Varicose Veins

Ow.  My leg hurts.  I had surgery yesterday to fix my varicose veins.

I’ve had varicose veins for over 20 years.  Every fall I keep thinking “This winter I’ll get my varicose veins fixed.”  And then every spring I think “I guess next winter I’ll get my varicose veins fixed.”

Well this year is THE year.

So therefore, my leg hurts.  Yesterday I had the first part of a two-part procedure to fix my varicose veins.  The plan is to have Part Two in 2 weeks and have my leg all healed up by summertime.

Why do we care about varicose veins?  What’s the big deal?  So my legs are lumpy-looking.  So what?

Turns out varicose veins can actually be a medical problem and not just cosmetic.  In my case, they make my leg swell and get sore and tired very easily.  If left alone for long enough, they can cause a skin condition called venous stasis dermatitis.

Stasis dermatitis happens when the veins are not functioning properly.


Many things cause the valves inside the veins to not work properly.  Gravity.  High estrogen levels from pregnancy.  Obesity.  Blood clots.  Connective tissue problems.  Heredity.  Whatever the reason, varicose veins have abnormal valves that allow blood to flow backwards.

The blood going in the wrong way makes the leg swell.  The blood cells are forced out by the pressure into the tissues and stain the skin with rust from the iron in the hemoglobin.  The skin can break down and any wounds are very difficult to heal.

As you can imagine, these problems are much more serious than the unattractive appearance of ropy, bulging veins.  And varicose veins tend to get worse as we age.

So what should you do if you want to avoid the problems of varicose veins and venous insufficiency?

Prevention is very helpful.  If you tend to be on your feet a lot for work, wear support stockings.  The moderate-compression stockings sold over the counter are helpful but keep in mind they need to be replaced regularly.  One key is, if you don’t have to work hard to get them on, they’re probably not tight enough.  And once they become easier to get into, they need replaced.

If you start to see ropy veins or spider veins, consider seeing your doctor for prescription stockings.  Any doctor can order them, but they need to be ordered from a pharmacy that carries home-health supplies.  You will need to be measured at the pharmacy to make sure your stockings fit you properly.

Follow the manufacturer’s directions for taking care of your stockings.  For instance, do NOT wash them in fabric softener.  This will soften and stretch the fibers and make your stockings stretch out more quickly.

If you start to see the big, ropy veins, your legs swell or your legs feel tired and sore after being on your feet for extended periods, see your doctor.  It may be that surgical treatment to close off and remove the veins that aren’t working properly will help the circulation in your legs.

Varicose veins aren’t serious like a heart attack or cancer, but they can certainly impact your health and affect your quality of life.  Take steps to prevent them, and if they develop, get them checked by your doctor.

QUESTION: Do you have varicose veins?  What are you doing to take care of them?


Is My STD My Fault?

This week we seemed to have a blue-light special on STD testing.  Sigh. I always feel terrible when someone comes to me worrying that they may have a sexually transmitted disease.  Even worse is when I suspect they may have an STD and the idea hasn’t even crossed their mind.

Whether they say it out loud or not, I always see the question in their eyes.  “Is my STD my fault?”

Most of the time the answer is YES.

Let me step back from that statement for a minute to clarify.  When a patient has an STD there’s a difference between BLAMING someone and JUDGING someone (i.e. seeing them as a bad PERSON), and seeing the illness as the natural consequence of a bad CHOICE.

In the vast majority of cases, STDs are the consequence of an unhealthy decision.  Everyone knows you can get STDs because your spouse cheated on you.  If someone has promised to have sex with no one but you for the rest of their life, and they cheat, that is NOT your fault.

Outside of that, you trust someone at your own peril.  There’s a management saying: “Trust but verify.”  One would do well to apply this idea to sexual activity.

I recognize the reality of the society we live in.  Relationships rarely last.  Even marriages end in divorce about 50% of the time.

