Tag: South Bay Vascular

THROBBING LEG PAIN AT NIGHT: WHAT CARETAKERS NEED TO KNOW ABOUT PAD IN LOVED ONES

Posted on by Michael Kokinos

Understanding Your Role as a Primary Caregiver

For many women, caring for aging parents or partners is not just an act of love—it’s a full-time responsibility. As the backbone of countless households, women often serve as the primary decision-makers when it comes to healthcare for their families. If someone you love has been experiencing throbbing leg pain at night, struggles to walk long distances, or has wounds that won’t heal, this may be more than aging or tiredness—it could be a warning sign of Peripheral Arterial Disease (PAD).

PAD is a serious condition that impacts blood flow to the legs, and it can lead to severe disability or limb loss if left untreated. This article is designed to help women caregivers understand how to recognize PAD, why it’s especially dangerous when symptoms are dismissed, and how early diagnosis and treatment can make all the difference.

What is PAD—and Why Should You Be Concerned?

PAD is caused by plaque buildup in the arteries that carry blood to the limbs. Over time, this buildup narrows or blocks blood flow, depriving the legs and feet of oxygen-rich blood. The result? Pain, numbness, and poor healing—especially noticeable at night when circulation slows.

As a caregiver, you may be the first to notice these symptoms in your partner, parent, or loved one:

  • Complaints of leg pain at night, especially in the feet or calves
  • Needing to dangle their legs off the bed for relief
  • Difficulty walking long distances due to pain or fatigue
  • Sores or wounds on feet or legs that won’t heal
  • Cold, discolored, or numb feet

Why Nocturnal Leg Pain Is a Red Flag

Leg pain that disrupts sleep is often one of the earliest signs of severe PAD. This pain happens because the legs aren’t getting enough blood while the person is lying down. Many caregivers mistake this for arthritis or poor circulation from diabetes, but ignoring this symptom can lead to critical limb ischemia, a dangerous condition that can result in amputation if not treated promptly.

Why PAD Disproportionately Affects the Ones You Care For

If your loved one has any of the following risk factors, their chances of having PAD are significantly higher:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Smoking history
  • Chronic kidney disease
  • Age 60+

Many of these conditions are common in aging men and parents, especially those with a history of cardiovascular disease. As a caregiver, being aware of these overlapping conditions is crucial.

How Women Caregivers Make a Difference in Outcomes

Research shows that patients with involved, informed caregivers are more likely to seek early care and follow through with treatment. As a woman making medical decisions for your family, your role is pivotal in catching PAD before it becomes limb- or life-threatening.

Steps you can take:

  1. Start the conversation – Ask about leg discomfort, cramping, or nighttime pain.
  2. Encourage screening – A simple test called an Ankle-Brachial Index (ABI) can detect PAD early.
  3. Seek expert care – Choose a specialist with extensive experience in PAD and limb salvage.
  4. Support follow-through – Ensure your loved one takes prescribed medications, attends follow-ups, and adopts lifestyle changes.

Why Choose South Bay Vascular and Dr. Polly Kokinos

Dr. Polly Kokinos at South Bay Vascular Center has over 30 years of experience treating patients with PAD. As one of the few independent vascular surgeons in Santa Clara County, she offers a level of personalized, patient-first care that many large systems simply cannot match. Her team works closely with caregivers to:

  • Explain complex diagnoses in easy-to-understand language
  • Involve families in every step of the treatment process
  • Provide compassionate care that respects cultural and emotional dynamics

Dr. Kokinos is especially known for her work in limb salvage and amputation prevention, helping families avoid devastating outcomes. With her background in both community-based practice and international mission work, she brings deep empathy and unmatched skill to every patient interaction.

Treatments That Can Help Your Loved One

The good news? PAD is treatable—especially when caught early. Treatment plans may include:

  • Lifestyle changes: Quitting smoking, eating healthier, and walking
  • Medication: To improve blood flow and control underlying conditions
  • Minimally invasive procedures: Like angioplasty or stenting to open blocked arteries
  • Surgical options: For advanced cases where blood flow must be rerouted

At South Bay Vascular, treatment plans are tailored to each patient’s specific needs, and you—as the caregiver—are never left out of the loop.

Conclusion: Your Leadership Saves Lives

As the primary caregiver, you are not just supporting a loved one—you are advocating for their future. By learning the signs of PAD, understanding its risks, and connecting with experts like Dr. Kokinos, you can help ensure your loved one receives the best care possible before the disease progresses.

