• author
    • Debra DeAngelo

      Columnist
    • November 9, 2013 in Columnists

    My life in compression hose, Chapter 37, or — listen to me now or hear me later

    If you’ve been visiting this space and/or elsewhere 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 (haha), 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 Tic-Tac. 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 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 salt solution that collapses the vein wall on contact (sort of like snails… ewww). 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.

    veinsIP

    These are my legs, immediately after vein ablation and sclerotherapy (left). The entire procedure took about 90 minutes. Following the procedure, the leg is cleaned up and the entry points sealed with gauze and surgical tape. Compression hose (these are waist-high black tights) are put on, and then the entire leg and foot is further compressed with ace bandages, which must stay in place for 24 hours. Compression hose must be worn 24 hours a day for one week, and then may be taken off to sleep until a follow-up appointment (usually about one month). Compression hose are then worn during the day indefinitely. You can switch to knee-high stockings with your doctor’s approval. The brand I wear is Jobst, and your insurance may cover a portion of the cost. They are very expensive (over $100 for pantyhose), and rather delicate. It’s not difficult to put your fingers through them while putting them on (particularly the nude colored ones), and ruining them. The black ones seem to be sturdier.



    • WOW, sorry you are going through this. I don’t have this issue but I got my Mom’s bad feet and have had many procedures to cure issues. Getting old and being like our Moms is not fun. Hope this all works and you are around for a long time to tell your stories.



    • Love the ads for compression hose below this article.:)



      • I know… Crazy, right? And I clicked on one of them, and they really DID have good prices. I wanted to see the other one that said they had patterns, but it disappeared. Hope it pops up again!



    • Wow, so sorry you have PVD. This is very powerful writing and advice. You gave me an understanding about this disease I never had before and would never find anywhere else. This should be available with the literature in doctors’ waiting rooms! Amazing work.



      • Eh… in the big wide world of diseases, this is not a major one – if you stay on top of it. It’s more of an annoyance than anything else. But I think it’s important for people to realize that “varicose veins” are not simply ugly and embarrassing. Your veins are part of your circulatory system, and when they begin to fail, it’s a larger problem than just having ugly legs. There is such a stigma to the condition that people don’t even want to talk about it or admit to having the problem. Many people just hide their legs in embarrassment, and never wear shorts or dresses, not realizing that what they see on the surface is happening on a much more concerning level underneath the surface. AND moreover – the problem is treatable and manageable, and the earlier you address it, the easier and better that treatment will be.



    • Venous disease, or venous insufficiency, is a condition in which there is improper blood flow between your legs and heart. It causes blood to pool in the vessels of your legs. This blood pool can often result in varicose veins during pregnancy. Keeping your legs healthy during pregnancy is important for your overall health and well-being.



      • Micah, interesting you mention pregnancy. For whatever reason, when I was about five months pregnant, that was when I first started experiencing PVD. The saphenous vein in my left leg failed, from ankle to thigh, and got progressively worse and worse, until I had an egg-sized/shaped out-pouching at the ankle. I had that one fixed, but over the years, the problems continued. Keeping your legs healthy – wearing support hose, putting them up at night, avoiding things that bind at the knee or even too tightly at the waist – all these things are helpful. Anything that places an extra load on a venous system that is genetically predisposed to fail should be avoided.
        Thanks for your feedback!



    • Great article. Good information. I’ll think good thoughts for you full and speedy recovery from this process . . . and look for you on Dancing with the Stars (which Robin watches but if you were on it I would watch too).



      • HAHAHA… dancing with the stars… no amount of vascular surgery is going to correct the fact that I’m clumsy as hell! 😀
        But… maybe The Voice…
        🙂


      • Terri Connett

      • November 10, 2013 at 3:41 pm
      • Reply

      So well written! I think it’s very cool you can be funny about it all. I had never heard of PVD. And I’m sorry you have to deal with it.



      • But… I’ll bet you’ve heard of varicose veins! There is such a stigma associated with this. They’re right up there with hemorrhoids – no one wants to talk about them. Why should we be so ashamed of a disease, over which we have no control?


      • Arry

      • November 14, 2013 at 1:00 pm
      • Reply

      I have to go periodically for the shots of detergent in my veins and have stylish compression hose in a few different colors…smokin!



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