Question: I think my doctor is shrugging off my concerns and I wanted to check with a hematologist/oncologist to see if you feel it might be justified. My doctor thinks I am losing it and marked me as having anxiety this last visit. I have never had anxiety before and I still do not but I do not think she is listening. Here is the breakdown over last 3 months:
July 9th- ultrasound says spleen enlarged 14.5 cm and fatty liver
july16th- ctscan with Iv contrast and oral contrast. All organs within normal limits. Nothing significant.
July 16th- chest X-ray all normal
July 16th CBC with differential/metabolic panel/lipids all normal but wBC 10.4, TRiG 183, ast40, alt 79, and iron osomility% low at 15%. all other blood work normal but iron low normal at 54.
had follow up blood work Oct and all blood work normal but iron % still low at 15%. I did give double red blood cells on Aug 27th so I know that can drop numbers. differential did not flag anything.
Gastro also tested for auto immune, tumor marker, and XXXXXXX All liver tests now normal and borderline XXXXXXX but still fatty liver.
My concern the doctor seems to be shrugging off. I can feel my spleen when standing or sitting down when I breath. laying down I cannot feel it and neither did my doctor. She said it is my spleen but ct says normal range. she does not seem concerned. I have never felt this before and there is discomfort in the upper quadrant. She says if something is there the ct would not of missed this. Also I always have slightly enlarged mandibul lympho nodes that seem a little on the firm side and rubbery. they do move around though. I want to get these aspirated to see if this could be lymphoma. She says they are fine and could just be shotty.
should I consider a hematologist or am I just going mental at 36? Never been concerned like this on anything and I know my doctor will get a report if I do go somewhere else. I do not want to go around her but I am considering it because I know I feel my spleen when I take a really deep breath. Quite easily.......though not when laying down for palpation.
Should I see a hematologist or just wait on this. Sorry for the rambling but I wanted to provide everything.

Thank you Dr. Konatam for addressing my concerns today. I will definitely follow up with the Gastro for the upper GI endoscopy. Maybe this would explain my low/normal iron for a male. If I have bleeding, though I do not have any in my stools. I had a fecal sample done in August and it came up clear of fat, blood, and parasites.

My concern with the spleen, or what I thought is the spleen, is directly below my left nipple under the coastal margin. It is in the upper left quadrant and not the epi-gastric region. When I put my finger under the rib and in about an inch is where I will feel something hard/solid and rubbery hit my fingers when I take a deep breath. It is about two inches wide and it will come down from under my ribs, hit my fingers, and then it will disappear. I will have to exhale, and replace my fingers to run through this again to have this mass hit my fingers again. If this is not my spleen then what is solid on the left side under the ribs that would come forward when I take a very deep breathe? In addition, wouldn't the ct scan see this? This is where all the concern, and anxiety have been coming from. If I could not feel this I would not be pressing the issue. If I leave the left side alone and do not go poking I will have discomfort in the upper quadrant unless I rub just below the rib cage.

I will still go for the upper GI, but I am just curious what is hard that hits my fingers at this location? This is what my concern is.

Thank you for the information about the lymph nodes. The side has not increased and they have always been slightly enlarged for years that I can remember. If they get bigger I will have it checked. Thank you for the piece of mind.

Thank you again Doctor! I do appreciate your time and knowledge!
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Thank you Doctor. I was just concerned since the original ultra sound showed enlarged at 14.5 cm and I can feel the spleen. I was under the impression you cannot feel the spleen at all unless you are really skinny. Since I am not that skinny and I can feel the spleen I thought that meant my spleen has to be enlarged. I know the ct with iv and oral contrast is very accurate but I seem to have a hard time accepting it is in normal range when I can feel the spleen. I am just concerned something might have been missed, I really DO want to accept it is normal size, but my body has me thinking something else.

Thank you for your time doctor and listening to my concerns........even if they may not be justified based on test results.
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