My experience with varicose veins

   To tell you the truth, any chubbiness or swelling near the ankles raised to me more alarms than the simple thought of varicose veins. I'm a physician, and I can also confess that my body weight is far from ideal, so when I see fullness around my ankles, dilated elongated tortuous leg veins, or what we call varicose veins, don't very much ring a bell at first thought, but instead, I usually think of other options like may be increased blood pressure, gout, liver disease, or other blood problems.

   To start with the simplest cause, I first thought of gout, because the swelling in my right ankle was more than that in the left. That one sided character was more likely in favor of gout, but there was no big toe pain or redness. Besides, I wasn't taking my ideal amount of water daily, and I was overconsuming myself at work which might have given urate salts the rare opportunity to precipitate by gravity in my foot joints and cause me the swelling and pain. But due to the absence of the typical pain I ruled that out and starting thinking of something else.

   My next suspect was liver disease. The pros were my fat which might have concentrated in my liver causing it to be ill and not be able to withdraw back the fluid that came out of my circulation

to feed my body parts, my job as a blood banker with the possibility that I might have got hepatitis viruses from it which in turn invaded my liver ..etc. Normally the liver is the factory for albumin and plasma proteins whose functions are to withdraw nutritious plasma after it left the circulation through the capillaries back into the circulation in a way similar to how salt or sugar crystals withdraw a small water pond when put on it. the water diffuses through the crystals and the pond is there no more. Luckily I was a regular blood donor and I donate blood every 3 months and each time I have my hepatitis virus checked out by the blood bank officials. My last labs were virus free, so I must be free, and so I set that suspect free.

   I then became more certain that a surge in my blood pressure was my grey ghost. There were many obstacles I had to overcome those 3 years, especially last year. I was getting ahead at work a lot faster than I was in my academic life. My second newborn child was on the way out to life and my elder 3 year-old son was having difficulty talking and I were in the process of making sure that this doesn't progress into possible future learning disabilities. All that pressed hard on my nerves. I'm also fat and that is somehow related to hypertension. There were also few occasions when I had to measure my blood pressure and found it over 140/90, but that was not for the classical 3 consecutive times, each is one week apart. Despite that, I had a blood-pressure pill once. The swelling subsided, but came back again and didn't go away since then, even when I took the medication again. It was sure not hypertension.

   A blood disease in the form of a clot closing the vein carrying the blood up along the leg was a possible cause, but usually signs would have been fierce. The swelling would have been  so immense that the skin sometimes oozes some sort of fluid especially with pressure, and the pain on walking or on pressing the calf would have been very awful.

   The reason I had to think all the previous possibilities was that the varicose veins I had were not classic. They were not obvious. Classically, varicose veins of the leg are dilated, elongated, and tortuous veins appearing on the surface of the skin of the leg. They are 2 of them; one beginning behind the inner side of the ankle and heading upwards towards the thigh pit passing along the back of the knee, while the other is much shorter and simpler in course, beginning behind the outer side of the ankle and just running upwards to join the first one behind the knee.

   To avoid medical terms, I didn't have the classical picture of varicose veins. I had no tortuous blue swellings crawling just under my skin along the courses of those two veins. I had only one tortuous greenish skin elevation next to my right knee, and for years, it caused me no pain during walking and no foot ulcers like many long standing cases experience.

   But it was still the only logical explanation for my swollen right ankle so far. Varicose veins are usually a surgical problem, and with my all due respect for all the surgeons out there, I'd rather  think first of a more conservative solution to my problem than to think of a solution with the knife in my hand. The problem with varicose veins is that, in some individuals, there is weakness in the muscles in the wall of those veins, a problem that on the long run can lead to the inability of those veins to maintain the upward movement of blood along the leg by causing leaks within their valves. The falling blood column inside the vein will dilate more veins making more valves incompetent and thus increasing the back pressure of the falling blood column by gravity. Furthermore, the sluggish leg circulation will deplete skin of the foot from having its necessary nutrients ( oxygen and others ) from the blood, and thus skin colour start to change and thin out and ultimately slough and produce leg ulcers.

   Since I didn't have the full blown picture of the classic  varicose veins, I've decided to use a medication to just improve my foot circulation, and to my surprise, the swelling went away and I'm now less worried about it.