The happiest moment was also my scary moment, I was pregnant with my first child in another country with no family to guide or support me. In those days, there was no internet, social media, or the numerous ways of getting information we have today. The first few months went by pleasantly. There was no morning sickness, which some had told me could happen; no pains or aches, just a growing appetite, and cravings for pizza and carrots. We were in Germany, a foreign country, with a different language, cuisine, and way of life, but I enjoyed exploring and learning. The months went by quickly. I traveled to Rome with my husband, eight months pregnant, and it was cumbersome dressing or getting up after lying down or sitting, and then I started getting cramps in my right leg and some swelling, especially after we had walked all over Rome. I didn't pay much attention to it, thinking the overzealous walks and exploring probably contributed to that. Once we returned to our home in Wiesbaden, Germany. I was resting more, and the discomfort seemed to ease. After the birth of my beautiful daughter, life slowly resumed as normal, but the slight swelling of the leg and pain persisted, and now there were noticeable veins that had magically appeared.

"These are varicose veins. Wear compression stockings — they will help," my physician husband's advice. I heeded but not fully, as the stockings were tight and uncomfortable. Unknown to me, those were the veins that would make my life miserable with time. I was lucky the varicosities did not appear in both legs. I wore the stockings for compression to ease the pain and swelling, I also raised and elevated my leg while sitting or lying down, which helped.

Baby number two came along, my son, and after his birth, the leg seemed to have grown slightly in size, swelling, and pain persisted, and the appearance of thick veins on my thigh and the calf made the leg ugly. I was highly conscious and slowly stopped wearing dresses. This annoyed me for multiple reasons. I was living with constant pain, swelling, and protruding veins which were not a pretty sight. I asked my husband if he could remove the veins surgically, as vascular disease was his specialty. No, he did not want to touch the leg; not only would I have a scar through the length of the leg, he said, but I would also have to go under general anesthesia to have them removed, and since this was not life-threatening, it was not necessary. The other major concern was if I ever needed open heart surgery, and the doctors had to use a vein from my leg, that would create a problem. At that time, the only way to remove the veins was by stripping, surgically removing the vein.

Time passed, and the varicose veins got worse. My right leg was in constant swelling mode relieved only when I wore the compression stockings. These were uncomfortable because of extra tightness, and the heat made it unbearable in summer. I was pregnant again with my youngest and the leg now seemed bigger than my left leg. My gynecologist saw my suffering and said to have it removed after the baby was born to stop the swelling, pain, discomfort, discoloration, and now itching of the skin. The skin had started getting dark at my ankles. It was suggested I exercise the leg, elevate it, and keep wearing the compression hose. All that helped but a temporary fix and slowly, the leg got worse. A patient in the waiting room of the doctor's office asked me to use a cream that helped with the varicosities. Even though my husband objected, saying it was a waste of money and the cream would not help, I was desperate and willing to try anything. It did not help.

More years passed and I learned to live with the discomfort and ugly leg. Needless to say now and then I would ask my husband to operate and take the veins out, and we would worry about the heart when it happened; for now, the priority was the leg, and the answer you guessed would be a resounding, no. I was not happy, I couldn't wear dresses, and when I wore a bathing suit in public I was so conscious I would cross my legs trying to hide the right leg under my left leg, which I found out later contributed to making the varicose veins worse. Wearing heels was becoming an issue as the legs would start hurting. Who knew that in a few years, my husband would open a Laser Vein Center where he would be treating varicosities? Who was his first patient? You guessed it. After fifteen years, relief came, the leg looked beautiful, all the pain and discomfort disappeared, and I could wear dresses and bathing suits without worrying about the leg.

The latest procedure is minimally invasive and performed in the doctor's office with a laser device that ablates (burns) the affected veins and reroutes the blood to the good veins. You no longer have to be admitted to a hospital and go under general anesthesia. When my husband started the vein treatments, lasers had been introduced, and the ease of the procedures made it a popular treatment. My husband was surprised to see how many people suffered from this debilitating disease. It altered their lifestyles due to the pain and extreme discomfort and eventually led to ulcers and serious vein issues. One also develops fine clusters of blue or red veins looking like a spider's web; these are Spider Veins and tributaries of the varicose veins.

If you suffer from Varicose Veins, find a reputable vein center with a board-certified vein doctor, preferably a vascular surgeon. Radiologists are also performing these procedures now. Some think of it as cosmetic, but if you have any of the symptoms listed below, it is best to have a doctor look as there could be circulatory issues. If an ultrasound determines there is reflux insurance will cover the cost of the treatment. Here is the summary of symptoms, diagnoses, and treatment options.

Symptoms:

Large protruding veins are sometimes twisted. Redness, swelling, discomfort, discoloration, itching Ulcers and wounds that won't heal

Causes:

Weak or damaged valves in veins that allow blood to pool. Family history, obesity, pregnancy, work-related -standing or sitting for long periods and age.

Diagnosis:

Venous Insufficiency causing Varicose Veins Spider veins (telangiectasia) An ultrasound is performed to determine which veins are affected. GSV-greater saphenous. SSV-shorter saphenous. ASV-anterior saphenous vein.

Treatments:

Laser Ablation (EVLT): a catheter is inserted in the vein and ablated, closing the defective vein which reroutes the blood to the healthy veins. Mini Phlebectomy: where a minuscule incision is done and the veins that could not be ablated are taken out with a medical hook. Sclerotherapy: treatment of the smaller hair-like veins with an injectable solution and sometimes laser. All these are in-office procedures, covered by most Insurance and Medicare. Downtime is minimal. Wearing compression stockings after the procedures helps heal the leg and provides comfort. After the procedure, walking is recommended, and elevating the leg while sitting for a lengthy period. The procedure requires an hour or less with a follow-up visit. After the procedure, an ultrasound is performed to confirm the veins are closed.

It was life-changing for me. I was happier, my pain and discomfort were gone. Wearing heels did not bother me, and I could wear clothes I loved worry-free. The only difference I saw was the size of my legs: the right leg is slightly bigger, and others say they don't see any difference.

If you have varicose veins and they bother you for cosmetic reasons or have symptoms that are affecting your life and health, do not ignore them, and do not wait. Be aware of all procedures, and proceed only if you are comfortable with the treatment. There is quite a bit of bruising after the laser ablation. Which is treated with arnica cream and compression hose, which help alleviate the pain and help with healing. The bruises slowly fade away, you see a remarkable difference in a few weeks. If you have spider veins, the doctor and his staff should explain that spider veins are a cosmetic and not a medical problem and unless they are due to varicose veins, no Insurance will pay for the treatment. Remember, the spider veins will never go away permanently; they will surface again in a few months or a year. Please do all treatments with knowledge of the aftermath and the cost, so you are prepared for any disappointment.

Here is a link if you are interested in learning more. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643

Lee Byrd Judy Haratz Cohen Brenda Long Alistair Knight Gratiela Grigorini