Usually, patients visiting their doctors have a list of complaints. Sometimes even written down, with a worried family member accompanying them. It’s an anxious time for patients, and my job is to offer help and hope.

Quite the opposite is another group of patients. These are the patients coming in for followup visits after vein treatments.  These people are full of goodwill, happily reporting how GOOD they feel.  This is one of the most gratifying experiences that a doctor can have:    seeing his patients dramatically improve and having a complete change in lifestyles as a result of treatment.

Last week we treated  such a patient.  I have been seeing him off and on since 2013.  He had the largest  varicose veins that we have ever seen in our practice and his life was almost completely dominated and  hindered by the nearly constant fatigue, heaviness and pain in his legs.  After 10 minutes of trying to do any kind of work, he would have to stop.  He had to plan all of his days’ schedules of activities around the leg symptoms from which he suffered.

But that was before!  What a different person he is today!   He dropped in for some touchup work and we  saw dramatic improvement in the way that he looks and feels.  He reports that this has completely changed his life and now he is almost unlimited in the activity he can do as a result of the varicose vein treatments.  It was great to talk with him and see his renewed zest for life.  It reminded us….

#1  It can take more than one treatment  to completely get rid of all of the severely diseased veins.  This is a good lesson to relay to other patients who  sometimes get discouraged  with their progress.

#2  Sometimes people think they are too old to get their veins treated.  This patient reminded us that varicose veins can be extremely symptomatic and  have debilitating symptoms, severely limiting even just everyday activities.  We are seeing positive results,  even in elderly patients.







This post was written by Vein and Skin Laser Center | December 13, 2017


This post was written by Vein and Skin Laser Center | December 13, 2017


This post was written by Vein and Skin Laser Center | November 14, 2017


Newly approved vein treatments give our patients more choice, more insurance coverage and better cosmetic results.  New less invasive treatments continue to get FDA and insurance approval.   So our patients get more choice–to choose one treatment over another or a combination of treatments,  all to meet their specific needs.

 Thankfully, insurance coverage is catching up with advances in vein treatment so veins can be treated in multiple ways.   No longer a cookie cutter approach, but rather varied approaches–choosing one treatment over another or a combination of treatments,  all to meet specific needs.
New treatments are glue treatment. called Venaseal, and foam sclerotherapy. called Varithena.   Varithena works better in tortuous and branch veins.  Previously this non-invasive foam treatment was not not approved by insurance companies.  However, starting in January,  Varithena foam sclerotherapy in tortuous and  branch veins will be paid for under insurance so the patient can have more insurance coverage for their treatment.  Also starting in January, Venaseal, the new glue treatment, will have a code for insurance coverage.
These treatments have now picked up a new term in describing vein treatment:  non-thermal treatment.  Veins now can be treated both thermally or non-thermally to get a better result. Thermal treatments are laser treatment and radiofrequency heat treatment (Closure).  Non-thermal treatments are  Venaseal and Varithema (glue and foam).  Both thermal and non-thermal treatments will all lead to a better cosmetic result for the patient.
Call today to schedule a consultation to determine which treatment is best for you.  So many options enable Dr. Fern to tailor a treatment plan that will make you and your legs happy.

This post was written by Vein and Skin Laser Center | November 14, 2017




This past week I got to reconnect with some high school buddies on a little beach trip.  We had so much fun catching up. It reminded me that…… 

Girlfriends are especially valuable to me as a doctor’s wife.   Enjoying the company of the girls can fill in the gap of, dare I say it, a missing husband.  Well, not really missing.  I’m fortunate he is always in town, but just not always able to be at home, 

So this little blog is a salute to GIRLFRIENDS!   

My first real girlfriend was unusual.  I had some lonely hours after school when my mother was teaching  piano, so I would run next door!  Oh, you think, how great–you had a little friend right next door.  But wait.  Not so fast with that assumption.   My friend?  A stay-at-home mom with two little baby girls!  An unlikely girlfriend for a 12 year old.  But she was a great friend to me: she made me feel that she loved and looked forward to our visits as much as I did!  I played with her kids, looked at fashion magazines with her and learned, not just to cook from her, but to LOVE cooking!  And she gave me some grown-up wisdom along the way.  

How about those girlfriends you shared when the kids were little?  That you talked to every day just to check in. During David’s surgical residency, I remember sitting on the floor, talking to a girlfriend, and feeding green beans to my first born as she came walking past. She had just discovered walking!  Our little condo was laid out so that she could walk in a circle – kitchen, den, dining room, hall, MOMMY- and she had fun walking that circle, over and over!  Every time she passed me, I handed her a green bean!  That was our dinner hour, minus daddy.  She learned finger foods and walking and had fun doing it—and I enjoyed her AND my girlfriend via the phone.  

