Leg Pain? Varicose or Spider Veins?

Take the first step toward relief.

Tim Bloczynski has dedicated his entire career to his country. First, he served in the military, then he worked for years as a civil servant with the US government. The Wisconsin native long suffered nagging issues with his legs, which only got worse when he retired and moved to Florida.

Nestor Guerrero, certified nurse practitioner, and staff at Premier Vein Institute in Tampa treated Tim Bloczynski for venous insufficiency in his legs.

The discoloration on Tim’s legs is still there, but better than it was.

“I had problems with my legs for years,” he shares. “They would swell up, and they felt like bricks when I walked. Eventually, they became very discolored.”

Tim noticed his symptoms would be worse by the end of the day. His legs became heavier, making it uncomfortable to walk, and the swelling increased. He found ways to reduce the swelling somewhat, from time to time, but it always returned.

“I have an adjustable bed, and I would put up my legs at night,” he describes. “That seemed to help drain the blood out of my legs so the swelling would go down. But it would just come back the next day.”

While the heaviness and discoloration in Tim’s legs were newer developments, the swelling had been a problem for him for a long time. He remembers how it began about 15 years ago.

“At first, I thought it was caused by my knee. It started after I suffered a sports-related injury when I got hit in the knee with a ball,” he shares. “I thought it burst the bursa sac, and blood was leaking down my leg. The swelling was only in my right leg at that time.

“After a while, though, the swelling started to show up in my left leg as well. But I’m one of those people who doesn’t go to the doctor unless the problem is really bad.”

It finally got bad enough. Tim became so distressed by his symptoms that he made an appointment with his primary care physician. The doctor was astute and realized Tim’s symptoms were likely related to a problem with the veins in his legs. He believed Tim needed a specialist in vein disorders. He recommended Premier Vein Institute in Tampa.

“My first impression of Premier Vein Institute was that it’s a very professional organization,” relates Tim. “I always suspected varicose veins might be the problem, but I didn’t have any visible signs of those. But they explained that the signs are not always obvious, as in my case, and there are many different signs of vein problems other than bulging veins.”

The staff at Premier Vein Institute performed an ultrasound evaluation of Tim’s legs. It revealed leaking valves in his veins, which caused excess pressure and pooling of blood in his lower legs. This is a condition known as chronic venous insufficiency, or CVI.

“The ultrasound examination we performed on Tim was bilateral [both legs] and diagnostic for CVI,” notes Nestor Guerrero, ARNP, certified nurse practitioner at Premier Vein Institute. “Most ultrasounds patients get from their physicians look for the presence of deep vein thrombosis [DVT]. We also check for DVT, but we go a step further and examine how blood is actually flowing in the legs.”

Symptom Evaluation

Sometimes, people with CVI have bulging varicose veins or spider veins, but that’s not always the case. CVI can also be present with no visible signs. Instead, symptoms might include pain, cramping, heaviness in the legs, burning, tingling and even the loss of sensation from neuropathy.Nestor Guerrero, certified nurse practitioner, and staff at Premier Vein Institute in Tampa treated Tim Bloczynski for venous insufficiency in his legs.

“Tim did not have visible varicose veins, but he did have swelling and discoloration, which are visible signs. He also had some invisible symptoms such as discomfort, a heavy feeling in his legs, numbness and tingling,” observes Nestor. “In addition, he had a history of skin ulcers, which is a sign of advanced venous insufficiency.”

The ultrasound evaluation performed on Tim by the Institute’s vascular technologist focused on Tim’s superficial veins, such as the saphenous veins. Saphenous veins run up the leg, from ankle to thigh/groin. They are most often the primary sites of CVI.

“Blood in leg veins flows upward against gravity, so they contain valves to keep the blood from flowing backward,” explains Nestor. “Occasionally, due to genetics, age, profession, trauma, surgery or life in general, those valves start malfunctioning.

“In Tim’s case, blood was not flowing in the proper direction in his saphenous

veins, which allowed blood to pool in his lower extremities.

Symptoms developed from the increased venous pressure, which caused the blood to seep outside of the veins, irritating the surrounding tissues.”

