Physician Profile – Dr. Levy

VCU Health’s medical staff at Baird Vascular Institute reflects fresh thinking about a collaborative approach to vascular care. VCU Health Medical Center’s Division of Vascular Surgery and Department of Radiology joined forces to create Central Virginia’s only academically based vascular center. We’ve brought together leading interventional radiologists and vascular surgeons to provide the Greater Richmond and Central Virginia region with the best in vascular diagnosis and treatment. Together, they offer area patients and referring physicians a level of medical expertise, experience and knowledge usually found only in a major academic medical center, as well as the most advanced technologies and facilities to support their work – all in a convenient outpatient setting.

Occasionally, we like to highlight some of our physicians on a more personal level. We recently sat down with Mark M. Levy, MD, our Chair of Vascular Surgery – to find out a little more about what he’s like outside of the office.

Where are you from?  I’m originally from Elberon, New Jersey – on the Jersey shore. The job at at VCU Health is what brought me to Richmond in the 1990’s.

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Mark M. Levy, MD

Would you say you’re a city person or a country person? I have no idea – I feel like I could be both. I feel comfortable in both an urban environment or a profoundly rural environment. But I would have to say, like most people, I can relax a little more in a rural environment.

What do you enjoy in your spare time? I like to spend time with family on the river in Deltaville, Virginia – both sailing and fishing. My children have small racing sailboats, Optis and Lasers, and they’ve all learned to sail in Deltaville over the past 15 years.

Tell us about your family. My wife & I moved to Richmond in 1998, and we have 5 children, all of which are in school in Richmond or at the University of Virginia in Charlottesville.

What’s your favorite television show and why? That’s a hard one, that presumes I watch anything other than news and sports and increasingly, only sports. As many folks do, we watch more and more movies on Netflix and online.

What’s your favorite sports team? I love so many teams, but I do like the Richmond Flying Squirrels – since I’m a baseball fan, they would have to be my favorite.

What’s your favorite book? I enjoy reading stories from the Bible, but don’t happen to have a current favorite book.

If you were stranded on a deserted island, what are 3 things you’d want to have with you? Well, first, a large container of spring water for obvious reasons, a sailboat and mosquito repellent – I’m very susceptible to mosquitoes.

What’s one thing patients would be surprised to know about you? Most people don’t know that I have 5 children – ranging in age from 14 to 19.

What do you like most about working at Baird Vascular Institute at VCU Health? I love taking care of vascular patients with both venous and arterial occlusive disease. I enjoy getting to know them as well.

Why do some people get varicose veins and others do not?

Baird why some varicose veins

Varicose veins, ranging from the blue splotches of spider veins to the thick, ropey and twisted dark varicose veins that can make standing and walking painful, have much in common. They’re unsightly. They can be painful. If left untreated, they can progress to serious health problems. They’re very common: 20 percent of all adults, and 50 percent of adults over 50, experience varicose veins, predominantly women.

Varicose veins are enlarged veins in the legs near the surface of the skin, ranging from tiny to large. Most people associate varicose veins with prominent, swollen, twisted, and ropelike veins wrapping their legs, often dark blue in color – and often quite painful.

Some people do not have any troublesome symptoms at first. Mild symptoms may include:

  • Swelling in your feet and ankles
  • Heaviness, burning, aching, tiredness, or pain in your legs, particularly when you stand or sit for a long time
  • Itchy skin over the vein

More serious symptoms may include:

  • Leg swelling
  • Swelling and calf pain after you sit or stand for long periods of time
  • Skin changes, such as skin color or dry, thin or scaling skin
  • Inflammation
  • Open sores or excessive bleeding after a minor injury

But why do some people get varicose veins, while others do not? Varicose veins can be caused simply by advancing age or pregnancy. They’re caused by weakened valves in the leg veins that flow blood back to your heart. When the valves weaken, blood pools and builds pressure in the leg veins, causing them to swell, expand and twist as the walls of the veins are weakened.

According to the Mayo Clinic, the following factors increase your risk of developing varicose veins:

  • Age. The risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing up to your heart.
  • Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
  • Family history. If other family members had varicose veins, there’s a greater chance you will too.
  • Obesity. Being overweight puts added pressure on your veins.
  • Standing or sitting for long periods of time. Your blood doesn’t flow as well if you’re in the same position for long periods.

