Dr. Bunke-Paquette and Dr. Fronek featured in San Diego Magazine

San Diego Magazine’s Top Doctors issue for October featured Dr.’s Bunke-Paquette and Dr. Helane Fronek. In the article, Dr. Bunke describes new therapies to treat venous disorders. ‘“New technology has eliminated the need for traditional vein stripping surgery. Using ultrasound scanning and other advanced procedures, we are able to provide precision treatments that are safe, painless, and effective—all without surgery,” said Dr. Bunke-Paquette.

What Is the Correlation Between Restless Legs Syndrome and Venous Insufficiency?

Patients with varicose veins often report a feeling of restless legs, especially at night when in bed. In our study, about 30% of patients with varicose veins complained of restless legs. Restless legs syndrome (RLS) is a sensorimotor movement disorder characterized by uncomfortable sensations in the legs and an urge to move them. There are other causes of restless legs syndrome such as, neurological disorders, anemia, and kidney disease to name a few and is often treated with medication. Venous insufficiency is often neglected as a cause of Restless Legs Syndrome. However, when recognized, it is easily treatable leading to resolution of symptoms.
Treatment is aimed at correcting the underlying venous insufficiency. This usually is accomplished by removing the varicose veins or incompetent veins by new, minimally invasive, non-surgical methods. In our study, 98% of the patients with venous insufficiency and restless legs, had resolution of symptoms following treatment.
In another study, by Hayes, CL et. al, 35 patients with RLS and superficial venous insufficiency underwent endovenous ablation of refluxing superficial veins and ultrasound-guided sclerotherapy of varicose veins. 89% of patients reported alleviation of symptoms.
If a patient has restless legs symptoms and evidence of varicose veins of the legs, a work-up for venous insufficiency should be considered. The work-up involves a duplex ultrasound evaluation of the leg veins. This may eliminate the need for medication for RLS.

Is Multiple Sclerosis Caused by Venous Insufficiency?

Multiple Sclerosis, also known as MS is an autoimmune disease that affects the brain and spinal cord. It affects women more than men and is most commonly diagnosed between ages 20 and 40, but can be seen at any age.
MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve impulses are slowed down or stopped.
Researchers are not sure what triggers the inflammation. The most common theories point to a virus or genetic defect, or a combination of both. Recently, however, venous insufficiency has been implicated as a cause of MS.
Venous insufficiency refers to the backflow of blood within veins due to faulty valves. In people with varicose veins, the leg veins are affected. But, in patients with MS, the cerebral veins may be insufficient. Impaired venous drainage from the central nervous system is termed chronic cerebrospinal venous insufficiency. There are some studies that implicate chronic venous insufficiency of the cerebral veins as a cause for MS. But, there have been recent studies which refute this. At this point, it is an area of investigation, but further studies are required.

Deep Venous Thrombosis Afflicts Serena Williams, Richard Nixon and more….

What do Serena Williams, Richard Nixon, Dan Quayle, Dick Cheney and David Bloom have in common? They have all suffered a potentially fatal deep venous thrombosis (DVT).

Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart, or other area, leading to severe damage.

Blood clots may form when something slows or changes the flow of blood in the veins. Risk factors include:

  • After a pacemaker catheter has been passed through the vein in the groin
  • Bedrest
  • Cigarette smoking
  • Family history of blood clots
  • Fractures in the pelvis or legs
  • Giving birth within the last 6 months
  • Heart failure
  • Obesity
  • Recent surgery (especially hip, knee, or female pelvic surgery)
  • Too many blood cells being made by the bone marrow (polycythemia vera), causing the blood to be thicker and slower than normal

You’re also more likely to develop DVT if you have any of the following conditions:

  • Blood that is more likely to clot (hypercoagulability)
  • Cancer
  • Taking estrogens or birth control pills.
  • Long airplane flights: London’s Heathrow Airport reports one passenger death a month from DVT. One nearby hospital recorded thirty passenger deaths from DVT in the past three years including a 28-year-old man. To reduce the risk of DVT during air travel,  passengers are advised to wear compression stockings on flights, frequent moving aroudnt he cabinand pumping the calf muscles, leg elevation and avoidance of sedentary positions for long periods of time without moving.

