DEAR DR. DONOHUE: Does “stripping” varicose veins mean they are removed from your legs? Does it leave scars? How is it performed? Please explain spider veins and their treatment. – Anon.

Stripping varicose veins has been a time-honored procedure. An incision is made in the upper leg, and the major vein that runs beneath the leg’s surface is tied off. Then the doctor inserts the “stripper” into the remaining vein. The stripper is a stainless-steel cable that removes segments (strips) of vein from the leg. After the thigh veins have been stripped, another incision permits the doctor to remove more vein strips. The incisions are not large, and the scars they leave are hardly noticeable.

Ambulatory phlebectomy (fluh-BECK-toe-me) is another way to remove varicose veins. The surgeon makes a series of small incisions and extracts smaller sections of the varicose vein through those cuts. The cuts are so small that, when they heal, they blend in with the surrounding skin and are hidden.

Sclerotherapy is another procedure to rid a person of varicose veins. The doctor injects a solution into the vein that makes it shrivel and disappear.

Endovenous Laser Treatment employs a catheter equipped with a laser that seals the vein with the heat it generates. The diameter of the catheter is about the diameter of a thin spaghetti noodle.

Spider veins are not varicose veins. They are dilated, tiny vessels. They have a small, central red splotch from which fine red lines radiate. The splotch looks like the body of a spider, and the radiating lines, its legs. Spider veins can be eliminated with sclerotherapy, electric current or a laser beam. PhotoDerm is a bright light shone on the skin that heats and seals varicose veins.

There are many more procedures. Don’t be disappointed if you do not have access to the ones described here. Plenty of others can take their place.

Varicose veins are discussed at length in the new pamphlet by that name. Readers can obtain 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.

DEAR DR. DONOHUE: Each year I have an eye exam, and my pressure is 15. This year the pressure was the same, but the doctor, after examining the interior of my eye with a light, said I have the beginning of glaucoma. Can you explain how the doctor came to this conclusion when my eye pressure is normal? – G.S.

The eye pressure you refer to is the pressure that the fluid inside the eye exerts. Normally it should be less than 21. When eye pressure is high and remains high, it compresses the optic nerve in the back of the eye. If nerve compression is not relieved, sight is lost.

Most often the process is not painful, and that makes vision loss sneak up on a person without warning. At first, side vision goes, and then central vision. I am speaking only of the more common glaucoma variety, open-angle glaucoma.

Eye doctors have learned that people with normal eye fluid pressure can still suffer from glaucoma. The optic nerve takes on the same characteristics as an optic nerve compressed by high eye fluid pressure. Up to 30 percent of glaucoma patients fall into this “normal pressure” glaucoma category.

Glaucoma, therefore, is defined by an increased eye pressure or by an optic nerve that shows destructive changes. Glaucoma detection requires a pressure reading and an inspection of the optic nerve.

DEAR DR. DONOHUE: My husband, a retired police officer, has attacks of depression and anxiety. Is there any treatment? – M.K.

Most assuredly, there is treatment. Medicines can restore normal brain chemistry to a depressed person. Talking with a mental health professional speeds the recovery process. Your family doctor or the county medical society can give you the names of respected therapists.

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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