However, when 80% of sexually active women in their teens and twenties will contract an STD and it’s so common we don’t even test for it and just assume it’s there, there’s a problem with the culturally accepted norm of sexual promiscuity.

Having sex with multiple partners is UNHEALTHY.

Having sex with someone before you know their STD status is UNHEALTHY.

Having sex under the influence of alcohol or drugs is UNHEALTHY.

Trading sex for drugs or money is pretty much the definition of UNHEALTHY.

So having said all that, what’s a girl or guy to do?  First of all, we need to start with some basic facts.

YOU are worth the effort to stay safe and healthy.  Your body is precious and worth the time and effort to keep it safe, healthy and protected from threats of all sorts.

When you recognize that no one is responsible for your health but YOU, it is very empowering.  It takes you from being a victim (Look what s/he did to me!) to being in control of your life and your body.  I made a bad choice, but now I can make different choices to respect and protect my body and keep it healthy.

If you are dating someone new, it is healthy and shows good self-respect to wait for sex until you know the relationship is going to last.  (I know, I’m hopelessly old-fashioned.)

If you’re sure the relationship is solid, talk to your partner about their sexual history and ask him or her to go with you to get an STD test.  Be frank about your expectations – if you’re going to have sex, you expect to be their only partner for as long as you’re together.

I know this type of conversation is HIGHLY unromantic and can be uncomfortable.  However, if you’re mature enough and the relationship is solid enough for sex, it’s a conversation that needs to happen.

If you are the person sitting nearly naked in the doctor’s office wondering “How did this happen?!” I want you to understand something.  Even though the answer to the question “Is my STD my fault?” might be YES, that’s a good and hopeful thing.

It means you are NOT a victim, and can keep it from happening to you ever again.


Hormone Supplements With Gland Extracts

I have a confession to make.  I lost it this week.  COMPLETELY lost it.

A new patient came in because she wasn’t feeling well and had some health problems she wanted to discuss.  Nothing new and unusual, right?

On reviewing her medication and supplement list, it turned out a health care provider was having her use supplements from a well-respected company that contained extracts from animal glands.

This lady was taking extracts from animal thyroid, brain, adrenal, ovary and testicular glands.  FIVE different types of endocrine glands were being used.  She had been taking them for over a year and had never had labs drawn to check hormone levels.

“What’s the big deal, Dr. Jen? These are all-natural supplements and are safe, right?”  I can hear some of you asking me this.

Well if you know me, see me in the office, or have been following my blog you know that I feel nutritional supplements are powerful medicine.  It’s like a knife that can be very useful but can cut you if you’re not careful.

So why are gland extracts dangerous?  Gland extracts contain hormones that, despite the claims of some practitioners, do NOT “balance” your natural hormones.  They replace them.  And if that “hormone replacement” goes on long enough your glands can lose the ability to produce those hormones, making you dependent on those supplements for the rest of your life.

An example from the medical side of things is prednisone.  There are patients who have inflammatory conditions that require long-term prednisone treatment.  They are known as “steroid dependent.”  Asthma, Crohn’s disease, rheumatoid arthritis, and other forms of autoimmune disease are among the many conditions that can require long-term steroid treatment.

After a period of time patients on long-term prednisone cannot come off it.  Their adrenal glands lose the ability to produce endogenous steroids like cortisol and patients taken off the steroids will die.  They have what is known as iatrogenic Addison’s disease.

My new patient has been taking supplements that contain an unknown amount of animal adrenal gland steroids (among other things) for over a year.  Without any blood tests or monitoring at all.  Now can you see why I saw red?  I was able to stay professional (mostly) but it was a near thing.

My readers need to be aware of two things.

