Vascular diseases are often encountered in medical practice. If a vein pops out in your leg, what should you do in such a situation? This condition most often indicates varicose veins. The entire human body is penetrated by various blood vessels: arteries, veins, capillaries. The lower extremities are very well supplied with blood, since the legs bear a high load. Varicose veins are a very common pathology among females. This disease poses a potential danger to human health and can cause disability. What is the etiology, clinical picture and treatment of varicose veins?
A large number of women experience symptoms of varicose veins throughout their lives. Varicose veins mean a pathology of the veins, in which there is dilation of blood vessels, their tortuosity, and the function of the valves is impaired. Blood flows through the human body in a certain direction. This is ensured by pressure, as well as valves. With varicose veins of the lower extremities, the function of the valve apparatus is disrupted, against the background of which the blood flow changes. Most often, this disease is diagnosed in women. According to statistics, the disease is present in varying degrees of severity in more than half of all women. The disease tends to be chronic.
If a vein is swollen, the main reason is the backflow of venous blood. Excess blood leads to stretching of the walls of the veins of the lower extremities. With prolonged hypertension, chronic venous insufficiency gradually develops. In advanced cases, all this can cause the formation of trophic ulcers on the skin. Varicose veins can go unnoticed for a long time. If the veins in the legs are swollen, this indicates the progression of the disease.
If a vein has popped out in the lower extremities, the reasons for this can be very diverse.
The main etiological factors for the development of varicose veins of the lower extremities are:
Veins in the legs are an occupational disease. Persons whose profession requires long periods of standing or sitting are more susceptible to varicose veins. This group includes salespeople, cashiers, waiters, hairdressers, and office workers. Recently, the incidence of this pathology has increased. This is partly due to wearing uncomfortable shoes and clothes. This is especially true for women who always try to follow fashion trends, while neglecting their own health. Wearing high-heeled shoes, tight jeans or trousers, or tight clothes are all risk factors for developing varicose veins in the legs. Varicose veins can be inherited. The risk group includes people whose close relatives suffered from this vein pathology. It is not uncommon for the veins in the legs to become dilated and thinner during pregnancy. This is facilitated by changes in hormonal levels and increased stress on the legs. An exacerbation of the disease is often observed during childbirth.
Predisposing factors for the development of varicose veins in women and men are:
Symptoms of the disease most often appear in adulthood (over 35 years).
The disease occurs in several stages. Stage 0 is characterized by the absence of external signs of varicose veins. Research also does not give a positive result. During this stage, a person experiences pain in one leg or both legs at once, swelling, cramps at night, or heaviness in the lower extremities. At stage 1, the vascular picture of the legs changes. At stage 2, dilated veins can be noticed. They can be identified as bluish nodules located close to the surface of the skin. At stage 3, the main symptom of the disease is severe swelling.
At stage 4, the development of eczema and lipodermatosclerosis is possible. Stages 5 and 6 of varicose veins are the most severe. With them, ulcers can form on the skin. In severe cases, the deep veins of the legs are involved in the process. Common symptoms of the disease are:
If your leg hurts due to varicose veins, what should you do? If swollen veins are visually detected in the legs, the patient needs to be examined. Diagnostics includes external examination, Doppler sonography, and transillumination of superficial veins. Treatment of swollen veins in the legs can be conservative or surgical. The main method of therapy is surgery. Radical and minimally invasive operations are currently being performed. The first group includes removal of pathologically dilated veins (phlebectomy).
Currently, minimally invasive interventions (laser and radiofrequency coagulation, sclerotherapy) are increasingly used to eliminate pathology.
During sclerotherapy, a special substance is injected into the lumen of the vessel, which leads to gluing of the vein. Such a vein cannot perform its function and does not participate in the conduction of blood. This procedure has some limitations. It is not performed for large nodes in the leg area.
Unlike many other vascular diseases, varicose veins cannot be cured with medication; you can only stop the progression of the disease and eliminate the main symptoms. Swollen veins indicate an advanced process. Conservative treatment is in addition to surgical treatment. Conservative therapy may include the use of medications in the form of ointments and gels, venotonic drugs, compression of veins, and reduction of the permeability of small vessels. Ointments and gels can be effective only in the early stages of the disease, when the nodes are not visible.
