Burning Bridges

Sealing leaky connector veins resolves leg ulcers.

An article in a sailboat magazine describing Punta Gorda as a thriving community and a great place to live prompted George Jackson, 71, to make a life-changing, spur-of-the-moment decision. The semi-retired real estate broker packed up his belongings, shipped his boat south and relocated from his Westchester, Pennsylvania home to Florida.

Photo by Jordan Pysz.

Friends have noticed the vast improvement in George’s left leg.

“The weekend after Thanksgiving in 1986, we pulled the boat from the Chesapeake, where we kept it, and hired a trucking company to haul it to Punta Gorda,” George recalls. “Then I thought, If I move the boat down there, I better go down and buy a house. I flew to Florida, bought a house in Punta Gorda Isles and put the boat behind the house. We moved to Florida on December 19, 1986.

“Talk about doing something crazy. It reminded me of the story of the Romans crossing the Rubicon. When the soldiers crossed the river, the general ordered the bridges behind them to be burned so they couldn’t go back. That’s what we did when we packed up and left Pennsylvania for Florida.”

Living in Punta Gorda has been a positive experience for George. He has fared well as a real estate broker in the up-and-coming community, but he suffered a setback in January 2018 when he was diagnosed with non-Hodgkin’s lymphoma. During his cancer treatment, George banged his left leg against a wheelchair and injured it. Even worse, the resulting wound wouldn’t heal.

“I went to a wound care clinic for six months trying to get that thing to heal,” George remembers. “It wouldn’t heal because I had poor circulation in my legs. And from the knees down, my legs were a purplish-orange color due to my bad circulation. I wouldn’t wear shorts because of the leg discoloration.

“I also had a nagging pain in my left calf. It felt like somebody had their thumb constantly stuck in it. The pain was like a charley horse, but it wouldn’t go away no matter what I did. Sometimes, it was painful enough to wake me up at night. But the doctors couldn’t figure out what was causing it. They were just scratching their heads.”

George was scratching his head as well until he read an article in Florida Health Care News about a woman with similar symptoms. That woman found answers from Douglas H. Joyce, DO, at Joyce Vein & Aesthetic Institute and The Ulcer Center at JVAI in Punta Gorda. George keyed in on the before-and-after photos of the woman’s legs and decided, That’s where I need to go.”

Before and after images courtesy of Joyce Vein & Aesthetic Institute and The Ulcer Center.Ulcer Generation

During his initial examination of George, Dr. Joyce used ultrasound to confirm that a lack of proper circulation, or venous disease, was the cause of the discomfort and discoloration of George’s legs as well as the stubborn wound on his left leg, which Dr. Joyce diagnosed as a venous ulcer.

The ulcer was small and in its early stages, but Dr. Joyce stresses that venous ulcers often don’t look like much in the beginning stages. Nevertheless, they still need to be treated because they can evolve into bigger ulcers with bigger consequences.

“Ulcers begin with a red, irritated spot on people’s legs, and the next thing they know, the area opens up and starts to weep,” Dr. Joyce educates. “It then begins to drain and progresses from there to a full-blown venous ulcer, which can lead to complications such as infection.”

“That’s why, whenever possible, I prefer to treat my patients’ veins before their ulcers open, when they have redness or irritation, or a spot on the inside of their ankle they think is an insect bite.”

Venous ulcers result when the valves in the perforator veins don’t function properly and blood leaks out toward the skin. Perforator veins are the veins that connect the high-pressure, deep veins in the middle of the leg to the low-pressure, superficial veins near the surface of the skin.

“Venous ulcers occur due to a short-circuit between the deep veins and the superficial veins,” Dr. Joyce observes. “The deep veins pump blood to the heart under high pressure when people walk. The superficial veins drain into the deep veins through the perforators when people aren’t walking. The valves in perforators snap shut to keep blood flowing toward the heart.

“If the valves in the perforator veins aren’t working, blood backflows out toward the skin, but it only travels a short distance, maybe three or four centimeters. Blood shoots out at a high pressure toward one spot under the skin like a pressure washer. With that much venous pressure, arteries cannot push fresh blood into that spot, tissue dies and an ulcer forms.”

For patients such as George, Dr. Joyce uses leading-edge procedures and state-of-the-art technology to treat ulcers. That technology includes single-needle laser ablation, a noninvasive method of sealing the diseased veins responsible for advanced venous conditions, including ulcers.

“Single-needle laser ablation is a technique we developed specifically to close leaking perforator veins,” Dr. Joyce describes. “We use the technique on other veins that are not accessible with a standard laser system, but it’s primarily for closing perforator veins.

“It works amazingly well, especially when there are venous ulcers. With George, we used standard laser ablation on his superficial veins as well as the single-needle laser ablation technique on his perforator veins.”

Ultimate Cure

Because it was the worst of the two, Dr. Joyce treated George’s left leg first. As expected, the single-needle laser ablation technique used on George’s perforator veins resolved his venous ulcer. The treatment is successful because it eliminates the root cause of the ulcer, the venous disease, instead of patching it with ointments and bandages.

“My wound is all closed up now. You can’t even tell it was there,” George reports. “And before this, I went through six months of wound care. At the wound care clinic, they did what they call debriding of the wound, but it did nothing.

“Now, the wound is gone, and the procedures Dr. Joyce said would rectify the nagging pain I felt in my left calf worked, too. I haven’t had that pain since I had the procedures.

“My wound is all closed up now. You can’t even tell it was there.” – George

“Even the discoloration on my left leg is gone. It’s amazing how much it’s gone away. I recently went to a barbecue by a pool, and as soon as I walked out in my bathing suit, my friends said, Wow! Look at your leg. It looks so much better. It felt good to have people notice the difference right away.

“Dr. Joyce is currently performing procedures on my right leg. I’ve had three procedures on that leg so far. I’m sure the discoloration will go away on my right leg as well, then I’ll wear shorts again.

“I’ve recommended Dr. Joyce to several people, and they were very happy to learn about him and his procedures.”

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