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?

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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.

3 nonsurgical ways to cover unsightly leg veins

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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.

Useful Apps for Cancer Patients

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Modern technology can be an amazing tool to help with our daily lives. Today, even cancer patients can find a variety of useful apps to assist in their treatment and recovery by monitoring symptoms, storing data, providing information and support. Of course, nothing can or should take the place of your physician and care team’s advice, but here are a few apps that may help keep and organize your data and assist in other ways as you navigate the course of your illness.

Cancer.net Mobile

Developed by the American Society of Clinical Oncology (ASCO), this app provides easy-to-use tools to help you plan and manage care – from diagnosis through treatment and beyond, and is provided by Cancer.Net. It includes the latest oncologist-approved cancer information.

Pocket Cancer Care Guide

Provided by the National Coalition for Cancer Survivorship, the Pocket Cancer Care Guide is an app that allows you to quickly and easily build lists of practical questions used to guide conversations between you and your doctors and nurses. Users can browse hundreds of questions in categories relevant to stages of your cancer diagnosis, build lists of questions to use when talking to your doctor or nurse, link doctor appointments to your lists and automatically add it to your calendar and record and playback your doctor’s or nurse’s answers. There’s also a glossary of medical terms for reference.

My Cancer Coach

This app, by Genomic Health, Inc., is a free mobile app developed in partnership with BreastCancer.org, Men’s Health Network, and Fight Colorectal Cancer. The app provides specific information about personalized cancer treatments to help manage your cancer’s progression. It’s like having ‘Cancer 101’ in your pocket. Questions about your stage of cancer? Should you get surgery? Is radiation necessary? Do you need chemotherapy? Is your cancer metastatic? My Cancer Coach provides easy-to-understand treatment information for breast, prostate, and colon cancer patients and their caregivers.

Create To Heal

This app is brought to you by The Women Wings Foundation Create to Heal (TM) program. It is designed to gently take you from your head into your heart, where the healing process begins. Because stress is the number one contributor to all major diseases, including cancer, the goal of this app is to provide patients with relief from stress through the use of beautiful imagery, sounds and words.

The Create to Heal (TM) guided meditations, music and art have been tested in several hospitals and cancer centers over a period of 5 years, with hundreds of cancer patients, survivors and their families. This app gives patients the tools to continue their creative therapy and stress reduction at home, at work, wherever they are. The app offers 10 music tracks, 4 guided meditations, 36 pieces of art, and 60+ inspirational messages.

My Medical

My Medical is a comprehensive record-keeping app for your personal medical information. The app offers autocompletion and autosuggestion for a wealth of medical jargon, including prescription drug names; vaccinations; common afflictions; life support options; laboratory units; and much more.

In addition, there are areas for emergency contacts, health insurance, doctors’ contact information, and other data that are not strictly part of a traditional personal health record (PHR) are all available. It will put doctor’s appointments and upcoming lab tests on your calendar. You can even set reminder alarms directly from the app, without ever going into your calendar. Finally, the app offers an area for files to be attached to your record. For example, you can add a picture of the pill next to a medication, or a copy of your insurance card alongside a provider’s contact information.

iHealth Log

iHealth Log helps individuals with chronic health issues manage their disease.  All medications and dosages are easily maintained along with important prescription details including a photograph of the medication and physician and pharmacy information.  The diary tracks daily medications and measurements which are critical to disease management.  iHealth Log makes it easy to email lists of medications to schools, summer camps and health care providers and it has reporting capabilities to plot measurement data and send this data via email to the physician.

Spring is around the corner and I don’t want to live with these spider veins anymore – what can you do for me?

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Don’t be embarrassed. You don’t have to live with spider veins anymore.

If you’re always covering up your spider veins, those unsightly dark blue or red blotches or jagged networks of tiny veins on your legs with longer skirts, pants and bathing suit wraps and towels – it doesn’t have to be that way. Today we offer gentle, virtually pain free treatments that eliminate or greatly diminish the appearance of spider veins.

Spider veins are similar to varicose veins, but are milder, involving the smaller veins just below the skin surface. Spider veins are more common among women of any age, and frequently appear during/after pregnancy or when gaining weight. The extra burden weakens the valves in the veins carrying blood back to the heart, so the blood pools and the veins swell. When only small, surface veins are affected, the result is spider veins, which can range from little patches to very large areas. They generally do not bulge or cause pain. But they can do damage to your self-esteem.

The good news is that today, spider veins are treatable – and easier to treat than other varicose veins. With new treatments using injections or safe laser technology, we offer cosmetic options that diminish or eliminate spider veins – and the embarrassment.

How are spider veins treated?

Until recently, spider veins went untreated. The veins are very small, there can be hundreds or thousands of them, and they do not present a significant health risk that requires surgery. However, today we can offer two gentle, technically advanced and effective treatments for spider veins that shrink or let the body absorb the damaged veins, leaving behind clear, unblemished skin: sclerotherapy or surface laser therapy.

Sclerotherapy involves using a tiny needle to inject individual spider veins with a solution that makes them shrink. As they shrink, blood is channeled to deeper veins, making the spider veins on the surface almost invisible. The vast majority of patients who have sclerotherapy experience significant improvement in the appearance of their veins.

