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

Past Present & Future


Varicose veins are common and their management has undergone a number of changes.  How about a brief history lesson on varicose vein treatment?


Surgery was the standard treatment option in the past.  You probably remember the stories you heard from a grandmother or great aunt about her “vein stripping.”  And that’s why many people suffered with their veins rather than get treatment.   Surgical removal of varicose veins required a hospital stay, a fair amount of pain and bruising, and an extended recovery period.  Not a pretty picture.



Towards the 21st century, new endovenous thermal ablation techniques  (commonly known as Venus Closure) were introduced which revolutionized varicose vein treatment.   Patients could now have a 30 minute procedure in the doctor’s office and return to work and activity the same day.  The procedure only requires a needle stick instead of major surgery.  Definitely a dramatic improvement over the traditional surgical treatment methods used in the past. 

In the last two years, another treatment entered the varicose vein treatment scene:  Varithena.  Varithena is a foam sclerotherapy which travels up the vein and destroys the diseased vein, so the blood can travel to one of the healthy veins.  This is particularly effective for larger, tortuous (twisting) veins. 

Both of these treatments are recognized as standard of care varicose vein treatment and are covered by insurance.



Vena Seal is a new gluing product that has been recently developed.  It is inserted into the diseased vein by a cathether.  It takes its inspiration from the Closure procedure, but does not involve a laser or the anesthetic that is pumped into the vein with the Closure procedure.  The vein is merely glued shut.  Clinical trials are showing results equal to the Closure/thermal ablation procedure.  Our office is certified in this very newest technique and offers it.  The FUTURE part of this treatment is that currently it is not covered by insurance, but we anticipate that within the next two years it will be recognized by insurance as a standard, acceptable procedure.

Mechanical chemical ablation is in research and trial stage.  A tiny thread-like wire rotates in the vein  while simultaneously a sclerotherapy solution is pumped into the vein.  Initial results show that this is not painful at all and could be valuable in certain cases.  It is not available at this time but is on the horizon.


At Vein & Skin, we are pleased to be able to offer all these options to our patients so that our patients will be comfortable with their upcoming procedure and not only satisfied, but delighted, with their results.  So don’t put off varicose vein treatment.  You can do it; it will be ok! 

beautiful lots of legs

Call today to schedule



This post was written by Vein and Skin Laser Center | January 24, 2017




I’ve heard it said that there is a difference between being alone and being lonely. How does one get from lonely to being alone, but not lonely? Practice?
I had some practice at this as a child. For a number of years, we lived in a regular, suburban neighborhood, but there were no kids there, i.e. no friends. And back in the dark ages, people didn’t have play dates and tons of activities. Did your mother cart you around every afternoon so you could be entertained, enriched, or whatever. Really?

Well, my mother taught piano lessons in our home after school. True, she was always at home, but there were no warm cookies and mommy and I sitting together sharing about my day. She was teaching. I walked home from the bus stop, got my own snack, and did my homework. Fun, right? I knew I was not to interrupt her when she was teaching, unless it was an emergency. So as far as entertainment and enrichment, it was up to me. Within reason, of course.
What I thought was a big, fat MINUS (can you say “boring”?) actually was a benefit. Learning to entertain myself prepared me for the many hours I would spend alone as a doctors wife. I spent many happy hours reading, flopped across my bed. And I still love to read. I did my homework and studied with no help from my parents. Did ANY parents help their kids back then? I taught myself to sew and to knit, things I still enjoy. (I made all my own clothes when David was in medical school and residency, giving me something to do when I wasn’t at work, but HE WAS.) I spent many happy hours exploring various recipe books and baking (leaving huge messes for my mom to clean up). And, of course, I still love to cook.

Fast forward.

So, true to my heart, I fell in love with a Georgia Tech man on the path to being an engineer like my dad. But my honey somehow ended up being a doctor! Oh my, was I shocked and not a little upset! While most of our friends from Tech days were starting their families with houses and station wagons (oh, how green that grass looked!), we were in an apartment. I was working to put David through school and he was studying or working what seemed like ALL THE TIME.

Almost ten years later, we finally started our family! We had the house and the baby and a neighborhood with lots of kids, like it’s SUPPOSED TO BE, right? No lonely, boring days for my kids! Our firstborn was happily engaged with many a friend. It seemed she was always arranging to be with friends, either at our house or at theirs or at camp or at a school or church activity, anywhere was always better with a friend. This, I thought, is the life! This is what I wished that I had had growing up. This is the way kids are happiest!

