PART 4: WHY DO MY TOES, ANKLES AND FEET HURT AT NIGHT? DIABETIC FOOT DISEASE

Over the past month, I have discussed why venous and arterial disease as well as Raynaud’s Syndrome may cause pain in the feet and toes at night. Today, I want to discuss another one of the most common causes I see in my clinic for pain in the feet at night: Diabetic foot disease.

Interestingly, diabetes mellitus has Greek etiology and literally means sweet (mellitus) urine (diabetes).  Diabetes is a condition in which the body loses its ability to limit the amount of sugar in the blood.  The high concentrations of sugar result in the formation of harmful chemicals that can hurt the eyes, kidneys, and nerves all around the body, especially in the feet.  Once the sugar levels become high enough, they overload the kidneys—the organ that creates urine—and sugar overflows into the urine, hence the Greek etiology of diabetes mellitus.

Diabetes causes pain in the feet via two main pathways: Neuropathic pain and pain from ulcers. 

Neuropathic Pain:

For neuropathic pain, the high blood sugar levels damage the small nerves in the feet responsible for sensation.  As a result, patients often complain of burning, cramping, tingling, and at the very worst end of the spectrum, numbness.  Sometimes only the toes have these symptoms, but often times the symptoms can encompass the entire foot!

Ulcerative Pain:

The way diabetes results in the formation of ulcers is multifactorial.

  • First, the damage to the nerves can result in numbness or lack of sensation.  Thus, when a person injures their foot, that person does not feel it and protects it from further injury.
  • Second, in addition to damaging the nerves responsible for sensation, diabetes also damages the nerves that innervate muscles responsible for moving.  The damage to the muscle nerves occurs in such a way that irregular contractions of muscles within the foot push the bones of the foot outward creating pressure points that ulcerate easily.  Once the ulcer is formed, infection of the ulcer or exposure of the raw tissues beneath the skin can cause pain.  In patients who otherwise have numb feet, an infection can spread to an area that does have sensation and cause pain there.

Given that diabetes is so common, patient education is vitally important to those impacted by this disease.  If you or anyone you love suffers from diabetes, my hope is that this blog will help you to better understand some of the underlying factors that may be contributing to your foot pain at night.  As a rule of thumb, always remember to share with your primary care physicians all symptoms of pain that you experience during your regularly scheduled appointments and if you think your condition may be getting worse, please do not hesitate to call my office to schedule an appointment for a second opinion! We can help.

408-376-3626

Dr. Ignatius H. Lau

Vascular Surgeon

Dr. Ignatius Lau grew up in Portland, Oregon. He attended the University of Washington in Seattle for college and Stony Brook University in Long Island for medical school. He then went on to train in vascular surgery at Mount Sinai Hospital in New York City. During his time in New York, he performed over 1600 cases involving aortic, peripheral, venous, and carotid surgery. He has a special interest in limb salvage and treating patients with peripheral arterial disease and has extensive training and experience in treating the full spectrum of vascular diseases. Dr Lau was also very active in medical research during his training, ultimately finishing with twelve peer reviewed manuscripts. During his training in New York he met his wife, Lisa, who is a practicing endodontist. Together they love to hike, try new restaurants, and travel.

To see what our patients are saying about us, follow the link below to read our reviews.

https://www.google.com/search?q=south+bay+vasculr&rlz=1C1CHBD_enUS878US878&oq=&aqs=chrome.0.69i59i450l8.2997409j0j7&sourceid=chrome&ie=UTF-8#lrd=0x808e34eecfbc0653:0xb9aa2de7f50ba6a5,1,,,

 

FIXING BLOCKED ARTERIES

The most common disease that I treat as a vascular surgeon is a medical problem called peripheral vascular disease.  Specifically, peripheral refers to the legs, and vascular disease refers to blockages of the arteries.

Because peripheral vascular disease is the most common disease that I treat, I want to talk today about what I can do as a vascular surgeon to fix these kinds of blockages in the arteries!

