Carotid Space Adenopathy

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I just had an MRI of the neck for left neck pain. The results stated no masses see, slightly enlarged nodes are seen in the vascular space in the carotid space. They are less than 1 cm in diameter and may be reactive in nature based on size. No inflammatory change or edema is seen in the subcutaneous fat. Musculature is grossly unremarkable.

Impression: Cariotid space adenopathy.

No infection was indicated on recent labs and I have not been sick.

My question: Should this be further examined? If so, by what type of specialist? What could these results indicate?

Gender: Female
How tall are you (feet and inches)?: 5'7"
What is your weight in pounds?: 154
How old are you?: 44
How long has this been going on?: More than a month

Check all symptoms you are currently experiencing:
Palpitations
Diarrhea
Weight Loss

Describe associated symptoms not listed above: Left neck pain. Pain along outer left breast and below left groin area.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): A-fib, diarrhea

Check all conditions present in your immediate family... :
Cancer
Cardiac Disease
Diabetes
Hypertension

Please list any medications you are currently taking (and dosage if known) ::

Dilazetam ER 300/24 one qd
Benicar 40 mg 1 qd

When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within 8 hours

What could the results indicate?
What type of  doctor should I see?
Should I have additional testing?

_____________________________________________________

Hello!

These results in and of themselves are not 'diagnostic' of anything. As to whether they have anything to do with the symptoms for which the MRI was ordered, probably not. This may well be what we call an 'indidentaloma'.... something we found on a study that doesn't mean much. However, I will admit, this is not my area of expertise. We will try to live up to your 8 hour request though our ENT consultant may not be available in that time. And that is who you would want to follow up with, an Ear Nose and Throat surgeon. But as to whether you NEED to or not, that is another question.

Focal Abdominal Pain in a Post- Menopausal Woman

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree

50 female, menopause and all it's glory.  Had lots of issues over the years.  I've had belly tenderness and pain for 3 weeks now.  Right side below the rib cage and it moves around my back.  I feel like there's a football in there taking up space.  On occasion, a very sharp/knifelike pain in my back on the right.  Over the years I've had off an on issues with my belly on the right.  They tell me it 'must be IBS' and when you can't 'go' or you are passing/puking blood, then is the time to call the doc.  Well, my 'gut instinct' is telling me this isn't a good thing happening.  Should I wait until one of the 3 options happens?  I know that describing belly pain is a nightmare since it could be something totally not 'belly' related.

Gender: Female
How tall are you (feet and inches)?: 5'4"
What is your weight in pounds?: 153
How old are you?: 50

How long has this been going on?: A week or two
Check all symptoms you are currently experiencing:
Abdominal Pain
Diarrhea


Describe associated symptoms not listed above: Belly is tender to the touch just below my right rib cage.  From the belly button on a diagnoal about 2" up. Constant 'discomfort and pressure' which escalates to sharp shooting pain that circles around my right side to my back.  When I breathe in deep, it feels like there is a football stuffed in my belly on the right.  I have a buging disc at C3-4, C5 is crumbling/pinching nerves and there is pressure on my spinal cord at C4-5.  I have been seeing a pain management specialist for 6 years now.  Injections as needed into the C3-4-5 area.

What have you done so far to remedy this condition? Please include tests and relevant studies here.

Increased water and fiber, lower caffeine and alcohol.  Haven't complained to my GP yet.  Trying to walk more.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!):

I have a 5.5 cm hiatal hernia/reflux/Barrett's esophagus  ongoing for 15 years.  I've had a salpingo oopherectomy/hysterectomy thanks to stage IV endometriosis, gallbaldder removed, tonsils are gone and they took the appendix with the removal of the first offspring.  DCIS diagnosis 9/11 (no big deal).  
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Diabetes

Please list any medication allergies that you have : :   Recent bad reaction to sulpha drug for UTI.  Turned beet red and felt as if I was on fire.  Stopped the drug immediately.  Old fashioned penecillin doubles me over with intestinal pain/cramping/diharrhea.

Please list any medications you are currently taking (and dosage if known) ::

Nambumetone  ??mg  2Xday), gambapentin (100 mg 2Xday), albuterol(as needed/not to exceed 2 inhalations 3Xday), advair 100/50  2Xday), citrical-D, vit C, magnesium, skelaxin(as needed ??mg).

When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Weekly


I don't want to be labelled a cry baby/whiner/hypocondriac which is what happens as soon as you walk in and you don't obviously have a knife sticking out of your body.  On the other hand, I'm really close to being in a miserable state and realize this is not an ER issue.  If you can at least tell me the best language to use with an MD to describe my pain that would help.  I'll be seeing my oncologist on Friday and he's bound to go poking on my guts.
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes

Chest Pain? Abdominal Pain? What Gives?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.


