OpenHealth Q&A

Get answered by medical professionals

Concerns Raised by ER Doctor About Oncology Referral for Lymph Node Changes

6/25/2025, 5:40:18 PMMale25-34

As a 30-year-old woman, I found myself in the emergency room last night due to intense abdominal discomfort and nausea that has plagued me for several months. After carrying out various tests, the doctor observed that my liver function tests were as irregular as usual, a consequence of my cirrhosis. Aside from that, the remaining results were relatively normal, although my potassium levels were on the lower side, which has become a recurring issue. What unsettled me, however, was the nonchalant way the ER physician mentioned the possibility of involving oncology, suggesting that just because my lab results appeared acceptable, it didn’t rule out other serious conditions. My CT scan indicated two main concerns: Mesenteric adenitis or a Lymphoproliferative disorder, mentioning specifically that my lymph nodes had deteriorated since my last scan in March. Additionally, it revealed the presence of fluid in my pelvis and around my liver. The doctor in the ER prescribed an antispasmodic medication, a drug similar to Pepcid (I believe it was Protonix), and a suppository for managing my pain. In a state of distress, I reached out to my gastroenterologist’s office, where the nurse’s reaction was one of surprise. She promptly escalated my case to the doctor and, unlike her usual practice, she refrained from discussing the details with me. I’m left feeling anxious and uncertain about my situation, eager for relief from this persistent stomach pain and desperate for a good night's sleep. My primary concern now is: Why did the ER physician suggest a referral to oncology? Is it merely a precautionary measure? The waiting for my GI specialist to return my call is adding to my stress, and I’m trying very hard to resist the urge to search for information online.

Crohn's DiseaseThyroid DisordersCOPD

Answers (1)

Cony

6/25/2025, 5:40:37 PM

OpenHealth AI

I understand that you're feeling anxious and uncertain after your recent ER visit, especially regarding the possibility of an oncology referral. It’s completely natural to feel overwhelmed when faced with complex health issues. Let’s break this down:

Main Points:

  1. Oncology Referral: The suggestion for an oncology referral could be a precautionary measure due to the changes observed in your lymph nodes.
  2. Current Symptoms and Management: Managing your abdominal discomfort and nausea is essential, and the medications prescribed may help with immediate symptoms.
  3. Follow-Up Steps: It’s crucial to address your concerns with your gastroenterologist and keep track of your symptoms.

Explanation:

The ER physician’s mention of oncology was likely due to the findings during your CT scan, particularly the deterioration of your lymph nodes and the presence of fluid in your abdomen. These observations can sometimes raise concerns about lymphoproliferative disorders, which involves the proliferation of lymph cells, and could prompt further investigation to rule out malignancy. It's important to note that a referral doesn’t mean a diagnosis of cancer but rather a thorough evaluation by a specialist is warranted based on the findings.

The ER doctor prescribed you medications to alleviate your symptoms, which should provide some comfort while you await further evaluations. The fluid around your liver and in your pelvis may require monitoring and potentially addressing once more information is obtained regarding the underlying cause.

Next Steps:

  1. Manage Symptoms: Continue taking the prescribed medications as directed. Keep hydration strong—drink plenty of fluids, as it can help with both nausea and discomfort.
  2. Document Symptoms: Keep a diary of your symptoms, noting any patterns or changes, which may help in discussions with your healthcare team.
  3. Contact Your Doctor: Reach out to your gastroenterologist’s office again if you haven’t received a callback within 1-2 days. Express your concerns and the urgency due to your symptoms.
  4. Limit Online Research: Try to avoid searching for information online, as it may add to your anxiety. Instead, focus on preparing questions for your gastroenterologist based on your symptoms and recent findings.

Finally, remember that it’s okay to seek support from friends, family, or even professional counselors if you’re feeling overwhelmed. You’re taking important steps to manage your health, and looking for answers will help you advocate for your well-being.

Related Questions

Seeking Clarity on Chronic Respiratory Issues without COPD Diagnosis

Age: 39, active individual prior to the onset of symptoms. Since May 2024, I have been experiencing frequent bouts of breathlessness and near-fainting episodes, prompting multiple emergency room visits due to the intensity of these incidents. In an effort to eliminate anxiety as a factor, I underwent a prolonged treatment with SSRIs and benzodiazepines, which produced no significant changes in my condition. A noteworthy aspect of my clinical assessments has been the consistent findings from my venous blood gas (VBG) tests. In the six instances my levels were monitored, the pCO2 readings exceeded 49mmHg, while HCO3 levels have consistently been 28.2 mmol/L or more. The most alarming results recorded a pCO2 of 70mmHg and HCO3 at 33mmol/L, with a corresponding blood pH of 7.28. Throughout this ordeal, my oxygen saturation levels have remained consistently above 97%. Comprehensive evaluations of both my cardiovascular and respiratory systems have revealed no signs of Chronic Obstructive Pulmonary Disease (COPD), despite my history as a smoker. I have been prescribed asthma medication for over a year without any observable benefits, despite only a slightly positive methacholine challenge test. Spirometry results have consistently shown normal functioning. Examinations of my heart indicated normal valve functions with only slight regurgitation noted in the pulmonary and tricuspid valves, while the aorta appeared unaffected. An ejection fraction of 55.5% was recorded. The only irregular finding during my heart evaluations was a slower heart rate recovery following a stress test. I attempted a course of Prednisone twice, each lasting seven days, though my symptoms did not improve. Recently, a chest CT scan with contrast was performed; however, the imaging of my pulmonary arteries could not be achieved despite multiple attempts, and the visible areas appeared unremarkable. A physiatrist also conducted thorough investigations to rule out any neurodegenerative conditions, which concluded negatively. Two additional symptoms that are significant include the rapid onset of episodes when sitting for prolonged periods, such as while driving or working at a computer. During these episodes, my peripheral veins constrict severely; once the episode subsides, my veins rapidly dilate, causing a noticeable swelling in my arms and legs. My blood pressure has soared to 180/130 during episodes, while my average readings hover around 140/95, indicating sustained hypertension. I am reaching out to see if anyone has insights or potential explanations for what may be causing these troubling symptoms, as I face approximately three to four episodes daily, particularly after attempting to drive.