First though, let me explain why blockages to the arteries of the legs are bad.  When not enough blood flow reaches the legs, patients can have pain in their calves or buttocks that limits their ability to walk longer than a city block.  When the blockages are very severe, they can also have pain in their feet and toes even when they are not moving or develop non-healing ulcers and gangrene.  When I open blockages in patients’ legs, I allow them to walk again, or I give them the ability to heal their ulcers and gangrene pain free.  The improvement in patient lives is the most exciting aspect of my job!

There are two main approaches to performing what we call revascularization. Revascularization refers to the opening of old passageways or creation of new passageways to bring blood directly from the heart to the foot without any obstruction.

  • Open Surgery: In the early decades of vascular surgery, namely the 1980s and 1990s the primary way to treat peripheral vascular disease was to perform an open surgical bypass.  If there was a blockage in the thigh, I would surgically expose above and below the blockage and take a synthetic tube or the patient’s own vein and then sew it above and below the blockage.  This would allow the flow of blood to bypass the blocked segment, hence, the reason we call this surgery a bypass!  Though this procedure does produce robust flow, it necessitates large surgical incisions that cause significant pain and are susceptible to poor wound healing and/or infection.

 

  • Endovascular Surgery: In the 2000s, an innovative approach called endovascular surgery started to become more widely used and is now actually standard of care today.  Indeed, I prefer to treat patients with peripheral vascular disease with endovascular surgery whenever possible.  We access the arterial system of the leg with a needle in the groin.  Through that needle we put in a strong wire and over that wire we can then advance several different instruments over catheters.  In general, there are three different techniques I can employ in my efforts to re-establish blood flow to an area that is no longer receiving blood due to some type of arterial blockage.
    • Balloons: The most basic instrument is a balloon that expands and breaks up the narrowing or blockage.
    • Stents: If the balloon does not work, we can use a self-expanding tube called a stent.
    • Atherectomy: If the stent does not work, we can use a special device called atherectomy.  Atherectomy involves the use of a device that can literally cut the plaque out of the artery and aspirate all the debris.

 

These three technologies allow the reopening of arteries from the toes to the pelvis and only necessitate a 2 mm puncture site in the skin of the groin to be used.  There is little to no risk of infection and the procedure can be performed several times over the course of the patient’s life.  On the other hand, surgical bypass can only be performed twice—three times—during the patient’s life due to the development of dense scar tissue after each operation.

 

If you have trouble walking because of pain in your buttocks or calves or have pain in your feet and toes or ulcers that will not heal, please do not hesitate to call my office today at 408-376-3626 to schedule an appointment.  The chances are that I will be able to help take your pain and ulcers away! We Can Help

www.southbayvascular.com

ANEURYSMS: WHAT ARE THEY AND WHY IS IT IMPORTANT TO KNOW IF YOU HAVE ONE?

Of the many reasons that a patient can be referred to a vascular surgeon, one is that their referring physicians believes that their patient may have developed an aneurysm.  Aneurysms, typically speaking, form in arteries which are the specialized vessels that carry blood from the heart to the rest of the body under high pressure.  When the wall of an artery weakens, it can develop into a balloon-like dilation called an aneurysm. (See below). This most commonly occurs in the main blood vessel in your abdomen, which is called the abdominal aorta. When the blood vessels dilate to 50% greater than their normal diameter, the vessel has become an aneurysm.

 

 

Interestingly, the reason why aneurysms form is actually poorly understood.  We know that smoking cigarettes and a family history of aneurysms increases the risk that a patient will develop an aneurysm, but no direct cause-effect relationship has been established.  Diabetes mellitus, however, appears to have a protective effect.  That is, the presence of diabetes appears to help prevent aneurysms!  The other health risks of diabetes including neuropathy and infection, of course, make diabetes an undesirable health problem to have.

Aneurysms have two main catastrophic problems: Rupture and thromboembolization.  (to learn more about aneurysms visit our website at https://www.southbayvascular.com/aneurysms/  Rupture refers to a tear in the wall of the blood vessel resulting in a leakage of blood.  When aneurysms in the abdomen rupture, the amount of blood loss into abdomen can be life threatening and result in death within seconds.  Thromboembolization refers to the formation of blood clot within the aneurysm that then breaks off and goes somewhere else.  When aneurysm and associated blood clot form in the abdomen, these blood clots can break off and travel to the leg resulting in a lack of blood flow to the legs.  Such a sudden cessation of flow to the legs can result in the death of the foot and/or legs within hours.

