As Schulist waited in the exam room, she noticed a poster on the wall. The poster highlighted a condition called chronic venous insufficiency (CVI) in which weakened valves in the leg veins cause a backwash of blood, slowing its return to the heart. Over time, blood pools in the legs, leading to varicose veins, swelling, leg pain, skin changes, discoloration, and eventually, leg ulcers.
It’s estimated that more than 175 million people in the United States have CVI.
Some people never progress past the first stage, in which spider veins start to appear in the legs. Others develop varicose veins. According to the Cleveland Clinic, one in 50 adults with varicose veins goes on to develop full blown CVI.
Studying the poster, Schulist felt a shock of recognition. She had spent her 40-year career as a hairstylist on her feet. By the time she retired, Schulist was dealing with chronic leg pain and swelling. She had tried sclerotherapy (a procedure often used to treat varicose veins that injects a solution into blood or lymph vessels, causing them to shrink), wore compression stockings, and put her legs up whenever possible. Even after she stopped working full time, Schulist continued to suffer.
“My legs,” she recalls, “were draining the life out of me from the knees down.”
Could CVI be causing the discomfort in her legs?
Dr. Wick believes that CVI is both underdiagnosed and undertreated. People may not notice a problem until their shoes start to feel tight. They rationalize that their aching legs are a natural part of aging. If a patient is wearing slacks and doesn’t bring up their leg issues, doctors have no way of knowing.
“After all,” Dr. Wick points out, “how many doctors check your legs?”
Fortunately, Schulist spoke up and Dr. Wick did just that. He suspected CVI, but other causes of leg pain and swelling, such as diabetes, arthritis or lymphedema, had to be ruled out.
In the early stages of CVI, only lifestyle changes are prescribed - stay off your legs, elevate them and wear compression stockings. Because Schulist’s disease was more advanced, Dr. Wick recommended radiofrequency vascular ablation, a procedure to seal damaged, leaking veins. Schulist was scheduled to have both her legs treated, three weeks apart.
Vascular ablation is minimally invasive and does not even require preoperative fasting - Dr. Wick even tells his patients to “have a good breakfast” before their procedure!
Schulist’s ablation was performed under local anesthesia in Eisenhower Desert Cardiology Center. Dr. Wick inserted a catheter under ultrasound guidance into the target vein below the level of the knee to ensure the entire diseased vein was treated. Then, using real-time ultrasound guidance, he slowly threaded the catheter up to the proximal end of the diseased vein. With the catheter properly positioned, radiofrequency energy was used to heat the vein wall, causing it to collapse and seal shut. Dr. Wick then retrieved the catheter, and a surgical assistant placed a bandage over the tiny incision in Schulist’s knee.
Dr. Wick’s ablation patients go home wearing a compression stocking and are advised to avoid baths, hot tubs and swimming pools for a week. Some bruising and tenderness is normal in the days following the procedure. People are encouraged to resume their normal routine while avoiding strenuous activities. Many patients even drive themselves home!
Treated veins usually take about three weeks to fully shut down. Schulist had her first surgery on July 2, 2024. By the time she came back on July 25 to get her other leg done, the first leg felt totally normal and the swelling was gone. Schulist’s second surgery was just as successful.
Dr. Wick does not hesitate to recommend ablation for qualified CVI patients.
“If you have swelling, heaviness, discoloration or wounds that are hard to heal due to CVI,” he explains, “it’s a very minimal procedure.”
As for Schulist, she is eager - as she puts it - to “share the happy.”
When asked about the difference radiofrequency vascular ablation has made in her daily life, she doesn’t hold back.
“The lack of the pain. After all the years I suffered with this, I feel like I have new legs,” she says. “I can’t tell you how impressed I am. It was a fluke that I even asked about it. I’m just so pleased!”
For more information about venous ablation, contact your established Eisenhower Desert Cardiology Center provider at 760.346.0642 or speak with your primary care physician.