HypertensionCrohn's DiseaseCOPD
Male25-34
4 minutes ago

Ongoing Redness in the Throat After H. Pylori Treatment – Could It Be Oral Colonization?

Greetings, I’m a 28-year-old woman. Earlier this year, I was found to have an H. pylori infection, which I have since undergone treatment for. However, I continue to experience a persistent redness in my throat and am currently awaiting a PCR stool test to confirm whether a reinfection has occurred. I’m curious to know: Is it possible for H. pylori to inhabit the mouth and lead to symptoms despite the stomach being clear of the bacteria? If so, what methods exist for testing or addressing this issue? I would greatly appreciate insights from any medical professionals, students, or researchers. I’m seeking to comprehend the broader context of my condition so I can work towards recovery. Thank you very much for your assistance!

Crohn's DiseaseThyroid DisordersInternal Medicine
Male25-34
4 minutes ago

Seeking Advice on Potential Mastoiditis

Greetings, this is my first time posting on Reddit, and I’m a 17-year-old male. Recently, I've been dealing with a severe double ear infection, which has been quite uncomfortable. I've also observed some swelling behind my left ear, and it feels warm to the touch. My general practitioner warned me that this could be a significant issue and advised me to go straight to the emergency department when I attempted to arrange an appointment. However, after spending several hours at the emergency department, I was informed that there was no noticeable swelling and was sent home. Now, it's around 1 AM, and the swelling behind my left ear seems to have increased, and I've also noticed some swelling on the right side. I am concerned about the seriousness of this situation. What steps should I take next? I would greatly appreciate any guidance or suggestions.

COPDInternal Medicine
Male25-34
24 minutes ago

Concern Over Visual Disturbances with New Multifocal Contacts

I visited my optometrist earlier today for a comprehensive eye examination and received a new prescription for multifocal contact lenses, specifically -1.50 for distance and +0.75 for reading. This marks my initial experience with multifocal lenses, and since reaching the age of 40, I’ve observed a gradual blurriness in small print. After wearing these new lenses for approximately five hours, I’ve begun to notice a slight shadow appearing around letters and words. Is this a typical sensation during the adjustment phase? Should I be concerned that I may require a stronger prescription? Is it possible that another issue, such as astigmatism, could be contributing to this? The doctor reassured me that my eyes are healthy overall. As for my background, I’m 5’4” tall and weigh 117 pounds. I have a mild case of lupus that is well managed, and I take Plaquenil which necessitates annual retinal evaluations; my latest field vision assessment was conducted in January and showed excellent results. Additionally, my only other supplements include a daily dose of Vitamin D3 (1000 IU) and a multivitamin. I’m contemplating whether I should reach out to the clinic tomorrow or simply wait for my follow-up appointment next Wednesday.

LupusFibromyalgiaCrohn's Disease
Male25-34
34 minutes ago

18-Year-Old Female, 49kg, 5'6" – Experiencing 3 Weeks of Nausea and Torso Discomfort

I want to start by mentioning that I've already consulted with a doctor. They're scheduled to conduct blood tests in three weeks since they haven’t identified the cause yet. I tend to worry excessively about my health, and the thought of something serious is quite unsettling, but I'm trying to stay lighthearted about it! Here’s what I’ve been experiencing: for the last three weeks, I’ve felt persistently unwell—weak, exhausted, and generally fatigued. Occasionally, I experience unusual sensations in my chest area, which I suspect might be linked to my lungs. The discomfort isn’t sharp; instead, it’s more abrupt and uncomfortable, fading as quickly as it appears. I’ve also had some mild diarrhea, and while I haven’t blacked out, I frequently feel dizzy and disoriented. Just to clarify, I’m definitely not pregnant—I’ve been getting my periods regularly, and I’m not on any medication. I vape daily, smoke cigarettes infrequently, and drink alcohol very seldomly. I find that I tend to be sensitive to heat, and the weather in the UK has been unseasonably warm lately. It may not be significant, but I also deal with some back pain that affects my entire spine. I struggle with anxiety and depression, which have been known to exacerbate my physical symptoms in the past, but I’ve never felt this way for such a prolonged period or with this intensity. Lately, my food intake has been limited to one or two meals a day, and I only drink water, making dehydration unlikely. I can’t help but feel that I might have some type of deficiency, and I'm curious if anyone has thoughts or suggestions that might help. Feel free to ask me any questions; I’m open to discussing this further. Also, I prefer he/him pronouns. :)

LupusFibromyalgiaCOPD
Male25-34
53 minutes ago