I recently had a consult with a doctor who is well regarded in the endometriosis world, however, she did not recommend surgery based on my MRI results (which found deep endo). She emphasized that my symptoms (10+ years of painful periods) are not severe enough on a daily basis to warrant a risky surgery. I was super confused by her response. What am I missing? Anyone else have a similar case? If so, how did you proceed?
Impression

1. Retroflexed septate uterus with fibromuscular septum.
2. Deep pelvic endometriosis involving the middle and posterior compartments with retrocervical serosal adhesions to the mid rectum.
3. Ill-defined fibrotic implant involves the right ovary, right hematosalpinx, right round ligament, and serosa of the distal sigmoid in the right pelvis.

UTERUS Retroverted and retroflexed uterus with septate morphology. Flat fundal contour with fibromuscular septum, internal endometrial indentation greater than 2 cm and divergent cavities with internal angulation approaching 90 degrees. SIZE: 8.6 x 4.6 x 6.7 cm JUNCTION ZONE THICKNESS: 4 mm and symmetric Focal Adenomyomas: Not present ADENOMYOSIS: Not present FIBROIDS: Small 1.1 cm FIGO 5 fibroid anterior uterine body. CERVIX: Normal ENDOMETRIUM: Each cavity measures up to 9 mm in AP thickness.
OVARIES Normal size and position of the ovaries. * Right ovary: least one endometrioma measuring 0.9 cm (401/28) * Left ovary: Physiologic corpus luteum. Several foci of T1 hyperintensity at the posterior aspect of the left ovary with 0.6 cm endometrioma or endometrial implant (401/31) * Abnormal T2 signal and architectural distortion within each of the ovaries extending to the pelvic sidewall, peritoneal reflection, and involving the proximal right round ligament, which is circumferentially thickened (401/25)
ANTERIOR COMPARTMENT BLADDER: Decompressed and normal. URETER: Nondilated URETHRA: Normal VESICOUTERINE POUCH: Normal VESICOVAGINAL POUCH: Possible focal adhesion anterior vesicovaginal pouch (401/37)
MIDDLE COMPARTMENT TORUS UTERINUS (Uterine body): * Fibrotic implant spanning 3 cm transverse by 3 cm craniocaudal at the torus uterinus extending into the retrocervical space involving the anterior serosa of the mid rectum 9 cm above the anal verge. * Small fibrotic implant anterior lower uterine segment/uterocervical junction (201/20) abutting loops of decompressed bowel without clear involvement. FALLOPIAN TUBE: * Small right hematosalpinx, 5 mm diameter. * Left tube not visualized. UTERINE LIGAMENTS: Fibrotic implant involving the proximal right round ligament, right anterior uterine body, and serosa of the distal sigmoid colon as it courses to the right towards the right internal iliac vessels (401/17)
POSTERIOR COMPARTMENT UTEROSACRAL LIGAMENTS: Involved bilaterally near the junction. RECTOCERVICAL SPACE (Pouch of Douglas): Involved as described above. RECTOVAGINAL SEPTUM: The fibrotic implant in the retrocervical space extends inferiorly to involve apex of the posterior vaginal fornix. ANTERIOR RECTAL WALL: Involved as above. SIGMOID COLON: Involved as above.
OTHERS APPENDIX: Tip not visualized, possibly involved. Cecum positioned anterior right pelvis. PELVIC SMALL BOWEL LOOPS: As above. PELVIC COLLECTIONS: 6.8 cm loculated fluid collection with thin septa in the right posterior pelvis compatible with a peritoneal inclusion cyst. ABDOMINAL WALL: Normal LYMPH NODES: Normal ILIAC ARTERIES AND VEINS: Patent

I recently had a consult with a doctor who is well regarded in the endometriosis world, however, she did not recommend surgery based on my MRI results (which found deep endo). She emphasized that my symptoms (10+ years of painful periods) are not severe enough on a daily basis to warrant a risky surgery. I was super confused by her response. What am I missing? Anyone else have a similar case? If so, how did you proceed?
Impression

1. Retroflexed septate uterus with fibromuscular septum.
2. Deep pelvic endometriosis involving the middle and posterior compartments with retrocervical serosal adhesions to the mid rectum.
3. Ill-defined fibrotic implant involves the right ovary, right hematosalpinx, right round ligament, and serosa of the distal sigmoid in the right pelvis.

UTERUS Retroverted and retroflexed uterus with septate morphology. Flat fundal contour with fibromuscular septum, internal endometrial indentation greater than 2 cm and divergent cavities with internal angulation approaching 90 degrees. SIZE: 8.6 x 4.6 x 6.7 cm JUNCTION ZONE THICKNESS: 4 mm and symmetric Focal Adenomyomas: Not present ADENOMYOSIS: Not present FIBROIDS: Small 1.1 cm FIGO 5 fibroid anterior uterine body. CERVIX: Normal ENDOMETRIUM: Each cavity measures up to 9 mm in AP thickness.
OVARIES Normal size and position of the ovaries. * Right ovary: least one endometrioma measuring 0.9 cm (401/28) * Left ovary: Physiologic corpus luteum. Several foci of T1 hyperintensity at the posterior aspect of the left ovary with 0.6 cm endometrioma or endometrial implant (401/31) * Abnormal T2 signal and architectural distortion within each of the ovaries extending to the pelvic sidewall, peritoneal reflection, and involving the proximal right round ligament, which is circumferentially thickened (401/25)
ANTERIOR COMPARTMENT BLADDER: Decompressed and normal. URETER: Nondilated URETHRA: Normal VESICOUTERINE POUCH: Normal VESICOVAGINAL POUCH: Possible focal adhesion anterior vesicovaginal pouch (401/37)
MIDDLE COMPARTMENT TORUS UTERINUS (Uterine body): * Fibrotic implant spanning 3 cm transverse by 3 cm craniocaudal at the torus uterinus extending into the retrocervical space involving the anterior serosa of the mid rectum 9 cm above the anal verge. * Small fibrotic implant anterior lower uterine segment/uterocervical junction (201/20) abutting loops of decompressed bowel without clear involvement. FALLOPIAN TUBE: * Small right hematosalpinx, 5 mm diameter. * Left tube not visualized. UTERINE LIGAMENTS: Fibrotic implant involving the proximal right round ligament, right anterior uterine body, and serosa of the distal sigmoid colon as it courses to the right towards the right internal iliac vessels (401/17)
POSTERIOR COMPARTMENT UTEROSACRAL LIGAMENTS: Involved bilaterally near the junction. RECTOCERVICAL SPACE (Pouch of Douglas): Involved as described above. RECTOVAGINAL SEPTUM: The fibrotic implant in the retrocervical space extends inferiorly to involve apex of the posterior vaginal fornix. ANTERIOR RECTAL WALL: Involved as above. SIGMOID COLON: Involved as above.
OTHERS APPENDIX: Tip not visualized, possibly involved. Cecum positioned anterior right pelvis. PELVIC SMALL BOWEL LOOPS: As above. PELVIC COLLECTIONS: 6.8 cm loculated fluid collection with thin septa in the right posterior pelvis compatible with a peritoneal inclusion cyst. ABDOMINAL WALL: Normal LYMPH NODES: Normal ILIAC ARTERIES AND VEINS: Patent

I have never posted before only read post. But I'm desperate to find answers on what possibly is wrong with my puppy. To start this off, I got my baby when he was 4 weeks old, the mother stopped feeding the litter, so we got my baby and his sister also and bottle fed them until they were switched to wet food. I got their first set of shots in the middle of April. All was well and they both were normal puppies. One day I noticed my baby wasn't acting like his usual self. He felt hot, and wasn't playful with his sister. I took him to the vet and he was given a shot of antibiotics. (possibilities were, virus, ear infection, parvo, or a cold) two days later he was still hot and developed a limp and had a knot on the shoulder of the leg he wouldn't put weight on. I took my baby to a different vet that i thought would be more thorough. ( I felt judged, and dismissed by the first vet like it was my fault because they were due for the second rounds of shots and they were over due by a week). I informed the new vet that both puppies missed their second rounds of shots by a week due to a busy work schedule and plans to take them on my first day off which was the dog i noticed that my baby was sick. I told the new vet that the first vet had given a shot of antibiotics and the possible causes, and that now my baby has a new symptom of black goopy guck coming from his ears and still had a fever. I showed her the knot on his neck and the new one that had popped up over night, and his limping. The new vet made the diagnoses of just a really bad ear infection. So my baby was given an oral antibiotic, and pain meds for the limp and ear drops. The knot went down on his neck to pea size, all meds were about finished when we went back to the vet because he still had new ones popping up and new symptoms. He became to have sores on his snout and his eyes were swollen. Back to the vet we went. This time we got a diagnoses of PUPPY STRANGLES. This could explain every symptom he had. We got a refill on the antibiotics, steroids, and more ear meds. Since that day my baby has had multiple knots pop up, some in places where no lymph nodes are located. SIDE NOTE (Sister puppy was taken in to new vet also and got her second set of shots), we went back to the vet on Thursday the 30th. The knot of the side of his neck was the size of a golf ball if not bigger. (the babies are CHIWEENIE-YORKIE-TERRIERS) AS a small dog its was very noticeable. This trip the knot was ultrasound and the vet stuck a needle in it to see what fluid was in it to try and test it. IT was pus, but the back of the knot is a blood clot. Several of the knots are swollen lymph nodes, some are abscesses(without injury) and some are blood clots. The knot know has gone down since being drained. The back of the knot is still there and hard. (none of the knots are sore or he doesn't so any signs of discomfort when you touch or squeeze them). This time we left with a vitamin supplement and told to change his food. The vet is thinking he may have an autoimmune disease or deficiency. If this treatment doesn't work, the vet is going to put him to sleep, lance the knots and test the fluid in them. The vet only wants to do this as a last resort because he is little and we don't know what were dealing with. We are just perplexed on what this could be, also i have spoken with several online vets and called other local vets to see if that have heard of such thing in a puppy this age and they have all said the same thing. So that brought me here to this side of the internet. He is currently taking two antibiotics, a steroid, a vitamin supplement, and a new diet. Since seeing the new vet he was eating and drinking normally he has gained weight due to the steroids. He is playful and active. He doesn't act sick, but you can look at him and see he's doesn't feel well at times. Has anyone experienced this issue with a puppy and what causes and treatments were used. I am desperate for answers to make sure this baby is well taken care of. I am planning to order a DNA genetic test as well.