As you can see arterial aneurysms can be very troublesome.  Luckily, vascular surgeons have many tools and instruments that we can use to treat these aneurysms in a minimally invasive way.  In my blog next week, I will go over the different options for treating aneurysms in the abdomen.  If you or someone you love have been told that you may have an aneurysm, please call our office immediately to schedule an appointment for a full vascular work-up. 408-376-3626

We Can Help!

 

WHAT IS “ENDOVASCULAR” SURGERY?

As a vascular surgeon, I perform two very different types of surgery: Open Surgery and Endovascular Surgery.

  • Open surgery is just as you might think!  It involves making an incision with a scalpel and using various tools like forceps, scissors, electrocautery, and needle drivers to expose and then repair specific structures.  Since the beginning of surgery itself, all surgeons, not just vascular surgeons, have been practicing open surgery.
  • Endovascular surgery is a recent development that only began in the 1990s.  Motivated by the desire to perform minimally invasive and less harmful interventions on the most sick and highest risk patients, pioneers in vascular surgery developed endovascular techniques.

Though the concept is simple, endovascular surgery now allows vascular surgeons to solve a multitude of problems with blood vessels very differently than they have in the past. Using advanced minimally invasive surgical techniques, vascular surgeons can treat many forms of vascular disease without the need to “cut-open” their patients to treat extraordinarily complex and in some cases life threatening diseases.

Endovascular surgical techniques utilize ultrasound (sound waves) to place the tip of a hollow needle into a blood vessel.  Once these hollow needles have been placed through the needle, we place a very stiff wire that allows us to advance large tubes called catheters into the vessel.  Catheters have many different functions depending on the situation and are used to re-establish blood flow in vessels that are diseased and or blocked.

For peripheral vascular disease, there are blockages in the legs of a patient that prevent blood flow from reaching the foot.  For peripheral vascular disease we can use balloons on the end of the catheter that are inflated to open a blockage.  If balloons do not work, then we can put a self-expanding metal mesh tube on the end of a catheter and then deploy it inside the blockage, thereby keeping it open.  There is also a technology called atherectomy which literally means cutting out plaque.  The atherectomy device has a cutting edge that sands down the plaque and then a suction function that removes all the debris.

For aneurysms, which are dilations of a blood vessel that can rupture, we use stent grafts, which are self-expanding metal mesh tubes that are lined with an impermeable fabric.  We place the stent graft above and below the aneurysm, thereby sealing it from the pressure created by the heart and preventing rupture.

At the end of these endovascular cases, the patient only has one or two 1 mm in size punctures over the arteries that were accessed.  Contrast this to the classic open surgeries where patients could have incisions up to 10 to 20 cm!  As a contemporary vascular surgeon, I take pride and joy in being able to offer both types of surgical interventions to my patients.  If you or your loved one may be suffering from vascular disease, please do not hesitate to call our office at 408-376-3626 to schedule an appointment today!

TRANSCAROTID ARTERY REVASCULARIZATION: THE FUTURE OF CAROTID SURGERY

One of the most gratifying problems we help treat for patients is carotid artery disease.  The carotid arteries supply the brain with blood.  In patients with high blood pressure, high cholesterol, diabetes, and a history of smoking, the carotid arteries can become narrowed and form blood clots that then go into the brain and cause strokes.  Traditionally, vascular surgeons have fixed this carotid artery narrowing’s with a surgery called a carotid endarterectomy.  The carotid artery is dissected out and cut open.  The plaque is then removed, and the carotid artery is sewn back together.

Over the past five years, however, I have had the opportunity to perform a new technique involving carotid stenting called trans carotid artery revascularization or TCAR.  Stents are self-expanding metal tubes that we can use in the carotid artery to stop clots from forming in narrowed areas.  TCAR uses a suction machine to reverse flow in the carotid artery during the placement of a stent to minimize the risk of inadvertent stroke during the procedure itself.  After having performed over 20 of these procedures in the past two years, I can say with confidence that the flow reversal and stenting that TCAR provides is a highly safe and successful way to treat carotid artery disease.  Furthermore, the length of the incision, postoperative pain, and risk of nerve damage and bleeding are all much less with TCAR than with CEA.

