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SWOLLEN ARTERY AT BASE OF THUMB
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SWOLLEN ARTERY AT BASE OF THUMB


  MY THUMB ON MY RIGHT HAND AT THE BASE EXTENDING INTO MY WRIST HURTS, IS SWOLLEN AND FEVERISH.  THERE IS A PROTRUDING ARTERY AT THE BASE OF MY THUMB AND IS WHERE IT HURTS THE MOST.  I HAVE HAD NO INJURY THAT I CAN RECALL.  CARPAL TUNNEL HAS BEEN RULED OUT.  NERVE TESTING DONE AND WERE NEGATIVE.  I AM WEARING A SPLINT BUT THAT SEEMS TO IRRITATE MY HAND MORE.I CANNOT SLEEP AT NIGHT AND IT IS A CONSTANT ACHE DURING THE DAY WITH PERIODIC SHOOTING PAIN.  WRITING IS ALMOST IMPOSSIBLE.
I AM A MIAGRAINE SUFFER ALSO ORGINATING ON MY RIGHT SIDE IN MY EAR. MY NECK IS STIFF AND WHEN I TURN MY HEAD I HEAR A GRINDING NOISE COMING FROM THE NECK AREA. MY RIGHT SHOULDER FEELS AS IF SOMETHING IS WEIGHING IT DOWN AND ACHES.MY GRASP IS NOT GOOD.  I AM CONSTANTLY DROPPING THINGS.  I KNOW MY DOCTOR IS SLOWLY RULING OUT THINGS, BUT IN THE MEANTIME THE PAIN IS GETTING WORSE.  
I AM CONCERNED ABOUT EVERYTHING SEEMINGLY IS ON MY RIGHT SIDE.  COULD ALL THIS BE CONNECTED? I WAS TOLD IN A PREVIOUS COMMENT THAT IT MAY BE HAND/SHOULDER PROBLEM.  IS THAT A NERVE PROBLEM?  I AM A 53 YR OLD OTHERWISE HEALTHY FEMALE AND HAVE A HIGH PROFILE JOB WITH THE PUBLIC.  THESE ACHES AND PAINS ARE MAKING IT ALMOST IMPOSSIBLE TO WORK.  I AM GETTING FRIGHTENED ABOUT THE PROSPECTS OF A HEART ATTACK OR SOMETHING.
=
Reading between the lines, I gather you have had this at least a few weeks or more. Otherwise, if it was a relatively acute problem (days), I would be concerned about an infection at the base of your thumb. Chronic pain there makes infection much less likely.
I suspect you are seeing a vein, rather than an artery. Looking at my own thumb, there are superficial veins there but the radial artery is buried much deeper. Arteries pulsate, veins don't. The reason this is important is that someone should also check the possibility that the vein is clotted (a condition which may produce pain). A vein there, if clotted, is not likely to cause major trouble - it just gets reabsorbed over time without further problem.
You say nerve problem has been ruled out. If I were to examine you from scratch, I would think of local nerve injury versus nerve root at the neck. Sometimes a cutaneous branch of a nerve can be injured somehow, leading to pain in a very specific patch of skin. In such cases, there is not any other damage and it isn't worrisome for something sinister. Of course, it still hurts even if you know what it is, and your doctor should be able to figure it out and suggest something for the discomfort.
The neck and shoulder symptoms make me think of cervical nerve root problem which could explain the hand, too. How much investigation has been done regarding cervical radiculopathy? An MRI of the cervical spine might help. Comment: many patients with pain and not much else are found to have a normal MRI. This is good - implies that the problem is local irritation rather than actual damage from compression or other structural lesion.
Heart attack sure seems unlikely. None of these symptoms seems to be a warning sign. Of course, as a neurologist, I am not competent to evaluate your risk of a heart attack. If you remain concerned about that possibility, see your primary doctor or cardiologist.
If you would like evaluation at CCF, you are welcome to call 800 223-2273 and ask for 4-5559 (neurology appointments). Request a neuromuscular specialist, tell them you are concerned about a possible neuropathy or radiculopathy.
I hope this helps. Sorry about the wordy reply.
By the way, could you please use lower case in future posts? It is hard to read all caps. :) CCF MD mdf.





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