There are a couple of ways to deal with varicose veins, starting with self-care. An individual can limit time sitting or standing, avoid sitting with legs crossed and may wear compression hose. If that's not enough, there are several treatment options: sclerotherapy, where injections are used to scar the vein and shut it down; or a phlebecomy, where the doctor takes out smaller varicose veins with little skin punctures. In severe cases with ulcerations, the surgeon may perform endoscopic vein surgery. One of the most common procedures is "vein stripping," a surgery to cut out the vein entirely. In all cases, the body's smart. It routes the blood a different way.

Increasingly, vascular specialists use lasers, a process called laser venous ablation. And that's the route that Hoggan chose because it's less invasive and takes only about an hour.

A number of Utah physicians use a laser to kill a varicose vein, including vascular surgeon Dr. Greg Goodman, who treated Hoggan while a reporter and photographer watched in the operating room at Mountain Medical in Murray.

The target was the long vein in Hoggan's left leg called the great saphenous vein. The goal, Goodman said, is to treat that vein through the thigh. Once it is obliterated, the blood pressure in Hoggan's leg will decrease, and other symptoms, both medical and cosmetic, will disappear.

Goodman said that's often all that needs to be done, although chronic venous insufficiency is a long-term problem, and many patients will experience it again in other veins. In cases where the problem is extensive, it's treated as a "step-wise process," Goodman said.

Using ultrasound to follow the vein, Goodman injected local anesthetic along Hoggan's leg. The local anesthetic serves another purpose, as well. It absorbs any extra heat from the laser, which will create a steam bubble inside the vein, heating the water component of the blood. It typically causes mild discomfort and a pulling sensation. The vein shuts down permanently, the blood rerouted.

After numbing the area around the vein, the laser is threaded into the vein. Just before using the laser, an assistant handed out dark glasses and they joked about being on the beach. The glasses are mandatory to protect the eyes of anyone in the room. The assistant warned Hoggan that he can get a funny taste or smell when the laser is deployed in his vein.

Then they counted, watching both time and the energy being emitted by the laser.

And just like that, it was over. The blood will reroute, the vein will die and resorb into the body and the lumps in Hoggan's leg will dissipate, Goodman said.

Hoggan was told to take it easy for a day or two, then he can go back to work, although he can't do any lifting for 72 hours.

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E-mail: lois@desnews.com