I am so happy to be able to offer this revolutionary, safe, and effective therapy to all my patients at South Bay Vascular Center.  Should you or anyone you know have any problems with your carotid arteries or a stroke, please do not hesitate to call us today at 408-376-3626 to schedule a consultation.

https://youtu.be/O32nDoovMPY]

ONE PATIENT, ONE DOCTOR, ONE NURSE; SOUTH BAY VASCULAR CENTER’S COMMITMENT TO PERSONALIZED CARE

Unlike so many big box medical centers (Kaiser, Sutter, PAMF, Stanford) where patients are often “overwhelmed” as soon as they get to the parking lot, South Bay Vascular Center and Vein Institute offers world class, cutting edge vascular surgical care in a kinder, gentler environment.  Individualized patient care, although talked about and marketed heavily by these corporate health systems, more often than not falls far short of patient expectations as higher order operational efficiencies and profitability concerns impact the kind of care patients actually experience in these larger health care systems.

ONE PATIENT; ONE DOCTOR; ONE NURSE. 

Putting patients at the center of everything that a physician does is a philosophy that sounds obvious…but is that always the case? At South Bay Vascular Center we are honored by the chance to earn your trust and to serve as your physicians; BUT, we also know that we must EARN the trust of every patient that we see.  That’s why our CREDENTIALS are NOT Enough…That’s why our REPUTATION is NOT enough. That’s why unmatched patient care is at the center of everything that we do. That’s why when patients come to our facility for a procedure each patient has their own nurse from start to finish to ensure the greatest patient care experience from start to finish. 

We know patients have options for their vascular care and that’s why we work hard to ensure that any patient referred to us by another doctor or that comes to us on their own has the confidence to know they’ve made the right choice of doctor to help them with their vascular related illnesses. ONE PATIENT; ONE DOCTOR; ONE NURSE is just one of the many ways that South Bay Vascular Center demonstrates our commitment to our patients in our efforts to provide the most advanced vascular care options offered anywhere in the world.

OUR TEAM

Together with her full time, highly skilled team of critical care and surgical nurses, radiological technicians, RVT certified Ultrasound Technologists and scrub assistants, Dr Kokinos provides unmatched peripheral vascular surgical care in her Nationally Accredited Surgical Facility. As diverse as Silicon Valley is, our staff reflects this same diversity as we have native speaking staff fluent in over 10 different languages. Be it Vietnamese, Mandarin, Korean, Russian, Tagalog, Hindi, Spanish, French, Greek or English, we have staff to make our patients comfortable in their native tongue.

OUR FACILITY

The South Bay Vascular Ambulatory Surgery facility is one dedicated entirely to the practice of Vascular Surgery and houses a specialized inventory of vascular medical devices and imaging equipment that surpasses the number of vascular medical devices and imaging equipment at Good Samaritan and O’Connor Hospitals combined. Together with her highly trained and specialized team, Dr Kokinos brings over 30 years of surgical experience and 7 years of specialized surgical experience operating in a specially built vascular surgery outpatient facility to her patients.  Other physicians may claim to have the kind of training and experience that Dr Kokinos has in the outpatient environment, but NO other Vascular Surgeon in Silicon Valley comes anywhere close to having the kind of experience and outcomes Dr Kokinos does when it comes to providing care to the patients who come to her for the treatments and care of their vascular disease.

Put another way, for 25 years Dr Kokinos and her team at South Bay Vascular Center and Vein Institute have provided unmatched, compassionate and individualized vascular surgical care to South Bay communities. It is why more independent physicians refer their vascular patients to Dr Kokinos than to all the other Silicon Valley vascular surgeons combined. When it comes to your health, we know that it’s not just our credentials and our experience that count.  It’s not about just having an accredited facility or a staff of travelling specialists to help when needed…   It’s about the RIGHT KIND OF EXPERIENCE EVERY TIME YOU NEED IT.

RESULTS matter when it comes to your health because sometimes you don’t get a second chance.

South Bay Vascular Center and Vein Institute: We Offer Hope When Others Say there Is None.

