Gary's Story: Varicoceles

30 Minute Minimally Invasive Procedure Enables Man Suffering from Painful Varicoceles to Return to Active, Pain-Free Lifestyle

Five years ago in 2009, at age 33, Gary S. began suffering from severe discomfort in his left testicle. “I wasn’t sure what the pain was from and I hate going to doctors, but I was in so much discomfort, I went to see a urologist in Tampa where I was living at that time”, said Gary. The urologist diagnosed Gary with a varicocele, a relatively common condition that affects approximately 10 percent of young men usually during the second or third decade of life.

Varicoceles are pain and swelling of the testicles caused by tangled blood vessels and weak defective valves in the scrotum resulting in blood pooling.  When the valves in the testis work properly, they only allow the blood to flow away from the testicle, but sometimes these one-way valves can fail and reverse the flow of blood. Sometimes, varicoceles cause no symptoms and are harmless. But sometimes a varicocele causes pain, testicular atrophy (shrinkage), or low sperm count resulting in fertility problems.

The urologist told Gary that his varicocele was not bad and that he should simply wear supportive underwear, take advil, and ice his testicles as needed. While there are surgical and minimally invasive procedures that can correct varicoceles, Gary was told it was not necessary in his case.

As an avid runner, martial arts lover and tri-athalon participant, Gary was forced to give up all of his daily activities because the pain became unbearable. He was no longer able to live the active life he once enjoyed.  He worked as a contractor, frequently on his feet and worked outdoors in the Florida heat and humidity which was also very difficult because the heat and humidity caused extreme discomfort in the testicle. Some men describe varicoceles as feeling like a bag of worms in the scrotum.

In June of 2014 Gary knew it was time to be proactive with his medical care and seek a solution that would help to alleviate his pain. He did some research on the internet about varicoceles and found Dr. William Julien, Medical Director at South Florida Vascular Associates (SFVA). Dr. Julien is a well-known and respected interventional radiologist who performs a minimally invasive procedure called varicocele embolization. Varicocele embolization is performed at SFVA in their in-office, out-patient facility.  Gary was very interested in what he read and immediately made an appointment to see Dr. Julien.

Varicocele surgery is often performed by a urologist using traditional open surgery.  The surgery is done in a hospital under general anesthesia, with an incision made in the skin above the scrotum and cutting down to the testicular veins. The veins are then closed with sutures. Recovery from this type of surgery can take two to three weeks. Gary was not interested in the surgical approach.

Upon examination, Dr. Julien confirmed that Gary did have a varicocele and that he was a candidate for varicocele embolization. Dr. Julien explained that the procedure is done by inserting a small tube with a catheter into the femoral vein in the groin then painlessly guided it into the abdomen and the varicocele using the guidance of x-ray imaging. The varicocele is then closed off by plugging it with small metal coils and using a special medication that slows the blood flow, causing the blood to clot and seal the vein. The coils remain in place to keep the vein permanently sealed. The procedure takes 30 minutes and the patient goes home a few hours later with only a band aid at the puncture site. Patients can immediately resume their non-exertional activities.


2 weeks later Gary had a very successful varicocele embolization. “The surgery was easy and the staff at South Florida Vascular Associates is wonderful. I can finally enjoy my life again”, says Gary. He is no longer in pain, is able to take long walks on the beach with his girlfriend and has also begun an exercise routine. He is hoping to resume running again too. Gary highly recommends this procedure to anyone who suffers from testicular pain related to a varicocele. “I waited 5 years before I got the help I needed, says Gary, but fortunately I found the right doctor and I’m back on track enjoying my life, free of pain”.

Do You Have Fibroids and Plan to Have a Hysterectomy? Here’s What you Need to Know

Many women diagnosed with fibroids are often told by their doctors that the best treatment is a hysterectomy however, if you suffer from fibroids, a hysterectomy isn't the only option; in fact a hysterectomy should perhaps be your last option.

 A non-invasive treatment, uterine fibroid embolization (UFE) has proven to be a safe and effective option. UFE is a minimally invasive procedure in which the blood flow of the uterus is intentionally reduced causing the fibroid tumors to shrink. It alleviates or improves fibroid symptoms 90% of the time. UFE is performed by making a tiny nick in the skin in the groin and inserting a tube, known as a catheter, into the femoral artery. Using x-ray imaging, the catheter is guided through the arterial system and into the arteries supplying the uterus. Tiny particles, the size of grains of sand are then injected into the uterine arteries to block the blood flow which starves and destroys the fibroid.

