Expert Relief From Venous Insufficiency

Minimally invasive procedures eliminate agony of venous insufficiency.

Before she retired in the late 1980s, Melissa Hulls operated in the medical field as an x-ray technologist. During an 18-year career, she spent 13 years in a hospital setting and five years working for physicians at a large medical clinic.

Melissa Hulls

“Back then, we did different things than what’s being done today,” explains Melissa, 68. “We performed procedures such as IVPs (intravenous pyelograms), where we inject a dye into a vein and examine the kidneys and bladder. We also did upper and lower GIs, where patients drink barium, which makes the gastrointestinal tract show up more clearly on the x-ray.

“Nowadays, the techs do more MRIs and CT scans and that type of thing.”

After retiring as an x-ray technologist, Melissa went on to work in other fields. First, she served as an administrator for a group home for 10 years.

“There were up to eight teenagers living with me at one time,” Melissa relates. “That job was very rewarding. After that, I owned my own business for several years.

“I always enjoyed weddings and dressing up, so I used that interest to create a store called The Wedding Gallery. I planned weddings and stocked all the dresses and tuxes. Some women that worked at the store baked wedding cakes. We did it all. It was so much fun.”

Ultimately, Melissa’s husband switched jobs, which required relocation. Melissa sold her wedding business and found a position selling manufactured housing in Proctorville, Ohio. When she and her husband finally retired for good, they relocated to the Sunshine State.

“We moved to the east coast of Florida in 2002,” Melissa elaborates. “We lived in a really beautiful condo on South Hutchinson Island. We had a motor home and would take off and visit the Gulf coast. Friends told us that Homosassa was a nice laid-back place. When we visited we loved it, so we moved here. We’ve been here for five years now.”

Remodeling their house has been an ongoing project, and Melissa has been doing much of the work herself. Her efforts were interrupted last year, however, by increasing discomfort in her legs.

“After painting my deck and doing other tasks that required standing for a long time, I paid for it later,” Melissa laments. “My legs bothered me during the day, but at night I really suffered. During the day, the pain in my legs was a six or seven on a scale of one to 10, but at night it was a nine. They really hurt.

“By the end of the day my legs felt really heavy, and there was swelling down by my ankles. My legs just throbbed, and that made it hard to sleep. I would just lay there and toss and turn all night.

“I noticed that in the back of my legs there were icky, purple-looking veins that poked out. One of my neighbors recommended Dr. Sharma to me. I said, I’ll go see him and have my legs checked out. I just can’t stand this pain.

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®.

Increased Pressure

To obtain a clear picture of Melissa’s problem, Dr. Sharma ordered an ultrasound of her legs, which revealed that a number of deep veins were leaking and restricting blood from flowing back toward the heart, a condition called venous insufficiency.

Multiple factors contribute to chronic venous insufficiency.

“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 visible, include 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, heaviness, nighttime leg cramps and restless legs.

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

“It is also 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.

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

Minimally Invasive Options

A range of advanced, minimally invasive treatments for venous insufficiency is available at Premier Vein Centers. 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 maintains. “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.

“My pain level now is zero, and I sleep very well at night.” – Melissa

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 using local anesthetics and result in little or no downtime and discomfort.

“Our patients are often very relieved to discover there is no general anesthesia involved in our minimally invasive treatments,” Dr. Sharma observes, “and 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.

“Zero” Pain

The pain in Melissa’s legs is now gone.

Dr. Sharma relies on his expertise to determine which procedures will work best based on each patient’s symptoms and health status. He tailored Melissa’s treatment to include EVLA and Varithena, and she is thrilled with her outcome.

“My legs feel great now, and I’m enjoying life,” Melissa enthuses. “I’m able to stand for a long time with no trouble. It’s amazing. At night, I don’t have that throbbing pain at all. In fact, my pain level now is zero, and I sleep very well at night.

“Since I had the procedures, I’m more aware of my legs. I look at them now and I don’t have any swelling, and the veins that were poking out in the back are gone.”

Because of her experience, Melissa offers only praise for the doctor and his staff.

“Dr. Sharma is a wonderful man and very knowledgeable,” she raves. “When I first met him, he was so warm and caring.

He explained how veins work and how the blood goes up and down the leg. He also explained how we needed to proceed to fix my legs.

“The staff is very pleasant to talk to. They’re very thorough and thoughtful. Every one of them is knowledgeable about their part in the treatment process. You can tell they know their jobs and do them well. I highly recommend Dr. Sharma and Premier Vein Centers.”

© FHCN article by Patti DiPanfilo. Photos 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 certified by the American Board of Thoracic Surgery. He graduated from the University of Maryland in College Park and attended the University of Maryland Graduate School in Baltimore before receiving his medical degree fro... Read More