If you dread the thought of baring your legs due to spider veins—those red or bluish, squiggly veins that appear predominantly on the thighs, calves and ankles—you’re not alone! It’s estimated that 60 percent of Americans are affected by this cosmetic condition.

Spider veins are small, dilated blood vessels visible just under the surface of the skin. They can appear in individual lines or branch out in clusters looking similar to a bruise. Spider veins often develop as people age and can be very difficult to camouflage.

Causes and Risk Factors

Spider veins are caused by swollen, weakened blood vessels. The most common risk factors for the condition include:

  • A family history of vascular problems
  • A lifestyle that involves prolonged sitting/standing or airplane travel
  • Trauma such as a broken bone or sports injury
  • Hormonal influences: puberty, birth control pills, pregnancy, hormone replacement therapy
  • Tight garments

Fortunately, spider veins can be very easily removed through a simple, minimally-invasive procedure called Sclerotherapy.


Sclerotherapy is considered the gold standard in eliminating spider veins, proved by studies to be more effective than newer, laser-based techniques.

The treatment involves the injection of a concentrated chemical solution directly into the spider veins using a very fine needle. This irritates the lining of the veins, causing them to collapse. Healthier vessels will absorb the blood flow of the collapsed veins, and the treated veins will fade over time.

Sclerotherapy is an outpatient procedure, and numerous areas can be injected in any one treatment session.


After treatment, spider veins will gradually disappear over several months. Depending on the severity of the condition, more than one treatment may be required for desired results.  After 3-4 sessions, most patients can expect to see up to a 90 percent improvement in the appearance of their spider veins.

If veins are eliminated through sclerotherapy, they will not reappear. However, new spider veins can develop over time.

Are you a Good Candidate for Sclerotherapy?

Women and men of any age may be candidates for sclerotherapy, but most patients are between the ages of 30 and 60. Women who are pregnant or breastfeeding and patients diagnosed with deep vein thrombosis are not suitable candidates.

Prior to having the procedure performed, a medical professional from Surgical Associates will review your medical history and examine the severity of your condition to determine the course of treatment that’s right for you.

Schedule Your FREE Vein Consultation Today

When you are looking for top-rated spider vein treatment in Central or Northern Wisconsin, trust your legs to the experts at Surgical Associates.

Call Surgical Associates at 715-847-2022 for more information and to schedule your free vein consultation today!



September is Peripheral Artery Disease (PAD) Awareness Month. The disease is the least recognized artery condition because many mistake its symptoms for arthritis or simply old age. However, early detection and treatment of PAD can significantly reduce pain and the risk of heart attack and stroke.

What is PAD?

PAD is a condition that develops when arteries that supply oxygen-rich blood to the limbs and internal organs are narrowed or blocked as a result of atherosclerosis (a buildup of plaque). The restricted blood flow can cause leg pain and cramping while walking or climbing stairs and ulcers on the feet.

One in every 20 Americans over the age of 50 has PAD, and an estimated one out of every three people with diabetes over the age of 50 has the condition. However, many of those with warning signs don’t realize they have PAD as it can be difficult to distinguish common joint pains from pain caused by PAD. Left untreated, PAD can lead to heart attack, stroke, and amputation.


Many patients with PAD do not have symptoms. Others may experience the following:

  • Leg pain, cramping or tiredness while walking or climbing stairs
    • This pain typically goes away with rest.
  • Leg numbness or tingling
  • Coldness in the lower legs or feet
  • Chronic sores on the feet or toes
  • Discoloration of the legs, feet or toes
  • Thickened toenails
  • Decreased hair growth on legs
  • Calf muscle atrophy
  • A weak or absent pulse in the legs or feet
  • Impotence
  • Gangrene

PAD can sometimes be confused with arthritis or sciatica pain. It’s important to remember PAD leg pain occurs in the muscles, not the joints.

