43 Female 5'6" 260 lbs Medications: Adderall, Cytomel Non smoker
I have had episodes of tonsillitis my entire childhood but was never diagnosed as chronic and I still have my tonsils. My tonsils are full of crevices so I am prone to tonsil stones.
My ENT ordered a CT of the soft tissues in my neck and I have the results. Could someone please interpret them for me? I don't think it's anything bad, correct? I'm worried about the lymph node and neck stuff.
CLINICAL INFORMATION: Chronic tonsillitis J3501. Difficulty swallowing/breathing
TECHNIQUE: CT of the soft tissues of the neck was performed without after the administration of 75 cc of Omnipaque 350 contrast with images reformatted in the sagittal and coronal planes. This CT was performed using Dose Check and Dose Alert along with structured dicom reporting by GE, compliant with NEMA XR 29 standards. Clarity by Saphenia was utilized for dose reduction and image enhancement. Patient has had 1 CT at this facility in the past 12 months
COMPARISON: None
COMMENTS:
Soft tissues: Nasopharynx: Unremarkable. Adenoids unremarkable
Oropharynx: Patent. Subjective mild prominence to the Palatine tonsils, axial image 22; coronal image 38, without fluid collection or airway narrowing. Parapharyngeal fat preserved. Remainder of Waldeyer's ring unremarkable
Hypopharynx/laryngeal vestibule: Unremarkable
Glottic/subglottic airway. Unremarkable
Lymph nodes: No enlarged or morphologically abnormal lymph nodes.
Several level 2B lymph nodes bilaterally, representative 5 x 9 6 x 916 mm on the left, axial image 27; coronal image 49. These are of normal size and morphologically normal
Bones: Degenerative endplate osteophyte formation at C5-C6 and C6-C7. Focal calcification/ossification of the PLL at C5-C6. Associated mild central canal stenosis at this level
Lung apices: Clear. Aberrant right subclavian artery, anatomic variant
Notes: Visualized paranasal sinuses: Clear
Visualized skull base: Unremarkable
IMPRESSION:
Subjective mild prominence to the Palatine tonsils without evidence for active inflammation/pharyngitis.
Patent airway. No mucosal lesion
Several chronic findings as detailed above

Only my fiance is sticking with me. Everyone seems to not care. They say chemo won't go as well with how much stress this is causing and and a result they are prescribing addictive meds that I don't want to take but I am suffering.
Last night I was diagnosed with Lymphoma and right after I quickly realized no one loves me that much besides my fiancé. I am just trying to get closure. I do not blame anyone, not even my past "friends". For all I know it could of made them freak out. The scan I found put about around my birthday: It is for closure. Here is proof: Coronal 2D T1 weighted SE MRI revealing homogeneous mass of slightly increased signal intensity compared with normal muscle (TR = 659 ms, TE = 20 ms, FA = 90°, SL = 8 mm, matrix = 512 × 512). Coronal 2D T2 weighted SE MRI showing both the subcutaneous tumour and the axillary lymph nodes had intermediate signal intensity. The lumen of the subclavian artery is intact (TR = 2697 ms, TE = 90 ms, FA = 90°, SL = 8 mm, matrix = 512 × 512). fat-suppressed contrast-enhanced T1 weighted SE MRI showing diffuse, homogeneous contrast enhancement. Subcutaneous stranding, skin thickening and marginal septal enhancement (arrow) are also present (TR = 659 ms, TE = 20 ms, FA = 90°, SL = 8 mm, matrix = 512 × 512). 2D, two-dimensional; FA, fractional anisotropy; SE, spin echo; SL, slice; TE, echo time; TR, repetition time.
Diagnosis: Hodgkins Lymphoma of a currently unknown stage
Follow up: not telling you this

OBSERVATION:
Multiple homogeneously enhancing lobulated lesions noted arising from the pleura involving both the upper lobe and lower lobe, mediastinal, and costal pleura. The largest lesion is in the left apical region, measuring 5.3 x 5.5 x 6.1 cm (AP x TR x CC). These lesions involve the mediastinum in the prevascular station. Some lesions show heterogeneous enhancement.
Lesions are causing a significant mass effect on the left brachiocephalic vein. This lesion encases the left subclavian artery with an arc of contact of about 180°. Multiple collateral vessels are noted on the left side of the neck and paravertebral region.
These lesions cause a mass effect on the left lung with the collapse consolidation of the left upper lobe. Ground-glass opacities are noted in the left upper lobe. No definite focal lesions are seen in the rest of the left lung parenchyma. Nodularity of the left oblique fissure is noted. Multiple enlarged lymph nodes are noted in the mediastinum, involving prevascular, upper, and lower paratracheal, and subcarinal stations, the largest measuring 2.5 x 2 cm in the subcarinal region. Lesions cause a significant mediastinal shift to the right. Trachea and bifurcation are mildly deviated to the right side.
No bronchial thickening or bronchiectasis is seen. Lung parenchyma: Right lung parenchyma is clear. Plate atelectasis noted in the right lower lobe medial basal segment.
Right hila appear normal.
Thoracic esophagus is grossly normal. No pericardial effusion.
No pleural effusion is seen on either side.
Bony thoracic cage is normal.
No lytic or sclerotic lesion in visualized bones.

