Health anxiety, lymph node edition
August 7, 2019 11:26 AM Subscribe
I've had a slightly enlarged lymph node for nine months, and yesterday it triggered a fresh spiral of health anxiety. Also, I'm moving in a week! Help me cope until my next doctor's appointment.
Since November I've had a slightly enlarged lymph node on the left side of my neck (1 cm across). It doesn't hurt and it hasn't noticeably grown. I've also been experiencing soreness/itching/mucus in my left lung, sore throats, neck pain, headaches, and fatigue. I've been to three different specialists. Finally an ENT gave me a tentative diagnosis of LPR (silent reflux). This checks out; super greasy foods seem to make the symptoms worse. Omeprazole hasn't noticeably helped, but this seems to be normal for LPR.
I had to cancel a followup appointment due to my job search, so it's been 4 months since I've seen a doctor. Now I'm moving out of state. Perhaps due to the stress, I've been coming down with lots of colds, which tends to make all my symptoms worse, and for some reason I thought it was a good idea to start googling symptoms again.
To my consternation, I discovered that an enlarged lymph node is not a particularly common symptom of reflux. My stupid chimp brain is now convinced that my reflux is actually a symptom of something more sinister. Chimp brain is also concerned that I've been losing weight recently without trying - 10 pounds over 4 months. Then again, I've modified my diet a lot due to the reflux, cutting out fat and reducing portion sizes.
I've literally had five different doctors look at this lymph node and none of them thought it was worth further investigation. My initial chest X-ray in November was normal. I'm scheduled to see a well-reviewed primary care physician in 6 weeks at my new location. Nevertheless, Anxiety Brain won't shut up.
Here are my actual questions:
-Is there any point in trying to make a doctor's appointment sooner, besides managing my anxiety? I figure if it's something really bad, a few weeks won't make a difference.
-I'm AWFUL at dealing with health anxiety. Right now I should be focusing on a really exciting move and new job. Please suggest strategies to cope.
-Bonus: have you had weird lymph node shenanigans that turned out to be nothing? My hyper-analytical brain would love an alternative theory of what's going on here.
Thanks a bunch!
Since November I've had a slightly enlarged lymph node on the left side of my neck (1 cm across). It doesn't hurt and it hasn't noticeably grown. I've also been experiencing soreness/itching/mucus in my left lung, sore throats, neck pain, headaches, and fatigue. I've been to three different specialists. Finally an ENT gave me a tentative diagnosis of LPR (silent reflux). This checks out; super greasy foods seem to make the symptoms worse. Omeprazole hasn't noticeably helped, but this seems to be normal for LPR.
I had to cancel a followup appointment due to my job search, so it's been 4 months since I've seen a doctor. Now I'm moving out of state. Perhaps due to the stress, I've been coming down with lots of colds, which tends to make all my symptoms worse, and for some reason I thought it was a good idea to start googling symptoms again.
To my consternation, I discovered that an enlarged lymph node is not a particularly common symptom of reflux. My stupid chimp brain is now convinced that my reflux is actually a symptom of something more sinister. Chimp brain is also concerned that I've been losing weight recently without trying - 10 pounds over 4 months. Then again, I've modified my diet a lot due to the reflux, cutting out fat and reducing portion sizes.
I've literally had five different doctors look at this lymph node and none of them thought it was worth further investigation. My initial chest X-ray in November was normal. I'm scheduled to see a well-reviewed primary care physician in 6 weeks at my new location. Nevertheless, Anxiety Brain won't shut up.
Here are my actual questions:
-Is there any point in trying to make a doctor's appointment sooner, besides managing my anxiety? I figure if it's something really bad, a few weeks won't make a difference.
-I'm AWFUL at dealing with health anxiety. Right now I should be focusing on a really exciting move and new job. Please suggest strategies to cope.
-Bonus: have you had weird lymph node shenanigans that turned out to be nothing? My hyper-analytical brain would love an alternative theory of what's going on here.
Thanks a bunch!
Unless you were tiny to start with, 10lbs in four months seems wholly attributable to portion control to me. Fats especially add up really fast, and they often come with salt and carbs, both of which can cause a person to retain excess water. Plus, don't forget that weight loss can make underlying structures more obvious, so perhaps your totally normal node is now somewhat accentuated, causing you to angst about it all the more.
The neck is a relatively good place to have an enlarged lymph node, all things considered. Lots of relatively minor ears/nose/throat-type issues can cause them to be enlarged. I actually have several on one side that are just chronically palpable for no particular reason (and I've checked), and every single person who's examined them has said that they'd only be interested in persistent changes unassociated with illness.
Six weeks will be fine but you might find that if you call and explain the situation and that it's causing you a lot of stress, they can slip you in with one of the well-regarded PCP's residents/PAs/NPs beforehand and the PCP will end up reviewing everything and maybe even coming in to talk with you at that appointment anyway, while saving the full physical for the later date.
posted by teremala at 11:49 AM on August 7, 2019
The neck is a relatively good place to have an enlarged lymph node, all things considered. Lots of relatively minor ears/nose/throat-type issues can cause them to be enlarged. I actually have several on one side that are just chronically palpable for no particular reason (and I've checked), and every single person who's examined them has said that they'd only be interested in persistent changes unassociated with illness.