At South Florida Vascular Associates our Board Certified endovascular surgeons, Dr. William Julien and Dr. Curtis Anderson have performed thousands of uterine fibroid embolizations in our outpatient facility, conveniently located in our office and it does not require an overnight stay. Pain-killing medications and drugs that control swelling typically are prescribed following the procedure to treat cramping and pain. Many women can resume light activities in a few days and the majority of women are able to return to normal activities within seven to ten days.

Benefits of UFE over hysterectomy
• No general anesthesia
• Abdominal incision is not required.
• There is little to no blood loss, so there is no need for blood transfusions.
• All fibroids may be treated at the same time.


About Fibroids
Fibroids are benign, non-cancerous growths in or on the walls of the uterus, or womb. They can range from less than an inch in diameter to more than six inches. African-American women and those with a family history are more likely to have fibroids than women of other racial groups. Fibroids affect close to 50 percent of African-American women over the age of 40 and are prone to having larger and more fibroids. Fibroids can also develop at a younger age.
Fibroids also affect more than 40 percent of women over the age of 40 and are often found in women immediately prior to menopause (ages 45-50) because they have more unopposed estrogen which causes them to experience rapid growth of their fibroids.

Many fibroids cause no symptoms and are only discovered when a woman has a routine pelvic examination. However, if you do experience fibroid symptoms, medical attention is necessary. Symptoms may include:
• Heavy, prolonged monthly periods, sometimes with clots
• Fatigue, secondary to a low blood count
• Pain or pressure between the hip bones or in the back of the legs
• Pain during sexual intercourse
• Frequent need to urinate
• Constipation or bloating
• An enlarged belly

If you are experiencing any of the symptoms above, we invite you to call our office today for a consultation to determine whether UFE is an option for you.

Are you Experiencing Leg Cramps or Cold Feet? Are you a Heavy Smoker?

If you answered yes, it’s time consider getting a vascular screening. It can save your life!

Vascular disease is among the leading causes of death in the United States, yet often, there are no symptoms until a major health event occurs such as a stroke or a deadly aneurysm. As the heart beats, it pumps blood through the circulatory system which carries blood throughout the body. Vascular disease involves any illness that affects the circulatory system, such as carotid artery disease, abdominal aortic aneurysm or peripheral artery disease.

While preventive vascular screening is widely available, millions of Americans who might be at risk for stroke or even death from vascular disorders, remain unaware of their risk. Vascular screening is painless and very easy to obtain. It is done in a series of 3 ultrasound procedures that provide an image of the major arteries. It can save your life!

If you are 55 or older with history of smoking, are overweight, have high blood pressure, high cholesterol, diabetes, or a family history of stroke you are at high risk for vascular disease.

The three most common vascular diseases are Carotid Artery Disease (CAD) Abdominal Aortic Aneurysm (AAA) and Peripheral Artery Disease (PAD).  Carotid arteries provide the main blood supply to the brain.

 Carotid Artery Disease (CAD) occurs when the major arteries in your neck become narrowed or blocked. A sticky substance called “plaque” builds up in the arteries causing a blockage, which can potentially lead to a stroke.
Symptoms include: weakness or numbness in the face, arm and leg (often on one side), confusion or trouble speaking, decreased vision, difficulty with walking, balance and sudden severe headache.

When a weak area of the abdominal aorta grows, it is called an Abdominal Aortic Aneurysm (AAA).  AAA can develop in anyone, but it is most frequently seen in people over 50 with one or more risk factors. The larger the aneurysm, the more likely it is to rupture. Once detected, the AAA can be monitored or surgically repaired. An undetected ruptured AAA has a fatality rate of 75%. and is often referred to as the "silent killer". Many people have no symptoms until they become severe such as intense back or abdominal pain. Men are at greater risk for AAA than women.


Peripheral ArteryDisease (PAD) is a condition caused by a thickening of the inside walls of the arteries of your legs. This thickening called atherosclerosis, narrows the space through which blood can flow, decreasing the supply of oxygen and nutrients to the legs or feet. PAD can affect both legs, but most often symptoms begin in one leg. Not only does PAD pose a threat to the health of the legs, it can often be a sign of heart disease. Symptoms include a cold feeling in lower leg or foot, discoloration of foot, pain or cramping in hips, thighs & calves when walking or exercising, which is relieved with rest, or when activity is stopped.