About a month ago I had pain in my shoulder and found a lump in my left supraclavicular area. Made the mistake of googling it to see more often than not, gastric cancer spreading to the virchow node. I scheduled an appointment with my primary who wrote me off pretty quickly saying it’s just a reactive lymph node.
Got an ultrasound and this lump measured 1.5x.4x1.5. Solid, not really mobile. Pulsates hard when my blood pressure rises and subsides when I calm down, maybe it’s over the subclavian artery or something. It’s still there and hasn’t shrunk.
CT scan if my abdomen, Chest, Pelvis came back perfectly fine, so the chance of a malignant cancer that has metastasized is not seen. I just saw this Schwannoma though and curious if anybody else has been misdiagnosed with a swollen lymph node?

Hi all-
I posted a few months ago and it’s taken quite some time to get through all the tests.
I’ve included my husbands BMB report and you can see they’re basically stumped. His oncologist said both he and pathologist don’t know what’s going on.
You can see my husbands history of Hodgkins Lymphoma and at the time of that diagnosis his BMB had the same exact presentation that it does today, however the thrommbocytosis completely resolved after chemo and stayed that way for years.
His platelets started around 1,400 in August and are down to 964 as of December 4th so they are going down slowly..
Looking for advice- his oncologist encouraged us to just re-do bloodwork in 3 months to see if his platelets continue to decrease which would then indicate this is somehow just reactive. We asked if we could be referred to a specialist at Mayo and he said yes, but that they wouldn’t be able to do anything more for us 🤷🏼‍♀️
Thoughts/advice? Is it worth just waiting to see what happens in 3 months then pursue a specialist meeting? Many thanks!

48* y/o male, Caucasian, 260lb, 6' tall, recovering from bilateral TOS procedures (one in 2022, one 9 weeks ago) to treat subclavian blood clots. Current medications Valsartan, Eliquis 5mg BID, Amlodipine, Albuterol PRN.
Since my most recent TOS procedure (left side) I have suffered from additional significant edema in the left pectoral and abdominal area, the pectoral area resulting in clearly visible gynecomastia. Wearing compression as tolerated but no change so far. No pain or discoloration present.
CT scan was performed this week. Thoracic surgeon did not see anything other than an elevated/swollen left diaphragm. Radiology report showed left hemidiaphragm elevated with adjacent multisegmental atelectasis. No effusions or pneumothorax, no other issues with lymph nodes, heart, bone or soft tissue areas.
Reading up on this, I see that the diaphragm issue may have been caused by damage to the Phrenic nerve; my procedure was "very challenging" according to the surgeon, guessing that it may have been damaged during the anterior scalene resection. I have not yet had an ultrasound to confirm this, however.
I have two questions:
Assuming the elevated diaphragm is in fact caused by Phrenic nerve injury, how worried should I be? It is currently a unilateral issue. I can breathe normally and have resumed exercise but I do find myself getting winded easier at times. Is this something that can improve over time and/or with therapy of some sort?
Second question is about the edema. The surgeon didn't see anything that was specifically causing this to happen. Could if be related to the atelectasis and will just go down on it's own in time as the body continues to heal, or do I have to be worried about any surgical possibilities to fix it? Right now I'm being told just to continue with compression shirts for the next few months, but this issue has been an added mental/emotional strain tacked on to a journey approaching three years dealing with this issue. It's honestly depressing at times, and I told the doctor as such, especially as that side now looks embarrassingly like it did before my large (160lb+) weight loss.
Thanks.

Considering you half asleep in bed, in and out of dreams, your straw and gold and silver and fawn hair on the sheets and pillow Your closed eyes, the thin delicate skin of your eyelids, finely vesseled, your eyes moving rapidly under your eyelids The flows of materials in your brain, blood and cerebrospinal fluid, the little molecules and ions, the cells opening and closing their gates in synchrony The overspilling of a membrane potential and the resulting cascading wave, making an image or a sound or a word in your dream A bird-fluttering movement in your skull The air going in and out of your nose and mouth Your larynx, trachea, bronchi, bronchioles, and lungs The atmosphere diffusing through the alveoli and entering your blood The blood going to your face, your lips, your tongue, your neck, your abdominal organs, your uterus, labia, thighs, calves, and feet The perfusion of the cells by their blood and then the flow back out, in the veins, and the draining of the interstitial into the lymph, a fluid now pale or clear Unhurriedly pushed along through the lymphatic vessels by small, almost invisible, contractions of your muscles, as you sleep, A shift in your posture maybe, flexion of the arch of the foot, the toes The fluid is pushed back up into your chest, into the subclavian vein, into the vena cava and back to your heart To your fingertips Your moth-fluttering eyelashes Your regular breathing The warm moisture in your nose The oils and wax in the cup of your ear Your hair softly against your ear The hair going into the scalp, its root and capillary bed The imperceptible accretion of keratin at the stem of the root The growth of the hair outwards into the universe The respiration of your skin, the pores and their secretions The evaporation into the air The little stray molecules of your body suspended in the air around you

