After Decades of Unsuccessful Treatments, Woman Finds Relief from Painful Varicose Veins

Anita Nickel built a career using her muscles, but it was her veins that ultimately sidelined her.

As a construction worker, she erected bridges and other large structures, including Jacobs Field. But, in her early fifties, pain in her legs caused Anita to retire early.

“I would spend all day climbing on ladders and holding myself up with my legs, but it just got too painful. My legs hurt so bad, I couldn’t even work anymore,” she said.

Anita suffered from varicose veins since she was a teenager. Varicose veins happen when the veins become enlarged and twisted. It’s generally not considered a serious medical condition, but can negatively impact quality of life. It’s often hereditary and Anita’s mother and grandmother both suffered from it as well.

“When I was young, it felt like someone was holding a lit match against the backs of my legs. I always associated the pain with heat. I never felt like running because my legs felt too heavy. And the veins looked awful, too. I stopped wearing shorts and short skirts when I was very young,” she said. “As I got older it hurt just to step down off a curb. I had a hard time stepping onto a high step and it hurt to stomp the snow off my boots in winter. It really affected my life.”

For decades doctors told Anita there was nothing they could do, or, advised her to wear compression stockings.

“The stockings helped with the pain minimally, but only while I was wearing them,” she said.

At one point, she did undergo a stripping procedure, which is used to remove or tie off large veins, but it didn’t do enough to address the pain or ugly look of bulging veins.

In 2020, at the age of 64, Anita found University Hospitals Harrington Heart & Vascular Institute and Dr. Karem Harth.

“It can be hard for patients to know where to go for their venous condition, or to know all of the therapy options,” said Dr. Harth, a vascular surgeon. “Most people come to see me with symptoms including pain, heaviness, burning, itching and swelling. We call this medically symptomatic venous insufficiency. Patients with prior interventions that have either failed or recurred have a more challenging case which can leave them with fewer options. When I met Anita, she had both symptomatic and recurrent venous disease.”

People with medically symptomatic chronic venous insufficiency have leaky valves or valvular dysfunction which leads to venous hypertension. Their veins are floppy and stretch like balloons. This translates into pain, itching, swelling, discoloration, and a feeling of warmth or heat. In more severe disease, patients can have bleeding from their varicose veins or even ulceration.

“I was so delighted that Dr. Harth would see me because other doctors I’d seen wouldn’t even touch me, or didn’t want to even talk about options other than compression stockings. From the first moment I met her I had hope for a new treatment,” said Anita.

Under the care of Dr. Harth, Anita did receive new treatments. Dr. Harth addressed her veins with a series of staged procedures including ablation, phlebectomy, and echosclerotherapy.

“There are several different procedures that we can individualize to the lower extremity venous anatomy of the patient and their symptoms,” said Dr. Harth. “We begin by completing a comprehensive evaluation which starts with history and a physical and includes an ultrasound. Based on the information we gather, we offer one or a combination of clinically indicated procedures to get the best outcome.”

Treatment of recurrent varicose veins is not routinely available in most vascular practices, so because Anita underwent a stripping procedure in the past, she had trouble finding advanced venous disease treatment options. Dr. Harth was able to offer her therapies tailored to her recurrent symptoms and anatomy with good success.

At 66 years old, Anita says the pain from her varicose veins is almost totally gone and her legs look better than they have in decades. She continues to return to UH to further improve the appearance of her legs by undergoing cosmetic sclerotherapy venous therapies with Dr. Harth.

“Venous disease is a chronic condition requiring longitudinal care and a good understanding of venous physiology. It’s been great helping Anita achieve an improved quality of life and a boost of energy and confidence. Making a difference in a patient’s daily quality of life is extremely rewarding.” said Dr. Harth.

“I feel like I hit the lottery!” said Anita. “I would tell anyone suffering from varicose veins to come see Dr. Harth.”