When "Ugly" Becomes a Medical Condition or "Raise Your Voice, Woman"

We've previously established that I'm old, haven't we? Because I am. Old. Getting older by the day, and developing old lady problems.

Specifically problems related to being an old lady that's crapped out a child or two (or three). These are my legs.

Let's talk about them.

I have ugly legs. They've been ugly most of my life. Don't jump all over me for that statement. I'm not talking about their length, shape, or size. All of those things are perfectly normal. They do all the leggy things a person's pins are supposed to do (except dance, they don't do that). They're just ugly. In addition to my clumsiness leaving me with constantly evolving bruises and scars, I developed spider veins and varicose veins pretty early on. Every job I've ever had has involved many hours on my feet. That combined with a genetic predisposition to varicosities, left me with little squiggly blue marks all over my right shin by the time I was 17.

Bruises, scars, and spider veins. Hawt.

The varicose vein at my ankle appeared in college when I was a waitress/pharmacy technician, working on my feet 40-60 hours a week. I wore capris and pants for many years to hide the ravages of time and genetics. My attitude has been much more "Eh, fuck it" in recent years, but it doesn't change the baseline ugliness.

These are my legs without their camouflage. 

The right leg is way uglier than the left.

After college I got my first job as a pharmacist...again working on my feet 60+ hours a week. A little purple mark appeared at the back of my knee. A little purple mark that was constantly remarked on (by my own boyfriend/fiance/husband no less) with "How'd you get a bruise there?" Well, it's not a bruise. It's a spider vein, but thanks for noticing. My first pregnancy bought me a lovely blue number that runs down the back of my knee into my calf.

FUCK! There's new spider veins back there, too!

It's a nice calf, though, yeah? Meaty.

My third pregnancy? Two little branches at the top of my thigh. This is where shit gets real. A couple of years ago the branches got bigger, one got a little squiggly. About a week and a half ago I felt something give in my pelvis when I stood up out of a chair. Now I've got a situation. My little non-issue branches have become a big damn problem.

Don't worry, you're not getting a picture of my ladygarden.

Suddenly sitting, standing, squatting, deadlifting, walking around, riding in a car, and just about everything else had become uncomfortable. Something was wrong. Lying down is the only time it's not visible. The only time I don't feel it, but I can't just spend my life lying down. I have shit to do. My hormone cycle makes it exponentially worse. The awful bloating I get once a month is worse, too, and never seems to fully go away.

So I did what I do. I researched. I researched varicose veins and spider veins and vulvar varicosities and pregnancy related varicose veins. (Don't Google that shit, you'll regret it). I ran across a condition called Pelvic Congestion Syndrome that explains everything I've been experiencing, including symptoms I didn't even recognize as related. Pain, pressure, heaviness...even the goddamn bloating. Shit, even back pain could be related to this.

Bingo.

Being a woman is total bullshit sometimes, you know? Not only do you have to bleed for 25% of your life and all the associated pain that goes along with that, you may also have to gestate humans which literally tears you apart from the inside out. In ways you can't even imagine. PCS is most often reported in women who have had two or more pregnancies and vaginal births.

Yaaaaaaaay.

Ok, so I have a starting place. Fucking now what, right? I know what it is...but how is it treated? Who treats it? A surgeon? A radiologist? A gynecologist? 

Because everybody is a specialist, but where do you start?

Let me first say this. Once you use the words "varicose vein" as a woman, you're pretty much going to get dismissed as a nuisance. Everyone assumes you're just being vain (homonyms, bitches) and because it's summer you think your ugly legs are an emergency. The veins in my legs don't concern me at the moment except as they relate to the larger problem. They're ugly, but no uglier than my scars and cellulite. Offices only see "vein patients" once or twice a week. I was reduced to hissing "The varicosity is in my GROIN, and it is GETTING WORSE" in order to get scheduled to see anyone.

I already do all the shit you're supposed to do to prevent/alleviate varicosities. I wear compression stockings when I fly and when I'm going to be on my feet and for recovery. My body weight is utterly normal. I don't smoke. I exercise. I'm the goddamn poster child for health. AND YET.

Tell me again all the things I should be doing to prevent this. I'm taking notes.

Last Wednesday I saw a surgeon. A female surgeon. She was...mean.  Cold, unfriendly, and worst of all? Dismissive.  "I'll cut it out. Make a couple of incisions and just pull it out." Really? You don't want to do any diagnostics? No vein mapping? No CT or MRI to see if there's a larger issue? Just cut it out. I'm a powerlifter. You don't think it could just recur?  "Well, I guess it could recur." So I should pay you to flay open my mommyparts and yank out the vein...just so it can come back? And you can do what? Cut it out again? Sounds sexy. Also I'm pretty sure there's not an unlimited amount of vascular tissue down there.

