Missing Out?

Vein disease can rob you of the joy of life.

Lisa Sulen is a stay-at-home mom of four boys. She had her sons in two stages. Her older boys are ages 21 and 19, the younger are three and one. The native of England developed spider veins in her legs when she was pregnant with her older boys. But when she was pregnant with her youngest son, she suffered more serious issues with her legs.

Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Lisa Sulen for venous insufficiency.

Lisa Sulen

“With my last son, I started experiencing restless legs, and it got to a point where I couldn’t exercise, which I like to do,” Lisa describes. “I actually couldn’t do anything. It was painful just to bend. I thought maybe once I lost the baby weight, the pain would go away.

“But after I gave birth, I still had the restless legs. I still couldn’t exercise, and I couldn’t sleep. It felt like somebody was at the end of my bed pulling on my legs. I tossed and turned all night. The pain I felt wasn’t just at night. I felt it during the day as well.

“I couldn’t even get up off the floor because of the pain. This was after the pregnancy as well, not just during. I had to get on my knees and push myself up in order to stand. I thought the extra pregnancy weight was playing on me somehow, but that didn’t make sense. A lot of people are the same weight as me, and they’re not having issues getting up.

Lisa put up with the pain and discomfort in her legs for about a year following the birth of her youngest son, but it eventually became so intense, she couldn’t take it anymore. That’s when she turned to the physician she had trusted to treat her spider veins, Joseph G. Magnant, MD, of Vein Specialists in Fort Myers and Bonita Springs.

Dr. Magnant is a board-certified vascular surgeon. At Vein Specialists, he is dedicated to the comprehensive, modern evaluation and most-advanced minimally invasive treatment of vein disorders.

“I figured Dr. Magnant would tell me to wear compression hose or something simple like that,” Lisa states. “But he checked my legs and said, No. There’s more involved than simply restless legs. He told me there was something going on with the veins in my legs.

“Until I went to Vein Specialists, I didn’t realize there was something wrong with my veins that was causing the restless legs and pain. I thought it was just my weight and being pregnant so many times.”

Failing Valves, Leaking Veins

The problem Lisa had with her leg veins stemmed from a condition known as venous insufficiency. This condition occurs when the tiny valves in the leg veins that keep blood flowing in one direction, toward the heart, begin to fail. As a result of that failure, blood leaks backward and pools in the legs and ankles. The collection of blood leads to symptoms such as varicose veins, swelling, heaviness and restless legs.

“Lisa is a young woman who had severe venous insufficiency in both legs and was unable to do many of the activities she enjoys, including running and exercising, because of the heaviness, achiness and feeling of restless legs,” Dr. Magnant observes. “These symptoms were interfering with her ability to function at one hundred percent, so she couldn’t be her best.”

The first step Dr. Magnant took in his evaluation of Lisa was to perform an ultrasound examination to identify the problem veins in her legs. Once that was done, Dr. Magnant recommended two minimally invasive procedures, endovenous ablation and phlebectomy to close off Lisa’s leaky blood vessels and remove her bulging veins.

“During endovenous ablation, we guide a very thin catheter through a tiny needle placed in the vein via a small puncture in the leg,” Dr. Magnant explains. “Using either radiofrequency or laser energy, we gently collapse the diseased veins, which are eventually absorbed by the body.

“During phlebectomy, we make a series of small nick incisions in the skin around the bulging varicose veins, which we numb first. We insert a special instrument with a tiny hook on it though the incisions and remove the varicose veins in small sections. After both procedures, blood flow reroutes through nearby, healthy veins.”

Happy Anniversary

For many years, patients and physicians alike considered venous disease, with its bulging varicose veins and swollen legs, to be strictly a cosmetic concern. Physicians now know better.

“Fortunately, we now understand that venous disease is a medical condition much like high blood pressure and high cholesterol,” Dr. Magnant notes. “We know when we identify it, we should, whenever possible, treat it. We should at least investigate it because it can rob patients of the things they enjoy.”Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Lisa Sulen for venous insufficiency.

