Bulging veins & leg pain = I'm dying? Or what?
November 4, 2011 6:57 AM   Subscribe

Bulging veins and pain. Am I dying? And if not, what is going on?

I'm traveling away from home and trying to decide what to do about a medical question. You are not my doctor!

So here's the deal. I'm a tall, pale woman (32, thin, fairly fit) who's always had some visible veins. A month ago, I began to notice that the veins on my arms and hands seemed a lot more visible than usual, wider and more ropey. It caused me a little alarm but I figured maybe it was just part of aging. Sometimes I felt like there was too much blood inside my body, which was weird. But I had my blood pressure checked around that time and it was normal.

Two weeks ago, developed a pain in my inner right thigh. I could feel it in two different places, a pinching/throbbing, not intense but definitely noticeable. Not in a joint and not seemingly in a muscle. Vein pain? At the same time, veins towards the inside of my right shin were popping out, especially after a shower or workout, like they do. I'd long had what looked like a few broken valves there (varicose vein caused by running on pavement, is my hypothesis), but they seemed to be getting worse, and more of them, connecting to each other. And they looked more blue than before, even when they weren't bulging. More alarming!

I've been tracking the pain since then. It never gets to an unbearable level but it also hasn't gone away. The thigh hurts less now, but the ankle began hurting: feels like a bruise but doesn't look like one. That pain now seems to be creeping up the shin. Sometimes the back of the knee hurts too.

I haven't been to the doctor yet primarily because I've been away from home this whole time and will be for one more week. I'm staying with family, completing a major project (book!) to deadline, so I don't have a lot of time to spare. But the problem doesn't seem to be going away either, and it's upsetting and creeping me out. I called my doctor back at home about a week ago when I was afraid it was a blood clot. He told me it doesn't sound like one to him, that there'd be swelling and/or a hard mass. Though I've also read they often don't cause any symptoms at all.

Bulging veins + roving leg pain + maybe varicose vein in the leg = What could it be? I've been under a lot of stress lately (for months, really), and wonder if that could play into it and whether it makes it likely that things will get better when stress abates. I've stopped running as of about two weeks ago, started taking horse chestnut, sometimes aspirin. Am I just getting ordinary varicose veins and being cranky about it? Could it be something else up w/ my circulation? When I do make it to the doctor, what should I ask? Is there any reason I should try to see someone within the next week rather than waiting? I don't exactly feel like E.R. material. Family belongs to an HMO so seeing their doctor isn't really possible. Thanks for any help!
posted by toomuchkatherine to Health & Fitness (15 answers total) 2 users marked this as a favorite
Flying alot?

Deep Vein Thrombosis maybe?
posted by empath at 7:00 AM on November 4, 2011

Response by poster: Haven't been flying a lot, don't smoke, don't use oral contraceptives.
posted by toomuchkatherine at 7:05 AM on November 4, 2011

If I were you, I would go to the ER. It sounds very much like a blood clot. And it doesn't matter what your doctor says over the phone he can't diagnose without seeing you.
posted by zia at 7:16 AM on November 4, 2011

Seeing a doctor would be worth it if only for the peace of mind, which in turn would probably save you time in finishing your book and making the deadline...
posted by Ms. Next at 7:22 AM on November 4, 2011

Go to the ER right now. Now now now. There are a variety of completely benign explanations for this, but it does sound like it could be an atypical blood blot. Here are things to consider:

1. Did you fly to see your family? As a tall person, you're more contorted when you fly, which raises the probability of a clot. Are you on birth control pills or any other medication which raises clot risk? Has anyone else in your family ever had a blood clot?

2. At the ER, they will almost certainly do an ultrasound. They should do an ultrasound of both your thigh and your calf, tracing the pathways of the major veins. You can still have a DVT even with a clear ultrasound, but it becomes much more unlikely.

3. This is not official medical advice at all, just something that I do as a total hypochondriac: I take an aspirin before flying, keep hydrated, stand up once on any flight and do toe-flexing stuff. I also take frequent breaks on road trips.

