Suggest treatment for right sided shoulder pain

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Posted on Mon, 10 Jul 2017 in Brain and Spine
Question: I've recently been experiencing some odd symptoms. A list provided below
-At random time my right eye will dilate. It is significantly bigger than my left pupil.
-right shoulder pain. Dull and achy. Not severe
-Found a lump under my right upper armpit. Pain upon pressure
-smoker 17 years
Have read articles about horners syndrome and pancroust tumors.
doctor
Answered by Dr. Shuba Hariprasad 2 hours later
Brief Answer:
To check for lung and brain tumor

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Would you clarify a few things for me, please?

*how long have you had these symptoms? Are they getting more frequent or progressive?
*do you have any other symptoms like muscle weakness, asymmetrical facial expressions, droopy eyelids, headaches, dizziness, blurred or double vision, weight loss, fever, loss of appetite, fatigue, cough or breathing difficulty with exercise or at rest? Any digestion troubles? Any bone pain?
*any family history of cancer?
*do you have any other medical issues or take any medications?
*any history of injury to your neck, head or spine?

Based on your symptoms and history, I would like to rule out lung tumor that is resulting in compression of the nerves leading to abnormal pupil size.
I recommend :
-a physician consult, an ophthalmologist opinion
-chest Xray
-CT scan of the chest and brain
-biopsy of the lump (probably an enlarged lymph node) to check for the type of tumor
-blood tests (complete blood count, Thyroid stimulating hormone, kidney and liver function test, CA-125, CEA, IDH1, blood glucose levels)
-electrocardiogram and echocardiogram
-urine analysis.

Based on this we can arrive at a diagnosis. The sooner this is detected and treated the better the prognosis. You are seeing your doctor on Monday. Please make sure you talk to him regarding the possibilities and treatment options. Tests must be done as soon as possible.

Please get back to me with the above requested clarifications and any further queries you may have. I'd appreciate an update after your doctor's appointment.

Hope this helps. Wish you good health
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Shuba Hariprasad 37 minutes later
-the dilation of the right pupil comes and goes. I probably noticed it a month ago. It's not accompanied with any pain or pressure.
-no other symptoms really. I sometimes get headaches, but nothing that is not relieved by OTC medications.
-bowel movements are about every 4-5 day.
-had a physician I work with feel the lump under my armpit. Said it was not rubbery, or didn't feel "cancerous".
-grandfather had prostate cancer. No other family history of cancer
-I take Paxil and occasionally phenargan for nausea. Melatonin for sleep.
-had a brachial plexus injury about 5 years ago from a restraint. Complete loss of function in my right arm. Came back after a couple of weeks.
Bronchitis maybe once a year.
That's all I can think of...any more questions
doctor
Answered by Dr. Shuba Hariprasad 13 hours later
Brief Answer:
I recommend investigating the lump to rule out underlying disease

Detailed Answer:
Hello,
Thank you for the follow up and clarifications.

*did your colleague say how big the lump was?
*was he/she able to feel any other nodes or auscultate you?

The lump could be an enlarged lymph node. The cause of its enlargement needs to found out. I urge you to consider my earlier recommendations.

If it hurts, a sebaceous cyst is another possibility. Please monitor the size and skin appearance over the lump.
Basic investigations can help to screen for anything serious.
Hope this helps. Please let me know if there is anything else I can help you with.

I strongly recommend investigating.
Wish you good health

Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Shuba Hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

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