Don’t ignore nighttime leg pain. If your partner, parent, or family member is struggling with any of the symptoms mentioned above, reach out today. If you or our loved ones suffers from any of the conditions outlined above, ask your primary care physicians for a referral to Dr Kokinos at South Bay Vascular Center or if you think you need a second opinion, please call our office at 408-376-3626 to schedule an appointment.

We offer hope when others say there is none

PAD IN THE AFRICAN AMERICAN COMMUNITY; BREAKING BARRIERS TO EARLY DIAGNOSIS AND TREATMENT

Posted on by Michael Kokinos

Understanding the Unique Risk Factors for PAD in African Americans

Peripheral Arterial Disease (PAD) is a silent but deadly condition that disproportionately affects African Americans. Research shows that Black Americans are up to three times more likely to develop PAD than their white counterparts. This stark disparity arises due to a combination of genetics, higher rates of diabetes and hypertension, and limited access to healthcare. However, beyond the medical risk factors, there are also deep-rooted cultural and societal barriers that make early diagnosis and treatment of PAD particularly challenging for this community.

Dr. Polly Kokinos, a highly respected vascular surgeon with over 30 years of experience, understands these challenges. Having served underserved communities both locally and globally—including her missionary work at Tenwek Hospital in Kenya—she is uniquely positioned to provide compassionate, culturally competent care to African American patients facing PAD.

This article will explore the barriers preventing early PAD diagnosis in the African American community and how Dr. Kokinos and her team at South Bay Vascular are working to break down these obstacles.

Cultural Barriers to Seeking Early PAD Diagnosis

For many African Americans, historical distrust of the medical system remains a significant barrier to seeking medical attention for conditions like PAD. Generations of systemic healthcare disparities and unethical medical experiments—such as the Tuskegee Syphilis Study—have left lasting skepticism in many Black communities. This hesitancy often leads to delayed diagnosis and treatment, allowing PAD to progress to Critical Limb Ischemia (CLI), a severe form of PAD that increases the risk of limb amputation.

Additionally, the concept of self-reliance and resilience within Black culture often discourages individuals from seeking help for health issues until they become severe. Many African Americans feel a sense of duty to “tough it out,” prioritizing work and family obligations over personal health concerns. This reluctance can be particularly dangerous for PAD, a disease that advances silently, often without pain in its early stages.

The Role of Extended Families and Community Support

Unlike in some other cultural groups where medical decisions are highly individualized, many African American families rely on extended family networks and community institutions, such as churches, for guidance. When a loved one is diagnosed with a serious illness like PAD, the decision-making process often involves multiple family members. This means that healthcare providers must do more than just educate the patient—they must engage the entire family unit.

Dr. Kokinos recognizes this dynamic and works closely with families to ensure they understand the severity of PAD and the need for early intervention. Her patient-centered approach is based on relational medicine, rather than the transactional care often seen in large hospital systems. She takes the time to build trust, answer questions, and provide families with the resources they need to make informed decisions.

Financial Concerns and Healthcare Access

Another major barrier to PAD treatment in the Black community is the issue of affordability and access to healthcare. Many African Americans face challenges with health insurance coverage, making it difficult to seek preventative care. Even when insured, high co-pays, deductibles, and medication costs can discourage individuals from following through with necessary treatments.

Unlike many physicians who are constrained by large healthcare systems and administrative bureaucracy, Dr. Kokinos operates as an independent vascular surgeon, meaning she has the flexibility to offer tailored treatment plans that fit each patient’s financial situation. Her team at South Bay Vascular assists patients in navigating their insurance plans and finding cost-effective solutions for care.

The Stigma Surrounding PAD and Amputation

Many African Americans associate vascular disease with amputation, often believing that a PAD diagnosis is a precursor to limb loss. While it is true that untreated PAD can lead to amputation, early intervention can prevent severe complications. However, because of the deep-seated fear of limb loss, many Black patients avoid seeking medical attention until the disease has progressed to a critical stage.

Dr. Kokinos and her team emphasize the importance of early screening and non-invasive treatments that can save limbs and lives. She ensures that her patients understand that PAD is manageable when caught early, and that proactive care is the best way to avoid amputation.

Why African American Patients Trust Dr. Kokinos

Dr. Polly Kokinos is not just another vascular surgeon—she is a physician who has dedicated her life to serving communities in need. Her work at Tenwek Mission Hospital in Kenya has given her firsthand experience treating patients in underserved areas, reinforcing her commitment to providing equitable care. In Santa Clara County, she applies these same principles to help African American patients overcome healthcare barriers.

Unlike other vascular surgeons in the area who may rely on their hospital affiliations for credibility, Dr. Kokinos has built her reputation through skill, experience, and patient trust. She holds hospital admitting privileges, ensuring that her patients receive continuity of care, but she is not bound by the financial interests of a hospital system. This independence allows her to always prioritize what is best for her patients.