At SFVA our highly trained, expert endovascular surgeons Dr. William Julien and Dr. Curtis Anderson, have successfully treated thousands of patients with vascular diseases. If you or a loved one suspect that you may have a vascular condition, we invite you to contact our office today for a consultation to learn more about your condition and about the treatments and procedures that are available to you.. We have three convenient office locations, Coconut Creek, Boynton Beach and Plantation. 

Did You Know That Eating Your Favorite Spicy Red Italian Sauce Can Reduce Cardio-Vascular Disease?

Puttanesca  a spicy, sharp and quite flavorful Italian sauce is very good for your health. Its ingredients include olive oil, tomato sauce, onions, garlic, hot chile peppers, capers, anchovies and olives. In addition to tasting great, each of these ingredients are beneficial to your health, proving the notion that food can also be a natural medicine.

Olive oil, especially the extra virgin kind, is heart-healthy oil responsible for reducing the risk of cardiovascular disease, which is the #1 cause of death. Olive oil is rich in mono-unsaturated fats making it a key part of a heart-healthy diet.

Tomato sauce provides lycopene, a red antioxidant that helps to protect cells and has specific protective benefits for the prostate gland, helping to reduce the risk of prostate cancer.

Onions that are often used in Italian sauces are great for reducing  triglycerides, a type of fat found in your blood that is used for energy. Onions are also a great food for thinning blood and for reducing the risk of atherosclerosis, plaque build-up in the arteries. Onions are high in super-antioxidants aid in slowing down the aging process, and onions are also thought to have anti-cancer properties.

Garlic fights bacteria and is sometimes used as an antibiotic because garlic kills almost every bacterium that can contaminate food. Studies show that garlic can also help to reduce high blood pressure because its composition is similar to that of blood pressure medications.

Hot chile peppers are a "super-food" that do much more than add a kick to the sauce. Chile peppers also act as vasodilators which are herbs that have the ability to lower blood pressure effectively because they have the same effect or end results as calcium channel blockers which cause smooth muscles within the arterial walls to relax enabling the arteries to open wider, allowing more blood to flow through and provide nourishment to all parts of the body. Additionally, hot chiles are thermogenic, which means that they burn calories. In fact, did you know that hot chiles can help you to burn an average of 20 percent more calories after eating. Hot chiles also cause the brain to produce feel-good endorphins which are mood enhancing.

Capers, another ingredient often used in spicy sauce possess anti-cancer properties. Capers help to reduce the risk of ulcers by inhibiting the ulcer-causing H. pylori bacteria and they additionally improve blood sugar by reducing high blood sugar after a meal. Capers are also a traditional remedy for the relief of rheumatic pain due to their anti-inflammatory action.

The anchovies add a bit of fish flavor and protein to Puttanesca sauce and are also rich in heart-healthy Omega 3 fatty acids. Omega 3’s help the body to maintain a healthy cardiovascular system, improve skin and metabolism, enhance mental health and cognitive function, and are anti-inflammatory.

Lastly olives provide many of the same cardio benefits as olive oil.

Many people don’t realize that cooking and eating certain foods can simultaneously provide not only a flavorful eating experience, but can also be very beneficial to your good health. In fact, there are many books published with recipes that teach you about the use of natural ingredients that can make your  bodies work more efficiently. In the case of Puttanesca or any spicy Italian red sauce, we have a pasta sauce that delivers complex, rich flavor, while offering numerous significant benefits to keep you healthier at the very same time. Try to plan your next meal using "super-foods" and feel good. Bon Apetit!

SFVA Physicians Participate In Education Series on Advanced Endovascular Procedures in an Outpatient Setting

South Florida Vascular Associates physicians William Julien, MD and Curtis Anderson, MD in collaboration with the Academy for Continued Healthcare Learning (ACHL) is pleased to announce that we are participating in a new educational series titled Advanced Endovascular Procedures in an Outpatient Setting, supported by an educational grant from Boston Scientific Corporation. The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This program has been developed to promote the development of necessary cognitive and technical skills required for interventions that will emphasize imaging, angioplasty, atherectomy, thrombectomy and stenting for peripheral artery disease (PAD) and uterine embolization for uterine fibroids. This continuing education course is offered to vascular surgeons who look to expand their experience in the treatment of peripheral arterial disease so that they can offer their patients the most current treatment options for the most optimal results.

