Ask a General Surgeon (Vascular): Dr Lee Chee Wei from Mount Elizabeth Orchard Hospital Singapore

Ask a Doctor ForumCategory: General SurgeryAsk a General Surgeon (Vascular): Dr Lee Chee Wei from Mount Elizabeth Orchard Hospital Singapore
Dr Lee Chee Wei asked 2 years ago
I am Dr Lee Chee Wei, General Surgeon (Vascular) based in Mount Elizabeth Orchard Hospital Singapore, Mount Elizabeth Novena Hospital Singapore and Parkway East Hospital Singapore. Ask Me Anything! I am a general surgeon with about 10 years experience in the field. At my clinics at Mount Elizabeth Novena, Mount Elizabeth and Parkway East Hospitals, I provide specialised care for patients with vascular diseases. Patients will receive a comprehensive assessment including a Duplex scan in the clinic. I am fully conversant in performing complex vascular operations such as open aortic repair, bypass surgery, peripheral angioplasties, endovascular repairs of the aorta and endovenous laser treatment of varicose veins. Upon my graduation from the Faculty of Medicine at the National University of Singapore (MBBS, 1995), I underwent basic training and received my Fellowship of the Royal College of Surgeons, Edinburgh in 2001. I completed my Advanced Specialty Training in General Surgery in 2005. Then, through the Health Manpower Development Programme (HMDP) Award, I attended a one-year fellowship programme at St Vincentʼs Hospital in Sydney, Australia where I trained in open surgical procedures as well as endovascular interventional procedures. My training there also involved an attachment to the Vascular Diagnostic Laboratory where I was trained to do duplex vascular ultrasounds and other non-invasive tests. Prior to my move to private practice, I was a consultant at the Department of General Surgery at Tan Tock Seng Hospital. During my tenure, I served as the Head of the Vascular Surgery Service as well as the Director of the Vascular Diagnostic Lab, where I was credited for pushing the boundaries of peripheral arterial interventions (including the use of drug-eluting balloons and stents), endovascular aortic repairs, arteriovenous fistula salvage for renal dialysis, bypass surgery (including distal bypass and trauma surgery) and minimally invasive interventions for varicose veins. I currently remain a Visiting Consultant to Tan Tock Seng Hospital. I was admitted as a Fellow of the Academy of Medicine of Singapore, Surgery, in 2011. I also have several local and international journals to my name such as Annals of Vascular Surgery and World Journal of Surgery. Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/lee-chee-wei/ I am excited to be here to share/discuss Vascular Health with everyone. I will be actively answering questions. Whether you've got questions about vascular diseases, venous diseases, arterial diseases or vascular operations, ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
13 Answers
Krystal answered 2 years ago

I am asking this on behalf of my aunt. She is 32 years old and gave birth last year. After giving birth, she experienced bulging veins on her legs. It looks like varicose veins. It has been around 8 months since but the veins are still there. She doesn’t have a history of diabetes. However, during the early stage of her pregnancy, she was taking medications to lower her cholesterol levels. How do we know if this condition is a vascular issue? And do you think 8 months is a sufficient time period for us to have waited before we see a doctor for her condition?

Dr Lee Chee Wei replied 2 years ago

The presence of bulging veins in the legs is most likely to be varicose veins. Varicose veins are more common in women and can be made worse during pregnancy. Usually after delivery of the baby, the varicose veins should subside after 3 to 6 months. If she still has persistent varicose veins after 8 months, she should seek medical attention.

During the consultation, she will have an ultrasound scan of her legs to check the condition of her veins. This is to assess the extent and severity of the varicose veins. The appropriate treatment will then be recommended based on the findings of the ultrasound scan. This can be managed in a few ways. One way to treat the varicose veins is to wear compression stockings which will need to be worn in the day time and the stockings will compress the veins to prevent them from swelling.

To cure this condition, surgery is the other option. One technique of minimally invasive surgery is RadioFrequency Ablation. This procedure is done as a Day Surgery procedure and is performed through a small incision (5mm) to treat the damaged Long Saphenous Vein.

Angela answered 2 years ago

Since his bypass surgery, my husband has been experiencing swelling in his arms and legs. His veins bulge and he feels pain when he walks for long distances. What is the best examination and treatment for his condition?

Dr Lee Chee Wei replied 2 years ago

I would assume that your husband had a heart bypass surgery. If he has swelling in his arms and legs, this would suggest that he may be having some degree of heart failure and he should consult the cardiothoracic surgeon who performed the surgery. He may require further tests to assess his heart function to understand the cause of the swelling in his arms and legs.

Jay answered 2 years ago

Doctor, my 72 year old grandfather was diagnosed with JVD. He is now taking ACE inhibitors and diuretics. His body seems to be getting paler. Is this due to his medication? Is it okay to continue the medication or would you recommend switching to other treatment types?

Dr Lee Chee Wei replied 2 years ago

Can we clarify what medical condition you’re referring to by ‘JVD’? Thank you.

Andy L answered 2 years ago

I have been working out regularly at the gym for 2 months now. I noticed the veins in my arms protrude and they are painful. I initially thought it was normal but my veins remain swollen days after the workout and even if I do not exercise for a few days. Do i need to be worried about this? Should I stop lifting and see a doctor?