The weakened valves and veins are prone to clots or hemorrhaging, which is why treatment is so important.

However, not all varicose veins require clinical treatment. In mild cases, home treatment may be all you require to ease your symptoms and keep the varicose veins from getting worse. You can:

  • Exercise to strengthen the muscles and veins of the legs
  • Wear compression stockings to improve blood flow and limit vein swelling
  • Prop up your legs to allow the blood to flow out of the legs easier.
  • Avoid long periods of sitting or standing.

Most insurers typically cover treatment of the more serious, symptomatic varicose veins; some do not cover treatment for spider veins, considering it a cosmetic procedure.

If your diagnosis indicates that you need a specific treatment, our staff will submit all relevant information to your insurance company for pre-authorization, or provide you with the approximate cost of treatment.

Call us at (804) 828-2600 to discuss your options.

 

 

 

 

 

Why Baird Vascular Institute at VCU Health is unique

Baird Institute

With the expertise of a major medical center and the convenience of a neighborhood clinic, VCU Baird Vascular Institute is unique.

We are the only academically based vascular center in Central Virginia, combining the medical expertise, knowledge and advanced technologies of a prominent academic medical center with the ease and convenience of a neighborhood outpatient clinic.

The history of the VCU Baird Vascular Institute – and the inspiration for our work in advancing vascular medicine – is rooted on the work of a pioneering cardiologist, Charles L. Baird, Jr., M.D.

In 1972, Dr. Baird, a graduate of VCU School of Medicine and a member of the staff at the Medical Center, decided to take a bold step to completely transform the way vascular and heart disease was diagnosed and treated. He was convinced that early diagnosis and treatment could prevent needless suffering and save countless lives, and established the Virginia Heart Institute – now the VCU Baird Vascular Institute – to prove it. By bringing together the experience and expertise of leading interventional radiologists and vascular surgeons from VCU Health, we work to detect problems earlier and to develop and refine new, minimally invasive treatments and procedures that reduce risk, increase success rates and speed recovery for a wide range of vascular conditions, all on an outpatient basis. Because of this, you no longer have to travel to downtown Richmond to find advanced, comprehensive vascular care. We offer all our services under one roof, in one convenient location.

Advanced vascular care with the utmost convenience.

Our state-of-the-art facility offers customized vascular care tailored to the individual needs of each patient – set in a warm and friendly environment located conveniently just off Interstate 195 in the near West End at 205 N. Hamilton Street, Richmond.

Whether you are referred by your physician or wish a personal consultation, we have both the expertise and the latest technologies and techniques to diagnose and treat vascular disease and other problems. If we uncover signs of vascular disease, our experts can develop a custom treatment plan for you in close coordination with your doctor, and, as part of the VCU Health team, we can ensure the highest level of care for even the most serious of conditions.

If you are interested in a consultation for any of the services we provide, please contact us at (804) 828-2600 or send us an email.

 

 

What are the risks of an IVC filter?

baird IVC filter risk

One of the services we offer our patients is IV filter placements. Inferior vena cava (IVC) filters are small metal devices placed in patients at risk of developing blood clots or deep vein thrombosis in the legs or pelvis; the clots can break off and cause pulmonary embolism, the lodging of an embolus, such as a blood clot, in the lungs. Your doctor may recommend an IVC filter for conditions such as deep vein thrombosis (DVT), pulmonary embolism, trauma immobility or recent surgery or childbirth.

Recently, IVC filters have been a topic of conversation on whether they’re safe or not. We talked to Dr. Brian Strife about IVC filters and here’s what he had to say.

“IVC filters have been placed for the last several decades, developed initially in the 1960’s,” he said. “Originally, they were designed as permanent devices, meaning the filter would be placed in the patient’s vein, and it was designed to remain in place for the life of the patient.”

In the last few years, retrievable filters were developed. They have a hook or some other component to the filter where a physician could grab it and remove it. “Over time, what we learned is that some of these filters were prone to develop problems in a very small number of them,” said Dr. Strife. “The problems included migration, or movement of the filter, fracture or breaking of the filter, and then clotting of the filter.” Those are the 3 main complications that we often hear about with inferior vena cava filters.

