Is this the beginning of the end?

[dappssee]

Please I'm so scared right now. I'm 35 and for over 2 years now I've been having frequent nose bleeds which are intense at certain periods and later stop. About eight months ago, I started feeling an upper right abdominal discomfort in addition to an abdominal fullness. I also have frequent diahrrea and occasional spasms almost all over my body. I have also been generally feeling ill with aches in my joints, some pain iwhich I suppose are in my bones and occasional headaches. Just 2 weeks ago, I started noticing some blood spots under the skin of my arms. I also notice that my injuries take a long time to heal. I have seen an ENT, done a CT Scan of my head,, abdomen and pelvis which all came out fine, except that the CT Scan of my head revealed concha bullosa which all the doctors dismissed as nothing. I also did two Liver Function Tests, an ESR and two Complete Blood Count tests. The tests are all okay but the LFT showed my direct bilirubin was slightly elevated; the first CBC showed my RDW was slightly elevated, the MCHC was slightly low and the Monocytes was very high at 16.9% (upper limit of normal range is 10%). In the second CBC test about a month after, all tests were normal but the lymphocytes were slightly low. I have also done bleeding tests as well as a Coagulation Profile which shows my blood doesn't clot easily despite that all the clotting ingridients are notmal. I also have had painless nodes under my jaw which have never increased in size in the last 3yrs. I once had a dark patch over my left eyelid for close to a year but it disappeared last year. I am very worried right now and do not know what to expect as most of my symptoms seem to indicate leukemia. Could this be lymphoma? Someone please help

[dappssee]

I can also feel delphian node. Small, rubbery, immovable

[dappssee]

And I've lost like 2kg since I started exercising though my apetite is still normal. I also take multivitamins, B -complex as well as Vitamin C capsules. I'm 178cm tall and presently weigh 84kg, down from 86kg.

My biggest fear right now is cancer though the haematologist seems to doubt me but the ENT is skeptical

[dappssee]

Thanks Ken, I met the ENT. She carried out all sorts of tests and she concluded there is no blockage in my ears. My blood sugar is slightly elevated at 115. Could this be the cause. I've taken to exercises and I jog about 15 minutes every morning with some situps and pushups to go with it.

This low grade fever just seems to come and go, sometimes some dizziness. I just dont know what might be wrong. Am just gettting paranoid?

[Ken_PA]

Well, I hope that tomorrow you ask the ENT about the possibility of a post viral syndrome, with initial infection having originated in that ear. I'd expect a skeptical reply, at which point you can ask: "but why are my submandibular nodes swollen for two years if a virus can't last that long?"

The bump on your shoulder blade is possibly a lipoma (not the same as lymphoma) - a benign body composed mainly of fat cells.

The most puzzling thing is the clotting problem, which exists despite normal platelet count and (apparently) normal coagulation factor levels.

I know the opposite can occur: super low platelet numbers (a 5, where the range is 150-450) yet no bruising or bleeding results. I've seen that.

Have you tried antihistamines such as benadryl for the aches and pains? I believe that antihistamines are used for that purpose in people who take interferon. If you have a chronic infection which results in elevated interferon and histamine, that can be a parallel situation.

Good luck tomorrow.

[dappssee]

The swelling behind my head has gone down slightly and I noticed a new one over my shoulder blade last week which I forgot to mention. Feels like a muscle but its not on the other side of my body

[dappssee]

Looking at the link you posted, the node which I can feel under my chin are the submandibular nodes

[dappssee]

I must add that every abnormal blood test result I've had apart from the monocyte count have been on borderline of normal and my platelets were well in the range and not close to any of the limits. Thanks

[dappssee]

ril. Strangely, when I woke up this morning, I could hear echoes when I talk or listen to people through my right ear. I've called the ENT and I should see her tomorrow. I really don't get dizzy standing for long periods but I once got so dizzy standing that I fell back on the bed. That was over 2yrs ago. Most of my days are spent sitting down at my desk, working on my computer. Also to one of your questions, I really don't have any sort of sensitivity to any kind of food. The spasms and occasionally flashes of pain which seems like they happen in the bone really bother me. Thanks so much Ken. You're way too kind and understanding

[Ken_PA]

Hi again. Sorry, I'd meant to ask if your red blood cells were close to the bottom end of normal.

Yes, monocytes went up as they fought some infection. They are typically the first type of cell to fight. They went down as the infection receded.

Cortisol, the stress hormone, can result in lymphocytopenia, But also neutrophils tend to  rise. Are neuts at the top end of normal? Most docs don't get excited unless numbers are way out of range, but you might get some clue if they are almost out of range.