You may, of course, just have tall pale person luck. I'm a short pale person with delicate skin and OMG, the veins.
posted by Frowner at 7:25 AM on November 4, 2011

(oops...I missed your follow-up because I didn't preview. I'd still go to the ER, honestly. The worsening pain and pain in the back of the knee are kind of ominous. They will take it fairly seriously - I went in for weird calf pain once and they were pretty much instantly on the "let's rule out a blood clot" thing.)
posted by Frowner at 8:35 AM on November 4, 2011

Response by poster: Good to know they won't laugh me out of the E.R. Thinking it over! It would be great to know there's nothing to worry about if there is, in fact, nothing to worry about...
posted by toomuchkatherine at 9:01 AM on November 4, 2011

Seconding go to the ER. I felt silly showing up with slight abdominal cramps and leg tingling but I found out I had a serious DVT and began treatment immediately. Leaving blood clots untreated can cause serious problems later. Don't wait; go now.
posted by halseyaa at 9:06 AM on November 4, 2011

Response by poster: Okay, you've all convinced me. Going to the E.R. this afternoon. I shall report back!
posted by toomuchkatherine at 9:23 AM on November 4, 2011

I hope ER tells you it's nerve pain from back strain (which I, a short person) have all the time. My favorite is when it feels like cold oil is slowly dripping down that back of my calf. (Not an iPhone issue, it feels like cold oil as in thicker than water but cold and dripping.)
posted by Lesser Shrew at 9:48 AM on November 4, 2011

Yeah, ER is a good idea. Had a friend with similar pain, ended up being a clot, after he was pressed to go to ER they admitted him directly to the hospital that day. Better safe than sorry.

Also - as to "feeling like you have too much blood in your veins", that is an actual condition! There was a recent article by the author Will Self describing a blood disorder he has which is that: overproduction of red blood cells. One of the treatments he has is they periodically have to take out some of his blood. So definitely mention that feeling to your doc.
posted by LobsterMitten at 1:25 PM on November 4, 2011

Response by poster: Well, I'm back from my ER adventure. They did a doppler ultrasound and did not find a DVT in my leg. Happy for that result, though a little vexed that they didn't come up with any alternative explanation for the symptoms. He was just kind of like 'well, it's not a DVT, dunno what it is, you're free to go.' Guess I'll go see the ordinary doc once I am back at home.

LobsterMitten, I will look into the Will Self thing. Funny. I had actually thought of going to donate blood and seeing if that would help the feeling, at least temporarily!
posted by toomuchkatherine at 3:54 PM on November 4, 2011

Sounds a lot like chronic venous insufficiency:

Chronic venous insufficiency or CVI is a medical condition where the veins cannot pump enough oxygen-poor blood back to the heart.[1] It is sometimes referred to as an "impaired musculovenous pump", this is due to damaged or "incompetent" valves as may occur after deep vein thrombosis (when the disease is called postthrombotic syndrome) or phlebitis. Paratroopers, utility pole linemen, and men with leg injuries can suffer from damaged leg vein valves and develop this condition. Ordinarily, women make up the largest demographic for this problem.
As functional venous valves are required to provide for efficient blood return from the lower extremities, CVI often occurs in the veins of the legs. Itching (pruritis) is sometimes a symptom, along with hyperpigmentation of the legs. Symptoms of CVI include phlebetic lymphedema and chronic swelling of the legs and ankles. The skin may react with varicose eczema, local inflammation, discoloration, thickening, and an increased risk of ulcers and cellulitis. The condition has been known since ancient times and Hippocrates used bandaging to treat it. It is better described as chronic peripheral venous insufficiency.

The running on hard pavement could have caused the kind of damage referred to in the first paragraph.

Nail abnormalities of fingers and toes can be caused by CVI, by the way, both deformities and nail consistency.

The great saphenous vein runs close to the surface along the inner thigh; the throbbing pinch points you feel could be damaged and incompetent valves that are allowing backflow.

If you are very flexible in addition to being tall and thin, you could have some level of a hypermobility syndrome such as Marfan's, for an extreme example, due to very stretchy collagen, and those are also associated with CVI.
posted by jamjam at 4:34 PM on November 4, 2011

Mefi link discussing the Will Self article - warning, the Will Self article talks a lot about needles (he was an IV drug user in the past), so if you're needle-phobic, it's a sort of hard read.
posted by LobsterMitten at 5:21 PM on November 4, 2011

I know you mentioned your shin and thighs and some higher places than your hands and feet, but does it happen specifically when you're cold or stressed? Do your fingers and toes ever turn white or blue?

I have Raynaud's syndrome with no known cause, and often even if my fingers and toes don't turn blue (though they do that a lot), the blue veins show up a lot more. And I get the "feeling like there's too much blood," though that is usually when they are warming back up (and turning red) for me. It can be very painful, though for me it's usually only painful in winter, whereas my hands and feet change color if I so much as get undressed to take a shower. Basically my body thinks it's freezing to death, so it cuts off most of the blood to my extremities in an effort to keep my vital organs warm.

Note: the color changes are not usually as severe as the pictures on the wikipedia article. It's usually more subtle and doesn't end at a straight line. This picture from Google images is much more representative of the color changes I get.
posted by IndigoRain at 11:38 PM on November 5, 2011

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