If venous insufficiency develops, the doctor may prescribe medications that increase the tone of the veins. These include Detralex and Venarus. These medications reduce the risk of blood clots later. Vitamin P (rutin) is used to strengthen blood vessels. Conservative treatment can be organized when preparing the patient for surgery or during the recovery period.
Sick people are advised to wear special compression bandages or stockings. For varicose veins, it is best to use bandages of low and medium elongation. They, along with compression hosiery, create increased pressure on the walls of the veins. In case of formation of ulcerative defects, a special elastic bandage is used.
Thus, varicose veins are a chronic and progressive vascular pathology. In the absence of proper treatment, motor activity is sharply limited.
Prevention of the disease consists of limiting physical activity, increasing physical activity, performing gymnastic exercises for the legs and massage, normalizing weight, maintaining a healthy lifestyle, and wearing comfortable low-heeled shoes. To reduce the load on the lower extremities, it is recommended to wear compression garments. If you follow all these rules, the veins will always be in the right tone, and the disease will not develop.
Many people experience periodic pain and a feeling of heaviness in their legs throughout their lives. For some, problems persist for a long time, which causes discomfort. Why does a person have a condition when he feels like a vein in his leg is pulsating?
Fluttering veins can be due to a problem in the bones and muscles, or to the nerves.
Factors that provoke the appearance of pulsation of the veins of the lower limb:
If numbness is added to the fluttering of the veins, then this condition indicates developing neuropathy (a problem with the nerve) or the occurrence of tissue ischemia (lack of blood flow to the affected area).
Pulsation in the legs sometimes masks muscle contractions (fasciculation) rather than problems with the veins.
The symptoms are similar to a pulsating vein. Usually the twitching goes away on its own. Despite the fact that muscle fluttering may appear for several years, fasciculation does not threaten health. If the patient observes weakness in the muscles and changes in motor function in the legs, then there is a reason to consult a doctor.
Benign muscle contractions may be a consequence of a lack of magnesium in the body. Constant stress, playing sports with increased stress, alcohol abuse, and hypothermia can also cause twitching in the legs.
Such pain can occur at any time of the day.
If the causes of venous pulsation are not known and there are doubts about which specialist physician to contact, then you need to consult with your local doctor.
After the examination, the specialist will establish an accurate diagnosis and advise further actions. The choice of equipment in modern medicine is quite large (ultrasound, MRI, CT, ultrasound).
If you suspect pinching of the sciatic nerve or nerve roots of the spinal cord, you must take an x-ray of the lumbar spine. You should not delay treatment of the disease, as this is a direct path to lameness, pain when moving and muscle atrophy. Weakness in the limbs and impaired joint mobility can also cause pinched nerves.
If you have varicose veins, you need to consult a phlebologist.
A neurologist treats diseases such as pinched nerves.
If you suspect a neurological abnormality rather than muscle fasciculation, you should consult a neurologist. A specialist will help you understand this problem and, if necessary, prescribe treatment.
When the pulsation radiates into the knee along the outer or front surface, the problem may be related to the nerves. If you have the same sensations in the popliteal fossa, then you cannot do without a vascular surgeon.
To prevent and reduce throbbing pain in the legs, it is worth reviewing your lifestyle and daily routine.
If accompanied by throbbing pain in the veins with a feeling of numbness in the legs (the calf is compressed), you should stop smoking and drinking alcohol. Constant stress leads to loss of vitamins, which leads to spasms and a feeling of fluttering in the veins.
With a vascular problem, poor circulation in the veins poses a threat to life (the formation of a blood clot can even lead to cardiac arrest). Therefore, if you have pain in the legs, timely treatment will help avoid complications.
In the human body, all organs are interconnected. To avoid throbbing pain in the limbs, you need to get rid of the causes that cause painful conditions.
To avoid pinching nerve endings, the following rules must be observed:
Measures aimed at preventing varicose veins:
Swimming, fresh air, walking, and diet (drinking plenty of water, avoiding foods that thicken the blood) are important as preventive measures for thrombosis of the veins of the lower extremities.
Prevention of all causes that contribute to throbbing pain in the legs comes down to a healthy lifestyle. Doing morning or evening exercises, contrast showers, giving up bad habits, cycling, massage and herbal foot baths - all these activities will help minimize the risk of foot disease.
Do not delay your visit to the doctor, because everyone knows for sure that early diagnosis is the key to successful treatment.