Conclusion: Taking the First Step

PAD is a life-threatening condition that disproportionately impacts the African American community. However, the barriers to care—ranging from cultural hesitancy to financial limitations—make early diagnosis and treatment difficult. The key to preventing amputations and saving lives lies in trust, education, and proactive healthcare decisions.

Dr. Polly Kokinos and her team at South Bay Vascular are committed to breaking down these barriers by providing compassionate, relationship-based care that empowers African American patients to take control of their health. If you or a loved one are experiencing symptoms of PAD—such as leg pain, numbness, or wounds that won’t heal—it is critical to seek medical attention before it’s too late.

If you or a loved one may be struggling to find answers to difficult medical questions and or a lack of compassionate care, please call our office to schedule an appointment with Dr Kokinos @ 408-858-3586. 

We offer hope when others say there is none. 

PERIPHERAL ARTERIAL DISEASE AND THE AFRICAN AMERICAN COMMUNITY: A SILENT THREAT YOU CAN NOT IGNORE

Posted on by Michael Kokinos

Introduction

Peripheral Arterial Disease (PAD) is a serious and often overlooked condition that disproportionately affects African Americans. Characterized by narrowed arteries and reduced blood flow to the legs, PAD is a major cause of disability, limb loss, and even death if left untreated. The risk of PAD in the African American community is significantly higher than in other racial or ethnic groups, making awareness, early detection, and expert care critical.

This blog will explore why PAD is more prevalent in African Americans, the specific risk factors that increase its impact, and how families can take action to prevent and treat this disease before it leads to devastating consequences.

Why PAD is More Prevalent in the African American Community

Studies show that African Americans are two to four times more likely to develop PAD than non-Hispanic white individuals. This disparity is due to a combination of genetic, socioeconomic, and lifestyle factors that increase the likelihood of vascular disease.

Key Risk Factors That Affect African Americans

 

  1. Higher Rates of Hypertension (High Blood Pressure)
    • African Americans develop high blood pressure earlier in life and with greater severity than other groups, leading to accelerated artery damage.
  2. Increased Prevalence of Diabetes
    • Diabetes is a major risk factor for PAD. African Americans are 60% more likely to be diagnosed with diabetes than non-Hispanic whites, and poorly controlled diabetes can lead to severe PAD and amputations.
  3. Higher Incidence of Chronic Kidney Disease (CKD)
    • African Americans are nearly four times more likely to develop kidney failure, which is closely linked to PAD. Poor kidney function leads to worsened arterial health and an increased risk of limb loss.
  4. Smoking and Environmental Factors
    • Smoking drastically increases the risk of PAD, and African Americans who smoke are at an even higher risk for severe, treatment-resistant PAD.
  5. Limited Access to Specialized Vascular Care
    • Many African Americans live in communities where access to vascular specialists is limited, leading to delays in diagnosis and treatment. Lack of awareness and preventive care further increases the likelihood of PAD progressing to critical limb ischemia (CLI) and amputation.

Recognizing the Signs of PAD: Don’t Ignore These Symptoms

The earlier PAD is detected, the better the chances of preventing life-altering complications. Unfortunately, many people mistake PAD symptoms for signs of aging or ignore them altogether. Here’s what to look for:

  • Leg pain, cramping, or fatigue when walking
  • Numbness, tingling, or coldness in the feet
  • Darkened or discolored skin on the legs or toes
  • Sores or wounds on the feet that won’t heal
  • Throbbing leg pain at night, a warning sign of critical limb ischemia (CLI)

If you or a loved one experiences these symptoms, don’t wait—seek medical attention immediately.

Why African American Families Must Take Action

PAD doesn’t just affect individuals—it impacts entire families. The burden of limb loss, disability, and heart disease due to PAD can have devastating emotional, financial, and social consequences.

How Families Can Help

  • Encourage Loved Ones to Get Screened – Early diagnosis is key.
  • Adopt a Heart-Healthy Diet – Traditional diets high in fried foods and processed sugars increase PAD risk.
  • Stay Physically Active – Walking can improve circulation and delay PAD progression.
  • Manage Diabetes and Blood Pressure – Keeping these conditions under control reduces PAD risk.
  • Seek Care from a Trusted Vascular Specialist – Not all doctors have the expertise needed to prevent amputations.

Why Choosing the Right Vascular Surgeon Matters

There is a huge disparity in the quality of vascular care provided to African Americans. Many patients are referred too late or receive subpar treatment at hospitals where financial motives override patient care.

