A Deeper Dive

Biomedical adhesive safely corrects varicose vein.

A large, white-framed photo of a school of canary-yellow butterfly fish swimming past a kaleidoscope of royal-blue, rhubarb-red and lilac-colored coral decorates one of the walls in the small den of Matthew’s* Longwood home.

The photo is one of Matthew’s prize possessions, and well it should be. He took it himself, after all, during what he considers to be the greatest adventure of his life – a dive three years back into the Coral Sea, the site of Australia’s Great Barrier Reef.

“The trip was a gift I got from my wife and kids for my sixtieth birthday,” says Matthew, a longtime scuba diving enthusiast who had a visit to the Great Barrier Reef on his bucket list for more than 40 years.

“Ever since I first took up scuba diving in college, I’ve always wanted to dive the Great Barrier Reef. And I can tell you: It didn’t disappoint. If there’s a more beautiful place on earth, I don’t know that man has found it.”

Matthew’s trip to Australia came while he was in the throes of a battle he had long been fighting with his legs, especially his right leg, which at the time was almost as unsightly as the Great Barrier Reef was beautiful.

“It literally looked like it had little snakes growing up the back,” Matthew confides. “That’s how swollen some of the veins were in my calf. I asked my doctor about them, and he said, If they’re not really bothering you, don’t worry about them.

“That’s why I put up with it for so long, because it wasn’t really bothering me that much. I didn’t like the way that leg looked, but it wasn’t until just after we got back from that trip to Australia that it really started to feel uncomfortable.

“Before that, my leg felt kind of heavy at night, and there was some cramping, but I never put much thought into it until after that trip, when it became a nightly thing. All of a sudden, it felt like I was having a bad headache in my leg every night.”

An avid walker and golfer, the recently retired financial advisor says his leg issue never kept him from any of his favorite activities, but he admits it was annoying to spend most of his nights with his legs feeling restless and uncomfortable.

“It was actually my wife who finally got me to do something about it,” Matthew reveals. “She said to me one day, Aren’t you tired of dealing with all this discomfort every night? After that, she started making some calls and set me up with an appointment.”

Visible Damage

The appointment was with Heart and Vascular Care, where Pradip B. Baiju, MD, an endovascular specialist and interventional cardiologist, works with Robyn Kempf, PA-C, who specializes in the evaluation and treatment of venous disorders of the legs.

Matthew’s visit was with Robyn, who first saw him in January and couldn’t help but immediately notice the unusually large, rope-like varicose veins that were running up and down his calves and into his thighs.

“They were very large, finger-sized and ropy,” Robyn says. “They were branches of the greater saphenous veins, which run from the ankle all the way up to the groin, and they’re normally about two millimeters in width. But his were six-point-three millimeters in some places and ten-point-six in others.”

Robyn’s findings prompted her to order a venous reflux study, which uses ultrasound to determine whether blood is flowing properly through the veins. Matthew’s test revealed the cause of his dilated veins and discomfort to be venous insufficiency.

Venous insufficiency is the condition that develops when the tiny, one-way valves of the superficial leg veins that open and close while assisting the return of blood from the legs back to the heart become damaged or diseased.

When those valves are damaged, blood refluxes backward in the veins and pools in the legs. That leads to the kind of symptoms that Matthew was experiencing such as varicose veins, pain, swelling and fatigue.

In advanced stages, venous insufficiency can also cause skin discoloration, and breakdown of the skin that leads to venous ulcers, which are usually found around the ankles, where they tend to heal slowly, if at all.

“We measure the amount of reflux, or blood flowing in the wrong direction, in terms of milliliters per second, where anything over five hundred milliliters per second is significant,” Robyn educates.

“In Matthew’s case, we measured some spots where his reflux was forty-five hundred milliliters per second, so he was definitely suffering from a severe case of venous insufficiency.”

Modern Medicine

At Heart and Vascular Care, Robyn uses the most modern, advanced techniques to treat venous disease, including the VenaSeal Closure System, which uses a biomedical adhesive to close the damaged veins, allowing blood to be rerouted through other, healthier veins.

“We also offer a treatment called radiofrequency ablation (RFA) that uses heat energy to close the veins. They’re both catheter-based systems where we treat the vein through a catheter, but the VenaSeal system has a couple of advantages over RFA.

“One advantage is that with VenaSeal, there’s only one little entry point where we put the catheter. With RFA, there a few more needle pokes along the leg because I have to apply numbing medicine at different points along the vein.

“You can also treat more of the vein, all the way down to the ankle, with VenaSeal. With radiofrequency, you can’t really go past the mid-calf because the nerves run very superficially after that, and the heat can irritate those nerves.

“The other nice thing about VenaSeal is that after the procedure, the patient wears a compression wrap for only a couple of days, until they get their follow-up ultrasound. After radiofrequency, patients need to wear compression stockings for two weeks.”

Given his choice of the two treatments, Matthew chose VenaSeal over RFA because of the convenience it offers. He was surprised by how easy the treatment actually was and amazed at how effective it proved to be.

“First of all, the procedure was nothing,” he says. “It wasn’t painful at all, and after a couple of days of wearing the compression stockings, I couldn’t believe how good my legs looked and felt.

“Some of my buddies that I golf with tease me once in a while about how good my legs look now, but I don’t mind because they feel great. There’s no more of that discomfort that was nagging me at night, and that is a relief.

“That’s why I can only say good things about Robyn, because she did a great job. I recommend her and Heart and Vascular Care to anybody because my whole experience there was terrific, and with excellent results.”

*Patient’s name withheld at his request.
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