Recently, patients have been asking me about the significance of "bear down" and what that exactly does to the exam. A Venous Reflux exam can be tedious if the patient does not know how to properly "bear down". I tell my patients to "bear down" like they are having a bowel movement. Many of them look at me weird and simply say "What does that do"? 

The calf muscle pump is critical in maintaining venous hemodynamics and the purpose of this exam is to know if the calf muscle pump is working effectively. An effective calf muscle pump consists of three things: 1) veins as reservoirs for blood collection 2) the contracting muscles of the legs, and 3) competent valves maintaining unidirectional blood flow. Therefore, when the calf muscle pump is effective, blood moves toward the heart resulting in a decrease in venous pooling, decrease in venous pressure, and an increase in venous return. 


Hopefully my patients know why it is important to "bear down" during the exam. I am craving some dark chocolate I think I might need some energy boost! 

Happy New Year everyone! I want to congratulate Manny Gracia for passing his Boards. Manny is a recent graduate from Chicago and was the blogger for the 2011 SVU Annual Conference in Chicago. He inspired me to create this blog. Best of luck in your future Manny!
I cannot believe it is January already, where does the time go??  Soon, I will start performing renal artery exams in my lab and although they are the toughest, I am still looking forward to it. The renal arteries can be challenging, but that makes it more intriguing for me. Time for some hot coco I am brutally cold! Why does Jersey have to be like Siberia!?