Getting back to good health – Carrie’s story

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Carrie Brinson Schulze and her husband, Ryan Schulze

When you visit or are referred to VCU Health at Baird Vascular Institute complaining of leg pain, we take a very close look at what’s behind it. Leg pain can be one of the first and most common symptoms of peripheral vascular disease, a variety of conditions and diseases that affect the arteries of the body, usually in the heart, brain and especially the legs, that can have life-threatening consequences. So leg pain is our signal to check out your overall vascular health.

Carrie Brinson Schulze experienced some unusual leg pain and swelling. Though she was only 33 at the time, and much too young, she thought, to experience such symptoms, she decided to come to us for an evaluation.

“I’m a chef and I stand all day long, sometimes 12 to 15 hours a day depending on what I’m doing,” she said. “About 4 years ago, I noticed that I would get a large amount of swelling in my left leg, and some bulging veins in my left calf, not the small spider-like veins, but big bumps on my leg.”

Her symptoms started appearing in 2012 after the birth of her child. It was then she noticed that after long periods of standing her left leg would swell to almost twice the size of her right leg. At the time, she didn’t have health insurance, but had been previously been tested for muscular issues and blood clots, and the results were negative.

“Living downtown, I was familiar with Baird Vascular Institute because I had seen their billboards,” said Carrie. “When I finally got health insurance, the very first appointment I made was to Baird Vascular.”

She had her first appointment with us in 2015. Since that time, she has had three separate procedures with our team.

“My experience with Baird Vascular Institute has been amazing,” said Carrie. “The first time I called there, the receptionist happened to be on vacation and I actually talked to Cindy, the one who does the ultrasounds. She fielded my call and made me feel very comfortable, and told me over the phone what to expect with my first appointment. She assured me that I was calling the right place.”

“When I came in for my first appointment with Dr. Komorowski,” she continued, “The ladies at the reception desk, Deena and Tiffany, were super fast, efficient, friendly, courteous – they were so great!”

“At the time of this appointment, I was 33 years old and my anxiety level was through the roof,” she admits. “I thought I was too young for anything like this to be happening. So I was really scared at my first appointment.”

Our experienced staff soon eased Carrie’s fears. “I first met nurse Richard – who is amazing,” said Carrie. “He has the best bedside manner of anyone I’ve ever met – nurse or doctor. He just makes you feel so relaxed with his great sense of humor and good stories. He assured me I would be OK.”

Carrie underwent a vascular ultrasound exam with Dr. Komorowski and discovered that her greater saphenous vein was four times its normal size. “That’s when I learned that I would need an ablation and at least 2 procedures to correct the problem,” said Carrie.

Carrie underwent the first procedure soon after her exam, and the only issue she had was some sickness from the anesthesia. “I had to stay in the recovery room for several hours because of the nausea,” Carrie recalled. “The staff took such excellent care of me and even called me that night to check on me. They followed me very closely throughout my recovery.”

When she came in for her follow up appointments, she had recovered well and got the approval to proceed with her second procedure. “This time,” she said, Nurse Richard had done some thinking on my behalf after the first procedure, knowing that I gotten very ill from the anesthesia. This time, they sent me a little patch to put behind my ear to prevent nausea.” She continued, “Richard really went above and beyond to comfort me in that manner – he really takes excellent care of his patients.” She underwent a second procedure to close the lower saphenous and some branch veins.

“I had to go in there a lot because I had 3 procedures, with many pre- and post-op appointments, and 2 week and 6 week follow ups,” she said. “I never felt like ‘just a patient,’ because they really take their time to answer all your questions thoroughly.”

“In May of this year, I had my final yearly examination,” said Carrie. “Right now, everything has been good.”

“I used to stand and within a minute, I would get a bulge in the back of my calf and my ankles and I would have fatigue and pain, and now I don’t have that any more,” Carrie said. “My leg doesn’t swell anymore.”

