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
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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.
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Pain Management: Consider over-the-counter pain relievers like acetaminophen or ibuprofen, to ease discomfort as needed, unless contraindicated based on your previous treatments.
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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.
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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.
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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.
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