Chronic Venous Insufficiency

Posted on November 7, 2025 by Patrick Hercules

Chronic venous insufficiency (CVI) is a form of venous disease that occurs when the veins in the legs become damaged and do not work properly.

Normally, the valves in the legs keep blood flowing back up to the heart. CVI damages those valves, causing blood to pool in the legs, increasing pressure in the veins, and causing symptoms such as swelling and ulcers.

Chronic venous insufficiency can happen due to damage to any of the leg veins. These can include:

Deep veins, which are the large veins deep in the body that run through muscle

Superficial veins, which are close to the skin’s surface

Perforating veins, which connect the deep and superficial veins

CVI may cause mild symptoms at first. However, this condition can interfere with a person’s quality of life and lead to serious complications over time. There are several signs and symptoms of chronic venous insufficiency, including:

Legs that feel tired or achy

A burning or prickly feeling in the legs

Reddish brown colored skin

Varicose veins

Flaking or itching on the legs or feet

The feeling of fullness or heaviness in the legs

Cramping in the legs at night

Swelling in the lower legs and ankles, especially after standing for a while or at the end of the day

Leathery-looking skin on the legs

Ulcers that form near the ankles, which can become infected and painful

Chronic venous insufficiency usually affects people over the age of 50. The risk of developing the disease rises the older a person gets. Overall, chronic venous insufficiency affects about one in 20 adults.

Venous disorders are a general category for many possible vein issues, including CVI. They have various stages that are based on clinical signs, which a healthcare provider can see or feel when they examine your legs. The stages of venous disorders range from 0 to 6. These stages include:

Stage 0: There are no visible signs; however, a person may feel fatigued or achy

Stage 1: superficial veins, such as spider veins, are visible

Stage 2: varicose veins that are at least three millimeters wide

Stage 3: swollen limbs that don’t have any changes to the skin

Stage 4: changes to the color and/or texture of the skin

Stage 5: an ulcer that has healed

Stage 6: an open ulcer

Chronic venous insufficiency is diagnosed at stage 3 or above.

There are three causes of valve malfunction: congenital, primary, or secondary.

Congenital causes of valve malfunction are deformities in the leg veins that a person is born with. Some people can be born without valves in their legs
Primary causes of valve malfunction are any changes to the leg veins that stop them from working correctly. A vein may get too wide, preventing its valve from completely closing
Secondary causes of valve malfunction are other types of medical issues that damage the leg veins. This is usually caused by deep vein thrombosis (DVT), the most common cause of CVI. The blood clot, or thrombus, leaves behind scar tissue, damaging the valve

Chronic venous insufficiency is diagnosed through a physical exam and ultrasound imaging.

Treatment for CVI involves lifestyle changes, such as leg elevation, exercise, weight management, and compression therapy. If these measures are not enough, a healthcare provider may recommend a procedure or surgery. The best treatment depends on how far the condition has progressed and the other medical conditions a person has.

The goals of treatment are to help the blood flow better through the veins, help ulcers heal and limit their chances of returning, improve the skin’s appearance, and reduce pain and swelling.

If you are experiencing symptoms of chronic venous insufficiency, you can schedule an appointment with a vascular surgeon from our Division of Vascular and Endovascular Surgery at Jamaica Hospital in New York or learn more about the services at our vascular surgery center in New York. Please call 718-206-6713.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Postpartum Depression and Psychosis

Posted on November 6, 2025 by Patrick Hercules

Postpartum refers to the time after childbirth. Postpartum mothers may experience mental health changes or challenges after giving birth, including mood disorders such as postpartum depression and postpartum psychosis.

Postpartum depression is a type of depression that happens after having a baby. It affects up to 15% of women, involving emotional highs and lows, frequent crying, fatigue, guilt, and anxiety. A postpartum mother may have trouble caring for their baby or themselves.

Postpartum psychosis (PPP) is a mental health emergency that affects a postpartum mother’s sense of reality, causing hallucinations, delusions, paranoia, or other behavior changes. In severe cases, postpartum mothers with PPP may attempt to harm themselves or their newborn.

Postpartum depression is common. A mother who has just given birth may experience baby blues, which affects between 50% and 75% of women after delivery. Up to 15% of them will develop postpartum depression. Postpartum psychosis is rare, as experts estimate that it affects between 0.089 and 2.6 out of every 1,000 births. In the United States, that means it happens in between 320 and 9,400 births each year. Globally, that means it happens between 12 million and 352.3 million births.

A mother can experience postpartum depression for up to one year after their baby is born. However, this doesn’t mean that they will feel cured in one year.

