View Full Version : Looking for help I am clueless/over reacting

10-19-2013, 11:13 AM
I have had a painless enlarged lymph node on the left side of my neck (front cervical I think/under ear behind jawline) for over a year. This was pointed out when I went to see my doc for fatigue. She seemed concerned so she sent me in for blood tests and a CT. I'll post my CT results but it didn't see the node or nodes I was surprised but it did see an enlarged Thyroid with nodules which I hear are common. I had a TSH and Free T4 which were normal (low side). This was in March. Since then I have had fullness off and on and a clogging sensation in my ear (same side) and now L eye twitching. She sent me to an ENT this month and he totally blew me off telling me it had to be from my TMJ issue which I have had for many years (so of course no solution). Last week I went in to see my doctor because that lymph node has grown so much and I had a fever of 100.1 and didn't even know it. I told her my throat felt pressure from the outside after having a cocktail the night before and I feel like something is in the way of other structures in my neck when I swallow and turn my neck. She noticed that my throat was red on the inside so she tested me for strep (neg) and said it couldn't be mono because my nodes in the back of my neck would most likely be swollen. I do not have a sore throat. It feels strange. I know what it feels like to have a sore throat and this is not what I have. Since then my sister noticed that when my head is turned or tilted back it bulges out quite a bit on that side only. Anyway my main concern is that if it is a type of cancer of course I would love to catch it early and the last couple times I've been to the doctor (which takes some courage building) I have left in tears because I am so frustrated with all of symptoms. Mainly fatigue and dizziness. But also some other neurological symptoms that have been blamed on my smoking for so long (cold hands and feet, numbness tingling in fingers especially when cold, vision changes and I'm up every hour of the night for what it seems like no reason) I really hesitate to go in to the doctor know fearing she may think I'm becoming a hypochondriac. I feel I even waited too long to go in to see her originally and I now I am totally frustrated because there seems to be no answer at this point. Could all this bee from bad tooth. Am I losing it? lol Shouldn't I be having a biopsy or something? How long is it ok to wait before I find out I have Lymphoma or Thyroid cancer and it has spread all over my body? No night sweats but I do have itchy skin and a feeling of blood rushing to my head that stays for awhile and goes away. CT Result below:

History: enlarged lymph node. .

Technique: Axial CT images of the neck were obtained with 75 mL of nonionic intravenous contrast administered. Sagittal and coronal reconstructions were made.

Comparison: None

Findings: No mass or adenopathy is seen in the neck. The thyroid gland is mildly enlarged, and there are a few tiny nodules in the thyroid gland. No dominant thyroid nodule is seen. The parotid glands and submandibular glands have a normal appearance. Bilateral skin markers were placed by the CT technologist and overlie the bilateral submandibular glands. The paranasal sinuses are well aerated. The orbits have a normal appearance. Mild facet joint degenerative changes are seen in the lower cervical spine. The nasal septum is mildly deviated to the left.

1. No mass or adenopathy is seen in the neck.
2. Mild enlargement of the thyroid gland. Recommend correlation with thyroid function tests.

Some of my blood tests:
WBC (3.7-10.5 K/uL) June 2011-5.6 March 2012-3.8 March 2013-3.6
RBC (4.00-5.20 million/UL) June 2011-3.83 March 2012-3.91 March 2013-4.04
TSH (0.358-3.740) June 2011-1.650 April 2013-1.960
Free T4 (0.76-1.46 ng/dL) April 2013-1.13
Vit D (30-100 ng/ml) March 2012-14 March 2013-50
DHEA (45-270 ug/dl) march 2012-27

My 11 yr old and I were also bitten by a tick this spring and I was possibly summer 2012 (they were really bad on my horses and dogs then) so...Lyme? I did have what I thought was Poison Ivy with red raised welts this spring and was given prednisone. Now that I read a little about Lyme that could have been a "tick rash". I have never had a reaction to Poison Ivy before and I have been around it all my life.

10-20-2013, 12:16 AM
You are not over reacting.

I have no clue what it could be. If I were you, though, I'd either find a new doctor or demand that the doctor finds out what it is and treats it.

10-20-2013, 01:32 AM
Well, you are absolutelynnot overreacting-your Drs are underreacting to what is going on. I would be concerned about the possibilities of autoimmune thyroiditis, thyroid cancer, lymphoma, lupus, and here is why: We know your thyroid gland is enlarged with nodules, which is usually a sign of Hashimoto's thyroiditis, an autoimmune condition quite common in females especially. It is diahnosed by checking anti-thyroid antibodies in serum (anti-TPO and anti-TG) plus TSH, free T4 and T3 to check thyroid hormone status. An ultrasound of thyroid is usually done and sometimes a scan of gland to see if nodules are hot or cold to guide biopsy decisions. The lymph node can be checked at same time with ultrasound for size and to see if there is just one or multiple ones. A lymph node over 1 cm in size, persistent for a month or more warrants diagnostic testing and possible biopsy. I mention lupus because of the fever, fatgue, cold hands and feet with numbness at times, low WBC on multiple occasions, low RVC, low Vit D, and lupus often causes lymph node enlargement. If thyroid cancer is present, it would spread to the cervical nodes first. Lymphoma causes fatigue, enlarged painless lymph nodes, fevers, and increased node discomfort after alcohol ingestion, plus itching, although lupus and thyroiditis can cause itching too. To check out lupus, you need a urine check, blood chemistry panel, a sed rate, CRP and most importantly an ANA antibody test on blood. A chest xray should be done to check for any lymph nodes in chest, and all node areas should be examined by physical exam. Lyme is a possibility with known tick bites, but I would start with the other things. Spleen and liver should be examined for enlargement, common in lupus and lymphoma both. If all the autoimmune tests are negative, then I would see an oncologist for a consult at least. You deserve to have a thorough exam, work=up, battery of tests run, and a new Dr. who won't dismiss all this. A good internist would be a place to start for the blood tests, exams, ultrasound, and then any clues followed up with endocrinology, rheumatology, oncology and a lyme specialist if all else is negative. I know I have thrown a huge amount of info at you, but your symptoms could be from several things, many of which overlap. The most common would be the Hashimoto's autoimmune thyroidits with lupus concurrently, as multiple autoimmune disorders can co-exist. But since thyroid cancer and lymphoma are serious, fortunately much less common, they must be considered as well. The low DHEA can occur in autoimmune disorders as well, but is the least of concerns and can be dealt with later with supplements if needed. After you research and digest all this, you will feel more confidant demanding that more tests be done to get this diagnosed and treated. You are NOT overreacting and IMO need a new Dr. for a fresh look at all of you and your test results thus far. Please keep us posted on your progress.