Georgina Health

Conditions

Trauma & Surgical Wounds

Wounds from accidents, injuries, or surgeries that aren’t healing properly or have reopened.

  • Patients with diabetes, PAD, or who take steroids
  • Injuries in high-tension or low-blood flow areas
  • Post-op patients with poor healing
  • Non-healing incision site
  • Wound reopening, redness, drainage
  • Pain
  • Irregular scarring

Chronic Vascular Ulcers

Persistent wounds caused by systemic vascular conditions. They resist healing and may recur without proper care.

  • Patients with PAD or venous insufficiency
  • People with a history of vascular surgery or smoking
  • People age 60+ or who have comorbidities
  • Non-healing ulcers with thickened surrounding skin
  • Ulcers that tend to persist despite standard wound care
  • May produce foul drainage

Diabetic Ulcers

Open wounds, often on the feet, that are caused by a combination of diabetes-related nerve damage and poor circulation. They are prone to infection and tissue breakdown.

  • Diabetics with neuropathy or PAD
  • Patients with high blood sugar and foot deformities
  • People who wear ill‑fitting shoes
  • Painless, deep ulcers under foot
  • Signs of infection: redness, odor, swelling
  • Callus buildup or foot deformity

Venous Ulcers

Venous ulcers are chronic sores on the lower legs caused by venous insufficiency. Poor valve function leads to blood pooling, skin breakdown, and open wounds.

  • Chronic varicose vein sufferers
  • People with obesity or a history of leg swelling
  • Elderly or people with reduced mobility
  • Ulcers near the ankles with uneven edges
  • Skin discoloration, itching, and heaviness
  • Recurrent itchiness or flakiness

Pressure Ulcers

Pressure ulcers (bedsores) are skin and tissue injuries caused by prolonged pressure, typically in areas like heels, hips, or tailbone. They range from mild redness to deep, open wounds.

  • Bedridden or immobile patients
  • People with decreased sensation (spinal cord injury, neuropathy)
  • Patients with poor circulation or frailty
  • Redness, swelling, blistering
  • Open sores or tissue loss
  • Pain, warmth or drainage

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is another name for enlargement of the prostate gland. BPH is common in men as they age, but it can health problems if it’s not treated.

In most men, the prostate gland grows with age. Sometimes, this leads to enlargement at a level that causes urinary or kidney problems.

Top risk factors for benign prostatic hyperplasia include:

  • Age: By age 60, a third of men experience some symptoms of prostate enlargement. By age 80, about half of men do.
  • Family medical history: Men who have a father, grandfather or brother with an enlarged prostate are more likely to experience the condition as well.
  • Diabetes and heart disease: People with diabetes, heart disease and those who use beta blocker medications may be at increased risk for enlarged prostate.
  • Obesity: Being obese increases the risk of BPH.

Some cases of BPH are very mild, but for most people who experience the condition, symptoms get worse over time. Common BPH symptoms include:

  • Frequent urination, including increased urgency and nighttime urination.
  • Difficulty in starting urination.
  • Weak urine stream or “dribbling”.
  • Urine stream that starts and stops.
  • Feeling that bladder isn’t completely empty after urination.
  • Increase in urinary tract infections.

If you have BPH symptoms, you should talk to your doctor about it. Your doctor will usually first have you complete a questionnaire called the BPH Symptom Score Index and talk to you about your medical history.

In order to get a proper diagnosis, your doctor may perform a physical exam, including a digital rectal exam to feel the back wall of the prostate gland for lumps or enlargement. Urine tests, blood tests and imaging tests may also be done to get the best diagnosis.

There are several options to treat BPH. Very mild cases may not require treatment, while others may be managed with prescription medication, including with alpha blockers and 5-alpha reductase inhibitors. There are a range of surgical treatments used for BPH, some of which are more invasive than others. At Georgina Health, we offer prostate artery embolization, which is an effective, minimally invasive treatment for BPH.

Peripheral Artery Disease

The buildup of fatty plaque deposits in the arteries, also called atherosclerosis, can lead to peripheral artery disease (PAD). Arteries that are narrowed or blocked cause reduced blood flow to the limbs, leading to discomfort, pain, and the risk for serious health complications.

