[46F] With swollen armpit gland, difficulty breathing, and fatigue

Patient Description

A 46-year-old female presents with a sudden onset of swollen and painful lymph nodes under the armpit, difficulty breathing, and significant fatigue. The patient reports that these symptoms have made it challenging to perform daily activities, such as getting out of bed and walking short distances. The patient also experiences migraines lasting a couple of days, which are a new occurrence for her. She has a history of spinal stenosis and degenerative disc disease, with a spinal fusion in the neck performed approximately two years ago. The patient occasionally smokes cigarettes, about three per day, and has no recent infections, illnesses, or travel history. She is allergic to tramadol and has been prescribed loritab and gabapentin in the past but is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations:

  1. Lymphadenopathy: The swollen and painful gland under your armpit could be due to an infection or inflammation. Lymph nodes can swell in response to infections, even if you don't feel sick otherwise. Sometimes, they can also swell due to more serious conditions, such as autoimmune diseases or cancers, but these are less common.

  2. Respiratory Issues: Your difficulty breathing and increased fatigue could be related to a respiratory condition, such as asthma or chronic obstructive pulmonary disease (COPD), especially given your history of smoking. However, it could also be related to anxiety or stress, which can cause similar symptoms.

  3. Fatigue and Weakness: These symptoms can be caused by a variety of factors, including sleep disturbances, nutritional deficiencies, or chronic conditions like your spinal stenosis and degenerative disc disease. It's also possible that they are related to your recent migraines.

  4. Migraines: New onset migraines can be triggered by stress, hormonal changes, or other underlying health issues. They can also cause fatigue and weakness.

It's important to consult with a healthcare professional to get a proper diagnosis and treatment plan. They may recommend blood tests, imaging studies, or other diagnostic tests to determine the cause of your symptoms.

What you can do

Swollen and painful gland:

  • Apply a warm compress to the affected area to help reduce pain and swelling.
  • Avoid tight clothing or activities that may irritate the area.
  • Monitor the swelling and pain, and seek medical attention if it worsens or doesn't improve.

Difficulty breathing and fatigue:

  • Try to avoid smoking or reduce your cigarette intake, as smoking can exacerbate respiratory issues.
  • Practice deep breathing exercises or relaxation techniques to help manage anxiety or stress-related breathing difficulties.
  • Ensure you are getting enough rest and maintaining a balanced diet to support your energy levels.

Migraines:

  • Keep a headache diary to track potential triggers and patterns.
  • Stay hydrated and maintain a regular sleep schedule.
  • Consider over-the-counter pain relief, such as ibuprofen or acetaminophen, but consult with a healthcare professional before starting any new medication.

You can use MDandMe to journal your symptoms, track your progress, and share your medical notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Persistent or worsening swelling and pain in the lymph nodes.
  • Severe or sudden shortness of breath, chest pain, or fainting.
  • New or worsening symptoms, such as unexplained weight loss, night sweats, or persistent fever.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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People Also Ask


What could cause sudden swollen and painful lymph nodes under the armpit?

Sudden swollen and painful lymph nodes under the armpit can be caused by infections, inflammation, autoimmune diseases, or, less commonly, cancers. It's important to monitor the symptoms and consult a healthcare professional for a proper diagnosis.


How can smoking affect breathing and fatigue symptoms?

Smoking can exacerbate respiratory issues, leading to difficulty breathing and increased fatigue. It can also contribute to chronic conditions like COPD, which can worsen these symptoms. Reducing or quitting smoking can help improve respiratory health.


What are some common triggers for new onset migraines?

Common triggers for new onset migraines include stress, hormonal changes, certain foods or drinks, lack of sleep, and environmental factors. Keeping a headache diary can help identify specific triggers.


When should I seek medical attention for swollen lymph nodes or breathing difficulties?

You should seek medical attention if the swelling and pain in the lymph nodes persist or worsen, or if you experience severe or sudden shortness of breath, chest pain, or fainting. These could be signs of a more serious condition that requires prompt evaluation.


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