What I Learn from My Patients Every Day
By John Hogg, MD, DABR, DABVLM, RPVI, RPhS, RVT, RVS
Founder, Medical Vein Clinic
In late September, we hosted free vascular screening events at our Stone Oak and Alamo Ranch clinics as part of National Vascular Disease Awareness Month. The experience reminded me of the countless conversations I have daily with professional women who come to our clinic: executives, entrepreneurs, healthcare workers, educators who walk through our doors ready to prioritize their vascular health. These are the unique vascular challenges that San Antonio’s women face that I see firsthand. And, it’s so important to be proactive with vascular disease as it kills nearly 700,000 Americans every year. Up to 90% of deaths are preventable through lifestyle changes and early treatment.
The Professional Woman’s Conundrum: Success Has a Cost
I see this pattern consistently in my practice: professional women manage everyone else’s needs perfectly while not prioritizing what their own bodies are telling them.
Sarah, a 42-year-old marketing director, came into the clinic straight from a client meeting, still wearing her heels and business suit. She’d been ignoring the heavy, achy feeling in her legs for months, blaming her demanding schedule. “I thought it was just from standing on hard floors in heels all day,” she told me. “I figured if I got better shoes or floor mats, it would go away.”
Then there’s Maria, a 38-year-old physician who spends 12-hour shifts on her feet at University Hospital. She’d noticed spider veins developing but kept putting off her appointment because she was too busy taking care of everyone else’s health to deal with her own.
Why Working Women Get Hit Harder
After treating hundreds of men and women over the years, I’ve learned that women in their 30s, 40s, 50s, and early 60s face a nearly perfect storm of risk factors:
The Desk-to-Dinner Marathon: Your typical day means hours of sitting in meetings, more sitting during your commute, then standing at evening networking events or your child’s activities. This pattern of prolonged sitting followed by extended standing is particularly hard on leg circulation because your veins struggle to adjust between these extremes, and blood starts pooling in your lower legs.
The Pregnancy Factor: Many working women delay having children until their careers are established, then have kids in their 30s and early 40s. Each pregnancy significantly increases venous pressure and can trigger varicose veins, even if you “bounce back” beautifully in every other way.
The Hormone Reality: Estrogen, while protective in many ways, does increase blood clot risk by making blood cells more likely to coagulate and stick together. This becomes more significant as we approach perimenopause and menopause, especially for women on hormonal birth control or hormone replacement therapy. The key is staying active, staying hydrated, and having regular conversations with your doctor about your individual risk factors.
The Travel Problem: Business travel means long flights in cramped seats, messed-up sleep schedules, and dehydration. All of these hurt circulation. I’ve treated countless patients who developed their first blood clot during or right after a business trip.
The Stress Connection: Chronic stress doesn’t just mess with your mental health. It creates inflammation that damages blood vessel walls and increases clotting risk. When you’re managing teams, budgets, and family responsibilities at the same time, your cardiovascular system can be compromised without proactive care.
Are Your Legs Trying to Tell You Something?
In my daily practice, I witness many accomplished women dismiss their symptoms as “normal wear and tear.” Let me be clear: leg discomfort is not normal; your legs are trying to tell you to seek medical attention.
Pay attention if you’re experiencing:
- Legs that feel heavy or achy by the afternoon, especially after a day of meetings
- Swelling in your ankles that’s worse on days when you wear heels or sit through long presentations
- Restless legs that keep you awake when you are sleeping
- Spider or varicose leg veins that seem to multiply during stressful periods
- Leg cramps that wake you at night, particularly during high-pressure work seasons
The Real Cost of Waiting: A Business Case
As busy women, you understand return on investment. Here’s the math on addressing vascular health early:
Early intervention cost: A consultation, maybe an ultrasound, possibly a minimally invasive treatment that takes 30-45 minutes with no downtime.
Delayed intervention costs: Potential deadly blood clots requiring hospitalization, progressive vein disease that eventually needs more extensive treatment and downtime, development of chronic leg swelling (lymphedema), chronic leg symptoms that drain your energy and affect your performance, and dealing with preventable health crises during critical career moments.
What You Can Do Right Now
After treating hundreds of professional women over the years, here’s what I tell my patients:
Schedule Like a CEO: Put your annual vascular screening on your calendar like any other important business commitment. If you wouldn’t skip your quarterly board or work meetings, don’t skip your health maintenance.
Update Your Workspace: Get a standing desk, take walking meetings when possible, and set phone reminders to move every hour. Your circulation will thank you, and your productivity may improve.
Master Compression Stockings: High-quality gradient compression stockings aren’t just for post-surgery recovery. They’re a professional woman’s secret weapon for maintaining energy and preventing swelling during long days. I recommend them for any woman who spends significant time sitting or standing.
Travel Smart: For flights over two hours, wear compression socks, stay hydrated, and walk the aisle regularly. Book aisle seats when possible and consider upgrading for extra legroom on longer flights. It’s a health investment, not a luxury.
Manage Stress for Your Veins: Your meditation practice, exercise routine, or therapy sessions aren’t just good for your mental health. They’re protecting your blood vessels from the inflammatory effects of chronic stress.
Self-Care Is Not Selfish
Sadly, my patients often tell me they feel guilty about taking time for medical appointments. But here’s what I want SA Woman readers to understand: addressing your vascular health is strategic. You can’t perform at your best professionally if you’re dealing with chronic leg discomfort, fatigue from poor circulation, or anxiety about untreated symptoms. Don’t dismiss your discomfort as inevitable. Healthy legs take you further™.
Dr. John Hogg, MD, DABR, DABVLM, RPVI, RPhS, RVT, RVS, is a board-certified radiologist specializing in Vascular & Interventional Radiology and the CEO/Founder of Medical Vein Clinic. With more than 30 years of experience, Dr. Hogg has established San Antonio’s leading vascular treatment clinic, helping thousands of patients since opening in 2017. To learn more, visit https://www.medicalveinclinic.com.
