Something Serious? Please Help!

[TNConsultant]

I am a 32 year-old woman desperate for answers. My general practitioner isn't concerned and sees no need to evaluate my condition further or refer me to a specialist. He has offered no follow-up care whatsoever, despite continued symptoms.  I don’t know if I should be concerned or just forget about everything.  My illness started New Years Day 2008, with a sinus infection. I was told it was a virus and sent on my way. When it didn’t improve, I was given an antibiotic the next week. Within 24 hours, my condition worsened.  I experienced shortness of breath, cough, a resting heart rate of 150, fever of 102 (flu test was negative) and a blood pressure of 160/105. The ER doctor suspected a PE, and a D-Dimer test returned positive.  A chest CT showed a "single small 2mm filling defect in a branch of the right pulmonary artery to the right middle lobe" which the radiologist said was of uncertain clinical significance. He noted "swelling nodular appearing opacity in the left lower lobe;" however the lung bases were not entirely included on the images, and he was unable to determine further findings. Finally he noted a small amount of subphrenic fluid.  I was released without treatment and told to follow up with my doctor about the tachycardia.  By the next day, my condition had declined further; I had significant trouble breathing with continued tachycardia and cough.  The ER conducted a 2nd chest CT.  It showed "nodular airspace disease" in the left lower lobe, soft tissue prominence in the left lower lobe, a "suspicious lytic or blastic process," and an enlarged lymph node measuring 26mm compared to previous healthy study where it measured 17 x 7mm.  While my breathing has finally improved for the most part, the tachycardia and high BP have continued, with added chest pains and heart palpitations. Upon examination for the chest pain and high BP (180/110) a few days ago, an ER doctor discovered my thyroid was enlarged. While the T-4 and TSH were normal, the Thyroglobulin Antibodies were just 1 point above the lab range of <20.  The doctor felt that this was of significance with my symptoms, and he stated that the condition could have developed as a result or in conjunction with my “lung disease,” whatever that meant.   I followed up with my general practioner who still thinks everything is OK and doesn’t see the need to follow up with anything or consult with a specialist. (The radiologists who read both chest CT’s recommended follow-up CT’s to further evaluate the lung condition).  For the past two months, my blood oxyen rate has been between 90 and 95, never higher. I am so frustrated by all of this and I don’t know what it means.  Do I have a reason to be concerned?  Should I pursue follow-up care with a specialist?  Is there any reason to think that the “soft tissue” in my left lower lobe could be something of significance?  The radiologist noted the following in my 2nd CT, “Neoplastic etiology including lymphoma considered less likely but not excluded.”   Should I be concerned with a positive D-Dimer and the first CT results?  Thanks in advance for your assistance and feedback.  

[Sunny602]

I don't think that it would hurt to get some more heads in on your case...see that specialist especially if you are still having problems
As far as that first CT scan and your positive D dimer, tachycardia and fever...I wonder if you did indeed have a PE.
I am not a doc, so please take what I say with a grain of salt...I have suffered what is called micro emboli,meaning that the blood clots that went to my lungs were very tiny and numerous. The only way the doc picked up on that was from my lung biopsy. The pathologist could see the tiny micoremboli in my arterioles in my lungs. At the time of my symptoms, they did CT scanning along with the typical tests for PE and they came back "normal"...my microemboli were missed by traditional testing. I too had tachycardia and low O2 levels (I have other issues that contributed to this, but they were more exaggerated at the time of my PE).
In my honest opinion, I think you need to see a new doctor who will listen to you. Nothing is more frustrating than a doctor who is so passive and not willing to explore why all of this is happening to you.
Good luck...Sunny