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National Geographic
18-07-2025
- Health
- National Geographic
This underdiagnosed vein disorder affects 4 in 10 Americans
A nurse practitioner examines a patient with chronic venous insufficiency (CVI), a vascular condition in which damaged leg veins impair blood flow back to the heart. CVI can lead to symptoms such as swelling, skin changes, and venous ulcers if left untreated. Photograph by Michael Macor, The San Francisco Chronicle via Getty Images From tingly legs to bulging veins, these warning signs may point to chronic venous insufficiency—a widespread circulatory issue doctors say is on the rise. Swelling, aching calves, tingling, or bulging veins might seem like everyday discomforts, but they could point to a hidden problem in your circulatory system. A surprisingly common yet underrecognized condition called chronic venous insufficiency is behind a growing number of cases—and scientists say it's far more widespread than most people realize. Here are five things to know about this painful and underdiagnosed vascular disorder. What is chronic venous insufficiency? Chronic venous insufficiency (CVI) occurs when the valves in your leg veins become weak or damaged and begin leaking. 'Because veins carry blood back to the heart, these leaky valves can allow blood to flow backward or pool in the leg,' says Raul Guzman, division chief of vascular surgery and endovascular therapy at Yale School of Medicine, New Haven Hospital. Over time, this backward flow and pooling increases pressure within the veins, leading to inflammation and damage to surrounding tissues. Left unchecked, the condition can trigger a chain reaction that affects both the skin's surface and the deeper structures of the leg. Early signs and symptoms of CVI Early signs of CVI can be as subtle as a tight feeling in your calves, cramping, or especially heavy or tired legs after a long day. But as the condition progresses, symptoms often intensify and include 'pain or discomfort in the leg, swelling, and skin damage,' explains Guzman. The skin may take on a discolored or leathery appearance, become itchy or cracked, and develop slow-healing wounds or ulcers. (Scientists are unraveling the mysteries of pain.) Due to the pooling blood, varicose and bulging veins are another hallmark sign, though not everyone with CVI has them. Left untreated, CVI can lead to increased venous pressure, more serious conditions, and even blood clots. Who is most at risk for CVI? Despite its low profile, chronic venous insufficiency affects an estimated 40 percent of Americans, according to the Society for Vascular Surgery. It's especially common in women over 50 and those who are pregnant. But men aren't immune, particularly if they lead a sedentary lifestyle or are living with obesity. It's also prevalent in individuals with a history of deep vein thrombosis or other venous diseases. 'We know that there is a hereditary component to CVI,' says Guzman. (Why heart attacks are rising in young adults—and what to watch out for.) Smoking and high blood pressure can also contribute to the condition. So can jobs that require prolonged standing or sitting because 'may cause blood to pool in the legs, increasing pressure on your veins,' says Marie Robert, a surgical pathologist at Yale School of Medicine, New Haven Hospital. Why CVI is often misdiagnosed One of the biggest challenges with CVI is that its symptoms are frequently misinterpreted. Swollen legs may be attributed to aging or fluid retention. Varicose veins are often seen as purely cosmetic, and skin changes may be mistaken for eczema or unrelated irritation. But ignoring these signs can allow the condition to worsen, Guzman says—sometimes even resulting in irreversible damage. That's why it's essential to consult a healthcare provider, such as a vascular specialist, if even minor symptoms persist or worsen. Robert says that a simple physical exam and either an magnetic resonance angiogram (MRA) or ultrasound are usually all that are needed to determine whether CVI is present and what treatment may be required. The good news is that CVI is highly treatable, especially when caught early. Doctors often begin with conservative approaches, such as suggestions to elevate your legs above your heart during the day and using compression garments to improve blood flow. 'The first method of treatment involves the use of elastic compression stockings,' says Guzman. (The ability to reverse damage to your lungs and heart is tantalizingly close.) Lifestyle changes, such as weight loss, improving diet, regular exercise, and avoiding prolonged periods of sitting or standing, are also frequently recommended. All such recommendations 'help ease swelling, improve circulation, and relieve symptoms,' says Robert. Medications such as blood thinners or diuretics may also be prescribed to reduce swelling or improve blood flow. 'And there are several surgical procedures and more advanced medical interventions that can be performed,' adds Guzman. These include sclerotherapy (an injected solution that causes the affected veins to collapse and fade), vein stripping, angioplasty and stents, endovenous ablation (a minimally invasive procedure using heat or laser to close off the affected veins), or surgical removal of malfunctioning veins. 'Use of these treatments depends on the location of the involved veins and the degree of the problem,' says Guzman. As awareness of chronic venous insufficiency grows, so do opportunities for earlier detection and more effective management. 'For many people, CVI is annoying and uncomfortable—but not usually life-threatening,' says Robert. 'It's a condition that can be helped by a variety of lifestyle changes and mild interventions.'
