Frequently Asked Questions
If you have any questions or concerns not addressed here, please don’t hesitate to contact our office during regular business hours so we can help you as quickly as possible.
Why am I still taking ASA and Plavix if I am having surgery?
In some patients, the risk of bleeding from surgery while on aspirin and Plavix is much lower than the risk of complications without it. Your physician will tell you what medications to stop depending on the procedure you are having
Why do I have to stop blood thinners and metformin?
Patients are asked to stop metformin prior to catheterization procedures which utilize contrast dye because in certain circumstances its use can result in a concerning condition called lactic acidosis. Blood thinning medication is held prior to procedures for many individuals to reduce the risk of excessive bleeding. Your physician will tell you what medications to stop depending on the procedure you are having.
I’m already on Aspirin why do I need to be on plavix?
Aspirin and plavix are both anti-platelet agents. Platelets are small particles that can clump together to form blood clots. Blood clots that form in the arteries can lead to heart attack, stroke, and even limb loss. Certain individuals who are at high risk for complications from vascular disease benefit from the added protection of two antiplatelet agents (such as aspirin and Plavix). These medicines may also be recommended after the placement of a stent to prevent clot from forming in the stent itself.
I am feeling fine, why do I still need surveillance ultrasounds?
There are a few conditions that represent a “silent risk” to our vascular patients. These conditions can be monitored through a routine ultrasound program so any worsening issues can be identified before they become a health threat to the patient.
Can I do my ultrasounds at another location? Or can I just go to outside imaging center?
Although you can have your ultrasound study done at other imaging centers, our vascular lab is well trained in vascular specific conditions so they know what to look for and what the surgeons may be looking for. Additionally, the vascular lab techs have a direct line of communication with the surgeons and real time access to your records to tailor your study appropriately. Having your study done in our lab lessens the chance that the study will have to be repeated.
Why can’t my PCP do surveillance?
Once we have performed a procedure on you, we often need to follow the results of the procedure with surveillance studies. It is critical that these be done in our vascular lab to get the most accurate information. As mentioned in a previous answer, our lab techs have a direct line of communication with the surgeons and real time access to your records (including the details of the procedure performed) to tailor you study appropriately. Additionally, having the studies done in the same lab read by the same physician (your surgeon) allows for a better comparison of studies over time
I had an ultrasound on my veins why do I need another one?
Sometimes ultrasounds done outside of vascular practices only evaluate for the presence or absence of a deep vein thrombosis (DVT). If you have had this type of imaging however if you are interested in evaluation of your varicose veins or have other lower extremity concerns, you will likely need a more detailed ultrasound which will provide more information about the valvular structure of your veins.
Why do I need an ultrasound for my arteries didn’t I just have one for veins?
The arteries and veins are separate anatomical systems and require separate imaging studies.
Why can’t I get a screening through my insurance if I am younger than 65 with no family history/nonsmoker. Why is it $99 even if my insurance states they cover ultrasounds.
Insurance companies have certain criteria for the coverage of imaging studies. If you do not meet these criteria your study may not be covered. We offer a $99 screening study of the carotid arteries, abdominal aorta, and legs for individuals who are asymptomatic and would just like a general screening to rule out vascular disease.
I have no symptoms but want to check, why won’t you just humor me and do it?
We offer screening studies of the carotid arteries, abdominal aorta, and lower extremities for individuals who do not have symptoms but would like a thorough vascular evaluation. This is not covered by your insurance company and costs $99.
I am able to get dialysis and having no issues, why am I being scheduled for a fistulogram?
While we try to minimize the number of procedures you have on your fistula/graft, some are necessary to keep the fistula/ graft open even if you are not having problems with dialysis. It is far superior to keep open a failing fistula that the try and save a failed fistula/graft.
I am getting/or have a kidney transplant, why am I still having to get surveillance and procedures for access?
In the unfortunate event the transplant should fail, a well-maintained access could then be used again for dialysis.
I am bleeding after dialysis treatments, why? And why do I need a fistulogram?
Blockages within the access can affect its internal pressure. This increased pressure can cause more bleeding when the needle is removed after dialysis.
Why do I need Cardiac Clearance? Will that cause me to not have surgery?
Before some surgeries we need to be sure your heart is strong enough to tolerate the stress of surgery/anesthesia. If your cardiologist has concerns about your cardiac status, alternate options for surgical intervention, anesthesia, and/or non-surgical therapies may be discussed.
Why do I need pre-admission testing?