If you recently began to worry about problems with blood vessels that appeared in blue-red cobwebs on your legs, or in the evening a vein in your leg suddenly swelled, it’s time to find out why this happens and how you can cure diseased vessels.
Swelling of the veins, which makes the appearance unaesthetic and causes discomfort, is one of the symptoms of the disease - varicose veins. For a vein to stretch, there must be contributing factors.
Let's consider the main reasons in order of importance:
According to statistics, every third of women and every fifth of men suffer from this disease. The international community has divided varicose veins into 6 stages from the onset of the first symptoms to death. If you do not take proper measures to eliminate the conditions for the development of the disease and do not take care of your health, then you can go through all these six stages quite quickly.
Those who take responsibility for their health need to know the symptoms characteristic of venous disease in order to begin treatment on time.
Let's consider the main signs according to the stages of development of the disease:
In order not to bring yourself to the last stage of the disease, which requires radical intervention, you need to correctly assess your condition and promptly consult a doctor who will prescribe effective treatment.
The initial stage is characterized by unpleasant sensations in the legs. If you find signs in yourself and know why this is happening, then do not think that they will go away on their own. This kind of thinking is especially noticeable in men, and by this they are more likely to bring themselves to the last stage than women.
Look carefully at your life, identify the most likely causes and try to eliminate them:
However, these measures do not give immediate results. Is it possible to start treatment myself so that the pain subsides immediately?
Yes, there are things you can do without waiting to see a doctor:
After conducting the necessary examination to determine the stage of the disease, the vascular surgeon prescribes comprehensive treatment, which may include:
If the disease is at a stage where conservative treatment cannot improve the patient’s condition, then one of the methods of surgical intervention is prescribed. There are several methods for quickly getting rid of a problem area of a vein in the leg: it can be soldered, cut out, glued together, for example, sclerotherapy, laser coagulation, stripping, miniphlebectomy. The choice of method is influenced by the condition of the vein and the general condition of the patient. In practice, several methods are combined, since varicose veins usually include an entire section of vessels in different states or even several sections.
Varicose veins usually entail long-term treatment and, sometimes, require the use of preventive measures for the rest of the lives of both women and men, since the main causes lie within the body and are associated with heredity, which cannot be avoided.
Therefore, if you understand why your vessels need help, provide it in the ways that we discussed above.
Solving the issue of bloating of veins is currently not very difficult. The main thing is to take responsibility for your health, seek help in time and carry out the necessary treatment.
Question: Hello! A few days ago I noticed that a vein in my leg was pulsating. At first I didn’t attach much importance to it, I thought it was due to overwork. But after this incident, the pain continues to appear systematically. I don’t understand what could have caused the painful throbbing, because I’ve never had such problems before. Please tell me why this feeling might arise. I would like to know the reasons in more detail, since the constant feeling of pain in my legs disrupts my usual way of life. In addition, I am worried and want to know if a similar problem could cause any complications in the future.
Answer: Hello! In fact, the reason that a vein in the leg is pulsating may not only be overwork. It is not surprising that the sensation of pain interferes with normal life, because, starting to pulsate in one place, the pain can spread to nearby areas. This makes it difficult to move around.
Here are the reasons that could provoke pulsating veins in the legs:
Any of the above reasons can provoke pulsations in the legs. To establish an accurate diagnosis, you must consult a doctor. Using modern equipment, he will quickly find out if there are any abnormalities in the functioning of the blood vessels, and will also suggest what to do in the future.
Considering the peculiarities of the constant manifestation of pulsation in the legs, it is urgent to find out why this is happening. Moreover, the feeling of pain can begin to bother you not only during the day, but also during sleep.
Veins in the legs are a common problem and concern for people of different ages and genders. Veins in the legs are not only and not so much a cosmetic problem, they are a serious sign of unhealthy blood vessels.
From the school course of human anatomy we know that the circulatory system consists of arteries, veins and capillaries. Through the veins, blood, saturated with carbon dioxide and other metabolic products of tissues and cells, returns to the heart. The veins in the legs experience the greatest stress. Therefore, it is useful for everyone to know how they work and what help they need.
The venous system serves as a kind of “blood depot” - it contains about 70% of the total blood volume. And to ensure uninterrupted blood circulation, it has a rather complex structure. The veins of the legs are especially far from the heart, so they bear the greatest load and most often suffer from disease.
