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Having GERD And Large Lymph Node In Groin. Little Hypochondriac. Had Prednisone And Having Mild Sweating. Advise?

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Posted on Mon, 16 Sep 2013
Question: I am really worried and cannot find any comfort at all. I was dealing with severe Gerd since May that I attributed was brought on by some work projects that we had going on at the time. Well after the projects were over the Gerd continued and continued. Then one day I started getting tired in the middle of the day which was not normal for me. This was the kind of tired where I was actually falling asleep at my desk for no apparent reason. I had to leave the office one day as I was not able to stay awake at all. Well this tiredness happened a few more times and I started to get a bit more concerned. Then out of my concern I started looking over my body for anything and feeling my lymph nodes. Bam I found a large hard lymph node in my right groin. I immediately woke up my gf who is an RN and had her feel. She felt it and said oh wow you are right there is something. I am very in tune with my body and keep a close eye on things. I am 31 year old male in good physical shape 6ft 3in tall 210 lbs. Well as soon as I saw the concern on her face I fell to the floor in a panic and hyperventilated. This was a week ago Tuesday. I immediately called and made an appt with the GI doctor. She saw me the next day and scheduled an endoscopy but not until Sept 6. She also did standard blood work and checked the lymph node herself. She said she did not think that it was anything but she barely felt for it. I knew that it was abnormally large from my experience and prior hypochondria. Please let me tell you that I am a bit of a hypochondriac as well. The really scary thing is that I have not had a swollen gland in probably 10 years since I had a cold sore. This is an inguinal groin in my groin. For what reason would a single gland swell there as my blood tests came back normal and no signs of any infection. Well there is no other explanation to it aside from lymphoma. Well she said I know you are worried so lets do an ultrasound. She ordered an ultrasound and they called with the results last week. Radiologist said the node was 2.6 cm X 2.1 X 1.0 cm and did warrant further evaluation. Her office called the next morning and ordered a CT scan of abdomen and pelvis. I know that this will only show other nodes in the groin that are enlarged but there are none that can be felt there, I had the CT scheduled for Monday so had to take some prednisone on Sunday night and Monday morning prior to the procedure. Well Sunday night I have a major night sweat where the bed and sheets and boxers are soaked good. This really freaked me out as I have not had one of those in 10 years or so either and there would be no other reason for it either than lymphoma. Can I also reiterate that the node was hard and fixed in place which is not a good sign. Well the morning of the ct scan I go to the office and then back out of the appt. The node was feeling smaller this day so my thought was if this is cancer it would not be shrinking. I did not want to have my 3rd ct scan and that much radiation at 31. I spoke to the doctor and she said ok well biopsy is the better bet any way. I was like why did we not take this approach from the get go. Well then again on Monday night I have a minor night sweat again which totally freaks me out but again the node feels smaller, and softer and not really fixed into place any more, This helps the anxiety subside a bit but the night sweats are still weighing heavy on my mind. Well I do some research and find out that a side effect from pred is night sweats so that even a bit more eases my mind and helps me more into a bit of denial that I might be ok. One thing I did not realize is the false hope that the pred offered to me. I understand that prednisone is prescribed to help shrink tumors and cancer caused by lymphoma. I only took 2 50mg doses and last one was 8am Monday morning. The node feels 60% smaller today but I think that it is going to come back now as it has to be lymphoma and that the pred just shrunk it down because it is anti inflammatory. Also had a mild sweat on Monday and Tuesday but I am hoping that is just the left over effects of the prednisone. I am driving myself crazy and do not think I can wait for the further testing to happen. Based on my symptoms and things I do not see how I could possibly not have lymphoma as there is no other explanation. I also found that pred can cause a false reading in the biopsy as well. In my haste to get answers I am actually making things go backwards. Please let me know what you think and what I can do here. Where can I go to get faster answers and help.
doctor
Answered by Dr. Robert Galamaga (1 hour later)
Brief Answer:
Try and focus on remaining calm

Detailed Answer:
Hello and thank you for sending your question.