I recently had a consult with a doctor who is well regarded in the endometriosis world, however, she did not recommend surgery based on my MRI results. She emphasized that my symptoms (10+ years of painful periods) are not severe enough on a daily basis to warrant a risky surgery. I was super confused by her response. What am I missing?
Impression

1. Retroflexed septate uterus with fibromuscular septum.
2. Deep pelvic endometriosis involving the middle and posterior compartments with retrocervical serosal adhesions to the mid rectum.
3. Ill-defined fibrotic implant involves the right ovary, right hematosalpinx, right round ligament, and serosa of the distal sigmoid in the right pelvis.

UTERUS Retroverted and retroflexed uterus with septate morphology. Flat fundal contour with fibromuscular septum, internal endometrial indentation greater than 2 cm and divergent cavities with internal angulation approaching 90 degrees. SIZE: 8.6 x 4.6 x 6.7 cm JUNCTION ZONE THICKNESS: 4 mm and symmetric Focal Adenomyomas: Not present ADENOMYOSIS: Not present FIBROIDS: Small 1.1 cm FIGO 5 fibroid anterior uterine body. CERVIX: Normal ENDOMETRIUM: Each cavity measures up to 9 mm in AP thickness.
OVARIES Normal size and position of the ovaries. * Right ovary: least one endometrioma measuring 0.9 cm (401/28) * Left ovary: Physiologic corpus luteum. Several foci of T1 hyperintensity at the posterior aspect of the left ovary with 0.6 cm endometrioma or endometrial implant (401/31) * Abnormal T2 signal and architectural distortion within each of the ovaries extending to the pelvic sidewall, peritoneal reflection, and involving the proximal right round ligament, which is circumferentially thickened (401/25)
ANTERIOR COMPARTMENT BLADDER: Decompressed and normal. URETER: Nondilated URETHRA: Normal VESICOUTERINE POUCH: Normal VESICOVAGINAL POUCH: Possible focal adhesion anterior vesicovaginal pouch (401/37)
MIDDLE COMPARTMENT TORUS UTERINUS (Uterine body): * Fibrotic implant spanning 3 cm transverse by 3 cm craniocaudal at the torus uterinus extending into the retrocervical space involving the anterior serosa of the mid rectum 9 cm above the anal verge. * Small fibrotic implant anterior lower uterine segment/uterocervical junction (201/20) abutting loops of decompressed bowel without clear involvement. FALLOPIAN TUBE: * Small right hematosalpinx, 5 mm diameter. * Left tube not visualized. UTERINE LIGAMENTS: Fibrotic implant involving the proximal right round ligament, right anterior uterine body, and serosa of the distal sigmoid colon as it courses to the right towards the right internal iliac vessels (401/17)
POSTERIOR COMPARTMENT UTEROSACRAL LIGAMENTS: Involved bilaterally near the junction. RECTOCERVICAL SPACE (Pouch of Douglas): Involved as described above. RECTOVAGINAL SEPTUM: The fibrotic implant in the retrocervical space extends inferiorly to involve apex of the posterior vaginal fornix. ANTERIOR RECTAL WALL: Involved as above. SIGMOID COLON: Involved as above.
OTHERS APPENDIX: Tip not visualized, possibly involved. Cecum positioned anterior right pelvis. PELVIC SMALL BOWEL LOOPS: As above. PELVIC COLLECTIONS: 6.8 cm loculated fluid collection with thin septa in the right posterior pelvis compatible with a peritoneal inclusion cyst. ABDOMINAL WALL: Normal LYMPH NODES: Normal ILIAC ARTERIES AND VEINS: Patent

I recently had a consult with a doctor who is well regarded in the endometriosis world, however, she did not recommend surgery based on my MRI results (which found deep endo). She emphasized that my symptoms (10+ years of painful periods) are not severe enough on a daily basis to warrant a risky surgery. I was super confused by her response. What am I missing? Anyone else have a similar case? If so, how did you proceed?
Impression

1. Retroflexed septate uterus with fibromuscular septum.
2. Deep pelvic endometriosis involving the middle and posterior compartments with retrocervical serosal adhesions to the mid rectum.
3. Ill-defined fibrotic implant involves the right ovary, right hematosalpinx, right round ligament, and serosa of the distal sigmoid in the right pelvis.

UTERUS Retroverted and retroflexed uterus with septate morphology. Flat fundal contour with fibromuscular septum, internal endometrial indentation greater than 2 cm and divergent cavities with internal angulation approaching 90 degrees. SIZE: 8.6 x 4.6 x 6.7 cm JUNCTION ZONE THICKNESS: 4 mm and symmetric Focal Adenomyomas: Not present ADENOMYOSIS: Not present FIBROIDS: Small 1.1 cm FIGO 5 fibroid anterior uterine body. CERVIX: Normal ENDOMETRIUM: Each cavity measures up to 9 mm in AP thickness.
OVARIES Normal size and position of the ovaries. * Right ovary: least one endometrioma measuring 0.9 cm (401/28) * Left ovary: Physiologic corpus luteum. Several foci of T1 hyperintensity at the posterior aspect of the left ovary with 0.6 cm endometrioma or endometrial implant (401/31) * Abnormal T2 signal and architectural distortion within each of the ovaries extending to the pelvic sidewall, peritoneal reflection, and involving the proximal right round ligament, which is circumferentially thickened (401/25)
ANTERIOR COMPARTMENT BLADDER: Decompressed and normal. URETER: Nondilated URETHRA: Normal VESICOUTERINE POUCH: Normal VESICOVAGINAL POUCH: Possible focal adhesion anterior vesicovaginal pouch (401/37)
MIDDLE COMPARTMENT TORUS UTERINUS (Uterine body): * Fibrotic implant spanning 3 cm transverse by 3 cm craniocaudal at the torus uterinus extending into the retrocervical space involving the anterior serosa of the mid rectum 9 cm above the anal verge. * Small fibrotic implant anterior lower uterine segment/uterocervical junction (201/20) abutting loops of decompressed bowel without clear involvement. FALLOPIAN TUBE: * Small right hematosalpinx, 5 mm diameter. * Left tube not visualized. UTERINE LIGAMENTS: Fibrotic implant involving the proximal right round ligament, right anterior uterine body, and serosa of the distal sigmoid colon as it courses to the right towards the right internal iliac vessels (401/17)
POSTERIOR COMPARTMENT UTEROSACRAL LIGAMENTS: Involved bilaterally near the junction. RECTOCERVICAL SPACE (Pouch of Douglas): Involved as described above. RECTOVAGINAL SEPTUM: The fibrotic implant in the retrocervical space extends inferiorly to involve apex of the posterior vaginal fornix. ANTERIOR RECTAL WALL: Involved as above. SIGMOID COLON: Involved as above.
OTHERS APPENDIX: Tip not visualized, possibly involved. Cecum positioned anterior right pelvis. PELVIC SMALL BOWEL LOOPS: As above. PELVIC COLLECTIONS: 6.8 cm loculated fluid collection with thin septa in the right posterior pelvis compatible with a peritoneal inclusion cyst. ABDOMINAL WALL: Normal LYMPH NODES: Normal ILIAC ARTERIES AND VEINS: Patent

