[44F] With severe leg pain, swelling, and unexplained bruising

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Peripheral Artery Disease (PAD):

   • Rationale: PAD occurs when the arteries that supply blood to your limbs become narrowed or blocked. Symptoms can include leg pain, especially when walking, leg numbness, and changes in skin color.
   • Typical Treatments/Testing: Diagnosis often involves a physical exam, blood tests, and imaging tests like an ultrasound or angiography. Treatment may include lifestyle changes, medications, and sometimes surgical procedures.

2. Chronic Venous Insufficiency (CVI):

   • Rationale: CVI happens when the veins in your legs don't allow blood to flow back up to your heart properly. This can cause swelling, skin changes, and ulcers.
   • Typical Treatments/Testing: Diagnosis may involve a physical exam and ultrasound. Treatment can include compression stockings, medications, and sometimes surgery.

3. Diabetic Neuropathy:

   • Rationale: Given your history of neuropathy, this condition can cause pain, numbness, and skin changes in your legs.
   • Typical Treatments/Testing: Management includes blood sugar control, medications for pain relief, and regular foot care.

4. Possible Skin Cancer (e.g., Melanoma):

   • Rationale: The hard, dark, scaly lump could be a sign of skin cancer, especially if it has changed in size and appearance.
   • Typical Treatments/Testing: A dermatologist would likely perform a biopsy to diagnose the lump. Treatment depends on the type and stage of cancer.

What you can do

Peripheral Artery Disease (PAD):

• See a doctor: It's important to get a proper diagnosis and treatment plan. Your doctor may recommend lifestyle changes, medications, or procedures to improve blood flow.
• Lifestyle changes: Quit smoking, eat a healthy diet, and exercise regularly to improve circulation.

Chronic Venous Insufficiency (CVI):

• See a doctor: A healthcare provider can recommend treatments like compression stockings or medications.
• Home care: Elevate your legs when sitting, avoid standing for long periods, and wear compression stockings.

Diabetic Neuropathy:

• See a doctor: Proper management of your diabetes is crucial. Your doctor may adjust your medications or recommend treatments for pain relief.
• Foot care: Inspect your feet daily for any changes, keep them clean and dry, and wear comfortable shoes.

Possible Skin Cancer:

• See a dermatologist: It's important to get the lump evaluated as soon as possible. Early detection and treatment are key.
• Skin care: Protect your skin from the sun and avoid tanning beds.

What you should look out for

Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Sudden increase in pain or swelling
• Signs of infection (redness, warmth, pus)
• New or worsening numbness or tingling
• Shortness of breath or chest pain

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.