DEAR DR. DONOHUE: Do varicose veins run in families? My mother had them, and I’m starting to get them. I’m 43. Not only did she have varicose veins, but her legs were swollen from them. What can I do to stop my veins from getting worse? — L.B.

ANSWER: Varicose veins are a family affair in many instances. Being a woman and having to stand for long periods without moving are other things that lead to varicose veins. They can be more than a cosmetic problem. Often, they lead to leg swelling, a feeling of heaviness or pain in the legs, and sometimes they’re responsible for sores arising on the legs, especially the ankles.

Leg veins face a formidable problem: They have to keep blood moving upward to the heart in the face of gravity pulling blood downward. Nature devised valves in the veins to keep blood from seeping back down. As blood passes by a valve, the valve closes. With varicose veins, the vein valves are incompetent. Blood pools in veins and stretches them out of shape.

You can keep the veins from worsening by wearing elastic hose during the day. Pressure from the hose keeps blood moving up and out of the legs. Take several breaks during which you lie down with your legs elevated above heart level. Walking also keeps blood moving out of the leg veins.

If varicose veins make their appearance, you have a number of choices to deal with them. Endovenous ablation is one. A catheter, a slender, pliable tube, equipped with a laser can collapse the veins and seal them off. A catheter that emits radiofrequency waves does the same. Sclerotherapy involves injecting the veins with liquids that cause them to close off by making their interior surfaces stick together. Miniphlebectomy is a surgical procedure done with several small incisions to remove the dilated veins. This is only a sample of the ways to treat varicose veins.

TO READERS: The pamphlet on heart attacks (myocardial infarctions) gives a detailed explanation of their symptoms and treatments. Readers can order a copy by writing: 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 address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I had a TURP for an enlarged prostate gland, which kept me going to the bathroom many times during the night to empty my bladder. The operation worked fine for that problem.

I am able to have sex, but I have no ejaculation fluid. Is that normal? If it is, why is it? — G.W.

ANSWER: “TURP” stands for “transurethral resection of the prostate.” The urethra is the tube that empties the bladder. It passes through the prostate gland and the penis. Resecting (cutting) the gland is accomplished by passing a scope equipped with instruments into the urethra. When the doctor reaches the gland, he or she is able to pare away excess tissue.

After such an operation, ejaculation fluid often passes into the bladder. That’s called retrograde ejaculation. It doesn’t diminish sexual sensation.

DEAR DR. DONOHUE: How does rheumatoid arthritis affect the eyes?

I have had rheumatoid arthritis for many years, and I take medicines that keep it in check. I had no idea that it could settle in my eyes. Isn’t this a joint disease? — M.F.

ANSWER: Rheumatoid arthritis is more than a joint disease; it’s a systemic illness. It affects many body organs and tissues in addition to joints. The heart, blood production, nerves and spleen are some of the nonjoint targets of this illness.

Rheumatoid arthritis can produce dry eyes. Or it can inflame the cornea, the clear dome over the pupils, and cause small sores on the cornea. It also can inflame the sclera, the white part of the eye.

Most doctors whose rheumatoid arthritis patients develop eye problems are referred to an eye doctor for care of this arthritis complication.

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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