Utilizing My Jugular Vein to Assess Fluid Retention

I am a 42 year old women with congestive heart failure (CHF), who really tries to stay on top of my fluid levels. I am very aware of my fluid because I started off my heart failure journey having had a widow maker heart attack, cariogenic shock and an ejection fraction (EF) of like 10! So, I know what major fluid retention is like and I still have PTSD over it.

Thus, I watch my sodium and fluid intake like a hawk, take my diuretics faithfully, and am on top of it excess fluid. So, when my doctor told me to call the office if/when I gain more then 2 pounds overnight or 5 pounds in a week, I take this assignment seriously.

Keeping an eye on my fluid retention as a person with heart failure

This might seem straightforward, but it can be unclear! Personally, as a 42 year old female, my body is changing. I am gaining weight, particularly around my midsection, which also happens to be where I carry fluid. There is also bloating, which is additional fluid. Also, life can happen! For example, if I forget to weigh myself in the morning as I am running late to work, then that night I feel like crap, there is not another great assessment until the next morning when I can weight myself again.

However, I am not alone. Having moderated for several years, I see many comments asking how to tell if you are carrying excess fluid - and I get it! And yes, edema has a pitting thing going on as well, but in my case I only get that when I am way over the 2-pound-daily weight gain benchmark, and honestly if I got that far I am not sure I would be calling my doctor... I would probably be headed to the emergency room! So, in my opinion, if there is anything I can do to get a temperature check (as they say) to my fluid situation, instead of waiting until it's an "oh crap" situation, I want to know about it. I think others would want to know as well, which is why I wrote this article.

Did you know about this way to assess your fluid retention?

Utilizing your jugular vein is another way to get a quick assessment on your fluid levels! My doctor told me and my fiancé about this during a previous visit because he was concerned I was confusing hormonal bloating with fluid retention. So I wanted to share...

In layman's terms, the jugular vein is on the right side of the neck. When this vein is being assessed, I lie on my back and tilt my head slightly to the left. There are 2 things that my doctor told my fiancé to look for:

1. A bulging vein. The first place extra fluid goes is your blood, so increased fluid manifests in additional blood volume and blood pressure causing the vein to bulge outward. Think about heavy traffic on a freeway!
2. When you press down on this vein, it should pop back up immediately. If it does not or the vein takes longer to pop back up, then you are carrying some amount of excess fluid. Much like signs of edema in other parts of your body, like edema at the ankles, the jugular vein can have edema as well.

Using the jugular vein to assess your fluid has a few admitted drawbacks. First, I need someone else to do it! Also, it is a little nuanced, so the person who is checking needs to be available (and patient) to continue checking until they have enough exposure to understand the variations and what they are looking for. However, if you are interested in another method of assessing your fluid, and you have someone who has the time, patience, and availability to help you, using the jugular vein has been helpful for me.

Talk to heart failure health care team

If you are interested, I would recommend that you bring it up with your doctor at your next appointment. Having someone check your neck should not negatively impact your health; however, having a doctor explain and show your person what to look for was helpful for us.

The other thing to confirm is, if you see excessive fluid, what is the benchmark and what is the next step. People's heart failure can be at different places, so depending on the severity of your condition, the next steps might vary person to person. Please ask your medical team what is right for you!