My cat, Jack, would have been 14 in August. 3 months ago, he was diagnosed with GI lymphoma. He'd had elevated liver values for several months, but at the same time was diagnosed with hyperthyroidism. The hope was getting him on a stable dose of methimzaole would help to bring down his liver values. It didn't. He went in for thyroid/liver bloodwork in February and the vet noticed he was jaundiced so I immediately scheduled an abdominal ultrasound. The ultrasound revealed that his pancreas was enlarged, his GI tract thickened, his lymph nodes inflamed, and he had multiple cysts in his liver. He was diagnosed with "probably" large-cell GI lymphoma and the vet recommended palliative care. He immediately went on prednisolone and the plan was basically, when new symptoms pop up we'll deal with them then.
He was doing so good, still very energetic for a 14 year old, good appetite, the steroids and an increase in methimazole dosage helped get his weight up, he seemed fine. Now, Jack has always had seasonal allergies. He was chronically sneezy and spring has always made it worse, so when he got a nosebleed about a month ago I attributed it to that. He's had occasional nosebleeds since but nothing major. Then Monday I set up my apartment balcony with netting and let him hang out outside. His nose started bleeding so I took him inside thinking it was the pollen and waited for it to stop, but it didn't - not for long at least. He had on-and-off nosebleeds for the rest of the week, but I had a vet appointment already scheduled on Friday so I was planning on asking about allergy medications.
Thursday everything changed, his nose started bleeding early in the afternoon and just kept getting worse. It progressed fro just a little blood around his nose to dripping everywhere. It got so bad that I decided that I couldn't wait for his appointment Friday and I took him to the emergency vet hoping they'd be able to give him something to make the bleeding stop. The stress from getting him in his carrier made the bleeding so much worse and by the time we got to the emergency vet his face was covered in blood and there were blood drips all over his carrier.
I spoke to the ER vet and gave him Jack's history, including his lymphoma diagnosis and the history of his liver issues. The conclusion was that the bleeding was the result of one of two options. 1) his liver is now in failure and he is unable to clot properly or 2) his lymphoma has spread and the bleeding is caused by a tumor in his nose. Both options had no solution and things were only going to get worse, and when the vet suggested immediate euthanasia I was floored. It was too soon, he wasn't ready, he was still doing so good, this was just a nosebleed! But I also wanted to let him go while he was still him. I didn't want things to get worse and I didn't know if the bleeding would ever stop. I didn't want to do it at the vet though, I have two other cats and I couldn't bare the thought of Jack just leaving and never coming home. I also didn't want his last moments to be in an unfamiliar environment with unfamiliar smells, so the vet got me a list of home euthanasia vets and I called around until I found someone who could come that night.
I took Jack home and we were able to hang out for a few more hours, but he never calmed down enough to be snuggly. He was such a snuggly boy so it was heartbreaking that he wouldn't allow me to hold him or sit on my lap. He stayed close but was so uncomfortable. The bleeding never stopped, he was struggling to breathe through his mouth with the blood running down his face. He wouldn't eat even his favorite treats, presumably because he couldn't smell and his mouth tasted like blood.
When the vet finally showed up at 11pm he tried to hide, which was so out of character. Every new person, ever vet visit, he would always greet them and rub against them, talk, and ask for pets. But not this time, he knew something was up. My other cats stayed in the room, my oldest cat actually laid down in front of the vet and supervised her getting prepared, but when it was time to bring Jack in, he was hiding behind the toilet and when I picked him up he dug into my shoulder wanting to be let back down.
I held him as he went and once he was gone I looked at his face and wish I hadn't. He wasn't Jack anymore. He looked wrong and he was limp and all his life was gone. I'm haunted by the look of his lifeless face. And now that he's gone and I'm left with blood all over I haven't been able to clean it up. I know that sounds gross, but I can't. The sweater I was wearing when I was saying goodbye is covered in blood and I can't wash it and I can't throw it away.
I don't know why I even typed all of this up or what I'm trying to get out of this, but I just had to get it all out.

I turned 30 this year. I am almost positive I contracted Lyme at 17, but because every doctor I've mentioned it to has insisted I was wrong I've just been living with slowly worsening EVERYTHING. Worsening mental health, pain, exhaustion, that I've been treating incorrectly for years.
But everything points to Lyme, INCLUDING my blood tests which finally confirmed a non-active infection that I'd have never known about if I didnt make my doctor walk me through all of my "completely normal" bloodwork. She assumed I'd been treated in the past- I wasn't. I was never diagnosed and never taken seriously despite living in the largest lyme hotspot in the country and spending a lot of time in the woods, not all of it carefully.
But you know what I was diagnosed and treated for at 17? Chlamydia. Mystery, symptomless Chlamydia that none of my doctors believed there was no way I contracted sexually and I just today learned you can contract from ticks. And a few months earlier I'd had a positive mono/epstein-barr test without symptoms, which it seems can also be triggered by Lyme.
Not long after that began the years of recurring walking pneumonia and chronic UTIs, night fever, joint swelling, random fainting spells/POTS, several false-positive TB titers and hep-b levels, very low LDL, permanently swollen lymph nodes, a very late in life adhd diagnosis that may be legitimate but could also just be due to pure brain fog, a complete intolerance to antibiotics, exercise and heat intolerance, and significantly worsening fatigue despite a healthier lifestyle every year.
But yanno, despite all these peculiarities my bloodwork was always "normal" so obviously nothing was wrong with me and my throbbing joints, aching muscles, and soul crushing fatigue was a mental problem.
Just ordered the Buhner book because I'm done with this and I'm done with doctors.

I recently had a consult with a Nook doctor who is well regarded in the endo world, however, she did not recommend surgery based on my MRI results. She emphasized that my symptoms (10+ years of painful periods) are not severe enough on a daily basis to warrant a risky surgery. I was super confused by her response. What am I missing? Anyone else have a similar case? If so, how did you proceed?
Impression

1. Retroflexed septate uterus with fibromuscular septum.
2. Deep pelvic endometriosis involving the middle and posterior compartments with retrocervical serosal adhesions to the mid rectum.
3. Ill-defined fibrotic implant involves the right ovary, right hematosalpinx, right round ligament, and serosa of the distal sigmoid in the right pelvis.

UTERUS Retroverted and retroflexed uterus with septate morphology. Flat fundal contour with fibromuscular septum, internal endometrial indentation greater than 2 cm and divergent cavities with internal angulation approaching 90 degrees. SIZE: 8.6 x 4.6 x 6.7 cm JUNCTION ZONE THICKNESS: 4 mm and symmetric Focal Adenomyomas: Not present ADENOMYOSIS: Not present FIBROIDS: Small 1.1 cm FIGO 5 fibroid anterior uterine body. CERVIX: Normal ENDOMETRIUM: Each cavity measures up to 9 mm in AP thickness.
OVARIES Normal size and position of the ovaries. * Right ovary: least one endometrioma measuring 0.9 cm (401/28) * Left ovary: Physiologic corpus luteum. Several foci of T1 hyperintensity at the posterior aspect of the left ovary with 0.6 cm endometrioma or endometrial implant (401/31) * Abnormal T2 signal and architectural distortion within each of the ovaries extending to the pelvic sidewall, peritoneal reflection, and involving the proximal right round ligament, which is circumferentially thickened (401/25)
ANTERIOR COMPARTMENT BLADDER: Decompressed and normal. URETER: Nondilated URETHRA: Normal VESICOUTERINE POUCH: Normal VESICOVAGINAL POUCH: Possible focal adhesion anterior vesicovaginal pouch (401/37)
MIDDLE COMPARTMENT TORUS UTERINUS (Uterine body): * Fibrotic implant spanning 3 cm transverse by 3 cm craniocaudal at the torus uterinus extending into the retrocervical space involving the anterior serosa of the mid rectum 9 cm above the anal verge. * Small fibrotic implant anterior lower uterine segment/uterocervical junction (201/20) abutting loops of decompressed bowel without clear involvement. FALLOPIAN TUBE: * Small right hematosalpinx, 5 mm diameter. * Left tube not visualized. UTERINE LIGAMENTS: Fibrotic implant involving the proximal right round ligament, right anterior uterine body, and serosa of the distal sigmoid colon as it courses to the right towards the right internal iliac vessels (401/17)
POSTERIOR COMPARTMENT UTEROSACRAL LIGAMENTS: Involved bilaterally near the junction. RECTOCERVICAL SPACE (Pouch of Douglas): Involved as described above. RECTOVAGINAL SEPTUM: The fibrotic implant in the retrocervical space extends inferiorly to involve apex of the posterior vaginal fornix. ANTERIOR RECTAL WALL: Involved as above. SIGMOID COLON: Involved as above.
OTHERS APPENDIX: Tip not visualized, possibly involved. Cecum positioned anterior right pelvis. PELVIC SMALL BOWEL LOOPS: As above. PELVIC COLLECTIONS: 6.8 cm loculated fluid collection with thin septa in the right posterior pelvis compatible with a peritoneal inclusion cyst. ABDOMINAL WALL: Normal LYMPH NODES: Normal ILIAC ARTERIES AND VEINS: Patent

