FAVA: And then one day, I needed hiking poles just to walk

In December of 2024, my left leg started to hurt more than usual. The pain started in my thigh, mainly. But also, in my knee and calf. My hip and pelvic region. The back part of my thigh, and deep inside my leg. It was a series of pains. And I couldn’t explain what happened to cause it.

The pain announced itself during a mini vacation in Montreal, Canada.

It was winter, and my sisters and I met up for a few days in this city known for its unique blend of European history and North American culture. As to be expected at this time of year, our visit coincided with particularly snowy and cold conditions.

These weather conditions are important. Not because they are responsible for the pain, but because in the first months after the onset of the pain, an array of specialists would explain my pain as having something to do with this trip, during a wintry December, walking on unsteady ground, in Montreal.

Once I got home to Tel Aviv (the flight back was horrendous – leg-wise), I set out on a circuit of medical appointments. Vascular specialists, an orthopedic specialist, a neurologist, and a rheumatologist would all write in my medical file that the pain in my left leg began in Montreal, after I walked in cold weather, in boots that were not my own (borrowed from one of my sisters), in snow.

During this time, I was left wondering why I couldn’t walk without pain, sit without pain, lie down without pain, or do anything without pain.

The diagnoses I was given ranged from overuse of muscles to underuse of muscles, intramuscular venous malformations, vascular anomalies, edema, orthopedic issues, possible arthritis, bursitis, and FAVA adipose.

It has been an excruciating 18 months of collecting medical assessments from senior doctors, often noting their skepticism of my explanations of constant pain throughout my left leg and hip -- this skepticism codified in my medical assessment reports: “Patient complaining of pain in upper thigh region, not congruent with possible calf pain,” or “Patient complaining of calf pain, not congruent with knee MRI findings.”

Because my pain didn't fit neatly into the anatomical silos, it was assumed the problem was with me, the patient, rather than the diagnoses.

According to multiple MRI scans, I have extensive posterior thigh intramuscular lesions with venous ectasia. Or, in human speak, extensive muscle lesions and tortuous veins in the back of my thigh, as well as throughout my left leg from hip to calf. Muscles affected: adductor magnus, semitendinosus, gluteus maximus muscles, and medial soleus muscle.

In December 2025, I underwent sclerotherapy to treat my intramuscular venous malformations. The procedure didn’t work; the interventional radiologist said my malformations were connected to my deep venous system and that he couldn’t do the procedure in full, though he did treat two veins in the back of my knee. The pain got worse after that procedure. Turns out this result – pain getting worse after sclerotherapy -- is often a sign of FAVA.

It would take a year and a half from the onset of symptoms in Montreal until I got the FAVA adipose diagnosis.

The FAVA diagnosis came in June 2026. It gave an explanation for the pain – which is half the battle, I guess. Just knowing what I have. However, it doesn’t take the pain away in any way.

Meaning the patient (me) is complaining because I am in constant, terrible pain. Every day.

For 49-plus years, I lived with severe venous abnormalities and lesions without knowing I had them. Now, every move is dictated by them.

My whole way of life has changed.

I walk with hiking poles. Not because I can't walk without them, but because the pain in my thigh gets so severe without warning -- and often becomes stiff, frozen, or feels like a cement block -- that it makes walking all the more painful. Moreover, without the poles, my right leg takes the strain. For a while, I was sure I had the same issue in my right leg because of the severe pain there, too. MRIs and orthopedic surgeons confirmed it was just me putting extra weight on my right side that caused it. I don’t love that I walk with poles. I try to make light of the situation. But I don’t like that I need them.

I have also started to use orthotics, which I never needed before. The podiatrist says he has never known someone to need so many adjustments on a pair of orthotics that are meant to last two years. We assume there's a correlation to the massive lesions in my left leg that are causing me to step and put weight down differently, but there's no certainty to that. The last pair lasted just 11 weeks before my foot changed, and I needed a new left orthotic.

I go to bed with ice packs. Without them, there’s no way I will be able to sleep. Even with them, I don’t necessarily sleep.

I need to change positions every 20 minutes. Because otherwise, the shooting or burning pains are too much.

I used to go on long walks. Today, it depends on my leg. If there’s a flare up, walking hurts. A lot.

So, I changed my exercise routine. I’m in the pool a lot. Walking, or walking and swimming. I also use a recumbent bike and lift weights (upper body). I know I need to do more for my leg muscles, but it hurts like hell.

I use a standing desk and a couch at work. So that I can change positions frequently. I put my feet up.

I take painkillers but don’t want to get addicted to meds. In any case, they aren't particularly effective.

I have changed my eating habits to try and eat foods that won’t exacerbate inflammation.

I am constantly reading and learning about FAVA.

And I’m desperately seeking something, anything that will relieve the pain I’m in.

I tried manual lymph drainage. It nearly killed me. It triggered a flare-up and I had off-the-charts pain for a week after one session.

I tried acupuncture. It helps my hip pain for two-to-three days at a time. Which is bliss, just ask anyone with FAVA.

I keep a log of my pain. My notes are filled with short missives: “deep left thigh pain,” “front and back of leg, killing,” and such. This is daily pain. Multiple logs per day. At all times of the day, with changing features: hard, painful lumps in the back of my thigh; deep, pulling pain in the middle of my thigh, with feelings of a cement block in there for good measure; burning in my calf; stiffness and pain in my knee; stabbing in my hip and pelvic region. Delightful, really.

Most people can’t understand chronic pain.

I know it makes people uncomfortable to hear that I am in pain.

They try to wish it away. But this isn’t a virus. It isn’t going anywhere anytime soon.

Everything I do -- from the most mundane, like cooking or taking a shower – can be the worst pain ever. No one really understands that standing to make eggs in a pan hurts like hell and takes all my energy. Or that just standing in the shower may take everything I've got at that specific moment.

I don’t want pity. I hope for understanding. I don’t always get it. Not out of malice. But because people don’t like knowing someone is in pain.

The day before that day in Montreal, everything was fine. I had leg pains. The truth is I can’t remember the last time my legs didn’t hurt. They’ve always hurt. And always my left leg more than my right. It just was what it was.

But it was never daily, excruciating, or at a point where I could barely walk. Now, every day is chaos in the left side of my body.