Immigrants at Ellis Island Turned Away for Varicose Veins?

It’s hard to believe that immigrants entering the United States through EllisIsland, in the early 1900’s could be considered as unfit if they had varicose veins.  But, historical documents suggest that Doctors had only seconds to examine each passenger, checking for 60 symptoms, from anemia to varicose veins. Each person was then asked a set of 29 questions, sometimes over and over again, and by a series of different inspectors.  ‘If the immigrant’s papers were in order and they were in reasonably good health, the Ellis Island inspection process would last approximately three to five hours. The inspections took place in the Registry Room (or Great Hall), where doctors would briefly scan every immigrant for obvious physical ailments. Doctors at Ellis Island soon became very adept at conducting these “six second physicals.” By 1916, it was said that a doctor could identify numerous medical conditions (ranging from anemia to goiters to varicose veins) just by glancing at an immigrant.

source:  http://www.nps.gov/elis/historyculture/upload/Brief-History-of-Ellis-Island.pdf

La Jolla Vein Care Welcomes Dr. Helane Fronek, MD, FACP, FACPh

La Jolla Vein Care is pleased to welcome Dr. Helane Fronek to its staff of venous disease specialists.  Helane Fronek MD, FACP, FACPh entered the field of phlebology in 1985 and has been an integral part of the development of this new medical specialty.  As the Director of the Varicose Vein Clinic at Scripps Clinic, she provided cutting edge treatment for the entire spectrum of superficial venous disorders and conducted research on venous leg ulceration, compression therapy, and emerging therapies for varicose veins.  Dr. Fronek is a past president of the American College of Phlebology, the largest medical organization devoted to vein care.  She is a respected speaker and educator in all aspects of diagnosis and treatment for venous disease and communication in the medical arena.  Dr. Fronek was the first recipient of the American College of Phlebology’s prestigious Leadership Award.  Board-certified in both Internal Medicine and Phlebology, she is also Assistant Clinical Professor of Medicine at UC-San Diego School of Medicine, where she teaches medical students the practice of physical examination and the art of medicine.  Dr. Fronek has dedicated her career to providing technically excellent and compassionate care to her patients and to inspiring and teaching the next generation of phlebologists.  Dr. Fronek is well known for authoring, ‘The Fundamentals of Phlebology’ which is a medical textbook used by most Phlebologists entering the field.

Dr. Oz Show Highlights Foam Sclerotherapy Treatment for Varicose Veins

The June 1st episode of The Dr. Oz Show brought attention to foam sclerotherapy. He describes it as latest, most advanced technique to eradicate painful, varicose veins. Dr. Oz’s guest demonstrated how the procedure is performed: He used a vein light to visualize the veins, followed by a painless injection of a foamed solution. He also mentions that the old Varicose Vein Treatments hurt because of the saline solution that used to be used, but newer solutions such as polidocanol, are nearly painless.

We’re pleased that Dr. Oz brought much need attention to foam sclerotherapy, as we have been using it as an alternative to surgery for years. What most people don’t realize is that foam sclerotherapy is not new, but rather newly recognized. Foam sclerotherapy offers patients a non-surgical alternative for the treatment of varicose veins. There is essentially no down-time and return to normal activities is immediate.

Newest Technology for Treating Spider Veins

La Jolla Vein Care is pleased to announce its newest device for treating small spider veins—The VeinWave. This device uses radiofrequency energy to destroy spider veins with a high degree of precision, thus making it easier than ever to remove unsightly veins on the face or legs. The VeinWave is considerably more advanced than laser technology because it capable of pinpointing the damaged vein with greater precision, keeping the surrounding skin unharmed. By focusing specifically on the damaged vein, patients can eliminate the sunburn appearance that often results after laser treatments.

Free Varicose Vein Screening

If you experience the discomfort and swelling of varicose veins, you may be suffering from venous insufficiency or venous reflux disease. Approximately 25 million people in the United States suffer from this condition. Currently, La Jolla Vein Care is offering a free varicose vein screening for a limited time. During the screening, you’ll get a patient history, examination of your the legs, and a recommend plan of treatment (if necessary).  So call (858) 550-0330 today and schedule an appointment. It’s the first step in keeping you healthy and looking good—and it’s free!