Venous insufficiency Without Visible Veins

After ultrasound reveals painful ailment, repairs done with minimally invasive procedures.

For 18 years, June Krippner worked as an administrative assistant in several departments of the University of Hartford in Connecticut. She spent eight years in the athletics department and eight years in financial aid. Ultimately, she served as an administrative assistant to the university’s president.

June has no trouble walking now that her leaky leg veins have been treated.

June was also a student at the university. She earned a bachelor’s and a master’s degree in education from the institution. Her goal was to become a teacher, a profession common among the women in her family.

“My mother was a teacher; my sister was a teacher; and my grandmother was a teacher,” June reveals.

Family responsibilities curtailed her career ambitions, however.

“At the time I received my master’s degree, my daughter had two children, and she asked me to babysit,” June recounts. “So, I didn’t get to use my degree as a full-time teacher, but I got to use it as a substitute teacher.

“I substituted for various grades at the elementary level in a little town called Simsbury. I’ve been retired since I started watching my grandchildren, about 15 years. We moved to Florida five years ago because the taxes and other expenses in Connecticut were too high, and the weather in Florida is much nicer.”

June, 69, now lives in a vibrant 55-and-over community in Punta Gorda and maintains an active social life.

“I belong to about 10 different clubs, including those for quilting, knitting and playing mahjong,” she relates. “I also create artwork at the visual arts center and go to many concerts and shows with friends. Every single day, there’s something going on, so I stay pretty busy.”

Two years ago, June developed a troubling issue with her legs that put a cramp in her active lifestyle. She experienced intense heaviness in both legs that limited her ability to get around.

“My legs felt like they weighed 50 pounds each,” June elaborates. “I couldn’t move my legs, and my feet were numb. It didn’t disturb me until I physically couldn’t walk. I got up at night, and I had to slap my feet on the ground to get the circulation going.

“There was not a lot of swelling, although my ankles swelled a little. I wore compression socks at night. There were no varicose or spider veins visible on my legs. I just had the heaviness in my legs and the numbness in my feet. I didn’t notice the problem coming on. It developed gradually over time.”

One of June’s friends is an administrator at Joyce Vein & Aesthetic Institute, the Punta Gorda practice of Douglas H. Joyce, DO, a board-certified cardiovascular surgeon. Dr. Joyce specializes in treating venous disease with minimally invasive procedures and addresses all stages of the ailment from spider veins to venous ulcers.

“My friend said, You should have Dr. Joyce check out your legs,” June remembers. “I followed her advice, and after the examination, Dr. Joyce said, June, your legs look good, but your veins are a mess. He told me I could potentially develop ulcers on my legs if I didn’t take care of the vein problem right away.”

Invisible Symptoms

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 system drains into the central system through perforator veins and the saphenous vein system.

Leg veins contain one-way valves that prevent blood from flowing backward and pooling. If these valves are weakened or damaged, blood flows back in the veins instead of toward the heart, a condition called venous insufficiency. As a result, blood collects in the legs, causing swelling and discomfort.

“June did not have bulging varicose veins or spider veins, swelling or discoloration, which are the common outward signs of venous insufficiency,” Dr. Joyce recalls, “but the disease doesn’t always have external signs.

“That was the case with June, who did have heaviness in her legs, numbness and some difficulty with balance. Venous disease sometimes presents that way, and sometimes it comes with aching, restless legs at night or an antsy feeling in the legs. Some say it feels like bugs are crawling on their legs when they’re sitting in a chair or trying to sleep at night.”

Recognizing June’s invisible symptoms, Dr. Joyce ordered a venous ultrasound mapping of her legs.

“It’s been about a year since my vein treatment, and my legs feel great.” – June

“The ultrasound showed significant venous insufficiency in her long veins — the great and small saphenous veins — and in her perforator veins,” Dr. Joyce reports. “She had the picture of what we would expect to see on someone that has visible signs of venous insufficiency, but she didn’t have those signs. We advised treating her venous dysfunction.”

Dr. Joyce performed two minimally invasive procedures to close them: standard laser ablation and single-needle laser ablation, the latter a technique he developed.

“During standard ablation, we slide a laser fiber along the length of the vein and use laser energy to seal the entire vein,” Dr. Joyce explains. “Blood flow is then rerouted to other healthy veins.

“During single-needle laser ablation, which we typically use to treat abnormal perforator veins, we take a specially designed needle and, using ultrasound guidance, place it into the target vein. We insert a laser fiber, apply anesthetic, then turn on the laser for 15 to 20 seconds to spot-weld the area of vein being treated.”

Dr. Joyce performed 14 procedures on June, seven on each leg.

“Once we’re done, we perform another ultrasound to make sure all the blood is flowing the correct way and there’s no more abnormal venous flow. That’s our ultimate goal,” the doctor says.

“World of Difference”

June is extremely pleased with the outcome.

“It’s been about a year since my treatment, and my legs feel great,” she enthuses. “The heaviness is gone, and I have no trouble walking. I also bike and do water aerobics. My legs are very comfortable now. I don’t have any issues, and I sleep through the night.”

June is just as delighted with her experience at Joyce Vein & Aesthetic Institute.

“Dr. Joyce is very knowledgeable,” she raves. “He’s excellent. After the initial ultrasound, he showed me a diagram of my legs and explained very thoroughly what had to be done. I understood exactly what he was saying.

“I’m very happy with Dr. Joyce’s professionalism and the professionalism of the people in his office. They’re kind people. I can tell they care. I’ve been to a lot of different doctors during my life, and Joyce Vein & Aesthetic Institute is the most kind and considerate office I’ve ever been to.

“I recommend Dr. Joyce and his procedures 110 percent. They made a world of difference in my life.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb
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