Pre-admission testing is required to ensure the safest possible surgical experience. It provides further reassurance that you are healthy enough to safely undergo anesthesia and surgery. This evaluation usually includes a physical examination, cardiac evaluation, lung function assessment, and laboratory tests. It also lessens the chance that the anesthesia department will cancel your surgery.
Why do I need blood work before my procedure and imaging studies?
Blood work is done prior to surgery to further ensure there are no concerns which may increase risk to you during your procedure – such as infection, high blood sugar, or electrolyte imbalances. Prior to imaging labs are obtained to check the status of your kidneys to be sure they can tolerate the contrast.
Why can’t I eat or have coffee before a procedure?
Your stomach needs to be empty before surgical procedures to lower the risk you could vomit while you are under anesthesia. Vomiting while under any anesthesia can cause severe complications.
Why can’t I use Uber/Lyft after procedure?
You may still be under the effects of anesthesia when you leave after your procedure. We do not want you to be accompanied only by an unknown person.
Why do I need an office visit to discuss surgery?
Your surgeon wants to see you in the office prior to surgery to thoroughly evaluate you and have a comprehensive discussion of the risks and benefits of the recommended procedure.
Can I fly or go on vacation after a procedure?
This answer depends on the individual patient/procedure. Don’t hesitate to inquire before your procedure about any post-procedure limitations.
I am an active person; how long can I expect to recover?
This answer depends on the individual patient/procedure. Don’t hesitate to inquire before your procedure about any post-procedure limitations.
Will I be put to sleep for the procedure?
The type of anesthesia used is customized to you and the type of procedure you are having. This will be discussed with you prior to your procedure.
My other doctor told me I am a candidate for a procedure, but you tell me I do not need one. Why?
At Vascular Specialists of Central Florida we specialize in treatment of the body’s arteries and veins. When you are referred here we perform a thorough vascular evaluation to determine the best course of action for you as an individual based on our experience and current guidelines. This may differ from the opinion of other physicians outside of this speciality/practice.
Why am I being asked to take Mucomyst before my CT scan?
It may help to protect the kidneys from damage which may be caused by the IV contrast (acute contrast-induced nephropathy). It is over-the-counter. It can be purchased through Amazon, GNC, Vitamin Shoppe.
Why do I need a CT scan? I just had an ultrasound.
Depending on your condition, a CT scan may be necessary to provide additional information which cannot be provided by a doppler. For example, if it has been determined by ultrasound that your abdominal aneurysm has grown to size which requires consideration for surgical repair, a CT scan provide even more detailed dimensions of the aneurysm which are essential for planning surgery.
Can I get a MRI when I just had stents placed? Is it safe?
Generally speaking it is safe to have an MRI after peripheral vascular stents are placed. However, you should always present your stent card/information to the MRI facility prior to any imaging study so they can make any adjustments necessary based on their equipment.
It’s a surgery, why is my authorization taking so long or why was it denied? Isn’t it medically necessary and dangerous?
We are obligated to follow your insurance guidelines prior to your procedure. Unfortunately, sometimes this process is lengthy. You can call either us or your insurance company to check on the status of your authorization. If you have any concerns about the urgency of your condition please discuss this with us so we can make appropriate recommendations.
Why do I need my primary to get me authorization to get ultrasound or office visit?
This is a requirement of your specific insurance company. There are plans that do not require authorizations.
Why did you do my surgery in hospital but your office does not take my insurance?
This may occur if you require an urgent procedure while hospitalized. We will follow up with you in our office while you are in the recovery period even if we do not take your insurance. We will also offer suggestions of vascular surgeons who do take your insurance to provide your ongoing care.
What does it mean to have a deductible, my insurance covers it, so why do I have to pay?
A deductible is the amount of money you must pay in one year prior to complete coverage from your insurance company. This information should be available to you through your insurance company.
My ultrasound is set for a date and I want to move it up but the office says they can’t for insurance reasons, why is this?
Insurance plans have very specific guidelines which dictate the timing of routine dopplers. If these guidelines are not followed, your insurance may not cover the scan. However, these time frames can be modified if you have any concerning symptoms. This should be discussed with your provider.
Can I get a second opinion by another doctor in the practice?
Second options within the practice are offered on a case by case basis. If you are interested in this, please feel free to inquire.
Why am I being told you do not treat my diagnosis when I was referred to your practice?
If it is determined by our providers that your symptoms are not related to a peripheral vascular condition it may be recommended you follow up either with your PCP or a different specialist to better assess your condition.
Why do I have to fill out so much paperwork before my visit?