I can appreciate that you're dealing with a very stressful situation. I honestly do not see a very significant sign of active Lymphoma in your case. I understand you have a lymph node that is slightly enlarged. There are many different reasons why this can happen. One reason is exposure to a virus or bacteria. Other reasons include allergic reactions. You're correct it sometimes certain cancers can cause this but honestly that is very rare and I do not see overwhelming evidence of cancer in your case Given the symptoms you have reported.

If you are going to obtain a biopsy I would suggest that you wait a couple of weeks before having this done. I am not exactly sure why you were given the prednisone. You are correct that the prednisone can sometimes disturb the interpretation of a biopsy. If you are going to obtain a biopsy I would suggest that you have a surgeon entirely remove one of the lymph nodes for analysis.

I think you also should try to focus on maintaining your health. This includes mental and physical exercises. If you continue to focus and worry about this it will only cause you to become more anxious and possibly depressed.

I feel the chances you have cancer or Lymphoma are very small. I do agree with an appropriate diagnostic workup and possibly a lymph node biopsy.

Please follow up with your primary care doctor. Also please discuss the scheduling of a biopsy with your primary care physician.

Thanks again for sharing your health concern. If you have any additional specific questions please let us know.

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga (31 minutes later)
Dr. XXXXXXX

I appreciate your response to my question and concern. The reason that I am very worried about this is for one I was having symptoms over the last few months that have been concerning me that there was something underlying that was wrong with me. I just took the wait and see approach. As the Gerd got worse and the fatigue increased I became more and more concerned that it could really be something. Then I found the node in the groin that was 2.6 cm confirmed by ultrasound. Doctor told me that 38% of nodes this size turn out to actually be cancer. The prednisone was given to me to stop any possible allergic reaction to the iodine given prior to the CT scan. Do you think 2 doses of 50 mg pred would decrease lymphoma that much? The node has certainly decreased but not gone. When it was first found it was very hard and stiff and fixed in place. Also the tissue around it was hard and inflamed. That is not normal for just a reactive lymph node. MY CBC and WBC and urine all came out perfect so no sign of infection at all. The GI was concerned by the size of the node. I have also had 3 night sweats, one really severe that I am trying to tell myself was just from the prednisone as it was the one I had after taking a 50mg dose before bed time. Based on the night sweats, the enlarged node and the fatigue what else could this be but lymphoma. I am also down to 208 lbs which is the lowest I have been in 10 years. I was dieting prior to this happening but now I have not been watching what I eat in hopes that I do not lose any weight causing further anxiety. I am 99.9% convinced that I have lymphoma based on my symptoms and lymph node. I should have just went through with the CT scan to at least put some of this to rest. I do not know what else to do. I really do not think I can wait that long for the biopsy results. I need to know something sooner as I am driving myself insane. The node was originally very hard and fixed in place as confirmed by myself, my gf and doctor upon examination. Then after she received the ultrasound back at 2.6cm that is when she called and said ok well we need to do further tests as that is not a normal size node. I am just having a hard time with this and all of the thoughts that this is it just keep running through my head. I also have a nagging lower left rib pain that comes and goes multiple times a day for the last few weeks. I am even thinking this could be a tumor that has spread to local lymph nodes now and this is just the first symptoms. How can you explain night sweats with all of this going on when I have not had one of those in probable 10-12 years. Not something normal for me as if they were to happen I would freak. Lymphoma symptoms I currently have 4 of the first warning signs of it. I am worried that I set myself back from diagnosis due to the fact that I took the prednisone. Whatever other information you can provide let me know. Sorry to bother you with this but I do not know what else to do. I feel like I need to be admitted to a hospital until the figure out what is wrong with me.
doctor
Answered by Dr. Robert Galamaga (39 minutes later)
Brief Answer:
Followup

Detailed Answer:
Ask your doctor to request an LDH. if this is not elevated this hoes against lymphoma.

You simply cannot have a diagnosis of Lymphoma without a tissue biopsy. This is why the biopsy needs to be done.

One additional test you might consider discussing with your doctor is a PET scan. This is a specialized imaging study which Is used to help provide additional information when searching for diseases such as lymphoma.

Honestly I think you have become very fixated on this and this is negatively affecting your mental health. Again you really need to focus on positive aspects of your life. You need to maintain good fluid hydration and good nutrition. You should also be exercising at least three or four days per week.