Six weeks will be fine but you might find that if you call and explain the situation and that it's causing you a lot of stress, they can slip you in with one of the well-regarded PCP's residents/PAs/NPs beforehand and the PCP will end up reviewing everything and maybe even coming in to talk with you at that appointment anyway, while saving the full physical for the later date.
posted by teremala at 11:49 AM on August 7, 2019
i also suffer from health anxiety. i feel you so hard. but, like you said, six weeks isn't going to change much in the scheme of things. i'd suggest calling your new doctor and asking to get on the cancellation list so maybe you can get an appointment sooner.
posted by misanthropicsarah at 12:01 PM on August 7, 2019
posted by misanthropicsarah at 12:01 PM on August 7, 2019
I have lymphoma, but no swollen lymph nodes, weight loss, etc. And can I ease your mind that many types of lymphoma are entirely treatable? I am not your doctor (or even a doctor) but lymphoma is not so bad as a worst case scenario.
posted by heavenknows at 12:07 PM on August 7, 2019 [2 favorites]
posted by heavenknows at 12:07 PM on August 7, 2019 [2 favorites]
Like you, I struggle with health anxiety. In fact, I've had this specific thing send me into a freak-out in the past. Allow me to give you the benefit of what I learned from said freak-out.
First off, lymph nodes can become enlarged for various reasons, most of which have to do with your body fighting off infections. You may have had a cold, or you may not have had a cold, because your immune system, of which your lymph nodes are a part, successfully fought it off - that kind of successful immune response can cause swelling in lymph nodes too.
But wait, you say, this has been going on since November! How can that possibly be a result of a cold if it hasn't gone away? To which I ask you: how do you know it's been swollen since November? How do you know how big it is? Have you, by any chance, been touching it regularly to see if it's still swollen, how swollen it is, and if it's grown? Because repeatedly touching an already swollen lymph node can absolutely cause it to remain swollen! That's exactly what happened to me - I was so freaked out that I kept touching it to see if it was still there, and that basically made sure it would be.
Some other things to think about. You say:
Right now I should be focusing on a really exciting move and new job.
Now I don't know you, and I'm not your psychiatrist (do you have one? I'll come back to that), but it's possible, and even likely, that it's precisely the moving and the new job that is causing you to freak out about this now. That's how it goes with me - something stressful happens in my life, and I displace my anxiety onto my health.
As to what you should do, I recommend a two pronged approach.
1. Go ahead and try to get an earlier doctors appointment. Not because anything serious is likely to be wrong, but because you're having a tough time, and some reassurance will likely help with that. Why suffer needlessly. BUT. That has to be paired with:
2. Seek treatment for your anxiety. You don't mention talking to a therapist about this, which leads me to believe that you've just sort of accepted health anxiety as part of your personality, or, even worse, as a useful and protective thing. I really, really encourage you to rethink this. You're going to doctors for other stuff, which makes me think you probably have health insurance. Go to the doctor for this as well! You don't have to live like this.
posted by Ragged Richard at 12:08 PM on August 7, 2019 [1 favorite]
First off, lymph nodes can become enlarged for various reasons, most of which have to do with your body fighting off infections. You may have had a cold, or you may not have had a cold, because your immune system, of which your lymph nodes are a part, successfully fought it off - that kind of successful immune response can cause swelling in lymph nodes too.
But wait, you say, this has been going on since November! How can that possibly be a result of a cold if it hasn't gone away? To which I ask you: how do you know it's been swollen since November? How do you know how big it is? Have you, by any chance, been touching it regularly to see if it's still swollen, how swollen it is, and if it's grown? Because repeatedly touching an already swollen lymph node can absolutely cause it to remain swollen! That's exactly what happened to me - I was so freaked out that I kept touching it to see if it was still there, and that basically made sure it would be.
Some other things to think about. You say:
Right now I should be focusing on a really exciting move and new job.
Now I don't know you, and I'm not your psychiatrist (do you have one? I'll come back to that), but it's possible, and even likely, that it's precisely the moving and the new job that is causing you to freak out about this now. That's how it goes with me - something stressful happens in my life, and I displace my anxiety onto my health.
As to what you should do, I recommend a two pronged approach.
1. Go ahead and try to get an earlier doctors appointment. Not because anything serious is likely to be wrong, but because you're having a tough time, and some reassurance will likely help with that. Why suffer needlessly. BUT. That has to be paired with:
2. Seek treatment for your anxiety. You don't mention talking to a therapist about this, which leads me to believe that you've just sort of accepted health anxiety as part of your personality, or, even worse, as a useful and protective thing. I really, really encourage you to rethink this. You're going to doctors for other stuff, which makes me think you probably have health insurance. Go to the doctor for this as well! You don't have to live like this.
posted by Ragged Richard at 12:08 PM on August 7, 2019 [1 favorite]
Make an earlier appointment because it WILL help the anxiety, or at least put yourself on a cancellation list.
