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Ask the doctor.

Q How complicated and painful is it to treat varicose veins, as mine seem to make my legs feel heavy and achy?

A Though their appearance may be unappealing, varicose and spider veins usually do not cause pain or health problems. The discomfort you describe, however, is not uncommon and can sometimes be treated without medical intervention. Mild to moderate symptoms may be managed by losing weight, which takes pressure off your veins and allows blood to flow more freely. Walking is also good exercise to help maintain healthy circulation in your legs, and elevating your legs above heart level has also been shown to be effective at relieving pressure in your legs. If a procedure is necessary, your doctor will likely order an ultrasound and thorough examination of your legs to identify possible blood clots and varicose veins that aren't visible on the surface. A procedure to destroy or remove the troubling veins can usually be done on an outpatient basis. Some treatment examples include sclerotherapy, laser therapy, endoscopic vein surgery, and vein stripping. Sclerotherapy and other surgical interventions are limited by the fact that there is a high recurrence rate after a few years. The best long-term treatment, which may at least keep vericose veins from getting worse, is the use of graduated compression stockings or fitted support hose. The most effective support hose often require a prescription.

Q Is there any way I can relieve the pain of a bunion without surgery?

A bunion, a deformity that forces the big toe out of alignment, is a common condition, especially among women. Narrow or poorly fitting shoes, and high heels in particular, can exacerbate the problem. People with rheumatoid arthritis are also at risk of developing bunions, due to inflammation and swelling in the toes. Surgery is an option to remove the bump and realign the joint. It's usually an outpatient procedure that lasts about an hour, but healing can take eight to 12 weeks and the swelling can linger for several months. However, a bunion can grow back, especially if you continue to wear ill-fitting shoes. And while shoes don't cause bunions, they are among the things you can control to help slow the progression of bunions and relieve the pain in your feet. Choose wider toed shoes with plenty of support, such as sneakers, rather than narrow, flat or high-heeled shoes. Also, make sure they're the right size--your feet tend to get a little wider and flatter as you age. Talk with your doctor about custom-made orthotics that fit in your shoe to help keep the entire foot in alignment and well-supported. Elevating your feet whenever possible can also help alleviate some pain and swelling, as can nonsteroidal anti-inflammatory drugs, such as ibuprofen. Sometimes a doctor might prescribe a steroid injection for similar relief. Finally, you may need to adjust your exercise routine to include walking, water aerobics, or stationary biking, rather than running or other high-impact activities, to help lessen aggravation.

Q I have trouble hearing people clearly when there is a lot of background noise. Is this normal with aging and is there anything I can do about it, besides get a hearing aid?

A Gradual, age-related hearing loss, or presbycusis, is very common as we age, but in most cases, it does not mean that you're doomed to a future of silence or muffled sound. Difficulty distinguishing certain sounds or conversation against background noise is especially common, as is the need to turn up the volume on the television or ask people to speak louder, regardless of other noise interference. Hearing loss in most people can be attributed to changes in the cochlea, the structure in the inner ear that helps transmit electrical signals to the brain. You should talk with your doctor as soon as you become aware of your hearing loss and discuss possible causes and treatments. If the problem is a build-up of earwax, a doctor can treat that by loosening the earwax and then scooping or suctioning it out. A cochlear implant may also help if you have profound hearing loss. And although you're seeking an alternative to a hearing aid, the truth is that the devices have improved through the years and are often the best approaches to overcoming many challenges. You'll want to work with an audiologist to find the right type of hearing aid and be prepared for an adjustment period as you get used to a louder, clearer voice.


Editor-in-Chief Bruce A. Ferrell, MD, Professor of Medicine and Geniatrics
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Title Annotation:treating varicose veins; treating bunions; old age hearing
Publication:Healthy Years
Geographic Code:1USA
Date:Feb 1, 2009
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