I agree the night sweats are disconcerting but these are Not diagnostic for Lymphoma.

Again the odds are strongly against Lymphoma or cancer in your case. I think you need to sit down with your doctor and put together a plan that both of you agree with. If you're not happy with the way things are being done I suggest you seek a second opinion from another doctor who can coordinate your diagnostic plan.

Thanks again for sharing your healthcare concern.

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga (18 hours later)
Dr.

I am having the biopsy tomorrow and the node is now 2/3 smaller than it was. Do you think if it was a node caused by lymphoma that it could have shrunk this drastically in a week? I only took two 50mg of pred on Sunday at midnight and Monday morning at 8am. So it was 100mg in 2 doses spanning out less than 12 hours apart. Do you think that this could have caused the node to shrink that much. I understand that pred can cause tumors and lymphoma to shrink but not sure how long it takes. It feels about the same since Monday maybe a little smaller. I am not sure how long it would take to start coming back if it actually is cancer. I guess I am hoping that it is just a reactive node and all these other symptoms have just been in my head. No night sweats since stopping the pred so maybe it was the high dose prednisone that brought on that really bad sweat. Well thank you for all of your help and insight.
doctor
Answered by Dr. Robert Galamaga (7 hours later)
Brief Answer:
Have the biopsy done

Detailed Answer:
Lets see what the biopsy shows. I feel the biopsy is reasonable to perform regardless of your recent history with the prednisone.

I think your senses are heightened and anxiety is playing a big role in how you're feeling.

I would be happy to review the biopsy results with you when available.

Sincerely,

Dr Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga (2 hours later)
Well just woke up with another night sweat for no reason at all. I am for sure this is lymphoma as there is no other reason for all of this. Now I am really freaked that all of this pain in my lower back for a while is going to turn out to be a large tumor that has spread. I have resigned myself to the fact that this is real and I guess my fight with cancer begins. I do not need the results as I already know what is going on. I am not leaving that office tomorrow until they tell me what is wrong with me as I cannot be at home all weekend knowing this is in my body.
doctor
Answered by Dr. Robert Galamaga (21 hours later)
Brief Answer:
Try and be patient for results

Detailed Answer:
Hello again and thank you for the additional information.

Unfortunately it will take a few days for the tissue to be evaluated by a pathologist. They will never be able to give you exact information immediately after a biopsy. In this case it is absolutely necessary to allow the pathologist to Thoroughly review the specimen.

I'm sorry that you're convinced that you're dealing with some type of cancer. I do not see this at all in your case. I think you should talk about this with your doctor and perhaps seek some type of psychological support. This is extremely important in order for you to maintain your mental and physical health.

Thank you again for your question. I would be happy to review the results of your procedure and biopsy in the near future.

Thank you again for sharing your healthcare concern and please try to maintain some degree of optimism.
I hope you have a good family and friends to support you through this.

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Robert Galamaga (23 minutes later)
Dr. XXXXXXX

Why do you say that you do not see this in my case? What in what I have told you makes you think that I would be ok? I am having unexplained night sweats with a swollen gland in my groin. It has gone down a bit more but it is certainly still there. The surgeon did not do the biopsy today because she said I should have had the CT scan first. She said the node has reduced in size and that was a good sign. I reiterated to her multiple times that you guys gave me 3 doses of 50mg prednisone and that is when the lymph node started to decrease. The doctor on Monday cancelled the CT to opt for the biopsy that I waited all week for. So now Friday and the weekend is here and I still do not have any answers on this. In my haste to expedite this and get some prompt answers I am actually going backwards with this it seems. Well here it is Friday night and I have to deal with another weekend of worry and anxiety. Also today when they weighed me at the doctors I weighed 208 lbs. That is probably the lowest that I have weighed in about 10years. I have been eating as much as I can the last week or so in hopes that I can keep the weight on. When I watch what like I do normally I never lose any weight and usually stay around 212-215 lbs is where I have been the last couple of months. Now all of the sudden not watching my diet and eating all I can every day and I am losing weight? I also have not been to the gym in a couple weeks due to the health scare I am going through. I am totally afraid to sleep tonight in case I have another sweat. I have to wait now until Monday 330 to get the ct scan done which should have been done this past Monday. Do you think that these sweats could honestly be brought on by the anxiety. Do you think people can actually make themselves believe they have something and then actually manifest those exact symptoms. I really do not think it is possible to the extent in my case but what do I know. I am very in tune with my body and know what none of this is normal. I am really worried and if this happens again tonight I am checking into the hospital and refusing to leave until I have an official diagnosis. Thank you for reading my message and I look forward to your feedback and professional insight.
doctor
Answered by Dr. Robert Galamaga (8 hours later)
Brief Answer:
Followup