South Florida Vascular Associates is a fully clinical office-based vascular practice that is focused on providing outstanding patient care. Our physicians have extensive training in minimally invasive endovascular techniques which have largely replaced open surgery for most vascular disorders. Our doctors bring their unique expertise to the practice offering the highest level of endovascular technologies within a clinical office-based practice setting. We are nationally recognized as a center of excellence because we are committed to running an outstanding clinical practice, participating in ongoing education and research in vascular disease. Our commitment to excellence is ultimately reflected by our well regarded patient outcomes and patient satisfaction.

We welcome patients suffering from vascular diseases to contact our office for a consultation with one of our board certified endovascular surgeons at 1 one 3 convenient locations in Coconut Creek, Boynton Beach and Plantation, Florida. Call us today at 954-725-4141.

November is Men’s Health Awareness Month: Get Educated, Stay Healthy and Spread the Word

Did you know that according to the National Center for Health Statistics, the average life expectancy for men in the US is almost 5 years less than women?  

The reason for the poor state of men’s health are numerous and include:

• Lack of awareness and understanding of the health issues men face
• Men not openly discussing their health and how they’re feeling
• Reluctance to take action when men don’t feel physically or mentally well
• Men engaging in risky activities that threaten their health  
• Stigmas surrounding mental health or other medical issues
• Men are 24 percent less likely than women to have visited a doctor within the past year

How many of you men avoid going to the doctor? How many of you ignore symptoms and say, “Oh, it’s nothing, I’ll be fine”.  November is a time for men to think about their health, don’t be embarrassed to talk about your bodies and anything that ails you.  Self-education and body awareness are key to early detection and early detection is key to having a proper diagnosis positive outcome.

At South Florida Vascular Associates, it is our goal to increase your understanding of some of the vascular disease health risks that men face;  encourage you to take action to remain healthy, and help to ensure that you take proper medical action if or when you do become sick.

 Below are some vascular conditions that are prevalent in men that you should be educated about. These conditions are successfully treated, especially when diagnosed in the early stages.
 
Peripheral Artery Disease (PAD)- Peripheral artery disease is a common disorder that mostly affects men over age 50, but women can have it as well. PAD is caused by arteriosclerosis and occurs when fatty material (plaque) builds up on the walls of your arteries and makes them narrower. As a result, the muscles of your legs cannot get enough blood and oxygen when they are working harder (such as during exercise or walking). If PAD becomes severe, there may not be enough blood and oxygen, even when the muscles are resting. The main symptoms of PAD are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms usually appear during walking or exercise, and go away after several minutes of rest.

Abdominal Aortic Aneurysm (AAA) -Abdominal aortic aneurysm is an abnormal bulging of the main artery that leads from the heart to the rest of his body. Without repair, the aorta can leak or rupture, potentially causing sudden death. AAA tends to occur in white males over the age of 60. In the United States, these aneurysms occur in up to 3.0% of the population. Aneurysms start to form at about age 50 and peak at age 80. Usually, aortic aneurysms are found in older people and are associated with hypertension or high blood pressure. AAA often does not cause any symptoms, however If they do, they may cause deep dull pain in the lower back or flank. Prominent abdominal pulsations may be also present.

Varicoceles- Varicoceles are a tangled network of blood vessels or swelling of the veins on the testicles similar to varicose veins in the legs but in this condition a vein called the gonadal vein. It has weak defective valves resulting in the blood pooling in varicose veins in the scrotum. It is a relatively common condition (affecting approximately 10 percent of men) that tends to occur in young men, usually in their 20’s or 30’s. Sometimes, varicoceles cause no symptoms and are harmless. But sometimes a varicocele causes pain, testicular atrophy (shrinkage), or fertility problems. 

Venus Insufficiency- Venous insufficiency is a common cause of leg pain and swelling, and is commonly associated with varicose veins. It occurs when the valves of the veins do not function properly, and the circulation of blood in the leg veins is impaired.  It may affect up to 20 percent of adults. By the age of 50, nearly 40 percent of women and 20 percent of men have significant leg vein problems. Symptoms include aching leg pain, leg fatigue and leg heaviness.