Call us at 408-376-3626. We Can Help

THE “RIGHT” EXPERIENCE COUNTS WHEN IT COMES TO YOUR HEALTH

The “RIGHT” Experience Counts When It Comes to Your Health! South Bay Vascular Center and Vein Institute is the Bay Area’s Most Trusted Varicose Vein Clinic and Treatment Center.

Having performed over 20,000 vein procedures in the past 24 years, more independent doctors refer their vein patients to Dr. Polyxene (Polly) Kokinos than to any other vascular surgeon in the greater Silicon Valley region. Recognized as San Jose’s most experienced Vascular Surgeon and Varicose Vein Expert, Dr Kokinos offers cutting edge care to patients suffering from all forms of both arterial and venous disease.

Here’s why more local doctors refer to South Bay Vascular than to any other Vascular Surgery Center in the Valley:

  • The “RIGHT” Experience Counts When it Comes to your Health: South Bay Vascular center has been treating vein patients in a private practice setting for over 24 years.
  • Cutting edge vascular care in a fully accredited, state of the art, and private out-patient surgery center dedicated entirely to the practice of vascular surgery.
  • Access to the most Advanced Imaging and Device technologies found anywhere in the world.
  • On-site fully staffed IAC accredited Vascular Ultrasound Clinic that is operated full time by Registered Vascular Technologists (RVT).
  • Vascular Studies ready by RPVI certified Vascular Surgeons.
  • Same day availability for Hemodialysis Access de-clots.
  • “One-Doctor, One Patient, One Nurse” practice philosophy means we put the patients first.
  • Full time access to practice physicians
  • Easy access to care: No admissions departments.
  • RESULTS:   We are MORE than just a colorful website and a Google Adwords campaign. Remember, all that glitters is NOT Gold!  https://www.southbayvascular.com/blog/varicose-vein-doctors/

 Trust the doctor your physician does.

 Remember, Its Not Just Experience That Counts.

When It Comes to Your Health, It’s The “RIGHT” Experience that Matters!

Dr Polyxene Kokinos, Silicon Valley’s Vascular Surgeon.

Call us today at 408-376-3626 to schedule your vein consultation.

Click here to learn more about Dr Kokinos  NOT JUST VASCULAR CARE, EXCEPTIONAL VASCULAR CARE

PERIPHERAL ARTERIAL DISEASE (PAD); EARLY RECOGNITION AND REFERRAL TO A VASCULAR SURGEON

According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 18 million people in the United States suffer from Peripheral Artery Disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Estimates suggest that anywhere from 12 to 20 percent of individuals over the age of 60 are living with PAD. Approximately 160,000 to 180,000 of the estimated 18 million Americans with PAD will undergo a limb amputation as result of PAD-related condition this year, resulting in lower quality of life, high medical costs, and shorter life expectancy.

But even with these alarming numbers, APPROXIMATELY 3 OUT OF 4 AMERICANS are unaware of PAD Symptoms.

Severe PAD symptoms include:

  • Leg pain,
  • Wounds on the toes or feet,
  • Gangrene and
  • A loss of leg mass compared to the rest of the body.
  • Individuals are at greatest risk for PAD if you have high cholesterol, high blood pressure, or diabetes.

Dr. Polly G Kokinos, a board certified Vascular and General Surgeon in Campbell, CA. is recognized as one of the regions foremost authorities in the diagnosis and treatment of PAD. With offices in both Campbell and Gilroy, CA. Dr Kokinos has dedicated her entire career to serving the South County community as an independent physician and as a pioneer in the evaluation and treatment of patients suffering from Peripheral Arterial Disease.

Unburdened by the productivity metrics, financial benchmarks and administrative red tape commonly found in Big Box Medical Systems, Dr. Kokinos has focused her entire career on providing exceptional vascular care building her practice one patient at a time. Her Campbell Surgery center, a nationally accredited Vascular Surgery Center of Excellence, is entirely dedicated to treating patients suffering from complex vascular surgical disorders. Unlike a traditional hospital or university operating room, Dr. Kokinos’ surgery center is entirely dedicated to addressing vascular issues ensuring that she has the most advanced imaging and device technology available anywhere in the world.

