Good-Bye leg Pain

Laser energy repairs damaged veins.

Degeneration caused John Darnell’s spinal discs to begin collapsing, placing pressure on his spinal cord and nerves. To ease the pain that resulted, John tried a number of treatments, including physical therapy and surgery. The pain, however, outlasted all attempts to relieve it.

Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated John Darnell and Patti Adornetti for venous insufficiency and varicose veins using endovenous laser ablation (EVLA).

EVLA treatment relieved John of the heaviness and
swelling in his legs

“I had several treatments on my back, including two surgeries by a spine surgeon, and still had pain,” John confirms. “I was going to my family doctor, and he referred me to a specialist who began treating me for the pain in my back.”

John’s doctor referred him to Kai McGreevy, MD, a board-certified neurologist and pain management specialist at McGreevy NeuroHealth in St. Augustine. Dr. McGreevy uses a variety of techniques to relieve his patients’ pain.

“Initially, I was treating John’s back pain using medial branch nerve blocks, which provided some relief,” reports Dr. McGreevy. “We have now completed those nerve blocks, and we’re close to performing radiofrequency ablation (RFA) on his spinal nerves, which is the next step in his treatment.

“Before doing those treatments, however, while completing a full history and physical on John, he relayed that he was experiencing a little heaviness in his legs. Many times, that’s attributed to the spine, but upon inspection, I saw he had discoloration and swelling in both legs. He then told me that he had been experiencing cramping and fatigue as well.”

“When Dr. McGreevy first noticed my legs, he said, “They don’t look good,” John confirms. “He mentioned the discoloration and told me, That’s not a tan. It’s a circulation problem. Your legs are holding blood. He told me I had varicose veins, which surprised me because I didn’t have any bulging veins on my legs at all.

“My ankles swelled, particularly in the morning when I woke up and started walking, but as the day went on, I really didn’t notice it as much. I guess with activity, my blood started circulating in my legs. But when I would lie down in bed at night, the swelling would build up. I also had cramps in my legs, but it wasn’t a continuous problem.”

As part of the body’s circulatory system, leg veins have the job of pumping blood upward, against gravity, toward the heart. They get help from the power of leg muscle contractions. To further assist with this task, there are a series of one-way valves in leg veins that keep the blood from flowing in reverse, or refluxing.

“With age, heredity or long hours of sitting or standing, these valves can weaken, and blood can flow backward and collect in the legs and ankles, causing symptoms,” describes Dr. McGreevy. “This condition is called venous insufficiency.”

To diagnose venous insufficiency,
Dr. McGreevy performs a Doppler venous ultrasound examination that allows him to see the flow of blood from the legs toward the heart. In John’s case, the simple, noninvasive exam revealed significant venous insufficiency in both legs.

Dr. McGreevy responded by recommending John wear compression stockings for about four weeks to help eliminate the swelling and heaviness in his legs. The stockings had little effect, however. At that point, Dr. McGreevy knew a new course of action was necessary.

“I sat down with John and discussed his entire scenario with him,” describes the doctor. “We developed a game plan for his leg veins.”

Symptom Reliever

The treatment plan for John’s legs included a procedure called endovenous laser ablation, or EVLA, in which the doctor introduces a sterile laser fiber into the problematic vein via a tiny puncture in the leg.

During EVLA, laser energy is delivered through this fiber, gently collapsing and sealing the vein. Blood flow from the sealed vein then reroutes through other, healthy veins in the leg, which reduces the impact of venous insufficiency on the patient.

“EVLA relieves the symptoms, including pain, swelling, fatigue, itching and weakness,” notes Dr. McGreevy. “It also improves the aesthetics of the legs, reducing any discoloration and breakdown of the skin, as well as the appearance of varicose and spider veins.”

“Getting those test results prompted me to make an appointment to have the laser treatment on my right leg, and after I made the appointment, I picked up a brochure about it on the way out of Dr. McGreevy’s office,” John notes.

“The brochure explained everything about venous insufficiency, and it verified everything Dr. McGreevy told me. When I returned to his office in St. Augustine and had the procedure done, it was painless.