48/M, 6'/260lb. currently in recovery from surgery of 1st rib removal and scalene muscle resection as treatment for left subclavian blood clot. This is following an identical procedure on right side in April 2022.
Meds: Eliquis 5mg BID for clot, Amlodipine 5mg daily and Valsartan 160mg daily for high blood pressure, Albuterol PRN for mild asthma.
Overall swelling has been much worse on the left side than it was in my previous procedure on the right. The procedure was much more involved, taking ~twice as long as before, due to a combinate of extensive scalene muscle size (10 year history as powerlifter) and what the thoracic surgeon called "the thickest 1st rib" he has ever operated on.
As part of the recovery, have been doing daily self-lymphatic massage. When doing the massage, salivary output goes through the roof; a massage of several minutes results in 2-3 full mouthfuls of salivary fluid.
From my reading and general instruction, it was said that discharge of lymphatic fluid would typically be via increased urinary output. While I am urinating more (also a function of increased fluid intake per instruction), my question is this: Is the additional salivary output an additional source of lymphatic drainage, or just a byproduct of stimulating the lymph nodes?

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https://reddit.com/link/13nbtri/video/kzm0u6sof21b1/player
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Integumentary human body subsystem includes skin (with epidermis and dermis), hypodermis, hair, and nails.
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Exocrine human body subsystem includes exocrine glands, which include apocrine glands (ceruminous gland, mammary gland, Moll's gland), sebaceous glands (Tyson's gland, Meibomian gland, Gland of Zeis, Montgomery gland, Fordyce spot), sweat gland, salivary gland, lacrimal gland, prostate gland, and mucous gland; and liver and pancreas, which are both exocrine and endocrine glands.
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Immune human body subsystem includes surface barriers, tears and urine, mucus, respiratory and gastrointestinal tract, skin and respiratory tracts that secrete antimicrobial peptides, saliva, tears, breast milk, vaginal secretions, semen, stomach, gastric acid, genitourinary and gastrointestinal tracts with commensal flora; innate immune system with immune sensing, innate immune cells, inflammation, and humoral defenses; and adaptive immune system with recognition of antigen, antigen presentation to t lymphocytes, cell mediated immunity (with killer t cells, helper t cells, gamma delta t cells), humoral immune response, and immunological memory.
Lymphatic human body subsystem includes primary lymphoid organs (with bone marrow and thymus), secondary lymphoid organs (with spleen and lymph nodes), tertiary lymphoid organs, other lymphoid tissue, lymphatic vessels, lymph, lymphocytes, tonsils, stromal cells, mucosas, lymphatic capillaries, lymph ducts, right lymphatic duct, left lymphatic duct, thoracic duct, and subclavian veins.
Muscular human body subsystem includes skeletal, smooth, and cardiac muscles.
Nervous human body subsystem includes neurons, glial cells, nervous tissue; central nervous system (CNS) consisting of the brain and spinal cord; peripheral nervous system (PNS) consisting mainly of nerves, axons, and divided into three separate subsystems, the somatic, autonomic, and enteric nervous systems; somatic nerves mediating voluntary movement; the autonomic nervous system further subdivided into the sympathetic and the parasympathetic nervous systems; the sympathetic nervous system activated in cases of emergencies to mobilize energy; the parasympathetic nervous system activated when organisms are in a relaxed state; the enteric nervous system functioning to control the gastrointestinal system; autonomic and enteric nervous systems that both function involuntarily; cranial nerves that exit from the cranium; spinal nerves that exit from the spinal cord; motor nerves or efferent nerves; sensory nerves or afferent; spinal nerves, which are mixed nerves that serve as both motor nerves or efferent nerves, and sensory nerves or afferent; neurotransmitters; chemical synapses; neural pathways, and neural circuits.
Renal and urinary human body subsystem includes kidneys, ureters, bladder, urethra, renal arteries, renal vein, and nephrons.
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So I want to improve my mcq answering skills by practicing a few anatomy mcqs but the issue is that my uni doesn't give any practice mcqs. Rumour says they're taking questions from a random book. Anyone recognize these questions? Or can find which books they're from? My mcqs are really really bad to the point it's dragging my grade down
Which of the following is true regarding the vertebral column? a. Individual lumbar vertebra articulates with adjacent vertebra by four joints. b. The apex of the ligamentum nuchae is attached to skull. c. Inferior border of pedicle forms the upper border of the intervertebral foramen. d. The superior articular facets of atlas are bean shaped and concave. e. The superior intercostal facet of the thoracic vertebra is larger than the inferior intercostal facet
Regarding axillary region, a) Divisions of the brachial plexus lie beneath the lateral 1/3 of the clavicle. b) Damage to axillary nerve affects abduction. c) Subclavian artery does not give any branches to scapular anastamoses. d) All the lymph nodes which drain the mammary glands are palpable. e) Apex of the axilla communicates with the posterior triangle of the neck
Regarding the thumb a) Flexor digitorum profundus only flexes the distal interphalangeal joint. b) Abductor pollicis longus is supplied by the dorsal interosseus nerve. c) Lumbricals extend the interphalangeal joints. d) Abductor pollicis is supplied by the deep branch of the ulnar nerve. e) Metacarpophalangeal movements are more marked in the thumb. f) First dorsal interosseusattached to its medial side of the extensor expansion
These are just three qs that our batch memorised during our exams to get some sort of a practice question booklet cause our uni doesn't give out the exam papers even. So the wording might be a little wonky but these ones seem to be the closest to the actual q on the paper.
I have more if anyone needs them.