Symptoms of CVI in its early stages include cramping, swelling, heaviness and pain. Without treatment, more severe CVI can develop, which can cause more serious symptoms such as discoloration, breakdown of the skin and ulceration. With potentially dangerous consequences, CVI is much more than a cosmetic concern.

After Tim’s ultrasound evaluation confirmed CVI, Premier Vein Institute’s knowledgeable staff described his next steps. First, they explained the condition that was causing the swelling, heaviness and discoloration in his legs.

“Evidently, at different points in your veins, you have valves that open and close,” he offers. “When a vein pumps upward, the valves are supposed to close to stop the blood from going back down. My valves weren’t closing correctly, so blood was settling in my legs.

“They then explained the procedures they were going to do to fix the problem. The first is called an ablation. They heated the veins to close them. With the other procedure, they injected the veins with a solution.”

Directed Treatment

Patients who come to Premier Vein Institute often have tried conventional therapies to treat the aggravating symptoms in their legs, without success. These therapies might include leg elevation, wearing compression stockings to reduce swelling and taking over-the-counter medicines, such as acetaminophen and ibuprofen, to relieve cramping and pain.Nestor Guerrero, certified nurse practitioner, and staff at Premier Vein Institute in Tampa treated Tim Bloczynski for venous insufficiency in his legs.

In most cases, however, an ultrasound evaluation shows CVI, which generally does not respond to conservative measures. CVI requires medical treatment, which is covered by most insurance.

“For patients with chronic venous insufficiency, we close the diseased veins and let blood be redistributed to veins that are working properly,” informs Nestor. “To do that, we typically use two procedures, ablation and ultrasound-guided sclerotherapy.

An endovenous laser ablation (EVLA,) takes roughly 30 minutes and is performed as an outpatient procedure. It involves minimal pain, no scarring, a quick recovery and immediate return to activities.

Ultrasound-Guided Sclerotherapy (UGS) is used primarily to treat the small vein branches that exit the saphenous vein. With this treatment, a solution is injected into the vein. The solution dissolves the small veins.

Following the procedures, patients are urged to continue wearing compression stockings for a short time. Patients can return to normal activities immediately afterward and are encouraged to increase their activity, which helps maintain the circulatory benefits of the procedures.

“With these procedures, we essentially restore good blood flow to the legs,” asserts Nestor. “About a week post-op, we do a follow-up ultrasound to ensure everything is going well and blood is flowing smoothly. We also tell patients they should stay active.”

At Premier Vein Institute, treatment for chronic venous insufficiency is easy, with no downtime. As long as patients stick to their recommended post-procedure treatment plans, they will achieve excellent results. Treatment for venous insufficiency, a medical condition, is covered by most insurance.

Painless Results

Tim agrees the treatment for his CVI was easy. He describes his experience with the ablation and UGS.Nestor Guerrero, certified nurse practitioner, and staff at Premier Vein Institute in Tampa treated Tim Bloczynski for venous insufficiency in his legs.

“The procedures were not difficult, and they weren’t painful. They felt like getting shots,” he reports. “When they were doing the ablations, I felt a little pressure, a little prick and a little heat.”

The ease of the treatment made Tim happy, but the results thrilled him even more. He’s still recovering, but already he’s seeing a tremendous difference in the way his legs look and feel.

“The swelling is not completely down, but my legs don’t swell up nearly as much as they used to,” marvels Tim. “My ankles used to get very round, like a softball, and they don’t get that big anymore. I’d say the swelling is about eighty percent gone already. And my legs don’t feel as heavy, so I can walk better than I used to.

“The discoloration is also going away. I still have some, but it’s not nearly as bad as it was. Now, I’m not ashamed of my legs. They’re not ugly.

“The treatment was a success. I need to go back for a follow-up ultrasound in a couple of months, but after the last one, they said my legs looked good.”

Not only is Tim delighted with his results, he’s pleased with his entire experience at Premier Vein Institute. He’s more than willing to share his thoughts about the Institute and its staff.

“It’s a really good organization,” says Tim. “The staff is friendly, and they’re very professional. Nestor was good; everyone there who worked with me was top-notch. I recommend Premier Vein Institute to anyone!”

FHCN article by Patti DiPanfilo. Photo by Fred Bellet. First set of before and after images courtesy of Premier Vein Institute.Photos from istockphoto.com. mkb
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