Recent Changes in Vein Visibility and Associated Symptoms

Medical consultation regarding the appearance of blue veins on the back of the hands and feet over the past 1-2 months?

Hello Dr.
Lee, my height is 158 cm and my weight is approximately 55 kg.
I work at a computer desk.
At the end of last year, I experienced numbness in my left hand after sitting at the computer for a few minutes, and my left foot also felt numb and swollen.
I consulted a doctor and underwent a lower extremity vascular ultrasound, which showed no signs of varicose veins, and I was advised not to take medication.
I have seen two cardiothoracic surgeons and one orthopedic surgeon, but none could determine the cause of my symptoms.
The orthopedic surgeon prescribed anti-inflammatory pain relievers and muscle relaxants, but these only provided temporary relief.
Previously, I did not have visible blue veins, but in the last 1-2 months, I have noticed many prominent blue veins (3-4 mm) on the back of my hands and feet.
When my hands are flat, the blue veins are slightly visible, and when I let my hands hang down, many prominent blue veins appear.
Similarly, when my feet are flat, the blue veins are slightly visible, but when standing, the blue veins become much more pronounced, even more than on my hands.
Moving my feet gives a slight itching sensation, almost like something is moving inside.
When I stand upright with my hands hanging down, I feel swelling in my hands, calves, and soles of my feet, which becomes uncomfortable after a while.
Occasionally, I experience slight pain in a few areas of my calves, and currently, there is one prominent blue vein in my left calf.
After walking for about 15 minutes, my calves and soles swell and hurt, making it difficult to walk for long distances.
In the past six months, I have also noticed a decline in my memory.
For example, after flushing the toilet, I forget immediately whether I flushed it or where I placed things.
I forget things almost instantly, and when I remember something, I forget it again in the next moment.
I am unsure which specialty to consult and whether my symptoms from last year are related to this year's symptoms.
I am worried that my condition is worsening, and I am afraid of going to the hospital only to be referred multiple times without a diagnosis.
Could you please provide medical advice and suggest which specialty I should see? Thank you for taking the time to respond, and I wish you peace and success.

Niming, 40~49 year old female. Ask Date: 2020/06/14

Dr. Li Han reply Cardiology

Hello, regarding your inquiry about the "blue veins appearing on the back of your hands and feet for the past 1-2 months," you also mentioned your work-related activities and some associated symptoms.
"At the end of last year, while sitting at the computer, my left hand would become numb after a few minutes on the table, and my left foot would also experience numbness, swelling, and pain." You consulted two cardiothoracic surgeons and one orthopedic surgeon at that time, and none found any "significant abnormalities." The previously unnoticed "blue veins" on your hands and feet have now become apparent in the last 1-2 months.
You also observed that these "blue veins" become more pronounced under the influence of gravity, and you experience numbness, swelling, itching, pain, and a sensation of foreign objects, even intermittent limping and forgetfulness.

I understand your concerns and anxiety.
The "blue veins" you mentioned are likely superficial veins, and whether they indicate abnormal varicosities needs further evaluation.
However, based on the previous examinations by cardiothoracic surgeons, including vascular ultrasound, the possibility of deep vein thrombosis should be ruled out.
Currently, your issue appears to pose low risk, so you can feel reassured.
Nevertheless, since your symptoms span both physiological and psychological aspects, I still recommend that you seek medical consultation in person.
It would be ideal if you could get a referral from your trusted family physician.

Take care, and the Changhua Hospital of the Ministry of Health and Welfare is concerned about your well-being.

Reply Date: 2020/06/14

More Info

Hello, thank you for sharing your concerns regarding the recent changes in vein visibility and the associated symptoms you are experiencing. Based on the information you've provided, it seems you are facing a combination of symptoms that may be related to vascular issues, nerve compression, or even other systemic conditions.

Firstly, the symptoms of numbness in your left hand and foot, along with the swelling and pain, could suggest a few potential issues. Given your sedentary lifestyle, particularly with prolonged periods of sitting at a computer, you may be experiencing symptoms related to poor circulation or nerve compression, such as carpal tunnel syndrome or thoracic outlet syndrome. These conditions can occur when nerves or blood vessels are compressed, leading to symptoms like numbness, tingling, and pain.

The recent development of prominent blue veins on your hands and feet, especially when standing or with your hands down, could indicate increased venous pressure or changes in venous return. This can happen due to several factors, including prolonged standing or sitting, obesity, or even genetic predisposition to venous insufficiency. The itching sensation and discomfort in your legs may also suggest venous stasis or inflammation.

Your mention of memory issues is concerning and could be related to several factors, including stress, anxiety, or even vascular health. While it may not seem directly related to your vascular symptoms, cognitive changes can sometimes occur alongside physical health issues, particularly if there is a lack of adequate blood flow to the brain.

Given the complexity of your symptoms, I recommend the following steps:
1. Consult a Vascular Specialist: Since you have already seen multiple specialists without a clear diagnosis, a vascular surgeon or a specialist in vascular medicine may provide further insights. They can perform additional tests, such as a Doppler ultrasound, to assess blood flow in your extremities and check for any underlying venous insufficiency.

2. Neurology Evaluation: Since you are experiencing numbness and memory issues, a consultation with a neurologist may be beneficial. They can evaluate for any neurological conditions that may be contributing to your symptoms.

3. Lifestyle Modifications: In the meantime, consider making some lifestyle changes. Regular physical activity, even short walks or stretching exercises, can improve circulation and reduce symptoms. Additionally, elevating your legs when sitting can help reduce swelling and discomfort.

4. Ergonomic Adjustments: If your job involves long hours at a computer, ensure that your workstation is ergonomically designed. This can help reduce strain on your hands and wrists, potentially alleviating some of the numbness you are experiencing.

5. Monitor Your Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and managing your condition.

6. Mental Health Support: If you find that your memory issues are affecting your daily life, consider seeking support from a mental health professional. They can help address any anxiety or stress that may be contributing to your cognitive symptoms.

In conclusion, while your symptoms may seem disconnected, they could be part of a larger picture that requires a multidisciplinary approach to diagnosis and treatment. Don't hesitate to advocate for yourself in seeking the appropriate care, and remember that it's important to address both your physical and mental health concerns. I wish you the best in finding the answers and relief you seek.

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