Unfortunately, even with all of her skill experience and technology, many patients don’t find Dr. Kokinos until its too late. Many patients go under diagnosed or undiagnosed until it is too late and their medical condition has declined to the point where no one can help. In this circumstance patients lose limbs, suffer unnecessarily and become an incredible burden on their family and loved ones. In the worst cases, patients can die if their leg wounds are left untreated.

In an effort to help front line medical doctors better evaluate and diagnose peripheral arterial disease Dr. Kokinos has spoken extensively to the Primary Community Care Team (Internists, Podiatrists, Orthopaedic Surgeons) in the management of lower extremity arterial and venous disease. As is the case in most instances, early detection of peripheral arterial disease has a dramatic impact on the success of any future treatments.

Bridging this educational gap was the topic of a recent talk Dr. Kokinos was honored to give in March of 2020 to a group of Northern California primary care physicians. The focus of this talk was to help primary care and referring physicians better understand the etiology (the cause of a disease or condition) its diagnosis, management, and referral strategies for peripheral arterial and venous disease.

The key takeaways from her talk are outlined below:

  • Prevalence of PAD and Venous Disease have reached epidemic proportions.
  • Peripheral Arterial and Venous Disease are both associated with high rates of disability and death.
  • Identifying arterial disease early may improve a patients quality of life and allow early medical and surgical interventions to lower the risk of critical limb ischemia and amputation.
  • Identifying venous disease can greatly improve a patients quality of live and lower their risk of dying from this disease.
  • Despite greater awareness, PAD and Venous disease are still under-recognized and under treated.
  • Due to the complex nature of vascular disease, an evidence-based multidisciplinary approach is essential to early assessment, proper diagnosis and optimal treatment
  • Minimally invasive endovascular techniques now enable vascular surgeons to treat significantly higher numbers of patients with a lower complication and death rate
  • Appropriate referrals to specialists must be emphasized if physicians are to continue to improve the lives of patients with PAD

Her underlying message to the audience was that primary care physicians are a patients first line of defense. Helping patients achieve better outcomes requires early recognition and management on the part of the primary care physician and that early referral to a vascular surgeon is essential to the successful outcome of advanced treatments.

If you or anyone you love suffers from any of the symptoms outlined in this blog, we would be honored to speak with them to discuss their symptoms. Call Dr. Kokinos’ office at South Bay Vascular Center to schedule an appointment at 408-376-3626.

DR. POLYXENE KOKINOS…AN INDEPENDENT COMMUNITY VASCULAR SURGEON SERVING SOUTH BAY RESIDENTS FOR 24 YEARS

For 24 years, Dr. Polyxene (Polly) Kokinos has worked in the greater San Francisco Bay Area community as an independent vascular surgeon, dedicating her time to serving patients suffering from vascular disease.

With offices in both Campbell, CA and Gilroy, CA Dr. Kokinos has worked with over 25,000 patients helping them as they suffer from circulatory illnesses and the impact of their disease. From the most delicate to the most complex surgical care, Dr. Kokinos’ and her staff have remained independent community physicians, offering patients an alternative to the “Big Box” medical systems of Santa Clara, San Mateo and Alameda Counties (Kaiser, PAMF, Sutter, Stanford) by offering unmatched personalized care and innovative surgical techniques to advance the care and treatment of her patients.

“We offer hope when others say there is none” is more than a simple message crafted by a marketing agent. It is at the core of everything we do and is the reason why we our facility operates in the most personal way available…

One Patient, One Doctor, One Nurse

South Bay Vascular Center and Vein Institute, located in Campbell, CA is the only fully accredited privately owned state of surgery center in the South Bay dedicated entirely to the practice of Vascular Surgery. Here, Dr. Kokinos provides unmatched vascular surgical care using cutting edge imaging and device technology that no other vascular surgeon or institution in the area can offer as she continues her pioneering work in the treatment of vascular disease.

