I was 29 with varicose veins
How one millennial confronted the chronic condition — and triumphed
I was trying on a bridesmaid dress for a friend’s wedding when I noticed it: the blue-green, raised vein on my right calf. I felt selfconscious and annoyed that I was having to deal with varicose veins when I wasn’t yet 30, especially heading into summer with its leg-baring shorts and swimsuits. But the truth is, it wasn’t the first time I’d thought something was wrong with my legs. I’d been experiencing heaviness and itchiness that had been getting worse for about six months, along with general discomfort and pressure on my ankles and calves. Vein issues run in my family. I probably should have reached out to a professional earlier, but that visible blue-green twist was what made me realize I couldn’t ignore the symptoms any longer.
Varicose veins are caused by venous insufficiency, or chronic venous disease, which is much more common than you’d think, even among those my age. “About 70 per cent of Canadian women have a symptom associated with chronic venous disease,” says Dr. Beverly Chan of Oakville Vascular. Indications that you have the condition range from the painful symptoms I experienced to the formation of spider veins to full-on varicose veins. Worse news: There’s not a whole lot you can do to prevent it. “Genetics are the single most important factor in developing varicose veins,” says Dr. Alexander Matz, founder of Canada Vein Clinics. “If you have one parent with varicose veins, your chance of getting them goes to 50 per cent. If both of your parents have them, your chances jump to over 90 per cent.”
Even though varicose veins are an indication of valve dysfunction, it’s a common belief that they’re simply a cosmetic concern or a normal sign of aging. In my own life, it was vanity that finally made me seek out a specialist, despite experiencing discomfort for some time. “When we treat veins, we get rid of them, so many people believe that they are being treated cosmetically,” says Chan. “But so many people come back afterwards and note that the heaviness has gone away, the aching and itchiness are gone — there are so many symptoms that people don’t realize actually have to do with their veins.”
Often, that’s because we get used to a new normal as the condition gets worse and worse, since venous insufficiency is a chronic issue and a progressive disease. “Many people learn how to live with it, and some can tolerate quite a bit of pain and discomfort,” says Matz. “If you have varicose veins and you don’t treat them or take care of them, they’re going to get worse.”
So, what is actually happening in your legs to cause problems?
When everything is working properly, your veins move blood back to your heart and lungs. When blood reaches your legs and ankles, it needs to fight gravity to make it back to the heart, which is why veins have valves in them that block the blood from moving backwards and causing venous reflux. Chronic venous disease stops valves from working properly, which allows blood to move in the wrong direction and pool in the legs. The veins become stretched, weakened and even leaky, which leads to spider veins, swelling, discoloration, varicose veins and, in extreme cases, leg ulcers — not to mention that pain I described before. According to Matz, recent studies have also shown a connection between venous insufficiency and deep vein thrombosis, which can cause blood clots and pulmonary embolism.
Treating venous insufficiency often comes down to an in-office procedure. The number-one way to treat varicose veins is with endovenous ablation, which involves closing the problematic vein so that blood bypasses it. A small incision is made in your leg, a catheter is inserted into the vein and then, through either thermal (radiofrequency or laser) or non-thermal (medical grade glue) ablation, the vein is sealed from the inside out. There is also a surgical option called vein stripping in which the vein is removed entirely, but it requires general anesthetic and downtime and has a higher rate of vein regrowth than endovenous ablation, so it’s now used much less frequently.
About six months before my 30th birthday, I opted for thermal ablation to treat my venous insufficiency. The procedure was quick and relatively painless, though I did feel some discomfort before the numbing cream kicked in. I was out of there in a couple hours, and I was able to walk out of the clinic and take a cab home. I was sore and achy for a while, and the inside of my right leg sported some seriously impressive bruising. I also had to wear compression stockings for several weeks afterwards and avoid any weight-bearing exercises, although walking frequently was highly recommended to help with healing.
Complete recovery takes time, but a few months out from the procedure I noticed that my varicose vein had shrunk considerably and was no longer raised. Even better, the pain that had characterized my existence for almost two years was gone. It’s shocking to me that I lived with it for so long when there was a relatively easy fix, not knowing that it isn’t normal and that it can lead to much worse symptoms. “I find that for patients, (treating veins) improves their quality of life quite significantly,” says Chan. I have to say I agree.
The main thing that held me back from treatment was the cost. In Ontario, endovenous ablation is not covered by OHIP, and it’s not cheap. Prices can start at $2,500 per leg — I spent about $3,500 to treat one vein in one leg. If you have private insurance, you may have partial coverage, but it’s a prohibitively expensive procedure for many and most people have to pay for it out of pocket, which is hard to understand given the complications that can arise from forgoing treatment. The good news is it’s a very effective procedure. The chance of the vein reopening is extremely slim, and if you treat it early enough, you can almost completely undo the damage.
I certainly didn’t expect to be treating varicose veins on the shy side of 30, but I know it’s important that I take this condition seriously — and not just because I now feel confident wearing skirts instead of covering up with longer hemlines. More important than my summer wardrobe is the fact that I can move through my day lighter on my feet (literally), no longer feeling heavy, sore and swollen. I almost forget what it was like to live any other way.