DEAR DR. DONOHUE: I need information about chronic venous insufficiency. I understand that the blood goes down my legs but my veins don’t carry it back to my heart. This leaves very unsightly legs. I was given compression hose to wear. I tried two different kinds. They both made my legs worse. Can anything be done for this situation? — J.C.

ANSWER: All veins have valves in them. When blood passes through the veins, their valves close so that the blood keeps moving onward to the heart. Leg veins, in particular, have a tough job getting blood out of the legs and back to the heart. They have to overcome gravity. Their valves make this feat possible. With age, leg veins often are stretched out of shape, and their valves are no longer competent. Blood moves back to the heart with greater difficulty, and it pools in those leg veins. They’re stretched even more. This is chronic venous insufficiency, a more precise name for varicose veins.

Compression hose put the squeeze on leg veins and keep blood moving upward and out of the legs. You need compression hose that are specifically tailored for your legs. Your doctor can write you a prescription for them.

Compression isn’t the only treatment. When walking, your leg muscles contract, and the contractions keep blood moving onward and upward. You ought to aim for 30 minutes of walking daily. When sitting for any length of time, get up and walk around; sitting also favors blood pooling in the leg veins.

Elevate your legs. They have to be on a plane higher than your heart. You can achieve that only by lying down and propping up your legs with pillows. Thirty minutes of leg elevation, twice a day, will keep your vein situation from worsening.

Have you talked to any doctor about varicose vein treatments? There are many ways to fix them. You’d be astonished at how easily they are taken care of these days.

DEAR DR. DONOHUE: I read where jaw pain is a sign of a heart attack. Some months ago I had jaw pain, and the pain was intense. I took an aspirin and rested. Later I saw my doctor, who had me take a stress test. It showed I had some heart damage. Chest pain and left-arm pain make sense, but not jaw pain. Why does the jaw hurt? — J.R.

ANSWER: The jaw, the neck, the shoulders and the arms (both left and right) share nerves that have a common origin with nerves of the heart. That’s why sometimes heart pain is felt in those locations. Most people feel heart attack pain as a pressing sensation in the lower middle or left side of the chest.

The heart attack booklet goes into details on heart attack symptoms and how heart attacks are treated. To order a copy, write: Dr. Donohue — No. 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am 82 and have had essential tremor for many years. I took Inderal for it. My new doctor took me off Inderal because my pulse was around 50. He says my tremor isn’t life-threatening, but the slow pulse is. I need a second opinion. My shaking is out of control. — W.F.

ANSWER: For readers, essential tremor is a common tremor, one that kicks in when a person moves his hands and arms, as in trying to get a spoonful of soup to the mouth. It can be disabling, and always is embarrassing.

Ask your doctor about trying a reduced dose of Inderal, one that doesn’t slow your heart so much but does control your tremor.

Or — and this might be a better way — try Mysoline (primidone). It’s quite effective for steadying essential tremor without slowing the heart.

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. Readers may also order health newsletters from www.rbmamall.com.

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