“When the filter itself develops a blood clot,” he continued, “it can block the main vein, the IVC, this can lead to significant pain and swelling in the lower extremities. Also, the filters themselves, being made out of metal, over time the metal can stress and fatigue. The filter can break, pieces of the filter can migrate into the patient and damage adjacent organs. Very rarely, pieces of the filter can break off and go to the heart and lungs.”

The filters, whether they are permanent or retrievable types, are meant to stay in the patient for a long time. The filters are made out of stainless steel or some kind of metal alloy that is designed to withstand years of being inside a human body. It’s a rare occurrence that the filters have any problems at all.

“Although these complications are extremely uncommon,” said Dr. Strife. “It is a source of patient anxiety and we often receive a number of phone calls from patients asking if they should have their filter removed to avoid these complications.”

“In 2010, the FDA recommended that physicians who placed these filters, and physicians who follow patients with these filters, make an attempted to consider IVC filter retrieval when the filter is no longer needed,” he continued. “Sometimes that’s a tough question to answer, because we don’t necessarily know which patients are best suited to have a filter in for the rest of their lives. When a patient calls our office and says ‘I have an inferior vena cava filter and I’d like to have it removed,’ we typically have the patient come in for a consultation, discuss why they have the filter in the first place, and try to make an informed decision on whether retrieval is appropriate for them or not. Sometimes, that’s a very easy question to answer, sometimes we need to do additional tests and consult with other physicians before making that decision.”

If you need an IVC filter, our would like to talk to us about one you currently have, call us at (804) 828-2600 to discuss your options.

Conscious Sedation

baird conscious sedation

One of the first questions that our patients ask us when they are scheduled for a procedure is, “Will I feel pain?” This is an understandable concern for someone getting ready to undergo a minimally invasive procedure, especially if it’s their first time having a medical procedure performed. Minimizing pain and discomfort is one of our primary concerns here at BVI. We want to do everything possible to ensure that our patients have a positive experience during their visit which is why we use conscious sedation during many of our procedures.

What is conscious sedation?

Conscious sedation is when a combination of medicines is administered to help you relax (a sedative) and to block pain (an anesthetic) during a medical procedure. Conscious sedation is safe and effective for people who need a minimally invasive procedure. Here at BVI, these medicines are given through an intravenous line (IV) by one of our nurses under the direct supervision of a physician. You will begin to feel drowsy and relaxed very quickly. You may fall asleep, but you will wake up easily to respond to people in the room. You may be able to respond to verbal cues. You will be monitored throughout the entire procedure by our medical team to make sure that your blood pressure, heart rate and oxygen levels stay within safe limits.

The medicine will wear off quickly and recovery after the procedure is generally very fast. After conscious sedation, you may feel drowsy and not remember much about your procedure including any associated pain. Afterwards, you will feel sleepy and may have a headache or feel sick to your stomach. During recovery, your finger will be clipped to a special device (pulse oximeter) to check the oxygen levels in your blood and your blood pressure and heart rate will be monitored. You should be able to go home 1 to 2 hours after your procedure.

Is conscious sedation the same as general anesthesia?

No. General anesthesia (also known as deep sedation) is when you are administered drugs that put you in a totally unconscious state. Under general anesthesia, you have no awareness of the procedure or your surroundings at all. General anesthesia is usually reserved for more complex and lengthy procedures or when your provider deems in necessary. General anesthesia also comes with higher associated risks. Only licensed anesthesiologists or nurse anesthetists are able to administer general anesthesia. Recovery times are usually longer than conscious sedation and may present more unpleasant side-effects. BVI does NOT use general anesthesia.

Before the Procedure

Be sure to tell us if you are or could be pregnant. We also want to know what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription. A day or two before the procedure, one of our nurses will contact you to go over pre-procedural instructions. This generally includes:

  • Not eating or drinking six hours prior to the procedure
  • Be sure to have someone accompany you to the procedure. You will not be in any shape to drive home
  • Discussion of any lab work that will be required prior to your procedure
  • Arrive at the time instructed

You will be given an instruction packet with more detailed information prior to your procedure. And as always, if you have any questions you can give us a call at (804) 828-2600 to talk with one of our providers. Conscious sedation is a safe and effective way to minimize pain and anxiety for our patients.

