Oct 222015
 
A 36-year old male—a very fit member of our U.S. Army force—previously had right leg pain symptoms evaluated by another vein clinic leading to heat ablating his diseased right great saphenous vein in the thigh segment several months before coming to VSA. (The lower leg portion of this vein was not treated).  He reported his symptoms on the right leg improved but did not resolve following this endovenous heat treatment, and in interim since right treatment, he had new onset of same symptoms but of somewhat lesser intensity in the opposite (left) leg.

His symptoms relayed in both legs (right > left), mostly described as a very dense numbness, onset within a minute or two of sitting at his desk job with the military, and consistently improving with movement of the lower extremities, mostly walking or just moving his ankles.  When standing still in formation, he also noted onset of this same progressive numbness to where he could not feel his feet.  With sitting/standing, he always reported onset of the numbness first in his toes/feet and gradually ascending his lower legs to knee region if he did not begin to walk.  Walking or running would consistently improve the symptoms.  Additionally, in the right leg, he was noting return of vein-typical symptoms of swelling and sharp, stabbing, stinging, aching, throbbing that for a few months seemed to improve after the endovenous heat ablation of the right great saphenous vein.

At his initial evaluation here at VSA, his general build was noted very lean/fit, with his legs slender, very muscularly fit, with no outward signs of varicose vein problems, aside from mild swelling right foot/ankle.  His ultrasound showed left great saphenous vein improper draining that was never diagnosed previously.  The right leg showed proper prior closure of the diseased thigh great saphenous vein as previously noted above, but the lower leg portion of the remaining great saphenous vein to be significantly diseased.

This Army Private shared further information with me: He voluntarily closed his successful family business (taking a significant pay cut doing so) to enlist in the armed forces to serve/protect our country, and was now facing a medical discharge due to this bilateral leg numbness and recurrent flare of right leg problems, impairing his ability to fully comply with all Army job duties required of him.  He expressed dismay that this discharge may be in his immediate future, stating a true love and honor for serving his country.

Hearing this, I agreed to perform procedures but I was not certain of improvement, since I feared his symptoms in both legs (mostly the numbness) might be from a yet-to-be-diagnosed spine problem.  We both agreed that since his right leg was most symptomatic, it should be addressed first and assess for improvement, especially from the numbness standpoint, before embarking on any left leg treatment.

He subsequently successfully underwent right leg remnant great saphenous vein chemical ablation and at his follow-up visit 3 weeks later, to his/my amazement and joy, the numbness noted in BOTH legs had completely resolved.  He also reported the other pain descriptors right leg (noted above) that had plagued him even after his prior vein heat treatment, had also fully resolved.

He has now been able to return to full active duty, completing all facets of his job with the Army without any further hindrance.

To this day, I cannot explain how treating only one leg’s vein problem could result in resolution of BOTH legs’ symptoms, especially from what sounded more like a spine neurologic problem, but what a blessing for this soldier and to our country for keeping this dedicated patriotic man on duty!  Thank you soldier for your service.

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