Dr. Polly Kokinos and South Bay Vascular are committed to preventing unnecessary amputations by offering: ✔ Advanced, minimally invasive treatments ✔ Limb-salvage expertise ✔ Comprehensive, relationship-based patient care ✔ Immediate access to cutting-edge vascular technology

Conclusion: The Time to Act is Now

PAD is a serious yet preventable disease. African Americans are at higher risk and must be proactive about screening, lifestyle changes, and expert medical care. If you or a loved one has symptoms of PAD, don’t wait until it’s too late—schedule a consultation with Dr. Polly Kokinos today.

Your health and your future matter. Let’s work together to stop PAD in its tracks. Call our office today to schedule an appointment at 408-376-3626 if you suffer or are diagnosed with any of the conditions outlined in this office. Ask your primary care physician for a direct referral to Dr Kokinos or visit our website at www.southbayvascular.com to learn more about how we can help. 

 

“We Offer Hope When Others Say There Is None”

AWARD WINNING WOUND CARE IN SAN JOSE

Posted on by Angelica Rodezno

The O’Connor Wound Care Center, which celebrates it’s 25th Anniversary this year, was the site of a ceremony on Thursday, June 18th 2019 honoring it with a Commendation from the City of San Jose. The honorable Sam Liccardo as well as all the City Council Members were involved in recognizing the O’Connor Wound Care Center for distinguished service to the citizens of San Jose. The plaque was presented by Council Member Dev Davis to Dr. Polly Kokinos of South Bay Vascular Center, who is the Medical Director of the O’Connor Wound Care Center, as well as to the entire staff of the Wound Care Center.

Chronic wounds are a silent epidemic in the United States affecting almost 7 million people. If not healed in a timely fashion, they can lead to loss of limb and life. The wound care center was started 25 years by Drs. Bruce Lehrman, Peter Schubart, and Jude Roussere, who are still active in it today. It is a testament to their vision and understanding that chronic wounds are best treated by a multidisciplinary approach and by a team that focuses on them. Their are 10 physicians from 6 different specialties all of whom are have special training in wound care, advanced treatment modalities for wounds, and hyperbaric oxygen therapy. Our team of twelve nurses and five additional staff members are committed to these patients, and several of them have worked at the center for decades. We follow published clinical practice guidelines to ensure the best outcomes and our wound healing rates are over 98%.

We are the only JHACO accredited center in the Bay Area, and are proud to offer advanced therapies such as skin substitutes, the LUNA laser system, and Hyperbaric Oxygen treatment for difficult to heal chronic wounds. We have treated and healed over 15,000 patients.

Should your patient need our expert help, please call us at 408-947-2804 for an appointment.

LEG SWELLING CAN BE MORE THAN JUST VARICOSE VEINS

Posted on by Angelica Rodezno

Time and again, patients come to our office following a vein procedure by local Vein “Experts”, Vein “Specialists” and Phelebologists complaining that their legs continue to hurt and to swell even after their varicose vein procedures. Disappointed and scared, many of these patients have spent thousands of dollars, have undergone multiple procedures and have endured months of pain, only to find that they have been treated for the wrong condition and have been told that there is nothing else that their doctor can do to help them. Not knowing where else to turn, patients walk into our office knowing that something is just not right and hoping that we we can help.

The question is, why is this happening?

For the past 23 years the physicians and surgeons at South Bay Vascular Center and Vein Institute have dedicated their entire practice to treating patients with the full range of venous issues–from cosmetic spider veins to non-healing venous ulcers. Since 2005 alone, we have performed over 10,000 endovenous closure procedures in our office, and have done thousands more phlebectomies and sclerotherapy sessions in an effort to help our patients return to a normal life. At South Bay Vascular, we are not just a varicose vein treatment center or vein clinic; we are a group of board certified vascular surgeons, clinically trained to treat patients with problems in any part of their circulatory system. Treating varicose veins is not something we have learned at a weekend course or seminar as a way to augment our primary practice…veins are our primary practice and that is what we have been clinically trained to do.

Unfortunately, this isn’t always the case. And that is why so many patients come to our office looking for help.

Many of our patients, having been previously treated for varicose veins by cardiologists, internists, dermatologists and phlebologists positioning themselves as Vein “Specialists” and Vein “Experts”, but have conditions far more complicated than “leaky valves” that show up as varicose veins. In most of the complications we see, patients have been treated by doctors thinking the problem could be easily fixed using a VNUS, EVLT or Sclerotherapy procedure. Unfortunately for the patient many times this simple procedure does not work because their underlying medical condition is a much more complex and difficult problem to treat. When a patients problems persists, these same doctors end up referring these patients to an emergency room or to a vascular surgeon hoping their complications can be undone. Worse yet, sometimes these same doctors simply tell their patients that there is nothing else that can be done for them.