Symptoms of postpartum depression can include:

· Feeling sad, worthless, hopeless, or guilty

· Worrying excessively or feeling on edge

· Loss of interest in hobbies or things you once enjoyed

· Changes in appetite or not eating

· Loss of energy and motivation

· Trouble sleeping or wanting to sleep all the time

· Crying for no reason or excessively

· Difficulty thinking or focusing

· Thoughts of suicide or wishing you were dead

· Lack of interest in your baby or feeling anxious around your baby

· Thoughts of hurting your baby or feeling like you don’t want your baby

It is believed that hormonal changes are linked to postpartum depression; however, more research is needed to determine the link between the rapid drop in hormones after delivery and depression. The levels of estrogen and progesterone increase tenfold during pregnancy but drop sharply after delivery. When a mother is three days postpartum, levels of these hormones drop back to pre-pregnancy levels.

In addition to these chemical changes, the social and psychological changes associated with having a baby increase the risk of postpartum depression. Examples of these changes include physical bodily changes, lack of sleep, worries about parenting, or changes to relationships.

Experts don’t know why postpartum psychosis happens, but suspect it involves a combination of factors, including:

· History of mental health conditions

· Number of pregnancies

· Family history of mental health conditions, especially PPP

· Sleep deprivation

· Hormone changes

· Other medical conditions

Hallucinations and delusions are the two main symptoms of postpartum psychosis. However, there are several other common symptoms, including:

· Mood changes, such as mania and hypomania or depression

· Depersonalization

· Disorganized thinking or behavior

· Insomnia

· Irritability of agitation

· Thoughts of self-harm or harming others, especially their newborn

Researchers have organized the symptoms of PPP into three types: depressive, manic, and atypical/mixed.

The depressive subtype of PPP is the most common, making up about 41% of cases. It is also the most dangerous. Research shows that depressive symptoms and psychosis are almost always a factor in cases that involve self-harm or harm to a child, especially hallucinations or delusions that command a person to harm their child or themselves. The rate of harm to a child is about 4.5% with this subtype, about four or five times greater than with the other subtypes. The rate of dying by suicide is about 5%. Symptoms that are most likely experienced with this type include:

· Anxiety or panic

· Delusions and hallucinations

· Depression

· Feelings of guilt

· Loss of appetite

· Loss of enjoyment related to things they usually enjoy

· Thoughts of self-harm, suicide, or harming their child

The manic subtype is the next most common of the types, affecting about 34% of cases. The risk of self-harm or harm to children is lower but still possible, happening in about 1% of cases. Symptoms can include:

· Agitation or irritability

· Disruptive or aggressive behavior

· Talking more or faster than usual, or both

· Needing less sleep

· Delusions of greatness or importance, such as believing your child to be a holy or religious figure

The atypical/mixed subtype makes up to 25% of cases. This can mix the symptoms of manic and depressive subtypes. It can also involve symptoms where a person seems much less aware or completely unaware of the world around them. Symptoms can include:

· Disorganized speaking or behavior

· Disorientation or confusion

· Disturbance of consciousness, where a person doesn’t appear to be awake or isn’t aware of activities or things taking place nearby

· Hallucinations or delusions

· Inappropriate comments, behaviors, or emotional displays

· Catatonia or mutism

There isn’t a specific test that diagnoses postpartum depression. A healthcare provider will evaluate you at your postpartum visit, which may include discussing your health history, how you have felt since delivery, a physical exam, a pelvic exam, and lab tests. They may also perform a postpartum depression screening or ask a series of questions to assess if you have postpartum depression.

Postpartum psychosis can be diagnosed by a mental health provider who can determine either by observation or what you describe whether you have the condition or not. They may also perform physical and neurological exams and order blood, urine, or imaging tests.

Postpartum depression is treated differently depending on the type and severity of symptoms. Treatment options include anti-anxiety or antidepressant medications, psychotherapy or cognitive behavioral therapy, and support group participation.

Treatment for postpartum psychosis may include medications to treat depression, anxiety, and psychosis. You may also be admitted to a treatment center for several days until you’re stable. To find out more about our mental health services or to schedule a virtual appointment, call (718) 670-5316 to speak with our intake coordinator or call (718) 670-5562 to reach the clinic

What is Lymphatic Circulation?

Posted on November 5, 2025 by Patrick Hercules

The lymphatic system is a group of organs, vessels, and tissues that protect the body from infection and help it keep a healthy balance of fluids throughout the body. Lymphatic system organs include bone marrow, the thymus gland, and lymph nodes.

The lymphatic system is a vital part of the immune system because it protects the body from infection and destroys old or abnormal cells that the body doesn’t need.