ATI Care of Children RN Proctored Exam – Level 3! Peds 2019. All 70 Q’s with the A’s Higlighted

1. A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective? a. An increase in venous pressure b. a decrease in peripheral edema c. a decrease in cardiac output d. an increase in potassium levels
2. A nurse is assessing an infant who has acute otitis media. Which of the following findings should the nurse expect (select all that apply) a. Increased appetite b. enlarged subclavian lymph node c. Crying d. Restlessness e. fever
3. a nurse is providing teaching to the parents of an infant who is to undergo pilocarpine lontophoresis Testing for Cystic Fibrosis. Which of the following statements should the nurse include in the teaching? a. We will measure the amount of protein in your baby’s urine over 24 hour period b. The test will measure the amount of water in your baby’s sweat c. a nurse will insert an IV prior to the test d. your baby will need to fast for 8 hours prior to the test
4. A nurse in an urgent care clinic is prioritizing care for children. Which of the following children should the nurse assess first? a. A toddler who has nephrotic syndrome and facial edema b. a preschool-age child who has a muffled voice and no spontaneous cough c. a preschool-age child who has diabetes mellitus and a blood glucose of 200 mg/dL d. an adolescent who has Crohn’s disease and recent weight loss of 5kg mg (11 lb)
5 .A nurse is providing teaching to the parents of a toddler who is to undergo a sweat chloride test. Which of the following statements should the nurse include? a. The purpose of the test is to determine if your child has Crohn’s disease b. the technician will use a device to produce an electrical current during the test lOMoAR cPSD8764867 c. during the test, your child will be in a room that is cold d. your child sweat will be collected over 24 hours
6. A nurse in the emergency department is caring for an adolescent who is requesting testing for STI. Which of the following action is appropriate for the nurse to take? a. Request verbal consent from the social worker b. contact the client’s parents to obtain phone consent c. postpone the testing until the client’s parents are present d. obtain written consent from the client

Just curious what your interpretation would be of the following findings. My Dr hasn't gotten back to me yet.
FINDINGS: There is no discrete neck mass or fluid collection. Soft tissue and fat planes of the neck are well preserved. No enlarged lymph nodes are seen by size criteria. A few nonenlarged cervical lymph nodes are seen, left greater than right. Mild nonspecific adenoid prominence..
Submandibular, parotid, and thyroid glands are unremarkable. The airway is patent and symmetric throughout.
There are no suspicious bony lesions. Left-sided aortic arch with aberrant right subclavian artery, an anatomic variant. The visualized intracranial portions and lung apices are within normal limits. The visualized paranasal sinuses and mastoid air cells are clear.
IMPRESSION: No discrete mass lesion or fluid collection seen within the soft tissues of the neck. No enlarged lymph nodes are seen by size criteria. A few nonenlarged cervical lymph nodes are seen, left greater than right.
Mild nonspecific adenoid prominence.

I have been dealing with severe stomach pain episodes since 2018. Only ever came up with mesenteric adenitis due to "prominent scattered lymph nodes" in the abdomen (CAT scan) and gastritis (during endoscopy), slight liquid delayed stomach emptying (dual phase emptying study), and one instance of esophageal candida (back in in 2017). While seeing my gastro specialist recently she had referred me to a hematologist due to my lab results. (High RBC, low MCV, high ABS basophil, high Eosinophil %, high total protein) I also had a mystery knee effusion which has since been aspirated and I'm waiting on those results... Appeared overnight with no injury and no signs of infection, but continued to grow in size over the course of a month before being aspirated. Since then I had the thought to feel my "weird lymph node" or so I call it because it's always been a bit bigger than the other and it felt both larger and as if there was some kind of hard tissue leading up to the bottom of my earlobe. It's starting to feel like my node is pushing into my esophagus and is uncomfortable. I also have an abberent right subclavian artery though.
TDLR SYMPTOMS: Nausea, vomiting, abdominal pain, 20lb weight loss over two months, sweating in my sleep, hot flashes (sometimes raising my actual temp, no fevers just ~99.5), "lump" on neck, delayed liquid emptying, Knee effusion (no injury/infection symptoms), dizziness, loss of appetite, dark veins on back of throat as well? Most similar comparison I could find was cobblestone throat but it's completely painless. abnormal blood work (listed above)
Waiting until my hematologist appointment on the 15th is hard and I'd really appreciate any insight on whether all these symptoms could be connected because it's just one after the other.. I've dropped below 120lbs for the first time since being an adult and I'm honestly so scared. Everyone thinks I'm just crash dieting for my wedding but I just have no appetite and it sucks😭