Years later, we were blessed with another little girl, and true to form, she had her best, best friend that lived next door, which whom she spent most of her waking hours. When our family moved, I agonized over leaving her idyllic childhood: day’s spent playing with her little friend, running back and forth between the two homes, skating outside together….. was I ruining her life to rip her away from all that? Would her childhood be marked by loneliness and boredom?

After the move, I made a discovery: I discovered that, yes, she enjoyed her friends, but she was equally happy to be alone. With company, without company, she was fine. I was a little surprised. What? How can this be? She taught me something. Can you say “contentment”?

Upon reflection, here’s my take: contentment is tied up with moving from lonely to alone, but not lonely. Some people seem to naturally come by that contentment easier than others, but I believe we can all get there. My journey perhaps took the boot camp of training for those years in my childhood. But I got there.

Maybe I was destined to be a doctor’s wife, despite my original thoughts of marrying an engineer with regular hours like my dad. Perhaps the lessons I learned as I spent time exploring ways to entertain myself BY MYSELF prepared me for the times when “the doctor is out.”

This post was written by Vein and Skin Laser Center | January 9, 2017


Now is the best time to have your varicose veins treated.  Now, before they get worse, with serious health risks. Take advantage of your health insurance deductible policies.  You may have met your insurance deductible for the year.

Also, this is really the best time to get your legs ready for next spring and summer.   Sometimes, it can take several months to go through the cosmetic side of healing.  The winter season gives your legs  the time they need to look their best.   This is particularly true in the case of spider veins.   If you need to wear compression stockings  for a few days after treatment, it’s easier to do this in the cooler months.

At Vein & Skin, we try to work in as many patients as  possible at the end of the year before the holidays.  We will even do treatments  between  Christmas and New Year  to help meet the end-of –year insurance  deadline for treatment prior to 2017. It  is imperative to come in earlier than the planned date for treatment  so that we can get insurance approval.  Call our office now  to save your spot.  Our staff will help you achieve your scheduling needs and  negotiate with your insurance company to  get the approval you need for  treatment before year’s end.    Benefit from the payments you have already made on your deductible by treating yourself to beautiful legs before year’s  end!

This post was written by Vein and Skin Laser Center | November 17, 2016



It’s bad form  to say you’re the greatest!  So that’s why I (Becky, wife of Dr Fern) am writing this little blurb.  It’s even not so great for you to say your husband is the greatest.  But I think it’s acceptable to say your husband’s staff is the greatest!

Tyson Powell  (pictured here with Dr Fern) has been with us for over 10 years, and he IS the greatest.  He knows I tell everyone this.  He laughingly tells me that he has to really be on his toes when someone comes in that is a friend of mine, because he knows I have told them so many good things about him…..the bar has been set high.

It’s not just me.  Recently an educator/rep from one of the national companies was in town, visiting the various vein treatment centers.  After observing Tyson and Dr Fern performing a Closure procedure together,  he said that if he ever needed vein treatment, he would catch a plane to Atlanta so he could have them do his procedure!   He was impressed with how smoothly they worked together and how well the whole procedure went.  

And how about this from a patient who comes in from North Carolina:

“I never in a million years would have believed the dramatic difference the Closure procedure has made in how I feel.  Your kindness, patience and skillful precision during the brief and painless procedure really made all the difference in putting me at ease.” 

So  OK,  I’ll go ahead and say it, I think my husband is the greatest!  You will too.  So call; don’t put treatment off.  Call him, you’ll like him!




This post was written by Vein and Skin Laser Center | November 17, 2016


img_2065Recently a friend brought me a lemon.   I watched the movie “Bucket List.”  And I went to a wedding.

The night before we were to leave to travel to the wedding, I was supposed to be packing.  That afternoon, I thought the weekend was starting.  But on his way home, David called to say that he would have to go back and operate that night.  So after dinner, David left, saying, “I’m just going to go in early and get this out of the way,” which for me was code for “don’t expect me until midnight.”  (He thinks he told me he would be back soon.)   While procrastinating my packing duties, I was channel surfing and came in on the middle of “The Bucket List.”  I was drawn in by how funny it was….I didn’t remember it being funny.  And ended up watching the whole movie, rather than the 20 minutes I had allotted.  I never made a bucket list…maybe I should.


