Ask a Vascular Surgeon: Dr Cosmas Chen from Mount Alvernia Hospital Singapore

Ask a Doctor ForumCategory: General SurgeryAsk a Vascular Surgeon: Dr Cosmas Chen from Mount Alvernia Hospital Singapore
dr. Cosmas Chen asked 2 years ago
I am Dr Cosmas Chen, Vascular Surgeon based in Mount Alvernia Hospital Singapore. I have practiced general surgery for more than 15 years. My expertise mainly covers laparoscopic surgery for gallbladders, hernia, and gastro-intestinal surgery. My experience with gastro-intestinal surgery includes surgery for diseases of the liver, colon, stomach cancer and more. I am experienced in both diagnostic and therapeutic endoscopy such as banding of oesophageal varices, injection of bleeding peptic ulcers and insertion of PEG (Percutaneous endoscopic gastrostomy) and removal of colonic polyps. My interests extend to vascular surgery, which includes diabetic feet, venous disorders such as varicose veins and arterial diseases of the limbs. I provide both minimally invasive methods (such as angioplasty and stenting of arteries) and bypass surgery of the lower limbs (available for threatened limb loss). For the treatment of varicose veins, minimally invasive treatment of varicose veins using endovenous laser is also available. Learn more about Mount Alvernia Hospital here: https://patients.smarterhealth.sg/hospital/mount-alvernia-hospital-singapore/ Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/cosmas-chen/ I am excited to be here to share/discuss Vascular Health with everyone. Whether you've got questions about venous diseases, arterial diseases, diabetes-related diseases or gastro-intestinal surgery, 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.
12 Answers
Nindi Ratnasari answered 2 years ago
Doctor, my veins bulge and throb, I can even feel them on my feet. I am scared, as if something is alive inside my veins. I consulted an internist and cardiologist, but they said I am fine. But I am not comfortable with this condition. What should I do?
dr. Cosmas Chen replied 2 years ago

The bulging veins are in both feet? Veins can normally be bulging at the dorsum of both feet. But, should not be uncomfortable. If there is an association with legs swelling, pigmentation or large veins in the calves, it may be part of a venous disorder.

Sofyan DY answered 2 years ago
Doctor, my father is 55 years old and he has diabetes. His feet are swollen and there is a hole in his calf. He cannot walk. The doctor gave him oral medicines but to no improvement. Now I can see purple veins on his feet, and the veins cause him to be in pain. Please give me your advice, Doc.
dr. Cosmas Chen replied 2 years ago

He may have either a pressure ulcer or venous or arterial ulcer. This will depend on the location of the "hole". And other signs: the dilated veins and leg swelling may suggest a venous cause of the ulcer. However, being a non-walker, he may be either in bed without turning, and this may result in pressure ulcers.
He will benefit from a consultation. The type of ulcer will decide the right treatment.

Hilda Wati answered 2 years ago
Doctor, I think the varicose veins in my thigh and calf are spreading. The color is dark red. It hurts if I stand or walk for too long. What should I do, Doc?
dr. Cosmas Chen replied 2 years ago

Varicose veins are dilated, tortuous vein. They are usually blue. If they are red, it would suggest the onset of inflammation. The veins may be filled with blood clots. They would improve with rest and anti-inflammatory pain killers. But it would take a while, usually, weeks to improve. Taking a Micronized Purified Flavanoid Fraction, such as Daflon would be helpful. For long term care, the veins need assessment with ultrasound with a view to vein surgery.

Hendri Huitian answered 2 years ago
My mother has pain in her knee, she cannot squat because the veins are tense. What should she do?
dr. Cosmas Chen replied 2 years ago

Your mum's pain in the knee could be from a knee problem. This is because when squatting, the knee joint surface is grinding against each other. If the veins around the knee are tense, and painful when you press them it would suggest inflammation of the vein. They can be surgically treated.

Hedi answered 2 years ago
Can a person with varicose pain do leg exercises, Doctor?
dr. Cosmas Chen replied 2 years ago

It's alright to exercise with varicose veins. It is prolonged sitting and standing, inactively, that allows symptoms to develop.

Budin answered 2 years ago
Doc, there are dark red spots on my swollen feet. They hurt. Why is this so?
dr. Cosmas Chen replied 2 years ago

Swollen feet may be due to heart, liver, kidney, venous problems, to name a few. Painful dark red spots can be due vasculitis, skin infection or red spider veins. This list is not exhaustive. You will need to have a consultation to determine the likely cause and hence treatment.

Wong Non Nah answered 2 years ago
Doc, what are the main causes of varicose veins? My mom doesn't often walk far, but why are there many varicose veins on her calves? Is there a therapy method such as use of stockings that can help to cure this?
dr. Cosmas Chen replied 2 years ago

Varicose veins result from reflux, or back flow from valves that regulate flow in the veins of the legs. These valves, allow blood flow upwards, back to the heart. If there is reflux, there is increase pressure within the veins of the leg, resulting in dilatation of the vein. These dilated veins are called varicose veins.
What causes the valves to leak is not clear. But, it can result from damage from previous deep vein thrombosis. It can run in families, or following or during pregnancy.
The amount of walking does affect incidence of varicose veins.
The correct stocking can treat the symptoms of varicose veins. But, does not cure it.

Kevin Wijaya answered 2 years ago
Doctor, my 70 year old father has a cimino (access to dialysis) on his left arm which has just been removed from his right arm. Now his left arm is swollen and reddish, what should I do?
dr. Cosmas Chen replied 2 years ago

Your father has an arteriovenius fistula in the left arm. This is a connection between the vein and artery, created, surgically. He is already using it for dialysis. The left arm is now swollen and reddish. This suggests there is possible venous obstruction in the same arm above the level of the fistula. He needs an ultrasound to be done for the veins of his left arm.

Rida HKsimn answered 2 years ago

Doctor, my father has a pen implanted in his shoulder 3 months ago. But now that area is swelling. Why is that so, Doc? How do we treat it?

dr. Cosmas Chen replied 2 years ago

Everything, something man-made is implanted, there is a risk of infection or the body does not accept its presence in the body. This results in inflammation.
A blòod test and and imaging study can be done. If due to an infection, antibiotics are needed.

Tikno answered 2 years ago

My veins bulge after I regularly do weight lifting these 2 months. How do I treat this?

dr. Cosmas Chen replied 2 years ago

Are these veins in the arms or legs? If you are doing weight training, the muscles may increase in size. Correspondingly, the veins will increase in size to handle the increase blood supply to the muscles. This is normal.

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