I have been dealing with severe stomach pain episodes since 2018. Only ever came up with mesenteric adenitis due to "prominent scattered lymph nodes" in the abdomen and gastritis (during endoscopy), slight liquid delayed stomach emptying (dual phase emptying study). While seeing my gastro specialist recently she had referred me to a hematologist due to my lab results. (High RBC, low MCV, high ABS basophil, high Eosinophil %, high total protein) I also had a mystery knee effusion which has since been aspirated and I'm waiting on those results. Since then I had the thought to feel my "weird lymph node" or so I call it because it's always been a bit bigger and it felt both larger and as if there was some kind of hard tissue leading up to the start of my earlobe. It's starting to feel like my node is pushing into my esophagus and is uncomfortable. I also have an abberent right subclavian artery though.
Waiting until my appointment on the 15th is hard and I'd really appreciate any insight.

I am a 31 male who was recently diagnosed with PSS and end up spending a week in the hospital after the diagnosis to receive treatment for blood clots and to have a rib resection. For the past decade I have been a dedicated gym goer so all the bench pressing, and overhead lifting may have been what caused the problems to eventually manifest.
Starting around June 23rd 2022 I started to notice that my right arm started to feel very full of blood when working out to the point that I could not remove ear phones with my right hand. I did not think it was a major problem. Initially I even thought it might be a good thing, just getting a bigger pump while lifting. However, June 26th after doing some pushups I noticed that my arms were not the same color. My right arm was purple/bluish. Not a drastic difference but noticeable when the arms were compared directly together. I still wasn’t too concerned though. I figured a swollen lymph node, or muscle was likely the issue. The inside of my armpit was sore but the rest of my arm did hurt at all.
Tuesday June 28th, I started to do more research into what the problem could be as the swelling was lasting for hours, and it just felt like pressure around my arm was restricting blood flow out of my arm. After coming home from the gym I took pictures of my arm comparing the size and color of the two so that I could document the symptoms. I also came across an article on Paget-Schrotter Syndrome or Effort Thrombosis.. The general symptoms seemed to match closely with what I was experiencing. E.g. swollen, discolored arm, and it also said that it is much more common in younger individuals with lots of overhead arm movement.
The next day my wife was able to speak with a vascular surgeon and described my symptoms. This surgeon agreed that I likely had a blood clot. He said that I should go to the hospital that day, and I would likely be admitted. I was not mentally prepared to go to the hospital that day. Instead an appointment was made to see the surgeon in his office the next day, June 30th.
I went into the meeting with the doctor knowing that something was likely wrong, but hopeful that he would prescribe an oral medication and perhaps monitor the situation going forward. This was overly optimistic. Using an ultrasound around my arm he quickly found blood clots and said that it was “bad”. He diagnosed me with Paget-Schrotter Syndrome. He explained that the clavicle and the first rib create an opening where the axillary or subclavian vein goes through to the arm, and the opening was too small. This was compressing the vein, causing blood to pool and causing clots to form. After discussion in his office an appointment was made to go to the “cath lab” in the hospital that afternoon. We also discussed doing a rib resection surgery possibly on the 4th of July.
Although my early optimistic hopes had been dashed, I still felt pretty good. I thought the hospital would be a two or three day trip, and while I would be bored I didn’t think it would be too horrible.
After checking into the hospital and being admitted I was sent to the “pre-op”. I was put into a hospital gown, and asked a lot generally just prepped for my upcoming hospital stay. At 4:30 I was wheeled into the “Cath Lab”, which is short for catheterization laboratory. There they are able to use x-ray/fluoroscopy to get more detailed images of the veins so that the blood clots can be treated. The cath lab is less invasive, so I was not put to sleep. I was given some pain medication as they worked on my veins. Their overall plan was to place catheters into the veins to break down clots and perform balloon angioplasty to widen some veins.
