ASSESS YOUR RISK FOR VEIN PROBLEMS

ASSESS YOUR RISK FOR VENOUS PROBLEMS

Sex Male Female
1 Your Age 0(Less than 14) 1
(14-29)
2
(30-45)
3
(More than 45)
2 How long have
you led a sedentary
life(seated or standing
for more than 6 hours a day)
0 (Non sedentary life) 1
(1 to 3 years)
2
(3 to 10 years)
3
(More than 10 years)
3 Do you weigh
More than your ideal
Weight?
0
(No)
1
(Yes,1 to 5 kg)
2
(5 to 10 kg)
3
(More than 10 Kg)
4 Number of pregnancies 0
(None)
1
(1)
2
(2)
3
(More than 2
Pregnancies)
5 What is your usual working position? Sitting or Standing 0
(For less than 4 hours A day)
1
(For 4 to 8 hours
A day)
2
(For more than 8 hours A day)
3
(For more than 8 hours A day ,
plus extensive travel)
6 Family history of
Varicose veins(parents)
0
(None)
1
(1parent with
varicose veins)
2
(2 parents with varicose veins)
3
(2 parents with
varicose veins)
7 Do you walk,swim,
Cycle,jog or go to gym?
0
(Yes, at least 3 hours
A week)
1
(Less than 3hours A week)
2
(Casually/holidays)
3
(Never)
8 Do you have painful legs? 0
(No, never)
1
(Yes, from time to time)
2
(Yes, often)
3
(I am nearly always In pain)
9 Do you have swollen
Ankles in the evenings?
0
(No, never)
1
(Only in warm conditions
And while traveling)
2
(Yes, almost everyday But only in the evening)
3
(Yes, every day from The morning onwards)

Less than or equal to 11(Women) or 7(Men) – you may have limited risk of venous stasis (insufficiency). Consult your doctor for advice on following a healthy lifestyle to protect your veins.Answer each of the questions and total your score (given in the squares). Then find out your risk for venous problems : –

  1. Between 12 and 22(Women) or 8 and 14(Men) – You may suffer from venous stasis (insufficiency). It is time you did something in terms of lifestyle and medical help.
  2. Equal to or greater than 23(Women) or 15(Men) – You may suffer from deep venous stasis (insufficiency) or be faced by it one day. You must do something to stop this evolving disease and take early medical help and advice.

Disclaimer : The information given is for general guidance of patients . The clinic does not accept any responsibility for any adverse event that may occur due to following these instructions.This pamphlet is not for medico legal use.