Then we went to a wonderful  wedding.   Bride and groom surrounded by friends and family and lovely surroundings faced each other with love and eyes brimming with emotion.  During the ceremony, the pastor said the bride and groom had written their own vows and would say them to each other.  Both the bride and the groom were barely able to read the words they had each written in their journals.  Words like adventure and travel and of course, love and loyalty…….it was over the top.  We were all moved and a little awed.

And I got a lemon.  Well, our dear friends came for the weekend and presented us with this lemon that was larger than I had ever seen.  And they said that it was from their very own lemon tree!  We were surprised that a lemon tree would live in their area.   The reason, they said, was that it was in a pot and they actually drag it in over the winter, but it lives and then produces fruit when they take it out in the warm weather.  We were a little bit impressed.

David and I were shopping for a camellia bush recently.  Some trees between us and our neighbors have fallen, and we have a blank spot.  As we were leaving, David pointed and said, “Let’s get one of these.  They are on sale for $15.”  Knowing it looked nothing like a camellia and was a little small, I thought, “Now, why would I want that?”  But, it was a little lemon tree!   We both agreed that it might be fun to try our luck, because of our friends’ example.

Today I was potting the little plant and I caught myself saying, “Well, I can cross this one off my bucket list.”  What?!  I don’t have a bucket list.  But I remembered a dream we had.  When David and I first married,  our future was so bright and stretching out before us and we were making all kinds of pledges and promises to each other about how our lives together would be.  One of the things we said was, “And we will  have lemon trees growing outside our windows, and when we wake in the morning, we will  smell the fragrant smell of lemons.”  Along with bluebirds flying in with a little sprig from a rose bush, turtledoves cooing….well you know how newlyweds are!    I had forgotten that dream…….until I snipped the tag off that little lemon tree today.  A moment.   A memory.  Maybe you don’t have to write it down.  Maybe all those dreams and promises, like the ones we heard at the recent wedding from the bride and groom,  are a bucket list too.




Juice of two lemons

Grated rind of two lemons

1 tablespoon cornstarch

½ cup butter, melted

1 cup sugar

2 eggs, well beaten

Combine sugar and cornstarch in a large glass measuring cup or bowl  (that can go in the microwave).  Add lemon juice and melted butter.  Cook in the microwave, in one to two minute intervals, until it is clear and slightly thickened.   (This should take about 3-5 minutes.)  Slowly add, a little bit at a time, about ½ of this mixture to the beaten eggs.  Then mix all together and return to the microwave for one minute.  Whisk.  Add lemon rind.  Refrigerate until serving.  This is great with pound cake!  Or other desserts!







This post was written by Vein and Skin Laser Center | November 16, 2016

Newest Treatment for Varicose Veins


imageThe treatment of varicose veins is ever evolving.  The new technologies being developed are revolutionizing the treatment of a very common disorder (called varicose veins) that causes a significant amount of pain and suffering to a large population of the world. The newest development is using glue to close diseased veins.  This new treatment has many benefits to the patient and the doctor.

Advantages of VenaSeal are many:  The  procedure eliminates the need for tumescent anesthesia.  Tumescent anesthesia is needed in the laser and radiofrequency procedure when pumping fluid around the vein to stop pain caused by heating the vein.  Since there is no heat applied in the VenaSeal procedure, there is no need for a numbing solution (tumescent anesthesia).  This means there is no risk for heat injury to nerves or skin.  There is also no need for post-treatment compression stockings, which is a huge benefit to the patient.  There is a more rapid return to normal activity.  And, multiple veins can be treated at the same time without complications.


Lottie Espinosa (3)image

The new treatment has been tested with a large treatment trial comparing radiofrequency closure or thermal ablation with VenaSeal.  This is called the VeClose United States Pivotal Trial.

242 patients completed treatment in 2013 and close folowup has shown that the VenaSeal gluing procedure is at least as effective as the radiofrequency procedure with a 98% successful treatment rate.  So it is just as good as the previous gold standard treatment of varicose veins and has many benefits for recommending its use.

The gluing substance that is used is called cyanoacrylate.  It has been widely used as a medical tissue adhesive for over 20 years.  It has an anti-microbial effect against gram positive organisms and has been safely used in patient care with no carcinogenicity in humans.   There has also been no bad side effects in the treatment trials.

beautiful lots of legs

Because of the many benefits and the unusual rise in insurance deductibles and copays, some patients are opting to use this method of treatment.  This is just one of the many ongoing options and developments in the treatment of varicose veins.



This post was written by Vein and Skin Laser Center | October 14, 2016