LIHUE — Joyce Yamace, 37-year resident of the South Side, was all ready to fly to Oahu for surgery on her varicose veins.
She started the process about a year ago. She went through the ultrasound, where technicians mapped the veins in her legs and her surgery was scheduled for five months later.
“It was going to be a nightmare, but I really wanted to have this taken care of,” Yamace said.
She even talked her daughter into going to Oahu with her to help after the procedure, but she discovered a game-changer just in time.
“About a week before I was going to fly out, I’m reading the newspaper, and I see this vein clinic opening on Kauai,” Yamace said. “So I called, and set up a meeting and canceled (my appointment on Oahu).”
The advertisement that caught Yamace’s eye was for Dr. Randall Juleff and his new Lihue office: Vein Clinics of Hawaii. The office is the first on the island to offer modern vein procedures for people with venous insufficiency.
That’s what causes spider and varicose veins in people’s legs, according to Juleff, but along with those surface marks comes leg achiness, heaviness, fatigue, cramping, and restless leg syndrome.
Yamace had already had the ultrasound completed and everything had passed through the insurance company, so she was first in line at the clinic.
“I was their fist patient because I’d already had my mapping done,” Yamace said.
She had the procedure on October 28, and Juleff said it was a success. Yamace said she’s thrilled.
“I’m an athlete,” Yamace said. “I run, play tennis, horseback ride, hike, bike, swim — fixing the veins increases the blood circulation because the valve wasn’t working, so now my blood’s flowing in my legs better.”
Normally, the veins in the legs carry blood against gravity back to the heart and one-way valves within the veins make this possible. When those valves fail, blood pools in the legs causing symptoms.
“There really wasn’t a vascular surgeon over here,” Yamace said. “A lot of people have varicose veins, but they don’t want to because they don’t want to fly (to Oahu).”
Now there’s a surgeon on the island that can address varicose veins, and do it with cutting-edge methods.
The clinic is pioneering modern vein procedures that are less invasive and require less recovery time than the traditional methods.
A decade ago, the treatment for varicose veins was vein stripping, which requires big incisions on the legs and has to be done in an operating room.
“The defective vein was completely removed from the leg and that was done in a fashion that created a lot of bruising and discomfort,” Juleff said. “People were in the hospital for two or three days.”
The procedure requires general anesthesia and takes “a fair amount of time to get over,” Juleff said.
The new procedure is called endovenous ablation, and uses either a laser or a radio frequency catheter to cauterize the inside of the problem veins. There are only a few needle puncture wounds to show after the procedure, instead of large incisions.
It requires no general anesthesia, according to Juleff, simply a local anesthetic and Valium or the equivalent to pacify the patient.
The endovenous ablation procedure takes about an hour, and is done in the office instead of at the hospital. The vein stays in the leg, and recovery is quick.
“We tell people that there is essentially no down time,” Juleff said. “We wrap up their leg with a dressing and they can leave our office and go out shopping, or for a run.”
Yamace said she wore compression socks for 10 days after the procedure, which was a warm experience here on the island, but all-in-all, she’s stoked about the results.
“It’s awesome,” Yamace said. “It’s super simple and they make it super easy.”
According to Juleff, about half of the adult population has some level of venous insufficiency by the time they reach 50 years old. In the past, procedures weren’t “very palatable to the patient and they weren’t that appealing to the doctors doing them.”
He said there are many people who haven’t been treated because the vein stripping was too taxing, but the modern procedures are more easily tolerated.
“Between that and no down time, we’re able to treat many more people now and help them,” Juleff said. “A lot of people, say their legs feel bad because they’re getting old, but often there is an underlying problem that we can fix and make them better.”
Cost is another barrier, especially on Kauai, where in the past patients had to fly off-island to get the procedure done.
With an office on Kauai, the expense of hotels, rental cars, and the like are eliminated. The other piece of good news is that insurance will most likely help with the procedure.
“Everything that we do is covered by Medicare and/or private insurance companies,” Juleff said. “That’s the other thing, people think that veins are just a cosmetic problem and they have to pay out of pocket, and that’s not the case at all.”
Juleff, who hails from Louisiana, has spent most of his career as a heart surgeon and for the last five years, he’s been concentrating completely on the treatment of vein disease. He also has an office on Maui.
Since opening in July, the Kauai office has treated approximately 10 patients. Every time he’s in town, Juleff sees 10 or 15 new patients. Those seeking endovenous ablation will visit the Vein Clinics of Hawaii office three times over 90 days before they can have the procedure.
“Everything we do has to be pre authorized by the insurance company, so for the last several months we’ve been getting those people from that initial group started through the process,” Juleff said.
The Kauai office is currently open for a few days every month and Juleff said as the word gets out about their modern vein surgeries, he will spend more time on-island.
“In the not too distant future, I foresee a week or more on Kauai (every month),” Juleff said.
Vein Clinics of Hawaii is located at 3214 Akahi St. in Lihue. For more information, call 214-5715.