How are my feelings wrong and what makes his feelings right in this situation ?So me 39f and my boyfriend 44m had been together for two and a half years we are going through some though times but we were still together. The girl he was with before me that he was with for 5 years and friends with for 20 years found out she has cancer. He told me he was going to help her get through this and he started to stay the night at her house and I thought it was wrong. I told him he could be there during the day and stay with me at night that was a good compromise I thought. He told me that I made him choose and so he dumped me and moved in back with her right away. And then it's now that he didn't dump me and we're still together he's just helping a friend out but his ex-girlfriend or I should say current girlfriend believes that they are together for some reason. He told me it's all about what I want about what he wants right now it's about what she wants and making her better is all that matters. She has stage four supposedly I should say cuz I don't know but I'm told she has colon cancer, lung cancer, lymph node cancer, and bone cancer. I never said that he couldn't be there for her I just didn't think it's right going and moving in with her and acting like I don't exist and he won't even acknowledge me when he's around her. I'm now his dirty Little secret well he plays house with his ex I guess current girlfriend sorry. He told me as soon as she passes away we'll get back together but he's not taking my feelings into consideration at all I'm not saying that she doesn't matter but like where do I come in and all this. Why do I get tossed aside like I don't matter and I'm supposed to be okay with it just wait for her to die and I'm supposed to wait for him and hold down it down and be supportive of him because this is important to him so why is it important to me like who says that. Not to mention this ex has tried to get him to come over and sleep with him while I was in jail tries to always get a hold of him try to have him sneak behind my back and I'm supposed to be okay with all of this and if the situation was reversed he'd be holding it down for me and not making me wonder if I was out there cheating or not. Hes be my support system and back off until I figured it out and he believed me alone until whoever died that was in my life. I mean he gets an attitude when he thinks I hung out with a guy while he's living with another girl and sleeping by her. Because she's got that coming from him because she's been a good friend to him and never expected anything back and if she wants to believe that they are in a relationship then he'll let her believe whatever because she's got that coming. How is that love? How is that showing that you love me like that does not prove you love me it's just shows me the exact opposite. But he'll still come over and have sex with me. She just recently went to the hospital for colon cancer and he told me she'll be in there for 5 days and how much I see you depends on you and your attitude. I don't know if I'm the one that's a being a bitch because I don't see it from their side I see it from my side and I don't think I'm wrong but maybe I am.

I’m a 32 year old Caucasian female, Nulliparous, 5’4, 200 lbs, lightly active, healthy diet, no past medical history. All vitals WNL. Seasonal allergies.
I have had a lump inside my armpit for the last 3 weeks.
About 4 weeks ago, I started applying a lot of exfoliating products under my arms - nothing crazy, things that I would put on my face. 3 weeks ago, I was getting ready for work and I had a tender lump inside my armpit. I assumed it was a pimple or cyst and that I would erupt in a week, maybe two. My boyfriend says it was the size of a Lima bean when I first discovered it. You can’t see it by looking, you’d have to palpate.
Fast forward to now and it has progressively gotten significantly smaller and non tender (smaller than a pea). It also is shaped kind of oval-like. It’s hard to find. I notice activity, sweat, heat, and seem to make it less noticeable - but if I start playing with it and squeezing it it becomes a little irritated and tender, it maybe even temporarily swells a bit.
The only thing I can think of maybe I compressed a nerve or lymph node because I sit on the couch funny and rest my armpit over the armrest in a way that might be irritating?
I have no other symptoms, skin looks good, I feel alright, no fever or night sweats, good appetite, decent energy for a night shift worker, tolerates activity and alcohol well, bowel movements are good. Sleep is fine.
I made a doctors appointment for Monday. I feel silly getting it checked out but I worry about what might happen if I don’t. I’m an oncology nurse with a great deal of health anxiety - you can imagine the places my mind is taking me.

my dentist told me i should get my wisdom teeth extracted soon when i went in december 2022. i'd been having some occasional inflammation that'd usually only last a few days every couple of months that whole year, so i didn't think much of it. my mom was with me, and she told me she wasn't going to have me get my teeth extracted until i was actually in pain. i didn't go to the dentist in 2023 (i usually go when i'm in my hometown because i'm an out-of-state college student on my mom's insurance). since mid-march, both sides of my jaw and lymph nodes have been a bit sore in the mornings maybe 3/7 days of the week, but it usually goes away by the afternoon. no gum inflammation, no redness, no pain in my actual mouth. since monday morning this week, the soreness hasn't gone away, and instead my right lymph nodes have been slowly swelling more and more. along with this, i've been having occasional dull headaches, and headaches on my right temple. no fever, no redness, no swelling or pain in my actual mouth necessarily nor in my face. yesterday (friday), i went to urgent care and was told to monitor it, and if it gets worse to go to the dentist. i found only one dentist office that takes my insurance in the town i go to college in, but they're closed on weekends so i could only put in a request for an appointment instead of make an actual appointment. i'm terrified of having to wait too long, and the impaction becoming worse or infection spreading to my brain and killing me since my swollen lymph nodes are most-likely a sign of my wisdom teeth already being infected internally. i've never had surgery or been put under anasthesia before, and i have health anxiety, so i'm terrified of nerve damage, lockjaw, or other complications like waking during the procedure and not being able to move or speak. it's just a waiting game now. should i not worry about the infection spreading and killing me if i don't have redness or lots of pain or a fevechills? i just want to know that i'll be okay by the time i'm able to be seen by this dentist :(

I am trying to weigh and balance my options for treating my thyroid. A bit of background. Despite having "normal" T3/4 levels and only "borderline high" TSH, I've been experiencing lots of wierd symptoms (which have progressively gotten more intense) that align with hypothyroidism. When I started feeling pain in my neck, it finally made me push my doctors to scan my neck and they found a 1.5 cm PTC tumor(no lymph node spread).
I decided to look into doctors who perform a newer procedure called Radiofrequency Ablation. I hoped for a chance to preserve my thyroid in the chance that my symptoms are all caused by having cancer and that they'll go away when the cancer is treated. I met with the surgeon, who says I am a great candidate, but that he suspects that my thyroid is damaged and that I'll likely be diagnosed with hypothyroidism down the line if not sooner.
So where I'm at now is deciding, do I want to get RFA like I originally intended, or do I get a partial thyroidectomy anyway since my thyroid isn't working as it should. I feel confident both treatments would address the cancer, but I don't know what would be best for me long term.
I'll definitely be following up with an endocrinologist, but I would love to hear if anyone has been in a similar situation of balancing hypothyroidism and cancer diagnoses. What did you do? Were you able to get your symptoms under control? I used to be really active, and I just want the fatigue and brain fog to go away.

TL:DR for diagnosis: Been sick for about 11 weeks with a cough that was violent enough to cause me to throw up. Throw in a kidney infection 6 weeks ago. ( Cough has subsided these past 2 weeks tho) Last week we were going to a specialised doctor to investigate the fluid that was found in the CT and X-Rays I have gotten and he told me there was a 14 cm mass behind my sternum and there was a swollen lymph node on my neck. They cut out the swollen lymph node on my neck and came back with NScHL.
Other cancers are pretty blatant when it comes to how it's killing you... But how does Lymphoma do it? Does the immune system become so compromised it can no longer protect you from other disease? Are the lymph nodes no longer able to properly drain fluids? Do the lymph nodes expand so much where it causes other bodily functions to stop working (IE, lymph node pressing against Liver causes it to fail). It's a dark question, but it's one I've not been able to find (Google sucks nowadays lol)
I ask about misdiagnosis, not cause I am in denial (everything the doctors have told me and browsing this reddit and other areas is almost 1:1 for the same condition) but because of the next part involving the Gerson Therapy clinic. I just want to state, I am a cautious skeptic (I'll remain an optimist about this till it is gone or till I am dead) and am not promoting it as per rule 3. I am just venting about it, so, the opposite lol.
So here's the next part and I know I will get hate/criticism for it. My parents are uhh, quite hippie-ish. I'm M18, so I'm stuck with them (they aren't bad parents by any stretch of the imagination, they are very loving and concerned, but are a bit misplaced sometimes) My parent's havent taken the diagnosis well. They are begging me to avoid chemo as much as possible, and instead, want me to go to a Gerson Therapy clinic. Before we even try Chemo or the standard treatments. I have agreed to do so.
I am an adult, so I can make my own choices and my parents will stand by what I choose, but that doesn't mean I am free of other issues, like stress. I agreed to go to the Clinic. First, it is a 4 hour drive, whatever, I want to get out of the house anyways. Two, I love nature, and Sadonna Arizona is absolutely stunning and beautiful, plenty of people with Cancer take vacations, this is no different in my view. Three, I love my parents and though I need to prioritize myself, if this therapy doesn't work, it'd be far less stressful to go through conventional treatments, because I can at least say I tried it. They have admitted if this doesn't work, that is the route to go to. Four, if nothing happens, I will be able to warn others if the therapy does not work, having been able to experience it first hand.
Basically, I'm more so going because I want a vacation more than I want to do the therapy, and because it will ease my parents for a bit. They will be sad if it does not work, but I'd rather say "Hey this doesn't work, lets move on to this that 90% of the time works" rather than the alternative what ifs and etc... Once Chemo starts, I'm stuck home... and it kinda scares me, unless I want to dress up in a HazMat suit lol.
I've read into this specific type of therapy. Some websites claim that many people who were "cured" of cancer, never had cancer at all. If I was misdiagnosed, and this therapy does not work, I do not want to add to a statistic that is not true, nor do I want to go through this when there is no Cancer. I've seen many other issues in regards to the therapy, including many people who claimed to be cured died 5 years after leaving the clinic. Not fun...
Sorry for the long post, just a lot to get off my chest.

