis.
What are the benefits of Mesotherapy over surgical techniques such as liposuction? Liposuction cannot be used to treat cellulite and in fact often ends up making the cellulite more prominent. Mesotherapy treats cellulite directly, resulting in a smoother skin surface. Mesotherapy is effective in targeted fat reduction or body sclupting, like “love handles” or "saddlebags". Liposuction removes fat cells and subsequent weight gain is mal-distributed in the remaining adipose fat cells such as arms, neck and axillas. Mesotherapy removes fat from the cells and subsequent weight gain is symmetrical. Liposuction requires two weeks of downtime and elastic garments, Mesotherapy requires no downtime and loose, comfortable clothing. Liposuction has significant bruising and pain, Mesotherapy minimal bruising. Liposuction is a surgical procedure requiring general anesthesia, surgery center admittance, and surgical recovery. Mesotherapy is a non-invasive procedure performed in the privacy of The MesoSphere™ Medical Center .
How Does Mesotherapy Work On Cellulite/Fat? Cellulite treatment includes treating several factors. The physician will create a personalized custom formula specific to your graded stage of cellulite. Components of the solutions utilized with the injection system dissolve the fat (induce lipolysis) in the cellulite, invigorate the impaired circulation with venous and lymphatic flow, and induce cellulysis of the damaged connective tissue. The aesthetic appearance is smoothing and contouring of the skin surface. Mesotherapy is the most effective Cellulite treatment available today and may be performed on any affected part of the body. Cellulite mesotherapy treatment is a permanent solution.
How Does Mesotherapy Work On Skin Rejuvenation & Wrinkle Prevention? Facial mesotherapy utilizes Vitamin and antioxidant injections under the skin to makes the cells more active metabolically, stimulate both collagen and elastin production, creating a skin rejuvenation process. For wrinkle prevention, you can start in your mid- twenties with Mesotherapy vitamin treatments to prevent wrinkles from forming. Facial mesotherapy treatments of the face, neck, and hands are recommended up to four times per year. The physician will recommend topical agents for daily care between mesotherapy treatments.
How Does Mesotherapy Work On Weight Loss & Spot Reduction Body sculpting mesotherapy may target specific areas or spots where your body stores excessive fat. The body sculpting customized formulas medically directed in a specific area blocks the cells from storing new fat and helps break down the existing stored fat cells and metabolize the fat (lipolysis). Your body then naturally flushes out the metabolized fat via invigorated venous and lymphatic circulation. The body sculpting mesotherapy spot reduction can be used for double chins, love handles, saddlebags, inner thighs, inner knees, and any other area where your body pockets fat.
How many treatments will I need? It will vary based on your personal treatment goals, medical recommendations, and areas of the body and extent of the cellulite/fat/skin/weight to be treated. The number of visits ranges from approximately five to fifteen. Longterm weight loss from exogenous obesity may require weekly treatment for several months, personalized to the client's specific goals, supported by daily exercise, diet management, and personalized vitamin supplements.
How fast will I see results? Results vary, according to your body type, treatment goals, and the severity of the problem. Often, clients report seeing results within two or three sessions. For certain conditions, you may appreciate immediate results. Clients with regular exercise programs seem to achieve optimal results sooner.
Will the results last? Yes, the results will last. Cellulite Mesotherapy is a permanent solution to cellulite. Body sculpting mesotherapy or targeted body sculpting and spot fat reduction, including weight loss are effective treatments. However, keep in mind that maintaining your weight loss and optimal sculpting result requires consistent exercise (with cardio and light resistence training) and consistent food management discipline (emphasis on lean protein and low glycemic carbohydrates). You may elect to have touch up treatments from time-to-time. Although aging is a dynamic process, you can benefit from mesotherapy as an important anti-aging and preventive medicine strategy.
Are the treatments painful? We use topical triple anesthetic gel on all of our patients to assure a comfortable mesotherapy treatment. Clients who have treatment au natural sans gel may slightly feel the 4mm micro injections with the "le pinch an inch" technique. We strive to assure your Mesotherapy experience will be comfortable and effective.
Are there any side effects? The most frequent side effect is bruising. You may experience some bruising, which resolves over approximately one week. We recommend using arnica and grape seed extract supplements to minimize any bruising. Topical ointments such as hydrocortisone and Traumeel are further used to decrease bruising events.
Who can have Mesotherapy? Generally, most healthy adults between 18 to 80 may have mesotherapy for body sculpting and weight loss, cellulite treatment, and skin rejuvenation. Exclusion criteria are in place and preclude those patients confronted with moderately severe heart disease, insulin-dependent diabetes, on blood thinners or arrhythmia medications, immune-compromised and/ or organ transplant recipients, and pregnancy. Cancer patients in remission must be carefully evaulated in conjuction with their personal oncologist's recommendations. With occasional exception, most likely this group is excluded from treatment. Hypertension must be controlled on medication. Thoughtful consideration is given to every patient request for mesotherapy treatment.
sclerotherapy
What is sclerotherapy?
