Yes I agree, why? The velocity was mentioned so readers could gain a more vivid idea of the magnitude of the increased venous flow state not so much that the velocity in and of itself has any specific meaning. I am seeking the "why" and encourage any input as to the "why" that might be supported with experience or reference. 

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On Oct 8, 2012, at 8:22 PM, Bill Johnson <[log in to unmask]> wrote:

> Calli, Bill and Jay,
> 
> I suppose I am not the only one that has witnessed the amazing ability
> of our bodies to overcome the invasion of infections and foreign
> matter.  I have always been amazed by hyperemic blood flow, and think
> those little guys, blood cells and platelets and the rest, somehow
> have minds of their own.  But, when we see them rushing along to do
> their duty, we must be aware that they are also telling us something,
> and look for the source of their excitement.  We see the effect, but
> we should look for the cause. The velocity is not important, but why
> are they rushing to get somewhere?
> 
> On 10/8/12, Jay Swede <[log in to unmask]> wrote:
>> Calli,
>> 
>> Yes I had those same thoughts regarding the vasodilation and was left
>> wondering how this was occurring. It is interesting to see all superficial
>> veins, peforators, tibial and peroneal veins with 60-100 cm/sec velocities!
>> 
>> Joe.
>> 
>> On Sat, Oct 6, 2012 at 7:39 PM, Calli opsis <[log in to unmask]> wrote:
>> 
>>> Narcotics like morphine and codeine typically have a vasodilation effect,
>>> which would in turn lower the flow state of the venous system and make it
>>> more difficult to get good waveforms in an extreme case.  I would think
>>> the
>>> body would compensate for any flow state with autoregulation, but I guess
>>> that is why some people get dizzy with narcotics (because they don't
>>> compensate).
>>> 
>>> I wonder if their excessive drug use has caused LV dysvunction and even
>>> though they don't have a diagnosis of heart failure with CHF, maybe they
>>> have increased load?
>>> 
>>> Very curious observation.  Certainly one that could result in a paper. :)
>>> 
>>> On Tue, Oct 2, 2012 at 6:26 PM, Joe Swenson <[log in to unmask]> wrote:
>>> 
>>>> I have observed, over several years, that patients using narcotic pain
>>>> medication or IV heroin users present with extermely high venous flow
>>>> states in the in the peripheral veins, both deep and superficial. Venous
>>>> duplex exams of these patients will produce extraordinarily high venous
>>>> velocities and significantly reduced phasicity within dilated Greater
>>>> Saph., Lesser Saph., perforators and tibial veins, which would typically
>>>> have nearly imperceptible spontaneous flow signals. This makes for
>>>> great color Doppler opportunities to clearly demonstarte every segment
>>>> of the tibial and peroneal vein anatomy. I am searching for information
>>>> that would reference and explain this type of venous vascular response
>>>> and the potential contribution to patients with venous insufficiency
>>>> signs and symptoms but without evidence of any area of reflux or other
>>>> obvious contributing factors. The impetus for this quandary was a
>>>> patient with a history of BLE hyperpigmentation, scleroderma, edema,
>>>> and episodes of LLE cellulitis. Duplex revealed only a single site of
>>>> minimal/trivial reflux. Medications included multiple long term narcotic
>>>> pain killers 3 years+, for leg pain. No CHF, obesity etc.
>>>> 
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>>> 
>>> 
>>> 
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