Serving Boone, Blowing Rock, Banner Elk, and other towns of the North Carolina High Country
Founded 05-05-05

Total Vein Care, PLLC—Boone’s Answer to Varicose Veins and Spider Veins

Story by Sam Calhoun

Twenty-five percent of the American population has varicose disease. For every male affected, twenty women suffer the same fate.

Varicose disease affects people of every age, but especially middle-aged women after pregnancy and people who stand or sit for long periods of their day. Varicose veins are bad valves in the superficial veins of the legs that fail over time. Blood deep within the leg backflow into these faulty veins and cause pressure that causes pain. It is more common for both legs to be affected rather than just one.

Before 2005, relief was hard to find in the High Country.

But that’s all changed.

Thanks to Total Vein Care, PLLC, 141 Doctors Drive in Boone, state-of-the-art treatment for varicose veins and spider veins arrived in the High Country in June 2005 via Dr. Joseph Ty Bell, member of the American College of Plebology.

Plebologists (“Pleb” = vessel, and “-ology” = study of) such as Bell are a growing group of physicians who use the relatively new procedure of EVLT, Endo Venous Laser Treatment, to rid patients of varicose veins.

The old treatment, ligation and stripping, was used widely until about five years ago. Patients were put to sleep and their varicose veins were literally yanked out of their legs. The procedure was painful and had an “incredibly high” recurrence rate, Bell said. Approximately 45 to 60 percent of patients who had the old procedure saw their varicose veins recur after stripping.

Five years of data exist on EVLT and so far, the recurrence rate is around 2 percent. What’s more, EVLT patients are “basically back to normal after two days,” said Bell.

With new patients, Bell conducts an initial evaluation—usually covered by insurance—to assess the symptoms, severity and how the condition is affecting the patient’s daily life. If the patient is a candidate for EVLT, Bell maps the veins using an ultrasound and color-flow Doppler to identify the incompetent veins.

“Most patients are candidates for the laser treatment,” said Bell, who has given more than 500 initial consultations and more than 200 laser treatments.

During the second visit, Bell conducts the EVLT. The patient receives local anesthetic and Bell inserts a laser fiber through an incision to the sapheno-femoral junction near the groin. The laser energy seals off the vein for about two minutes, cutting the blood flow to tributary varicose veins.

“Then, the laser actually melts the vein from inside the leg,” explained Bell.

After EVLT, patients must stay off their feet for two days and then wear compression hose for about two weeks.

Some of Bell’s patients come for cosmetic reasons and some come for discomfort.

“It’s both,” said Bell. “Insurance will cover the procedure if it hurts, if there’s discomfort or swelling, but not for cosmetic reasons.”

Bell was not always a plebologist.

Born in Asheboro, Bell attended the University of North Carolina in Chapel Hill for his undergraduate degree and medical school. He received his undergraduate degree in 1984 in zoology and finished medical school in 1988.

Loving the mountains, Bell headed west to the University of Wyoming in Casper to complete his residency and finished in 1991. During the next year, he operated a family practice in the middle of Tennessee, “but that wasn’t for me,” he said.

He switched his focus to the emergency room from 1992 to 2005, moving to Boone in 1994 and working at hospitals around the High Country.

“I wanted the mountains,” said Bell, who chose the Appalachians over the Rockies after his wife Nancy leaned toward the East Coast. The couple now has two children—Courtney, 16, and J.T., 14—who both attend Watauga High School.

In 2004, Bell developed varicose vein disease and experienced pain in his legs. He had read about EVLT and decided to travel to Asheville to see the nearest specialist in the treatment. During his treatment, he asked the doctor if she would take him on as an apprentice, because no formal training or residency methods had been set up for the field. Figuring that Bell’s location in Boone was far enough away that he would not become any competition, she took him on and he learned from her for a year.

At the end of his apprenticeship, Bell joined the American College of Plebology and began attending meetings and comparing notes. He was ready to start his own practice—a practice that would bring better hours and allow him more time with his family.

“I saw a need in the area,” said Bell. “Before me, people had to go to Charlotte, Greensboro or Asheville.”

Bell not only takes care of varicose veins at Total Vein Care, but also spider veins—faulty reticular veins, or surface veins under the skin that blacken and become unsightly. Spider vein treatments are done strictly for cosmetic reasons. Spider veins are caused by genetics, but appear more often in people who are overweight, on their feet all day or smoke. Bell removes spider veins by injecting chemicals into them with small needles. The procedure is fast but because it is cosmetic, insurance rarely covers it. Because insurance doesn’t cover the removal of spider veins, Bell offers free consultations to see if a procedure is necessary.

“I feel very happy doing what I’m doing. I finally found my niche,” said Bell. “I don’t dread going to work. I really love my job and I have a more stable family life.”

Total Vein Care is located at 141 Doctors Drive in Boone. The office is open from 8:00 a.m. to 5:00 p.m. Monday through Friday. Call for an appointment. For more information, call 828-265-1345 or click to www.tvcboone.com.