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    What does my scan report indicate?

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Posted on Tue, 28 Nov 2017 in Medicines and Side Effects
Question: I have a lot of problems which seem to me to be unrelated. I've been sick for about 5 months now. Should I give you a list of all of my symptoms?
Here's a list of a lot of my symptoms; both current and very recent past:

nausea, vomiting, constipation, poor bowel movements (very small stools), fecal incontinence, dizziness, vertigo, difficulty swallowing,

ENLARGED LYMPH NODES in neck, behind ear only on right side

Severe, severe facial pain, also right side only, that goes from temple through face into sternum area.

Loss of sensation in face, right side only. I can feel a little bit, but about 80% of feeling is gone from cheekbone to chin
doctor
Answered by Dr. Sanjay Kini 9 minutes later
Brief Answer:
Can you please share the investigation reports & CT scan reports....?

Detailed Answer:
Hello. Can you please share the investigation reports & CT scan reports....? That may give a more clear picture as to what exactly your problem is.
with regards- Dr Sanjay Kini
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sanjay Kini 28 minutes later
I will give you what I have. I do not have copies of reports but I can summarize:

More background:
I was taken to the ER in August because I could not swallow anything. Every time I tried to swallow water or saliva, I would choke. I was admitted for 4 nights and was administered many tests including neurology - normal, ENT - normal, barium swallow study - normal. I was given high does of clindamycin and was feeling better for the duration of the stay. The day I got home from hospital, the severe, right side facial pain began.

The facial pain has progressed over the past 2 months.

CT of neck, August 2017:
Results were normal for the most part. There were some "ridges" noted in esophagus. This CT was done with NO contrast because I was dehydrated and the staff was unable to start and IV. Also, because I couldn't swallow, I was unable to swallow contrast.

The MRIs I've had include brain, cervical, whole back, pelvis. The brain scan was looking for MS. All images were normal except where noted permanent hardware in hips and c-spine.

Thyroid ultrasound - thyroid was normal but there were a few 2mm tumors in neck. I was told that these are nothing to be concerned about and do not know locations.

Blood tests were mostly normal. There was an elevated calcium level for a few months and this has not been rechecked since August.

**Blood tests include: leukemia/lymphoma in March, CBC, ionized calcium, histoplasmosis (used to live in OH river valley), heavy metals/contaminates, pesticides, parathyroid function (essentially normal, slightly high), hormone levels,
**unless noted, blood work came back within normal ranges. Can blood work be subjective? I even saw a hematologist because I was told to see him after blood work was slightly off (elevated calcium and albumin). Was told that I was dehydrated at time of test but I was so certain that I was not dehydrated because it's very hard to draw blood from me no matter what, so if I was dehydrated, I would have known. The phlebotomist would have told me also.

Let me know if there are any other tests you would order. I will check to see if it's been done. My records are on a patient portal and many times, the results are not wholly available to me.

Thank you! XXXXXXX
doctor
Answered by Dr. Sanjay Kini 30 hours later
Brief Answer:
Consult an endocrinologist

Detailed Answer:
Hello. I apologize for the late reply as i was bit busy. Anyways first of all i feel that since you had episodes of chocking, you may be having esophageal hypomotility disorder. Generally it is diagnosed through barium swallow, but as you said it was normal. Sometimes it may not be picked up by barium swallow. So other tests like Manometry, Multichannel intraluminal impedance (MII), 24-Hour pH monitoring may give some clue. But it depends on your treating doctor whether he feels the need to.

Now there are lot of reasons for esophageal hypomotility. One of the most common is thyroid and parathyroid disorders. Elevated calcium may be due to parathyroid disorders. You may need to consult an endocrinologist and get thorough evaluation.

But as far as treatment modality goes nothing much has to be done except some lifestyle changes. People with esophageal motility disorders might benefit from the following:

1. Eating smaller meals
2. Eating dinner earlier, to give food a better chance to reach the stomach before bedtime
3. Sleeping on an incline, with the head of the bed raised
4. Losing weight, if the patient is obese
5. Diminishing, or abstaining from, alcohol consumption
6. Seeking psychiatric care, if the patient has a history of anxiety or depression

Regarding medications: Smooth muscle relaxants, including nitrates and calcium channel blockers, were the first medications to be used in all patients with esophageal motility disorders. The greatest experience has been with isosorbide dinitrate and nifedipine. Botulinum toxin injections into the XXXXXXX have been used in treating patients with conditions called achalasia which cause esophageal hypomotility.

With regards- Dr Sanjay Kini
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Sanjay Kini

General & Family Physician

Practicing since :2009

Answered : 1355 Questions

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