 As part of Men’s Health Awareness Month we urge you to be proactive with your health and to encourage other men to do the same. To help increase men’s health awareness, during the month of November many men are growing moustaches or beards to help support the cause, promote awareness of the health issues men may face and to empower men to be more proactive about their medical choices.
 
 If you suffer from any of the vascular conditions listed above call our office today to schedule a consultation with one of our board certified physicians. We are here to help you and make sure that you stay healthy.

Start growing your moustache today and send us a picture for our Facebook page to  info@southfloridavascular.com

Do You Have Varicose Veins? A New Study Shows: When Treating Varicose Veins, Laser Therapy (EVLT) Remains the Best Option

When treating varicose veins, laser therapy remains the best option, a new study says. Laser is preferred over surgery or foam due to higher success rates with the least amount of complications.

Researchers in the study examined 798 participants who had varicose veins and were treated at 11 vascular surgery centers in the United Kingdom, between November 2008 and October 2012. The participants underwent one of three types of treatments: closing off the veins with a laser, injecting a drug "foam" into the vein or surgically removing the vein.

After six months, the researchers compared the outcomes, looking at how well the treatments worked and at their complication rates, as well as how the participants rated the change in their quality of life since their treatments.

The main findings indicated that laser therapy, endovenous laser treatment was the preferred treatment for varicose veins. It was determined that all three treatments reduced symptoms associated with varicose veins, but there were fewer complications after laser treatment.

What causes varicose veins?

Varicose veins are blood vessels that have become swollen, enlarged and twisted. Improperly working valves in the veins cause the disorder. In people who have this condition, blood returns up to the heart from the veins in the legs because of the contraction of the calf muscles. Normally, valves in these veins prevent blood from flowing backwards, down towards the feet.

People with varicose veins have leaky valves, which means that some blood flows backward and pools in the veins, causing them to become enlarged.

The procedure called endovenous laser ablation (EVLT), uses heat generated by laser energy to seal off faulty blood vessels, diverting blood flow to nearby healthy veins.

Foam or saline treatment, sclerotherapy, involves injecting drugs into a blood vessel. The medicines, when mixed with air, cause the vessel wall to thicken and helps to seal off blood flow. The recent study showed that foam was less likely than the other treatments to completely close a vein that had leaky valves, which may increase the likelihood that a patient will need future treatment.

In the study, about 1 percent of patients who underwent treatment with a laser experienced complications such as lumpiness, skin staining and numbness. About 6 percent of those who received the foam treatment, and 7 percent of those who underwent surgery experienced such complications, according to the study.

The researchers of the study also found that successful ablation of the great saphenous vein occurred in 83 percent of those who received the laser treatment and 84.4 percent of the participants who underwent surgery.  These numbers were significantly higher than the 54.6 percent who had such successful ablation after the foam treatment. The great saphenous vein, the longest in the body, runs along the length of the leg.

Can varicose veins be prevented?

Varicose vein treatment is not only done for cosmetic reasons, it is done because people with who have them often suffer from pain and discomfort. Varicose veins can also cause swelling of the ankles, skin changes and sometimes even ulcers. Some people with severe varicose veins have difficulty walking.

Both men and women get varicose veins and the condition is very common in pregnant women, older patients, overweight people and those who stand for long periods of time. It is also more prevalent in people who have a family history of varicose veins.

According to the National Institutes of Health (NIH), people cannot prevent varicose veins from forming, but may be able to delay their formation or prevent existing varicose veins from getting worse. The NIH recommends that people avoid standing or sitting for a long time without taking breaks; avoid crossing their legs when sitting; and keep their legs raised when sitting, resting or sleeping.

Losing weight and doing exercise that works the leg muscles can also help, the NIH said.

South Florida Vascular Associates offers endovenous laser treatments and they are done right in our office. The treatment takes less than 1 hour, provides immediate relief, there is no use of anesthesia, quick recovery period, no scarring and provides a much less rate of complication compared to surgery. If you have unsightly or painful varicose veins call our office today to make an appointment for a consultation at one of our 3 convenient office locations, Coconut Creek, Plantation or Boynton Beach. We can help you to feel better and look better. Call 954-724-4141.