Carrie notes that she was particularly impressed with the technology at Baird Vascular Institute. “It’s not a scary thing to go into the clinic like it is to check into the hospital,” she said. “You’re kind of awake while they’re doing the procedure, they let you pick out the music you listen to, it was all very relaxed.”

“If I do need to go back in the future, I have no worries,” Carrie continued. “I’ve just been really impressed with that whole clinic.”

Carrie concluded, “I feel like I’m finally on the path to wellness. I’ve been able to exercise again, and standing at my job is no problem. It was a successful treatment for me, definitely.”

If you’re facing leg pain like Carrie, we have the latest in technology, techniques and medications to treat vascular disease, ease your pain and help you get back into good health. Call us at (804) 828-2600 to discuss your options.

Who are the best candidates for image guided tendon treatment?

baird image.guided candidate

Tendons are the tough, flexible bands of tissue that connect your muscles to the bones in your joints, working together to allow all the twisting, gripping, grabbing, bending and lifting in your busy life. But repetitive pounding motions can cause microscopic tears every time you use your tendon. As you keep at it, these micro tears do not have time to heal properly and, unless treated, can get worse, making you suffer for months or years. This condition is often called simply tendinitis (tendon inflammation), but usually is actually tendinosis, tendon tissue that has simply broken down from the overuse and micro tears.

It’s impossible to ignore the pain…and you shouldn’t. Tendon injuries need attention. Sometimes, rest, therapy and a change in activities may ease the pain…but often the damage is permanent, and only gets worse.

We talked to Dr. Jeffrey Elbich, who said, “The majority of the time, tendon pain goes away on its own with time, rest and ice – and reducing the activities that brought the pain in the first place. However, if the pain lasts more than 3 months, medical research suggests that it is unlikely to go away on its own.”

“If you’ve had pain more than 3 months and you’ve tried all the home remedies with no relief, you may be a good candidate for image guided tendon treatment,” continued Dr. Elbich.

If you’re frustrated with chronic tendon pain or have tried multiple treatment options, our image-guided tendon treatment – also called percutaneous tenotomy or fasciotomy – could be the treatment you need for rapid pain relief. Unlike other medical or physical therapies, this procedure safely removes the cause of the pain at the source, and unlike many traditional surgical procedures, it is far less invasive, requires far less recovery time – and has a much higher success rate.

The treatment requires only a local anesthetic and a tiny incision, and is virtually pain-free. We use a targeted application of ultrasound energy to break down the damaged tendon tissue while leaving surrounding healthy tissue untouched.

We then use an FDA-cleared device to remove the damaged tendon tissue. You don’t even need stitches. The entire treatment takes about 20 minutes.

You may be asking if image-guided treatment is right for you.

If you answer yes to these questions, it may be time to discuss our image-guided tendon treatment.

  • Have you given up any activities due to tendon pain?
  • Have you been suffering for three months or longer?
  • Have you taken multiple steps to get rid of your pain without lasting success?
  • Are you tired of masking the pain or enduring it rather than treating it at the source?

Call us at (804) 828-2600 to discuss whether image-guided treatment is the right option for you.

How does having a port affect my daily life?

Baird Cancer Treatment Port

Many conditions, such as cancer treatment, long-term IV medication or kidney dialysis, require frequent or constant access to your veins. Repeated needle sticks in the same area can be hard on you and hard on your veins. That’s why we specialize in placing vein access ports, so that doctors don’t have to stick you with a needle or restart an IV line every time you need treatment. That makes care easier — and your life easier.

Once you have a port, you may wonder how it will affect your day to day activities. We spoke with Richard Williams, RN, BSN, OCN at Baird Vascular Institute, who said to think of it as you would any medical procedure, “For the first few days, avoid any heavy lifting or strenuous activities.” Williams continued, “There are folks who like to hunt, or play tennis, or even have a job like a hairdresser where their arms move up and down frequently, for those folks we tell them they need to give the site a chance to heal, to let the skin start coming together and heal.”

Williams added, “We do ask people about their lifestyle and take that into consideration when placing the port. We can put the port on a different side if needed. All these things are discussed with the patient because we know they’re going to have this port for awhile.”