On Saturday I was carrying in some groceries, when I noticed a strange pain at the bottom of and/or slightly behind my ribcage on the right side. – immediately to the right of my sternum.  I wondered if I had pulled some nameless muscle, although it did not feel like a muscle pull (having been an athlete I am very familiar with muscle pulls), but I thought it may have been some deep "core" muscle that gives a different sensation when pulled. But over the next 24 hrs as I tried to locate the offending muscle group it became clearer to me that it was not muscular because it seemed "tender" to the touch - a feeling half way between a runners "stitch" and a soreness due to inflammation.  It kind of felt like maybe some gas trapped in an odd place.

On Sunday eve the pain was about the same, maybe a tiny bit greater, I was getting a wee bit concerned because I figured a stitch was out of the question, and I was seriously doubting a sore muscle pull.  At some point my 5 yr old hit me right in the old solar plexus – not really, but he hit me right on the money spot below my ribs, it was a fairly typical 5 yr old playful punch- not much force.  The pain was so sharp that I yelled so loud that it sent my son screaming for mommy, and it even surprised me.  This is no muscle pull.  About 3 hrs later I started experiencing a very sharp pain when trying to breath deeply.  Also only on my right side but about 2 inches below my nipple (too high for any gastro-intestinal pain I am assuming) that was, once again similar to a side stitch -  the kind that hurts to breath deeply,  but about 2 -3x more intense and after a few hours it is still here. 
The pain is way to intense to “fight through the pain”, if I try to complete a breath, the pain is so sharp that my body reacts reflexively and forces me to stop.  I don’t mean a reflex like when your knee is tapped, I mean it is as if tried to keep your hand on a stove as it slowly got hot, at some point you will take your hand away no matter how much you try to will yourself not to – your body just takes over.

When I push straight into my stomach (liver? kidneys? gall bladder? Isles of Langerhans? gut? Whatever is located at the bottom of the rib cage) just below the rib, the pain starts about 1 inch to the right of my sternum and ends about 5 inches to the right of the sternum.. As I push it feels as if something is bloated, and if as I push into my body I angle my fingers up underneath the rib cage that seems to be the locus of the pain, maybe about an inch or 2 up from that lowest rib.

Also if I try to arch my back (not while inhaling) I feel both the sharp pain near my nipple and the “tender” achy bloated-y pain near the bottom of my ribs.

Could this be an old debate-team injury manifesting itself 30 years later?  Or is this merely mean I have to talk to my wife about her “cooking”?  Seriously though, I would like know if this is the beginning of appendicitis or pleurisy that me be a symptom of some underlying and serious condition, or if this is something I can ride out for a few days.

Thanks and Happy New Year

Update on the breathing pain.  I awoke this morning and found that lying on my back or left side gave me pain breathing with shallower breaths, and it just hurt to be in those positions.  When standing or sitting, only pain with deep breaths.  At 3pm I took a deep breath without the stabbing pain.  It is now 345 and still no more stabbing pains. But when I breath deeply I can feel a very mild pain where the sharp pain was, and I can feel a small to medium increase in the "tenderness" pain at the bottom of my ribs. It is wonderful to be able to breath, yawn, cough, sneeze without stabbing pain. BTW, any movement that is even slightly jarring Running dancing, twisting quickly) brings on a small to medium increase in the pain at the bottom of my rib cage.

Oh I was googling stuff last night and I realized in may be relevant that I have been having headaches quasi-regularly for about the last 3 weeks.  I rarely get headaches and almost never take pain killers but I have taken pain killers 3 times in the last 3 or so weeks.

Thanks again
Gender: Male
How tall are you (feet and inches)?: 6' 1
What is your weight in pounds?: 215
How old are you?: 50

How long has this been going on?: A few days
Check all symptoms you are currently experiencing:
Abdominal Pain
Difficulty Breathing
Chest Pain

Please list any medication allergies that you have : : None
When was your last menstrual cycle?: I'm a man, baby!

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days
Given that the sharp pains have subsided what should I do?
_______________________________________

Sir,
You need to proceed directly to the ER. You have two if not three potential life threats. The comments below are very good, but basically I am very concerned about the possibility of this being a blood clot in your lungs. It could be pain from your heart... it could be a collapsed lung.... it could be a lot of things. But, as long as the pain is as you describe all guessing is pointless. You could be in grave danger tonight. You need to go to the ER now. Now. Stop guessing about this pain and go get it looked at.

A Cold Weather Syndrome.... Very Curious!

Dear Canadian Runner,

I am an ENT and have a few thoughts.  The fact that this is exclusively cold weather induced is the most significant piece of information.  This is actually very common, except that most people's pain goes away once they cover their ears.  With you, however, this does not help.  I agree that most likely this is nerve related caused by cold exposure to the face, or cold air within the nose, mouth or throat.  I'd be very interested to hear if wearing a face warming mask while running helps.

The jaw joint (TMJ) is an extremely common cause for ear pain, and the fact that your jaw locks in association with the ear pain is very suspicious.  But, why does your jaw do this in cold and not otherwise?  Do you clench in the cold?  If so, you may have an answer to the cause.  Even if you don't, the TMJ and ear share some of the same nerves and both issues may be cold/nerve induced.

Eustachian tube problems remain a possible cause, and you have some history and symptoms to suggest this as a cause, but usually that shouldn't be temperature related.