The veins in the legs are interconnected systems of superficial and deep veins, the communication between which is carried out by communicant veins. All of them ensure the movement of blood from bottom to top, from the periphery to the heart. This difficult task is facilitated by a muscle pump located on the lower leg and creating variable pressure in the veins.
The veins themselves in the legs (as well as other veins) have a three-layer wall. The inner surface of the vein is lined with special cells - endothelium. The middle layer consists of muscle fibers, and the superficial veins have a thicker muscle layer than the deep ones, although about 85-90% of the blood flows through the deep veins, and only 10-15% through the superficial veins. The outer layer of the vein is a kind of frame made of collagen fibers. This structure provides greater extensibility of the venous wall, which affects venous blood flow.
In order for blood to “flow” from bottom to top through the veins of the legs, despite the force of gravity, the veins have valves consisting of two valves. These valves do not allow blood from upstream to flow into downstream areas. In addition, venous circulation is helped by muscle contractions during physical activity, especially when walking. The natural movement of blood through the veins of the legs can be ensured provided that the valve apparatus works without failures, the venous walls are in good shape, and the physiological lumen of the veins changes depending on the position of the body. Violation of at least one of these conditions leads to venous diseases.
The expansion of the veins in the legs below the valve disrupts its function: blood begins to flow down (this pathological process is called reflux). Blood stagnation forms in the vessel, pressure on the walls of the vein increases, their permeability increases, as a result of which plasma penetrates through the walls of the vein into the tissue, causing swelling. This phenomenon disrupts blood circulation and in small vessels, where products of tissue metabolism (tissue metabolism) accumulate, the amount of free radicals and specific substances known as inflammatory mediators increases.
Overload of the lymphatic system appears, lymph outflow is disrupted, tissue nutrition (trophism) deteriorates, which can lead to the appearance of trophic ulcers.
According to foreign phlebologists, up to 40% of the population of developed countries suffer from various vein diseases. And Russian specialists identify signs of chronic venous insufficiency in half of the population aged 20 to 50 years. The veins in the legs are especially often affected - this is humanity’s retribution for walking upright. And since no one intends to move on all fours yet, in order to avoid problems with veins in the legs, it is useful to take some preventive measures.
The veins in the legs do not suddenly become ill: venous insufficiency and varicose veins never appear suddenly. Signs of the disease at an early stage include heaviness in the legs, especially after a long stay in an upright position, and night cramps. After exercise, swelling appears, disappearing by morning, the skin of the lower leg becomes dry and loses elasticity.
It is these initial signs that will warn you that the veins in your legs need help! In this case, following simple rules will help slow down or avoid the development of the disease:
To prevent serious disease of the veins in the legs, if symptoms of venous insufficiency appear, you should consult a phlebologist. Specialists in this profile know everything about medications for veins, therefore, based on the patient’s condition, to increase venous tone, he can prescribe a medication that will be most effective for a particular patient.
One of these drugs is Phlebodia produced by Laboratoires INNOTHERA, France. Each tablet of the drug Phlebodia contains 600 mg of the active substance - diosmin. The medicine increases the tone of the veins, reduces venous stagnation, increases the tone and frequency of contraction of lymphatic capillaries, improves microcirculation, reduces the adhesion (sticking) of leukocytes to the venous wall. In addition, the drug blocks the production of free radicals and the production of inflammatory mediators - the synthesis of prostaglandins and thromboxane. Thanks to these properties, Phlebodia is indicated for varicose veins in the legs, chronic venous insufficiency and a number of other diseases.
Depending on the type and severity of the disease, taking Phlebodia can last from 1 to 3 months, repeated courses are possible. It is especially important to note that Phlebodia can also be prescribed during pregnancy, and this is very important, since pregnancy is one of the main risk factors for the development of venous insufficiency and varicose veins in the legs.
Contraindications for the use of the drug are hypersensitivity to the components of the drug.
However, despite its effectiveness and safety, the drug Phlebodia is not intended for self-medication: its prescription and dosage are determined only by a doctor.
“Chiseled, slender” - this is what they say about the beauty of healthy legs. For those who have a vein in their leg, it’s time to start fighting varicose veins or thrombophlebitis. When blood stagnates in the vessels of the lower extremities, blue veins appear, protruding venous nodes. Early signs of disease include swelling of the lower extremities. Already at this stage it is necessary to use medications and compression garments.