  1. Go and check all of your supplements.  I don’t care where they came from or who recommended them to you.  If ANY of the ingredients have the words “gland extract” in them, make an appointment with your medical provider (preferably an MD or DO) and ask whether you should continue taking them or stop.  If you are told to stop them, ask for specific instructions on HOW to stop taking them safely. If you have been taking them for some time, you may need to slowly and gradually decrease the amount you take to wean off and give your own endocrine glands time to resume functioning normally.
  2. In the future if a medical professional (doctor, naturopath, chiropractor, etc.) recommends to you that you take a supplement like this (for “adrenal support,” “thyroid support,” “menopause support” or for any other reason) they need to order bloodwork before starting.  Insist that they check bloodwork, NOT saliva testing, and demonstrate that the gland(s) in question are not functioning normally.  Ask how long to expect to need the supplement and if they say you will need it for the rest of your life, get a second opinion from a medical doctor.

Taking hormone replacement is a big deal.  Supplements are not tested to the same standards as pharmaceuticals and supplement-quality hormone testing and labeling is NOT good enough.  If you have Addison’s disease (the only thing that would require you to take adrenal steroids for “adrenal support”) this is a very serious disease.  Same with hypothyroidism, ovarian failure or testicular failure.

DO NOT take supplements with animal ovarian extracts for menopause.  They contain estrogen and progesterone.  If they contain enough to improve your hot flashes and night sweats, they contain enough to stimulate breast and uterine tissue and to increase your risk of heart attacks.  You cannot get the good effects without the risks.  Anyone who tells you different is misinformed or deliberately misleading you.

There is a lot of crap out there.  Unfortunately some practitioners in their zeal to help patients feel better believe the marketing hype of some supplement companies.

Be careful, be skeptical, and above all be safe!

QUESTION: Have you ever taken supplements with gland extracts in them?  What was your experience?


Green Burial

Today is a tough day for me to be writing.  My uncle passed away 3 days ago and I’m writing from Georgia because today was his funeral.

My uncle Don Wissman was my godfather and was an important part of my childhood as well as my adult life.  He and my aunt Sue were a constant, loving, supportive presence as I was growing up.

Over the last several years Don has had a number of challenges, between two cancer battles and an ongoing struggle with COPD.  He died quite suddenly from a respiratory illness on February 1.

My father and my uncle were both members of their parish’s Knights of Columbus council and the council has a close relationship with the Trappist Monastery of the Holy Spirit in Conyers, GA.  The Monastery also runs the Honey Creek Woodlands, which is a natural burial ground on the monastery property.

My Aunt Sue and Uncle Don had purchased a plot at Honey Creek.  He was cremated after he died and today after the funeral Mass we went out to take him to his resting place.

We laid him to rest under a Georgia pine on a hilltop with the sun shining and the breeze blowing.  After the blessing and the burial we hugged and cried a little and laughed a little and shared memories of a 72-year lifetime of love and family.

It has been a learning process to see what is involved in a green burial and I think I’d like to have a green burial myself once my life journey is done.

A green burial is one in which the body is not treated with chemicals and is allowed to naturally return to the Earth.  There is no embalming if the body is buried intact.  If embalming is performed, the body must be cremated.  Either way, the remains are buried in a biodegradable container (either a plain wood casket or a wooden urn).  The remains decompose quickly and return to the Earth, and soon all that is left is whatever marker the family chooses to place.

Who chooses a green burial?  I seriously cannot see myself taking up a casket-sized chunk of real estate until the end of time.  It appeals to me to have my body become part of the trees and grass and wildlife surrounding the place where it is buried.  Many people who choose a green burial feel the same.

If you are are interested in a green burial, here are a few things to know:

  1. Green burials tend to be a lot less expensive than traditional burials.
  2. If you are considering a green burial, you should consider cremation.  Burying an intact body is definitely an option, with a biodegradable casket, but timing is trickier and should be arranged in advance.
  3. There aren’t very many natural cemeteries.  I’m only aware of one in the state of Ohio, Foxfield Preserve in Wilmot.  If cremation is chosen, there is no significant time constraint, the remains can be interred at any time.

For those of us who feel it is important to walk gently on our planet and treat it with respect, a green burial may be a fitting way to close one’s life in keeping with those values.

QUESTION: Would you consider a green burial?