7 Years and Counting

Novel vein closure technique eliminates leg swelling, heals ulcers.

Larry Alumbaugh walking down his street with his cowboy hat on.

Larry’s legs were treated for venous disease seven years ago. He hasn’t a problem with them since.

Larry Alumbaugh is a genuine Colorado cowboy. He started young. At age 13, he bailed hay by hand for local sheep and cattle ranchers.

“I put the hay in 80-, 90-pound bales instead of stacking it loose in haystacks,” Larry details. “The ranchers often got heatstroke in the summer and pneumonia in the winter taking loose hay out of stacks to feed a thousand head of cattle. My bales made feeding a lot easier, so they went over big.

“I worked as a cowboy for many years but got cold in Colorado. I figured that being uncomfortably warm in Florida is nothing compared to being painfully cold in Colorado, so I moved to Florida in 1965 and started a manufactured housing development in Venice called Florida Pines Mobile Home Park.”

Over the years, Larry upgraded and modernized Florida Pines, which is a 55-and-older community. The development also houses retirees who travel from northern climates to spend the cold winter months in a snowbird paradise.

“On one side of the park, we accommodate 31 RVs – those big motor homes that belong to people who come down to Florida for six months during the wintertime,” Larry elaborates.

As owner of Florida Pines, Larry continues to manage the property at 80 years old. Overall, his health is good, but a few years back, he struggled with a nasty problem: an open wound on his right leg that wouldn’t heal.

“It was a big, ugly sore, which was vicious and looked terrible,” Larry describes. “I had it for close to a year, and it caused a huge infection all over the outside of my leg. I tried using Neosporin®, but nothing like that did any good because the sore was so bad. It was so bad my whole leg swelled up.

“My father lost both of his legs for the same reason, after an infection called osteomyelitis rotted out his bones. They cut off his legs about eight inches below the knee. I was afraid the same thing would happen to me, but then a friend told me about a doctor who could help.”

That doctor is Douglas H. Joyce, DO, of Joyce Vein & Aesthetic Institute.

Dr. Joyce specializes in treating nonhealing wounds at The Ulcer Center at JVAI. Larry eagerly agreed to meet with him.

“When I initially saw Dr. Joyce, he looked at my sore and said, I can fix you, but first you have to go to a wound center,” Larry remembers. “He recommended a place in Punta Gorda, and when I went there they said, You’re going to the hospital right now. But I told them I couldn’t do that. I have too many responsibilities.

“Instead, the wound center sent a woman to my house every day. She put medicine on my sore, dressed it and kept it very clean. It took months, but the sore finally healed. Then, I returned to Dr. Joyce so he could do his thing.”

Drainage Systems

“We saw Larry back in 2013,” Dr. Joyce recalls. “He arrived with an ulcer on his right leg that was infected. We evaluated him using ultrasound and discovered that he had veins that were not working correctly. We treated him with several vein procedures and his ulcer, which was healed, remained closed. Today, he still has relief from his problem.”

There are two systems in the legs for venous drainage. The veins on the outside of the legs that supply the skin and tissue just underneath are part of the superficial system. It runs at a very low blood pressure of 15 to 20 millimeters of mercury (mmHg).

“That system drains into the central vein system,” Dr. Joyce educates. “When a person walks, leg muscles squeeze the central veins and generate enough pressure to send the blood all the way to the heart. The pressure in the central system can run up to 300 mmHg. A third set of veins, called perforator veins, connect the superficial to the central system.”

“Dr. Joyce got the blood flowing in my leg, and everything healed,” – Larry

Leg veins contain one-way valves that prevent blood from flowing backward and pooling in the legs. But with venous disease these valves are compromised. Consequently, the veins leak and blood collects in the legs, causing swelling and discomfort.

“The valves in the perforator veins make sure high-pressure blood doesn’t leak out to the low-pressure skin system,” Dr. Joyce explains “If the valves don’t work properly, high-pressure blood shoots through to the skin. With the intense pressure that results, the arteries can’t push enough oxygenated blood into the area. The skin cells don’t get the nourishment they need and begin to die. The result is a venous ulcer.”

To seal longer veins in the legs that are leaking, Dr. Joyce uses a standard laser vein closure procedure. For the perforator veins, he employs a novel technique called single-needle laser ablation.

“During single-needle ablation, we place a special needle into the perforator vein and then slide a laser fiber through the needle,” Dr. Joyce details. “Using the laser, we perform a ‘spot weld’ of the area for 10 to 15 seconds, which closes the vein.

“In the past, we took patients to surgery and placed titanium clips on the perforator veins. Today, we simply seal the veins with a needle through the skin. The procedure works extremely well, and patients don’t have to go to the hospital, be put under general anesthesia and be on a ventilator.

We perform single-needle laser ablation in the office and afterward patients can go out and have lunch.”

“A Normal Person”

“I didn’t understand how I could get along without the veins that were messed up,” Larry queries. “But Dr. Joyce explained that once he disabled the bad veins, the blood would flow through the good veins instead.”

Larry’s leg was treated more than seven years ago, and he hasn’t had a problem with it since.

Larry was dismayed when a staff member at the wound center informed him he would have to wear compression stockings for the rest of his life to
eliminate the swelling in his right leg. As it turned out, the staff member was wrong.

“Dr. Joyce got the blood flowing in my leg, and everything healed,” Larry announces. “I had no swelling in my leg two to three weeks after he started working on me. Now, there’s no pain in my leg and no swelling, and I don’t have to wear compression stockings.”

In fact, Larry hasn’t required treatment for his legs in more than seven years.

“I’ve never been back to Joyce Vein & Aesthetic Institute and my leg has not swelled since,” Larry enthuses. “I’m a normal person, a normal human being thanks to Dr. Joyce. I deal with many retired people in my mobile home park and I always tell them, Don’t give up.”

©FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. Before and after images courtesy of Joyce Vein & Aesthetic Institute. js
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