Modern Procedures, Old-Fashioned Attention

New-age treatments re-kindle active lifestyle.

Five years ago, Susan Schultz retired from her career as an accountant and relocated to Florida to escape the cold and snowy winters of her native Maryland. For fun and something to do in her retirement, Susan went to work part-time selling steel buildings and sheds. What wasn’t fun for her were the uncomfortable issues she was having with her legs.

Photo by Jordan Pysz.

Susan Schultz

“I’ve had problems with my legs for seven or eight years at least,” she shares. “I got leg cramps in the middle of the night. They’d be so bad, they’d wake me up. There was discoloration of my legs, and there was swelling. I tried the usual things to ease the swelling, such as elevating my feet and taking naps. Nothing seemed to help.
“My legs also itched. I drove myself crazy trying not to scratch the itching in my legs.”
The problems with Susan’s legs just got worse over time. Earlier this year, symptoms of aching, fatigue and swelling progressed to the point where she was unable to perform some of her favorite activities.
“I couldn’t do a lot of the things I like to do because my legs would start to hurt,” Susan confirms. “I like to ride my bike and do a lot of gardening, but I found I couldn’t be on my feet for very long. I love to bake and make candy, but that takes a lot of standing, so I couldn’t do that anymore because I was always uncomfortable.”
When Susan still lived in Maryland, she sought help for her legs from her primary care physician, but the doctor brushed her off and told her the issue was nothing to worry about. Susan worried nonetheless. When she moved to Florida, she looked again for answers to her leg problems, and found them in the pages of a local newspaper.

“If anyone looked at my legs today, they’d never know I had a problem.” – Susan

“I saw an article in Florida Health Care News about Dr. Sharma and Premier Vein Centers,” she relates. “I said, I’m going to go there for an opinion on my legs. I did, and it was the best thing I’ve ever done in my life.”
Premier Vein Centers is the practice of Ravi Sharma, MD, a board-certified cardiovascular surgeon with expertise in blood vessel disorders of the legs. Premier Vein Centers has offices in Homosassa and The Villages®.
As a cardiovascular surgeon, Dr. Sharma spent many years working with the intricate blood vessels surrounding the heart. Now, he focuses his practice full-time on treating patients with venous disease of the legs. As soon as Susan met Dr. Sharma, she was thoroughly impressed by the cardiovascular surgeon.
“I absolutely loved him,” she raves. “He explained everything that could possibly be going on with my legs. He knew what he was talking about. And I didn’t feel rushed. He made me feel like I was important, that I mattered. I’ve never had a doctor who made me so comfortable because I had so much confidence in him.
“Dr. Sharma explained that the valves in my leg veins were not working properly and were not permitting the blood to pump back toward my heart. Instead, the blood was leaking back down into my legs, and that’s what was causing the cramping, tiredness and heaviness.”
The condition that results in weakened and leaking valves is called venous insufficiency. Using ultrasound imaging, Dr. Sharma confirmed that Susan had venous insufficiency in both legs. He recommended two advanced, minimally invasive procedures to treat Susan’s condition.
Dr. Sharma performed a thermal treatment, endovenous laser ablation, and then supplemented it with the latest technology for smaller veins called VenaSeal. VenaSeal is a non-thermal closure system that relieves symptomsby delivering a small amount of a specially formulated medical adhesive to the diseased vein. This permanently seals the vein, and blood is rerouted through nearby healthy veins.
“First, Dr. Sharma used a laser treatment, where he went into the vein and actually closed it off so the blood supply would go through other veins in my legs,” Susan states. “He also performed a new procedure on the smaller veins where he injected an adhesive that glued the veins shut.
“When he was finished, he wrapped my legs and said, Have fun today. I never expected it to be that easy. I really thought I’d be on crutches or have to be hospitalized, but everything was done in his office.
“Dr. Sharma explained what he was doing and what I should expect every single step of the way. He even sympathized when I didn’t want to wear the compression stockings, but he explained that it’s part of the treatment.”

Circulatory Condition

The human circulatory system is composed of an intricate series of blood vessels. Veins are the blood vessels that return oxygen-depleted blood back to the heart. There are three types of veins: superficial veins, deep veins and perforating veins. Superficial veins lie close to the skin, deep veins lie in groups of muscles, and perforating veins connect the superficial veins to the deep veins.
“Venous insufficiency is a condition in which the leg veins cannot pump blood back to the heart,” explains Dr. Sharma. “Chronic venous insufficiency, or CVI, has multiple causes. Over long periods of sitting or standing, the blood in leg veins can pool. This increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves. Damaged valves prevent proper blood flow back to the heart.”

