Shades of Distress

Discoloration signals advanced venous disease.

When David Snook settled in Florida, he found his niche teaching gardening to mentally disabled students. He also keeps busy as a wrestling referee.

Douglas Joyce, DO, performed laser ablation for venous insufficiency on David Snook at Joyce Vein & Aesthetic Institute in Punta Gorda.

When he’s not teaching, David spends time in his garden.

“I settled in Florida about fifteen years ago,” shares the Grand Rapids, Michigan native. “I decided to get into education, and that’s what I’ve been doing for the last eleven years. I’m also an official for high school wrestling.”

Four years ago, David began experiencing distressing symptoms in his left leg, primarily his foot and ankle. The symptoms were both annoying and agonizing, and they began affecting him in his daily life and on the job.

“My leg started itching, and sometimes I would scratch it until I broke the surface of the skin, and it would bleed,” he describes. “It was really irritated and painful. It also swelled and changed colors; it was maybe four or five colors. My leg was pretty scary looking.

“I figured I’d have to stop officiating because I couldn’t be on my feet and have this much pain. I move around a lot while I’m refereeing, and that caused my symptoms to become even worse.”

While working a wrestling tournament, David finally accepted he had a serious problem. While David was changing his shoes, another official caught a glimpse of his foot. The colleague remarked that the foot looked severe and needed to be evaluated by a physician.

That comment prompted David to visit his doctor, who referred him to vein specialist Douglas H. Joyce, DO, of Joyce Vein & Aesthetic Institute. Dr. Joyce impressed David from the first appointment.

“Dr. Joyce looked at my leg and knew exactly what was going on,” remembers David. “I was a little worried about it, but he had so much confidence and said, I can take care of this issue so you don’t have to be in pain.

As a vein specialist, Dr. Joyce immediately recognized venous disease by David’s symptoms. Initial symptoms of venous disease include swelling, tired legs, spider veins, varicose veins and a feeling that the legs are getting progressively heavier. Over time, venous disease slowly worsens. Left untreated, it can lead to skin discoloration, thickening and ulceration.

“There are two systems of veins in the legs,” explains Dr. Joyce. “There are the high-pressure deep veins in the middle of the leg, and the low-pressure superficial veins near the surface of the skin. With venous disease, we find numerous connections between the superficial system and the deep system that are not functioning correctly.”

These connections, called perforator veins, can be identified using ultrasound, a safe and painless imaging test. Once Dr. Joyce confirmed the problem areas in David’s leg, he initiated his treatment plan.

“We scheduled the surgery,” relates David. “I was terrified at first, but Dr. Joyce has good people working at Joyce Vein and Aesthetic Institute. They made me feel relaxed. While I was a little apprehensive, the procedure was worth it because afterward I wasn’t in pain anymore.”Douglas Joyce, DO, performed laser ablation for venous insufficiency on David Snook at Joyce Vein & Aesthetic Institute in Punta Gorda.

Laser Energy

There are six stages of venous disease, informs Dr. Joyce, and symptoms such as leg swelling, pain and varicose veins are common in stages one through three. Discoloration like David experienced occurs in stage four. A healed ulcer is stage five venous disease, and an open ulcer is stage six. Stages four through six are considered advanced disease. Joyce Vein & Aesthetic Institute specializes in treating advanced venous disease.

“Anytime patients have leg discoloration, they’re heading toward serious problems with their legs,” notes Dr. Joyce. “People who start to get discoloration need to have their veins evaluated right away, before ulcers form. Without correcting the underlying vein disorder, an ulcer is very difficult to heal permanently.”

For David, the leg itching was a particularly bothersome early-stage symptom. Dr. Joyce explains that itching is not unusual with venous disease. It is one possible reaction to the increased pressure caused by venous disease.

“That pressure stimulates the nerves in an unfamiliar manner, and the brain identifies that stimulus in different ways,” educates Dr. Joyce. “Some people feel pressure, some feel pain and some feel electrical shocks. Others might get the feeling of water on their legs or of insects crawling on their legs. Some people, like David, feel itching.”

Dr. Joyce approaches vein disease in all stages with the same purpose. He begins with an ultrasound examination to identify which veins are not working properly, and then determines the appropriate course of action to treat them.

“The problem is usually with the perforator veins and the long veins of the legs,” he observes. “We close those leaking veins with laser energy and reroute the blood through healthy veins. Fortunately, we have methods of doing this that are noninvasive and well tolerated.”

Dr. Joyce is a pioneer in treating all of the causes of venous disease of the leg. He has developed new techniques to treat venous disease, including single-needle laser ablation, a noninvasive method of treating the diseased veins responsible for advanced venous conditions.

“Joyce Vein and Aesthetic Institute is one of the few centers in the United States performing a significant number of the single-needle ablation procedures,” notes Dr. Joyce. “We teach physicians from all over the world how to do this technique. We have developed it to the point where it’s quite successful and have performed more than fifty-five hundred procedures, with a very high success rate and almost no complications.”

Absolute Success

David was thrilled with the results of his laser ablation. He began to feel a difference in his leg quickly after his procedure. To David, Dr. Joyce cured his venous disease and gave him back his life.Douglas Joyce, DO, performed laser ablation for venous insufficiency on David Snook at Joyce Vein & Aesthetic Institute in Punta Gorda.

“I had the procedure with Dr. Joyce, and I immediately started feeling some relief,” he confirms. “The next day, my pain was better. I couldn’t believe it. Now, the itching has been eliminated. There is no swelling, no pain and no discoloration. My leg is normal.

“The surgery was an absolute success. I’m able to do things I thought I couldn’t do or had to stop doing. Before, I thought I was not going to be able to officiate, but I’ve been officiating every year since. It would’ve been a loss of a lot of income if I couldn’t officiate.

“Because of Dr. Joyce, I’m able to do what I want to do.”

David adds that he would recommend Joyce Vein & Aesthetic Institute and Dr. Joyce without a doubt.

“Dr. Joyce is very confident, and that made me as a patient feel comfortable. He’s also knowledgeable and professional, and his staff is wonderful.

“Going to Joyce Vein and Aesthetic Institute was a great experience, and the procedure took care of my problem. If anyone asks me, I say, Dr. Joyce is the best!”

FHCN article by Patti DiPanfilo. Photo by Fred Bellet. Graphic from istockphoto.com. Before and after images courtesy of Joyce Vein & Aesthetic Institute.
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