If you’ve been visiting this space for long enough, and God bless you if you have, you’ll recall my ongoing battle with peripheral vein disease (PVD). People frequently ask if that means varicose veins. Well, yes and no.
Varicose veins are part of PVD. They’re what you see on the surface — like big lumpy snakes have slithered up under your skin, and they look like they’ve swallowed some marbles. Those marbles are the valves that have failed, allowing blood to collect there, and they’re just fluttering in the bloodstream rather than opening and closing to help return blood to the heart, which ends up doing all the work.
With PVD, in addition to what’s visible on the surface, the same thing is happening on a much grander scale in the larger veins deep inside the thighs and calves. Just like on the surface, those valves are also fluttering uselessly, and there’s a domino effect. The smaller veins down the line begin to fail, all the way to the capillaries. That causes hugely swollen ankles and feet because those tiny veins and capillaries weren’t meant to accommodate all that blood — so they just don’t.
Essentially, everyone on the whole blood-return assembly line just quits. Except the boss — the heart — which must keep pounding on. That’s a lot of extra work for a heart, and if it quits too, you have much bigger problems on your hands. As untreated PVD progresses, the skin around those varicose veins near the surface starts to die and can ultimately ulcerate. At that point, I suppose amputation is the only alternative. So, yes, I’m try to stay ahead of this.
PVD is often hereditary, and thank you, Mom, for this little parting gift. I gasped when I saw the photo charts on the vascular center wall at my first visit, because I recognized my mother’s legs. She also had lump-laced legs, brown and blue in places, with huge brown patches near her ankles that looked like horrific motorcycle pipe burns. She was one stage away from earning the nickname “Stumpy.”
Back in her day, the only treatment was stripping the veins, which was also the only option when I decided in my 30s to do something about my left leg before it got any worse. The procedure is somewhat barbaric. They make incisions at the ankle, knee and thigh, and, quite literally, just start yanking them out like you might yank invasive vines out of your garden — lots of tugging and tearing by brute force, just like weeds. Only with blood.
Is it too late for a Halloween horror story?
I thought I’d clamped the vein issue off (ha ha), but I didn’t get the larger explanation of PVD and its progression. Without external support — support hose or even better, compression hose — the valves in the remaining veins would eventually fail too. I found this out the hard way, which is why I’m writing this column: Look at your parents’ and grandparents’ legs (and this goes for men too). Do they have lumpy snakes slithering under the skin? Nasty motorcycle burns when they’ve never even owned a Harley? Consider your own legs: Can you see veins bulging? Are your feet and/or ankles swollen most of the time? Do your legs just feel tired and seem like they’re made of lead? Or even ache? My advice: See your doctor, and wear support hose now.
Yes, you there, in your 20s, with the kind of legs Rod Stewart warbled about — you’re sure this level of ick will never happen to you. So was I. I’d look at my mother’s legs, gag a little, and be thankful I wasn’t like her. Little did I realize, I already was. I just couldn’t see it yet. So, slip those hot legs into some support hose whenever you can, missy. Prevention is infinitely better than cure.
Rather than stripping, the cutting edge cure nowadays is vein ablation. First, they numb the area they’ll be ablating (read: frying). Consider that this is deep inside the thigh on veins you can’t see. And, obviously, the area isn’t already numb when they stick the needles in that deep, so you feel every stab to the hilt. To call it torture would just be precious. For reasons I cannot comprehend, the only sedation you are allowed is one stinkin’ Valium, which is about as effective as a Tick-Tack. What sort of medical Bizarro World is it when they will give you nitrous oxide to clean your teeth but not to repeatedly stab you down to the hambone?
Once numb, a laser line is threaded up the vein, which is then fried shut it in stages, creating an actual blood sausage, which hardens over time and is eventually absorbed by the body.
Ready to go get your support hose now?
Lesser veins on the surface are then treated with sclerotherapy, an injection of a substance that collapses the vein wall on contact. Piece of cake, compared to ablation. And then, you do this all over again in a couple months because they can’t treat everything all at once. Worse yet, some veins are so big and badly damaged that they require multiple treatments, such as the one I have, that was both ablated and schleroed last week, for the fourth time.
But wait! There’s more! In between these treatments, I must wear compression hose, which apply a specific amount of constant pressure to help the remaining veins pump blood. They are not comfortable. Or attractive. But, I diligently wear them most of the time, because they seem entirely more comfortable and attractive than stumps, and infinitely more attractive than letting it all go until my heart finally gives my sad, lazy veins a big middle finger and shrieks, “I quit too.”
My point is this: Slipping into plain old over-the-counter support hose now could pay off big time in the future. And also, you’re welcome.
— Email Debra DeAngelo at firstname.lastname@example.org; read more of her work at www.wintersexpress.com and www.ipinionsyndicate.com