DEAR DR. DONOHUE: My mother had varicose veins, and now I do. She had them taken out with surgery. I don’t relish going through what she did. Are there any other ways of getting rid of them? What causes them? – R.R.

Varicose veins are veins that have become stretched out of shape. That results in blood pooling in those veins, stretching the veins even more.

Leg veins in particular have a daunting task. They have to return blood to the heart, a task made formidable since gravity draws the blood downward. Veins get the job done because they have one-way valves that close after blood has passed through them. The closed valve stops the downward flow of blood that the force of gravity encourages.

Incompetent vein valves are the major mechanical factor in the development of varicose veins. Without competent valves, blood falls downward in the leg. The pooled blood stretches the veins, and that renders the valves even more incompetent and the varicose veins even larger.

Family history is definitely at work here. If one parent has varicose veins, the children have a 40 percent chance of developing them. If both parents have them, the children have an 80 percent chance of also having them.

There are many options other than the surgical procedure your mother had. One is sclerotherapy. The doctor injects the veins with a liquid that shrivels them. Or doctors can make a series of very small incisions and remove the veins in segments. Scars are not visible after this procedure. In endovascular laser closure, the doctor inserts a catheter – a pliable soft tube – into the vein and heats it with a laser. That causes it to collapse. This is only a small sample of varicose vein treatments that were not available in your mother’s time.

The varicose vein pamphlet goes into greater detail on treatment and prevention. Readers can order a copy by writing: Dr. Donohue – No. 108, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: When I looked at my back in a mirror, I saw fairly large brown spots on it. I thought they might be melanoma cancers and saw my doctor. He called them seborrheic keratoses. He suggests I leave them alone. Do they become cancer? – R.G.

People who have 40 or more years under their belts are likely to have seborrheic keratoses. They’re oval, slightly raised, brown to black patches about an inch (2.54 cm) in diameter, and they have a slightly rough surface. Their favorite places are the back and chest. They also like the face, neck, arms and legs.

Seborrheic keratoses are not cancer and almost never become cancer. I had to put the “almost never” in that last sentence because a tiny number of reports have mentioned cancerous changes. That is not the usual story.

It’s perfectly acceptable to leave them alone. On the other hand, if they create a cosmetic problem, freezing and scraping them off is a simple procedure that gets rid of them.

DEAR DR. DONOHUE: I am a diabetic, and I pay very close attention to what I eat. I wonder if honey is off-limits to diabetics. Can I use it as I would an artificial sweetener? – C.W.

Honey contains several sugars, including sucrose – common table sugar. One teaspoon of honey has about 20 calories. That’s an amount slightly greater than 1 teaspoon of table sugar.

You cannot use honey as an artificial sweetener. You can use it if you calculate the number of carbohydrate calories it adds to your carbohydrate allowance.

DEAR DR. DONOHUE: In an answer to a question about chocolate allergy, you did not answer the question. I believe you ought to try to give the writer an answer, don’t you? – P.M.

I tried to be as clear with an answer as I could be. I said: “Some food allergies disappear with age. Peanut and shellfish allergies are exceptions.” He must have gotten the message. He has not written for a clarification.

DEAR DR. DONOHUE: My mother is in her 80s. She is active mentally and physically. She takes no medicines except for a water pill. I asked her why she takes a water pill, since she does not have high blood pressure. She said her doctor gave it to her to prevent osteoporosis. Does that make sense? -L.J.

ANSWER: Many water pills stop the kidneys from filtering calcium into the urine. So, in a sense, it makes sense.

Not many doctors, however, prescribe water pills for osteoporosis prevention. Calcium, vitamin D and exercise are the more commonly used preventive measures for osteoporosis.

Osteoporosis is epidemic among older women. Neither does it spare older men. The osteoporosis report can give you information on the process, how to avoid it and how it is treated. Readers can obtain a copy by writing: Dr. Donohue — No. 23, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 along with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible.

Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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