Forbes
20-05-2025
- Forbes
Six Peaceful Places In Silicon Valley Where You Can Actually Unplug
Hikers make their way up and down the rolling paths of the, "Dish" trail on the Stanford University campus in Palo Alto, CA Photo by Michael Macor/ San Francisco Chronicle (Photo By Michael Macor/The San Francisco Chronicle via Getty Images) Silicon Valley isn't exactly known for being chill. Stanford's acceptance rate hovers just below 4%, and getting your toddler into Bing Nursery School might be even tougher. Even the dog parks are full of Type-A retrievers perfecting their agility skills like their fluffy futures depend on it. From Palo Alto to San Jose, burnout is practically a badge of honor. Founders boast about 'biohacking' their sleep. VCs wedge in mindfulness sessions between morning pitch meetings. But for those craving a deeper kind of off-switch, there are still places in the Valley where you can genuinely unplug. So let's go. Take a breath and power down (after you finish reading this, of course). What follows are screen-free sanctuaries designed to help you loosen Silicon Valley's grip, if only for the weekend. Shashi has complimentary wine and cheese hour, a pantry loaded with treats and a pool and spa to shake away all of life's pings and dings. Shashi in Mountain View sits quietly between a Google campus and Stevens Creek Trail. Technically, the 200-room hotel is in the heart of Silicon Valley (you can also walk or take the free bikes to Intuit, NASA and Microsoft), but in spirit, it's somewhere else entirely. Forest-toned interiors, a courtyard pool, happy hours with live jazz, hallway scents to calm the nerves. Clearly, someone got the memo that here, productivity can wait. In a chic space downstairs, Broma offers a Spanish-inspired menu curated by Michelin-starred chef Jarad Gallagher, whose acclaimed Chez TJ restaurant in Mountain View kept its star for eight years. And the hotel's wellness spa has a sauna, steam room, and Jacuzzi, ideal for dissolving any lingering thoughts of the 36 open tabs waiting for you on Monday. This is what Silicon Valley would feel like if it stopped checking its metrics for five minutes. The trails around the Stanford Dish communicate calm and timelessness. The Stanford Dish, overlooking the campus, is where you go when your brain feels overclocked and you need a reset that doesn't involve control, alt or delete. The 3.5-mile nature loop winds through Stanford's rolling hills, past grazing cows, the occasional curious deer, and the giant Cold War-era radio telescope the place is named for—the dish was originally built in the 1960s to track Soviet satellites. Now it mostly listens to weather patterns and space noise, which to me feels like a suitable metaphor for trying to work in tech these days. From up 'there,' you can see all the way from the Bay to the Santa Cruz Mountains, and you start to remember that these hills have been here long before Google or Meta, and they'll still be here when whatever version of ChatGPT we're on gets replaced by something even more disruptive. Pool in formal garden. Filoli, Woodside, California. It's part of the National Trust for Historic Preservation. Filoli, in Woodside, doesn't feel like Silicon Valley at all. Once the private estate of a wealthy gold mine magnate, this 654-acre property now functions as a living time capsule of flowery opulence. Stroll through meticulously designed formal gardens, wander the orchard path under century-old trees, or lose an afternoon (and your worries) under a canopy of wisteria. Inside the historic house (some may recall it from Dynasty or Heaven Can Wait), you'll find rooms preserved from the Great Gatsby era. But the real draw is outside, with roses taller than your inbox backlog, and fountains that gurgle with dignity, and wide lawns where you can sit and do nothing for as long as you want. There's also a shady café for pastries and lavender lemonade, and trails that stretch into the surrounding nature preserve if you want a little less prim, and a little more wild. It's hard to believe Hidden Villa is only 15 minutes from the boardrooms and kombucha bars of Palo Alto. This 1,600-acre nonprofit farm and wilderness preserve in Los Altos Hills celebrated its 100th anniversary last year, and it feels like it's existed in a parallel universe ever since. You can spend the day wandering oak-lined trails, feeding goats, watching udders get milked, or sitting under a tree while chickens cluck around like they own the place (because they kinda do). There's an education garden, shaded picnic tables, reptiles to meet, and crappy cell reception in the best possible way. Very little here is branded or curated; Hidden Villa just is. Breathe that in! It's a gentle reminder that not everything around Silicon Valley needs to scale. Red bridge over a man made pond, Japanese Friendship Garden, San Jose, San Francisco bay area, California In San Jose, the Japanese Friendship Garden is the anti-notification—a gorgeous space that is profoundly unconcerned with your to-do list. Set on six acres within Kelley Park and modeled after the Korakuen Garden in Okayama, Japan, the Friendship Garden has koi ponds, wooden footbridges, burbling waterfalls, and paths designed for more for strolling than power walking. You won't find loud music or vendors or selfie sticks. But if you're in need of trees, water, and an excuse to leave your phone in the car and not log into anything for an hour, this is your place. Just south of San Jose (in Campbell), Float Station is where you drift for an hour inside a watery pod without dings, distractions or gravity. There's a reason this place gets hundreds of five-star reviews: The futuristic facilities are sleek and spotless, the staff is gracious and well-informed, and the experience of floating your cares away is instantly addictive. It's also good for you. There's tons of research (just ask them to share it—no doubt it comes from Silicon Valley) on how floating can help you shake off arthritis, insomnia, PTSD, generalized anxiety disorder and whatever else made you sign up to bob inside a glow-y clamshell for 60 minutes. ALSO ON FORBES
