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Next Step - Your opinion please
Nov 20, 2004

Dr. McGovern,

Thank you for your response.

With respect to my lymph nodes, I saw a gastroenterorlogyst about two weeks ago and she confirmed that I had enlarged lymph nodes in my neck. She suggested that maybe I get a biopsy and questioned whether or not I thought they would be there long enough to schedule that proceedure(good question). I have not followed up because i fear that they will go down by the time I make an appointment and my primary care thinks I am crazy as you have so politely suggested. My primary care also felt my enlarged lymph nodes at the end of a past episode when they were not quite as pronounced as they have been.

I have definately considered the psycosemadic possibilities and have admitedly been stressed about this situation. Having said that, would psychosematic symptoms manifest in such physical way (lymph nodes, night sweats etc)? There are other symptoms which I did not mention in my previouse email but one inparticular was red and burning hands and feet which I experienced for approx 1 month. There have been other hep related symptoms including dark urin and light stool but I take acid reducers which are known to turn stool light so hard to say where that is coming from.

If these facts change your opinion on me pursuing futher testing etc please let me know. Otherwise I will be seriously considering psychological help.

I do realize that if there is some validity to my syptoms by way of hep or hiv, that mine is an extremely unique case.

Thanks Again

Response from Dr. McGovern

If your gastroenterologist felt you had enlarged nodes, by all means, follow-up on her recommendation for a biopsy. If I recall correctly, your primary care doctor had not detected these, so it is possible that they are increasing in size.

Dr. McGovern



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