Let Your Blood Flow

Medley of minimally invasive procedures ends symptoms of venous insufficiency

JORDAN PYSZ / FLORIDA HEATH CARE NEWS – Although William no longer plays professionally, he maintains a studio in his home where he records his music.

William Hannagan’s life as a musician began at age 6. That’s when he learned to play the accordion. Before long, he was also playing piano and guitar. He later orchestrated his natural talent into a profession with several bands. 

“With most of the bands I was in, I did the front work — the vocals — and played keyboards,” William expounds. “We also had a guitarist, a drummer and sometimes a bass player. It varied over the years.” 

Now 74, William loved his musical career, but he notes it was a serious business. 

“Anything you’re getting paid to do, you have to do well,” he stresses. “Being a musician requires a lot of work and practice, but I enjoyed entertaining people. My bands traveled some, but we didn’t go very far. 

“We went up into Georgia and Tennessee, but we mostly played around Daytona Beach and Crystal River back when more venues offered live entertainment. There were some nice clubs for dancing in those areas. We used to play in those clubs.” 

William’s career was borne out of desperation in the early ’70s. At the time, he was working at a nuclear plant for Florida Power & Light, but he was eventually laid off. 

“I had to think really quickly in that moment,” William confirms. “I decided to work at playing music and started my musical career around 1972. I retired in 2005, but I still have a little music studio at my house, so I still play and record. Other than that, I haven’t been able to do much physically because I have a bad back.”

That wasn’t the only ailment keeping William sedentary. Over the past few years, his lower legs and feet were consistently swollen and hurt terribly. Further, the discomfort was getting worse over time.

“The  pain  in  my  legs  was  just constant,” William describes. “Not only that, but they felt like they were dead, just hanging there, especially in bed at night. Sometimes I had to lift them just to get into a chair. It was just miserable.

“It was also very painful to walk. It got so bad, I had to use a cane. One time, I went to the grocery store to get something for my wife, and when I got to the store I had to lean on the shopping cart because I couldn’t walk very far, even with the cane.”

Because his feet hurt, William went to a podiatrist, but the doctor was unable to help. His primary care physician gave him water pills to decrease the swelling, but the discomfort continued.

“At that point, I didn’t know what to do. I figured I would have to live with bad legs, along with my bad back,” William laments. “Then I saw an article in Florida Health Care News about Dr. Sharma and his vein treatment, and I made an appointment with him.”

Tailored Treatment

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®.

During the initial visit, Dr. Sharma ordered an ultrasound of William’s legs that confirmed his suspicions. William was experiencing venous insufficiency, a condition that can become chronic if left untreated, according to Dr. Sharma.

“After long periods of sitting or standing, the blood in leg veins can pool,” the doctor informs. “This increases the venous blood pressure and weakens the vein walls and valves, thereby damaging

the valves and preventing proper blood flow back to the heart.”

There are multiple signs and symptoms of venous insufficiency, Dr. Sharma explains. These are indicators that the veins are not functioning properly.

“Signs, which are visible, include varicose veins and swelling, thickening, and skin discoloration of the ankles or legs,” he continues. “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 cautions. Leaving the condition untreated can lead to more serious complications, including leg ulcers, infection and a breakdown of the skin.

“The problem with my veins was that the valves weren’t working, so the blood was pooling in my legs. Dr. Sharma told me some of my veins were four times the size they were supposed to be,” William recalls.

“My legs were discolored on the bottom, and I remember wondering, Why are the bottoms of my legs tan? But Dr. Sharma explained it was the blood pooling under the skin. He said, I can help you with that right away.”

Minimally Invasive Options

At  Premier  Vein  Centers,  Dr. Sharma offers a range of advanced, minimally  invasive  treatments  for venous  insufficiency.  These  include microphlebectomy,  endovenous  laser ablation (EVLA), sclerosing injections, VenaSeal™  and  Varithena®    The procedures are designed to divert blood from faulty veins to healthy ones.

Microphlebectomy,  which  removes larger varicose veins, has replaced vein stripping,  an  invasive  and  outdated 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 declares. “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 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,” that permanently seals the diseased vein. This procedure does not require multiple needle sticks, and in some cases support stockings are not necessary.