Dr Lee Chee Wei replied 2 years ago

If the veins in your arms remain painful and swollen, there may be inflammation and blood clots in the veins. This will require an ultrasound scan to confirm the diagnosis. The scan will also show if there are clots in the other deep veins in the upper limb.

The treatment for this is usually with medications to reduce the inflammation in the veins and allow the blood clots to dissolve over time.

Samuel Wong answered 2 years ago

My uncle has complaints about the veins in the sole of his feet. They are visible and painful when he walks. He has to sit and let his feet rest. Is it varicose veins? He is 59.

Dr Lee Chee Wei replied 2 years ago

The presence of veins in the soles of the feet is less likely to be due to varicose veins. Sometimes it can be due to a collection of abnormal blood vessels known as an arteriovenous malformation. He should be assessed by a Vascular Surgeon and may require further tests in order to find out the cause of the swollen and painful veins in the soles of his feet

Daryl answered 2 years ago

I had a small aneurysm in my leg and I also have high blood pressure. I was only given medication to control my blood pressure. Is it okay not to treat the aneurysm? When should surgery be necessary?

Dr Lee Chee Wei replied 2 years ago

For arterial aneurysms in the legs, treatment with blood pressure medicines will help to reduce the risk of the aneurysm rupturing or bursting. However, the aneurysm can also cause other problems. Sometimes, small blood clots may form in the aneurysm and this can be dislodged and flow into the smaller blood vessels further down the leg causing a condition called acute embolism. This is a condition where the artery gets blocked by a blood clot and this cuts off the blood supply to parts of the legs. In severe cases, this can cause gangrene and risk of limb loss and amputation.

For this reason, the assessment of an arterial aneurysm is not merely for the size and risk of rupture but also for the risk of blood clot formation and embolisation. You should be assessed by a Vascular Surgeon where a detailed history of your symptoms will be elicited. Further tests including ultrasound scans of the arteries may be required. In cases where the risk of blood clot formation is high, medications including blood thinners may be recommended to reduce the risk of clot formation. Surgery to ligate or tie off the aneurysm, followed by creating a surgical bypass may also be recommended by the Vascular Surgeon.

Jerome answered 2 years ago

I have stiffness and bulging veins in the inner thighs. Is this considered varicose veins? What is the recommended treatment for this?

Dr Lee Chee Wei replied 2 years ago

The presence of bulging vein on the inner thighs is likely to be varicose veins. You will need to have a consultation with a vascular surgeon and most likely will have an ultrasound scan of the veins in your legs to confirm the diagnosis.

Further treatment will depend on the extent of the varicose veins and which veins in the legs are affected. Varicose veins caused by backflow in the main superficial veins in the thigh can be treated with Minimally Invasive techniques such as Laser or Radiofrequency Ablation. If the deep veins are affected, then the recommended treatment is to use medical grade compression stockings.

Linda answered 2 years ago

I have noticed that after sitting on the floor for a while, my calves become red and itchy with red spots. When I stand up or walk, they tingle. It will usually take hours for the sensation and the spots to go away. Is this a vascular issue?

Dr Lee Chee Wei replied 2 years ago

The presence of skin redness and itch with red spots suggests that this may be a dermatological or skin issue. I would suggest you seek medical attention with a specialist Dermatologist to have a professional medical assessment

Wei Ru answered 2 years ago

Around my right ankle, the veins are very obvious. I have read online about ways to resolve the issue including herbal medication and compression socks. How effective are those or should I see a vascular doctor?

Dr Lee Chee Wei replied 2 years ago

The presence of swollen veins around the ankles suggest varicose veins. You should have a consultation with a vascular surgeon to assess and should have an ultrasound scan of the legs to confirm the diagnosis as well as to see which veins are damaged.

Treatment with compression stockings can help as these medical grade stockings can provide sufficient compression of the calves and thighs to prevent swelling of the veins.

Some conditions may be more effectively treated with minimally invasive surgery such as RadioFrequency or Laser Ablation.

The use of herbal medications has not been shown to be effective in treating varicose veins. Medications such as Daflon can help relieve some of the symptoms of varicose veins such as the sensation of tightness and heaviness but it doesn’t reverse the visible swelling of the veins.

Jean W answered 2 years ago

There are blue veins around my stomach that are painful when I sit up after lying down. When I lift heavy items the pain is also uncomfortable. What’s the treatment option for this condition?

Dr Lee Chee Wei replied 1 year ago

Presence of dilated veins around the abdomen which are symptomatic will need medical evaluation. You should seek a medical consultation with a vascular surgeon. The presence of veins around the abdomen is not common and could be due to a few underlying causes. One possibility is narrowing or obstruction of the Inferior Vena Cava, which is the main blood vessel that brings blood from the lower half of the body back to the heart. Another possibility is liver cirrhosis which causes abnormal blood circulation in the veins due to high vein pressure in the liver.

Further tests will need to be performed. Imaging tests such as a CT scan of the abdomen will help to confirm the diagnosis.

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