Laser Specific

Nonsurgical procedure relieves pain and improves appearance of varicose veins.

Pittsburgh, Pennsylvania native Robert Vamos spent a career in the supply end of the automotive industry in Michigan before retiring in 2012 and relocating to Florida. Here, he started a new career in real estate. But showing properties became somewhat uncomfortable when he began experiencing numbness and aching in his feet and legs.

 Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated Robert Vamos and Patti Adornetti for venous insufficiency and varicose veins.

Free of leg pain, Robert can walk Layla again

“I contracted a disease from Type 2 diabetes called Charcot foot syndrome, which is a type of neuropathy, or loss of sensation, in my legs and feet,” says Robert. “As a result, I lost the arch in my right foot. And for some reason, my legs always ached terribly after that.

“My podiatrist referred me to Dr. McGreevy, and he ran a bunch of tests on me. He determined that the nerves in my L4 and L5 lumbar vertebrae were pinched. I wasn’t having any pain in my back, just a little stiffness maybe, but Dr. McGreevy said the pinched nerves were contributing to the aching pain in my legs.”

Kai McGreevy, MD, is 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. For Robert, he recommended a nonsurgical procedure called radiofrequency ablation.

During radiofrequency ablation, radio waves are used to produce heat that is delivered through a probe to the target spinal nerves. In Robert’s case, the target was the nerves exiting the spinal cord near the vertebrae of his lower back. The heat from the probe creates a spot on the nerves that impedes the transmission of pain signals to the brain. This reduces discomfort from the affected area of the spine.

“Dr. McGreevy said he hoped to avoid surgery for me, and he wanted to try the radiofrequency procedure to put the pinched nerves to sleep,” confirms Robert. “He said the pain relief would last from six months to two years. For me, it lasted a year and a half. Just recently, my legs started hurting again, and he gave me a second radiofrequency treatment. Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated Robert Vamos and Patti Adornetti for venous insufficiency and varicose veins.

“This time, however, he noticed a varicose bump on my right leg and didn’t like the way it looked. He said, I’ve done artery studies and nerve studies, so let’s do a vein study. He did and found that the veins in both of my legs weren’t working properly. He also detected swelling in my ankles, which he said would have been worse if I wasn’t swimming a mile every day.”

Leg veins are responsible for 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 the leg veins that keep the blood from flowing in reverse.

“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.”

Venous Diagnosis

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.

Its symptoms include pain, aching, swelling, heaviness, nighttime cramps, restless legs, discoloration and, in later stages, skin ulceration, but it is “hugely underdiagnosed,” according to Dr. McGreevy.

“Many of its symptoms are invisible and misunderstood by patients,” the doctor notes. “In some cases, the condition is misdiagnosed by physicians, who attribute the signs and symptoms of venous disease to different disorders.”

Treating veins was a natural evolution for Dr. McGreevy. Many symptoms of venous insufficiency mimic those of other disorders, including neurologic problems. Dr. McGreevy often sees patients who come to him with “nerve” issues that turn out to be venous disease, so he is trained to treat vein issues and nerve conditions.

“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 acknowledges. “These are all things patients describe to me every day when I examine them and do 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, there’s a high index of suspicion for venous insufficiency, the treatments for which are generally covered by insurance. And 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.”

After seeing some of the visible signs of venous insufficiency and learning that Robert was also experiencing aching and heaviness in his legs, Dr. McGreevy performed a Doppler venous ultrasound examination that allowed him to see the flow of blood from Robert’s legs toward his heart

 Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated Robert Vamos and Patti Adornetti for venous insufficiency and varicose veins.

Robert Vamos

The simple, noninvasive exam revealed what Dr. McGreevy described as “significant reflux” in Robert’s legs. He then suggested that Robert undergo 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.

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.

“It relieves the symptoms, including pain, swelling, fatigue, itching and weakness,” explains 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.”

Robert says he has a very strong will, and as a result, he refused to let any of the symptoms caused by his venous insufficiency alter his active lifestyle. As soon as the EVLA treatment was completed, however, he realized how easy it was to relieve the pain and discomfort associated with the disease.

“Dr. McGreevy did the procedure right in his office, and there was very little discomfort associated with it,” verifies Robert. “I could have walked right out of his office and gone to the golf course. I didn’t need to take any pain medication or anything like that. Afterward, I had to wear compression stockings for a couple of weeks, but that was it.”

“I Trust Him Wholeheartedly”

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.

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

 Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated Robert Vamos and Patti Adornetti for venous insufficiency and varicose veins.

Patti has been relieved of both her back and leg pain.

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 states. “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 Robert, Dr. McGreevy began his treatment of Patti’s veins with an 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. Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated Robert Vamos and Patti Adornetti for venous insufficiency and varicose veins.

“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.”

Robert and Patti were already seeing Dr. McGreevy for pain management when their venous insufficiency was detected. In Robert’s case, the aching pain in his legs had two contributing factors – his varicose veins and the pinched nerves in his back.
Dr. McGreevy treated both factors, and Robert responded positively. His pain was alleviated, and the swelling in his legs dissipated.

I feel great right now,” he enthuses. “I no longer have any of that aching pain in my legs. I achieved really good results. But, I had both the radiofrequency ablation and my veins treated at the same time, so if you ask me which one helped me more, I couldn’t tell you. I just know the combination of the two really helped.

“Dr. McGreevy told me the radiofrequency ablation can be repeated if necessary, but the results of the vein treatment will last forever. I go back in another week, and Dr. McGreevy will perform another ultrasound of my legs to be sure the veins are no longer leaking.”

Back on Track

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.

 Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated Robert Vamos and Patti Adornetti for venous insufficiency and varicose veins.

Patti Adornetti

“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,” she raves. “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.”

Both Robert 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.

“Dr. McGreevy is a wonderful doctor,” states Robert. “He’s very gentle, and he explains everything he’s doing as he goes along. He’s a pain specialist, and as people get older, a lot of us get different kinds of pain in our bodies that Dr. McGreevy can treat. I recommend him to anybody, and I already have to numerous people.”

“Everybody at McGreevy NeuroHealth is great,” notes 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!”

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    • 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. The American Board of Independent Medical Examiners also certifies him. His medical training includes completion of a neurolog... Read More