Put your feet up

Do you have aching legs? Then like many primary teachers, you may have varicose veins. If you get cramp and swelling in your lower legs, if prolonged sitting or standing tends to make them feel worse, or if enlarged veins are visible, it's time to buy support hose. Varicose veins are gnarled, enlarged veins close to the skin surface. The word comes from the Latin varix, meaning twisted.

In their mild form, varicose veins and spider veins - a common variation - are nothing to worry about. More serious signs can include brownish-gray discolouration on your ankle, itching around one of your veins and, at worst, skin ulcers near your ankle.

Fully developed varicose veins can be painful, and may indicate more serious disorders of the circulatory system, such as deep vein thrombosis. Any sudden leg swelling, especially if accompanied by pain and redness, needs urgent medical attention. If a blood clot has formed it may travel and - perhaps fatally - block a lung or the heart.

Varicose veins develop as a result of weakening of the veins, which return blood to the heart for recirculating to the lungs, where it receives oxygen. The veins in your legs must work against gravity. They do this by toned, elastic vein walls and by tiny one-way valves which open as blood flows toward your heart and close to stop it from flowing back. As you get older, the veins lose elasticity and the valves may malfunction, causing blood to leak backward and pool in the veins, which swell and become varicose.

You are more likely to get achy blue snakes down your legs if: you are a woman, middle-aged, have had children, are overweight, stand for long stretches of time and have a family history of varicose veins. If you have varicose veins, you can soothe suffering by: exercise, losing weight, avoiding tight clothes (no tight girdles), putting your feet up when possible and avoiding long periods of standing or sitting. Support hose (some really do look OK) help and may be available on prescription.

If you can't bear the thought of years in the classroom in support hose (and teaching Year 4 with your feet up seems unlikely), more invasive procedures can work very well. In sclerotherapy, a scarring solution which closes the vein walls is injected, forcing your blood to reroute to healthier vessels; in ambulatory phlebectomy, smaller varicose veins are pulled out through a series of tiny skin punctures. In vein stripping - probably the most common procedure - a long vein is pulled out through small incisions. All these are usually done in outpatient clinics, with a minimum of discomfort. Lasers are now used by some doctors: they leave even less scarring but can be less effective on darker skin. In more extreme cases, a surgeon uses a thin video camera inserted in your leg to direct the operation to close veins.

There is no evidence that horse-chestnut extract helps varicose veins, though a nice soak in Badedas may refresh your spirit. For really aching limbs, try five minutes' lying with your bottom against a wall and put your legs up at right angles, resting them against the wall.

www.nlm.nih.govmedlineplusvaricoseveins.html

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