Tag: LEG WOUNDS

BLOOD THINNING MEDICATIONS PART 1: ANTICOAGULANTS: WHAT ARE THEY AND HOW ARE THEY USED?

Posted on by Michael Kokinos

Over the next few weeks, I want to discuss the medications that vascular surgeons may prescribe.  These medications include anticoagulants, antiplatelets, statins, and other miscellaneous agents.  This week I will discuss anticoagulants!

Anticoagulation refers to agents that STOP the clotting of blood.  The clotting of blood starts with what is known as the coagulation cascade.  The cascade refers to a series of consecutive events each involving special proteins that are needed to occur for blood to form a clot.  Different anticoagulants block specific parts of the cascade.  The main reason we usually see patients with anticoagulants are for hypercoagulable states, certain heart arrhythmias like atrial fibrillation, and deep vein thromboses otherwise known as blood clots.  Hypercoagulable states are specific genetically inherited disorders that result in the blood being more likely to clot.  Atrial fibrillation and other arrhythmias can cause blood clots to form in the heart.

 

Anticoagulant agents are given to prevent the formation of clots in the heart that can then break off and go to the brain, hands, feet, kidneys, or any other part of the body and cause problems. 

 

Deep vein thrombosis or blood clots mandate the prescription of anticoagulant therapy to ensure that more blood clot does not form.

 

Anticoagulants can be broken up by many different classification schemes.  For the purposes of this blog, I will limit our discussion here to agents that are appropriate for the OUTPATIENT (Outside of the hospital) setting.  Please speak with you private physician to answer any additional questions you may have regarding Anticoagulation medication of feel free to reach out to me directions for more information on how anticoagulation is used. Anticoagulation agents that are used during hospitalization or in the IN-PATIENT setting in patients are outside the scope of this article.

 

Up until the 2010’s the mainstay of anticoagulation therapy was with a drug called warfarin (Trade name: Coumadin).  Warfarin, though effective, requires the weekly or biweekly measurement of a specific lab for the blood called the prothrombin time.  The active monitoring of the prothrombin time facilitates modulation of dosing to always allow for safe levels of effective therapeutic anticoagulation.  Since the beginning of the 21st century new agents have come to market that require only taking one or two pills a day.  They include Xarelto or Rivaroxaban and Eliquis or apixaban.

If you have a question about how your medications may be affecting your vascular disease, please do not hesitate to call and schedule an appointment today!

South Bay Vascular Center and Vein Institute is Silicon Valley’s largest and most trusted Vascular Surgery practice.  Serving South Bay communities for over 26 years, Dr Kokinos and her Colleague, Dr Ignatius Lau are the region’s foremost experts in advanced vascular care and provide innovative care for patients suffering from circulation relation problems. At South Bay Vascular Center and Vein Institute our job is to understand the “Why” so that you have real solutions to living a healthy life. Call us today at 408-376-3626 or visit our website at www.southbayvascular.com to learn about what makes us the most referred to vascular surgery clinic in Silicon Valley.

PART 3: WHY DO MY TOES, ANKLES AND FEET HURT AT NIGHT? PERIPHERAL ARTERIAL DISEASE

Posted on by Michael Kokinos

In part one- and two of our four-part series on “Why do my feet hurt at night”, I discussed Venous disease and Raynaud’s Syndrome. In today’s discussion I want to focus on an even more common reason for why patients may suffer from leg pain at night: Peripheral arterial disease (otherwise known as PAD.)

As we’ve discussed in our earlier blogs, there are two kinds of blood vessels: Arteries and veins.

  • Arteries bring blood from the heart to the foot and toes under high pressure while
  • Veins bring the blood back from the foot to the heart under low pressure.

Over the course of anyone’s lifetime, blockages may build up in the arteries between the heart and the feet, especially in the pelvis and the legs.  Risk factors that increase the risk of formation of these blockages include:

  • Obesity
  • High blood pressure
  • High cholesterol
  • Diabetes
  • History of smoking tobacco.

As you may imagine, the tissue within the foot needs a certain amount of blood to supply the nutrients and oxygen necessary to keep the cells within the foot living.  Though a single, short segment blockage of the arteries in the leg may not result in any problems, multiple blockages from the pelvis to the foot may can make it difficult or even impossible for the cells within the foot to survive this lack of nutrients and oxygen.

What Does PAD Feel Like?

Typically, patients notice a gradual onset of pain in the forefoot and toes over the course of a few weeks to months.  As their blockages worsen, their pain becomes more severe.  Pain from PAD occurs in the forefoot and toes because those parts of the body are the furthest away from the heart and thus any blockage along the way from the heart to the toes can contribute to the lack of blood flow. One classic symptom of PAD pain is a burning, tingling, or numb sensation that can be partially relieved by hanging your foot off the bed or a chair.  In this position with the foot hanging down, gravity assists the flow of blood to the foot and toes and relieves the pain.  Typically, patients complain that when they lay flat at night, the pain in the forefoot and toes or just the foot in general will wake them up.  I always specifically ask patients if they are woken up at night by the pain.  If they are woken up by the pain, then I know the PAD must be very severe.