Lymphatic circulation is the drainage system for your body, which functions by taking fluid that has seeped into your body’s tissues and returning it to the bloodstream. During this process, the lymphatic circulation system filters the fluid and works to remove toxins and potentially harmful waste. Other key functions include:

Helping the body absorb fats

Protecting the body against bacterial, viral, parasitic, and fungal infections

Many conditions can affect various parts of the lymphatic system. Some happen during development before birth or during childhood. Others develop because of disease or injury. Some common diseases and disorders of the lymphatic system include:

Swollen lymph nodes

Swelling or accumulation of fluid

Cancers of the lymphatic system

Lymphangitis

Lymphangioma

Intestinal lymphangiectasia

Lymphocytosis

Lymphatic filariasis

Castleman disease

Lymphangioleimyomatosis

Autoimmune lymphoproliferative syndrome

Mesenteric lymphadenitis

To check if a person’s lymphatic system is working properly, a healthcare provider may use imaging tests such as a CT scan or an MRI.

There are many ways to keep your lymphatic system strong and healthy, including:

Avoiding exposure to toxic chemicals, such as those in pesticides or cleaning products. These chemicals can build up in the lymphatic system, making it harder for the body to filter waste

Drinking plenty of water to stay hydrated so lymph fluids can easily move throughout the body

Keeping a healthy lifestyle that includes regular exercise and a nutritious diet. A healthcare provider can offer specific advice that is tailored to your medical history and needs

If you would like help with lymphatic circulation, you can receive treatment from a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

COPD Myths

Posted on November 3, 2025 by Flushing Hospital

Chronic obstructive pulmonary disease, or COPD, is a group of health conditions, such as chronic bronchitis and emphysema, that limit airflow in the lungs.

Many myths and misconceptions exist about COPD. Here are some misconceptions surrounding COPD:

Myth #1: Only people who smoke get COPD

COPD is often associated with smoking, as smoking cigarettes and other tobacco products is the most common cause of the damage done to the lungs and airways. However, nearly 30% of people with COPD have never smoked a cigarette. Nonsmoking causes of COPD include:

Long-term exposure to polluted air, such as smog in an urban area or dust and fumes at a workplace
Genetics plays a role, specifically a condition called Alpha-1 antitrypsin deficiency (Alpha-1)
Asthma that’s active or even inactive. Researchers have found that 29% of people with asthma eventually receive a COPD diagnosis
Childhood respiratory illnesses, such as pneumonia

Myth #2: COPD is rare

According to estimates from the Centers for Disease Control and Prevention (CDC), over six in 100 adults in the U.S. had a COPD diagnosis in 2022.

That means millions of adults across the country have received a diagnosis of COPD. The actual proportion of adults with COPD may be higher due to delays in obtaining a diagnosis.

Myth #3: Exercise is too hard if you have COPD

Shortness of breath, wheezing, a chronic cough, and fatigue can all be a part of COPD. Any one of these symptoms can make exercising challenging.

Moderate exercise may not affect your lungs. In some cases, exercise can minimize the symptoms of COPD while strengthening the heart and helping reduce stress.

Try to build up to 20 to 30 minutes of exercise three to four times a week. Combine safe cardiovascular activities such as walking or biking with stretching and strength-building. It won’t be easy to start exercising. Speak with your healthcare provider about building an exercise plan that works for you. They may be able to connect you with a respiratory therapist for breathing techniques and exercises you can do. It is recommended that you speak to your doctor about your health before starting a new exercise regimen.

Myth #4: Only older people develop COPD

COPD is more common in people 65 or older. However, younger people can also develop this condition.

A 2023 study found that COPD affected more than 1.6% of adults ages 20 to 50 in the U.S. Adults aged 35 to 50 had a higher risk of COPD than those under the age of 35.

A history of smoking or secondhand smoke exposure significantly increases the risk of COPD in young adults.

Myth #5: COPD is a man’s disease

The Centers for Disease Control (CDC) reports that women are more likely to develop COPD than men in the U.S.

More women than men have also died from COPD since 2000 in the U.S.

Exposure to tobacco smoke and other pollutants raises the risk of COPD for anyone; however, women can experience more harmful effects than men from these pollutants.

Women with COPD also tend to get a diagnosis later than men, after the disease has progressed and treatment is less effective. This may contribute to reduced survival in women with COPD.

Myth #6: Nothing can be done to treat COPD

COPD treatments are available to help limit symptoms and potentially slow the progression of COPD.

Your treatment plan can include lifestyle changes like quitting smoking (if you smoke), as well as one or more of the following:

Vaccinations
Medications
Pulmonary rehabilitation
Supplemental oxygen
Lung transplant
Surgery

Talk with your healthcare provider to learn more about your treatment options.

Myth #7: There’s no point in quitting smoking after you develop COPD

Avoiding tobacco smoke is one of the most important things you can do to manage COPD.

If you smoke, cutting back and quitting can help limit symptoms and slow the progression of COPD.

Although more research is necessary, it may also be helpful to avoid e-cigarettes and other vaping products.

Avoiding smoking and vaping altogether is likely your healthiest option. Talk with a healthcare provider to learn about smoking cessation counseling, medication, or other resources that can help you cut back and quit smoking or vaping.