“After rubbing my skin with a solution to deaden the pain, a technologist put needles in my leg. He had a scope that traced the vein Dr. McGreevy wanted to block off, then he injected it with numbing medicine.

“After that, Dr. McGreevy came in and performed the laser treatment. There was a little bit of a burning sensation, but it was bearable. Afterward, they wrapped my leg in ACE bandages. I had the treatment on a Thursday and had to keep the ACE bandages on with compression until Sunday, then I could take the bandages off.”

“We performed EVLA on both greater saphenous veins in John’s legs, and he experienced significant physical improvement,” Dr. McGreevy says. “John was pretty amazed by how much better his legs felt as well. He had reduced discomfort in his legs with less fatigue, swelling and cramping.

“Sometimes, when we perform EVLA, it takes a little while for the results to be fully realized by patients. In John’s case, however, he had a very quick response. Within a week of performing EVLA on his right greater saphenous vein, he indicated he already started to feel a difference in his right leg.”

Prevalent Problem

Venous insufficiency is a very common condition. It is estimated that more than 30 million Americans suffer with symptomatic venous insufficiency. Venous vascular disease is five times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated John Darnell and Patti Adornetti for venous insufficiency and varicose veins using endovenous laser ablation (EVLA).

Patti has resumed her
fitness-oriented lifestyle

Symptoms of venous insufficiency include pain, aching, swelling, heaviness, nighttime cramps, restless legs, discoloration and, in later stages, skin ulceration, but it’s “hugely underdiagnosed,” asserts Dr. McGreevy. Symptoms are often attributed to other disorders.

“Symptoms of venous insufficiency, the things that can be felt by the patient, can result in sensory changes such as numbness, tingling, weakness and fatigue,” he states. “These are all things patients describe to me every day when I examine them and perform nerve conduction studies.

“These symptoms may appear neurologic at first glance, but there’s no perfect box they fit into, so I don’t make assumptions that they’re caused by nerve injury. If I test and discover these symptoms are not nerve related, they can be generated from multiple sources.

“If these symptoms are accompanied by visible signs such as swelling in the legs, I look at other possible sources. I have to rule out a cardiac condition such as heart failure, as well as a liver condition, protein imbalance and other disorders that can lead to leg swelling.”

In the absence of those sources, Dr. McGreevy continues, there’s a high index of suspicion for venous insufficiency, the treatments for which are generally covered by insurance. They’re covered not just for pain relief, but also for prevention because there are complications that can occur later in life that are very expensive to treat.

Wholehearted Trust

In 2015, Patti Adornetti was involved in a serious auto accident that left her badly injured and ended her career as a high-production print specialist for Xerox® Corporation. The Cleveland, Ohio native suffered severe pain in her legs and back, which required surgery, and eventually, she turned to Dr. McGreevy for help with pain management.

Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated John Darnell and Patti Adornetti for venous insufficiency and varicose veins using endovenous laser ablation (EVLA).

Patti Adornetti

“I’ve been Dr. McGreevy’s patient for going on two years,” shares Patti. “The doctor who performed my back surgery recommended him.”

During that two-year period, Dr. McGreevy used several pain management techniques to help keep Patti’s back pain at bay. At the same time, however, Patti was being bothered by another uncomfortable issue.

“Over the years, I developed pain in my legs, and about a year and a half ago, the varicose veins on my legs started to become more and more intense,” she relates. “The discomfort was becoming intense as well.

“The pain was mostly a tired and achy feeling, but it became more of a stabbing pain at night, especially when I was trying to sleep. During the day, my legs ached and felt heavy, like their weight had doubled.

“As the pain got worse, I had to give up doing some of the activities I used to do routinely. It became difficult for me to do things I liked, including kayaking, walking and riding my bike.”

One day, while driving to McGreevy NeuroHealth for a pain management appointment, Patti saw a message about varicose veins, and it got her thinking. That day, as she talked with Dr. McGreevy, she casually said, “I want to do something about my varicose veins.” In response, the doctor explained that he treated vein concerns as well as nerve disorders.

“It was just a coincidence,” comments Patti. “I only said something because I saw that message. After he told me he did vein treatment as well, I told him, Good. I’ll have you take care of my veins, because I trust him wholeheartedly.”