I remember that as a starry eyed young thing, once married, I thought that husband/wife was the one and only relationship.   Forever pledging myself to this wonderful man, I forsook all others.  So later on, I couldn’t begin to  understand it when a group of women in our neighborhood invited me on a girl trip. I remember saying, “I enjoy being with these folks in the daytime, but when the sun goes down, I will be right here with my husband!”  Somehow the girls broke through this resolve. I’m so glad they did!   Beach trips let us set a leisurely pace if we wanted it or we could fill up the days with non-stop activity if we wanted that. Long bike rides together gave time for deep one-on-one conversations.    Nights were filled with laughter as we played games.   Oh,  how we laughed!  And talked!  And shopped!  Now that some of these friends have passed on, I treasure these happy times.   I wouldn’t trade them for anything!  

Girlfriends, be they your “best friend” when you’re in kindergarten, your high school buddies,  your friend you met at PTA and instantly knew that  you were kindred spirits, or that group at church, work or neighborhood, they are essential to our well-being. We know and count on the fact that our girlfriends have our backs.  I can’t even count the times my girlfriends came through:   showers, parties, meals, weddings, babies, beach trips, Africa trips, and  celebrations .  Most of the really big times in life were enriched by the love and effort that girlfriends gave. 



This post was written by Vein and Skin Laser Center | October 17, 2017


Just this week, I have seen several patients with leg pain and swelling but no large visible varicose veins…….d3d66472-3d72-49ed-8a15-75bab12cd76a

Symptoms of leg pain and discomfort and swelling in the lower legs are often a diagnostic sign of damaged leg veins, even in the absence of visible varicose veins.  Patients frequently get used to the symptoms of heaviness, fatigue and aching and are not aware that having these symptoms is not normal.  Some large broken veins are deeper under the skin surface, so they are not visible.  Later on, the larger varicose veins will eventually appear as a raised varicose vein.

After the treatment, which is done in the office as a walk-in-walk-out-and-return-to-work-the-next- day procedure, the patient will notice an immediate improvement in their symptoms.  This changes their lifestyle and allows more normal symptom-free living.  This is one of the reasons that vein treatments are so satisfying to patients.  In fact, the satisfaction rate is 95%!

veins compression hose dog play

Remember, some patients have vein disease symptoms and don’t have noticeable varicose veins.  This can all be diagnosed easily in the office with ultrasound diagnostic scans.


Call today to schedule a simple 15 minute ultrasound diagnostic scan to make sure your leg veins are healthy.

David Fern, MD





This post was written by Vein and Skin Laser Center | September 29, 2017


When referring to something that is surprisingly wonderful or over-the-top great, my son will say, “crazy, right?!” It seems that’s the new word for all good things or occasions. Well our summer has been crazy, or crazy busy!



That’s my introduction to tell you that this will be a quick blog. In June we had our annual beach vacation with our 3 adult children, their spouses and two grandsons.  Somehow, we lost the rest of June when we came back home.

Here’s how:

Lots of extended family have been dropping in….and staying!


I dropped OUT by spending three days and two nights at a friend’s house sewing non-stop to make drapes for Swaziland (44 panels, lined!).


AND, our daughter and son-in-law, who live nearby got a PUPPY!  A 6 week old laborator.  We get to babysit often.




My daughter summed this endeavor up aptly, “I don’t get anything done because when she’s awake she’s all over me and when she’s asleep I sit and look at her because she’s SO CUTE!”  Sounds like a new mother, right?  Crazy, right?  All good things, but June was eaten up.

Before, I end, I do have one little cute story to introduce this month’s recipe.  Hopefully I haven’t already given you the recipe for pound cake that I have cobbled together from several recipes.


It was a last minute thought, as I was finishing lots of cooking for our family vacation, I threw together a pound cake, just in case anyone wanted some.  Well that ANYONE was my 4 year old grandson, Wilder.  He LOOOOOVED it and it became Becca Cake.  This was the motivating carrot for the trip…”want some Becca Cake?  Eat your dinner, etc.”  By the end of the trip, of course, it was gone.


Wilder and family came back to Atlanta with us for  a few days and I promised him I would make another Becca Cake.  I wish you could have seen him one night, sitting at the counter, eating Becca Cake.   He had put so much in his mouth that he couldn’t chew; a puzzled look was on his little face as he was attempting to move the cake around in his mouth;  I was afraid he would choke!  But he got it down.

