Please Help!!!

[football_fan]

Hi, I need some help with where to go from here. I am 32y/o and used to smoke a little under a pack a day since I was 17. Otherwise very healthy and active. Shortly after the birth of my first child, I was having minor chest pains and some back issues. I went to my pcp and he dx'd me with anxiety attacks. Just to be safe, I went to the ER back in Jan08 after having some tightness. CXR was clean, went back to pcp and begged him to send me for a CT scan to be sure. So I had the CT scan back in Feb08. CT was clear.
Most recently I was changing a tire. While turning the lug wrench I pulled something in my shoulder. The pain lasted a few days and then went away. 2 weeks ago I started having slight pains in my shoulder. Nothing major, I have full range of motion. Just sore in my clavicle area. It was off and on. It bother me during the day and go away at night or vice versa. Over this past weekend I had slight pain in my other shoulder as well. Now they kind of alternate. Half of the time I don't even have any pain. None of the pain has been severe. Just annoying. 3 days ago my stomach started getting really bubbly too. Not sure if thats just stress.
My question is who should I make an appt with to get immediate dx's and tx? I've been searching the internet and came across pancoast tumors. I'm worried because of my smoking history that this might be the problem.
Should I see a nuerologist, pulmonary specialist, Spine specialist. I am very scared, but I understand I need to get looked at ASAP.
My other question is being as though I had the CXR in Jan08 and CT Scan in Feb08, is it possible for anything to grow that fast? Is it possible to go from clear to a tumor large enough to press a nerve in less than 3 months? Or is it possible both test just never picked it up?
Please help

[football_fan]

Can someone please explain this ct scan report to me? My doctor said I was all clear and sent me on my way. But it seems to me that this report suggest further investigation?

Findings: Amorphous density in the anterior superior mediastinum could represent residual thymus and/or lymph nodes. Several nonpathologically enlarged mediastinal lymph nodes are seen in the aorticopulmonary window and right paratracheal region. While evaluation of the mediastinum and hilum is limited without contrast, no other large abnormality in seen. The lungs and pleura are clear. Slightly prominent lymph nodes are seen in both axillae. There is soft tissue asymmetry in the portion of the larynx.

I'M NO DOCTOR, BUT SOUNDS TO ME LIKE SOME STUFF NEEDS FURTHER INVESTIGATION.

Impression:
1.Possible residual thymus in anterior superior mediastinum. Findings suggest 2.nonpathologically enlarged mediastinal lymph nodes.
3.Mild soft tissue asymmetry in larynx requires clinical correlation
4.Slightly prominent axillary lymph nodes
5.No pulmonary or pleural abnormality
6.Followup requires a decision based on the clinical background

WHILE I KNOW #5 IS A GOOD THING, WHAT ABOUT 1,2,3,4, & 6?
ESPECIALLY SINCE NOW I HAVE SWELLING IN MY RIGHT AXILLAE. WHICH IS WHAT I SUSPECT CAUSED/ING MY ARM PAIN. IF I LIFT MY RIGHT ARM YOU CAN'T REALLY TELL ITS SWOLLEN, HOWEVER IF I PUT MY ARMS AT MY SIDE. I CAN FEEL THE DIFFERENCE BETWEEN BOTH ARMPIT AREAS.
ON THE BRIGHT SIDE(IF THERE IS ONE) MY SHOULDER NO LONGER HURTS. BUT I DO FEEL SOME PAIN IN THE LYMPH NODE AREA UNDER ARM.

[National Jewish Health]

Given the history of back pain and now bilateral shoulder pain, including the shoulder that was not strained while changing a tire, the pain could be a reflection of nerve root compression.  In any event, your best bet would be to see a neurologist first, unless you have reason to believe that you might have traumatized both shoulders changing a tire, in which case you would do best to see your primary care provider (PCP), a rheumatologist or an orthopedic doctor.

Pancoast tumors would be very unlikely, even with a history of smoking, especially at age 32, with no sign of such on either the recent chest x-ray or a CT scan.  A tumor would almost never grow that fast.  An infection with an abscess could, but that is rare.  That the symptoms seem to be bilateral, would strongly favor another, most likely benign cause.

[bonster4097]

I hope they help ya, i recently quit smoking march 18, 2008.  ever since my breathing is worse myself, and other things.  i'm trying not to panic about it. hopefully you have a doctor you can trust and you  will just have to have faith. I am a worrier like you, and i have had many tests run. I still have one more doctor to go.  After that, I will have to believe in my doctor, and just have faith. I know I don't do what I'm supposed to and maybe that would help me, so if you are doing the same you might want to quit too and that is your diet. Caffeinie, sugar, soda, salt? to much of anything,is bad for you, and afterwhile you've done so much, that even a little is to much.  later bon