Recognized by her peers as a national expert in the care of complex vascular disease, Dr. Kokinos is highly sought after as a speaker at national and international vascular surgical conferences and educational symposia. On March 4 2020 as part of her ongoing commitment to her community, Dr. Kokinos spoke in San Mateo, CA. addressing a large group of her peers as an invited guest of Global Education Group and Educational Awareness Solutions under a grant from Philips Image Guided Therapy. Her topic was “The Essential Role of the Primary Community Care Team in the Management of Lower Extremity Arterial and Venous Disease”

Her talk focused on Vascular diseases, “Including peripheral arterial disease (PAD) and venous thromboembolism and their prevalence in the US. When unrecognized or inadequately treated, these disorders may be life threatening and disabling. The therapeutic an diagnostic landscape for vascular conditions is rapidly evolving; yet there remains an unmet need for more awareness among healthcare professionals and patients.” As a recognized expert in her field, Dr. Kokinos was asked to address these topics with her peers, offering solutions and answering questions and was honored to present at this event.

As an independent community surgeon, Dr Kokinos isn’t forced to achieve the “productivity” targets or revenue targets that are by design a part of “Big Box” Medicine. Her practice has always been one of service to her community and as such continues taking emergency vascular call at Good Samaritan Hospital, O’Connor and El Camino Hospital’s in the Silicon Valley. She has served as the chair of vascular surgery at Good Samaritan Hospital in San Jose, Headed the wound care clinic at Good Samaritan, O’Connor and St Louis hospitals and continues to treat patients at the O’Connor Wound Care Clinic.

As an independent community physician Dr. Kokinos focuses her work on providing cutting edge care in the treatment of the most difficult vascular problems. Free from “corporate” medicine Dr Kokinos’ practice is dedicated to finding the “Why” you are suffering so that you have “real” solutions to living a healthy life. At South Bay Vascular, our first job is to listen. We take the time to fully understand your symptoms so that we can provide the best possible solutions to get your legs and your life back…and that’s what she has been doing for over 24 years.

Unlike Big Box medical practices where doctors see the patients on their “list” every morning, Dr. Kokinos must earn the trust and respect of everyone she sees. She’s knows each and every one of her patients by name and everyone who comes in to see Dr. Kokinos gets her cell phone to call if they ever have a problem. It’s what she does and what she’s always done, building her practice patient by patient, referring physician by referring physician for the past 24 years.

If you or anyone you love suffers from vascular disease, we would be honored to meet with you to discuss your symptoms. Please call our office at 408-376-3626 to schedule an appointment.

PERIPHERAL VASCULAR DISEASE (PVD)

Peripheral vascular disease, sometimes referred to as PVD, in the legs or lower extremities is the narrowing or blockage of the vessels that carry blood from the heart to the legs.

Dr. Polyxene G Kokinos, founder of San Jose’s South Bay Vascular Center and Vein Institute is a board certified general and vascular surgeon who specializes in treating patients who suffer from this condition. For 24 years, Dr. Kokinos has dedicated her practice to helping South Bay patients regain their circulatory health by bringing advanced surgical solutions to complex vascular problems. Having treated over 20,000 Varicose Vein patients, Dr. Kokinos understands both the aesthetic as well as the complex side of her field and is recognized one of the regions most respected surgeons.

Recent advances in both imaging and medical device technology has revolutionized the practice of Vascular Surgery. Of particular interest to Dr. Kokinos is treating vessels in the deep venous systems, as well as the treatment of peripheral vascular disease. Having performed hundreds of these procedures, Dr. Kokinos has found that many of her patients, being properly treated and educated are able to make great strides to regaining their health and quality of life.

Recently, the US Centers for Disease Control and Prevention published a patient educational bulletin that Dr. Kokinos shares with her patients as part of re-educating them to live a healthier life and to recognize the symptoms of Peripheral Vascular Disease. As part of her continuing efforts to educate her patients, she wanted to share this handout, written and published by the CDC for patients following her blog to read.

Please click on the link below to receive this CDC authored bulletin in the hopes that you too can begin to live a healthier life and become aware of the signs of peripheral vascular disease.

https://www.cdc.gov/heartdisease/pad.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fdhdsp%2Fdata_statistics%2Ffact_sheets%2Ffs_pad.htm

If you or anyone you know suffers from peripheral vascular disease call today to schedule an appointment at 408-376-3626.