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wieyedoc
wieyedoc, Board Certified MD
Category: Medical
Satisfied Customers: 11414
Experience:  Over two decades of clinical practice. Completed a medical internship in New York City
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In January 2016, a CT scan to investigate intermittent pain

Customer Question

Hi, in January 2016, a CT scan to investigate intermittent pain under my left rib radiating into my back detected a 4mm nodule in my left lung. (A colonoscopy previously showed inflammation of the bowel but nothing more.) I've had some breathlessness over the past 2-3 years, but with the use of an inhaler over the past 4 weeks, my airways function has improved from 60 to 75%. I also do have the appearance of unexplained scattered petechiae that have come in two bursts - one burst a few months ago and another now. Finally, my eyes are showing nerve damage and I have sight loss, but with normal pressure in my eyes, so I'm a 'glaucoma suspect' but glaucoma hasn't been confirmed. I'm not responding to either the first or second type of eyedrops prescribed. An MRI head scan showed normal results.
I do have a family history of cancer, including my 50-year-old sister who has breast cancer with metastasis.
My questions are: could any of my symptoms be related, or is it likely that they've just appeared over the past 2-3 years as I'm ageing? Secondly, should I wait as long as 12 months to have another CT scan to check for any growth of the nodule or would you recommend to scan within a shorter timeframe? Would 9 months or 12 months be likely to make any difference if there is a problem?
I smoked a very small amount when I was younger but haven't smoked for 20+ years. I'm a 47 year old woman.
Submitted: 1 year ago.
Category: Medical
Expert:  wieyedoc replied 1 year ago.

Hi. My name is***** have over two decades of experience, and I'm online and available to help you today.

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Expert:  wieyedoc replied 1 year ago.

Where are the petechiae?

Do you have copies of your visual fields that you can upload?

What is your optic disk morphology, color and cup to disk ratio?

What is your eye pressure?

Do you have any other medical problems or take any medications?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

Customer: replied 1 year ago.
Hi, the petechiae are on my chest, legs and arms. They aren't extensive - maybe 25ish overall.The opthamologist report in January 2016 states: 'There is no RAPD, her colour vision is normal. Her central corneal thickness is below average right 483um, left 490um, but she has had lasik surgery previously. Both drainage angles are open on gonioscopy. The right optic disc has a notch superior temporally, the left disc is healthy. Her macula and peripheral retina are normal. The left eye visual field test is normal, the right shows an interior nasal defect, which is reproducible.'I attach the only scan I have of the results of a visual field test done in December 2015, but I have no doubt that this would show considerable deterioration now as the continued sight loss is noticeable with fluctuations during the day.My eye pressure was 16 mmHG in both eyes on that day, and it went up to 19, I believe, when, two months ago, it was checked over the course of a few hours.I don't take any other medications except Omeprazole for some nausea (which, to be honest, I don't know has an effect) and vit D for a detected smallish deficiency.I also attach the results of blood work I requested recently.
Expert:  wieyedoc replied 1 year ago.

Thank you for the additional information and test results.
It sure does appear from that one visual field test that you have glaucomatous visual field loss in your right eye. Of course, without knowing your optic nerve morphology and eye pressure history it is impossible to rule out other causes....

I would say that you should consult with a glaucoma specialist rather then just be labeled a "glaucoma suspect" and sit around and watch things......vision lost to glaucoma can never, ever, be restored.

It is hard to tell if all your symptoms are related but, from what you have posted, I do not believe that there is one underlying cause...

Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS

Concerning your nodule I would probably like to see it checked in 6 to 9 months as we really do not have any data on how it has been changing over time. In that light, it seems prudent to get a look at it again a bit sooner.

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Customer: replied 1 year ago.
Hi, can I just check please: I'm assuming the bursts of petechiae are not of concern? Thanks Diane
Expert:  wieyedoc replied 1 year ago.

If they come back then you might need some blood tests and a bleeding panel...talk to your MD about it.