Many new techniques for correcting varicose veins
DEAR DR. DONOHUE: I have varicose veins on both of my legs. I wear only long dresses and slacks to hide them. My legs don’t hurt, but I would like to be rid of these veins. What can I do for them? At this point, I am not interested in surgery. — L.H.
ANSWER: Leg veins face a Herculean task. They have to return blood to the heart in the face of gravity, which works to keep blood from moving upward. They couldn’t accomplish their task if they didn’t have valves. As blood moves upward in the vein, its valves close so that it can’t fall back down. The problem with varicose veins is a valve problem. Their valves no longer work. Blood stays in the leg veins, distends them and stretches them out of shape — varicose veins. Varicose veins can make the legs ache or cause them to tire quickly. Sometimes, the pooled blood leaks fluid out of the veins, so the ankles and feet swell, and open ulcers — most often around the ankle — might form. And then there is the cosmetic aspect, about which I’m not qualified to comment.
Things you can do for varicose veins are limited but worth trying. One is compression stockings. The very best stockings are the ones with graduated compression, with the compressive force greatest in the lowermost part of the leg and with lesser force in the upper parts of the leg. Compression moves blood upward. Another way to keep blood from pooling is lying down with your legs higher than your heart. That position empties blood out of leg veins. Admittedly, you can’t spend the entire day with your legs elevated, but elevate them as often as you can. Never stand for long in one place. If you have to stay still, contract your calf and leg muscles to push blood out of the legs.
Should you change your mind about surgical vein removal, you should know that today there are many methods of getting rid of these veins. Endovascular lasers, radiofrequency catheters and sclerotherapy are recent-vintage techniques. Surgical removal has been refined to the point that most patients return home on the day of operation.
The booklet on varicose veins explains this common problem in depth. Readers can obtain a copy by writing: Dr. Donohue — No. 108, Box 536475 Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My right ear began to throb so bad that I had to see a doctor. She said I have otitis externa, and gave me prescriptions for eardrops and pain medicine. She didn’t say much to me about this. She was in a hurry to see other patients. Will you explain to me what otitis externa is? — P.P.
ANSWER: It’s an infection of the ear canal, that small tunnel (about one inch) that runs from the external ear to the eardrum. It’s the place where wax forms. Infections of the canal come about for a variety of reasons. They always hurt, and they sometimes cause a foul drainage.
Be sure to use the eardrops — which, I am sure, are antibiotic drops — for as long as the prescription says to. Don’t stop when the pain leaves, or the infection can return.
I know what you mean about the doctor being busy. Managed care has doctors on such tight schedules that the doctor-patient relationship is often lost.
DEAR DR. DONOHUE: At what age should a man have a prostate exam? I am 44, and my dad died of prostate cancer, as did my uncle, his brother. I am concerned about my chances of getting it. — H.W.
ANSWER: Most authorities say that age 50 is the time to start prostate cancer screenings. The exam consists of a finger palpation of the gland, as well as the PSA blood test.
Men at higher risk of prostate cancer should have the exam at a younger age. You are at higher risk because of your family history. Black men are at higher risk than white men, and they should be examined at a younger age — 45.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.