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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Headache, Pain In Stomach, Upper Back And Chest, Recurrence Of Mono, Swollen Lymph Nodes

I apologize in advance for the length of my post: Three months ago, all of my lymph nodes became swollen (neck, collar bone area, under arms, groin , etc.) in conjunction with feeling extremely tired and achy with waves of severe nausea that would pass as quickly as they began. I have had headaches, stomach, back (upper), and deep chest pain. In addition, I feel like I am falling (or dizzy), my balance is off when walking and standing (I often have to catch myself), I have frequent muscle spasms, and my right thumb has developed a constant tremor . The lymph nodes did not go down for over five weeks but the swelling did eventually reduce. All of the other symptoms have not ceased since then (I have some days that are better than others but it is never entirely gone). Since the beginning of this situation, I have been working with my primary care physician to try and determine what is occurring. She first referred me to a surgeon to look at the lymph nodes, with the possibility of doing a needle biopsy. Prior to seeing the surgeon, my primary care doctor ordered a wide range of blood tests to rule out some things: Epstein Barr , AIDS, West Nile, and some other possible viral causes. All of those tests came back negative but she did see indication of a past infection of Mono (I was infected with Mono when I was sixteen). When I saw the surgeon, she said that she felt it was a re-activation of the Mono, that she could not do a needle biopsy on a lymph node, and that surgery to remove one is complicated. Because she felt she had the answer with a diagnosis of the re-activation of Mono, she recommended I did nothing at that point (except get rest, etc.). Confused by this explanation, I made another appointment with my primary physician and she thought this was an unusual analysis of the situation as well. However, she suggested we do another blood test to look at the Mono levels and see if they had changed at all since the last one. The results came back at the same level as the first test and so she told me we had confirmation that the Mono detected in my blood was from the original infection over twenty years ago. From there, she ordered a CT (with and without contrast) to check gallbladder, liver, spleen, uterus and ovaries (I had an elevated CA125 and have historically had elevated levels on this test with a history of ovarian cysts and ovarian cancer in my family (mother, maternal great-aunt)), a MRI (to rule out MS or some other brain disorder as a possible source of the loss of balance, headaches, and tremor in my thumb). The CT showed my right ovary to be 4 cm (larger than the typical 2cm) and they thought they saw something that appeared to be cystic. She told me that they did not see anything that would evoke any concern about cancer. Other than that, the CT was normal. The MRI was normal as well. My primary has referred me to an Obstetric Gynecologist just to rule out any concerns with the elevated CA 125 along with the CT findings. As far as I have been told, this is only a precautionary measure. The Dr. that I have been referred to is very busy and was supposed to have reviewed my records yesterday in order to determine if I need to be seen on a rush basis (before his next available appointment at the end of October). Unfortunately, I did not get the call back from his office yesterday so I do not know where I stand in that regard but I think this is probably something that should be looked at but not necessarily related to the issues that I am having. In preparation for my referral appointment and to further investigate the pain in my stomach/abdomen, I had a pelvic and abdominal ultra sound done last week. The results were normal for the abdominal and the right ovary was found to have what appeared to be a cyst (as the CT did). These results were made available to the Gynecological Oncologist as well. I am now three months into this and just last week, the headaches and pain in my stomach, upper back and right chest was so severe that I could not sleep and had trouble getting through my days. All of the things I am experiencing in combination with the inability to find a diagnosis or course of action is really taking a toll on me both physically and emotionally. I am hoping someone can offer me some insight or direction so I can try and correct, treat, or just identify the source of what I am experiencing so I can find a way to cope with it and get on with my life (however it may be). Thank you
Fri, 27 Dec 2013
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General & Family Physician 's  Response
Hello. From your history , I wud suggest u to go fr peripheral blood film and bone marrow examination subsequently. Bone pain along with lymphadenopathy is there, so ifs imp to rule out leukemias or lymphomas, thanx.
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Headache, Pain In Stomach, Upper Back And Chest, Recurrence Of Mono, Swollen Lymph Nodes

Hello. From your history , I wud suggest u to go fr peripheral blood film and bone marrow examination subsequently. Bone pain along with lymphadenopathy is there, so ifs imp to rule out leukemias or lymphomas, thanx.