Seals of Approval
Craig Nichols

Craig Nichols

Ablation techniques close damaged veins, reroute blood to bring leg relief.

Before the COVID-19 pandemic, Craig Nichols worked part time for a car rental company in Punta Gorda. His primary responsibility was to shuttle customers to the office so they could pick up their rental vehicles.

“When the customers finished with the vehicles and returned, I took them wherever they needed to go,” recounts Craig, 79. “I also transported cars to and from a branch in Arcadia. I worked there about three years.”

Prior to that job, Craig made his living in sales for the frozen potato industry. For years, he crisscrossed the country selling French fries.

“My career started in Portland, Maine,” Craig relates. “From there, I went to Baltimore for four years and then to Chicago for 20 years. I traveled throughout the Northeast when I lived in Maine. While in Baltimore, I branched out to the Carolinas and the middle of the country. When I moved to Chicago, I headed up sales for the entire United States.

“My company had factories from the East Coast to the West Coast, and I frequently brought customers to those factories. I was constantly flying around the country, which is why, in my opinion, I ended up with leg issues.”

Craig is convinced that the changes in air pressure that occur in an airplane contributed greatly to the leg problems that began 25 or 30 years ago and got worse over time. 

“I developed severe swelling in my legs, and that caused all kinds of problems, such as aches and pains and stiffness,” Craig describes. “It cut down on my mobility a great deal as well. It pained me to walk very far. 

“Working in sales, I was going in and out of airplanes and in and out of airports sometimes four times a week. When you park at Chicago O’Hare International Airport and have to get to Gate C30, it’s about a 2½-mile walk. It’s a monster, and there’s no other way to get there but to walk. It was detrimental to my legs.”

After retiring, Craig became a much-less-frequent flyer. But his leg condition worsened. Eventually, he developed open wounds on his legs. He sought advice from several physicians but wasn’t satisfied with their answers. 

“The best suggestion I received was to visit Dr. Joyce,” Craig reveals. “As soon as I walked into his office, I felt comfortable with him and with his initial interview. Dr. Joyce recommended some procedures on my veins, and I said, Let’s get this done.”

Douglas H. Joyce, DO, is a board-certified vascular surgeon at Joyce Vein & Aesthetic Institute in Punta Gorda. Dr. Joyce specializes in treating venous disease with minimally invasive procedures. This type of treatment has been proven to treat non-healing vascular leg ulcers. 

“Craig presented with tremendous swelling in his legs, which were also painful,” Dr. Joyce reports. “The skin on his legs was inflamed and weeping. Craig also had a history of venous ulcers. He had an active ulcer on his left leg and several healed ulcers on his right leg.

“We assessed his legs with ultrasound and identified several veins that were not working correctly. We recommended two procedures to seal those incompetent veins and reroute the blood flow through healthy veins.”

Like a Soaker Hose

There are two vein systems in the legs: the high-pressure central vein system deep in the muscles and the low-pressure superficial vein system just below the skin. The superficial drains into the central through perforator veins.

Leg veins contain one-way valves that prevent blood from flowing backward and pooling. If these valves are weakened or damaged, blood refluxes into the veins instead of flowing toward the heart, a condition called venous insufficiency. In cases of venous insufficiency, the affected veins leak and blood collects in the legs, causing swelling and discomfort.

“People with venous insufficiency present in many different ways,” Dr. Joyce discloses. “Some present with skin changes on the legs. Others present with pain as well as some degree of swelling. Some people present with leg swelling alone.

“Legs swell because the incompetent veins experience intense pressure and begin to stretch. The spaces between the cells of the vein wall grow larger as the vein stretches. Consequently, the vein becomes porous. It’s like a soaker hose in a garden. Water comes out of the holes in the hose.”

Initially, water leaks out of the veins into the surrounding tissues, which causes the leg to swell. Then, blood leaks from the veins and deposits iron under the skin, which causes the discoloration of the legs that is common with venous insufficiency.

“We begin treatment of venous insufficiency by sealing the leaking superficial veins, such as the great saphenous vein and small saphenous vein, using a standard laser ablation closure technique,” Dr. Joyce informs. “During this procedure, we slide a laser fiber along the length of the vein and use laser energy to seal the entire vein.”

To seal incompetent perforator veins, which are typically responsible for venous ulcers, Dr. Joyce uses a technique he developed called single-needle laser ablation.

“We first numb the skin,” Dr. Joyce explains. “Then, we take a specifically designed needle, and using ultrasound guidance, place it through the skin into the perforator vein. We apply anesthetic, then turn on the laser for 15 to 20 seconds, which spot-welds the area of vein being treated.

“Venous insufficiency is a significant disease of the legs that can lead to serious complications, including infection and a breakdown of the skin. Individuals experiencing swelling, pain, skin discoloration, restless legs at night or ulcers would do well to visit a physician that specializes in veins rather than someone who treats veins on the side.”

“No Swelling Whatsoever”

Craig can attest to that. His decision to seek out Dr. Joyce worked out well.

“Dr. Joyce explained that some of my veins were working properly and some were not,” Craig recalls. “He blocked off the bad veins and steered the blood into my good veins. 

“Once Dr. Joyce completed my treatment, I experienced a great deal of relief in my legs. Now, I have no swelling whatsoever, no aches or pains, and no sores on my legs. Everything works perfectly.”

Craig is as thrilled with the doctor and his staff as he is with the outcome of his procedures.

“Dr. Joyce is extremely knowledgeable and talented. I’m so glad I found him,” Craig enthuses. “I feel very comfortable with him. I listen to what he says, I do what he suggests and it works. 

“The entire staff at Joyce Vein & Aesthetic Institute is excellent. I’ve touched base with all of them during the course of my treatment. Like Dr. Joyce, they’re also very good and knowledgeable.”

© FHCN staff article. Photo by Jordan Pysz. Before and after images courtesy of  Joyce Vein & Aesthetic Institute. mkb
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