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Family Medicine (Expert Forum)
Causes of Extreme Fatigue/ swollen lymph node/ bowel problems...
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Causes of Extreme Fatigue/ swollen lymph node/ bowel problems...
by CanadianCartier, Aug 03, 2005 12:00AM
Hi,
I am a 28 year old female, who, aside from an injury, was in very good health, up until about 8 months ago. Let me start off by saying that due to a traumatic accident I have an injury to the joints/ligaments/muscles in my neck from 5 years ago. I have Joint facet syndrome, myofacial pain syndrome, and chronic tension headaches that NEVER have gone away since the moment of the injury, although the headaches due very in intensity and they are controlled by pain medications, chiropractic adjustments and massage therapy. I am currently taking for pain Avinza 90mg, 1x daily (at bedtime), I have been taking this for nearly 2 years, and I also take Topomax (topamax), 75mg, 2x daily. Approximatly 8 months ago I had strep throat, I was treated with antibiotics and seemed to get better.
However since then my menstrual cycle has been completely messed up, much much heavier than usual, especially for the first 2 days and instead of the usual 27-29 days between, it is upwards of 35- to sometimes 40 days between cycles, with quite a bit of spotting in between. The spotting is ALWAYS a dark, thick brown, very dark brown though, it doesn't even look like blood.
Whenever I have gone to the doctor the last couple of years, they all tell me I have a fast heartate, with a resting rate over 110. I mention that other doctor's have said that, and it is noted on my chart.
Some of the medications I am on causes constipation, so I take citrucel to help avoid that, but th last few months it seems that it just doesn't seem to be working as well. I eat a pretty well balanced diet with lost of fruits and vegetables.
I have had 3 cesareans for the births of my children and other than that nothing else has gone on in my abdomen.
About 3 months ago I had bronchitis and an ear infection(in the middle of the summer!!) Once again, antibiotics (Omnicef).
It is quite rural where we live, only a nurse practioner is readily available, and I am afraid that that this could all be one BIG thing, instead of a series of little ailments. I still have a lingering nagging nuisance cough, it is NOT the barking cough like the bronchitis, but almost like a fake sounding throat clearing cough, but it produces a foul tasting phlegm, unlike any phlegm from any bronchitis I have ever tasted. It is a white w/a touch of yellow in color to it. Also, the lymph node on the right side of my neck is swollen and extremely painful, the left is a little swollen, but doesn't seen so painful. I was given Zithromax for this. I've been asked about my meds causing some of my symptoms, but I've been on these meds for 2 years with no problems, and only been experiencing these symptoms for 1-8 months, depending on the symptom.
I have always been very healthy and active. I am 5'2, and weigh 135 lbs. I have 3 young children, and I just can't bear the thought of something serious being overlooked, and ideas to steer the practioner in the right direction would be greatly appreciated. Thanks
I am a 28 year old female, who, aside from an injury, was in very good health, up until about 8 months ago. Let me start off by saying that due to a traumatic accident I have an injury to the joints/ligaments/muscles in my neck from 5 years ago. I have Joint facet syndrome, myofacial pain syndrome, and chronic tension headaches that NEVER have gone away since the moment of the injury, although the headaches due very in intensity and they are controlled by pain medications, chiropractic adjustments and massage therapy. I am currently taking for pain Avinza 90mg, 1x daily (at bedtime), I have been taking this for nearly 2 years, and I also take Topomax (topamax), 75mg, 2x daily. Approximatly 8 months ago I had strep throat, I was treated with antibiotics and seemed to get better.
However since then my menstrual cycle has been completely messed up, much much heavier than usual, especially for the first 2 days and instead of the usual 27-29 days between, it is upwards of 35- to sometimes 40 days between cycles, with quite a bit of spotting in between. The spotting is ALWAYS a dark, thick brown, very dark brown though, it doesn't even look like blood.
Whenever I have gone to the doctor the last couple of years, they all tell me I have a fast heartate, with a resting rate over 110. I mention that other doctor's have said that, and it is noted on my chart.
Some of the medications I am on causes constipation, so I take citrucel to help avoid that, but th last few months it seems that it just doesn't seem to be working as well. I eat a pretty well balanced diet with lost of fruits and vegetables.
I have had 3 cesareans for the births of my children and other than that nothing else has gone on in my abdomen.
About 3 months ago I had bronchitis and an ear infection(in the middle of the summer!!) Once again, antibiotics (Omnicef).
It is quite rural where we live, only a nurse practioner is readily available, and I am afraid that that this could all be one BIG thing, instead of a series of little ailments. I still have a lingering nagging nuisance cough, it is NOT the barking cough like the bronchitis, but almost like a fake sounding throat clearing cough, but it produces a foul tasting phlegm, unlike any phlegm from any bronchitis I have ever tasted. It is a white w/a touch of yellow in color to it. Also, the lymph node on the right side of my neck is swollen and extremely painful, the left is a little swollen, but doesn't seen so painful. I was given Zithromax for this. I've been asked about my meds causing some of my symptoms, but I've been on these meds for 2 years with no problems, and only been experiencing these symptoms for 1-8 months, depending on the symptom.
I have always been very healthy and active. I am 5'2, and weigh 135 lbs. I have 3 young children, and I just can't bear the thought of something serious being overlooked, and ideas to steer the practioner in the right direction would be greatly appreciated. Thanks
Doctor's Answer
by Kevin Pho, MD, Aug 04, 2005 12:00AM
, Aug 04, 2005 12:00AM
Difficult to say without examination. Regarding the cough - there are various reasons for a chronic course. This can include post-nasal drip from chronic sinusitis, GERD, or asthma. These can be evaluated with a sinus CT, upper GI/24hr pH study, and pulmonary function tests respectively.
The swollen lymph node needs further evaluation. Most cases of neck nodes (i.e. cervical nodes) include infection - which is why antibiotics were likely prescribed. The cough that you are having may be related to this.
Cases of cancer can also present with lymph nodes. If they persist despite antibiotics, then you may want to discuss the possibility of a biopsy with your personal physician.
With the changes in bowel habits, you can consider an endoscopy to rule out any anatomical obstruction that can lead to a slowing of bowel habits. If negative, you can consider GI referral for more specialized testing.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
The swollen lymph node needs further evaluation. Most cases of neck nodes (i.e. cervical nodes) include infection - which is why antibiotics were likely prescribed. The cough that you are having may be related to this.
Cases of cancer can also present with lymph nodes. If they persist despite antibiotics, then you may want to discuss the possibility of a biopsy with your personal physician.
With the changes in bowel habits, you can consider an endoscopy to rule out any anatomical obstruction that can lead to a slowing of bowel habits. If negative, you can consider GI referral for more specialized testing.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Member Comments
by MimiDe, Jul 27, 2008 09:55AM
A related discussion, extreme fatigue, accompanied with vaginal bleeding was started.
