Advanced Treatments For Venous Disease

Vein specialist calms fears after others misdiagnose her leg condition.

Rita rested the first day after her vein treatment but then went right back to playing pickleball.

Dominick’s Finer Foods has been a staple of the greater Chicago landscape since 1918, when the first store was opened by founder Dominick DiMatteo. Rita Olson made a valuable contribution to the grocery store chain’s epic history, devoting 23 years to a career with the Windy City icon.

“I started out at the bottom and worked my way up,” Rita reveals. “I started as a bagger and then did cashiering, customer service, pricing, you name it. Pricing was my final job at Dominick’s. I updated all the product prices and corrected anything that wasn’t put out for sale properly.

“But when my son finished law school I said, I’m going to find a job closer to home, and I worked at a furniture store for several years. I loved that job because I worked for an elderly man, and the store was his life. It was wonderful, a lot of fun.

I really enjoyed that job. I retired when I was 66. That was seven years ago.”

Rita and her family lived in Lansing, Illinois, a south suburb of Chicago and a stone’s throw from the Indiana border. Once Rita and her husband were retired, the couple considered spending part of the year in Florida. They began by traveling to The Villages® for a brief holiday.

“The first time we came down we stayed for a week and there was so much to do here that we felt like a week wasn’t long enough,” Rita recalls. “The next time we came down, we stayed for a month. Then we came down and stayed for two months, then three months. Now we stay for the entire winter, and we still love it.”

Two years ago, Rita suddenly noticed something she didn’t love: varicose veins on her legs. She didn’t like the way they looked and became concerned they were a sign something medically was amiss.

“It seemed like they just showed up overnight; one day, there were these two bulging veins, one on each leg, and they looked horrible,” Rita describes. “Bulging veins alone aren’t something that would send me to the doctor, but these looked abnormal. They scared me.

“Now, those ugly, bulging veins are gone, and I’m back to wearing my little skirts for golfing.” – Rita

“My mother died of a stroke, and in my head I was thinking, This doesn’t look right. The doctor I visited said if my legs didn’t hurt, treating them would be cosmetic surgery. I said, This isn’t cosmetic. Something’s wrong. This isn’t normal. I was afraid I was going to end up with a blood clot.

“I was angry because the doctor wouldn’t even look at my legs, so I went on the internet and researched vein doctors and discovered Dr. Sharma. There must have been five people on that website who wrote that he’s the best, so I made an appointment to see him.”

Ultrasound Indications

Ravi Sharma, MD, is a board-certified cardiovascular surgeon with expertise in blood vessel disorders affecting the legs. His practice, Premier Vein Centers, has offices in Homosassa and The Villages.

“Dr. Sharma took one look at my legs and said, No, this isn’t normal!” Rita remembers. “He showed me what healthy veins look like, what my veins looked like and explained why it wasn’t normal. Then he assured me he was going to take care of my problem.”

Dr. Sharma began by ordering an ultrasound of Rita’s legs. The ultrasound showed that a number of deep leg veins were leaking and restricting blood from flowing back toward Rita’s heart, a condition called venous insufficiency.
Chronic venous insufficiency has multiple causes.

“After long periods of sitting or standing, the blood in leg veins can pool,” Dr. Sharma informs. “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.”

Venous insufficiency has many signs and symptoms, indicators that the veins are not functioning properly. Signs, which are seen, include bulging varicose veins as well as swelling, thickening and discoloration of the skin of the ankles or legs.

Symptoms, which are felt, include throbbing, aching, stinging, burning, itching, nighttime leg cramps and restless legs.

“It is extremely important that patients experiencing any signs and symptoms have their leg veins assessed,” Dr. Sharma maintains. “Leaving the condition untreated can lead to more serious complications, including leg ulcers, infection and a breakdown of the skin.

“And it’s crucial that people choose surgeons who specialize in venous diseases and only venous diseases. I recommend staying away from physicians in large practices that offer a variety of services and perform venous treatment as a side service. Vein treatment must be tailored to the individual. There is no one-size-fits-all approach.

“In addition, the physicians should be experienced in the advanced procedures available to treat venous diseases. They must also express genuine concern and compassion for their patients. Physicians with these qualifications achieve the best outcomes.”

Advanced Treatments

Premier Vein Centers offers a range of advanced, minimally invasive treatments for patients with venous insufficiency. These options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections, VenaSeal and Varithena®.

Microphlebectomy has replaced vein stripping, an outdated, more invasive procedure during which doctors removed the large veins by making big gashes across the leg, often leaving sizable 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 contends. “With this procedure, patients end up with tiny marks on the skin or no scars at all.”

EVLA involves a sterile laser fiber that is introduced into the incompetent vein through 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 treat spider veins, which are small, twisted veins that are visible through the skin. Dr. Sharma uses
ultrasound-guided sclerotherapy (UGS) to guide the injections, which gently close problem vessels.

VenaSeal is a non-thermal closure system that relieves symptoms by delivering small amounts of a specially formulated medical adhesive, or “super glue,” to the diseased vein. This permanently seals the vein. This procedure does not require multiple needle sticks, and in some cases support stockings are not necessary.

Varithena is a microfoam injected into the diseased area of the vein. It treats the vein wall and collapses the vein. This and the other advanced treatments at Premier Vein Centers are 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,” Dr. Sharma observes. “They are happy to learn that they can resume activities right away following the procedure.”

Premier Vein Centers provides a free initial consultation and accepts most insurance, including Medicare, for these treatments, which are designed to divert the blood that used to flow through faulty veins to healthy veins.

Amazing Outcomes

Dr. Sharma relies on his expertise to determine which procedures will work best based on each patients’ symptoms and health status. In Rita’s case, he chose microphlebectomy. Rita was amazed by the outcome.