Vessels with varicose veins bulge due to weakening of the walls and deficiencies in the functioning of the valves.
With thrombosis of the lower extremities, blood clots form inside the veins, partially or completely closing the lumen.
Thrombophlebitis is thrombosis with simultaneous inflammation of the venous wall.
Vessels protruding under the skin look outwardly unpleasant. With prolonged standing or physical activity, the veins become more engorged with blood. If a vein in your leg has recently popped out and is painful, then drug therapy will help. If left untreated, the symptoms of varicose veins and thrombophlebitis intensify, and discomfort is constantly felt.
Medicines help strengthen the walls of blood vessels, relieve swelling, pain and cramps in the lower extremities. However, it is impossible to completely cure the disease without changing your lifestyle. Therefore, first of all, you need to reconsider your diet, daily routine and habits.
Medicines related to venotonics and anticoagulants inhibit the development of the pathological process in the early stages. You will also need to adhere to the drinking regime and diet. To these “three pillars” of successful treatment of varicose veins and thrombophlebitis, one should add smoking cessation and physical activity.
Medicines act on the causes of the disease, alleviate its symptoms and help prevent complications. For varicose veins, angioprotectors are used to relieve spasms and improve microcirculation. They also activate metabolism in the walls of blood vessels. Angioprotectors, venotonics and microcirculation correctors - pharmaceutical preparations:
Venotonics, in addition to tablets, are produced in the form of ointments (gels, creams). Methods of use are very simple - apply the product twice a day to the affected areas of the legs and rub in gently. The most popular ointments contain troxerutin and other flavonoids, horse chestnut extracts. The advantage of these drugs is that they can be used for a long time (with breaks).
These are substances that inhibit the development of reactions that underlie blood coagulation and the formation of fibrin clots. Heparin and hirudin reduce the activity of thrombin in the blood, thereby having a direct anticoagulant effect. Heparin is included in the ointment of the same name, gels Lyoton 1000, Heparin-Acrigel, Hepatrombin. Hirudin can be found in preparations based on the extract of pharmaceutical leech.
Anticoagulants thin the blood and prevent the formation of blood clots in the lumens of blood vessels. There are direct (prescribed by injection) and indirect (oral) anticoagulants. They must be taken in the dosage prescribed by the doctor. It is strictly forbidden to shorten the interval of taking drugs or increase the dosage as they are taken; this can lead to extensive bleeding.
Warfarin and dicoumarin are produced in the form of tablets and solutions for injections. These compounds are indirect anticoagulants. They disrupt the synthesis of prothrombin in the liver. Without this substance, the process of blood clotting and blood clot formation slows down.
If a vein pops out in the leg during pregnancy, then the woman should treat anticoagulants with great caution. Warfarin is contraindicated - it can cause bleeding in the unborn child. Heparin derivatives are preferred, although data on the safety of these anticoagulants is still insufficient.
This type of therapy is used for chronic venous insufficiency and varicose veins. If a vein in the leg has popped out, compression facilitates the operation of the valves. However, this seemingly simple method has a serious contraindication - vein thrombosis. Therefore, you can use compression products for treatment only after consulting a doctor.
It is necessary to select the degree of compression of the vein depending on the stage of the disease. This can best be done by an experienced phlebologist or vascular surgeon. You can also contact a specialized salon, where consultants will help you choose the most appropriate compression level.
For varicose veins, special socks, stockings and bandages made of elastic materials are worn. At the initial stage, light compression underwear is chosen. For severely bulging veins and pain, a high compression class is used. Compression garments are put on in the morning and removed before going to bed.
Nonsteroidal anti-inflammatory drugs are famous for their analgesic effect. They can be used together with venotonics, which creates the possibility of quickly getting rid of pain, inflammation and swelling. The most widely used drugs for the treatment of varicose veins and thrombophlebitis are diclofenac, nimesulide, and indomethacin. These active ingredients are included in ointments and gels that relieve pain in various parts of the musculoskeletal system.
Taking most NSAIDs can lead to the development of ulcers and bleeding in the gastrointestinal tract. Therefore, before taking it, you should definitely consult your doctor to avoid complications.