Just as he did with John, Dr. McGreevy began his treatment of Patti’s veins with a Doppler ultrasound examination. The examination revealed that Patti, too, was suffering from significant reflux in her superficial veins and was therefore a good candidate for EVLA.

“At the time of the procedure, the technologist did the preparation, such as numbing the area, and then Dr. McGreevy stepped in and took care of the veins,” Patti reports. “He used a laser to treat the veins and relieve the pain.

“The procedure wasn’t bad at all. The worst part of it was when they numbed me because they had to give me several shots to numb the area around the veins. I couldn’t even feel it when Dr. McGreevy came in and did his part. I didn’t feel any real pain after the treatment, either.”

Miraculously Successful

John’s right leg didn’t look much better that Sunday after his first EVLA, but it did by the following week, when he returned to McGreevy NeuroHealth to have the treatment on his left leg.

“My right leg cleared up miraculously,” John raves. “It was very clear and had lightened up considerably compared to the leg Dr. McGreevy hadn’t treated yet. When I first went into the office, the receptionist said, Look what happened here. I walked into the little staff area, and everybody looked at my right leg and said, Wow!

Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated John Darnell and Patti Adornetti for venous insufficiency and varicose veins using endovenous laser ablation (EVLA).

John shows off some of his stained glass handiwork

“I looked at my leg and said, Gee, I really did have a problem. I didn’t know the problem with heaviness in my legs was that bad, but since I had the procedures on my varicose veins, my legs are a lot lighter and I can walk much better. I must have gotten used to the heaviness. I don’t have the swelling anymore, either.

“And all this time, Dr. McGreevy is still treating my back pain.”

The EVLA was a success for Patti as well. She reports that her legs feel good since the treatment. She’s also very pleased with the aesthetic results she’s achieved so far, and
Dr. McGreevy told her it will only get better. He said it will take about a year for her legs to be completely healed and functioning optimally.

“My legs look great,” she marvels. “My right leg had very big, bulging veins, and they’re completely gone. There are no varicose veins in my right leg at all. My left leg had bad veins as well. There are still a few little pieces of vein visible on my left leg, but they will eventually work their way out once everything has properly healed.

“The pain is phenomenally better than it was before. I would say it’s about a two out of ten now, when it used to be seven or eight.”

With Dr. McGreevy managing her back pain and since achieving relief from the achiness of her varicose veins, Patti’s been able to return to her active lifestyle. She’s thrilled because she likes to stay active for fun and fitness.

“I’m back to doing the activities I had to stop doing before,” she confirms. “Now, I’m finding it easier to walk and bike again.”

John and Patti are impressed by Dr. McGreevy and his staff at McGreevy NeuroHealth. They find the neurologist to be knowledgeable, kind, understanding and worthy of their trust.

“Over the years, I had a knee replacement and a broken ankle that was due to my back and loss of balance,” offers John. “I went to physical therapy for both of those conditions. Nobody noticed I had a problem with my leg veins
except Dr. McGreevy.

“My EVLA procedures were absolutely, in capital letters, successful. I recommend EVLA for varicose veins, and I recommend McGreevy NeuroHealth and Dr. McGreevy. I have complete confidence in him.”

“Everybody at McGreevy NeuroHealth is great,” adds Patti. “I think Dr. McGreevy is a fantastic doctor. He listens to me. Of all the doctors I’ve been to over the years, he’s definitely one of the best. I wouldn’t have gone to another doctor. Dr. McGreevy is definitely the only doctor I would let touch my legs. He’s a great physician, and I recommend him one hundred percent!”

Print This Article
    • McGreevy Neuro Health

      Your neurological health is nothing to worry about when you visit McGreevy NeuroHealth, conveniently located between Saint Augustine and Jacksonville, Florida. Their facility hosts a qualified interventional pain physician who is also a board-ce... Read More

    • Kai McGreevy, MD

      Kai McGreevy, MD, is board certified in neurology and pain medicine by the American Board of Psychiatry and Neurology. His medical training includes completion of a neurology residency at the University of California, San Diego, and an interven... Read More