Conversation: The conversation between human and AI assistant.
[|Human|] My husband has numbness in his lower arms and hands , he is very weak, he said it feels like ice inside his hands and arms, his balance is not good, he get tired quickly and we just notice bulging veins in his forearm and hand. what could be his problem.
[|AI|]  Hello! Thank you for asking on Chat Doctor! I carefully passed through your question and would explain that the bulging veins could be related to increased central venous pressure. Indeed, there is not any relation between his symptoms and the bulging veins. Anyway, it is important performing a comprehensive differential diagnosis between different causes that may lead to this clinical scenario: - a metabolic disorder like thyroid dysfunction, a Chat Doctor.  So, I would recommend consulting with his attending physician and performing some tests to investigate for the possible causes: - a chest X-ray study- a resting ECG and cardiac ultrasound-some blood lab tests (complete blood count, PCR, sedimentation rate, blood electrolytes, kidney and liver function tests, thyroid hormone plasma levels, cortisol plasma levels, vitamin D and vitamin B12 plasma levels, fasting glucose)If all the above tests result normal, I would recommend consulting with a neurologist for a careful physical exam. A cervical spine MRI may be needed in case of abnormal neurological examination. Hope to have been helpful! Kind regards,