PAD Risk Factors

People over the age of 50 are at a higher risk of developing PAD, and the disease is slightly more common in men than women. Additional risk factors include:

  • Diabetes
  • Smoking
  • High blood pressure
  • High cholesterol levels
  • Obesity
  • A history of heart disease, heart attack or stroke
  • A family history of heart disease, heart attack or stroke

PAD Treatment at Surgical Associates

If detected early, lifestyle changes and medication can sometimes treat and manage PAD. Your doctor may recommend the following steps:

  • Maintaining healthy blood sugar levels
  • Quitting smoking
  • Lowering high cholesterol and blood pressure
    • Managing these conditions can improve circulation.
  • Exercising
    • Exercise can increase circulation and reduce leg and foot pain.
  • Eating foods low in saturated fat and calories
  • Regular follow-up care to monitor your condition

In severe cases of PAD, surgery may be needed to open arteries that are blocked or narrowed.

  • Angioplasty involves threading a small tube into a patient’s artery through the arm or groin. Once it is near the blockage, an attached balloon is inflated, widening the narrowed artery. The surgeon may then insert a wire tube, called a stent, to keep the artery open.
  • Artery bypass surgery is a procedure in which a blood vessel is taken from another part of the body and reattached to detour around a blocked artery. This creates a new path for blood to flow to the body’s tissues.

Treatment is chosen based on the pattern and extent of blockages a patient is experiencing, as well as his or her overall health.

Schedule an Appointment for a FREE PAD Screening

In recognition of September being PAD Awareness Month, Surgical Associates will be performing FREE PAD screenings.

During the appointment, a patient questionnaire and ankle-brachial index (ABI) will be used to evaluate risk. An ABI is a quick, painless procedure that compares the blood pressure in your ankle to the blood pressure in your arm to determine how well your blood is flowing.

For more information about peripheral artery disease or to schedule a FREE peripheral artery disease screening, call Surgical Associates at 1-888-278-3795.



Colorectal cancer is the third most common cancer and cause of death from cancer in the U.S. Fortunately, through Surgical Associates, there are convenient ways to screen and prevent colon cancer, right here in central and northern Wisconsin.

Colon cancer usually starts as a small, benign growth called a polyp. A colonoscopy is a very effective and relatively painless cancer screening method used to detect polyps or abnormalities and remove them. Certain kinds of polyps will almost always become cancerous if they are not removed, making colonoscopy screening vitally important for those at risk.

When colon cancer is found and treated in the early stages, it’s highly curable. Even better, colonoscopies often find and remove polyps at a precancerous stage—preventing colon cancer from developing all together!

When to get a colonoscopy screening

Everybody between the ages of 50-75 should be screened for colon cancer. People at high risk—notably those with a family history of colorectal cancer or polyps—should start earlier.

If you’re over 75, always had normal colonoscopy results, and are not experiencing any symptoms related to colon cancer, you can stop being screened. After the age of 85, all screening should stop.

What to expect with a colonoscopy exam

It’s normal to feel nervous before a colonoscopy, but at Surgical Associates, we do whatever we can to prevent any discomfort during the procedure. Patients are lightly sedated before the colonoscopy, and most do not remember the procedure when they wake up.

During the colonoscopy screening, a highly-skilled surgeon will guide a thin, flexible camera through the rectum and into the colon. The scope will inflate the colon with air to give the surgeon a better view. If any polyps are found during your colonoscopy, they will be removed and sent away for testing. The surgeon will also remove any other abnormal tissue that may warrant a biopsy. For most patients, a colonoscopy takes 30 minutes to an hour, depending on whether any polyps are removed.

Make an appointment

Surgical Associate’s Dr. Marjorie Miller is now performing colonoscopy screenings in Wisconsin Rapids.

Dr. Miller will take the time to explain your procedure, answer any questions, make sure you are comfortable and provide reports immediately following the procedure.

Do you qualify for a FREE or reduced-cost colonoscopy screening?

As part of the Affordable Care Act, colonoscopies are often mostly or fully covered by private insurers and Medicare. Eligibility is determined by a number of factors, including your age, family history, personal health history, and insurance plan. To find out if you qualify for a free or reduced-cost colonoscopy, take Stop Colon Cancer Now’s Free Colonoscopy Quiz here.

To schedule your colonoscopy, call 1-888-278-3795.


For more information about colonoscopies, visit our colonoscopy screening FAQ page.

Steve T. Weiland MD Bariatric Surgeon

Bariatric surgery has long been identified to be one of the only interventions that maintains significant weight loss.


Surgical Associates offers two bariatric surgery options: The Roux-en-Y Procedure and Sleeve Gastrectomy.