Seeking treatment for peripheral artery disease is important so that you can manage and treat it properly.

Some key points to keep in mind:

  • Some people report no symptoms of PAD before they’re diagnosed, or have only mild sympoms. Regular visits with your primary care doctor can help you identify health risks, even when you’re not experiencing common symptoms.
  • PAD is more common in the legs and feet, but it can occur in the arms and hands as well.

Learn to recognize some common symptoms of PAD:

  • LEG DISCOMFORT AND PAIN

One of the most common complaints with PAD is leg discomfort and pain while walking. This pain, called claudication, can be felt as muscle cramping that goes away with rest. The pain is usually felt in the area where the artery is clogged or narrowed. Calf pain of this kind is the most common, but people can experience cramping and pain in the hips or thighs as well.

While pain usually goes away with rest, if PAD progresses untreated, people can still feel pain while lying down. Some people even experience enough discomfort that it is difficult to sleep. In fact, some people report a burning or aching feeling in the feet and legs while at rest.

  • WEAKNESS AND NUMBNESS

With PAD, decreased blood flow to the limbs can also cause weakness and numbness, as the amount of blood isn’t enough to keep up with the body’s demands. Muscles may feel heavy or tired, making physical activity difficult or unpleasant.

  • NON-HEALING WOUNDS

Another very recognizable symptom of PAD are signs of poor healing on the legs, feet, or toes. Wounds need nutrient-rich, oxygenated blood to promote healing. Decreased blood flow from PAD can negatively affect the healing process. If you have sores or wounds that seem slow to heal on your limbs, talk to your doctor about a PAD screening.

  • HAIR AND NAIL GROWTH

Good blood flow is also important for the growth of nails and hair. If you have PAD, you may notice slower growth of your nails (especially toenails), and you may notice slower hair growth or even hair loss on the legs and feet.

  • SKIN COLOR AND TEXTURE

Another visibly noticeable symptom of PAD can be changes in the skin. The skin is the largest organ in the body. When blood flow is decreased it can have an impact on the health and appearance of the skin in affected areas.

Some people notice their skin seems shiny on the legs, or that it appears thinner and more brittle. It may also change in texture, feeling leathery or itchy. Other people may notice a change in skin color on the legs, either with discoloration in spots or redness.

  • OTHER SYMPTOMS

Other symptoms result from poor circulation due to blocked or narrowed arteries. Some people with PAD have a very weak or nearly undetectable pulse in the legs or feet. Some people experience coldness in the lower leg or foot, and may notice it particularly if it’s present on one side, but not the other. Men who have PAD sometimes experience erectile dysfunction as well.

Like many other vascular health conditions, the best way to “treat” PAD is to prevent it altogether. To lower your risk for PAD, there are some basic steps you can take, including:

  • Maintaining a healthy body weight
  • Don’t smoke or quit smoking
  • Exercise regularly
  • Eat a balanced diet low in sodium, added sugars, as well as saturated and trans fats.
  • Keep other chronic health conditions well-managed.

If you have noticed PAD symptoms or recieved a diagnosis of early state PAD, you should start treatment with a medical provider. With early stage PAD, your doctor may advise lifestyle changes, supervised exercise therapy, or medications. If the disease has progressed, or if you have additional risk factors, you should consult with a vascular specialist who has experience treating PAD.

Varicose And Spider Veins

People often use the terms “varicose veins” and “spider veins” interchangeably, but they’re not quite the same thing. Varicose veins typically appear bulging and blue, while spider veins appear as thin, weblike networks of red and purple veins.

Despite the differences in appearance, however, varicose and spider veins share a list of common causes. The primary cause behind both conditions is weakened or damaged valves. Here’s a little more about how these vein conditions occur:

Your veins carry deoxygenated blood back to your heart from the body. Your veins contain one-way valves that prevents blood from flowing backward (away from your heart). If these valves cease working blood can pool in the effected veins. As the blood pools in the effected veins side branches bulge leading to the formation of varicose veins and spider veins.

