Veins, pains and ankle stains... how I ended 30 years of leg hell
The misery of varicose veins had plagued IAN HYLAND for his entire adult life. Here he explains how a revolutionary technique changed everything
I’LL never forget the words my mother said to me as I prepared to have my varicose veins removed at the tender age of 19. “I don’t know why you’re bothering. They’ll only come back again.”
She said the same thing when I had them done again in my early 30s – and when I had a third operation in my early 40s.
So yes, you should always listen to your mother. Not least when she speaks from bitter experience.
In fact varicose veins and leg ulcers have been blighting both my parents’ lives for decades.
As I approached my 50s, genetic destiny and an unsightly patch of brown staining around my ankles suggested full-blown leg ulcers were coming my way too.
My varicose veins had also returned with a vengeance. My left thigh was beginning to resemble a contour map of the Himalayas.
It was also incredibly tender – not ideal when you have two young children who mainly view you as a mobile climbing frame/ trampoline.
Plus, it was a rather disgusting sight to behold, especially if I’d been on my feet all day.
My Miss Lovely Legs days may have been long behind me, but I couldn’t help feeling more than a little self-conscious whenever I had to get my legs out for the beach or on the school run in summer.
AS SOB stories go, missing kick arounds with my kids for fear of the ball hitting my ankles probably wouldn’t get me through to Boot Camp on The X Factor.
However, it was on my list of grievances alongside having to skip music gigs because standing for long periods was an issue, constantly having to listen to people saying, “I thought only grannies got varicose veins” and being woken in the night by leg cramps.
And so, somewhat belatedly (well, I am a bloke), I decided to find out why my mother’s prophecy kept on coming true.
My online research pointed in the direction of one man: Professor Mark Whiteley, who is something of a varicose vein surgery pioneer.
Twenty years ago he became the first surgeon in the UK to use a keyhole technique to remove them. In 2010 he called for the
end of surgical stripping – the technique I’d had done on the NHS when I was 19.
Stripping uses a scalpel, requires general anaesthetic, has a longer recovery time and increases the chance of the veins recurring.
Professor Whiteley recommended the use of laser treatment instead and three years later this became the official clinical guidance from the National Institute for Health and Care Excellence (NICE). I booked an appointment at The Whiteley Clinic in Guildford and following an initial consultation, Professor Whiteley had two pieces of news.
One, the reason my veins recurred was that I’d never had a proper ultrasound scan prior to my procedures.
And two, one of the pending ulcers around my left ankle was about to erupt.
Given my medical history, he also suspected pelvic congestion syndrome (PCS).
I’d never heard of this condition, but it didn’t sound very appealing.
In short, it means you have varicose veins originating in your pelvis – from which the ones in your legs can arise, totally or in part.
It is more likely to be found in women but men can have it too.
A further scan – this time using an MRI – was required to determine whether I was in fact suffering from PCS.
Consultant interventional radiologist Dr David Beckett confirmed the diagnosis and outlined the treatment.
He spoke for quite some time, but all I heard was, “We go in through your jugular vein while you are fully conscious.” Whaaaat?!
PCS is treated by embolisation (in other words, blocking) of the faulty valves using tiny platinum coils which are put in place via a catheter.
The “popping in via the jugular” part of the plan filled me with enough dread to make me seriously think maybe I could live with varicose veins after all.
In practice the whole procedure turned out to be a piece of cake.
I showed up at the clinic one Saturday morning and relaxed on the operating table with Dermot O’Leary’s Radio 2 breakfast show playing in the background.
Local anaesthetic was injected near my jugular vein, Dr Beckett inserted his tiny catheter and got to work.
Guided by X-ray, he positioned the coils.
All the while I could witness what was happening on the X-ray monitor.
I found this weirdly fascinating. It was like following a Manchester to Norwich train on a real time rail tracker
map. There was the odd bit of pushing and prodding but the pain was bearable.
An hour later I was in a pizzeria with my family discussing the next stage of my treatment.
This was where the lasers came in. Having dealt with the suspected source, it was time to remove the varicose veins themselves.
This involved two “walk in, walk-out” procedures: EVLA (endovenous laser ablation) to treat the major veins and TRLOP (transluminal occlusion of perforators) to get rid of the perforator veins that are linked with skin discolouration and the development of leg ulcers. Given the complex nature of my varicose veins I was on the table for two hours in the morning and another two after lunch.
THE good thing about being awake for these procedures is that you can speak up if you feel any pain. Professor Whiteley prefers you to simply say “Stop” – although I can confirm he will also accept other four-letter words.
There was mild discomfort as the laser burned the veins away but in general the anaesthetic did its job.
I’m not saying I needed a lot, but by the end my leg was so pumped full it resembled one of those giant hams you see hanging behind Spanish deli counters.
Two weeks later I was back to have the other leg treated. Once that was over I was able to complete my new look: black compression stockings with black compression shorts.
As my wife pointed out, I
looked very much like a young Rudolf Nureyev. There was a serious side to it though.The stockings help control inflammation and reduce the risk of DVT (deep vein thrombosis)
– a risk that had already been substantially lowered by me being able to walk around post-op.
I had to keep the stockings on for two weeks at which point I was able to pose for my “after” pictures.
I wasn’t allowed to burn the stockings though. I needed them again eight weeks later as I underwent my final procedure, ultrasound guided foam sclerotherapy.
This was an hour-long “walk-in, walk-out” procedure which enabled Professor Whiteley to deal with the smaller veins that could cause problems in the future if left untreated.
It involved the injection of a special foam into the veins to destroy them by inflammation.
Thanks to the discomfort caused by the inflammation it was by far the least enjoyable of my procedures.
However that was to be expected given my historical scar tissue and imminent leg ulcers.
I’m certainly not complaining. In the space of four months I’ve gone from having chronic varicose veins, undiagnosed pelvic congestion syndrome and imminent leg ulcers to having no varicose veins, no PCS and a greatly reduced risk of developing leg ulcers.
More importantly, the probability of my veins coming back is now the same as anyone’s chances of developing them in the first place: three per cent.
Not even my mum could argue with those numbers.
TheWhiteley Clinic has branches in London, Guildford and Bristol. For information go to thewhiteleyclinic.co.uk or call 0330 058 1850