By Becky Wiese

We all need that one friend who will be brutally honest with us. Kathie Hovenden ran into her brutally honest friend in the grocery store one day and, during the course of their conversation, the friend told Kathie that she had just been to see the Vein Specialists. “Then she looked at my legs and said, ‘You should be there, too,’” Kathie laughs.

But, she realized, her friend wasn’t off base at all. “I remember both my mom and grandma would complain of ‘tired’ legs,” she says. “And I was starting to feel the same way.” Heredity is one of the leading causes of varicose veins, along with pregnancy, and jobs that require long periods of standing or sitting.

Kathie called The Vein Specialists for a consultation, and when she explained her symptoms and her family history, Dr. Kathryn Bohn knew exactly what needed to be done. “Dr. Bohn did a sonogram and showed me exactly what was going on — basically the valves in my veins would open, but not close, so blood would pool at my ankles instead of getting pumped back up to my heart.” The result was swollen, discolored ankles and heavy, tired-feeling legs.

Classic Symptoms, Common Misunderstandings
Kathie’s symptoms strongly indicated varicose veins, but unlike some people, hers were not visible or bulging. This is one area that the physicians who are The Vein Specialists are constantly educating people about. “Varicose veins are not always visible, so using the latest sonogram technology to see if the valves are broken have made them easier to treat,” says Dr. Kathryn Bohn, the founding physician of the practice.

Regardless of whether they are visible or not, varicose — which literally means swollen, twisted, and lengthened — veins can cause aching, fatigue, tiredness, and swelling in the legs. “There is true physical discomfort,” explains Dr. Richard Castillo, another partner in the practice. “Severe cases can also cause ulcers on the lower legs. The good news is, if the veins get fixed, the ulcers can heal.”

The Vein Specialists physicians, who include Dr. Thomas Nielsen, Dr. Jonathon Benson, and Dr. Ruel Wright along with Drs. Bohn and Castillo, find themselves doing a lot of educating about varicose veins.

“The biggest misconception is that treating varicose veins is only for cosmetic reasons,” says Dr. Nielsen. “Women especially have felt that way, many of whom thought they had to simply live with the pain, discomfort, and unsightly effects. And the advances in ultrasound and laser technology have made treatment more successful than ever before.”

The most eye-opening news, for many people, according to Dr. Castillo, is the fact that varicose veins is a medical condition — “95 percent of the procedures we do are covered by insurance, even Medicare” he explains.

Advances in Treatment
Treating varicose veins took a giant leap forward in 2002 when the Food and Drug Administration approved laser use for ablation procedures.

Prior to that, “stripping” the veins was the most common method of treatment. This surgical procedure involved making an incision (several, if necessary) on the leg or groin and inserting a wire which would be tied to the vein; the vein would then be pulled out. However, due to the nature of varicose veins, especially the twisting, the vein can sometimes break, requiring several incisions. If not all of the vein is removed, more issues can develop later. For these and other reasons, stripping is only 50-60 percent successful five to ten years post-treatment.

Laser ablation, on the other hand, has shown an 85-100 percent success rate five to ten years post treatment. “And I’d be willing to say that here [at The Vein Specialists] our success rate is more like 90-95 percent,” says Dr. Nielsen.

This procedure, technically called Endovenous Laser Ablation, uses ultrasound to guide a very small laser fiber through the diseased vein (the vast majority of varicose vein problems are found in the Great Saphenous Vein, which is the longest subcutaneous superficial vein in the body that runs the entire length of the leg).  Laser energy is delivered to the vein wall, causing the vein to collapse and seal shut. The blood is naturally diverted to other, healthy veins.

The Vein Specialists are proud to say that their laser is state-of-the-art and was purchased when their office opened five years ago. This up-to-date laser is less painful and causes less bruising, making treatment even more amenable to patients.

Since the procedure is done in the office with local anesthesia, patients are able to walk immediately after it is completed. A compression stocking needs to be worn for a period of time during the healing process and further treatments, such as sclerotherapy, when necessary, take place after healing has occurred.

Sclerotherapy is another treatment process in which, instead of the laser, medication is used to destroy the lining of the blood vessel to seal it shut. This treatment also uses ultrasound for finding the exact veins that need to be treated. Often the sclerotherapy treatment is performed four to six weeks after the laser ablation is done.

Benefits of a Specialized Practice
According to Dr. Nielsen, patients who undergo treatment at The Vein Specialists benefit from the fact that “this is all we do — varicose veins and spider veins — all day, every day.” They provide each patient with uninterrupted care and treatment and are able to concentrate on providing the best care possible. “Patients also get more expertise,” adds Dr. Castillo.

That expertise enables them to consult with each other as needed on more challenging and complex cases.

For example, when Kelly Uszcienski’s mother told her she “needed to do something about the bad spider veins behind [her] knees, she visited The Vein Specialists and underwent treatment in June 2014. “My legs would get tired and achy, especially when I walked my dog,” she said. She wore compression hose (usually required by insurance prior to any treatment procedure) and then underwent treatment.

“I felt so comfortable during the procedure; Dr. Castillo just kept talking to me and making me comfortable.” He also explained that it might look worse before it got better, simply because of the treatment and healing process.

Kelly also had some scar tissue, so Dr. Castillo brought in both Dr. Nielsen and Dr. Wright to help. “They worked together” to ensure the best possible outcome.

Kelly finished her injections for sclerotherapy in August 2015. “It’s been a long process,” she says. “But it took a while to get them [spider veins], so it made sense that it would take a while to get rid of them.”

Focusing on the Patient
The length of time it takes to complete treatment depends largely on each patient’s needs. Susan Manahan explains that after she saw Dr. Nielsen for a consultation, he developed a treatment plan and explained everything in as much detail (“and in terms I could understand”) as necessary to make sure she knew what to expect. “I started my treatments back in April and am almost finished.”

The treatments typically take several months, if not longer, from start to finish because they have to allow time in between procedures for healing to take place. Susan also felt very comfortable asking questions and bringing any concerns she had to Dr. Nielsen’s attention. “At one point I had some painful swelling with redness — I went in to have Dr. Nielsen take a look at it, and he took care of it right away.”

As any doctor knows, patient satisfaction is due in large part to the quality of the staff in the office — it’s rarely all about the doctor. “We have a fabulous staff,” says Dr. Nielsen. “We stress a team approach in caring for our patients.” Patients agree wholeheartedly with his assessment. “The staff is wonderful,” says Kelly. “I felt like I was going to see friends.”

Susan describes The Vein Specialists staff as “warm, friendly, knowledgeable, and considerate — I just love the staff!”

Kathie agrees. “Starting with my very first appointment, I felt that I had never seen a group of people happier and more convinced that everything they were doing was to make life better for each one of their patients.”

“I highly recommend The Vein Specialists,” Kathie goes on to say. For anyone who is suffering from the symptoms of varicose veins, “I would advise them to go get checked. It’s well worth it!”

The Vein Specialists are located at 3302 Gerig Drive in Bloomington. Find out more at www.ILveins.com or by calling 309-862-4000

The Signs and Symptoms of Varicose Veins

• Large veins that you can see on or just under the surface of your skin.
• Mild swelling of your ankles and feet.
• Painful, achy, or “heavy” legs.
• Throbbing or cramping in your legs.
• Itchy legs, especially on the lower leg and ankle. Sometimes this symptom is incorrectly diagnosed as dry skin.
• Discolored skin in the area around the varicose vein
• Restless Leg Syndrome
• Leg Ulcers