Next day I took older brother Dean to the Atlanta Aquarium; Wilder was left behind with Aunt Andie.  Dean got to PET A PENGUIN!  Crazy, huh?!


Back home, Andie was watching TV in the den when Wilder came sauntering  through the room, carrying in his little hand and casually munching a piece of Becca Cake that was at least six inches wide, the size of about 5 pieces of cake.


When questioned about how he got it and who approved it, he proudly announced, “I cut it myself!”  One can only imagine how all this happened and probably the sense of exhilaration he felt at having circumvented all the approvals he usually needed to get in order to have some Becca Cake.  Unfortunately for Wilder, his hopes spiraled  downward as Aunt Andie made an adjustment to his cake-cutting!!  Wilder thinks Becca Cake is crazy good!


3 sticks butter, 6 oz cream cheese and 3 cups sugar:  cream together


beat in 6 eggs and 1 tablespoon of vanilla or 1 teaspoon of almond extract or half of both


add gradually 3 cups White Lily plain flour


Turn into greased and floured bundt pan


bake at 325 for 1 hour 15 minutes.



This post was written by Vein and Skin Laser Center | June 29, 2017


IMG_0170 Isn’t it fun to dream and make resolutions? Not the New Year’s kind! Not the I’m going to eat more kale and floss every night plus get up an hour earlier so I can work out. No, no, I’m not talking about those kind of resolutions. I’m talking about the resolutions that are more like wonderful dreams.

Like when you are looking at a magazine and see a photo layout that the food editor spent a zillion hours creating. It looks so inviting and you dreamily resolve, “I’m going to do that this summer with my family.” Or a recipe that works out, and you think, “when we go to the beach I’m going to do that PLUS I’m going to create something wonderful EVERY DAY!” Or reading a novel that describes someone coming into a house after a blustery walk over lovely beach cliffs, only to smell a good cut of meat roasting with some crusty potatoes, and you decide, “I’m going to create that kind of environment in my home!”

All of these dreams center around cooking, but you name it! When you see something well-done, it can be inspiring. How many men have dreamed dreams about their golf game after watching a professional golfer? How many women have started painting or hanging wallpaper after attending a decorator show house? Or crafting after going to a craft fair? Or gardening after watching HGTV? The list goes on. Here’s how I got thinking about this whole subject


Recently I was walking past a tennis court where some AA players were having a match. They made the game look so graceful, and even easy. When a point was ended, it wasn’t because someone flubbed a shot, with a ball landing in the net or the back fence. No, points ended with firm, well-placed volleys and opponents conceding, “good shot” and maybe one of those little claps on the strings of the racket that’s the tennis version of applause for a shot well-done.

While watching this match, one of the players hit an overhead, but not just HIT the overhead, she DESTROYED the overhead! You know, she hit the ball so hard that when it bounced on the opposite side of the net, it then bounced over the fence! No chance whatsoever of THAT  being returned. Wow! I hadn’t seen that since my son played high school tennis. He played on a team so talented that this over-the-fence-overhead shot was a regular occurrence. While other coaches were getting their boys pumped up with strategy and encouraging words, our coach would say, “now boys, try not to lose so many balls over the fence when you are hitting overheads!”

Back to resolutions. When I saw that girl hit that overhead, I remembered a goal that was really more like a dream.   I want to do that. I always said I wanted to be able to do that. I know it’s probably beyond me, but maybe I should resurrect that thought. Hmmmmmm. Dare I even wander there in my mind?  Could I dream big enough to make a resolution in that department?


Later that day, while lazily enjoying a glass of wine on the porch, I shared these thoughts with Dr David. Many enthusiastic words flew between us….lessons from a coach…plus he would take me out and feed me practice balls….oh, and as long as we are at it, he wanted me to get a really good second serve. Isn’t it all so exciting and even EASY to make resolutions and dream big when the dreaming is just that….dreaming! You know, like the diet you are going to go on when vacation is over? Ha ha.

But guess what? Sometimes a fraction of those resolutions actually happen. Maybe you cook ONE of those great meals, not EVERY DAY of the vacation, but more than you would have. Maybe you just rearrange a little, rather than redecorating the whole house. That’s good! These resolutions and dreams count for something. And don’t we admire the person that attempts great things, even if they can’t get all the way there? Rather than the negative Nellie who doesn’t even try.

Did I hear somewhere that you are old when you stop dreaming? And trying? I think I’m going to book a tennis lesson next week……..



