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Experience is often the best teacher, and in Griffin Coates, MD's case, the lessons learned can open up a whole new career.

Coates, a thoracic and cardiac surgeon with more than 6,000 heart surgeries to his credit, is now the driving force behind Vein Therapies of Chattanooga, PLLC, which he opened in April 2008. And the move from heart surgery to vein repair wasn't as complicated as one might think.

"My genes, my heredity, led me to have some very bad varicose veins," Coates said. "Working as a heart surgeon, you're standing up for four or five hours in each case, two or three a day, five to six days a week. That didn't help. I knew I needed to do something, but I didn't want to have the vein stripping done because I'd seen the results on other people, and saw their discomfort."

Further exploration into alternative therapies and treatment led him to look at the laser-removal method, which Coates says has significant bruising and pain as postoperative issues. In the end, he settled on radiofrequency removal, and got the result he wanted.

"I was back at work 12 hours later, and did a long surgery the next day," he says of his procedure, which was done in 2007. He was so pleased, in fact, that he almost immediately began considering the field as a new area for practice, and also began to look at the Chattanooga area as a place to set up shop.

"I had done my training here, and knew a lot of physicians that were based in Chattanooga," said Coates, who did his surgical residency at Erlanger Medical Center and subsequently practiced at Memorial Hospital. "I looked around when we were visiting to see who was using the radiofrequency method, and saw that nobody was. Since we wanted to come back to the southeast part of Tennessee, and I saw a great opportunity in a place where I knew people and they knew me, we made the move."

Vein Therapies treats the various aspects of venous reflux disease, the most common of which are varicose and spider veins. Coates uses the VNUS® Closure® procedure, which allows for an outpatient treatment. The procedure also works well for individuals with venous ulcers, offering patients a new option in terms of chronic-wound treatment.

More importantly, Coates also works with patients before and after to ensure that they understand the disease in terms of it being the underlying cause of their condition, and how the treatment itself will work. This is key in what is a rapidly growing population: Some 20 percent of adults have venous disease or venous reflux, a number that jumps to 50 percent for women older than 50. Some 20 million to 25 million Americans suffer from varicose veins, and many are seeking treatment now more than ever before, Coates says, so he's out to educate both them, as well as their doctors, about his procedure.

"A lot of physicians don't know there's another method besides stripping and laser removal," he said. "When I went to medical school in the 1980s, we were taught that the only options were a lifetime of those hot compression stockings or having the veins stripped. Most doctors know that those aren't great options, but they may not know about all the improvements that have been made."

Coates' public relations effort focused on physicians he knew in family practice and other areas that saw people with the condition, and from there he was able to build his own practice. Once he was up and running, however, the patients themselves became a marketing force in their own right.

"We talked to podiatrists, dermatologists, and surgeons, and they sent us quite a few patients," he said. "And we've been able to get those people in and basically cure their venous reflux and venous hypertension, and we've been able to get ulcers cured in a week or two. Those are really the most gratifying people to see because all of a sudden they can wash their leg, it feels better, they can do things again. We saw one lady who'd been working two jobs but was out of work because of her wound. She healed up in a week and was just bouncing off the ceiling."

Cautioning people not to do too much, too fast, takes up plenty of postoperative time, not to mention trying to get them to wait a couple of weeks before having a second round of procedures on their other leg, he added.

"This is something you have to be conscious of the rest of your life because gravity is always trying to pull blood down into other branches where the valves have failed," Coates said. "What we do requires a long-term education process because we're not just treating the spider and varicose veins. We try to make sure the patient knows everything that we're doing, and what they'll need to do after their procedure."

Given that research into vein issues lags far behind the work done on arteries for any number of reasons, Coates said that he doesn't see much in the future for transplants or other major procedures. But what he's doing now can be so transformative, he added, that the patient gets a terrific result nonetheless.

"We have gotten away from the old venograms and now use ultrasound, which is much better at seeing the variations with the veins," he said. "The venograms were painful, the ultrasound isn't. The old stripping was painful, the radiotherapy procedure isn't. The technology has really come around, and this is already getting people back to work and doing other things much quicker."

As further proof, he points to the 65-year-old Senior Olympian he treated.

"She bowled three games and was going to pay some volleyball," he said, "and this was the day after her procedure."

Tags:

Griffith Coates, spider veins, varicose veins, vein removal, vein stripping

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