If you've had severe stress for a while, that certainly can weaken immunity generally.

Is the concha bullosa on the same side as the nosebleeds? Is the ear on that side worse, as far as ringing and also any pain? The large node from 3 years ago, same side?  Also the new bump in back of the ear?

(Btw, take a look at location of lymph nodes, URL courtesy of redred:
http://drbentownsend.files.wordpress.com/2010/12/lymph-nodes-in-head.gif  )

Here's my guess: when they poured water intro your ears, they introduced some infection, probably a virus. You've had it ever since, with intermittent flareups. Flareups can be provoked by stress and the cortisol that gets produced, which weaken immunity.

Some your symptoms might result not from the infection itself, but from the immune reaction and its signalling chemicals, like interferon and histamine. Look into adverse affects produced by interferon in people who take it as therapy, such as in hepatitis - which is a viral infection of the... liver.

Do you find you have sensitivities to foods or smells, even chlorine in water? Molds? Sometimes such sensitivities can result in symptoms. Do you have trouble staying asleep all night?

I've also just looked at your older posts. there is such a thing as viral myocarditis, which can cause heart block.

Overall, there is such a thing a 'post viral syndrome', which includes Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

Do you ever get dizzy when you stand up? Or after standing still for a long time? When your creatinine was high, was that before you started drinking lots of water daily? Post viral syndromes are also often associated with "orthostatic intolerance".

The troubling part is the spasms, which might mean the nerves are beginning to be affected.

I believe you would have a tough time getting most doctors to accept that a post viral syndrome is responsible. But that doesn't mean it isn't true, just that it's not widely investigated or known yet.

After all, you know very well that your submandibular nodes have been swollen for years, and your docs have no explanation for that.

P.S. Antibiotics will not fight a virus, only bacteria.

[dappssee]

I must add that I also experience occasional itching especially in my neck, armpit and waist. Some rashes sprung up in the areas which the doctor called a fungal infection and went when I used a medicated lotion. I was treated with camoquinn for malaria last week and was placed on some diuretics because my BP has been slightly up and I noticed full body itching.

[dappssee]

Also about three years ago, I woke up with one very large node under my neck which the doctor described as tonsilitis and it was treated but after it went down, I noticed the two peanut sized nodes under my jaws on either side and they've been there ever since. I've been on antibiotics and I have this sore throat which never seems to go away. I also noticed a small lump at the back of my head close to my ear a few days ago. It feels kind of bony. On my lip is also one very very small growth which has been there since I was a kid. I guess I'm beginning to take note of these things now based on my symptoms. Also in the last one year, I don't eat breakfast but drink up a bottle of water between 8am and 12noon when I go for lunch and then I eat dinner kind of late around 9pm-10:30pm while bedtime is from 10:30pm.

[dappssee]

Thanks for your kind response Ken. Yes there is malaria where I am but I seem to be the only one that is most affected. My bilirubim is borderline and in my last CBC, my monocytes were close to normal and my lymphocytes were slightly below normal. The nosebleed is only from my left nostril and never from anywhere else. Could it be stress related as there's no history of auto immune disorders in my family. The nodes under my jaws are not so large and have not increased in size ever since. The CT scan of my head however showed concha bullosa but all the doctors have dismissed it as not a threat. I also have tinnitus ringing in my ears very occasionally although it was more frequent when I was younger and as a kid my seniors in school used to punish me by pouring water in my ears. I await a feedback. Thanks

[Ken_PA]

Greetings to Nigeria.

Bleeding/bruising from lymphoma typically occurs because the cancer cells get into the marrow and crowd out the normal cells (megakaryocytes) that produce platelets. So the number of platelets is reduced, sometimes drastically. Yet your CBC showed normal platelet count.

Just some guesses:

"Monocytes was very high at 16.9%"  "frequent diahrrea"

Is there much malaria or dengue where you are at? Other parasites besides malaria?

I would wonder, what infection causes a clotting disorder without causing thrombocytopenia? Platelet number can be okay but platelet function is inhibited. You don't take large amounts of fish oil, do you?

"all the clotting ingridients are notmal." I presume you mean that your coagulation factors are normal. Most are made in the liver, and you have pain there but your LFT is normal.

Bilirubin is up a little (breakdown of RBCs?) yet RBC count is okay. Is it at the bottom of normal?

Lymphocytopenia can be from infection also. Also for chronically enlarged nodes, though that is not well understood.


You don't have recurrent fevers? Do you have a history of autoimmune disorders in your family?