Photo by Jordan Pysz.

Susan is standing pain free following her treatment at Premier Vein Centers.

Venous insufficiency has many signs and symptoms. Signs are the issues that can be seen, such as bulging varicose veins, swelling, and thickening and discoloration of the skin of the ankles or legs.
Symptoms are those things that are felt but not seen. They include throbbing, aching, stinging, burning, itching, heaviness, nighttime leg cramps and restless legs. These are all indications that the veins are not functioning properly.
“It is important that patients who experience any of these signs or symptoms have their veins assessed,” stresses Dr. Sharma. “Leaving the condition untreated can lead to more serious difficulties, including leg ulcers, infection and a breakdown of the skin.

Modern Techniques

At Premier Vein Centers, a full range of advanced, minimally invasive treatment options for addressing varicose and spider veins is available. These treatment options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and the new, non-thermal procedure, VenaSeal.
Microphlebectomy has replaced stripping, an outdated, more involved procedure when doctors treated the large veins by making big gashes across the leg that often left the patient with large scars.
“With microphlebectomy, the incision is tiny – about the size of the tip of a scalpel – and we can do much more through that small incision,” Dr. Sharma asserts. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”
During EVLA, a sterile laser fiber is introduced into the incompetent vein via a small puncture in the leg. Laser energy is then delivered through the fiber, painlessly closing the vein in less than an hour, using local anesthesia.
Sclerosing injections are used to treat spider veins, which are tiny, dilated blood vessels in the skin that become swollen with stagnant blood. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injections that gently close the problem vessels.
VenaSeal is a non-thermal procedure using a proprietary medical adhesive delivered endovenously to close the vein. This procedure does not require multiple needle sticks and, in some cases, support stockings aren’t necessary, as well as having other benefits.

“If anyone needs to have something like this done, they have to see Dr. Sharma. He walks on water as far as I’m concerned. He’s just marvelous.” -Susan

Dr. Sharma uses his expertise to determine which procedures to use based on each patient’s symptoms and health status. These advanced treatments are all performed in a comfortable office setting and result in little or no downtime and discomfort.
“Our patients are often very relieved to discover that there is no general anesthesia involved in our minimally invasive treatments,” offers Dr. Sharma. “And they’re happy to learn that they can resume activities right away.”
Premier Vein Centers provides a free initial consultation and accepts most insurance, including Medicare.

Beautiful Outcomes

It’s been a year since Susan read that article and scheduled her first appointment at Premier Vein Centers. During that time, she’s had both legs treated for venous insufficiency. She says she couldn’t be happier with the outcome of the EVLA and VenaSeal procedures
Dr. Sharma performed for her.
“The results are beautiful,” Susan marvels. “I sleep all the way through the night now, and I haven’t done that for years. I can go out and work in my garden, bike and swim in my pool. Before, my legs felt so tired and heavy, and that cut down on my swimming time. I just couldn’t do it.
“I’ll be making Christmas candy this year because I’m able to stand without my legs aching so badly that I have to sit down. I don’t have that aching anymore.”
The appearance of Susan’s legs has also improved. The discoloration has decreased significantly and the texture of her skin is healthier.
“My legs look so much better now,” she reports. “The discoloration is almost one hundred percent gone, and I don’t have the scaly flakiness going on anymore. Also, there’s not a bit of an itch anywhere. If anyone looked at my legs today, they’d never know I had a problem.
“People have no idea how wonderful my legs feel now. If anyone needs to have something like this done, they have to see Dr. Sharma. He walks on water as far as I’m concerned. He’s just marvelous.”

Print This Article
    • Premier Vein Centers

      Many people inherit vein disorders. The incidence is higher in women than men. In the United States, nearly 50 percent of the adult population suffers from painful and unsightly vein diseases. The most common forms are spider veins and va... Read More

    • Ravi Sharma, MD

      Ravi Sharma, MD, is board certified by the American Board of Thoracic Surgery. He completed his undergraduate studies at the University of Maryland at College Park and attended the University of Maryland Graduate School, Baltimore, before r... Read More