In some patients, the lack of blood flow is so diminished that there is also the development of ulcers, or defects in the skin with exposure of underlying fatty tissue, bone, and muscle or gangrene, the death of the tissue itself.

Even though PAD is a very severe and life limiting disease, specially trained vascular surgeons have many tools to combat it!  We can do a minimally invasive procedure called an angiogram that I described in an earlier blog post that you can access here!  Essentially, I access the diseased blood vessel with a needle and through that needle use contrast and x-ray to see where the blockages are.  Then, using balloons, stents, or self-expanding metal tubes, it is possible to re-open the blockages to re-establish blood flow to the impacted area.  For severe blockages, I also use a device called atherectomy that allows me to cut through and to remove the plaque responsible for blocking this vessel.  The procedure on average takes 1.5 to 2.5 hours and most patients can go home the same day.

Does foot pain wake you up at night? If you are experiencing pain in your foot or toes, please do not hesitate to contact my office at 408-376-3626 to schedule a clinic appointment today!

We Can Help!

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.

WHAT IS “ENDOVASCULAR” SURGERY?

Posted on by Michael Kokinos

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!

WHY DON’T THE WOUNDS ON MY LEGS AND FEET HEAL ANYMORE?

Posted on by Michael Kokinos

Hi! Dr. Lau here again with South Bay Vascular. Today, I wanted to shed some light on one of the most common issues that we see in vascular surgery, non-healing wounds of the feet and toes. My hope is that after reading this blog you will have a better understanding of what causes leg wounds and ulcers; why sometimes they won’t heal on their own, and what we in vascular surgery can do to help them heal.

Ulcers, generally speaking, develop because of TWO main causes: nerve damage induced by diabetes and lack of blood flow. When patients have elevated levels of sugar in their blood with diabetes, the sugar forms toxic compounds that damage nerves in the foot. Consequently, the patient cannot feel injuries that would otherwise cause a normal patient to adjust position to stop the injury. With this loss of sensation ulcers form at the point of repeated injury that the patient cannot feel.

The second cause, a lack of blood flow, develops over decades in patients who smoke and who have high blood pressure and high cholesterol. These medical problems cause hardening and narrowing of the blood vessels, otherwise known as atherosclerosis.

In patients with diabetes, I coordinate carefully with my podiatrist colleagues who are experts in specialized footwear and surgical interventions that alleviate common areas of trauma. In patients with poor blood flow, I, as a vascular surgeon, can perform minimally invasive surgery to restore blood flow to the affected area. We use wires and specialized tubes to gain access to the blood vessels and then use balloons to break open the narrowing’s and self-expanding tubes called stents to keep the vessels open. Afterwards, we use a specialized x-ray machine called fluoroscopy to see that the narrowing’s have opened again to allow blood to flow back to the area. Patients usually leave to go home the same day with only a 2-millimeter puncture in their groin and are back to normal activity the day after surgery!

If you or anyone you know has a wound on their leg, foot or toe that hasn’t healed in more than two weeks, please call our office at 408 376 3626 to schedule an appointment.

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

Posted on by Michael Kokinos

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

FOOT PAIN AT NIGHT: IT MIGHT BE MORE SERIOUS THAN YOU THINK

Posted on by Michael Kokinos

Many patients over the age of 65 who have a history of smoking, diabetes, high blood pressure, and/or high cholesterol wake up at night with pain in their foot or toes. Some believe this is arthritis or gout; others think it is the result of just spending too much time on their feet during the day.  Patients often self-adapt to this problem, as it usually develops slowly over time, but when questioned about their sleep habits, they will sometimes tell you that they sleep in a recliner or they sleep with their leg hanging over the side of the bed to make their pain go away.

It is very common for elderly patients to get up at night to go to the bathroom. Sometimes, however, it’s actually foot pain that wakes them up.  Once up, they get out of bed because that makes their feet feel better (again due to gravity) and after walking to the bathroom they can go back to sleep, pain -free for a couple of hours.  Even that small amount of walking helps to get their blood flowing again and makes it easier for them to go back to sleep.

Sometimes, foot pain at night is the sign of a more serious condition.

  • Foot pain at night may be related to having poor circulation in the foot. The name for this in medical terms is “rest pain”. This is not “pain at rest” but rather pain that happens because the circulation cannot support the tissues even when they are at rest.

Foot pain at night may be an early warning sign of critical limb ischemia.

