Last week I attended the monthly local medical society meeting at the Benton Club in St. Joseph. The bartender gave me a tour, attempting to squeeze in every highlight of its 100+ year history, while all the other member physicians gathered and greeted each other in the reception hall. Soon we were watching a local cardiologist give a presentation on the use of a non-invasive CT Scan to compute in seconds the risk of a heart attack in patients.
As I watched the colorful pictures on the screen, I thought of my mother, who passed away at a fairly young age after living with “heartburn” for years, that was treated with medications for indigestion. Being a woman and a diabetic are both major factors that confound the symptoms of heart disease. A slightly higher index of suspicion could have saved her life and one of the newer diagnostic tools such as the Coronary Calcium Scan could have kept her health in check.
My thoughts shifted to one of my recent patients, a 93-year-old woman with advanced venous disease in her legs. She was brought to my clinic in a wheelchair by her two daughters. When I asked her what changes she hoped to accomplish, she promptly responded, “Can you help me get me out of this wheelchair?”. There was no hesitation in her voice as she expressed her desire to not only live longer but also enjoy her life along the way.
Life is a beautiful journeyI witness the daily hopes and aspirations of numerous patients like this amazing woman who is 93 years “young”. Some have the usual symptoms of heaviness in the legs, cramps, restlessness, and swelling. Many others have lived long enough with vein problems in their legs and present with clots or sores in their legs. Hope tends to be contagious. Earlier this week, while treating a patient who came with a clot in her leg, I found out that her husband was also on my schedule. He has lived with swelling and sores in his legs for many years. She indicated with pride that, “I diagnosed his problem myself and told him to come and see you”. I won’t be surprised if he will soon be able to enjoy the full use of his legs without the constant fear of ongoing pain, infection, or even risk of amputation.
My kids did not have an opportunity to spend time with my mother, their grandmother, and I never had a chance to be her doctor. I take consolation from knowing that my work allows many of my patients to enjoy a longer, healthier life. Life is much more beautiful when mothers and grandmothers are part of the journey.
Treatment of ropey varicose veins may require one or more combinations of the following: Endovenous Laser Ablation, VenaSeal Closure System, Injection Sclerotherapy (including Ultrasound Guided Sclerotherapy and Catheter Assisted Sclerotherapy), and Microphlebectomy.
Large bulging veins that appear on the skin surface as ropey veins are frequently a major branch of a deeper (inside the leg) saphenous vein, such as the Great Saphenous Vein, which is often, but not always, involved. Ultrasound testing is frequently necessary to determine the level of involvement. If the saphenous vein is involved, it would likely need to be sealed first using Endovenous Laser Ablation (EVLA) or VenaSeal Closure System. This step in itself is sometimes enough to “shrink” the bulging vein. Any remaining unsightly veins may be either closed with sclerotherapy (using medication to seal the vein) or sections of the bulging veins may be removed by microphlebectomy. Unlike vein stripping, microphlebectomy is a simple, out-patient procedure performed under local anesthesia. Using very fine instruments, sections of unwanted veins are carefully removed through tiny openings without the need for sutures and with minimal risk of scarring. Vein treatments may be staged (occur on separate days) or a combination of treatments may be performed on the same day if recommended by your Phlebologist (Vein Specialist).
Now you may be able to get rid of the unsightly ropey varicose veins during your lunch break (and start looking for that pair of shorts you thought you could never wear!).
Where did summer go? It seems like only yesterday the snow had finally melted, after a prolonged winter, and here I am talking about fall. In fairness, this summer was an extraordinarily busy time for us at Alsara Vein Clinic. We saw more new patients in July than any other month in the past. Every one of my staff members worked extra, long hours to ensure each patient received top-notch care, even in the face of increased patient volume and the numerous urgent requests to see a patient the same day.
I am humbled by both the confidence that numerous referring providers have in our care and the trust of patients who refer family and friends. For example, Jim*, a 76-year-old gentleman, came to Alsara Vein Clinic after exhausting all options at hospitals and other clinics in the area. With a tracheostomy collar in place, he was unable to talk and breathe at the same time, yet he had much to discuss. After providing his medical history, he cleared his “airway trash”, drew a deep breath, and concluded by saying, “I am hanging by the last straw. My neighbor across the street advised me to come to you. You took care of him when he had no hope that anything could be done.” Since then, the topic of his conversation has been anything but medical. Taking swift breaks to inhale, he seemed more interested in talking about his friends, family and his many aspirations although, as he politely stated, “I realize that I won’t be able to participate in a bikini contest anytime soon!”
