Vein Treat Overview

Rick Owens, MD, is the director of the Hackett Hemwall Foundation's phlebology program. On this page of the HHF website, Rick would like to share with you information about the program, his involvement, history and future of the HHF phlebology program.

Thanks for your interest in the Hackett Hemwall Foundation's service mission trips to emerging nations. The experience is a life-changing one, and becomes an ongoing part of one's world view. The interdependence and bonding with coworkers are a big part of the rewards for participants. This is a powerful and personal experience of giving and sharing that both exhausts and enriches all concerned.

The Hackett Hemwall Foundation is a nonprofit organization based in Madison, Wisconsin and headed by Jeff Patterson, D.O. who is a professor in the Department of Family Practice at the University of Wisconsin School of Medicine and Public Health. The foundation is named after two pioneers in a technique of therapeutic injection for ligamentous laxity in chronically painful joints, George Hackett, MD and Gus Hemwall, MD.

Since 1969, this group has been conducting annual service missions to Honduras in Central America, serving their dual commitment of providing free care to suffering people, and accomplishing the hands-on preceptorship training that is indispensable to learning Prolotherapy.

In early 2002, Jeff approached me at my phlebology practice in Madison, described his mission and foundation activities, and invited me to come along and help them update their vein care offerings for patients with severe varicose veins in their legs. The following year, 2003, I joined their group for the two weeks in March.

The group of volunteer physicians and nurses and helpers numbered about 50, and included young and old, experienced and novice, religious and atheist, Americans, Canadians, Europeans, teens, parents, singles, grandparents, wealthy and modest incomes, shy folks and gregarious. We met at the airport in San Pedro Sula, Honduras, on the appointed day, and began our team effort together.

After a weekend of setting up our treatment areas, plus classroom lectures and demonstrations of the treatment techniques and safety precautions used in the clinics, we awaited Monday morning and the arrival of the patients.

Local radio stations had broadcast announcements, as had local churches, of the upcoming arrivals of the doctors who treat painful joint problems and varicose veins, and each morning the courtyard in front of our clinic site was filled with quiet, hopeful people, some of whom rode six hours by bus to get there.

Our group of student volunteers from a local bilingual high school worked with us constantly, and were quite endearing as they helped us collect historical information from the patients and to instruct them in examination and treatment procedures.

Despite Dr. Patterson's verbal descriptions, I was unprepared for the intensity of the vein problems we saw, or the numbers of those afflicted.

Patient after patient presented themselves for help, revealing histories of multiple pregnancies (up to 20!) and decades of coping with complications such as open ulcers, and daily discomfort borne stoically and expressed with a shrug. Physical findings revealed woody-hard lower legs with deep brown staining, thick scaly dermatitis, and often multiple ulcerations of several square inches.

With the majority of patients, we perform a duplex ultrasound examination with our portable machine, establish the diagnosis, and pinpoint the source of the damage to the leg ve

ins. Then we prepared a syringeful of medication, guide the needle into the target blood vessels with the ultrasound imaging, and deliver the injection to the faulty veins.

We are faced with dozens of similar patients, and we gradually gain in efficiency as our teamwork improves, and each day more people with terrible problems are able to be treated, after years of suffering.

Followup is unreliable in this population, owing to transportation uncertainties and the extreme poverty of the patients, but by the end of the second week of my second annual visit to the Honduras clinics, it was very obvious to me that long term relief of symptoms, and rapid healing of huge open venous ulcers that had been present for many years prior to these treatments, were predictably attainable.

It was equally obvious that the numbers of patients in need was immense. I became determined to return with reinforcements, and to share the treatment techniques with local physicians for enduring impact. Since that first year of involvement, the number of vein specialists who volunteer to help has increased steadily and rapidly. In 2008, we were able to staff three simultaneous vein clinics in three cities, with a total of 28 doctors. The wonderful and devoted efforts of many nurses and interpreters and clinic helpers has made it possible to treat thousands of patients.

The mission experience is one I treasure. Admiring friends and relatives tell me I am doing noble work. But I reply that I will continue to go on the mission trips for selfish reasons: I love the way it makes me feel about myself. It is both exhausting and exhilarating, and has given me the chance to become friends with some of the finest and best motivated professionals anywhere.

There is a world of folks out there waiting for what you can help us do. Please join us!

Thanks for your interest!

Richard Owens, MD

Director, HHF Vein Care Clinics