  • Chronic Limb Ischemia is another term for lack of blood flow;  if you experience this rest pain at night and it goes away after hanging your foot over the side of the bed or chair you are sleeping in, immediately call and speak with your doctor to set up an appointment for them to evaluate your symptoms. Although it may come on slowly, the arteries in your feet may be so blocked that they cannot even deliver the minimal amount of oxygen the tissues in the foot and toes need to keep them nourished. Left untreated, this blockage can lead to a more serious problem, amputation or even death.

What’s important for the patient to realize is that chronic limb ischemia causes the foot and leg to get swollen, so the patient is often MIS-DIAGNOSED with a vein problem, not an arterial problem

If this sounds like something you or someone you love is experiencing, it is important to tell your primary care doctor OR schedule an appointment DIRECTLY with a vascular surgeon. These symptoms are a sign that your body is giving you that you may need immediate help. This truly is a sign that your foot is starving for oxygen and blood and that if left untreated, might lead to an unnecessary amputation. Help is possible, however and if treated early enough, those suffering from these symptoms can be helped significantly.

If you suffer from painful feet in the middle of the night, WE CAN HELP

contact us today  at 408-376-3626 to learn more about PAD and how Dr. Kokinos can help, click here.

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

 

 

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

Posted on by Angelica Rodezno

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

Posted on by Angelica Rodezno

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.

WHY DIABETIC FOOT WOUNDS DON’T HEAL

Posted on by Angelica Rodezno

One of the main complications of diabetes is the development of diabetic foot ulcers. Diabetic foot ulcers occur in 15% of all patients with diabetes. There are four primary contributing factors to the developments of these ulcers.

  • The presence of peripheral neuropathy (loss of feeling over the toes);
  • Changes in the architecture (shape) of the foot causing it to have pressure on areas ot built for it;
  • Poor blood flow to the foot;
  • A decreased ability to fight infection in the foot.

The main reason why diabetic wounds do not heal is due to lack of blood flow to the ulcer and ongoing pressure to the wound

Diabetics must pay special attention to their feet and ankles and it is vitally important to NOT ignore a small wound when it develops. Diabetic wounds, when left untreated, are the cause of 85% of the amputations that occur in these patients. Once these ulcers develop, they often DO NOT HEAL just by putting a Band-Aid over them, or even with wound care and ointments prescribed by your primary care doctor.

Care of Diabetic Foot Wounds

It is very important to see both a podiatrist (foot specialist) and a vascular surgeon (blood flow specialist) to examine your foot. These doctors can help with special treatments such as debridement (cleaning the wound), off-loading (taking pressure of the wound) and improvement of blood flow to help your wound heal. Debridement helps remove dead tissue and bacteria from the wound. Off-loading and special inserts or shoes allow the pressure to be removed from the wound so that it can heal. Diabetes causes blockages with calcium deposits inside your small blood vessels, which are below the knee, and this prevents oxygen and nutrients from getting to your feet. The vascular surgeons at South Bay Vascular Center have a special interest and expertise in opening these blood vessels in order to bring flow to your toes and feet that can help save patients from amputation. If you or anyone you know suffers from diabetes and are experiencing foot wounds that do not heal, call us immediately at 408-376-3626 to schedule an appointment to have these wounds evaluated.

GILROY, CA. VASCULAR SURGERY CARE

Posted on by Angelica Rodezno

South Bay Vascular Center and Vein Institute is a full service vascular surgery clinic and accredited vascular ultrasound testing lab located at 8420 Church in Gilroy, CA. Dr. Polly Kokinos offers cutting edge care to patients suffering from vascular and arterial conditions and continue their 20 year commitment of caring for patients in the South Bay.

Patients suffering from swollen, aching legs; painful, non-healing leg wounds; blood clots (DVT); dialysis access problems; clotted grafts; varicose veins and peripheral arterial disease (PAD) no longer need to travel to the greater San Jose area as local care continues to expand into the South Bay. World class surgeons, bringing state of the art technology offer a whole new level of Vascular care to the greater Gilroy, Hollister, Salinas and Hwy 152 corridor to the Central Valley Community.

Recognized as one of the most experienced and respected vascular surgeons in Northern California, the practice of Dr. Kokinos is focused on restoring the circulatory health of their patients thereby helping them return to a normal way of life. Together, our surgeons have performed more complex vascular procedures than any other Vascular Surgeons in Northern California. Recognized as San Jose’s and Silicon Valley’s most respected varicose vein experts Dr. Kokinos has performed over 20,000 vein procedures over the past 25 years and are not only the most highly trained vein specialists in San Jose, they are also the most experienced varicose vein experts in all of San Jose, Silicon Valley and the entire San Francisco Bay Area.

Call today to schedule an appointment at 408-376-3626.