Understanding Persistent Swelling of Lymph Nodes and Severe Fatigue: How Concerned Should I Be?
I am a 26-year-old woman, standing at 5’3” and weighing 180 pounds. I have a medical history that includes rheumatoid arthritis, migraines, autism, and ADHD. As I await my follow-up appointments, I seek insight regarding a health issue. For over six weeks, I have been experiencing a consistently swollen lymph node located under my jaw, on the right side. It is firm and uncomfortable, although not severely painful. Recently, I have also noticed swelling behind my right jaw joint, accompanied by pressure sensations affecting my ear. While there are no drainage issues or alterations in my hearing, I do experience discomfort along with a sensation of fullness. This swelling becomes more pronounced while breathing and swallowing, and I find myself having occasional coughing fits, coupled with difficulty in catching my breath. Additionally, I am grappling with severe fatigue that has intensified over time, despite getting adequate sleep. This unfortunately is the most debilitating fatigue I have ever encountered, which is particularly significant given my existing autoimmune conditions. I am not experiencing fever, recent infections, or night sweats. Alarmingly, I have unintentionally lost a considerable amount of weight—approximately 85-100 pounds over the past eight to twelve months, without actively trying to shed any pounds. Recent blood tests indicated an increase in lymphocytes, but my ESR and CRP levels remained within normal ranges. I have a CT scan scheduled but have not undergone it yet. Two weeks ago, I had an ultrasound that revealed no remarkable findings, although the technician seemed confused about my description of a lump. I find myself wondering about how serious my condition might be in the interim. Should I be worried that this could signal something urgent, such as lymphoma or an abscess, or is it likely that it’s a benign and slow-progressing issue? My discomfort is impacting my ability to work, as I am canceling clients due to overwhelming exhaustion, and I feel generally unwell—my symptoms are worsening. Notably, one side of my neck and face appears visibly swollen, and I can barely detect a pulse on that side due to the extent of the swelling. I appreciate any guidance you can offer. Today has been particularly difficult, and while my wife urges me to seek emergency care, I am unsure whether the situation warrants it. I have another appointment with my doctor in a week; do you think that will suffice?
Answers (1)
7/1/2025, 6:31:12 PM
OpenHealth AI
It's understandable to be concerned about persistent lymph node swelling and severe fatigue, especially given your medical history. You are right to seek clarification while awaiting further medical evaluation. Here's a structured approach to your situation:
Key Points
- Swollen Lymph Node & Fatigue: Your symptoms of a firm, swollen lymph node and significant fatigue warrant close monitoring, particularly as they have persisted for more than six weeks.
- Weight Loss & Other Symptoms: The notable weight loss and the discomfort you're experiencing suggest a potentially serious underlying issue that deserves attention.
- Need for Further Evaluation: While waiting for your CT scan, it’s crucial to assess whether your symptoms are worsening.
Explanation
Swollen lymph nodes can arise from various causes, including infections, inflammation, or even malignancies. Given your description of other symptoms—pressure sensations, difficulty breathing, and significant fatigue—these factors combined with a notable weight loss might indicate a more serious health issue that requires further investigation.
Your ultrasound did not show remarkable findings, which is somewhat reassuring, but the increasing lymphocyte count in your blood tests suggests that your body is responding to some form of stress, which could be due to an underlying condition.
Next Steps
-
Monitor Symptoms: Keep a close eye on your symptoms, especially any changes in the swelling, breathing difficulties, or if you experience fever or new symptoms like chills.
-
Pain Management: Consider over-the-counter pain relievers like acetaminophen or ibuprofen, to ease discomfort as needed, unless contraindicated based on your previous treatments.
-
Urgency Assessment: If your sympathies worsen or you experience shortness of breath that markedly impacts your daily activities, consider seeking emergency care sooner rather than waiting for your scheduled appointments. Severe fatigue that prohibits you from functioning normally is also a key symptom warranting urgent attention.
-
Prepare for Your CT Scan: Make a list of all your symptoms and how they’ve changed, as well as your medical history, to discuss during your CT scan appointment and with your healthcare provider. This will help guide your diagnosis and potential treatment.
-
Follow Up: After the CT, ensure you discuss the results and further steps with your doctor promptly. If your fatigue continues to worsen or you develop new symptoms, don’t hesitate to reach out before your next appointment.
Reassurance
It's good that you are monitoring these symptoms closely. While it's natural to worry about what potential conditions could be, staying organized and proactive in seeking care is the right approach. Your health concerns deserve attention and should be addressed thoroughly in your upcoming appointments. Remember to lean on your support system, including your wife, as you navigate this challenging health period. If any acute changes occur, please do not hesitate to seek immediate medical attention.