I agree seeing an ENT would be valuable as they can do exams and testing that should narrow the possible causes, and hopefully give you a diagnosis and resolution of the problem.

Keep me posted on how things go.  I'm interested in hearing what happens.

Good luck!  I hope we have helped.


MD.STAT_DOC123

Failed Back?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Gender: Male
How old are you?: 35
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing:

Musculoskeletal Pain
Describe associated symptoms not listed above: 

Doc, severe lumbar, thoracic muscle spasms.

What have you done so far to remedy this condition? Please include tests and relevant studies here: 

I have bulging disks l3,4,5. Had 2 epidural injections to l5 which is the worst. Muscle spasms will not stop.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): 

Htn
Check all conditions present in your immediate family... :

Cardiac Disease
Diabetes
History of Back Pain
Hypertension
Please list any medication allergies that you have : : Nods
Please list any medications you are currently taking (and dosage if known) :: Lisinopril
soma
simvastin
ultram
ultram
zanaflex

When was your last menstrual cycle?: Now
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily

Docs, I've done everything from pt, massage, ice and heat. These spasms won't stop. There worse if I'm laying down and try to move in bed. Relaxers don't help! What could be any other causes other than muscleskelton issues?

___________________________________________

Dear Back Pain Sufferer,
Please be sure to check the comment section for some very good answers. With your underlying KNOWN pathology it is unlikely that a second cause for your symptoms would be likely. But, that being said, after seeing a spine specialist and inquiring about surgery, you might consider seeing a Rheumatologist. There are conditions like ANKYLOSING SPONDYLITIS which are rare and hard to diagnose and often confused with more common back ailments, and this may be worth considering. I hope the below comments will be helpful to you. Please feel free to add questions or comments there.

Thanks

MD STAT Docs

A Cold Weather Syndrome.... Very Curious!

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Hi Doctors,

I live in Canada and enjoy running outdoors for exercise. However, whenever I run in cooler temperatures (which for me is anywhere from about 10 to -10 degrees C), I get extreme pain in my ears soon after I start running (maybe 10 minutes into the run - sometimes less!). I always warm up and don't have issues in any other muscles or parts of my body, and I dress warmly, including a fitted headband that completely covers my ears.
 
The pain is debilitating and usually causes me to need to stop running and head home. It does not occur when I run indoors or in warm spring/summer weather. Sometimes it feels like intense pressure in my inner ear, and sometimes it feels like it is just behind my ear. Usually, my jaw also locks and tends to "pop" when I open my mouth. The symptoms take about 20 minutes to resolve. I should also mention that other than this pain, I feel fine while running - to my observation, it is not linked to fatigue.

I was wondering if there's anything I can do to stop this? I really love running but the pain is extreme.

Thanks!
Gender: Female
How old are you?: 21
How long has this been going on?: More than a year

Check all symptoms you are currently experiencing:
Ear/ Nose / Throat
Describe associated symptoms not listed above:

Pain/pressure in both ears on exposure to cold weather while running, even when well-dressed. The pain is debilitating and has at times been severe enough to cause nausea. Does not occur if I am outdoors in the same temperatures while not exercising. However, ears are sensitive to cold in general and I am most comfortable in a hat or headband from November to March. A locked jaw accompanies the pain in my ears. Both resolve in ~20 minutes after coming indoors.

What have you done so far to remedy this condition? Please include tests and relevant studies here.

Wear a headband or skullcap while running. I have been told that I should put cotton balls in my ears but I am confused about why this would help and am more interested in understanding the cause of this issue.



Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days

So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response. You will likely get more than you ask for, but we wish to understand your priorities.

1. What is this?
2. Why does it happen?
3. What steps can I take to reduce or eliminate the symptoms?
_________________________________________________________

Dear Canadian Runner,

I am struggling with this one. I did fine a link on WEB MD but I think the explanation, for what appears to be a fairly common syndrome, is less than satisfactory. My feeling is that your problem may be a combination of extreme sensitivity (because of your particular ear anatomy) of a Cranial Nerve, or, a cold-variant migraine, or, perhaps, some combination of these. Dr SWB is going to weigh in on this a little later today, and since this is right in his wheelhouse I think we will both learn something. Stand by, and thanks for your question.

MDSTAT DOC 1

The Lap Band.... A good solution?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.

I am an obese woman, 45 years old, who has tried a variety of diets and I'm considering the lap-band procedure. I am 5'3" and weigh 260 pounds. The best I ever did in the last ten years was on weight watchers and I got to 190 over 6 months but I put it all back on over the next year. I am strongly considering the procedure. Do you have any opinion on this for me?
Gender: Female
How old are you?: 45
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Psychiatric

Describe associated symptoms not listed above: I am depressed about the way I look.

I am "borderline diabetic" but otherwise quite active and healthy.
 

Check all conditions present in your immediate family... :
Cardiac Disease
Diabetes

Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally  

 

Summary:

 

What is the reality of the long term success with the lap band? Will I stop the yo-yo cycle? Are there any risks associated with the surgery aside from the normal surgical risks?