Surface laser therapy uses an extremely accurate laser to deliver painless pulses of light energy to the spider veins on the surface of the skin. The energy causes the blood inside the veins to coagulate, which eventually destroys the spider veins, which are gradually absorbed by the body, which redirects blood flow to veins deeper below the skin’s surface, leaving behind clear, unblemished skin.

How long does treatment take?

The number of treatments needed to clear or improve your spider veins depends on their amount and severity. The average treatment is three to five sessions. Smaller veins may disappear after the first session. However, severe cases may require as many or ten or more sessions: in some cases, a vein may need to be injected one to five times or more, over a period of weeks or months. Multiple areas can be treated during each session, reducing the total number of treatments needed. In general, you’ll see an overall improvement within weeks or months.

Spider vein treatments do not prevent development of new spider veins over the years. Pregnancy, high estrogen levels or jobs that require a lot of standing may increase the likelihood that spider veins will reappear. Many people will require additional treatments from time to time to keep their legs clear.

Will insurance cover my treatment?

Most insurance companies consider spider vein treatment a cosmetic procedure, not medical, and in most cases it is not covered by insurance. You should check your individual plan to verify what varicose vein treatment options are included in your plan. Call us at (804) 828-2600 to discuss your options. You may decide that your beautiful legs are worth it.

Is image-guided treatment right for me?

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“Excruciating.” That’s the word every active person uses to tell us about the pain of “runner’s heel” (plantar fasciitis), “tennis elbow” and other tendon injuries. That little twinge you felt on your daily jog or practicing your forehand has now become a knife-sharp sting in the exact same spot with every step or every swing you take, every day. 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.

Until now. Using precision ultrasound imaging guidance and a minimally invasive treatment, we can delicately remove the damaged tendon tissue and get you back to the activities you love in a matter of weeks – with little to no pain.

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?

Sometimes you can cope with tendon injuries with ice, rest, physical therapy and other treatments – particularly if you stop the repetitive activity and rest as soon as you feel the very first twinges. More often than not, people try coping with the growing pain, on the job or at play. However, if the damage doesn’t heal properly, or if you continue the activity and increase the damage, you risk long-term injury, constant pain – and giving up an activity you love.

If you’re frustrated with chronic tendon pain or have tried multiple treatment options, 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 may require 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.

Most people won’t need any further treatment, such as physical therapy. You wear a walking boot for a week or two while the area heals. The most common post-procedure problem reported is some soreness, which can generally be treated with over-the-counter pain medication and typically lasts less than a week. In a recent study, doctors reported no other side effects. More than 35,000 people have had the treatment since 2012, with a high rate of satisfaction. In most cases, patients are back to the activities they love in six weeks or less.

We treat a range of common tendinitis or tendinosis conditions that can take you out of action:

  • “Runner’s heel” (plantar fasciosis or fasciitis)
  • “Tennis or golfer’s elbow” (lateral or medial epicondylosis of the elbow)
  • Achilles tendinosis

If you’re been coping with tendon pain, it may be time for us to help you get back in action.

 

 

 

How to get back in the groove after image-guided tendon treatment

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Chronic tendon pain is often called tendonitis, tendinosis, runner’s knee, or tennis elbow. These are different terms for a condition that is common throughout the body.

Often when you have chronic tendonitis, you can easily pinpoint the exact location of your pain. Every time your dog yanks his leash, you step onto the next stair or you hammer a nail, you feel a sharp sting in one precise spot. This pain shouldn’t be ignored; tendons are important body parts that need attention when they are injured.

VCU Health at Baird Vascular Institute offers Image-Guided Tendon Treatment that has been proven to improve tendonitis in the elbow, shoulder, knee and foot, dramatically decreasing pain and improving overall functionality– all without the need for traditional open surgery or arthroscopic surgery. The highly effective treatment uses ultra-sound imaging and patented TX MicroTip technology to provide relief with less pain and minimal downtime. Unlike medicine or injections that mask the problem, this treatment eliminates it by removing the cause of your pain: the damaged and degenerated tendon tissue.

Once you’ve made the decision to go with image guided tendon treatment to alleviate your pain, you’re likely wondering how long it will be until you can return to normal activities. Because the surrounding healthy tissue is not disturbed, and no stitches are required, typical recovery is 6-8 weeks with image-guided tendon treatment though it may take up to three months for the treatment to take effect. That’s about a quarter of the recovery time compared to open surgery.

Here’s a timeline:

Minutes after procedure: Once your treatment is complete, you are permitted to go home. You may drive yourself if your doctor permits though it is likely that you will need someone to drive you home if you were given any sedation.

Days after procedure: You can take over-the-counter pain medication such as Tylenol® (you want to avoid NSAID pain relievers such as Motrin® or Aleve®) should you feel any discomfort; though many patients feel pain relief very quickly. However, always be sure to follow your physician’s instructions.

2 weeks after procedure: For at least 2 weeks after your procedure, you should not perform any weight-bearing exercises or activities. For your knee, ankle and foot, wear your walking boot for a minimum of 2 weeks.

6-8 weeks after procedure: You should be back to your everyday activities as normal in 6-8 weeks. Your individual results may vary, so talk to your doctor about what to expect.

We have an entire series of videos that describe the various patient questions surrounding image guided tendon treatment, so be sure to give them a look. When you’re ready to learn more and see us in person, call us at (804) 828-2600 to discuss whether image-guided treatment is the right option for you.

Sources: Tenexhealth.com