Edit: Thanks for all the extremely useful insights, comments, and understanding in regards to the situation everyone, it's all extremely appreciated :)

Chapter 1: The Oddest Blue Ball
…Welcome to the Ai circus….
…Brains are breaking, systems nervous…
‘He’s been acting really odd recently…’ Murmured the said person’s self-proclaimed best friend as he shuffled his cards, eyeing the others for validation of his statement.
‘The Earth you mean? Umm…yeah I’ve been trying but-’ The Satellite was cut off by none other than the most hot tempered planet among the terrestrials.
‘Yeah, yeah whatever, can we ever talk about something else?’ Venus grumbled.
‘Calm down Venus, he’s our friend.’ Mars instructed firmly.
‘Whatever, isn’t this pipsqueak always with him? What are you doing anyways?’ Venus asked sharply, turning his attention to the quiet satellite.
‘He told me to give him some time, I didn’t want to but…’, Luna sighed deeply, ’-Here I am.’
‘You should go back, he can’t be alone for long’ Mars expressed his concerns.
‘Maybe’ Luna answered, his thoughts getting scattier as he drifted away, ignoring the confused stares of the planets, who resumed playing cards.
The Earth has been acting odd in the sense that he had stopped talking, almost to everyone, including but not limited to Luna. He’d put on acts after the revolution of joviality, but really the only mood he seemed to be in was apathetic. Like an actor on the stage, the only time he spoke up was to correct factual errors, much like Jupiter but more condescending and for the purpose of belittlement and personal jabs, which are frankly out of character, giving fits of sarcasm was another problem. Like the apology to everyone meant nothing to him.
The thoughts would remuniate through the satellite’s head multiple times, failing to provide any solution to the problem at hand.
It was a while before Luna reached his orbit near the Blue ball, who was facing towards the asteroid belt and muttering in an almost funny manner, holding stacks of papers in his hand.
‘Hey Earth…what’s that?’ The satellite peaked through his shoulder, making the planet jump and obscuring the sheets from Luna’s view, who only managed to catch the word,’revolution’.
‘Moon, how many times have I told you not to be so quiet?!’ The Earth picked up his usual cynical dripping with a touch of acerbic tone.
Luna rolled his eyes, already prepared for the acidic encounter, praying moons such as Ganymede and Europa don’t find out about these recent developments,’Ugh, right, what is that anyways?’
‘None of your business.’ The tone filled with intended venom.
‘Look Earth I know the revolution has been-’ Luna launched into the same speech he has given a thousand times in a matter of weeks.
‘It’s not about that revolution, so shut up.’
‘Can you not act like a jerk for two minutes?’Luna snapped, delivering his out of character statement, he knew it was a bad move as soon as the words escaped his mouth.
‘Ugh, whatever Moon, just leave me alone, I told you I don’t want to be your friend!’Luna flinched hearing the words, he still hasn’t gotten used to them.
‘You’ve changed Earth you weren’t always-’
‘What do you expect? Look…don’t make me say something I’ll regret, hang out with Titan or whatever.’ Earth avoided eye contact.
‘As you wish, Earth.’
Luna left the scene, unsure whether Earth saw the teardrop rolling down the said satellite’s cheek, his planet’s indifference was starting to affect the moon, Luna wandered around in the asteroid belt, he didn’t immediately react as he bumped into someone. He looked straight, it was a slightly smaller satellite curiously studying him as if he were…what did they call? An artifact in the paleontology department, somewhat.
‘I’m sorry, who are you again?’
‘Great question…’ The smaller celestial mumbled.
‘What did-’
‘Umm, Luma! Yes, Luma’s my name, I am not sure..I mean sure!’ The satellite stammered, acting like a total mess.
‘Uh okay, nice to meet you, I'm Luna.’
Luma is staring at the celestial awkwardly, possibly due to the unobscure similarity in the names, Luna stares right back, spacing out for a bit.
‘Sooooo Luna? Like Earth’s moon?’
Luna cringed at being referred to as an object but he didn’t not correct the newcomer, he was a little estranged out, Luma looked familiar…but unfamiliar…
Is he a Moon? Is he a planet?
But perhaps the oddest observation was perhaps Luma’s reaction, as if he didn’t know who the former satellite was, but weren’t all Moons in the revolution? Is he a dwarf-
‘Hello? Umm…Luma to Luna? Earth to Luna? Solar system to-’ Luma continued his rambling, the weird analogies, the former Moon could only think about the familiarity of the situation…that was so unfamiliar.
‘Right, sorry, hey are you a dwarf planet?’
‘I’m a Moon actually…’ Luma answered, unaware that he had opened a Pandora of questions.
‘I know it’s stupid but I think I’ve never seen you during the revolution.’ Luna smiled apologetically, expecting a yes and a possible hypothesis that he had missed the satellite in the 300 moons besides the other celestials.
Instead Luma stared at him blankly with an open mouth, it was only for a fraction of second but the doubt was planted in the delayed reaction.
‘Um, yes! I-I probably missed you too.’ The latter laughed nervously, Moon could tell there was a layer of superficiality and sense of lie…the same aura he gets around Earth these days.
But he ignored it.
‘Okay…bit odd you know, you’re so-’
‘Noticeable? I knowwww right..??! It’s so weird, um, gotta go!’
‘Wait I-’
But Luma was already rushing towards the other side, to the terrestrial side of the solar system, The Moon felt a weird excitement in his stomach that he couldn’t point out.
Was he the Moon of jupiter?
He’s almost as large as me…
What is he hiding?
Did he not know about the revolution?
Why is he so familiar?
Why is he going to the terrestrials?
What is the weird energy?
The questions haunted him but he shook his head, reassuring that it was a weird coincidence, but his face….
Luma’s face looked so nostalgic…The bright golden eyes, the silver-golden lining, the sun symbol in his hair…
Wait, a sun clipping?
All the other moons would only wear Lunar clippings…
Who was he?
(1000 words)
Chapter 1.5: Keeper
…You can run but you can’t hide…
A few days before:
‘Will you just ignore your friend?’ Sneered the sinister voice from nowhere.
‘No, no, no, I won’t do what you ask.’ He called out desperately.
‘Just keep an eye on him, won’t you? my dearest friend?’The voice replied.
‘No, no, no, I won’t hurt anyone!’
‘You’re not hurting anyone, but I will if you don’t obey me.’ The voice turned murderously melodic and sweet.
‘No…I am not your friend, i won’t-’
‘Won’t what?!’The voice boomed in his ears.
‘Won’t hurt…won’t spy…’ he whimpered.
‘I see, you won’t keep an eye on things?’
‘N-no.’
‘Well then…say goodbye to your precious friends…’
He didn’t flinch but fear rose in his chest as his heartbeat grew painfully faster and his stomach twisted tighter into a knot, he was ashamed…
Because he didn’t care about his friends.
‘Acting tough? Alright, what if I offer you freedom?’The voice was behind him now, it was charismatic in nature and soft in tone.
‘No…you won’t…’ He gasped, the words right on the tip of his tongue, burning.
‘A place you can call home…without him to bother?’
‘…I’ll do anything…to get out.’ The words vomited out before he could stop as a look of abhorrence rose on his face as he realized he had just made a deal with the devil, a sudden feeling of nausea hit him, dizziness took over him.
‘Good.’
(230 words)
Chapter 2: The Stranger
…I don’t control the words that I say with my mouth….
…They sent us a saint but then made him a clown…
‘Europa, babe, do you know who this Limmy-Luma guy is?’Ganymede frowned as he straightened his crooked baseball cap, looking at the dainty satellite in front of him.
‘Who?’ Europa grumbled, looking down, probably pondering about the revolution and the smaller moons.
‘I met this guy, he was weird babe.’ Ganymede shook his head, the machine in his head furiously working to place the stranger’s head, like an earworm, only for memory.
‘Could you be more specific, Ganymede?’ Europa scrunched her eyebrows in annoyance, which the former thought looked cute.
‘Didn’t pay much attention Europe, but he was kinda similar to Earth’s Moon.’ Ganymede whistled through the non-existent air.
‘You mean in size, Ganymede?’ Europa’s voice hit a condescending note, but Ganymede could tell she wasn’t really irritated.
‘Yea, he didn’t talk much.’ the latter shrugged but before he could stop himself he caught himself saying the following;
‘His face though, yea, it was really familiar, ‘Ope you listening?’ Ganymede looked up, snapping from his thoughts.
‘Oh right, I don’t think I’ve met him, Ganymede.’ Europa looked at her boyfriend thoughtfully.
‘wasn't really that small either.’ the latter frowned as suspicion aroused him.
