[40F] Experiencing persistent fatigue, swollen lymph nodes, and shallow breathing

Patient Description

A 40-year-old female presents with persistent fatigue severe enough to interfere with daily activities and maintain a healthy weight, despite sleeping 8-10 hours nightly. The patient reports feeling unrested upon waking and has not found relief through exercise, yoga, walking, or showers. Over the past few months, the patient has also noticed swollen lymph nodes; one hard node behind the right ear present for approximately 6 months, and another in the armpit for about a month. Additionally, the patient experiences shallow breathing, described as an insufficient air intake, which has been ongoing for about a month. The patient also reports a decrease in appetite and mood changes, including irritability and a lack of energy, which have been present for 3-4 months. The patient is not currently pregnant and has no known allergies. Current medications include Cymbalta, Lyrica, and Baclofen.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possible conditions that could be causing your symptoms:

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. This condition also often involves poor sleep quality, which you've mentioned.

  • Depression: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It can lead to a variety of emotional and physical problems, such as difficulty sleeping, changes in appetite or weight, loss of energy, and feeling tired all the time.

  • Anemia: This is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. It can cause fatigue, skin pallor, and shortness of breath.

  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough thyroid hormones. It can cause fatigue, weight gain, and depression.

  • Lymphoma: This is a cancer of the lymphatic system, which is part of your immune system. It can cause swollen lymph nodes, fatigue, and weight loss.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

Given the severity and duration of your symptoms, it's important to seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your healthcare provider: Discuss your symptoms in detail with them. They may order tests to help determine the cause of your symptoms.

  2. Keep a symptom diary: This can help you track your symptoms and identify any patterns or triggers. It can also be helpful when discussing your symptoms with your healthcare provider.

  3. Maintain a healthy lifestyle: Try to eat a balanced diet, get regular exercise, and ensure you're getting enough sleep. These can help manage your symptoms and improve your overall health.

What you should look out for

Watch for any changes in your symptoms or the development of new symptoms. If your symptoms worsen or you develop new symptoms such as severe pain, difficulty breathing, or changes in consciousness, seek medical attention immediately.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include severe fatigue that doesn't improve with rest, poor sleep quality, muscle or joint pain, headaches, sore throat, and difficulty concentrating or remembering things.


How can depression affect physical health?

Depression can affect physical health by causing changes in appetite and weight, sleep disturbances, fatigue, decreased energy, and physical aches or pains. It can also weaken the immune system and increase the risk of chronic illnesses.


What are the signs and symptoms of anemia?

Signs and symptoms of anemia include fatigue, weakness, pale or yellowish skin, irregular heartbeats, shortness of breath, dizziness, or lightheadedness, and cold hands and feet.


What should I do if I notice swollen lymph nodes?

If you notice swollen lymph nodes, especially if they are hard, persist for more than a few weeks, or are accompanied by other symptoms like fever, night sweats, or unexplained weight loss, you should consult a healthcare provider for further evaluation.


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