The Roux-en-Y procedure reduces the size of the stomach to a small, egg-sized pouch. This decreases the amount of food a patient can take in at meals. Additionally, a portion of the small intestine is shaped into a “Y” and attached directly to the pouch. As a result, food that is being digested travels directly to the lower part of the small intestine, restricting the amount of fat and calories absorbed after eating. The Roux-en-Y procedure is the most common type of weight-loss surgery performed.


During a Sleeve Gastrectomy, approximately 85 percent of the stomach is removed, with the remainder being sewn into a cylindrical, sleeve-like shape. The stomach is drastically reduced in size, but its function is preserved. Weight loss occurs because the reduced stomach volume restricts the amount of food a patient can eat before feeling full. The production of Ghrelin, an appetite-stimulating hormone, is also drastically reduced, helping prevent harmful overeating.


Both the Roux-en-y gastric bypass and sleeve gastrectomy have demonstrated approximately 70% excess weight loss at 18 months and 50 to 60% excess weight loss at five years. Recent published studies have emphasized the positive impact on important medical conditions.


Researchers at the Geisenger Obesity Institute in Pennsylvania published a study presenting the positive impact of weight-loss surgery on heart disease in the June 2017 issue of the AHA journal. The group studied 3400 tightly matched patients relative to BMI, sex, Framingham risk score, smoking history, use of antihypertensives and diabetes status. Half of the patients underwent gastric bypass surgery and the others did not. The group that underwent bariatric surgery saw a BMI drop from an average of 46.5 to 32.5 after five years while the BMI remained the same at 46 in the group that did not receive surgery. At eight year follow-up, 24 patients who had had surgery and 55 patients who had not were diagnosed with heart failure. The surgery group also experienced fewer myocardial infarction’s and strokes compared to the non surgical group.


The STAMPEDE Study published in February 2017 in the New England Journal of Medicine reported five year outcomes comparing randomized patients undergoing bariatric surgery versus intensive medical therapy for type 2 diabetes. At five years, changes from baseline observed in the gastric bypass and sleeve gastrectomy groups were superior to the changes seen in the medical therapy group with respect to bodyweight, triglyceride level, high density lipoprotein cholesterol level, use of insulin, and quality life measures. These findings and others have motivated the American Diabetes Association to recommend bariatric surgery for type two diabetes patients with body mass index of 30 or higher.


These results support the growing body of evidence that metabolic surgery can improve overall health and quality of life. For more information or to refer a patient to Aspirus Bariatrics, call 715-847-0024.

The aorta is the body’s largest artery. This major blood vessel, with nearly the same diameter as a garden hose, runs all the way from the heart through the chest cavity and abdomen. The abdominal aorta (the portion of the artery running through the abdomen) carries oxygenated blood to the lower half of the body.

An aortic aneurysm occurs when a bulge forms in the wall of the blood vessel, like a balloon. The condition can occur in any part of the aorta but most commonly occurs in the abdominal aorta. If left untreated, abdominal aortic aneurysms can burst or rupture, causing life-threatening internal bleeding. They are the tenth leading cause of death in men over 55 in the United States, accounting for approximately 20,000 deaths annually.

Fortunately, an abdominal aortic aneurysm can be effectively monitored and treated, especially when diagnosed early.

Abdominal Aortic Aneurysm Symptoms and Risk Factors

Most people are unaware they have an abdominal aortic aneurysm because in most cases, it is asymptomatic. However, as an aneurysm grows, the most common symptoms include:

  • Abdominal pain
  • Back pain
  • Abnormal pulsations in the abdomen, similar to a heartbeat

If the pain in the abdomen and/or lower back is sudden and severe, it may be a sign the aneurysm is about to burst. A ruptured aneurysm is life threatening and requires immediate medical attention.

Although the exact cause of abdominal aortic aneurysms is unknown, there are certain factors that increase a person’s risk:

  • Smoking
  • A first-degree family history of abdominal aortic aneurysms requiring surgical repair
  • High cholesterol
  • Hypertension (high blood pressure)
  • Coronary artery disease
  • Chronic obstructive pulmonary disease (COPD)
  • History of cardiac bypass
  • Arteriosclerosis

How is an Abdominal Aortic Aneurysm Treated?