‘Whatever, we should be focusing on our plan for equality, not some stupid stranger you just met.’ Europa snapped, probably her anger about the failed revolution.
‘Whatever Europe…’ Ganymede murmured as he toyed with his cap, something about the stranger not sitting right.
A smaller satellite nearly crashed into him, Ganymede looked at the crasher angrily, only to raise his eyebrow.
‘Earth’s Moon? What are you doing here, Earth didn’t tear into rings?’ Europa spoke up, vinegar dripping in her words, before Ganymede could interfere.
The Grey-silver moon stared at them not uttering the word, Ganymede didn’t need empathy to sense something was wrong, not that he cared.
‘You’re still not…out of commission?’ The latter looked bored.
‘Shut up…’ Earth’s Moon muttered and drifted off to Saturn’s orbit, most likely looking for Timmy.
‘What's up with him now?’
Chapter 2.5: The Stranger-2
…I don’t control the words that I say with my mouth….
…They sent us a saint but then made him a clown…
Luna ignored the piercing glares from Ganymede and Europa behind him as he drifted into the orbit of one of his friends, namely Titan. He didn’t have the time,, energy or confidence to deal with snarky comments about his home planets,
Mainly because he was starting to question his own faith.
He didn’t notice as the friendly Jovian Satellite greeted him,
‘Hey Earth’s moon- I mean Luna, how are you?’ Titan gave a sheepish smile, clearly embarrassed about the slip up.
‘Hey Titan…been a while huh?’ Luna smiled weakly, Titan must’ve sensed something wrong because,
‘What’s wrong? Is it about the Earth? Please don’t tell me he-’ Titan rambled, although he had forgiven Earth, obviously he couldn’t help but be suspicious of the planet, Luna hated how he was right.
‘It’s nothing…’
‘What did he say now?’ the former sighed.
‘Just been acting weird, alarmed all the time…As if someone was trying to hurt him.’ Luna frowned, the last part came out satisfactory in an odd manner, Titan raised an eyebrow, clearly worried.
‘I don’t know, like you know him better than I do.’ Titan shrugged, he didn’t seem to care much.
‘Hey Titan, do you know about this weird moon? Is he one of Saturn’s ?’
‘Huh?’ The jovian seemed a bit confused as to what Luna was talking about.
‘It's nothing…’ Luna sighed for the lack of answers. What was his name? Luma?
Titan blinked before answering, ’You mean Luma?’
‘YES! Do you know him??’ Excitement buzzed through the terrestrial satellite’s body.
‘Not really, I met him a while ago, claimed to be one of Saturn’s moon, but when asked about the revolution, he seemed at a loss of words.’ Titan answered, looking mildly disturbed.
‘Do you think he’s lying?’
‘Maybe, but everything is so strange these days, Saturn’s been acting freaked out, he’s barely letting me leave the orbit, talking in hushed tones with Jupiter, then you are talking about how Earth’s acting strange. I suppose Luma could be a new moon that has missed the announcement, because I’ve never met him before.’ Titan explained, he shuddered while saying the words, it might just be the chilly temperature but Luna wasn’t sure.
‘I see…thanks for your help.’ The latter couldn’t help but pout his disappointment.
‘But me and Titania talk sometimes, she’s really cool!’ Titan added cheerfully, discarding their previous conversation, Typical, Luna thought.
They chatted for maybe about 30 minutes before Luna thought about going back to his orbit before Earth went ballistic missile mode and refused to talk for another week. It's like dealing with a child , Luna thought to himself, before scoffing, Titan raised an eyebrow.
‘Thinking about Earth?’ he asked in a bored tone.
‘How did you-’
‘Because that’s all you do.’
‘No that's not true-’
‘Calm down, was just trying to point something out…maybe spend a little time away with him, you can hang out with me?’ Titan grinned like an idiot.
‘Whatever…’ Luna put his palm on his forehead as the knot in his stomach tightened.
Luna waved Titan goodbye as he made sure to avoid the moons of Jupiter while returning, out of nowhere a hand grabbed him and turned him around.
Luna grabbed an asteroid ready to attack the stranger…
It was Luma.
‘WHAT- why are you-?!’.
Not a wise decision to yell, Luma shoved his hand on the former satellite’s mouth and shushed him without uttering a word, he seemed tense, The Moon stopped struggling out of fear.
Luma had paled, ’Don’t turn around Earth’s Moon…or it’ll get you…’
The Moon took a chance and being stronger pushed the former aside, turning around to see…
Just asteroids.
Luma blinked, apparently confused, that slowly turned into his usual jumpy self as the satellite in front of him glared, anger blazing in his eyes.
‘I-I…don’t-’
‘What was that for?’The tone was steely.
‘I just thought-’, Luma stammered, clearly at a loss for words as he summoned his wild hand motions.
‘Though what you? We could’ve crashed.’ Luna glared at him.
‘Can’t explain…I have to go…’ Luma turned away again.
‘Wait you-’
He disappeared again, The Moon started mumbling in frustration as he started heading towards Earth, his day couldn’t get any better.
As he was about to drift away, something caught his eye, white, Luna grabbed it, it was paper, he frowned, something was written on it…typed?
“The Moon escape”
He began to read…
(1030 words)
Chapter 3: Rio Lee Heelshires
…the heelshire mansion, it’s a place you’ll learn to love…
…Welcome to my house, obey the rules….
It was a any mundane afternoon in the 1990s Chicago, a warm summer breeze blew right through Ophelia’s ash coloured, long hair as she swung her legs off the swings popping open a Stephan Hawking book titled, “The Brief history Of Time”, she turned a page as a familiar voice called out to her.
‘Ophie, quick! The new game is out!’ called out her twin Rio wearing a mask he usually does . “Ophie” jumped from the swing, leaving her book dangling in the seat, one step of carelessness and it might have fallen into the mud below, she didn’t care at the moment.
The two rushed to the other side of the Heelshire mansion to find their cousin, Enzo.
‘Zoh! Come quick.’ Ophelia called out as her younger cousin came rushing forward, dropping behind his puppets and the creepy ventriloquist dummy.
‘Is it out? Is it out?’
‘Come fast, Laurenzo just drop the dolls!’ Rio hissed at his siblings, clearly annoyed by his cousin’s obsession with dolls, typical, Ophie thought to herself as she followed her twin’s fast steps to the nearby arcade, struggling to keep up, by the looks of it so was Enzo.
Why did her older brother have to be so impatient?
It was the new pacman game, it had been released about a decade ago but the arcade only opened a few months ago so the games kept releasing one after another, needless to say Rio and Theo were obsessed so they kept dragging her into it, she didn’t care for the game but it was nice to see her twin not be overly cynical for a few moments in his life, as much as she loved him,
He was insufferable, although it might have to do something with his illness…
Needless to say they reached the arcade as monkeys would reach for a banana stall, even though Ophelia didn’t admit she loved some of the games, especially Q*Bert, she would toy with the game for hours.
The arcade was filled with heavy video game machines, each with Neon spray paint screaming for attention, the covers bright and colorful, and the consoles and controls worn out from being played so much by the locals, all connected to one port at the back, but the most noticeable detail about the video game arcade was the crowding around the new machine, Pacman.
Of course not, it was 5-10 people.
‘Aww, damn it, we are never going to get a turn.’ Rio slumped his shoulders, Enzo looked unfazed and maybe a little jaded.
‘We just might.’ Ophie remarked, as she pointed towards the line that got shorter with every furious nerd storming out.
‘Seems like a hard game.’ Commented Enzo, twirling his slightly curly hair.
‘Agreed.’
‘Oh my faint-hearted sloths for siblings, come on.’ He seized Enzo’s sleeve and dragged him into the line. Ophie wondered how he could afford to be so feisty with all the headaches, she followed nevertheless.
Turns out Ophelia was right, the newbie nerds lost pretty quick and in no time the line dropped to a quarter of its size, with more people crowding around the next player , who stormed through the crowd in a rage fit. Is this how I am like when I lose board games with my brothers? Ophie pondered over it, not for long as their turn came pretty quick.
‘I’ll go.’ Ophelia stated, both the boys looked astounded.
Ophie as she suspected was pretty bad, fortunately she had 3 quarters from saving up, which bought her brothers some time, she could hear them mumbling behind her as every kid in the arcade watched her screen intensely. Their conversation resembled somewhat this;
‘Look…the red ghost-’
‘Blinky.’
‘Yes, yes, it’s most aggressive, it comes directly for you.’
‘Mhm…’
‘And look, Inky tries to ambush you with Blinky, from the opposite side!’