Side effects are observed with long-term oral administration of NSAIDs; negative reactions are less observed when using rectal suppositories and ointments. The veins in the legs will become less noticeable and will not cause pain with the optimal treatment regimen. In the initial stages of chronic venous insufficiency, varicose veins and thrombophlebitis, external preparations with venotonics and anticoagulants are prescribed. For severe pain, NSAIDs are used in the form of tablets and ointments. Advanced forms of the disease are treated surgically.
Often, during drug therapy with drip administration of solutions, a seal appears on the vein. A similar symptom may appear in case of injury.
This is a sign of damage to the vessel. Often, compaction in a vein is an alarming symptom, signaling the presence of blood clots that can completely block the lumen and thus disrupt normal blood flow. In this case, we are talking about a rather dangerous disease - thrombophlebitis, which mainly affects the venous vessels of the lower extremities.
The causes of thrombophlebitis are quite varied, but they all lead to blood thickening. This process can be caused by the consumption of too spicy and fatty foods, low activity, complications of labor, and a hereditary factor. Thrombophlebitis can also be caused by inflammatory processes that can spread to some parts of the brain, causing the formation of blood clots or affecting the liver.
In any case, independent treatment of thrombophlebitis is impossible. The use of traditional methods is not able to eliminate the cause of the disease. On the contrary, the lack of professional help can cause the blood clot to detach from the vessel wall. Moving along with venous blood, the clot can easily enter internal organs, including the heart muscle, which can be fatal.
The disease is differentiated into two types: acute thrombophlebitis and chronic. Also, depending on the location of the veins, superficial and deep types of pathology are distinguished. The acute form is especially dangerous. The progression of the disease lasts only a few hours. During this time, the patient develops swelling of the tissues of the lower extremities, the temperature rises significantly, and muscle soreness is noted. Treatment allows you to quickly eliminate symptoms. However, the risk of the problem becoming chronic cannot be ruled out. Despite therapeutic treatment, the clot may remain in the vein, continuing to obstruct blood flow. Often, blood flows through other vessels, leading to their expansion, which becomes the cause of a disease such as varicose veins.
Treatment of acute thrombophlebitis occurs in an inpatient department and takes only a few days. If treatment is started with delay, there is a risk of developing a purulent process with the formation of phlegmon. That is why, at the slightest danger of exacerbation of thrombophlebitis, you should immediately go to the hospital.
Especially often, exacerbation of thrombophlebitis in the chronic form is observed in the case of a deep vessel location. Symptoms are manifested by swelling of the tissues of the legs, which increases significantly when the patient is in a standing or sitting position. At the same time, swelling quickly disappears if the patient lies down. There may be some mild pain that gets worse when you are at rest, such as at night.
Treatment of deep thrombophlebitis during exacerbation should also take place in a hospital setting. However, in this case, it is strictly forbidden to use massage and warming procedures, which can seriously complicate the course of an already serious pathology. The use of warming ointments leads to the detachment of a blood clot. If an exacerbation of the chronic form of superficial thrombophlebitis is diagnosed, treatment can be carried out at home, following the recommendations of doctors. The development of a purulent inflammatory process becomes an indication for surgery.
In the absence of exacerbation, chronic thrombophlebitis is treated with therapy using physiotherapeutic procedures and a complex of physical therapy. Doctors often advise patients to wear special compression garments that normalize blood flow in the lower extremities as a result of compression of the venous vessels. You can also use the advice of traditional medicine on the advice of a phlebologist. For example, taking an infusion made from nettle is a good blood thinner.
A couple of tablespoons of dry or fresh leaves of the plant are steamed in a glass of boiled water for an hour. The infusion is recommended to be drunk in three doses. The duration of treatment is several months. No less useful are foot baths with the addition of a decoction of marsh cudweed. In case of complications of varicose veins, you can lubricate the areas with bulging vessels with alcohol tincture of white acacia or a solution of apple cider vinegar. It is advisable to limit your usual diet during treatment, excluding fried and spicy foods, fatty fish and meats, and alcohol-containing drinks. In this case, you can guarantee quick relief from the problem and a significant reduction in the risk of recurrent blood clot formation.
Unfortunately, thrombophlebitis is a disease, the risk of recurrence of which is present throughout life. Therefore, after eliminating the blood clot, it is better to adhere to a healthy lifestyle.