As an avid runner and mountain bike rider, Raquel Meono's legs are toned. But there's one small area that bothers her.
"Right now, I'm a little ashamed of my left leg," Meono said. "When I'm out running I feel like I need to hide it."
She says the raised veins faintly visible on her leg when she's lying down, bulge out when she's standing or running, forming in a rope-like pattern, familiar to varicose vein sufferers.
"And that's why I'm getting this done, actually," Meono said. "Because with my running gear, I don't want to see the bulgy veins."
But today Dr. Joel Erickson, a surgeon with the Laser Light Treatment Center in Novato, is going to treat the area with an increasingly popular combination therapy. He says it replaces older techniques that while effective, often required return visits.
"First to close the long straight veins, but that doesn't take care of all those little varicose veins and big medium sized ropey veins," Dr. Erickson said.
First Dr. Erickson uses an ultrasound to guide a laser into the larger saphenous vein which is feeding the problem area. Over the course of the next few minutes he'll use the heat from the laser to kill off the vein, a process known as thermal ablation.
"So this vein eventually gets destroyed because so much heat is produced it becomes seared or cooked," Dr. Erickson said.
The next step is to destroy the bulging veins using an evolving technique known as foam sclerotherapy. It involves injecting a liquid agent into the problem vessels to kill the tissue.
He says the challenge in the past has been to keep the solution in place. To help that process, Dr. Erickson whips the solution into a foam state to make it less likely to be diluted by any residual blood flow.
"If blood gets back into the vein that's been treated with sclerotherapy, there's a chance or a reasonable chance the vein can recover from the injury," Dr. Erickson said.
In a final step, Dr. Erickson injects liquid under the skin surrounding the veins to compress them, ultimately wrapped in a compression sock. The effect can be long lasting.
Salsa dancer Julia Sanchez underwent the treatment several months ago.
If all goes well, Dr. Erickson says Meono will avoid a secondary surgery often required in the past.
"She'll be on her bike within one week, I've told her she can go running after two days, her prognosis is great," Dr. Erickson said.
While commercial versions of the foamed chemical are in use in Europe, they're not yet approved in this country. One British company has just submitted a new product application to the FDA and they're hoping for approval in the next few months.
written and produced by Tim Didion