Dear Dr. Donohue: Do varicose veins run in families? My mother had them, and I'm starting to get them. I'm 43. Not only did she have varicose veins, but her legs were swollen from them. What can I do to stop my veins from getting worse?
L.B.
Varicose veins are a family affair in many instances. Being a woman and having to stand for long periods without moving are other things that lead to varicose veins. They can be more than a cosmetic problem. Often, they lead to leg swelling, a feeling of heaviness or pain in the legs, and sometimes they're responsible for sores arising on the legs, especially the ankles.
Leg veins face a formidable problem: They have to keep blood moving upward to the heart in the face of gravity pulling blood downward. Nature devised valves in the veins to keep blood from seeping back down. As blood passes by a valve, the valve closes. With varicose veins, the vein valves are incompetent. Blood pools in veins and stretches them out of shape.
You can keep the veins from worsening by wearing elastic hose during the day. Pressure from the hose keeps blood moving up and out of the legs. Take several breaks during which you lie down with your legs elevated above heart level. Walking also keeps blood moving out of the leg veins.
If varicose veins make their appearance, you have a number of choices to deal with them. Endovenous ablation is one. A catheter, a slender, pliable tube, equipped with a laser can collapse the veins and seal them off. A catheter that emits radiofrequency waves does the same. Sclerotherapy involves injecting the veins with liquids that cause them to close off by making their interior surfaces stick together. Miniphlebectomy is a surgical procedure done with several small incisions to remove the dilated veins. This is only a sample of the ways to treat varicose veins.
Dear Dr. Donohue: I had a TURP for an enlarged prostate gland, which kept me going to the bathroom many times during the night to empty my bladder. The operation worked fine for that problem.
I am able to have sex, but I have no ejaculation fluid. Is that normal? If it is, why is it?
G.W.
"TURP" stands for "transurethral resection of the prostate." The urethra is the tube that empties the bladder. It passes through the prostate gland and the penis. Resecting (cutting) the gland is accomplished by passing a scope equipped with instruments into the urethra, allowing the doctor to pare away excess tissue.
After such an operation, ejaculation fluid often passes into the bladder. That's called retrograde ejaculation. It doesn't diminish sexual sensation.
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 at P.O. Box 536475, Orlando, FL 32853-6475.