Detailed Answer:
Hello again,

The mind and body are very intimately connected. Anxiety can absolutely manifest symptoms which mimic systemic diseases. In your case I think there is a strong influence of anxiety. I completely understand your concern and I am confident that your doctors will ultimately provide you with an accurate diagnosis. Unfortunately we must wait some time for proper diagnostic testing to be done.

In the meantime it is extremely important that you try To shift your focus away from negative thoughts about diseases and cancer and more about maintaining good healthy lifestyle activities. I encourage you to continue to exercise interact with family members and friends and continue to eat a well-balanced diet. I realize your weightt is fluctuating as well but anxiety is well-known to cause shift in weight including weight loss.

I would encourage you to consider exercises such as meditation To help clear your mind.

Thank you again for sharing your concerns with me. I look forward to continuing to interact with you as we gain further information about what is going on and ultimately lead to a true diagnosis.

Sincerely,

Dr Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Robert Galamaga (4 hours later)
Dr. XXXXXXX

I appreciate your reply and interest in my situation. I did not have a night sweat last night and slept pretty good for the first time in a couple weeks. I have not run a fever as of yet which is a good sign I guess. The weight loss has me really concerned as I have thrown the diet to the wind and trying to eat as much as I can. Normally if I did this I would have already packed on 5-6 lbs certainly not lost weight. Last night I had pain in my bones mainly lower back and shins. Could I attribute this to the anxiety and stress my body has been put under? My BP was 164/113 yesterday when I was at the doctors office. That is the highest I have ever had in my whole life. The nurse looked at me and said are you sure you are ok that is off the charts. It is usually around 120/76 or so. Another question is that after taking the two doses of prednisone do you think that it could have had that much effect on the lymph node size reduction . It was just 100mg in 12 hours that reduced the size. The node feels like it has continued to decrease in size some more since then. The surgeon thought it was really small and said that we would do the CT and then that would determine if a biopsy was warranted. I am still convinced that I have this but part of me is trying to tell myself that I do not. If this is somehow all in head then I really need to see a psychiatrist and be studied cause I think I would be an extreme case for sure. Also based on the quick dose of pred on Monday do you think that the node would have started to increase in size again by now?
doctor
Answered by Dr. Robert Galamaga (12 hours later)
Brief Answer:
Followup

Detailed Answer:
Hello again and thank you for the follow up question.

I don't think two single doses of prednisone would be significant enough to resolve any changes in the lymph node. I still think a CT scan is a reasonable approach. The surgeon can sample any of the lymph nodes if they are enlarged.

I think you're experiencing an enormous amount of stress. This is causing symptoms such as elevation of blood pressure and fluctuation in your weight and appetite.

You might request a PET scan From your doctor if the CT scan is not revealing or if the surgeon thinks a biopsy is not indicated.

Again please try to be patient. I think a consultation with a psychiatrist would be an outstanding idea and this would benefit you immensely.

Thanks again for sharing your concerns with me.

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Robert Galamaga (10 hours later)
Dr.

