Photo by Bill Green Dr. Paul McNeill, a board-certified vascular surgeon of the Capitol Vein and Laser Center on Thomas Johnson Drive in Frederick, holds a catheter used to perform a new minimally invasive, outpatient treatment of varicose veins.

It was invasive and painful, she said. "They put me to sleep and actually went in and removed the veins. I had 30-some 1-inch incisions on one leg and 40-some on the other," she said.

Recovery time was about two weeks, taking it easy with her legs wrapped in ACE bandages.

"The surgery was supposed to be an outpatient procedure, but I had to stay overnight because it was so involved," said the 44-year-old Frederick resident. "It was probably one of the most horrible procedures I've ever had -- and I've had four C-sections."

So when varicose veins developed in her legs a second time, she was reluctant to have the procedure again, even though they were worse.

"I'm more prone to (varicose veins). My mother and all her sisters have them, even a couple of uncles have them," she said. "And I had four children in a short amount of time."

Pregnancy increases pressure on legs, which increases risk for varicose veins.

Shoemaker was referred to board-certified vascular surgeon Dr. Paul McNeill of the Capitol Vein and Laser Center on Thomas Johnson Drive in Frederick . McNeill and his practice partner, Dr. Garth Rosenberg, are two of the first physicians in the country to perform a new minimally invasive, outpatient treatment of varicose veins. The procedure uses a catheter, which has been in use several years. But a new catheter, ClosureFAST, became available in March and closes diseased leg veins in less time using radiofrequency energy.

"Traditional varicose vein care was performed surgically and required two to three weeks recovery," said McNeill. "That kept a lot of people away from getting treatment, but that hesitation in care resulted in worsening of the condition and a bigger operation for a bigger problem. This new catheter enables us to do this procedure very rapidly. The actual procedure takes two to three minutes."

Patients can return to full activity in 24 hours. McNeill and Rosenberg also teach the procedure to other doctors around the country.

Varicose veins occur when vein valves become aged or damaged and allow blood to flow back toward the feet, resulting in a buildup of pressure and vein enlargement. This condition is known as venous reflux. Symptoms may include leg aching, heaviness and fatigue. Some people experience itching, burning, pressure, pain, leg swelling and skin color changes.

"The (vein) valves can't be repaired," said McNeill. Valves occur every couple of inches in the vein to keep blood moving toward the heart. When they fail, they fail in sequence from top to bottom. Women have a greater tendency to develop varicose veins. Heredity and pregnancy are other contributing factors. But men are also susceptible. "Men typically wait even longer (than women) to get care," said McNeill.

"Once a bulging vein appears on the leg, you know something is going on internally. The longer you wait, the more serious it can become," he said. Blood flow becomes sluggish, which can lead to clotting. Left untreated, it can also lead to skin discoloration and ulcers.

In June, McNeill treated Shoemaker using the new RF catheter. Ultrasound was used to identify the veins not functioning properly. The catheter was threaded through the vein, and as it was removed, heated to close it.

"The protein in the vein shrinks, like when you put a steak on the grill, the protein shrinks," he explained. Radiofrequency heats the end of the catheter to 120 degrees centigrade to close the vein. The RF catheter reduces catheter treatment from 20 minutes to about three minutes.

"He explained what the procedure is like. I thought it would be horrible," said Shoemaker, but "living on Advil" for leg pain wasn't what she wanted to do anymore.

During the procedure, a numbing agent was used at the site and McNeill explained every step of the process.

"I kept waiting for something painful to happen," said Shoemaker. "But there was no pain. There was nothing to it." She drove herself home and within 24 hours was able to resume normal activity. Two weeks later, she had her other leg treated.

"After one leg was done, it was like night and day between them, even in appearance. The (treated) leg was lighter in feeling and color because of better circulation," she said. "I highly recommend it to anyone who has had the stripping or anyone who has varicose veins.I hope it's the new answer for varicose veins."