Orthopedic Issue?

Fixing your veins may improve your orthopedic recovery and outcome.

Photo by Fred Bellet.

Without the cramping and pain in their legs, Cliff and Rhonda are enjoying boating more.

Thirty-four years as a career firefighter wasn’t enough for Cliff Linzalone. Although he “retired” two years ago, he continues to volunteer with a company in nearby Alva. He’s also a member of a regional search and rescue team.

As for Cliff’s wife, Rhonda, she works in the cafeteria of a local school, where she spends a lot of time on her feet. At one point, she began experiencing uncomfortable issues with her legs. She also had several unsightly varicose veins that annoyed her.

“A few years back, I had swelling, achiness and heaviness in my legs,” she describes. “I was also having leg cramps, and I would get restless legs at night that kept me awake. I had some trouble walking because my legs would cramp up and hurt, and then they would swell. I also had big, green veins on my legs.”

For years, Rhonda simply “tolerated” the issues with her legs, but she recently decided to get rid of the ugly veins. A coworker recommended Joseph G. Magnant, MD, a board-certified vascular surgeon who specializes in treating vein disorders.

Dr. Magnant’s practice, Vein Specialists, is dedicated to the modern evaluation and minimally invasive treatment of leg vein disorders. Vein Specialists has offices in Fort Myers and Bonita Springs.

When Rhonda met with Dr. Magnant, she learned he could treat her varicose veins as well as her other leg issues. He told her all of her symptoms were caused by a disorder affecting her veins called venous insufficiency.

Veins are the blood vessels that return deoxygenated blood to the heart and lungs. Inside the veins are one-way valves that assist blood flow against gravity. Venous insufficiency occurs when these valves fail, creating pressure that builds up in the veins. This leads to signs and symptoms such as varicose veins, swelling, heaviness, achiness or cramping, discoloration, restless legs and frequent nighttime urination.

After an ultrasound evaluation, Dr. Magnant confirmed that Rhonda had venous insufficiency in both legs. He recommended a treatment called endovenous ablation, a minimally invasive procedure that uses radiofrequency energy to close leaking veins and reroute the blood through healthy veins.

Following the procedure, Rhonda’s symptoms improved tremendously, but she continued to follow up with Dr. Magnant to have several small spider veins treated. At one follow-up appointment, she brought Cliff with her.

Secondary Injury

Photo by Fred Bellet.

Rhonda Linzalone

During one of Rhonda’s procedure appointments, Dr. Magnant came out to the waiting room to speak with Rhonda’s husband Cliff and noticed his swollen, disfigured and discolored right leg and ankle. He asked Cliff about it, and Cliff explained that he had been in a motorcycle accident ten years earlier, and nearly had his right foot severed off as a result of a badly injured ankle. Despite receiving appropriate limb-saving treatment from an orthopedic surgeon, the ankle had been swollen and painful ever since.

“My foot was ninety percent severed in the accident, and I eventually had eight different operations to save it,” Cliff clarifies. “After that, my ankle blew up to twice its normal size. It was always swelling and hurting. My leg from the knee down looked like a diabetic’s leg; it was really discolored.

“I lived with it every day and did what I had to do because I was a firefighter, but I did it with a lot of pain. Every time I went to the orthopedist, he told me it was all because of the trauma. He said the ankle wasn’t getting the right blood flow because of the injury.”

When Cliff accompanied Rhonda to her appointment at Vein Specialists, he wore shorts, which made his swollen, discolored leg visible. When Dr. Magnant looked over from Rhonda and saw it, he knew he had to speak with him.

“Cliff was willing to proceed with an evaluation, and our venous ultrasound revealed he had significant, treatable venous insufficiency,” shares Dr. Magnant.  “His problem was pretty straightforward. I performed an endovenous ablation with a ClosureFast catheter  (radiofrequency), just like I did for Rhonda.”

Orthovenous Disease

“The symptoms of venous insufficiency and orthopedic disease are different,” explains Dr. Magnant. “Orthopedic disease, whether it’s in the ankle, knee or hip,

Photo by Fred Bellet.

Cliff Linzalone

is usually worse after prolonged periods of immobility, such as riding in a car, sitting in a chair or sleeping. When you stand up, there’s a stiffness that generally works its way out a little bit as you walk. However, by walking, you put stress on the joint, so eventually, it’s going to hurt more.

“Venous disease is generally better after sleeping or elevating the legs for a period of time, and gradually gets worse with sitting or standing and as the day wears on. It’s improved by walking, elevation and compression hose.”

“After I had the vein procedure, all my symptoms cleared up.” – Cliff

Dr. Magnant notes that arthritis is a common orthopedic condition that frequently affects the hip, knee and ankle, as well as other parts of the leg. The population most often affected by arthritis are those in their 40s through 80s.

“Venous disease is very common in this age group, as well,” observes the doctor. “We have developed an excellent working relationship with orthopedic surgeons in Southwest Florida and are often asked to evaluate their total joint candidates prior to surgery. In some cases, we are asked to consult on their patients postoperatively as well to rule out deep vein thrombosis, or DVT, with ultrasound.

“Patients may be negative for DVT yet have undiagnosed venous insufficiency as a contributing factor to their residual leg swelling postoperatively. Some of these patients may benefit from formal venous evaluation and minimally invasive vein treatment such as what we used with Cliff.

“Why not consider a thorough venous evaluation to determine whether or not some of the discomfort is vein-related and treat it? Then, you can eliminate the venous symptoms and improve treatment of the orthopedic condition.”

If venous insufficiency is detected and treated before surgery, it leads to more than symptom relief. It results in improved wound healing, which reduces swelling postoperatively.

“Patients have better mobility in the postoperative period if there’s less swelling,” notes Dr. Magnant. “Therefore, physical therapy, walking, range of motion, recovery – everything that goes along with an orthopedic intervention – are improved.

“In addition, the risk of DVT blood clots and the complications related to them, such as pulmonary embolism and death, is reduced.”

Enjoying Life Again

The endovenous ablation procedures performed by Dr. Magnant improve circulation in the legs and eliminate symptoms. Rhonda and Cliff are delighted by the outcomes of their procedures.

“My results are great,” comments Rhonda. “Now, I can sleep through the night without any pain or discomfort. My legs look a lot better, too. I’m happy with the way the procedure turned out.”

“My results are excellent,” agrees Cliff. “My ankle is normal size now; it’s not all swollen. Everyone who sees it tells me, Your leg is skinny! They used to call it a cankle because it was always twice the size from the leaking and swelling.

“The blood flow is really good now, and my leg isn’t discolored and doesn’t look like a diabetic’s leg anymore.”

Not only did Cliff’s procedure make his leg more attractive, it also gave him more mobility. Since his surgery, Cliff can be on his feet for hours without the pain and cramping that hampered him before.

“After I had the vein procedure, all my symptoms cleared up,” he confirms. “Now, I can walk most of the day without any problem. A couple of weeks after surgery, I went to Walt Disney World® and walked all over the place all day.”

Dr. Magnant stresses the importance of a venous evaluation for patients with orthopedic ailments because people with bone and joint disorders often have a co-existing venous disease. Rhonda agrees.

“Everybody should look into their veins as a cause of their symptoms because venous disease can cause a lot of trouble,” she suggests. “Dr. Magnant is a great doctor, and I really like him.”

“Absolutely, we recommend Dr. Magnant and Vein Specialists,” says Cliff. “We already have.”


Print This Article
    • 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