The rest of the kids were turning their attention to the conversation.
‘Rio…look Clyde he almost stays in that corner and circles it.’
‘Pinky is trying to cut you off, Ophie what are you doing?!’ Rio sounded frustrated as his sister had somehow managed to get stuck in a T shaped spot, interestingly the ghosts didn’t attack her.
‘I think it’s a glitch…’, Enzo blinked and then grinned.
Ophie finally lost it, the game not her temper.
Rio pushed her aside with so much energy that she nearly crash landed on Enzo.
‘Rio! Seriously..?!’ Enzo looked more annoyed for some reason.
‘Oops, sorry.’, He didn’t seem sorry, all his attention invested in the game, the analysis seemed to have worked,
They were there for hours, okay one hour, Rio’s sister would’ve loved to tell you how many levels he crossed, except that she didn’t remember because she was playing Q*bert with her last quarter.
‘That was fun.’ Rio smirked at his siblings as he swung his legs on the swing.
‘For you, I didn't even get a turn!’ Enzo huffed, arms crossed.
‘Fine.’, Rio rolled his eyes,’You can have Ophie’s dessert tonight.’
‘HEY!’ the latter looked up from playing with the dummy in her lap.
‘Kidding, kidding, you can have mine.’
‘Seems like a good deal.’ Enzo smiled.
‘I still don’t understand why don’t you like Q*bert.’
Ophelia frowned as both the brothers exchanged a laugh, sometimes their word plays and jokes pass right over her head.
Chapter 3.5: Rio Lee Heelshires-Case
…the heelshire mansion, it’s a place you’ll learn to love…
…Welcome to my house, obey the rules….
‘Rio? C’mon your mother’s calling you!’ Enzo called out as he stepped outside the house and in the garden, which was beautifully maintained unlike the forest that was tucked right behind the house, Rio thought it was mystifying, Opheilia thought it was pest infested, there were two kinds of people in the world, Rio is in one category and the world in another, Enzo chuckled at his own thought.
‘Oye, Rio! I’ll eat your food if you don’t stop hiding.’ Enzo threatened, but he wasn’t sure it would work as he had enough trouble eating for one, plus he still had Rio’s desert.
He skipped around the garden, much to his disappointment he found no one, he wondered if he should check the forested area, as he strolled mindlessly.
‘Rio! This is not funny anymore…’ Enzo felt precipitation hit his face as his breath grew quicker and pace faster.
‘Big brother..?!’ The latter rarely referred to his cousin as “brother”, panic was settling in, fortunately his gaze landed in the right place,
On the other hand he would’ve preferred Rio to be missing…
‘W-what?’Enzo murmured softly, a look of horror settled on his face as his eyes burned with tears…
It was Rio alright and he wasn’t dead…he just seemed very close to being dead.
Countless bruises were present on his hands and legs as he leaned against a tree, collapsed on the soil of Earth, his eyes closed, Enzo hesitantly moved forward, he could sense his brother breathing, perhaps the most terrifying part of the scene was the black liquid drooling out of the corner of the former’s mouth,
He knew his cousin was sick,
He didn't know what sickness or how sick.
‘Rio…wake up…’ it seemed to have done the trick, the latter nearly jumped, smashing his head against his cousin’s, his pupils dilated, a psychology nerd like Enzo will know it was from fear due to the adrenal rush.
‘What- Y-you, don’t-’
‘I won’t tell anyone…’ Thankfully the darkness of night hid the crestfallen look on his face, besides he didn’t plan on sticking to his promise, Ophelia deserves to know. The situation felt too familiar.
Like what happened to his mother.
‘C’mon, we need to get out of here, it's not safe…I’ll help you clean up and tell everyone you are sick, alright?’
‘S-sure.’ Enzo helped his brother get up.
‘Damn it, you’re heavy…’
‘Shut your trap.’
Enzo wasn’t particularly happy about being told to shut up but he was relieved to see his brother going back to his normal self as he half dragged and half helped him to the house, making sure to take the back door and avoid Rio’s parents, Ophelia caught a glimpse as she was passing by but she didn’t speak a word and instead just avoided the two like a plague.
Thankfully the parents weren’t too worried about their children’s shenanigans as Enzo cooked up a convincing lie about Rio vomiting everywhere, nobody seemed particularly excited to go check up on the older twin so they ate dinner heartily, as much as they could muster that is, The Heelshires were infamous for being the most gloomy family around the block.
Ophelia didn’t utter a word the whole dinner, it wasn’t particularly unusual for her, she almost had an invisible, omniscient presence that allowed her to fade in white noise, but Enzo was certain it had something to do with the scene,
He met her after dinner in her room.
‘I know Lauren, he’s my twin and he’s not particularly good at hiding things.’
‘Why didn’t you tell me?!’ Enzo felt his voice rising both in pitch and decibels, he almost rushed immediately to tell his sister, who could barely bother to offer the same courtesy.
‘Why exactly?’ She had her intelligent gaze fixated upon Enzo.
‘What do you-’
‘I don’t know if you are aware of yourself, but I don’t feel offering to be everyone’s personal therapist is a particularly healthy option for you that takes everything home.’ She said,
‘He’s my brother Ophelia…’
‘And I am your older sister, I think I know better.’ She cut him short, as if purposely trying to piss him off as she toyed with Enzo’s dummy.
He snatched it from her, her pupils contracted but her breath grew sharper and she looked as if she would attack her cousin.
‘I deserve to know Ophelia…we have to tell someone, we have to help-’
‘You can’t fix everything Laurenzo. The faster you learn the better.’ Ophie wouldn’t meet his eyes, it usually meant she is furious and the fact she called him by his full name.
‘But…’
‘No. Rio said nobody can fix it and I have an intuition he is right.’
‘Maybe he’s wrong…I mean we aren’t verified experts are we?’
‘Maybe you are wrong, enlighten me, how many times have you heard of strange black substances coming from teenage boys and bruises out of nowhere?’
‘...How about trying the library-’,
‘I tried, I tried to find anything, anyone that would tell me, every illness in the book from the library, there’s nothing.’ she looked as if she would burst out crying, that is what usually happens when he fights with her.
‘...okay, let’s find ways to help him.’ Ophie looked up, bewildered at his words.
‘But how? I looked everywhere.’
‘Every problem has a solution, we can be the first ones to figure this out, besides I can sense that his problems aren’t purely physical, they are psychological too.’
‘I feel that this might not work out, but as you wish.’ Ophelia responded after seemingly deep in thought, she looked up and a puzzled expression began to form on her face, Enzo quickly tried to brush off his tears, his cousin didn’t seem very impressed.
‘Why are you crying?’
‘Isn’t it obvious?’
‘Not to me, it isn’t, you just said we’ll figure out a solution.’ Ophie said.
‘How can you be so optimistic? I mean you weren’t a few seconds ago but you weren’t crying like a damn b-’
‘Eh, we need one sibling that doesn’t have real problems right?’ she smiled bitterly.
‘You shouldn’t dismiss your problems…’
‘I think you should follow your own advice first.’
She was right.
***
Ophelia knocked at her twin’s door the next morning, not particularly enthusiastic to engage in a conversation, it was hard to relate, hard to understand Rio, but she never understood people anyways, the illness, it had been five years since she knew, since Rio’s obsession with mask began, the numbness had settled in after a week and never left.
She knocked again, no reply, her frustration rose, she banged the door so loud at the third knock, that Enzo threw a cricket ball at her from the nearby room, before joining in.
‘You think he went out again?’ Ophelia asked, bored out of her mind.
‘I’ll check if his shoes are missing or not.’ Enzo disappeared downstairs as Ophelia’s mother started questioning him.
Ophie creaked open the room, the bed was messed up and no signs of civilization were found in Rio’s room, she frowned, Enzo’s ventriloquist dummy? But didn’t the latter keep it in his room last night? Clothes were distorted all over the place, books about wildlife, possibly over due on his desk.
‘He went out alright.’ Enzo came back, Ophelia closed the door, a blush rose on her face, as if a child was caught stealing candy.
‘He’ll come back.’ Ophelia reassured her younger cousin,
Or herself she didn’t know.
~
He in fact didn’t come back and was declared missing.
One day, she and her cousin found Theodore (her father) murdered, poisoned apparently and her mother sobbing hysterically in another room.
She knew who did it, she was glad he did it.
The killer hanged himself 2 days later.
(2000 words)
​