You can even travel with a port. Williams added, “If you do go through an airport scanner, it shouldn’t go off because there’s not metal in the port, but you can pull out a card that we’ll give you and show the agent what the ‘bump’ is in your scan.”

If you’d like to learn more about port and the procedure, we have a whole series of YouTube videos on the topic.

We’ll work with you and your health care team to choose the best long-term IV access option for your situation. Give us a call at (804) 828-2600 to discuss your options.

 

Why you should talk to your doctor about PAD

PAD, or peripheral artery disease, affects about 8 million Americans. It can start as early as the age of 20, and becomes more common as one gets older. By age 65, about 12 to 20 percent of the population has some degree of vascular disease. Early diagnosis is critical, as people with PAD have a four to five times higher risk of having a heart attack or stroke. Unfortunately, PAD often goes undiagnosed as symptoms are often mistaken for something else.

So how do you know if you’re at risk for PAD? “Unfortunately, with PAD, sometimes there are factors that the patient can control and sometimes not. Sometimes it runs in the family and your risk factors are genetic,” said Dr. Jeffrey Elbich. “Other risk factors include advanced age, male gender, smoking, especially those with a long smoking history, and people with other medical problems such as diabetes and hypertension.”

Dr. Elbich explained some symptoms to watch out for. “A typical patient will describe walking for a few block and being affected by sudden painful cramps in the legs and thighs that resolve after a period of rest.” He continued, “For every one person who has symptoms, there are three to four who have no symptoms at all. If you have some of the risk factors we just mentioned, it’s important to talk to your doctor and be screened.”

The screening involves a review of the patient’s medical history and any symptoms, followed by a physical exam. “You physician will preform an ABI, or ankle brachial index which measures the blood pressure in your arms, compared to the blood pressure in your ankles,” said Dr. Elbich. “If it’s significantly different, that indicates a blockage in your legs and is indicative of PAD.”

Many peripheral vascular conditions can be diagnosed and treated on an outpatient basis by the interventional radiologists and vascular surgeons here at VCU Baird Vascular Institute. If you want to learn more about peripheral artery disease and treatment options, wish to discuss symptoms or problems you may be experiencing or if your doctor has recommended that you see us for a vascular test, please contact us at (804) 828-2600.

3 nonsurgical ways to cover unsightly leg veins

Baird cover spider veins

Warm weather is here, and with it comes shorter hemlines, lighter fabrics and more skin showing. Unfortunately, 20 percent of all adults, and 50 percent of adults over 50, experience varicose veins, predominantly women. If the unsightly veins on your legs embarrass you, there are a few natural remedies to help.

Makeup. Today, there are a number of high-quality makeup formulas designed to temporarily hide significant skin imperfections. These long lasting products can cover a variety of discolorations and irregularities such as scars, birthmarks, veins and even tattoos. Even your own makeup concealer can be used to cover small areas, but if you have larger areas to cover, there are products for that as well.

Self-tanners. We’ve talked about minimizing skin cancer risks here in the past, so we’re already big fans of any sunless tanning options. But did you know that sunless tanning products can also minimize the appearance of varicose and spider veins? Self-tanning creams and lotions can help cover scars and light veins, and even make skin dimples, cellulite and protruding veins less conspicuous. The bronzing reflects light and evens the overall skin tone and greatly improves appearance. Besides, who doesn’t love a little tan color for those summer picnics and events?

Stockings. Even though stockings are not the first option that comes to mind when you think of summer, you might want to think again. Today’s compression stockings offer a multitude of cute and fashionable options to wear with shorts and skirts. They look like regular knee-high socks, but offer coverage of any discolored or protruding leg veins, as well as the added benefits of compression for pain relief, improved circulation and slowing the progression of vein irregularity.

