Just The Ticket

Gloria Milam began working on the railroad right out of high school. She served 41½ years in the industry, mostly with CSX, which transports freight along 21,000 miles of track throughout North America.

“Initially, I hired on with Penn Central in Michigan and then moved to New Jersey with Conrail,” Gloria recounts. “Then in the late ’90s, CSX and Norfolk Southern bought chunks of Conrail. The headquarters for CSX is in Jacksonville, and my family was living in Florida, so I said, Florida is where I need to go.

“I worked in customer service operations for CSX. I handled all the train documents, which included details such as where the train was going and what it was hauling. I made sure the conductor got the documentation wherever he got on the train, via computer. Once he received the official paperwork, he was legally able to leave the station.”

Gloria was 62 when she retired in 2019. She was ready to retire two years sooner but agreed to stay on to help the company through a difficult time.

“At CSX, you can retire at 60 as long as you have 30 years of service,” Gloria discloses. “But when I was getting ready to retire, there were 28 other people retiring at the same time. That would have crippled the office, so they staggered our retirements to avoid that.”

Following retirement, Gloria relocated to Summerfield to take care of her aging mother. The caregiving situation was reversed in 2021, however, when Gloria began experiencing issues with her health. Her legs, especially, were a wreck.

“My legs were swelling a lot and really big,” Gloria laments. “I suffered from lymphedema. I developed sores on my legs and had to go to wound care because they wouldn’t heal. At one point, I had MRSA on my left leg.”

Lymphedema is an accumulation of fluid in the limbs that is normally drained through the lymphatic system. This network of vessels, organs and tissues carries clear fluid called lymph, which contains disease-fighting white blood cells. Lymphedema typically causes abnormal swelling in the legs or arms.

MRSA (methicillin-resistant Staphylococcus aureus) is a bacterial infection found in various parts of the body but primarily on the skin. It is difficult to treat because the bacterium resists many antibiotics.

“Eventually, I could barely walk and had to use a walker to get around,” Gloria describes. “In May of last year, I couldn’t walk at all. I had to go to rehab because my legs were so heavy that I couldn’t lift them. I slept in a recliner because I couldn’t swing my legs into bed. And I couldn’t climb into the car without my sister picking up my legs.

Gloria’s sister suggested that she seek help from Ravi Sharma, MD, 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® (Summerfield).

“My sister is a retired nurse, and she heard about Dr. Sharma from a friend. She asked me if I would be willing to go see him. I said, It can’t hurt. If he can help me, that’ll be really good. My first appointment was at the end of October, first part of November.”

Pain From Veins

During Gloria’s first visit, Dr. Sharma performed an ultrasound of her legs that revealed Gloria had venous insufficiency, a condition that can become chronic if left untreated.

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

There are multiple signs and symptoms of venous insufficiency, Dr. Sharma reports. These are indicators that the veins are not functioning as they should.

“Signs are visible indicators,” the doctor details. “They include varicose veins, and swelling, thickening and skin discoloration of the ankles or legs. Symptoms, which are felt, include throbbing, aching, stinging, burning, itching, heaviness, nighttime leg cramps and restless legs.”

These signs and symptoms are indicators that the veins are not functioning properly; Dr. Sharma urges anyone experiencing them to have a leg assessment. Leaving the condition untreated, he stresses, can lead to more serious complications, including leg ulcers, infection and a breakdown of the skin.

As with Gloria, venous insufficiency is often the cause of lymphedema because backups in the veins interfere with lymph circulation.

“After he received the results of the ultrasound, Dr. Sharma told me my vein condition far exceeds the requirements for Medicare to pay for treatment,” Gloria remembers. “He then explained the procedures he could use to fix my bad veins, and I said, OK, let’s get it done.”

End of the Line

Jordan Pysz / ifoundmydoctor.com
A comprehensive treatment plan for venous insufficiency helped Gloria regain her mobility and independence.

At Premier Vein Centers, Dr. Sharma offers a range of minimally invasive, advanced treatments for venous insufficiency. These include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections, VenaSeal™ and Varithena®. These 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 contends. “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.

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. It treats the vein wall and collapses the vein.

All of these advanced treatments are performed in a comfortable office setting using local anesthetics and result in little or no discomfort or downtime, according to Dr. Sharma.

“Our patients are often very relieved to discover there is no general anesthesia involved in our minimally invasive treatments,” Dr. Sharma notes. “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.

Expertise and Compassion

Dr. Sharma relies on his expertise to tailor the procedures to each patient’s symptoms and health status. For Gloria, he selected EVLA, Varithena and UGS. She’s thrilled with the results, particularly the decrease in leg swelling.

“He used everything to make my veins do what they have to do, and it worked,” Gloria enthuses. “The width of my legs is down at least three inches from what it was when I first went to see Dr. Sharma, and it’s staying down.

“I wear support hose to help keep the swelling down, which is fine, because I’m walking with a cane now instead of a walker and taking short walks that I hope will get longer as time goes on. But I don’t think I would be walking at all if the treatments didn’t work.

“I’m driving again, and I can get in and out of the car by myself. I don’t have any problems picking up my legs the way I used to, so I’m sleeping in my bed again instead of a recliner.

Dr. Sharma attributes Gloria’s recovery to her decision to visit a surgeon who specializes in venous diseases. He strongly urges others seeking vein treatments to do the same.

“I also recommend staying away from physicians in large practices that offer a variety of services and perform venous treatment as a side service,” the doctor states. “Vein treatment must be tailored to the individual. There is no one-size-fits-all approach.

“I also recommend finding a physician who is experienced in the advanced procedures to treat venous diseases. In addition, the physician must express genuine concern and compassion for patients. Physicians with these qualifications achieve the best outcomes.”

Gloria believes Dr. Sharma possesses these qualifications and has complete trust in him.

“Dr. Sharma told me he used to perform open-heart surgeries. I felt pretty confident that if he can connect those veins and arteries, he can take care of my legs,” Gloria reveals. “His experience made a difference to me.

“I really like Dr. Sharma. He cares about his work. He takes his time and answers any questions you have, which I appreciate because a lot of doctors don’t do that. And he communicates everything he does.

“During treatment you can’t see what he’s doing, but he tells you. He’ll say, Now, you’re going to feel a little poke. Tell me if you feel any pain. If you do, he’ll numb you a little more.

“I like the whole staff at Premier Vein Centers. They’re great. They’re all about the patient. I absolutely recommend Dr. Sharma and Premier Vein Centers.”