It wasn’t very painful but certain parts were very uncomfortable. I especially felt that I could feel the balloons being expanded, and it made my entire body feel flush. The first vein they tried to work though was too blocked to get the catheter through. So other veins had to be used. In the end two catheters were placed in my arm up towards my chest, and two other IVs were put in my arm as well. The catheters and IVs were injecting Heparin, as an anticoagulant/blood thinner and tPA as medicine that actually works to break up clots. Overall the feeling was that while the clots were bad and difficult to deal with, there was a good plan, and I would be back the next day to reassess how the catheter thrombolysis were working.
That night in the hospital I was placed into the ICU. I was uncomfortable but still in pretty good spirits. There was pain where things had been placed in my arm and because I was hooked up to so many IVs and other monitoring equipment I couldn’t move too much.
Day 2 in the hospital I went down to the cath lab again at 9 AM. The procedure was similar. Angioplasty, and venography was performed again. Coming out of it I was told that things looked better. But I still had all the catheters and IVs and I was told they wanted to come back the next morning. Unfortunately, day 3 had bad news. In the cath lab showed that clotting had returned, despite the procedures and medications. Because of the return of the clotting it was decided that the rib resection surgery would be moved up to the next day, July 3rd.
After the surgery I remember waking up and feeling like breathing was pretty difficult. I could not take deep breaths. I felt that it hurt in my chest and shoulder. But overall I was told the surgery went well, and a stent was also placed in my subclavian vein to help keep it open. I also had a chest tube coming up to drain fluid. The first time I actually used the inspirometer post surgery I could only get 500 ml vs 3500 mls before the surgery.
The next day after the surgery. I was pretty sore, and breathing continued to be difficult. My surgeon came in to do another ultrasound and check on the clotting. And again there were still issues. He wasn’t really sure what to do next. Initially he felt that my body should be given a break. But after talking to some other colleagues he decided that another surgery the next day would be the best option.
So Monday July 4th, I was headed back to surgery for a thrombectomy to take the clots out. This was another more invasive surgery where a larger incision was made in my arm on the inside of my elbow, and my veins were stripped up and down my arm to clean out all the clots they could, including in superficial veins. At the site of the stent there were some irregularities so they did an angioplasty again to expand that area. 7 staples were used to close the incision.
An ultrasound the next morning showed clear veins finally! I had a bad headache that continued for days, and high blood pressure, so I was taking blood pressure medication now as well. But I was finally taken out of the ICU! Now out of the ICU I only had one IV connected for heparin, and was no longer on tPA. With only one IV I was able to get out of bed for the first time and walk around. I was like an old man shuffling around hanging on to my IV poll. After a few laps around my new floor I was pretty tired.
Over the next two days, ultrasounds continued to show good blood flow in my veins. On Thursday July 7th, I was finally given the ok to leave the hospital. That morning my heparin IV was removed and I was given the pill Eliquis to take as a blood thinner moving forward. I will need to take it for at least a few months.
It has now been a week and a half since leaving the hospital. I spent the first week taking things pretty easy. I didn't drive, my wife helped me with lots of things. My range of motion on my right arm is limited. I can't fully straighten it, and it a lot to raise it above my head. The plan is to continue to take things pretty easy for at least another month before I start running, and then probably 3 months before I do any lifting. I have been going on 1 hour walks as my strength has come back. For the last two days I have had pretty intense shouldeneck pain. I'm not totally sure why, but that has been the biggest problem lately.
That's where I'm at so far. I feel like my treatment of the problem was very aggressive. Both in treating the clots and the surgeries that were performed. Was this the best way to go? Who knows. Hopefully it is all worth it in the end. It's good to read about other people who have had the surgeries and been able to get back to the active things they enjoy.