Today I have a whole new worry that has come into my mind. Yesterday I felt severe fatigue again where I could not stay awake from the beginning the afternoon until I went to sleep last night. I have been telling people that last few weeks that if the lymph node is cancer then it has metastasized from a tumor on my left side cause that is where any real pain is originating from. Also had a couple night sweats last night which are very concerning. I know you are going to think I am crazy but I am now thinking this is Pancreatic cancer. The reason being I have been having this aching and pain from my left upper abodomen and rig cage to the center of my back near spinal cord. I have gotten up in the middle of the night to take aleve probably 10 times of the last few weeks. I have not had any upper abdominal pain, but have had lower pain and bloating, and acid reflux. I am thinking that the pacreatic could have been the reason I was having such bad Gerd and now this nagging pain in my left side is due to the tumor. I have had this pain with severe fatigue that comes and goes as well as weight loss. I have lost 7-8 lbs over the last few weeks. FYI my uncle on my dads side died of pancreatic cancer in his 70s. I understand it is rare in people my age but i have read multiple stories of people from 23-35 that I had it. Also there symptoms were simply indigestion, back pain, abdominal pain etc. The most alarming part is that this pain is aggravated after eating. If I lay on my left side at night then the pain really flares up and I have to take the aleve again. Reading up on this disease it scared me because it stated that the back pain is mainly after eating or lying down.
doctor
Answered by Dr. Robert Galamaga (2 hours later)
Brief Answer:
I understand. Please see psychiatrist

Detailed Answer:
Hello again.

I am very concerned that all of this is getting the best of your mind. You are really struggling with a significant amount of anxiety and I think you need to seek professional advice. Please contact the local psychologist or psychiatrist to discuss your concerns while your medical doctors work on looking to see if there is any true cost to your symptoms.

Thanks again for sharing your healthcare concerns.

Dr Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Robert Galamaga (21 hours later)
Doc,

The CT scan results came back and according the radiologist everything looked fine. The only thing that was noted was diverticuli in the colon but that was it. Would a pancreatic tumor show up on a standard CT scan? They did the CT with berrium and iv contrast. They also did a full blood workup which came out normal again. Should I accept these tests and be comfortable with the results and move on. I still have the upper endoscopy for sept 6th. Something is going on in my stomach that is not completely right. If I manifested all of these symptoms in my head then I need to be in a research study on hypochondria.
doctor
Answered by Dr. Robert Galamaga (11 hours later)
Brief Answer:
Reassurance

Detailed Answer:
Hello again.

I am glad to hear that the scan is excellent. Again it does not look like there is any evidence of lymphoma.

A CT scan is a very good test for pancreatic cancer. In your case the radiologist would have certainly commented on changes in the pancreas that might be suspicious.

Again I think the main concern at this point is with your mental health. I think you definitely need To contact your primary doctor to talk about a referral to a good psychologist.

Again I am very glad to hear about the findings of the newest imaging study. I don't think any additional studies need to be done at this point. Please work on helping to build confidence that you are healthy.

Thank you again for sending a question.

Dr. Galamaga
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Robert Galamaga

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Having GERD And Large Lymph Node In Groin. Little Hypochondriac. Had Prednisone And Having Mild Sweating. Advise?

Brief Answer:
Try and focus on remaining calm

Detailed Answer:
Hello and thank you for sending your question.

I can appreciate that you're dealing with a very stressful situation. I honestly do not see a very significant sign of active Lymphoma in your case. I understand you have a lymph node that is slightly enlarged. There are many different reasons why this can happen. One reason is exposure to a virus or bacteria. Other reasons include allergic reactions. You're correct it sometimes certain cancers can cause this but honestly that is very rare and I do not see overwhelming evidence of cancer in your case Given the symptoms you have reported.

If you are going to obtain a biopsy I would suggest that you wait a couple of weeks before having this done. I am not exactly sure why you were given the prednisone. You are correct that the prednisone can sometimes disturb the interpretation of a biopsy. If you are going to obtain a biopsy I would suggest that you have a surgeon entirely remove one of the lymph nodes for analysis.

I think you also should try to focus on maintaining your health. This includes mental and physical exercises. If you continue to focus and worry about this it will only cause you to become more anxious and possibly depressed.

I feel the chances you have cancer or Lymphoma are very small. I do agree with an appropriate diagnostic workup and possibly a lymph node biopsy.

Please follow up with your primary care doctor. Also please discuss the scheduling of a biopsy with your primary care physician.

Thanks again for sharing your health concern. If you have any additional specific questions please let us know.

Dr. Galamaga