Brief Answer:
Very happy to hear that you are in peak health

Detailed Answer:
Hello and many thanks for your question here on this network. I understand that for the past couple of months you've been experiencing an odd/throbbing feeling in the hands and neck which to me gives me the sense of a HEARTBEAT going on in your hands and/or neck. Is that another way to describe what you're feeling young lady? Rhythmic? Low level intensity? Not painful, Not numb, not tingly? Not in your head, not in your eyes...but rather the hands. Wrists as well?......Just pulsing....Ba-Boom....Ba-Boom....Ba-Boom....in synch with your heart rate?

In the neck does it seem to be right or left sides? Does it pulse along with the hands? Can you either SEE or FEEL the neck bounding near the collarbone area if you were to look carefully in a mirror? Or is it deeper than that? Do you HEAR the pulsation in your head at all or is it strictly a FELT sensation?

Well, in all likelihood but your initial description of things my initial impression of this problem is that the cause is NOT LIKELY a significant PHYSICAL PROBLEM or at least not something that can't easily be corrected.

Here are a few quick things to consider whenever you feel a bounding or throbbing sensation in an area of the body that you're not used to feeling in the ABSENCE of heavy exertional exercise/working out, etc.

1. Dehydration (are you losing a lot of fluids during the day that you're not replacing?)
2. Increase in blood pressure either due to position of the body, medications that cause retention of water, or medications that can cause increases in blood pressure or cardiac palpitations).
3. Development of an aneurysmal swelling in a blood vessel that is close in territory to the sensation or visibility of the bounding/throbbing area.
4. Psychological stress or tension that may have either ACUTELY or insidiously developed (especially at night when things are much more quiet and one's attention is easily focused on such a body symptom).

And there are other reasons as well. A more extreme example of psychological stress that could easily cause bounding pulses or sensations is that of a PANIC ATTACK. Of course, you didn't mention any symptoms of such an entity but can you think of anything very stressful, scary, or sad that has happened in the past few months or the last year involving family, friends, coworkers, neighbors, etc. which have gotten you thinking about them or even about yourself? Sometimes this can happen very unobtrusively and without knowledge of the person feeling the symptoms. Of course, since the symptoms are occurring at night there really wouldn't be much of a way for you to tie together your thoughts about whomever you may be thinking to the symptoms....especially if you may not even directly be thinking about them.

So, in a healthy person with no other medical conditions, medications to report, allergic reactions, or mental disorders--- excessive psychological stress causing nocturnal elevations of blood pressure and felt as a bounding pulse in some part of the body is the MOST COMMON EXPLANATION of the problem. Usually, these are easily addressed and only last a temporary period of time until the stressor or stressors are identified and managed appropriately.

However, several other ORGANIC causes to think about would be:

1. HORMONAL CHANGES that could be heralding the "change of seasons" which in a 49 woman may be signaling the beinning of the menopause. Is that possible? Are your periods becoming more irregular in any way either with respect to frequency, timeliness, or amount of bleeding? Are you PMS'ing at all...or more than usual....or even LESS than usual (which most people wouldn't even consider compliaining about but nevertheless can represent a fluctuation in hormonal regulation).

2. Fevers (even low grade)...any hot flashes from possibly #1 just above?? How about just checking your temperature at night just for the heck of it? It would be interesting if you were to discover a nighttime elevation of temperature from the normal 96.8 degrees Fahrenheit to something along the lines of 99.3-5 or even 100 which you probably wouldn't even notice. I'm sure if it were higher than 100 degrees...you'd feel something odd.

3. CARDIAC ARRHYTHMIAS such as atrial or ventricular tachycardias or significant junctional arrhythmias.

4. HEART DISEASE due to peripheral arterial disease....I notice that you are 168 lbs. but you didn't say what your height is so I cannot get an idea of your Body Mass Index (BMI) which would help me determine a little bit about your risk for coronary artery disease. And although you did say that you were in peak health I must include this cause as a reason for bounding pulses....because my dear, IT IS.... right?

5. CARDIAC VALVULAR PROBLEMS- Especially AORTIC VALVE insufficiency.

And those are the primary organic causes of a bounding pulse....usually such symptoms are self limited and tend to go away on their own. If, however, you have been steadily having these sensations for the past couple of months may I suggest the following:

See your primary doctor who can perform first and foremost a good physical examination to see if they can perhaps even detect the bounding pulses you are mentioning. See if your doctor would be willing to send you for some labs to include a profile of your CBC to check for evidence of an anemia, electrolyte imbalance, or other organ insufficiency that was unexpected. I'd also want to have some hormonal balances checked such as thyroid, adrenal, AND OVARIAN (i.e. could menopause be knocking on the door?--- probably not if you tell me that you either don't have your uterus anymore or have had some other type of surgery or are already on female hormone replacement....HAHA!

Say, you couldn't be PREGNANT COULD YOU? That would be an EXCELLENT reason for bounding pulses noticeable at night. LOL.....Heck...don't know whether to congratulate you or not if this turned out to be the case! HA! But, honest to goodness,.....this can be a reason for bounding pulses since the intravascular compartment volumes will increase during pregnancy causing a relative rise in BP and when one is supine (notice I didn't say YOU) pulses may be more noticeable.....

Finally, if nothing else is panning out with the hormones, hydration, nor pregnancy thought....perhaps a good cardiovascular evaluation would be in order where your BP's can be monitored at night as well as your rhythms (Holter Monitor x several days...or even 1-2 weeks if necessary). I would also make sure you got a good ECHOCARDIOGRAM which details the heart valves. I'd also send you for an ULTRASOUND of the aorta looking for any type of aneurysmal swelling in either the carotid system or the aortic system.

If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'd also be very interested in knowing followups on your condition so please drop me line either way and let me know what's going on!

This query has utilized a total of 65 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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