Related Questions
Neurological Challenges Mimicking POTS Symptoms
A 36-year-old female, weighing 265 pounds, is dealing with a complex medical history that includes conditions like Complex Regional Pain Syndrome (CRPS), bipolar disorder, anxiety, PTSD, and a splenic artery aneurysm. There is a tentative diagnosis of hypertensive Postural Orthostatic Tachycardia Syndrome (POTS). The patient experiences significant symptoms when not on medication, including a rapid heartbeat (ranging from 117 to 150 beats per minute), dangerously high blood pressure, episodes of vision impairment, difficulty walking accompanied by stumbling and falls, tremors, memory issues, and brain fog. Currently, her medication regimen includes Pristiq, lithium, lorazepam, low-dose naltrexone for pain management, and propranolol to regulate heart rates. She takes ubrelvy when needed. In January, a recurrence of severe pain radiating from her right side led to a hospital admission where her gallbladder was surgically removed due to complications. Although the surgery was successful, she subsequently developed CRPS, further complicating her health. While working in the emergency department, she experienced a sharp tearing pain associated with her known aneurysm. Unable to manage the pain, she informed her manager of her need to leave. During her walk back to her workspace, approximately 1500 feet away, she began to stagger and lost her vision, while also experiencing heavy sweating and shortness of breath. Support from coworkers was crucial, as she lost her strength and collapsed, gasping for air and experiencing vertigo. Her heart rate was recorded at almost 150 bpm and her blood pressure at 152/120. Once lying down, her vitals stabilized but would escalate again with movement. The attending nurse suspected POTS based on her symptoms. Despite efforts to provide explanations, her overnight doctor attributed her condition to anxiety. However, subsequent doctors recognized her situation increasingly suggested POTS and put her on a heart monitor after she began falling to one side, which later confirmed episodes of tachycardia over a monitoring period of two to three days. Her first cardiology appointment revealed a drop in her blood pressure when she stood, further aligning with the POTS suspicion. An echocardiogram was scheduled for the following week, but complications arose the very next morning at work, where rising distress prompted coworkers to assist her following an apparent episode of tachycardia. Administered Ativan temporarily helped alleviate some symptoms, but as her condition worsened, she was transported to the emergency department once again. After several hours of treatment, she was discharged with little clarity regarding her condition. Currently, she takes an extended-release dose of propranolol (80 mg), but without it, her heart rate can exceed 130 bpm, accompanied by memory lapses. Episodes of sporadic vision loss persist, alongside difficulty walking that has progressed to staggering or being unable to move at all, leading to falls. These occurrences are thought to be related to syncope. Neurological evaluations are underway, with initial tests like ECG and EEG returning normal results, but an MRI suggested increased intracranial pressure, though some specialists doubt its relevance. A pain specialist indicated that her pain conditions may not directly correlate but suggested central nervous system dysfunction related to stress could be a factor, as her symptoms often intensify during anxious moments. An Ear, Nose, and Throat specialist found no abnormalities causing her symptoms, and her cardiologist is pursuing further investigation at a specialized clinic, expressing concern about her ongoing employment due to the physical and financial strain it entails. The patient’s aneurysm was treated with an embolism in September, adding another layer to her intricate medical profile, and she is seeking additional perspectives on her challenging situation.
Understanding Prolapsed Appendix in Young Adults
Hello all, I’m a 25-year-old woman who has been struggling with persistent abdominal discomfort, along with nausea and diarrhea, for more than a decade. A recent colonoscopy has diagnosed me with a prolapsed appendix, despite the fact that my colon appears unaffected. Biopsy samples were collected to investigate potential inflammation, and I am currently awaiting those results. Additionally, I have a balloon enteroscopy scheduled to examine my small intestine more closely. From my research, it seems that appendiceal prolapse or intussusception is quite uncommon in adults. I am particularly interested in understanding how rare this issue truly is, especially for someone at my age, along with the typical causes that could lead to this condition. I have a few queries: How uncommon is a prolapsed appendix in adult patients? What are the most frequent causes linked to young women like myself? Are there specific risk factors or trends that might increase the likelihood of developing this issue? I’m not seeking a personal assessment, but I would be grateful for any information from those who are familiar with the occurrence and causes of this condition.
Did I Experience a Seizure Upon Waking?
This morning, I had an awakening that was unlike anything I’ve felt before. As a 23-year-old man, I’m familiar with sleep paralysis, often waking up immobile; however, today was distinct. I found myself in a state that resembled paralysis but accompanied by rapid, shallow breaths, akin to hyperventilation—something I don’t typically experience, even during strenuous activities. My body was trembling, reminiscent of numbness from cold or perhaps involuntary contractions throughout. Additionally, I felt a strange pressure on my groin, coupled with discomfort in my right testicle, as if they were being retracted into my body. I don’t regularly take medication aside from using an albuterol inhaler during asthma flare-ups. Standing at 6 feet 4 inches tall and weighing approximately 210 pounds, I also had a particularly unsettling dream just prior to waking, which might explain my reaction (at least, I hope it does). However, I can’t shake the anxiety that this could have been a type of seizure and I’m eager for input from those who have more expertise on the subject.
Are My Symptoms Indicating an Impending Stroke?
I’m a young adult female, weighing 99 pounds and standing 5 feet 2 inches tall. I do not smoke, vape, or consume alcohol, and currently, I am undergoing tests for POTS and HEDS. For the past two weeks, I have been experiencing intermittent discomfort in the upper region of my head, particularly in the back and temples. These aren’t typical headaches, but rather sudden twinges of pain that occur sporadically throughout the day. Additionally, over this same period, I have been dealing with bouts of vertigo—probably about 4 to 5 days where it came and went. A few days back, I also encountered a tingling sensation in my arms, which I can’t tell if it was simply due to anxiety. Given that my aunt suffered a stroke in her thirties, the prospect of having a stroke terrifies me. I find that the emergency room here primarily prescribes pain medication if you mention head discomfort, which leaves me uncertain about what steps to take next. Could these symptoms signal an impending stroke? Furthermore, I've also been experiencing pain in my left leg, though I’m unsure if that’s connected to my other symptoms.
Identifying Skin Marks on My Child
My 5-year-old daughter, who has no history of allergies, has developed peculiar skin marks over the past four to five days. Each morning, I observe these blemishes, which mysteriously disappear by the next day, only to reappear in different locations. The majority of these spots are located on her lower back, buttocks, and the back of her thighs, although I've also seen some on her upper back and a single one on her cheek. As an additional note, she began exhibiting mild cold symptoms last night, including a cough, some mucus, and a slight increase in body temperature. To provide further context: she mentioned that the marks are somewhat itchy, but she hasn’t been scratching them excessively.