Men face too much pressure
Feb. 17, 2006. 01:00 AM
KEITH ROBINSON
SPECIAL TO THE STAR

It's the stuff of which male nightmares are made: as I start to change into my gym clothes I get the sense people are staring — maybe evening snickering. I have varicose veins and, to prevent my legs from swelling up like ham hocks, I sometimes have to wear compression hose. They are a prescribed medical device, I swear, but they just happen to look exactly like women's stockings, frilly lace tops and all.

I'm a typical-looking, 35-year-old sweater-and-jeans guy. But sitting on the change room bench, struggling to get my hosiery off, I must look like the world's least successful drag queen — some kind of sweaty, demented version of Anne Bancroft's Mrs. Robinson tempting Dustin Hoffman on the poster for The Graduate.

Varicose veins happen when the little valves that are supposed to help squeeze blood back up the veins to the heart start leaking. Veins enlarge and become unsightly, legs swell and become achy. It's not a serious condition, but over time some pretty gruesome complications can develop, such as weeping leg ulcers that won't heal, blood infections and even blood clots.

With the valves in my veins pulling a Valdez, the compression stockings pick up the slack, tightly squeezing my legs, preventing blood from pooling in the veins in the legs.

I didn't even notice I had a problem until I lost more than 80 pounds over a year in the late 80s. When I was heavy, my back ached and so did my legs. I just assumed it was all part of being a big, fat, out-of-shape guy. After I dropped the weight, the backaches improved, but the pains in my legs didn't. My GP referred me to a vascular surgeon, who made the diagnosis after an ultrasound.

It was really only after the diagnosis that I noticed the other symptoms. My legs would swell and ache after a long day, and if I had a bruise it would take a long time to go away. I have one enlarged vein on the back side of my thigh that runs through the back of my knee. I think because of the location, I hadn't really noticed it before.

After I got the diagnosis, I felt like I was the only guy on earth with the problem. To my way of thinking there were two groups who were supposed to suffer from this affliction: pregnant and elderly women. I was neither, and somehow the diagnosis wounded my ego.

Okay, so varicose veins aren't up there with gynecomastia (male breast growth) on the emasculatingly embarrassing disease scale, but couldn't I have been afflicted with something a little more robust and manly — perhaps a torn rotator cuff? Why is it that we think that the diseases we get somehow say something about who we are and the lifestyle we lead, even when they don't.

Having to wear those stockings just reinforced any insecurities I had. I mean, back when I was single, I used to worry when the moment came, how exactly I would explain my proclivity for wearing women's undergarments? And while I don my hose every time I'm going to be sitting on a lengthy flight, I always wonder: if this thing goes down, is this how I want to be found?

It turns out, however, that I am far from alone. In fact, one peer-reviewed study published by the University of Edinburgh in 1999 showed that more men were affected by mild varicose veins than women. Of the more than 1,500 people examined, 40 per cent of men and 32 per cent of women had some form of the condition, although it tended to be more severe in women. The researchers didn't know why, but said it was probably as a result of changing lifestyles.

"It's a lot more common problem than you think." Says Dr. Sanjoy Kundu, of the Vein Institute of Toronto, which specializes in the diagnosis and treatment of varicose veins, although he feels the condition is still somewhat more common in women than in men.

While about 70 per cent of his female patients sought treatment for cosmetic reasons, "95 per cent of men are coming in because of symptoms."

Turns out I'm in pretty good company.

"I see a lot of men who come in their twenties and thirties," says Dr. Kundu, a radiologist by training. And it gets better: many of his male patients are athletes — runners even! — who find that aching, swollen legs are affecting their performance.

With all those male varicose vein sufferers out there, you'd think someone would make something a little less dainty? Truth is they do make men's compression socks. But they only come up to the knee, and my problem is in my thigh. And they do make hose without lace, I just find they don't stay on as well.

No one knows exactly what causes the condition, but heredity, obesity, aging and prolonged standing are thought to play a role. According to Dr. Kundu, once you have them, they never go away. Aside from wearing support hose and staying off your feet, treatments used to be pretty unappealing.

"Vein stripping" involves tying off and surgically removing veins while under general anesthetic. But according to Dr. Kundu, in about one quarter of the cases, the problem will eventually occur in a different vein. Small veins can be collapsed with an injection, but that doesn't work if the problem is in larger, deeper veins like mine. In both cases, you might not like the idea of losing some of your veins, but the body is a miraculous thing and the workload is quickly spread out among the remaining ones.

In the past five years a new procedure, endovenous laser ablation has become available. Under local anesthetic, a fiber optic laser is inserted into the offending vein from the groin to the knee. The laser scars it, causing the vein to collapse and eventually disappear.

"With the procedure, there's a 95 per cent success rate and 5 per cent reoccurrence," says Kundu, who treats about 250 patients a year.

It's done under local anesthetic, and there's no lengthy recovery. Aside from the laser in the groin part, it sounds great doesn't it? The catch is, as a newish procedure, OHIP doesn't cover it, so it'll cost you about $2,500.

That's why I opted for the wait-and-see, wear-my-hose plan. Over the years, though, that's gradually given way to a more typically male approach to health: ignore the problem and hope it somehow all goes away.

Keith Robinson is a freelance writer and television producer who lives in Toronto.

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