However, if you’re just simply tired of trying to find new ways to camouflage your embarrassing leg veins, give us a call and let’s see what we can do for you. Our vascular specialists are experts in evaluating and treating varicose veins, from unsightly spider veins using new, gentle and highly effective treatments to the relief of more serious, painful and even dangerous major varicose veins. Our vascular surgeons and interventional radiologists work hand in hand to treat patients with varicose using today’s most advanced technology and procedures, with your treatment plan tailored to your specific needs. Call us at (804) 828-2600 to discuss your options.

3 Famous Athletes Who Have Dealt With Plantar Fasciitis Issues.

BVI celebrity atheletes

Celebrity athletes – they’re just like us! Well, in some ways. Even with their glamorous high-profile lifestyles, famous athletes can be sidelined by everyday ailments just like all of us. Here are 3 recognizable names that have dealt with the symptoms of plantar fasciitis.

Quarterback Eli Manning was diagnosed with plantar fasciitis in 2009. With rest and rehabilitation, Eli is still in the game today.

Way back in 2001, Shaquille O’Neal, an NBA MVP, missed that year’s All-Star game due to a strained foot. Shaq’s size 21 shoe took quite a beating on the hardwoods, but again, with time and rehab, was able to maintain his game for another 10 years before retiring in 2011.

Joakim Noah of the Chicago Bulls continued to play despite the pain through the NBA playoffs in 2013, but admitted “It feels like you have needles underneath your feet while you’re playing.”

At VCU Health at Baird Vascular Institute, we’ve been helping patients overcome the pain and frustration of plantar fasciitis with a non-invasive procedure called image-guided tendon treatment. Whether you’re a famous athlete, or an infamous slow jogger, we can help relieve the pain and get you back to the top of your game.

Why a port is a good idea

VCU Health Baird Port

From needle sticks and blood draws, from injections to IVs, everybody has had their shots. Usually, a pinch is all there is to it. But many conditions, such as cancer treatment, long-term IV medication or kidney dialysis, require frequent or constant access to your veins. Repeated needle sticks in the same area can be hard on you and hard on your veins. That’s why we specialize in placing vein access ports, so that doctors don’t have to stick you with a needle or restart an IV line every time you need treatment.

We talked to VCU Baird Institute’s Dr. Shep Morano about why someone might need a port.

“A port is a safe, reliable and low maintenance way to access a patient’s bloodstream,” said Dr. Morano. “Sometimes a port is recommended for patients who have used up all their peripheral veins, or doctors or nurses are having difficulty accessing their veins.”

Placing a semi-permanent catheter such as a “port-a-cath,” chemotherapy port or IV access port into a large vein in the upper arm or neck can make treatment easier for patients undergoing treatments that require frequent or constant vein access.

  • Chemotherapy or anti-cancer drug infusions
  • Hemodialysis
  • Long-term intravenous antibiotic treatment
  • Long-term intravenous feeding
  • Repeated drawing of blood samples

These ports can remain in place for several weeks or months and can help patients in many ways:

  • Fewer needle sticks to draw blood
  • Multiple IV lines accessible at one site
  • Lowered risk by reduced leakage, which is particularly important with chemotherapy agents that can cause tissue or muscle damage if they leak

Dr. Morano added, “The benefits of added safety, patient comfort, infection control, and ease of access make ports a great option for someone who needs long term central venous access.”

There are several types of long-term IV ports, the most well-known is the Port-a-cath. Unlike most other types of catheters, a port-a-cath is implanted completely underneath the skin. This type of port allows you to bathe and swim without the risk of infection. Port-a-caths can remain in place for months or even years.

A peripherally inserted central catheters or PICC line is inserted into one of the large veins in the arm near the elbow. PICC lines are generally used for shorter periods (one to six weeks) and are easier to remove.

These types of catheters, such as a Central line, tunneled venous catheters or Hickman catheters, are inserted into a large vein under the collarbone or in the neck and leave the body through a separate exit point, usually the upper chest. A “cuff” secures the line, providing protection from infection and holding the catheter in place as your body heals around it.

We work with you and your health care team to choose the best long-term IV access option for your situation.