Varithena is a microfoam that is 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 asserts. “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.

“Normal Legs”

Dr. Sharma relies on his expertise to tailor the procedures to each patient’s symptoms and health status. For William, he selected EVLA and Varithena. William was amazed by the difference the treatments made in the look and feel of his legs.

“My ankles were so swollen, but they’re not swollen at all now,” he enthuses. “And the bottoms of my legs used to be about the size of my thigh. Now they look like normal legs. You can see the difference between my ankles and calves now, which is cool.

“I can also walk without a cane now because my legs don’t hurt like they used to. And they’re no longer discolored. Even that dead feeling is gone. My legs feel like legs again.”

William is as impressed with Dr. Sharma as he is with the results of his treatments. He is especially impressed by the doctor’s credentials. 

“My wife and I were really surprised by how much time he took with us explaining everything,” William raves. “Knowing he is a cardiovascular surgeon really helped make us comfortable. It proves he has the knowledge and experience to work with veins.”

Dr. Sharma emphasizes that it is crucial that people seeking vein treatments choose a surgeon who specializes in 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,” the doctor says. “Vein treatment must be tailored to the individual. There is no one-size-fits-all approach. 

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

Bonnie can walk as far as she wants now because the pain in her legs is gone.

Road Trip

As a young woman, Bonnie Jones landed a job in the typing pool at a large title company in her home state of Ohio. Seeking to further her career, she later took a position in the firm’s escrow division and thoroughly enjoyed her time there.

“Escrow officers meet with clients to close on their homes,” explains Bonnie, 72. “We handle the money and other financial matters. I worked for the title company, and we worked for the banks. I was in that job for almost 30 years.”

Following her retirement, Bonnie and her husband spent several years traveling, which for this outgoing couple essentially meant camping. They steered away from big tourist traps and gravitated more toward smaller towns with interesting attractions. 

“We bought a 37-foot RV for our main house in Florida and had a small camper to travel around in,” Bonnie relates. “We visited Canada a couple of times, but we mostly stayed in the United States, particularly the eastern United States.”

Bonnie and her husband no longer live in the RV, and their days of traversing the continent are all but over. They still take brief road trips by car, though, usually to destinations that allow for a bit of hiking.

During one trip this year, Bonnie noticed that her right leg was swollen. As the weeks passed, she observed that her left leg also began to swell. Soon after, she learned there was nothing swell about this growing problem.

“I didn’t have bad cramps in my legs, just aching on the tops of my feet,” Bonnie describes. “And my legs were weak, especially my right leg. I noticed that whenever I went up a curb or step, I always led with my left leg because my right leg was too weak.

“My legs felt a little heavy, too, and they easily became fatigued. Eventually, I started feeling pain in my legs, and then a couple of varicose veins started to appear. I also had some loose, wavy skin on my legs.”

Bonnie says she never experienced leg problems before, but she learned the likely cause by reading an article in Florida Health Care News.

“I received the newspaper in the mail, and after reading an article about venous insufficiency, I thought, Geez, I wonder if that could be my problem,” Bonnie relates. “I decided to investigate it by visiting the doctor I read about, which was Dr. Sharma.”

“100 Percent Better”

As with William, Dr. Sharma began by performing an ultrasound. That showed Bonnie did indeed have venous insufficiency. To correct the problem, Dr. Sharma treated her with EVLA, Varithena and UGS. Bonnie is quite pleased with the outcome.

“My legs feel great; they’re 100 percent better,” she enthuses. “The swelling is way down, and the fatigue is gone. I can walk as far as I want now because I have no more pain in my legs. The heaviness is gone, too, and the wavy skin is going away. Dr. Sharma fixed everything.”

Bonnie is grateful to Dr. Sharma and his staff for making her visits to Premier Vein Centers positive experiences. 

“I love Dr. Sharma,” she raves. “Everybody in the office there is so nice. They make me feel relaxed. I haven’t been through a lot of procedures in my life, and they calm me down. They tell me what’s going on, and they do a good job. I highly recommend them.”

William agrees.

“Dr. Sharma is very nice and friendly. He’s really down to earth. My wife and I are very happy with him. We definitely recommend Dr. Sharma and Premier Vein Centers.”  

© FHCN article by Patti DiPanfilo

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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