Sclerotherapy is a medical procedure used to treat varicose veins and ?spider veins.? Sclerotherapy involves an injection of a solution (generally sodium chloride) directly into the varicose vein. The solution irritates the lining of the vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view. Sclerotherapy is a well-proven procedure has been in use since the 1930s to treat varicose veins.
How is sclerotherapy done?
Sclerotherapy is performed in a doctor?s office. In most cases, a 23 percent sodium chloride sterile solution mixed with lidocaine (a local anesthetic) and heparin is injected into a very fine needle directly into the blood vessel, using a very fine needle. A solution without lidocaine is available for people who are allergic to lidocaine. The number of varicose veins injected in one session is variable, depending on the size and location of the veins, and the patient?s overall medical condition.
Mild discomfort may occur, and a cramping sensation may be felt for 1 to 2 minutes when larger varicose veins are injected. The procedure itself takes about 30 to 45 minutes.
How successful is sclerotherapy in treating varicose and spider veins?
Sclerotherapy works well for most patients with varicose veins. It is estimated that as many as 50 percent to 80 percent of injected varicose veins may be eliminated with each injection session. A few (less than 10 percent) of the people who have sclerotherapy on their varicose veins do not respond to the injections at all. In these instances, different solutions or a different method, such as laser therapy, may be tried.
In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months. If the veins respond to the treatment, they will not reappear. However, new veins may appear over time. If needed, you may return for injections.
What you need to do before the procedure
Prior to sclerotherapy, certain medications should be avoided. Tetracycline or Minocin, both antibiotics, may possibly cause a staining of the skin if taken 7 to 10 days before or after sclerotherapy. Ask your doctor about other antibiotic medications you may take, or ask for safe guidelines for discontinuing these medications. If you are required to take an antibiotic before any invasive procedure, such as dental procedures, colonoscopy or surgery, please inform your physician.
Do not take aspirin, ibuprofen (i.e. Advil and Nuprin) or other antiinflammatory medications for 48 hours before and after sclerotherapy, because these medications may interfere with the action of the sclerosing agent. Tylenol is permitted. Ask your doctor for specific guidelines before discontinuing any medication.
Prednisone also decreases the effectiveness of the sclerosing agent. Ask the doctor who prescribed your prednisone if it can be safely discontinued for 48 hours before the sclerotherapy procedure.
No lotion be applied to the legs before or after sclerotherapy. It is recommended that you bring a pair of shorts to wear during the varicose vein treatment procedure.
If you have compression hosiery from previous treatments, please bring them with you so we can make sure they will provide adequate support after the procedure.
What are the side effects of sclerotherapy?
Certain side effects may be experienced after sclerotherapy. Larger injected varicose veins may become lumpy and hard for several months before resolving. Raised red areas may appear at the injection sites and should disappear within a few days. Brown lines or spots on the skin may be noted at the site of the injection, possibly caused by a form of iron that escapes from the injected veins. In most cases, they disappear within 3 to 6 months, but can be permanent about 5 percent of the time. Bruising may occur around the injection site and can last several days or weeks.
Other side effects rarely develop after sclerotherapy. If you have any of these side effects, please contact your physician immediately:
- Inflammation within five inches of the groin
- Sudden onset of a swollen leg
- Formation of small ulcers at the injection site
- Red streaking, especially in the groin area
- Allergic reactions to the sclerosing agent may occur at the time of the injection and are rarely serious.
Call your physician with any concerns or questions you may have after the procedure.
What happens after the treatment?
After the treatment you will be able to drive yourself home. You may resume your regular activities and are encouraged to walk. You will be instructed to wear support hosiery or compression wraps to ?compress? the treated vessels. All support items can be purchased at The Cleveland Clinic. Support stockings purchased from a department store may not be adequate if a heavy compression stocking is prescribed.
After the procedure, avoid aspirin, ibuprofen and other antiinflammatory medications for at least 48 hours. Tylenol may be used if needed.
Do not take hot baths or sit in a whirlpool or sauna, nor apply hot compresses or any form of heat to the injected areas for 48 hours after treatment. In addition, avoid direct exposure to sunlight (sun bathing and tanning beds)jogging, high-impact aerobics and swimming for 7 to 10 days after the procedure.
Showers are permitted, but the water should be cooler than usual. The injection sites may be washed with a mild soap and lukewarm water.
How will I know if I am a candidate for sclerotherapy?
Prior to the procedure, you will have an initial consultation with a vascular medicine specialist who will tell you if you are eligible for sclerotherapy. You are not eligible for sclerotherapy if you are pregnant, breastfeeding, or are bedridden. You must wait at least three months after birth before you can be considered for this procedure. You can have sclerotherapy if you take birth control pills. If you have had a blood clot in the past, your eligibility will be decided on an individual basis, and will depend on the extremity and the reason for the clot.
Veins that are potentially usable for future surgical bypass procedures (such as the saphenous vein for coronary artery bypass graft surgery) will generally not be considered for injection, unless they are already deemed unusable for bypass procedures