Problem Solvers

Leading-edge procedures heal leg ulcers, eliminate varicose veins.

Kentucky native Labon Richardson, 68, retired three years ago after more than 22 years as a territory sales manager for R.J. Reynolds Tobacco Company in Louisville, Kentucky. Labon learned about the job during a friendly neighborhood chat.

Labon Richardson

“One of my neighbors worked for R.J. Reynolds, and while we were talking, he told me there was an opening at the company,” Labon recalls. “I was interested in doing that type of work, so I applied for the job. They must have liked me because they hired me.

“After I retired, we moved to Punta Gorda. My wife and I grew tired of the winters in Kentucky with all the rain, snow and sleet. We love sunshine and warmth, and we like to be active, so we decided to come to Florida and find an active community.

“Mostly, I like to golf. That’s my number one sport, but I also enjoy walking, playing cards and sightseeing.”

Unlike most golfers here in Florida, Labon never wore shorts on the golf course, even on the hottest and most humid summer days. He was extremely unhappy with the appearance of his legs and did his best to hide them.

“I didn’t have very nice looking legs in my opinion,” Labon states. “The veins on my legs were dark and bulging and were quite unattractive. I’ve been embarrassed by those veins for years, so I wore long pants to events when I should have worn shorts. I just didn’t want people to see my legs.

“Then, I developed a small ulcer on my right leg. I went to my regular doctor and she tried a few things, but the ulcer didn’t heal very well. She suggested I visit Dr. Joyce for treatment of the ulcer as well as my varicose veins.”

Douglas H. Joyce, DO, is a board-certified vascular surgeon at Joyce Vein & Aesthetic Institute in Punta Gorda. Dr. Joyce specializes in the diagnosis and minimally invasive treatment of leg vein disorders. At The Ulcer Center at JVAI, Dr. Joyce uses specialized procedures to heal venous ulcers, a complication of venous disease in the legs.

“Many people who develop small wounds on their legs think it’s an ant bite or spider bite, and the wounds are often misdiagnosed as that,” Dr. Joyce notes. “People try to heal the wounds with dressings and antibiotics, but many times, the cause of the wounds is leaking leg veins, or venous disease. That was true with Labon.

“He came to us with a small mark on his leg, but as we examined him further, we discovered he had significant venous disease. We knew that by repairing his leaking leg veins, we could prevent Labon’s small wound from turning into a really big wound, which can lead to infection of the skin.”

Compromised Circulation

There are three types of veins in the legs. There are the low-pressure superficial veins near the surface of the skin, the high-pressure deep veins in the middle of the leg and the perforator veins that connect the deep veins to the superficial veins. Venous ulcers result when the valves in the perforator veins don’t function properly and high-pressure blood leaks out like a pressure washer toward an area of the skin.

“The ulcer on my right leg is completely gone, so I’m comfortable wearing shorts now wherever I go.” – Labon

“People develop venous ulcers on their legs because the venous pressure in the skin in that particular area becomes so high that the arteries cannot overcome it to push fresh blood into that area,” Dr. Joyce explains. “As a result, that area cannot get oxygen and nutrients, and it cannot get rid of waste products, so the skin dies and an ulcer forms.

“People who have compromised circulation due to diabetes or older age are at greater risk for developing ulcers, but anyone with a break in the skin, especially on the inside of the ankle, should be evaluated for venous disease using ultrasound.”

The ankle is the most common site for venous ulcers, Dr. Joyce notes. One of the reasons for that is because the ankle is the lowest point in the arterial chain, so the arteries there are quite small.

“Venous ulcers almost always develop above the foot in the ankle,” Dr. Joyce stresses. “When the valves in the leg veins don’t work properly, gravity forces blood backward down the veins, and it pools in the ankle. That’s where the venous pressure is highest and the arteries cannot push in fresh blood, so ulcers develop.”

For patients such as Labon, Dr. Joyce uses leading-edge procedures and state-of-the-art technology to treat ulcers and varicose veins. Before and after images courtesy of Joyce Vein & Aesthetic Institute.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 informs. “We use the technique on other veins that are not accessible with a standard laser system, but it’s primarily for closing perforator veins, and it works amazingly well.

“With Labon, we used standard laser ablation to treat his varicose veins in addition to the single-needle laser ablation technique on his perforator veins to treat his venous ulcer.”

“I can’t remember the name of the procedure, but Dr. Joyce went into my leaking veins with a probe,” Labon describes. “He used a laser to heat up the blood itself, and that made the vein collapse and stop protruding, eliminating the bulging varicose veins on my leg.

“He did the procedure several times in different areas of my right leg first. When Dr. Joyce was done, they did another ultrasound on my right leg to make sure the treatment worked and nothing else needed to be done. Then he treated my left leg.”

Shorts Season

Dr. Joyce used standard laser ablation and single-needle laser ablation to treat Labon’s varicose veins and venous ulcer. The treatment is successful because it eliminates the root cause of these conditions, venous disease.

“My legs look a lot better,” Labon enthuses. “The ulcer on my right leg is completely gone, so I’m comfortable wearing shorts now wherever I go. I’m very happy with my results. I’m also happy with Dr. Joyce and his staff at Joyce Vein and Aesthetic Institute.

“The first time I sat down with Dr. Joyce, he was very businesslike, but I felt very comfortable with him. He explained what was going on with my legs and described the treatments he performs for the problem.

“And everyone on his staff there is professional and friendly, and they treat me well. They put me at ease, made me feel at home and helped me through the entire process. I recommend them to anyone.”

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