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Afraid I have a DVT or is it PAD? Very scared

I’m having severe leg pain that I believe is related to the huge varicose vein I’ve had all my life. I’m SUPER scared a DVT has formed or the vein is somehow becoming dangerous to me and I really need some advice and would like to hear if anyone has similar stories.

Some basic info about me:
Female
23 yrs old
height: 5’ 3” weight about 135-140 lbs
I am NOT on hormonal birth control and never have been
I don’t know if I have any clotting disorders but there is no known history of that in my family (several old relatives have had strokes and clots but they were also smokers or alcoholics/not active lifestyle)

I’ve had a big rope varicose vein that is pretty visable most of my life (since middle school It runs from my left foot up to high in my thigh. I mostly started having pain, swelling and stiffness in the varicose vein leg in middle school. Symptoms have become suddenly worse the last couple months.

For the past 8 months I’ve been doing dog walking so I exercise daily for several hours but it’s low intensity walking and don’t think I’ve had any injuries. I just quite that job last week to pursue other work so now I’m not moving as much, but these symptoms started before I quite…just for context.

About a month or two ago I noticed very sharp pain in my left leg in various places. Feels like a knife going to my knee, behind me knee, then up in my thigh. One week I had a sudden bulge in a vein in my left foot with stabbing pain all night. It was visibly swollen and hurt to the touch. For the last month or so following that, pain has been randomly occurring all over my left leg: ankle, shin, thigh sometimes I feel left arm pain but maybe that not related idk. Sometimes the leg feels heavy but then other times it feel completely normal (usually after I’ve been moving around). I also get some throbbing and pulsating feelings. It often feels like my whole left calf is beating with my heartbeat, this makes me VERY concerned that there could be a clot or some severe problem occurring.

I panicked eventually and went to an urgent care center doctor on Dec 13th. She measured my left calf and said it was definitely swollen (not super easy to see with naked eye but enough to cause concern) she ordered I get a scan immediately. I went to the ER (I was supposed to be on a VERY long train ride that week so I knew I needed to get cleared ASAP).

The ER full leg ultrasound came back clear. They said it was most likely my vein hurting but that there were no signs of a clot/DVT and it was safe to travel. I then went to my primary care physician for more advice. She said I should see a vein doctor and wear some stockings to help circulation and take low dose aspirin to help with pain and prevent small superficial clots. I then went to my acupuncturist (they are the only people that actually listen to me lol) and the treatment helped SO much. My pain was almost entirely gone for a week while I was on a CRAZY long 4 day train ride. It did hurt a bit but nothing like the previous weeks.

Now I’m home for the holidays and the pain is getting bad again. I’m moving less which maybe is related, but I’m very concerned about the stabbing pains and pulsing feeling. My leg is still more swollen than my right leg (but keep in mind that my left leg has ALWAYS been bigger than my right leg  to some extent since like puberty. I know it’s from the vein because it get worse sometimes but is always slightly larger so this is not really a new symptom but it does seem a little bigger than usual lately.)

My main concerns and questions are:
I’m worried there is a DVT that was missed in the ER ultrasound and that I could have a dangerous clot growing/potential for a pulmonary embolism.
I wonder if that very severe foot pain a while back was a clot that has slowly moved up in my leg and started growing.
Could my intense pain and symptoms (including pulsing and heaviness)  just be nerve pain that’s related to the vein? And maybe there’s no clot but rather the vein is in such a place in my tissue that it causes really bad pain when swollen?


Also side note: I’ve been drinking alcohol pretty heavily this year, never really drank much before in life till this year. Been trying to cut back recently but also wonder if alcohol/dehydration could be irritating my vein and causing this flare up in symptoms.

I know this was very long but I am SO scared and worry every night about sleeping. I almost can’t function because I’m convinced a clot will break off any second and travel to my heart, lung or brain. I know I’m young and healthy and not on birth control which is the usual risk factor but I’m going crazy knowing that there are exceptions and sometimes healthy people do have a deadly clot. ADVICE PLEASE so I can enjoy the holidays with my family :(
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