4 questions you may have about ports

VCU Health Baird 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.

For long term IV access, 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 such as:

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

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.

If you’ve been told you need a port, you may have questions – here are 4 questions people want to know.

Is having a port painful? Having a device implanted under your skin can seem frightening to many people as is concern for ongoing pain. As with any medical procedure, you can expect some pain after the insertion, but ongoing pain is minimal, and relative to each individual patient’s level of pain tolerance. We talked to Dr. Shep Morano about ports. “You’ll notice that you can see and maybe even feel the reservoir of port area under the skin,” said Dr. Morano, “you can also sometimes feel and see part of the catheter as it runs over the clavicle and into the vein into the base of the neck.” For most people, he continued, “They don’t even notice the port after a while, it just becomes part of their body and it doesn’t bother them or even notice it that much.”

What is a cancer port pillow? A cancer port small pillow with a strap is sometimes used to cover seat belts, purse handles, cross body bags, or other straps that may rub against the port. They can be handmade or found at several online retailers.

Can my port get infected? Just like any other medical device, certain precautions must be taken to care for your port. We wrote a blog post a while back on port care, but the best thing to remember is follow the instructions from your physician and care team, and be sure to contact us if anything seems out of the ordinary.

What is a cancer port tattoo? When we went to research questions related to ports, a cancer port tattoo was something that was frequently searched online. Like many life experiences, some people commemorate their cancer journey through body art like tattoos. A cancer port tattoo is simply a tattoo that uses artwork to cover or minimize the appearance of the scar where the port was placed. Whether or not to have one is a deeply personal choice, but many cancer survivors view their tattoo as a badge of strength, or a symbol of renewal and hope.

If you need a port, or have questions, call us at (804) 828-2600 to discuss your options.

Could I be at risk for PAD?

Baird PAD risk

Vascular diseases range from diseases of the arteries, veins and lymph vessels to blood disorders that affect circulation. Among the most common types of vascular disease are peripheral vascular disease (PVD), peripheral artery disease (PAD) and coronary artery disease. The terms peripheral vascular disease and peripheral artery disease are often used interchangeably, but we discuss both here. Many of the problems we diagnose and treat involve peripheral vascular disease in one degree or another.

The most common type of peripheral vascular disease (PVD) is peripheral artery disease (PAD). Like the blood vessels of the heart (coronary arteries), your peripheral arteries (blood vessels outside the heart) also may develop atherosclerosis. Over time, the plaque buildup narrows the artery, causing increased pressure in the blood vessel. Eventually, the inside of the artery narrows so much that it restricts blood flow and less oxygen is delivered to the tissues, causing a condition called ischemia, an inadequate supply of blood that causes tissue damage.

If a fragment of this plaque from any part of the body breaks loose and clogs one of the arteries supplying the heart itself, the result is a heart attack. If a fragment breaks and blocks an artery going to the brain, a stroke will result. Narrowing of the arteries that supply the kidneys with blood can cause high blood pressure and kidney failure. Any tissue that does not have an adequate supply of blood and oxygen will, over time, become permanently damaged and die. That it is critical to diagnose and treat peripheral vascular diseases before it becomes a more serious problem.

In the early stages of PAD, symptoms include cramping and pain in the legs and buttocks, indicating poor circulation in the legs. Other common symptoms include fatigue, heaviness and discomfort during exercise or activity. These symptoms generally go away when the activity stops or you are resting. This is called “intermittent claudication.”

PAD affects about 8 million Americans. Atherosclerosis 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. The exact cause is unknown, but several risk factors are known to accelerate the formation of fatty deposits, or plaque, in the arteries:

  • Smoking
  • Family history of vascular disease, angina, heart attacks or stroke
  • Being overweight
  • An unhealthy diet
  • Lack of exercise
  • Diabetes
  • Being male
  • High blood pressure
  • High cholesterol levels
  • Stress

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.

If you want to learn more about peripheral vascular disease (PVD) 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 or email us.