As a data point, when I had a lymphoma scare (weeks of unexplained horrible night sweats and weight loss) the first line of diagnostics was a chest X-ray, so you having a clear one is a very good sign. They only gave me a CT scan because symptoms remained unexplained.
But. Your weight loss is not unexplained and your symptoms can very well be related to GI issues, including the swollen lymph node. So expedite for your own mental heath but do not let this spiral into panic!
posted by lydhre at 12:13 PM on August 7, 2019
As a data point, when I had a lymphoma scare (weeks of unexplained horrible night sweats and weight loss) the first line of diagnostics was a chest X-ray, so you having a clear one is a very good sign. They only gave me a CT scan because symptoms remained unexplained.
But. Your weight loss is not unexplained and your symptoms can very well be related to GI issues, including the swollen lymph node. So expedite for your own mental heath but do not let this spiral into panic!
posted by lydhre at 12:13 PM on August 7, 2019
I had a couple of nodes in my head/neck last year that felt larger and more solid than I remembered, and I'd also been losing weight without trying. I freaked out about it and had a bunch of tests done, including a CT and a neck ultrasound, but ultimately it turned out that I just have larger-than-average lymph nodes (and ironically the unrelated weight loss, which was most likely from a combo of coming off some medication a few months earlier and getting a bit more active overall, made the nodes more prominent, and thus more worrisome for me).
The most reassuring part was when I had the neck ultrasound and the radiologist showed me my nodes, and the fact that they were a healthy shape/had healthy centres; they're just on the big side of average.
posted by terretu at 12:44 PM on August 7, 2019
The most reassuring part was when I had the neck ultrasound and the radiologist showed me my nodes, and the fact that they were a healthy shape/had healthy centres; they're just on the big side of average.
posted by terretu at 12:44 PM on August 7, 2019
By chance were you ill (any kind of ill--head cold, sore throat, etc.) before you noticed the enlargement? Sample size of one here, but I had a lymph node triple in size and become a bulging thing on my neck when I was sick one time twenty years ago, and it just... never went back to normal. Which is apparently a thing, that lymph nodes sometimes do.
Also, if you have seen five doctors and are not satisfied by their unanimous collective diagnosis, have you considered the possibility that an SSRI can make medical anxiety improve immensely? It might be worth mentioning the extent of your concerns at your next appointment.
posted by Mayor West at 1:34 PM on August 7, 2019 [1 favorite]
Also, if you have seen five doctors and are not satisfied by their unanimous collective diagnosis, have you considered the possibility that an SSRI can make medical anxiety improve immensely? It might be worth mentioning the extent of your concerns at your next appointment.
posted by Mayor West at 1:34 PM on August 7, 2019 [1 favorite]
Where is it on your neck?
A friend of mine had a lump on her neck that she thought as a lymph node and turned out to be a thyroid nodule, but it was in the area of her thyroid.
posted by jamjam at 3:54 PM on August 7, 2019
A friend of mine had a lump on her neck that she thought as a lymph node and turned out to be a thyroid nodule, but it was in the area of her thyroid.
posted by jamjam at 3:54 PM on August 7, 2019
I don't think that's a significant weight loss, especially since you've changed your eating habits. 10 pounds over 4 months works out to be about 2.5 pounds a month. That works out to about .75 pounds a week. That can totally be explained by reducing the fat in your diet.
I'll agree with others that trying to get on a cancellation list in your current area is a good idea. Perhaps that doctor can help your with your anxiety in the short term. Longer term, it might be an idea to talk to your new doc about the level of anxiety you're having WRT your health. A therapist can definitely help with that.
posted by kathrynm at 6:22 PM on August 7, 2019
I'll agree with others that trying to get on a cancellation list in your current area is a good idea. Perhaps that doctor can help your with your anxiety in the short term. Longer term, it might be an idea to talk to your new doc about the level of anxiety you're having WRT your health. A therapist can definitely help with that.
posted by kathrynm at 6:22 PM on August 7, 2019
Response by poster: Thanks, all! I'm feeling a lot better about this. I'll call the doctor and try to get myself on a cancellation list.
Seeing a mental health professional is on my list of things to do in New City. I haven't been in regular treatment for my anxiety + other issues, and I'm actually quite excited that my new situation is going to make it possible.
Re: the infection theory, I had bronchitis right before my probably-reflux symptoms started, so yeah, my lymph node might just be permanently wonky.
posted by toastedcheese at 6:35 PM on August 7, 2019 [1 favorite]
Seeing a mental health professional is on my list of things to do in New City. I haven't been in regular treatment for my anxiety + other issues, and I'm actually quite excited that my new situation is going to make it possible.
Re: the infection theory, I had bronchitis right before my probably-reflux symptoms started, so yeah, my lymph node might just be permanently wonky.
posted by toastedcheese at 6:35 PM on August 7, 2019 [1 favorite]
This thread is closed to new comments.
I am not saying you don't have cancer, but I am saying that all the swollen and sore lymph nodes I ever had were the result of infections and not the result of cancer.
posted by Jane the Brown at 11:43 AM on August 7, 2019 [3 favorites]