I am a 32 yo female with no health issues beside anxiety. I don’t take any meds. I am 5’5 and weight 127lbs. I don’t smoke anymore or drink. I workout and try to eat a balance diet.
About 4 months ago I noticed a radiate pressure on the left side of my head that did not fully go away. It was dull and not painful but just felt pressure. I had a CT scan and all was well with my brain. Fast forward March 30th I notice a small bulge on my subclavian artery on the same left side. I had a pulse there. Prior to me feeling this I have been working out and doing weight lifting at the gym and with a trainer. Also doing sit ups on a machine and may have overused my neck muscles. I notice this bulge hasn’t gone down and is still there even after 2 weeks. I went to my doctor and she said I pulled a tendon in my neck and it’s causing the bulge but I can’t help to feel otherwise as it causes shoulder pain off and on and small spasms in my neck also feels tightness around my throat a little. I even feel small pains in my chest that comes and go (may be anxiety related but idk) I wanted to know what this small bulge would be is it something more serious? Should it have went down in size a little? They said it’s not a lymph node but it is causing discomfort in my neck and spasms.

32 F, 5'9", 135lbs Current medications: Effexor, Concerta, trazodone, omeprazole, Zyrtec, prucalopride, klonopin (tiny dose PRN approx 1x/month)
Medical history: if you couldn't guess from my meds, I have major depression, generalized anxiety, and ADHD - currently well managed by medication and therapy, no major med changes in ~2yrs. Also have history of anorexia nervosa, most recent major relapse ~18 months ago - discharged from treatment Jan. 2021, weight has been stable (+/- 5lbs) since although psychiatrist, PCP, and dietitian would like me in the 145-150+ range, they have been willing to compromise on this. Diagnosed with gastroparesis this past March - had significant motility issues during re-feeding were not resolving, now well managed with prucalopride aside from occasional reflux. About a mouth ago was diagnosed by a geneticist with (presumably - echo was clear but waiting for genetic testing to confirm) hypermobile ehlers-danlos - diagnosis was not a surprise, numerous docs had suggested it over the years, I have a history of dislocations, PCP had suggested consult because of my current symptoms and possible co-morbidities (he suspects POTS, I have an MCAS-like/non-IgE mediated allergic reaction to whey protein/dairy). Yes, the hEDS + POTS + MCAS + gastroparesis and my collection of mental illnesses make me feel like the personification of munchausen's or just your basic 30 - something white girl who needs to get off the Dr. Google but I swear I'm not! Although that's probably what they all say...
The current issue: sometime end of April-ish, I noticed that my left leg was entirely pins-and-needles. Figured I was sitting weird or something because I'm hypermobile, of course I probably was. Didn't go away. A few days later, left leg still tingling, my left hand is now also pretty much entirely numb and dead - I have no grip strength or coordination, tingly and numb up to my shoulder. About a week later, with a still half dead body, I decide its probably worth trying to see my PCP about. Office staff all but laughs at me and tells me to get my ass to the ER because it could be a heart attack or stroke - I'm a smartass and tell them Ive already ruled that out by waiting over a week, they're unimpressed by my humor and off to the ER I go. EKG, head CT, and just about every lab test imaginable comes back clean. Presence of large ketones in my urine (again, I'm nutritionally stable and eat plenty of carbs), lymph count is low but not much lower than my normal - CT shows nothing of concern but notes absent right v4 segment of vertebral artery and an aberrant right subclavian.
I'm admitted for monitoring and more imaging - have head MRI. Multiple subcortical bilateral white matter hyper-intensities. T2/FLAIR enhancement on left side of mid-pons. Told possibly migraine phenomena, likely not ms (wrong side of brain). Have follow-up MRI 2 weeks later, looks virtually identical. Lumbar puncture is inconclusive, low (but not crazy low) CSF glucose, no Lyme, no oligoclonal bands. Develop awful post-lumbar puncture headache, passing out if upright for more than 30 seconds - admitted again awaiting blood patch. Labs still normal aside from the ketones in my pee. Blood patch finally happens 2 days later - headache lingers for another 2 weeks but at least the passing out stopped. At this point its June - neurologist concludes its best explained as a stress response, tells me to follow-up in 3 months.
PCP prescribes a trial of lyrica ... I start lactating (if there's any chance of that being a side effect, it happens for me. My prolactin levels are otherwise normal). Try amitryptiline and depression gets SO BAD. He refers for EDS consult. EDS doc is like "sure, it could cause these symptoms but the sudden onset would be odd." Just had follow-up with neuro - his diagnosis is stress and treatment plan is positive thinking (I wish I was making this up). Trying to figure out what to do next - stress is not a major concern right now. Recently had a large tattoo finished on my left thigh and truly could not feel 95% of it - its NOT psychosomatic.

