A 58-year-old male with the worst case of RLS and PLMD ever noted by Dr. Bell.
PLMD (Periodic Limb Movement Disorder) is thought by some authorities to represent a continuum and more severe form of RLS (Restless Leg Syndrome).
Dr. Bell: “This patient had literal constant need to move his legs, and if he voluntarily chose not to, he would involuntarily muscle twitch his legs, sometimes in a violent manner, much worse in evening hours and overnight hours after work. His wife had put up with this for many years, still sleeping in the same bed, but not very happy about it, since her sleep was more and more impaired secondarily. His wife, by the way, was also instrumental in arranging his evaluation in the office.
His venous ultrasound in the office was very definitive for bilateral Great Saphenous Vein (GSV) disease. He was subsequently scheduled for minor vein surgery with planned Endovenous Laser Treatment (EVLT) to eradicate the back flow in each leg’s GSV.
His case proved to be one of the most technically challenging in my already experienced vein career. To access a diseased vein requires a steady hand and good hand-eye coordination to correlate findings with the sonogram. The intra-operative sonogram is the vein surgeon’s eyes for much of the procedure, especially to prepare for and perform EVLT.
In this case, I literally had a moving target during the entire procedure. He could not will himself to be still, so I had to time key parts of the procedure around when I thought he might jerk. It took longer than usual, but I accomplished the procedure without complication. The best part of this story is when he returned for his follow-up after both lower extremity’s procedures, both he and his wife were tearful with joy that his longstanding RLS/PLMD had completely resolved the very night of procedure. Both of them are now sleeping blissfully after years of not.”