The main difference is the size and color of the veins. Varicose veins are larger (often bulging in appearance) and blue in color. Spider veins are tiny in size and often pink or purple.

Some patients won’t need treatment for their varicose and spider veins, but others can benefit from some form of intervention.

Almost 1 in 4 adults in the United States will deal with varicose veins at some point in their lifetimes. People of any age can get varicose veins, but they’re much more common as you get older.

Additional risk factors include:

  • Genetics
  • Pregnancy
  • Obesity

Varicose veins are more common in women than men, especially women who’ve had multiple pregnancies.

Symptoms of varicose veins include:

  • Pain, throbbing, or heaviness in the legs
  • Spasms or swelling
  • Discolored or itching skin

Varicose veins can lead to ulcers and bleeding.

Several factors can contribute to spider veins, including:

  • Genetics
  • Sun damage
  • Hormonal changes
  • Heredity
  • Obesity
  • Pregnancy

Spider veins most commonly appear on the legs. Patients of all ages can develop spider veins, but women are more likely to have them than men.

Uterine Fibroids

Uterine fibroids are incredibly common and noncancerous. They range in size from being barely visible to the naked eye to being as large as a grapefruit. In many cases, fibroids don’t cause symptoms, but in some women, they can be extremely disruptive.

  • Heavy bleeding during periods
  • Painful cramping
  • Persistent pelvic and/or low back pain
  • Pelvic pressure
  • Urinary frequency and constipation
  • Bleeding between periods

As fibroids get larger, you may notice your abdomen looks swollen and distended. You may also have pain during sexual intercourse as a result of fibroids.

Dr. Golshan uses diagnostic imaging tests, including ultrasound, MRI to detect uterine fibroids. He also evaluates your gynecological history and symptoms to determine if fibroids are likely the cause of your discomfort and issues.

Uterine Fibroid Embolization (UFE) is a non-surgical treatment for symptomatic uterine fibroids. Symptoms associated with uterine fibroids can include: heavy bleeding, painful cramping, pelvic bloating, and urinary frequency. At times symptoms can be managed with medication. But when medication and conservative treatment are not effective UFE offers an excellent minimally invasive, uterine preserving, treatment option. 

In 9 out of 10 cases, women who undergo UFE experience significant improvement in their symptoms. Uterine fibroid embolization has many benefits over surgery, including:

  • Preservation of the uterus
  • Nonsurgical and minimally invasive
  • Fewer complications than surgery
  • Reduced recovery time

Alternatively, uterine fibroids can be treated with surgery – either a myomectomy in which just the fibroid is removed or a total hysterectomy to remove the entire uterus. 

UFE involves the insertion of a thin catheter into an artery near the fibroid’s blood supply. The catheter releases small particles that block the small blood vessels feeding the fibroid, so the growth is deprived of nutrients and cannot survive. Dr. Golshan performs more than 1,000 vascular procedures per year and is experienced in uterine fibroid embolization. The procedure is effective for multiple fibroids.

Pelvic Congestion Syndrome

Your veins carry blood back to the heart. When the veins in the lower abdomen stop working as they should, you may experience a build-up of blood that causes varicose vein-like changes in your pelvic region. The veins become enlarged and change shape, resulting in pain – a condition known as pelvic congestion syndrome.

If you’ve had pelvic pain that’s persisted for at least six months, you may have pelvic congestion syndrome.

You’ll also feel:

  • Pelvic pain that’s heavy and aching or sharp, usually on the left side
  • More pain when you change posture
  • Pain during or after intercourse
  • Standing or walking for long periods of time
  • Pain during your period

You may notice enlarged, distorted veins on your lower abdomen or genitalia.

Pelvic congestion syndrome can be hard to diagnose, but UCLA- and Johns Hopkins-trained radiologist Dr. Golshan is skilled in identifying the condition. He’ll evaluate your symptoms and health history.

He’ll also run several different diagnostic tests that may include:

  • Blood tests
  • Pelvic ultrasound
  • Venogram (x-ray guided imaging of the pelvic veins using contrast material)
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