Yeah, ok. Thumbs up.

I don't need touchy feely. You don't have to be nice. But for fuck's sake, you will address me as an equal. I'm a highly educated, skilled medical professional in my 40s. I'm not a child and I'm not a dummy. Beyond that, I am a human being who has come to you for help with a painful, somewhat delicate problem. I just had to sit here in a goddamn drape so you could prod me and then basically tell me to suck it up. "You've had kids, you know what pain is, you can handle it. It doesn't even look that bad, and your legs look fine." She says after examining me lying down. 

Thanks a heap, sister suffragette. Excuse me while I get appointments with literally anyone else. I got an email with a patient satisfaction survey yesterday. I can't wait to fill it out. 

Friday I went to a vein center. They only do legs. No help there. Can't really blame them I guess, ugly is where the money is.

Monday, though...holy shit. I hauled myself to Neenah to have a consult with a radiology group. I wasn't hopeful. I thought I'd probably get another "we only do legs" spiel.

But sweet chocolate Christ...they listened. I met with a NP who looked at my veins and asked me a few questions. She then began to explain PCS. I stopped her and said "You're describing Pelvic Congestion" and she looked at me and said "You have a medical background". I told her what I do for a living and she went into a detailed description of exactly what the practice can do for me. They'll set up an abdominal MRI at my very own hospital, and if it shows what I think it will, a simple intervention will occlude or ablate the abdominal varicosities, and by extension fix my pelvis. As in the veins may simply disappear on their own. No surgery. My ugly leg can be dealt with at a later date whenever it's convenient. Because I already understand what's up, I may not even have to have another visit with the Interventional Radiologist prior to the procedure. They'll just call me to discuss the findings and set up a date. 

This could all be over soon. Pending insurance approval, of course. Fucking insurance. Truthfully, I don't even care. I'll make payments until I retire to have this fixed. 

Hallelujah.

My point in relaying all of this to the internet at large is that you have to be your own best advocate when it comes to health care. Especially as a woman. The medical system is patriarchal and paternalistic. It's a lot of "Listen here, little lady, you just do as I say" and most doctors don't take kindly to questioning, especially by female patients. I mean, we're just dumb girls! WTF could we possibly know about our bodies?!? The proof of this is in the treatment for everything even remotely gynecological. Oh, you have an icky uterus problem? You should see a gynecologist, or better yet - just take these birth control pills. That'll fix it. We think. There's not a lot of research on it...or really anything else that goes on in your demon abdomen, but hey it's worth a shot! 

Even a female surgeon didn't want to offer me more than a "I'll do this, make an appointment". I had to make her sit down and listen to my concerns, while I sat half naked on a paper covered table, because that is a position of power. 

I have been very fortunate in my OB/GYN. I lucked into his practice when he was just a little baby doctor and 18 years later we still have a strong doctor/patient relationship. He can't retire until I die because he is amazing and I don't ever want to see anyone else. What sets him apart is that he listens. Find a provider who listens to you. It is so important. 

Another reason I dump all this shit into cyberspace is that so often we don't seek help for problems we see as embarrassing. Me? I'm not going to beat around the bush (TWSS, also how excellent of a phrase is that for this situation?). There could be any number of women reading this who have a similar problem and don't want to talk about it, or don't realize it could be a symptom of a larger syndrome. So I'll talk about it. I've got no one to impress and nothing to lose.  

You don't have to settle for sub-standard care. There is nearly always someone else to consult. Make them listen, and if they won't? Find someone else who will. Get a second opinion. A third. A fourth. Ask for recommendations. Don't be afraid or embarrassed. Bodies are weird and messy and gross and stupid and wonderfully magically complicated. The first answer isn't always the right one. Keep pushing. If you know that something is wrong, keep pushing. 

All I want is to be able to do the things I love to do without pain. I want to lift weights, and ride my bike, and run, and wear shorts. I want to stand on the sidelines at my kids' rugby games and not hurt. I want to be able to sit in a chair or drive my car without my damn leg swelling up or feeling like my pelvis is bruised. I'm done using my uterus, but I'd like to continue using the rest of my parts for another 40 or 50 years thank-you-very-much. I don't think that's too much to ask. 40 is the new 20...except with more wrinkles and a hip that can feel the rain coming.

If all goes well I'll have some fancy pictures of my inner workings and a couple of embolization coils. Like jewelry for my ovaries (you thought your belly button ring was hard core). What I won't have is pelvic varicose veins. 

And maybe I will have those spiders and leg veins ablated. It might be kind of nice to only have bruises and scars.