Varicose veins treatment: one woman's story

New techniques can work wonders on unsightly, ageing varicose veins reveals Eve Cameron

This summer, things are different. I am wearing shorts and skirts with bare legs, rather than trousers. And I'm feeling less self-conscious on the beach. None of this is because I have lost weight, had liposuction or developed a robust who-cares-anyway attitude - but because I have had my varicose veins treated.

 

My leg veins started to look more and more visible throughout my 30s and, by the time I hit 40, my right calf had developed an ugly bunch-of-grapes look, with the veins blue, twisted and prominent. I could even see them sticking out through opaque tights.

 

What causes varicose veins?

 

Natural movement and a series of valves in the saphenous veins (the two main veins in your leg outside the muscles) pump blood back up from the foot. In healthy leg veins, the valves prevent the blood from rushing back into your legs when the muscles relax. But when your valves are faulty, the blood is able to fall back down the leg, resulting, eventually, in varicose veins. If you have varicose veins, your legs can get tired and ache, thread veins can develop and, worse, there's a risk of ulceration, so getting rid of them isn't just about aesthetics - there's a health reason too. And they do seem to run in families, but it's a myth that they're caused by standing all day (though this exacerbates a pre-existing problem).

 

The treatments

 

Before deciding what to do with my troublesome veins, two friends shared their experiences. Millie, 35, and a mother-of three, had hers ‘stripped' (the most common operation) at a private hospital. She had a general anaesthetic and was discharged 24 hours later with swollen legs that were black and blue and wore surgical stockings for 10 days.

 

"I got an infection in the incision in my groin and the bruising took months to go down," she says. "I still have an area on my right leg where the skin is totally numb. I was told that a temporary loss of feeling is often experienced but that permanent loss, although a risk, is unlikely. But veins have appeared in areas where they weren't before and the scar on the back of my knee is still red."

 

That didn't sound good. But Sally had a better experience. The 40-year-old mother-of-two got hers treated on the NHS as they were causing her severe discomfort and she had discoloration around her left ankle. The vein in the right leg was stripped under general anaesthetic and the left one was treated with foam sclerotherapy (a vein-destroying mix of liquid and gas) three months later. Although the procedures were trouble-free, she's less than satisfied with the results.

 

She says, "I have extensive broken veins around the sclerotherapy injection site and broken veins all over my legs - the NHS doesn't address these as they are only cosmetic. I'm glad that I've stopped any potential ulceration in my left leg, but I'm still in trousers for summer and very self-conscious about my legs when I take the kids swimming - it looks as though someone's scribbled all over them with blue and red biro!"

 

What's the alternative?

 

I didn't fancy going on the NHS so I did some research on having it done privately. I ended up having a number of treatments* with leading vein specialist Mark Whiteley, whose clinic is in Guildford, Surrey (www.thewhiteleyclinic.co.uk). Ten months later, my legs look fabulous! Here's what happened:

 

27 June 2008

 

An ultrasound investigation identified where my problems stemmed from, then I had the first treatment, EndoVenous Laser Ablation (EVLA), on both legs. This technique uses heat to destroy veins with faulty valves from inside, which means there's very little chance they'll grow back again. Take a deep breath now if you are squeamish.

 

My legs were loaded with local anaesthetic and a needle was passed into the vein to be treated, followed by a wire and a thin tube. Under ultrasound these were passed up the vein, which also had local anaesthetic and saline injected around it to prevent pain and protect my leg from the laser. A laser fibre was passed up the vein and, as it was pulled out, it omitted short bursts of heat, closing the vein behind it.

 

It took half an hour and I was on my train home another half an hour after that. Did it hurt? Surprisingly not. It's a bit like having a filling under anaesthetic at the dentist. You don't feel pain but you do feel tugging and movement. You also smell or taste (it's hard to say which) burning in your mouth while the laser fires, which is disconcerting. Forget keyhole surgery, this is pinhole surgery that Whiteley has pioneered. On my left leg I have a scar the size of half a grain of rice and I can't find the scar on my right leg.

Cost: a rather more painful £2,526 (one leg would have been £1,684)

 

2 July 2008

 

Next, I had radiofrequency treatment with the latest Trans-Luminal Occlusion of Perforators (TRLOP) technique, designed by Whiteley, in which, again under local anaesthetic (so zero pain), a catheter is inserted for the radiofrequency current to heat and destroy the vein. This was used to target perforator veins, which are often ignored in traditional surgery.

 

Perforating veins should take blood from superficial veins under the skin, through muscle and into the deep veins to be pumped back to the heart. When their valves become faulty, high pressure blood from the deep veins squirts out into the surface veins, causing thread and varicose veins.

Cost: It was the quickest £948 I've spent!

 

The following day

 

Now that the underlying problems had been treated, my bulging calf veins had to come out. In contrast to the high-tech procedures I'd had, my ‘phlebectomies' seemed barbaric in comparison, but it's the only procedure to do the job. A scalpel makes several 2-3mm cuts over your veins through which a hook, similar to a crochet hook, is used to pull them out. Despite having had lots of anaesthetic, the thought of what was being done, plus the quite strong tugging, made me gag.

Cost: £473

 

Three months later

 

After summer, I had two foam sclerotherapy sessions to treat the remaining veins. Best on veins that are less than 3mm wide, it pushes blood out of the vein and destroys it. It's painless, though you are tightly bound afterwards to stop blood flowing back into your veins and lumps developing. It takes 14 days for your veins to scar together and then your body breaks them down. The bandages come off after five days and then you're in stockings for nine days, which is restrictive as far as clothes are concerned.

Cost: £711 per session

 

January and April 2009

 

As I was left with some thread veins, I decided to have a couple of microsclerotherapy sessions, in which a liquid kills cells in the vein wall and your body eats away the dead veins. The surgical stockings go back on.

Cost: £279 for the first session (inc. stockings), then £263

 

The verdict

 

So, having spent £5,911, was it worth it? Absolutely. I've had a great job done and it's unlikely that new veins will develop. Audited figures of The Whiteley Clinic shows their recurrence to be 3.3 per cent per year, using the techniques I had, as opposed to Whiteley's findings that where veins have been stripped the traditional way, 23 per cent start to grow back in a year and 80 per cent within five years. My legs look so much younger. I'm enjoying the summer!

 

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