In our years of treating patients with venous disease we have achieved a technical success rate using our endovenous VNUS and laser procedures of nearly 100%. But NEARLY 100% is a far cry from 100%. Some patients don’t feel better. Some patients, continue to have legs that ache, legs that remain swollen, and wounds that do not heal. Some of our patients were just not getting better.

Up until about two years ago, all we could do for those patients whose legs did not heal was to repeat the ultrasound and hope to find some other vein issue that we could treat. Sometimes this worked; but many times it didn’t. In the instances when we did find a secondary vein or discovered that a vein treated earlier just did not close entirely, we would proceed to treat this vein a second time; but even then, many of our patients simply did not get better. Our question continued to be Why?

After 20 years and tens of thousands of patients, we discovered that in certain patients, there was in fact, another mechanism in the venous system that was keeping our patients from getting better. It was called May-Thurners Syndrome.

What we have discovered is that in many of the cases where our patients did not heal, the problem wasn’t with the the Greater Saphenous Vein (the main vein treated in the vast majority of varicose vein procedures) but with the iliac veins; the vein between the belly button and the groin. What we discovered was that problems in the iliac vein could cause many of the same types of symptoms and problems that we saw when there were leaky valves in the leg veins. What we learned was that the problems with the iliac vein were usually the result of a compression or a scarring. What we discovered was that iliac vein compression (first identified in the early 50’s by Dr’s May and Thurner) happened because of the way the iliac vein is anatomically positioned between a beating artery and a hard pelvic bone and that often times this presented as varicose veins and swollen left legs.

Iliac Vein Compressions not only causes elevated pressure in the left leg resulting in aching, swelling, and non-healing wounds, but predisposes the left side to a much higher risk of blood clots after orthopedic surgery, long flights or drives, cancer, periods of immobility or bed rest.

Very few doctors, it turns out, are able to treat iliac vein compression, because one has to be a vascular surgeon and or an interventional radiologist to do so. Many of the so-called phlebologists, and “vein doctors”, who decided to abandon their field of training to treat varicose veins and other cosmetic issues, are not people who were trained in their residencies or fellowships to perform this type of procedure. Nor were they trained in ultrasound or in understanding the flow dynamics of the vascular system. Because of this lack of clinic training, they are unable to treat iliac vein compression, and so they ignore it, keeping many patients from options that could help improve their daily lives, relieve their leg swelling, and heal their leg wounds.

At South Bay Vascular, we have trained and have performed thousands of venus procedures and have treated hundreds of cases of iliac vein compression. We are experts in all aspects of vascular surgery, including conditions like iliac vein compression. Unlike phlebologists, we can offer all approved treatment options to patients for the treatment of their leg aching, swelling, and discoloration. Most importantly, it is our state of the art accredited vascular lab and registered ultrasound technologists who make so much of what we do at south bay vascular possible. Our advanced vein mapping and screening protocols, together with our national accreditation gives us the ability to do cutting edge surgical procedures; this is what sets us apart from nearly every other vein clinic and treatment center in the whole of Northern California.

Because of the advances in medical imaging and device technology, a large number of our procedures can be done on an outpatient basis in our office. Dr. Kokinos is a recognized leader in the area of deep venous disease and has treated more patients in northern California using Intravascular Ultrasound than any other physician in the region. As a result of her cutting edge treatment protocols and surgical techniques, Dr. Kokinos has been recognized as an international expert and has been an invited speaker at national vascular and interventional meetings in San Francisco, Miami, and Colorado over the last 6 months to discuss her findings and her treatment for patients presenting with these types of problems. Most recently she has been asked to speak at the main venous meeting in the United States, the American Venous Forum, where she will be presenting her clinical research on the use of non-invasive and minimally invasive techniques to diagnose and treat iliac vein compression.

Currently, Dr. Kokinos serves as the Medical Director of the Wound Care Centers at O’Connor and St. Louise Hospitals, and is the Chairperson of the Cardiovascular department at San Jose’s Good Samaritan Hospital. She and her partner, Dr. Carlos E. Pineda, are dedicated to offering patients suffering from both arterial and venous wounds the most cutting-edge and effective treatments available to save their legs, stop their pain, and improve their lives.

If you or anyone you know suffers from varicose veins, diabetic infections, non-healing leg wounds and or are facing an amputation, please call our office to understand your options.

We offer hope when others say there is none.

408-376-3626