Later that week I saw Tom**, a 58-year-old, who had avoided seeking care as he was sure that leg amputation was going to be the only option available, given the advanced stage of chronic venous insufficiency in his leg. It seems that every clinic day has its fair share of patients with swelling, severe leg cramps, and restlessness. We also see many male patients with clots, bleeding, and poorly healing sores in their legs, all of which are features of advanced, chronic venous insufficiency.
A detailed duplex ultrasound scan (Mapping) provides us with a “road map” of all the key veins in the legs. The goal of every treatment modality is to get rid of the underlying varicose veins and restore proper blood flow by routing blood to the healthy veins. The new, modern, minimally invasive treatments allow us the opportunity to eliminate the diseased veins safely and effectively with very little downtime; these are also much safer than surgeries used in the past. Over the last 10 years, further advancements have occurred in our understanding of venous diseases and the options available to treat them. For instance, the latest 1470 nm laser used at Alsara Vein Clinic offers a 40-fold improvement in energy absorption, compared to older generation lasers, resulting in even less bruising and discomfort. All treatments including Endovenous Laser Ablation and Ultrasound Guided Sclerotherapy are performed in the comfort of the office setting and patients can resume normal activities immediately.
I feel very fortunate for the technology and scientific knowledge backed by the experience of successfully treating thousands of patients over the past decade. Although participating in a bikini contest is not completely ruled out for Jim*, I suspect that he will put his legs to much greater use in the years ahead!
Concerns about your legs? Call Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.
Sam Gupta, MD, MPH
* Jim is an actual patient of Alsara Clinic and has graciously given permission to use his quotes, story and images. ** Tom – his name changed to protect confidentiality.
Treatment of ropey varicose veins may require one or more combinations of the following: Endovenous Laser Ablation, Injection Sclerotherapy (including Ultrasound Guided Sclerotherapy and Catheter Assisted Sclerotherapy), and Microphlebectomy.
Large bulging veins that appear on the skin surface as ropey veins are frequently a major branch of a deeper (inside the leg) saphenous vein, such as the Great Saphenous Vein, which is often, but not always, involved. Ultrasound testing is frequently necessary to determine the level of involvement. If the saphenous vein is involved, it would likely need to be sealed first using Endovenous Laser Ablation (EVLA). This step in itself is sometimes enough to “shrink” the bulging vein. Any remaining unsightly veins may be either closed with sclerotherapy (using medication to seal the vein) or sections of the bulging veins may be removed by microphlebectomy. Unlike vein stripping, microphlebectomy is a simple, out-patient procedure performed under local anesthesia. Using very fine instruments, sections of unwanted veins are carefully removed through tiny openings without the need for sutures and with minimal risk of scarring. Vein treatments may be staged (occur on separate days) or a combination of treatments may be performed on the same day if recommended by your Phlebologist (Vein Specialist).
Now you may be able to get rid of the unsightly ropey varicose veins during your lunch break (and start looking for that pair of shorts you thought you could never wear!).
As I watched the colorful pictures on the screen, I thought of my mother, who passed away at a fairly young age after living with “heartburn” for years, that was treated with medications for indigestion. Being a woman and a diabetic are both major factors that confound the symptoms of heart disease. A slightly higher index of suspicion could have saved her life and one of the newer diagnostic tools such as the Coronary Calcium Scan could have kept her health in check.
Life is a beautiful journeyI witness the daily hopes and aspirations of numerous patients like this amazing woman who is 93 years “young”. Some have the usual symptoms of heaviness in the legs, cramps, restlessness, and swelling. Many others have lived long enough with vein problems in their legs and present with clots or sores in their legs. Hope tends to be contagious. Earlier this week, while treating a patient who came with a clot in her leg, I found out that her husband was also on my schedule. He has lived with swelling and sores in his legs for many years. She indicated with pride that, “I diagnosed his problem myself and told him to come and see you”. I won’t be surprised if he will soon be able to enjoy the full use of his legs without the constant fear of ongoing pain, infection, or even risk of amputation.
Treatment of ropey varicose veins may require one or more combinations of the following: Endovenous Laser Ablation, VenaSeal Closure System, Injection Sclerotherapy (including Ultrasound Guided Sclerotherapy and Catheter Assisted Sclerotherapy), and Microphlebectomy.
I am humbled by both the confidence that numerous referring providers have in our care and the trust of patients who refer family and friends. For example, Jim
