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Dr. Andrew Rynne

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Having anxiety problem, pain in arm and found lump around vein. What should I do?

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Dr. Ashish Mittal

Psychiatrist

Practicing since :2004

Answered : 1856 Questions

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Posted on Mon, 24 Dec 2012 in Anxiety and Stress
Question: I feel like I am close to a complete breakdown, well that starts things off well doesn't it.
I found lumps in my left arm vein over my bicep a week ago that come with strain and go when it is relaxed, and since then have completely lost all sense of rational though.
Since finding these I have slowly moved into a stage of self diagnosis, and having not been able to find other people with a similar problem online I have not been able to rationalize it in my head, because of this I have lost the ability to focus on anything else.
Now I have shooting pains and spasms in the arm that started the day after I found them, and I have convinced myself that there is something wrong with my cardiac system, with the pains on the underarm related to my artery and the pains over the vein area and on the bicep to do with the visual problem of the vein lumps.
Having spoken with another online doctor he mentioned venous valves, said there was nothing to worry about and to get on with my life, sadly as I have no explanation for why I have them only on one arm and why I have aches and shooting pains, I have found myself not necessarily questioning his judgement but considering that there may be more to it, which over a period of days has brought me to a point of complete despair and frustration.
Having suffered from health anxiety in the past I am aware that many of my feelings are fear responses and although I accept that, I have not been able to break the cycle of bad thoughts. I fear my GP will not take me seriously and despite having a flight response to go and get checked out I just cant bring myself to make the appointment,
the problem with health anxiety I have always found is that no matter how many times I have been proven wrong, there is always something in my head that says, 'this time it could be real'.
I don't know whether to seek further reassurance or to force myself to get on with my life regardless of how I feel, I'm not sure If I even could.
I am scared that If I go to my GP and say I have been dealing with health anxiety that the underlying symptom that caused it will be dismissed and I will continue to live in fear of it, or it will kill me. I broke down last night and hit a point where I knew I had to at least do something! anything, and getting some practical advise on here seems like a good start.

Sorry for the essay, but thought it best to be concise and honest.
any assistance would be appreciated.

Kind regards
XXXXXXX
doctor
Answered by Dr. Ashish Mittal 2 hours later
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     31 year old male
•     Known case of Depression-anxiety related illness and fungal infection in groin area
•     Complaints of: swelling around vein, pain in multiple parts of body and health anxiety.


From your description we should suspect presence of anxiety disorder. Anxiety disorder also present as multiple pain like like somatic complaints (like in somatoform disorder) in which patient has multiple and disabling pain/other complaints with normal investigation.

Psychological issues can cause above symptoms by causing muscle spasm, as we used to have headache during tension due to forehead muscle spasm.

Other symptoms of anxiety which may or may not be present in your case: nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, muscle spasm, heaviness in body, easy fatigability, headache, sleep disturbance, palpitation and dry mouth. Let me know if you have them.

It is important to know that patient usually have following symptoms (mimicking cardiac symptoms) during anxiety: Increase heart rate, palpitation, sinking feeling in chest, chest pain and fluctuation in BP.

Anxiety is not always situational (because of stress). Many times it is biological due to biochemical changes in brain. Such anxiety does not improve by exercise or guidance or lifestyle modifications only but all these measures help in recovery with medicines.

In biological anxiety, anxiety occur without stress or not in proportion with the stress in life. Such depression occur most commonly due to lack of serotonin in brain, apart from other neurotransmitters.


Following steps and measures will help you:
-Healthy diet: Milk and fruits in diet.
-Daily morning walk and breathing exercise.
-Swelling around vein
-Get concurrent opinion from psychiatrist apart from seeking opinion from other physicians. You may require treatment with medicine and psychotherapy.


I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,
Dr Ashish XXXXXXX Mittal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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