Interesting and weird clinical cases from the files of the experienced physicians of Vein Specialists of Alaska.
From the case files of Dr. Bell:
- Soldier with numb legs and feet
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), ...
- Numb Feet
A 48-year-old female with longstanding diabetes and chronic progressive numb feet—blamed on diabetic complication termed peripheral sensory neuropathy.
This problem was to the point that she could not feel the floor beneath her feet. She also was afflicted with longstanding varicose veins that caused heavy and tired sensations in each leg and minimal swelling each day.
Her vein problem was repaired in the office without complication.
Surprisingly, at her initial post-op follow-up a week later, she reported dramatic improvement in the degree of feet numbness, such that she could easily feel the floor/ground beneath her and resultantly, her balance and gait improved. Over ...
- Recurrent Leg Infections and Skin Ulcers
There have been many such cases I’ve encountered over my years that were either undiagnosed for too long, or misdiagnosed. This case just happens to be the worst to stick out in my mind.
A 62-year-old male without diabetes and otherwise healthy who initially presented to his primary care provider (PCP) several years ago for the first bout of infected lower leg skin along with swelling.
He was appropriately prescribed antibiotics, but the improvement was short-lived, and over a relatively short span of time, this cycle continued, and each episode caused more skin damage, to the point where the skin in the ...
- Chronic knee pain (following orthopedic surgery)
80-year-old lady with longstanding varicose veins of right lower extremity.
She presented mostly at insistence of a family member concerned about the appearance of the veins. The patient, instead, was fixated on a chronic right knee pain for the last 5 years that plagued her despite a total knee replacement (TKR) done 5 years ago. While I was attempting to gather necessary vein history, the patient consistently re-directed the conversation to badmouth the orthopedic doctor who she felt has botched her TKR since she was left with daily aggravating right knee pain. The sonogram I performed of the right lower extremity ...
- Restless Leg Syndrome (RLS)
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 ...