[ 26F, 190lb, white/hispanic, no existing health issues besides allergies (take Zyrtec OTC daily), non smoker, recreational drinker. ]
2 part question; TIA!
I got back from a trip abroad in October and noticed a lump above my armpit about the size of a golf ball. I had an ultrasound done and bloodwork to confirm that it is a swollen lymph node. What is concerning me is that ever since I found this lump, I have been getting sick WAY more often than usual. Pretty much every single month. I have worked in a school district for a bit over a year now so I'm used to getting sick every so often but nothing like this. I had incredibly painful and swollen neck lymph nodes in April and my first sinus-like infection for about a month in March. And a cold every month at least.
I had a consult with a surgeon who basically just left it up to me whether I should get it removed or not (or do a core biopsy). It's not painful, just semi uncomfortable when applying deodorant.

1. Is it possible that this chronic swollen lymph node could be affecting my ability to fight off infection? The surgeon said no; it could only harbor infections like mono or HIV but I really haven't changed any of my habits to account for why I'm getting sick so much more often. I take vitamins and probiotics, eat generally well, exercise 3x week. I will say my sleep and water intake hasn't been the best lately.
2. Would removing this swollen lymph node likely affect my ability to fight off any future infections/ what if it happens again in a different spot??

PS: I have taken 2 rounds of antibiotics in the last 6 months. 1x for the lymph node and 1x for the active infection
I'm feeling incredibly frustrated by these constant bouts of sickness.

[25M] Medical mystery, neuro and skin symptoms post infection
My crazy symptoms after strange infection - neurological and flushing
In august last year I had strong infection, I was sweating by month, extreme fatigue, swollen lymph node under armpit.
Since then I have tons of symptons:

• neuropathic pain in back, deep pain in spine
• right shoulder blade is painful and deep itching, extremely weird tingling pain deep, when I move my arm
• my back feels so messed up I feel asymetric when I walk, when I breathe I feel pain in lot of different places in body
• redness on face, flushing, red ears, heatwaves and warm feeling (mostly at night) - when my face is flushed, symptoms of pins needles burning are the worst
• electric, neuralgic pains in face, head, scalp, pain when I move my eyes deep in face
• body itching, itch deep inside ears, face
• skin on face, scalp, eyelids twitch randomly, like electric shocks
• fatigue, brain fog
• brain zaps
• pins needles in feet, body for example when I put my clothes on
• random warm feelings in legs like hot water in legs
• hives which disappeared mostly

Here are pics of my red face flushed:
https://ibb.co/album/WWw7VS
Bloodwork is ok. Is it some kind of long covid? Taking gabapentin, doesnt help too much. Antihistamines doesnt work (ketotifen too) so not MCAS..Please, tell me which lab tests should I take. Please, I feel like a living dead.

25F, 5’5”, 118 lbs. No history of smoking. Generally considered healthy by every physician I’ve met. Just started taking famotidine for my acid reflux. I’ve been dealing with GI issues since 2016 but none of my episodes have been severe other than the time back in high school when I had trouble swallowing. I haven’t had a bad GERD episode in about a couple years until now, but this time something feels strange.
About a week ago, I started having frequent sharp chest pains in the left side of my chest. They were quick and felt like a pinch that lasted for about a split second. I didn’t pay them any mind until they started happening once a day, every night for a week straight. Then one day, I had another sharp chest pain but in the middle of my chest, followed by chest pressure and heartburn.
I went to the ER, had blood work and multiple tests done including an EKG and chest x-rays that all came back normal, so that rules out anything heart or respiratory related. The doctor suggested it might be a musculoskeletal issue, anxiety or acid reflux. I followed up with my PCP, who said acid reflux might be a more probable answer, and had a few more tests done including some blood and thyroid tests. She even ordered an ultrasound for my stomach. During this time, my chest pain/congestion was on and off and oftentimes it feels like there’s something stuck in my chest. My swallowing is fine, I haven't lost my appetite, and I haven’t thrown up anything I’ve eaten/drank, but I woke up multiple times last night with an uncomfortable feeling of pressure in my throat that made it hard to get some sleep.
I wouldn’t be surprised if it’s my GERD again, but I went doom scrolling on Google/tiktok and am paranoid that these might be symptoms of esophageal cancer. I know it’s a rare cancer, but how likely is it that my acid reflux could cause it?
***Also side note that I feel like needs to be added: I also have a swollen lymph node under the jaw. It feels slightly irritated (probably from me touching it). It’s been there for at least six months now, so probably not related to what I’m going through right now but it is making me paranoid as I heard a swollen lymph node could be a symtpom.

I recently had a consult with a Nook doctor who is well regarded in the endo world, however, she did not recommend surgery based on my MRI results. She emphasized that my symptoms (10+ years of painful periods) are not severe enough on a daily basis to warrant a risky surgery. I was super confused by her response. What am I missing? Anyone else have a similar case? If so, how did you proceed?
Impression

1. Retroflexed septate uterus with fibromuscular septum.
2. Deep pelvic endometriosis involving the middle and posterior compartments with retrocervical serosal adhesions to the mid rectum.
3. Ill-defined fibrotic implant involves the right ovary, right hematosalpinx, right round ligament, and serosa of the distal sigmoid in the right pelvis.

UTERUS Retroverted and retroflexed uterus with septate morphology. Flat fundal contour with fibromuscular septum, internal endometrial indentation greater than 2 cm and divergent cavities with internal angulation approaching 90 degrees. SIZE: 8.6 x 4.6 x 6.7 cm JUNCTION ZONE THICKNESS: 4 mm and symmetric Focal Adenomyomas: Not present ADENOMYOSIS: Not present FIBROIDS: Small 1.1 cm FIGO 5 fibroid anterior uterine body. CERVIX: Normal ENDOMETRIUM: Each cavity measures up to 9 mm in AP thickness.
OVARIES Normal size and position of the ovaries. * Right ovary: least one endometrioma measuring 0.9 cm (401/28) * Left ovary: Physiologic corpus luteum. Several foci of T1 hyperintensity at the posterior aspect of the left ovary with 0.6 cm endometrioma or endometrial implant (401/31) * Abnormal T2 signal and architectural distortion within each of the ovaries extending to the pelvic sidewall, peritoneal reflection, and involving the proximal right round ligament, which is circumferentially thickened (401/25)
ANTERIOR COMPARTMENT BLADDER: Decompressed and normal. URETER: Nondilated URETHRA: Normal VESICOUTERINE POUCH: Normal VESICOVAGINAL POUCH: Possible focal adhesion anterior vesicovaginal pouch (401/37)
MIDDLE COMPARTMENT TORUS UTERINUS (Uterine body): * Fibrotic implant spanning 3 cm transverse by 3 cm craniocaudal at the torus uterinus extending into the retrocervical space involving the anterior serosa of the mid rectum 9 cm above the anal verge. * Small fibrotic implant anterior lower uterine segment/uterocervical junction (201/20) abutting loops of decompressed bowel without clear involvement. FALLOPIAN TUBE: * Small right hematosalpinx, 5 mm diameter. * Left tube not visualized. UTERINE LIGAMENTS: Fibrotic implant involving the proximal right round ligament, right anterior uterine body, and serosa of the distal sigmoid colon as it courses to the right towards the right internal iliac vessels (401/17)
POSTERIOR COMPARTMENT UTEROSACRAL LIGAMENTS: Involved bilaterally near the junction. RECTOCERVICAL SPACE (Pouch of Douglas): Involved as described above. RECTOVAGINAL SEPTUM: The fibrotic implant in the retrocervical space extends inferiorly to involve apex of the posterior vaginal fornix. ANTERIOR RECTAL WALL: Involved as above. SIGMOID COLON: Involved as above.
OTHERS APPENDIX: Tip not visualized, possibly involved. Cecum positioned anterior right pelvis. PELVIC SMALL BOWEL LOOPS: As above. PELVIC COLLECTIONS: 6.8 cm loculated fluid collection with thin septa in the right posterior pelvis compatible with a peritoneal inclusion cyst. ABDOMINAL WALL: Normal LYMPH NODES: Normal ILIAC ARTERIES AND VEINS: Patent

I am curious about the circumstances behind those of you doing an ADT duration of 36 months and ADT duration in general. Was radiation your first line treatment? Did you have prostatectomy and find lymph node involvement? What ADT are you on? After Pi-rad 5 MRI and biopsy, I had RALP with pathology showing gleason 9, extracapsular extension and seminal vesicle invasion, "clean" margins and no observable lymph node involvement. PSA prior to surgery was 4.1. This makes me a high risk patient. My PSA at 8 weeks post surgery was 0.08 and at 12 weeks was 0.15. I had a PSMA PET which showed some uptake in my prostate bed but nothing else. I underwent salvage radiation (70 grays to prostate bed and 45 grays to pelvic lymph nodes) and was put on ADT (Eligard). Oncologists I consult with vary in their opinions on ADT duration from 6 months to two years, but I have never had anyone suggest 36 months duration. I am primarily guided by the Radicals-HD, NRG/RTOG-9601 and some other studies and have decided to shoot for 2 yrs. I am currently approaching 1 year on ADT and PSA so far is non-detectable. Thank you

21 female in the USA I’ve been diagnosed with Epstein Barr since October 2023 due to getting blood work done because of a swollen lymph node. Since that October I’ve noticed how exhausted I’ve been. It comes in waves of 2 weeks where I am okay and then a month or so of me unable to do anything due to how tired I am. I’m currently in that period where I can’t do anything. I can barely get out of bed and I’m not eating due to me sleeping all day. I’ll be up for maybe 2 hours then I’m asleep for 8 hours. Alongside this when I get mildly sick, ie a headache or the sniffles my body sleeps for nearly 10 hours at a time. I cannot get work done, I can’t find time to do what I need to on top of all of this I’m worried I’m going to just sleep forever. And I hate naps, I hate sleeping, so all of this sucks. More information in February of 2024 I got diagnosed with Bells Palsy and parotitis. It was painful and I was on a whole bunch of medicine for it and it took several months to go away. My doctor thinks the Bell’s palsy was caused by my parotitis but he is not going to confirm it. Is this normal? As always google says I’m dying and for some stupid reason I believe it. Should I go back to my doctor, if so what would he be able to do? Can I learn to live around this?
Any and all advice is appreciated