Dr. Magnant’s modern attitude toward venous disease wasn’t always the opinion of others. Even now, venous disease is not fully understood by many patients and physicians. Patients with symptoms of venous disease are often advised to wear compression hose but do little else to address their condition.

“In many cases, patients are told by their doctors to do nothing until a complication arises,” Dr. Magnant relates. “I think that’s not the best advice. Two common complications of venous disease are thrombosis, or clotting of a leg vein, and hemorrhaging, or bleeding from the leg veins.

“The final complication is what we call stasis dermatitis. That’s when the skin turns hard, inflamed and discolored, especially just above the ankle. Then, a small trauma such as a bump, scratch or dermatologic biopsy occurs in that unhealthy skin, and it becomes an open wound. It becomes a venous ulcer, which is a serious complication.”

Before 1999, there was little hope for people with vein disease to return to their normal, enjoyable activities. Back then, the only treatment physicians had for venous disease was vein
stripping,
a major surgical procedure performed in a hospital under general anesthesia.

“Vein stripping was morbid,” Dr. Magnant asserts. “Patients had to be in the hospital for a couple of days, and there was significant risk of blood clots afterward. There were generally large scars as a result as well. Because of this, we hardly ever treated patients with vein disease before 2000.

“But in 1999, endovenous thermal ablation was introduced, which offered a minimally invasive solution to the roughly fifty million Americans with venous insufficiency. With the introduction of endovenous sealing with heat, and now with glue, we’re able to be more proactive dealing with venous disease.”

This year, 2019, marks the 20th anniversary of endovenous thermal ablation. Today,
Dr. Magnant and his staff can investigate vein disease, then identify and treat it in its earlier stages to avoid complications. He likens it to treating high blood pressure to reduce the risk of hardening of the arteries, which, as a result, reduces the risk of heart attack and stroke.

The treatment worked for Lisa, who underwent her first vein surgery within two weeks of her initial appointment with Dr. Magnant. A second surgery was performed on the other leg two weeks later.

“Before we began, Dr. Magnant explained everything about the procedures, but during the surgeries, I asked him to walk me through the different steps,” Lisa explains “He said, Okay, I’m getting ready to do this, so just take a deep breath and relax. That was very comforting.”

A Spin on Pain Relief

Lisa was instructed to wear compression hose continuously for the first 48 hours following her procedures. After that, she wore the hose only during the day. Lisa believes the compression hose helped, and she was amazed by how good her legs felt and how quickly the pain and discomfort disappeared.Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Lisa Sulen for venous insufficiency.

“I began to feel some relief within the first week of having my first leg done,” she shares. “By the second week, when I was down to wearing the compression hose just eight hours a day, I noticed a real difference. I thought, Wow, my legs are actually not hurting. My legs are great now. I could do cartwheels. I don’t have any pain at all. I don’t even have restless legs.

“Sleeping is good. It’s back to what I would call normal. I’ve got a one-year-old, so he wakes up, but I’m not waking up at night with pain in my legs. The issue I was having getting up off the floor is like it was never there. It’s really bizarre. There’s no pain in that area.”

With her restless legs and pain now a thing of the past, Lisa has returned to her exercise regimen. The treatments for her venous insufficiency gave her back the things she enjoys.

“I’m back to exercising,” she confirms. “I’m taking spin classes now, and I signed up for a Peloton® spin class. I definitely recommend Dr. Magnant and his procedures to anyone with vein problems.”

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    • Vein Specialists

      Vein Specialists is 100 percent dedicated to identifying and treating vein disorders. Led by Dr. Joseph G. Magnant, they understand that the venous system varies between patients and consists of both deep and superficial venous systems and a net... Read More

    • Joseph G. Magnant, MD, FACS, RPVI

      Joseph G. Magnant, MD, FACS, RPVI, is a Fellow of the American College of Surgeons and is board certified by the American Board of Surgery in vascular surgery. He earned his medical degree from Medical College of Virginia. He completed a g... Read More