“I get keloids (thick, raised scars), so I thought I would have scarring from the tiny cuts he made to remove the veins, but the cuts healed up well,” Rita describes. “The incisions were really small, and they disappeared entirely in about six months. If I didn’t know the procedure was done, I wouldn’t believe it.

“Now, those ugly, bulging veins are gone, and I’m back to wearing my little skirts for golfing. I have no more concerns about ugly varicose veins on my legs. And I felt no pain.”

Rita was also amazed by how quickly she returned to her active lifestyle following the minimally invasive treatments.
“They told me not to run around on the first day after treatment, but beyond that, I went right back to playing pickleball and golf,” she enthuses. “I had to wear compression stockings, but that’s no big deal.

“I couldn’t be happier with my results, but I knew I would be. I was so impressed with Dr. Sharma that I walked out of his office after that first visit feeling very hopeful and as if I had definitely gone to the right place.”

Helpful Advice, Finally

Molly* dreamed of becoming a legal secretary. She prepared for her career by taking all the business law classes and general business courses offered by her high school. The preparation paid off. She got a job as a legal secretary right out of school.

“I went to work for the FBI,” recounts Molly, 70. “But to get promotions within the government, you have to move around. I stayed with the FBI for two years and then worked in the General Accounting Office.”

While Molly was technically a legal secretary, her job with the GAO involved statistics, which she didn’t particularly enjoy. She stuck it out in the GAO for 3½ years, then accepted a position in one of President Jimmy Carter’s programs. When Carter left office in 1981, Molly moved on to the Small Business Administration.

“While I was working with the government, a friend recommended me to a patent and trademark law firm in Washington, DC,” Molly relates. “As a legal secretary, I did everything to make the attorneys’ lives easier. I helped them with their calendars, scheduled their appointments and helped prepare patent applications. I loved my job.”

She didn’t love the daily commute, though. Molly lived 59 miles from her office, and over time the drives and long hours each day wore her down.

“When I went in for my interview, I had to sign an agreement that I would work eight to 15 overtime hours a week,” Molly shares. “I was 36 when I started with the law firm, so it was no problem at the time. But as I got older, it became harder. By the time I was 61, I was ready to retire. That was in 2011.”

Following retirement, Molly made another dream a reality by relocating to the Sunshine State. Shortly after that move, however, a distressing leg issue hampered her dream life.

“My legs hurt,” Molly expounds. “They hurt so bad I couldn’t even touch them. It felt like muscle pain, but it wasn’t. I was in so much pain that I wouldn’t even go shopping anymore. It wasn’t worth it. I stopped going to restaurants, too, because I couldn’t get out of the chairs because my legs hurt so bad. On a scale of one to 10, my leg pain was a 50.

“It also felt like there was water inside my legs. My ankles and feet swelled up terribly. I was miserable all the time, and the pain kept getting worse. I used so much Aleve® that it stopped working. The pain reached a point where I was afraid I would have to start using a walker.”

For years, Molly complained to various internists about the pain and swelling in her legs, but she never received advice that helped.

“All I ever heard was, You’ve got to lose weight,” she recalls. “So I lost weight. But that didn’t help the pain. Then, I got a new internist, and he referred me to Dr. Sharma.

“When I called to make an appointment, Dr. Sharma answered the phone. I told him I was in a lot of pain and afraid of doctors. He talked to me for 35 minutes and made me feel so relaxed that by the time I went in for my appointment, I wasn’t afraid anymore.”

Return to Form

As he did with Rita, Dr. Sharma chose microphlebectomy for Molly. Like Rita, Molly is delighted that the scar-sparing procedure left only small marks that are barely visible.

“They look like pinholes from tiny pins,” Molly describes. “My friends can’t believe that I even had a procedure done.”

Molly was among those pleasantly surprised by the ease of Dr. Sharma’s vein procedures. She says she had heard some “horror stories” about old-fashioned venous treatments but was relieved when Dr. Sharma’s methods proved to be pain-free.

“When Dr. Sharma turned off the machine and said, That’s it, I couldn’t believe it,” she enthuses. “It was so easy; the procedure didn’t hurt at all, and I had no bruising. I had the procedure one day, and the next day I was driving and meeting friends for lunch. I was so impressed.”

Dr. Sharma finished Molly’s procedures in March. It didn’t take long for her to return to all of her activities without restrictions.

“The procedure didn’t hurt at all, and I had no bruising.” – Molly

“I’m back to helping my friend with her cleaning business full time. I do the vacuuming for her,” Molly reports. “I’m doing more now than I’ve done in a year, and I’m doing it without having to use any pain medicine. And I don’t have any swelling in my right foot, either.”

“I was so impressed with Dr. Sharma that I told him that I would love to visit his office and talk to new patients who are afraid to undergo some of these procedures. I’d tell them, Relax. Dr. Sharma is a good doctor. He’ll make you feel comfortable.

“But it’s not just Dr. Sharma who makes you feel that way. Everyone there makes you feel comfortable. The atmosphere at Premier Vein Centers doesn’t feel like a doctor’s office. The staff is fun. They joke around, and I love it!”

Rita is pleased with her experience at Premier Vein Centers as well. She found Dr. Sharma’s credentials as a cardiovascular surgeon reassuring.

“He explained to me that he was a heart surgeon and that it really helped him in the field of vein treatment,” she says. “That made me feel very comfortable. I thought, Finally I found somebody who’s going to help me.

“And the staff is very friendly. From the minute I walked into the practice, they made me feel comfortable and welcome. They took very good care of me. I highly recommend them.”

© FHCN article by Patti DiPanfilo. Rita’s photo by Jordan Pysz. mkb
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    • 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