Depending on the size of the abdominal aortic aneurysm and how quickly it is growing, treatment may vary from medical management and monitoring to emergency surgery.

After abdominal aortic aneurysm is diagnosed, Surgical Associates’ vascular team will monitor it closely so that a surgery can be planned if necessary. There are two types of surgery used to repair an abdominal aortic aneurysm: open surgical repair and endovascular aneurysm repair (a less invasive procedure). Typically, surgery is only recommended when the abdominal aortic aneurysm is larger than 5 cm (2 inches) in diameter.

 How to Manage your Risk Factors for an Abdominal Aortic Aneurysm

The best way to prevent an abdominal aortic aneurysm is to maintain a heart-healthy lifestyle. You can lower your risk for developing the condition by following these guidelines:

  • Don’t smoke
  • Eat a healthy, balanced diet
  • Maintain a healthy weight
  • Exercise regularly
  • Lower your blood pressure if it is too high

Set Up an Abdominal Aortic Aneurysm Screening at Surgical Associates

An ultrasound examination is the most effective way to diagnose an abdominal aortic aneurysm. The non-invasive, pain-free screening lasts about 15 minutes.

Six to eight hours before the examination, patients are required to take nothing by mouth (NPO), including no smoking and no gum. After the ultrasound, a report will be sent to the patient’s primary provider.

Expanded Medicare Coverage

Under the Screening Abdominal Aortic Aneurysms Very Efficiently Act, Medicare Part B (Medical Insurance) now covers a one-time abdominal aortic aneurysm ultrasound.

Who’s eligible?

People with Part B who are considered “at risk” qualify for the free, one-time abdominal aortic aneurysm ultrasound. To be considered “at risk,” you must meet one of the following criteria:

  • You have a family history of abdominal aortic aneurysms.
  • You’re a man age 65-75 and have smoked at least 100 cigarettes in your lifetime.

Enrollees must also obtain a referral for an abdominal aortic aneurysm ultrasound from their doctor. 

Why Choose Surgical Associates for the Management or Treatment of an Abdominal Aortic Aneurysm?

Surgical Associate’s team of board-certified vascular surgeons is highly-trained in the complex practice of correcting vascular problems. Our surgeons work closely with the Vascular Laboratory (located in our clinic) as well as the catheterization laboratory at the Aspirus Heart & Vascular Institute.

We take pride in our comprehensive approach to vascular care at Surgical Associates.  Our clinic has trained nurse practitioners focused on vascular disease and an accredited vascular ultrasound department providing services within our clinic setting. Surgical Associates vascular surgeons are fellowship-trained and dedicated to quality outcomes. Patients at Surgical Associates report a client satisfaction score of 4.98/5.

Call 715-847-2022 to set up an abdominal aortic aneurysm screening today or contact Surgical Associates for more information.

Surgical Associates has been doing some digital spring cleaning over the last several months, and we’re excited to announce the launch of our new website – sawisconsin.com.

As we’ve been developing the strategy behind this redesign, our number one priority has always been you and your online experience. We hope the new functionality, content, and features make it easier to find the info you need to make the most informed healthcare decisions possible.

Through its new responsive design, the website is easily accessible on mobile devices, with click-to-call telephone numbers and no pesky pinching, zooming, or excessive scrolling to read the site’s content. You’ll also notice the most exciting feature of the new site—the blog you’re perusing right now! We’re thrilled to offer this new online resource to our patients and their families. We believe this is yet another way our team at Surgical Associates can deliver the highest standard of patient care in a friendly and approachable manner.

In today’s ever-connected world, there’s a deluge of information about the latest health study or newest diet. It becomes difficult to differentiate health facts from the rumors and myths.

And that’s where this blog can help! We’ll post on a variety of topics—from inspirational patient and staff stories to health-related news and insights, clinic updates, community events and more. And just like in our clinic, if you have questions, we’ll help you find the answers! Our goal is to help you and your family live happier, healthier lives.

We welcome you to join the conversation!

Connect and Comment

All readers are encouraged to leave thoughts and feedback in the comment section of any blog post. Share your stories or a topic you’d like us to highlight. You can also reach out to us privately through our contact form.

We hope you enjoy the new blog and look forward to the discussion!