(38)(F) white, 5'7-185 pounds. Former smoker (pack a day) for the better part of 12 year old to 26. Second hand smoke between birth and 12. Diagnosis list includes partial complex epilepsy, ankylosing spondylitis, depression, insomnia, COPD from allergy induced asthma.
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Medications- Xyzal, CLARITIN
DICLOFENAC ER, CIMETIDINE, Prednisone 5-10 mg daily, WELLBUTRIN XR, Cosentyx, Viibryd, Tylenol arthritis, as needed 0.5 lorazepam and 6.5 Ambien for sleep.
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Learning and socially disabled as a child, symptoms of asperger's syndrome left me extremely isolated, had to be home schooled by district. Severe suicidal depression started at 11. Now have associates degree and enough social skills to successfully work full time in long term job.
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EEG verified partial complex epilepsy at 11 years old, primarily from temporal lobe.
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Diagnosed with idiopathic intracranial hypertension at 23. LP shunt resolved the issue.
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COPD/allergy induced asthma diagnosis at 27 after multiple colds/allergies/infections led me to an allergist after I was no longer able to exale long enough to blow up a balloon. No obvious shortness of breath between occasional bouts of bronchitis. Improvement of 60% of expected lung function to 90% after allergy shots/inhalers.
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Diagnosis of ankylosing spondylitis 5 years ago after years of pain symptoms led to CT of SI joint confirming diagnosis.
Was on humeria from February 2016 until November 2020. Switched to taltz, then Cosentyx (formulary change) last month
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Cervical radiculopathy of my left shoulder lead to ACDF surgery in August 2019. My right shoulder was fine.
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While on the humeria, my alkaline phosphate levels were high. Progressively higher. Getting towards 260. Creatine levels low, A/G high. But nothing ever crazy or setting off red flags for the rheumatologist.
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So, this is kind of a long wild ride, but as you can see, my health hasn't always been the best. My father's side of family has a tradition of dying from cancer, if they don't die of a self inflicted injury sooner. My Great Grampa/great uncle died of stomach cancer. His sister (my grandma) had breast cancer, developed COPD that landed her in the hospital multiple times. But kidney/Bladder is what killed her. Between the time of the ultrasound and the oncology consult, she died, because there was already way too many tumors to count in her abdomen. So we don't know what type of cancer it was specially (elderly nursing home death-no autopsy). The other two were believed to be neoendoctrine type tumors. My father has had some cancer scares of the stomach, but thank God they were benign.
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So, my doctor during a physical suggested a cancer panel from invitae. I took it, and thankful it was all negative. With the exception of one odd variation of unknown signifince that I didn't really quite understand, nor was the GYN concerned about. So I didn't really read into it. The mutation was
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**A Variant of Uncertain Significance, c.932C>T (p.Pro311Leu), was identified in TSC1. The TSC1 gene is associated with autosomal dominant tuberous sclerosis complex (TSC)**
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http://imgur.com/a/qaoRNcw
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So, cool beans. life moves on. Two years later in 2019, I have my neck surgery, and I feel like a new woman.
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Fast forward to November 2020, and this bad boy rears itself on my subclavian
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http://imgur.com/a/IwEbUAW
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Given my family history of cancer, I hightailed it to the doctors office. All blood work came back squeeky clean. CBC/CMP/tuberculosis/valley fevethyroid were all spectacular. Aside from that ever so slightly elevated A/G ratio, I'm the picture of health. Ultrasound shows a slightly enlarged lymph node on the left side, and my right neck/shoulder looks great.
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http://imgur.com/a/ipWCkwW
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So, life moves on. The doctor offers to biopsy it if I want, and to be honest I wasn't completely involved in the conversation when she called with the results, I had just put my dog down two hours prior. But between the labs and the ultrasound, I just didn't want to stress on it. I had asked about getting a CT or X ray of my chest. She ordered the low dose CT of my chest, but insurance wouldn't cover it because I was not old enough. A regular CT is fine. Hell, I don't even need a pre-authorization. But not for this CT.
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So, fast forward, from about march on, I am starting to have the same radiculopathy type pain, but now on the right side. It comes and goes. Every time it starts, it hangs around longer, disrupting my sleep, before it finally stops days later.
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But the weird thing, is that even though the pain feels identical, the motion of my neck has no effect on it. You could bop my head back and forth as much as you want, it won't hurt or change it.
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So, I get back to a place where I can try to get this adressed, and Ortho says he can't do anything with the chest. He gave me an order for a two view shoulder x-ray and cervical MRI. Which could very well address the cause.
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But here's where all this history boils down too..
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The TSC1 gene mutation thing has got me thinking. It didn't know any clinical significance to that specific mutation, but the more I read about tuberous sclerosis complex in the context of all my volumes of medical issues, the more it starts to make a lot of sense to me.
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So questions being
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1) Am I clutching at straws to explain the lump and pain with TSC? What theories would you suggest be explored?
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2) If it could be TSC, given it's complexity and rareness, how on earth would I go down the rabbit hole of proper diagnosis given how many bodily systems it affects.
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3) Let's just throw TSC out the window. What are your thoughts about what's going on? What possibilities come that you would explore?
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If you have made it this far, I appreciate it. I'm crashing out for bed now, but I will be back in the morning to see if anyone has words of wisdom they can share, or any questions I can answer for you. Thank you!

This post is for my mom (46F). I am worried that she might have lung cancer and the doctors ordered a biopsy. She had a few tests done in the past month. These are the results for the PET scan. I'm not sure if some of the things are good/bad and hoping someone can give some info on this.
Findings: There is a 28 x 12 mm hypermetabolic round glass
nodule in the far posterior superior segment left lower lobe.
The SUV max is 10.5. There is a 9 mm hypermetabolic nodule in
the left upper lobe with an SUV max of 4.6. There is bulky
mediastinal and bilateral hilar adenopathy. Lymph nodes in the
superior mediastinum have an SUV max of 9.2. Subclavian
adenopathy with an SUV max of 6.6. There is bilateral hilar
adenopathy with an SUV max of 10.3 and the right and 7.1 on the
left. There is a single metabolic posterior mediastinal lymph
node with an SUV max of 6.8. There are right supraclavicular
lymph nodes with an SUV max of 6.2. There are no hypermetabolic
lesions about the mucosa of the head or neck.
There is no evidence of extrathoracic metastatic disease or
adenopathy to the abdomen, pelvis, or retroperitoneum. There is
normal physiologic activity above soft tissue viscera the
abdomen. There are no hypermetabolic bony lesions. There is
bilateral renal excretion. There postsurgical changes of right
mastectomy.
IMPRESSION: Groundglass hypermetabolic nodule in the posterior
left lower lobe. 9 mm hypermetabolic solid nodule left upper
lobe. These are suspicious for primary or secondary malignancy.
Bulky adenopathy including the right supraclavicular region,
superior mediastinum, subcarinal region, posterior mediastinum,
and bilateral hila consistent with malignant adenopathy.
No evidence of soft tissue metastatic disease or adenopathy in
the abdomen, pelvis, or retroperitoneum.