Melt:  one stick of butter, 4 squares baking chocolate, 1-1/2 cup of chocolate chips (12 oz bag).  Cool


Sift together:  1-1/2 cups flour, 1/2 teaspoon baking powder, 1/2 teaspoon salt


Beat:  4 eggs, 1-1/2 cup sugar, 2 tablespoons vanilla.


Add:  Chocolate mix; beat well.  Then add 12 oz chocolate chips and 2 cups of pecans or walnuts.

Drop:  spoonfuls onto parchment lined pans.

Bake:   In 350 oven for approximately 10 minutes.


This post was written by Vein and Skin Laser Center | April 12, 2017


Patients with varicose veins and venous insufficiency complain of many painful symptoms.  Symptoms associated with varicose veins are aching pain and heaviness in the legs with prolonged standing and walking.  Patients also complain of fatigue in the legs with increased activity.  Also, they complain of itching and burning symptoms around the varicose veins, which are symptoms of mild pain.  The pain can even be seen in the symptoms of restless legs.  Or, it can be seen as throbbing pain in the legs with increased activity.  Venous insufficiency can also cause swelling because of the increased venous pressure, which is painful.  So much pain!

stasis detmatitis 3


Unfortunately, there’s more pain as venous insufficiency progresses.  Prolonged swelling results in a painful condition called stasis dermatitis.   Plus, this condition can become a significant cosmetic problem if left untreated.  Stasis dermatitis initially causes patchy redness and itching of the skin along with swelling in the legs. It can advance into skin thickening and darkening of the skin with pigmentation from broken red blood cells.  We see these conditions result from chronic cases that have delayed diagnoses or treatment.

stasis dermatitis 2


We have also seen swelling related to venous insufficiency that exposes patients to an increase in skin sensitivity.  Patients’ skin will be sensitive to commonly used skin products.  Skin products containing lanolins, fragrances, neomycin and related antibiotics, rubber, and topical steroids have been identified as allergy-causing products in many patients with venous insufficiency.

Studies have now shown, and it has been our experience, that treating the venous insufficiency problem not only treats the pain-related symptoms of varicose veins, but it also eliminates the swelling and symptoms of stasis dermatitis.  Treating venous insufficiency even corrects the problem of skin allergic sensitivity to skin products.  Patients also see a correction of the chronic skin changes of thickening and darkening after the treatments.

stasis dermatitis 1

The pain as well as cosmetic issues associated with varicose veins and venous insufficiency  can be relieved.  Plus, treatment may avoid the development of stasis dermatitis, as well as correct damage already done by stasis dermatitis.

If you have any of these multiple symptoms of pain or the cosmetic symptoms, don’t hesitate to contact us so that we can treat this problem.   We can help you be happy with your legs.

beautiful lots of legs

This post was written by Vein and Skin Laser Center | April 11, 2017


beautiful lots of legs

Leg pain can sometimes be a precursor to a deadly medical problem, commonly known as DVT (deep vein thrombosis).   DVT  is a serious condition that occurs when a blood clot forms in a vein located deep inside your body.  Leg pain behind the knee could be a red flag.  When a patient comes in complaining of pain in this area of the leg, we want to immediately do an ultrasound to identify any vein blockages or narrowing of the vein behind the knee.  If left undiagnosed,  DVT can occur. 


VEINS popiteal back of knee

The technical description of this condition is as follows:  There can be an occlusion of the deep vein of the leg in the femoral popliteal area (the area behind the knee).  An occlusion could be described as a blockage, which would prohibit the free flow of blood in the vein.   Narrowing of the vein could be another way of “blocking” the free flow of blood.  The area behind the knee where this can occur is referred to as “Hunter’s canal.” 

veins man in airplane



A nickname for this condition is “Economy Class Syndrome.”  Patients who have taken a long airplane flight, thus being put in an immobilizing chair position, can experience this pain behind the knee.  (The thought being that in “first class” the passenger can stretch out!)   Being  immobilized in the chair position can produce unusual pressure on the femoral  vein, causing the  development of  deep vein thrombosis (DVT). 

In summary, blockage or slowing of the blood flow, whether caused by a narrowing of the vein or a long, long flight, can occur because of prolonged muscle compression within the Hunter’s canal on the femoral vein as it passes up the back of the leg. 

After sonogram examination, if there is a problem, a prevention plan can be made for the patient.  Recommendations may include occasional use of compression stockings as well as exercises for the calf muscles.  Every resource  should be utilized to prevent possible formation of DVT.  At Vein & Skin we are experienced in diagnosing and creating a treatment plan to minimize the risk of DVT.    





This post was written by Vein and Skin Laser Center | March 7, 2017