We understand that patients rarely like to fill out the extensive paperwork required for an office visit. However, as we are a medical practice we are required by law to obtain certain information prior to your visit. We apologize for this inconvenience; however we are obligated to obtain this information at your initial visit and also update it at various intervals.
Why can’t I access my reports on the patient portal? What is the portal for if I can’t see anything?
Visit summaries are available on the portal. If you would like a copy of your imaging results we can mail this to you or send it to you via the portal. The portal can also be used to communicate directly with us electronically.
Why do you need a CD of my imaging studies prior to my office visit?
We provide thoughtful review and analysis of your prior vascular imaging studies. Our physicians would like to take time to review your imaging studies prior to your visit so that this does not cut into the time spent with you during your visit or delay the visits of other patients.
Why do you need records/record release prior to visit?
It is ideal to review your history/records prior to your visit. This allows our providers to be well-prepared for your visit and assists with keeping our appointments running on time.
Why can’t I have my ultrasound and results the same day?
Unfortunately, it is often the case that insurance plans will not cover imaging studies performed prior to office visits on the same day.
My referral was for an ultrasound, why can’t I get that without an office visit?
We are a physician’s office not an imaging center. We are obligated to evaluate you and determine what type of imaging, if any, is appropriate for you.
Why can’t you just go online and get all of my records? Don’t you all share records?
It would be wonderful if this was the case, but unfortunately not all medical practices/hospital systems share records.
Aren’t you part of Orlando Health?
Our physicians perform procedures at Orlando Health, however Vascular Specialists of Central Florida is not owned by Orlando Health. It is a private practice owned by the physicians themselves.
I am being scheduled for a PA or a nurse practitioner, why? I have a serious health issue and shouldn’t a doctor see me?
We have two board-certified advanced practice providers who are well qualified to address your routine or urgent vascular concerns. They also offer convenient appointment times when your surgeon may be in surgery with other patients. However, if you prefer to schedule an appointment with your surgeon this is always an option, although this may delay your appointment.
Common Medical Questions
What is the difference from ascending/descending aneurysm?
The aorta is a large blood vessel that leaves the heart in the form of an arch. The upwards portion is closest to the heart and is called the ascending aorta. Aneurysms in this area are typically treated by cardiac interventionalists/surgeons. The downward portion is the descending aorta. Aneurysms that form in this portion of the aorta are commonly treated by peripheral vascular surgeons.
I had my veins treated blank years ago, now the same ones are back, why?
Treatment of varicose veins does not guarantee you will not develop varicosities in the same area in the future.
What is an endoleak? When do I need to get it fixed?
An endoleak occurs when an aneurysm treated with a stentgraft continues to have bloodflow. This can be from other vessels or malpositioning/defect of the graft. Endoleaks can be detected through routine imaging after the graft. Some endoleaks self-resolve and others require procedural repair.
I was told my carotid is blocked, however surgery is not being recommended. Why?
Generally speaking, blockage in the carotid artery is treated to lower the risk of stroke. The risk of stroke is only significant if you have a high amount of blockage. If you do not have a high amount of blockage, the risk of surgery is higher to you than the risk of stroke, so it is safer to monitor the blockage with routine imaging.
What is the difference between SVT and DVT and when is anticoagulation needed?
A SVT is a clot in a superficial vein and a DVT refers to a clot in a deep vein. Typically new-onset DVTs require treatment with anticoagulation to lower the risk of the clot traveling to the lungs (pulmonary embolization). Your provider may also recommend anticoagulation for thrombus found in the superficial saphenous veins as these do connect directly to the deep system and may carry a risk of pulmonary embolism as well. SVTs involving only the superficial varicosities pose low risk and will self-resolve.
What causes leg pain and swelling? Is it vascular? Can I lose my leg?
Swelling in the legs is actually a complex issue with many possible sources. During your visit your provider will assess whether your leg swelling is related to a vascular condition or something else. Generally speaking, swelling of the limbs does not lead to limb loss.
My feet are always cold, am I going to lose my leg?
There are numerous reasons an individual may feel coolness of the limbs. Sometimes this is completely normal and other times it can be an indication of a concerning condition. Don’t hesitate to give us a call to discuss your particular situation or come in for evaluation.
Do I have to wear compression socks 24/7? I can’t stand to wear them to sleep.
Unless you have been specifically advised to do so by your provider, compression stockings do not need to be worn while sleeping. An exception to this may be if you have had a recent procedure and have been advised to do so.
Where can I get compression socks? There are no durable medical supply stores in my area.
Compression socks can be purchased without a prescription at many major retailers such as Amazon, CVS, Walgreens.