Surgeon’s Expertise Key To Vein Repair

Array of minimally invasive options available for venous insufficiency.

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

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 liked it.

“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 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 country 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 had begun to swell. Soon after, she began to feel the effects of the swelling.

“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 problems with her legs until these issues. Not long after, she learned the likely cause by reading 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.”

That doctor, 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®.

Indicators of Disfunction

At Bonnie’s first appointment, Dr. Sharma ordered an ultrasound of her legs that confirmed her suspicions. She was suffering from 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 explains. “This increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves, preventing 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 declares. “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 physician 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.”

Options Available

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®.

Bonnie Jones

Microphlebectomy has replaced vein stripping, an invasive and outdated procedure during which doctors remove 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 affirms. “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 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,” that permanently seal 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 informs. “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 from faulty veins to healthy ones.

“100 Percent Better”

Relying on his expertise as a guide, Dr. Sharma determines which minimally invasive procedures will work best based on each patient’s symptoms and health status. For Bonnie, he selected EVLA, Varithena and UGS. She is quite pleased with the outcome.

“My legs feel great; they’re 100 percent better,” Bonnie 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.”

Rewarding Career

Before she retired in the late 1980s, Melissa Hulls worked 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 at a large medical clinic.

Melissa Hulls

“Back then, we did different things than what’s being done today,” enlightens 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 tech, Melissa shifted into 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.

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

“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.”

When a change of jobs by her husband forced a relocation, Melissa sold her wedding business and took a position selling manufactured housing in Proctorville, Ohio. The couple later retired to Florida, where they have been remodeling a home in Homosassa.

Melissa has been doing much of that work herself, but her efforts were interrupted last year 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. tossing and turning all night long.

“Then I noticed one day that there were icky, purple-looking veins that poked out in the back of my legs. One of my neighbors saw it and recommended Dr. Sharma to me. I decided to go see him and have my legs checked out because I couldn’t stand the pain anymore.”

“Zero” Pain

As with Bonnie, Dr. Sharma began his treatment of Melissa with an ultrasound, which showed she had venous insufficiency. To correct the problem, the cardiovascular surgeon recommended EVLA and Varithena.

“My legs feel great; they’re 100 percent better.” – Bonnie

Melissa is thrilled with the result.

“My legs feel great now, and I’m enjoying life again,” 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.

The pain in Melissa’s legs is gone.

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

Melissa offers praise for Dr. Sharma and his staff.

“Dr. Sharma is a wonderful man,” 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, very thorough and thoughtful. They really 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