A Thing of the Past

Minimally invasive treatment eliminates need for vein stripping.

For 20 years, Elena Tewmey worked in the county sheriff’s office. In 2009, she left her post to become a stay-at-home mom to her two young children. Beginning in 2007, when she was pregnant with her first daughter, the foot pain and swelling in her feet and ankles, which she’d had for years, intensified. Elena blamed the intensification on her pregnancy, but after she delivered her daughter, it only got worse.

Dr. Vijay Narasimha of Surgical Associates of Tampa Bay in Brandon treated Elena Tewmey’s varicose veins.

After vein treatment, Elena has resumed her active lifestyle

“I’ve had the swelling for the last six or seven years,” the Tampa native elaborates. “I didn’t realize how bad it was until the doctor recommended I wear support socks. At first, I thought the swelling was a fluke, so I took off the socks and pledged not to wear them. But by the end of the day, after not wearing them, my ankles were heavy, blue and swollen.

“My feet were achy all the time. The meaty portions of my feet, especially my left foot, were always hurting. It almost felt like they were bruised, like I stepped on a stone, and my foot was on the stone at that instant. It always felt like somebody was pushing on the bottom of my foot with a rock, and not a smooth rock.

“I wasn’t able to run because it hurt too much, and I hadn’t done it for probably four years. But I promised myself I would someday get back to running.”

In addition to the pain and swelling she was experiencing in her feet and ankles, Elena also noticed a blue area on the inside of her left thigh that bothered her. The area was identifiable as a varicose vein. Elena’s husband encouraged her to have her leg examined, and her research brought her to Surgical Associates of Tampa Bay in Brandon, where she met Vijay B. Narasimha, MD.

“Elena came to us complaining of pain, swelling and heaviness in her ankles and feet, more so on the left side,” notes Dr. Narasimha. “She had a troubling varicose vein on her left leg as well.

“We went ahead and performed an ultrasound of her left leg, and it showed her great saphenous vein was incompetent, meaning there was significant reflux, or backward flow. The reflux started in the groin area, and there were also multiple incompetent branches associated with it. Because of this abnormal finding, I recommended treatment.”

Incompetent veins are those in which the one-way valves in the leg veins have weakened and can no longer keep the blood from flowing backward and pooling in the legs. Fluid that pools in the tissue of the legs is what leads to the symptoms of pain, swelling, discoloration of the skin and, of course, varicose veins.

“After the ultrasound, Dr. Narasimha said he could feel lumps under that varicose vein on my left thigh, and he said that my veins were really leaking,” states Elena. “I was somewhat surprised. I’m forty-six, and in my mind, varicose veins are a problem for people in their seventies or eighties. I chose to take care of this problem before I got any older.”

To treat the leaky veins in Elena’s left leg, Dr. Narasimha chose a minimally invasive procedure and scheduled it for mid April. Elena notes a quick turnaround in her condition.

“I started seeing results within two to three days of the procedure.”

Battling Leaky Veins

In the past, there was only one option to treat varicose veins, and that was to strip out the affected veins, reports Dr. Narasimha. Vein stripping is a serious and painful procedure that requires a long period of recovery and leaves an unsightly scar. Today, vein physicians have a variety of techniques that are minimally invasive, require little downtime and result in minimal to no scarring.

“One of these options, and the one I selected for Elena, is ablation,” Dr. Narasimha relates. “There are different techniques of ablation, including radiofrequency ablation and endovenous laser ablation.

“With radiofrequency ablation, radio waves are used to produce heat energy to shrink the incompetent veins. Laser ablation uses a laser to generate the heat and seal the veins. At my practice, I use radiofrequency to do ablations.

“I can’t say enough good things about . . . Dr. Narasimha and Surgical Associates
of Tampa Bay. Thanks to them, I feel like a new woman.” -Elena

“The primary reason is that patients who have had the treatment using the laser reported a little more pain and bruising post procedure. However, both techniques are safe and effective.”

Another treatment option is chemical ablation, also known as sclerotherapy, during which specialized medications called sclerosants are injected into the problem veins under ultrasound guidance. These medications shrink the targeted veins.

“Nowadays, we have even newer agents in our armamentarium for treating varicose veins,” notes Dr. Narasimha. “One very new treatment is a specialized glue to safely seal the veins. To use the glue, the physician places a small catheter into the target vein, injects the glue, which is a medication, then withdraws the catheter.

“Once the glue is injected and hits the warmth of the blood, it begins to thicken, and that shuts down the problem vein.”

Varicose veins are a very common condition, especially in women, informs Dr. Narasimha. The good news, he adds, is that they’re treatable.

“People don’t have to suffer from aching, heavy, swollen legs,” he says. “They also don’t have to risk the complications of leaky varicose veins, such as discoloration and thickening of the skin, eczema and ultimately ulcers.

“If varicose veins are treated, swelling and ulceration can be avoided. The discoloration, or pigmentation, can also be avoided. This is important because once the legs get that pigmentation, it’s permanent. It’s like a tattoo. The color will remain for life.”

Like a New Woman

When Dr. Narasimha told Elena that the pain, swelling and heaviness in her left ankle and foot were related to her varicose vein, she was surprised. She was shocked again when Dr. Narasimha’s radiofrequency ablation left her relieved of those symptoms.

Dr. Vijay Narasimha of Surgical Associates of Tampa Bay in Brandon treated Elena Tewmey’s varicose veins.

“I told my husband, This is absolutely amazing. It’s like my left foot isn’t even there,” she raves. “It’s wonderful.

“About two weeks after the procedure, I felt well enough to try a little jog. I didn’t plan to go fast, just do my two-mile jog around the neighborhood, and I made it. When I got in the house, my husband asked me how I felt. I told him my right foot hurt, but I didn’t even feel my left foot.”

Another thing that amazed Elena was how inadvertently she found out about her incompetent veins. For years, her symptoms consisted of the foot pain, and swelling and heaviness in her ankles. She assumed these symptoms were due to all the standing and walking she did with her family.

“I just had that one varicose spot on my left leg,” she comments. “Had I not seen that spot, I never would have known my symptoms were from a vein issue. I’m a mom. I’m always moving. I just associated my foot pain with being on my feet all the time.

“I think my age played a role in not getting my left leg checked out earlier. I felt that I was young, so the symptoms were not an issue. I also believed vein problems were not going to happen to me because they happen to older people. Now that I feel better, I wish I’d had my legs checked out sooner.

“I can’t say enough good things about my procedure, Dr. Narasimha and Surgical Associates of Tampa Bay. Thanks to them, I feel like a new woman.”

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