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DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65671
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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I have a wheezing cough, complete fatigue and lethargy, night

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I have a wheezing cough, complete fatigue and lethargy, night sweats and fevers, daily sweats on my face hair neck and trunk, extreme bouts of thirst, and lately for some months a slight purplish bruise on the inside of my shin and a soft lump at the bottom of my shin near my foot which has now become a really bad pain at night, it wakes me and even a sheet burns it? I haven't gone to a doctor at all as I am a bit scared of them after having 3 spinal surgeries the last being in 2010, so I'm not anxious to see another one any time soon, I have just struggled on, but I am becoming so tired I can spend 16 hours a day in small bursts of max 3 hrs at a time in bed or in a chair. I am a 56 year old women, widowed, living alone, not working, with 2 independent grown up daughters, who I don't complain to, but I have become quite socially isolated because of the tiredness and lethargy, and now the pain. I have smoked all my life
Hello from JustAnswer.
It will help if you could provide some further information.
Have you tried to quit smoking? What is the longest that you were able to quit?
Which over the counter pain killers have you been taking? At what dose and frequency?
Customer: replied 3 years ago.

Yes I tried to quit 3 years ago but wasn't successful. I take paracetamol, but they are largely ineffective so I take a couple just now and then if I have a headache

Thank you for the additional information.

First, it would be better for you to be seen. There are several different medical problems that should be considered in this situation and any attempt to manage this at home will be very limited compared to what can be done by your doctor. I understand that you do not want to see a doctor, and I will comment on a few things that you can try at home, but none of this will be as good as being seen by your doctor and having a proper evaluation.

Many of these symptoms could be due to chronic lung disease that can occur from smoking, called COPD. COPD can cause wheezing and chronic cough, and can have low oxygen levels that can also cause systemic symptoms, including fatigue, lethargy, and sweating. It also can predispose the lungs to get infections. There are no good treatments for COPD that are available over the counter, but the best intervention that can be done at home is to quit smoking. Quitting will not alter any permanent damage that has already occurred, but some of the inflammation from the smoke can improve and there can be better oxygenation of the blood because of clearance of carbon monoxide from the body.

Another major concern in someone with excessive thirst would be to exclude the possibility of diabetes. This is best done by checking a fasting blood sugar and the level of sugar that is attached to haemoglobin. It is possible to purchase home test kits to check the urine for sugar or to perform finger sticks to check blood sugar, so you could do a certain level of evaluation at home, but your doctor can perform more testing. If you do have diabetes, the best intervention that can be done at home is dietary management, with avoidance of sugar in the diet. All of the medicines for treatment of diabetes are only available by prescription.

From the perspective of relief of pain, it may be more effective to try an anti-inflammatory medicine. There are a couple of anti-inflammatory medicines available over the counter, such as ibuprofen and naproxen, so you could try one of these medicines instead of the paracetamol.

If I can provide any further information, please let me know.
Customer: replied 3 years ago.

I don't have copd, and I know I should stop smoking, you don't have to be a a doctor to reply as you have. I'm very disappointed with your reply. I have had preliminary tests prior to surgeries already mentioned 3 years ago, and both of your answers were addressed then. Plus you did not ages the lump of adjoin pain. Very generic answer

How do you know that you do not have COPD?
What evaluation has been done to exclude the diagnosis?
Customer: replied 3 years ago.

I have had lung function and x rays prior to anaesthetics. I am also a registered General nurse and midwife, obviously not currently working for the last 10 years.

Customer: replied 3 years ago.
Relist: Answer quality.
I received a generic answer as a nurse I would observe both answers myself.
If you have only had the evaluation several years ago prior to surgery, then that is not adequate to determine whether you currently have COPD. Blood tests at that time also would not be adequate to address metabolic causes of your current symptoms, such as diabetes. Even if you had all of these tests repeated prior to every surgery, it still would have been four years ago and would not be sufficient to evaluate current symptoms.

It is impossible to know the cause of a lump without being able to examine it. However, I did address the intervention that you can try at home to be able to ease the pain with an anti-inflammatory medicine.

If you want to know the cause of any of these symptoms, then you will need to be seen by your doctor. If you are trained as a nurse and midwife, then you should know that a specific diagnosis cannot be made over the internet and without an appropriate examination and further evaluation.
Customer: replied 3 years ago.

Thank you for very little. What a waste of money,. Why are you on the internet if you can't answer anything in detail. Rubbish site, with too many prompts to sign up for a free week trial and a lock on for a monthly fee.... For nothing. Yes! I should have known better

Customer: replied 3 years ago.

I asked for a 2nd opinion

Customer: replied 3 years ago.
Relist: Answer quality.
I would like a 2nd opinion to my original question please
The other expert was quite correct in that you need to be seen here.
What could be going on?
Other autoimmune disease
Lung cancer: this is a huge concern given your history and you need a high resolution CT scan to rule this out. That should have already been done.
3 years is way too long for someone with your history not to have seen a doctor.
I am a double board certified clinician with over 20 years of taking care of patients.
I have a severe concern about lung disease reading your story.
I would see a doctor today in fact, or at least when the week starts.
Perhaps I am missing something in your posts....I don't know why you rated correct information above badly....
I would add the additions I just stated.
Is there another question?
Customer: replied 3 years ago.

Thank you for your response. I think I needed to hear that I should not ignore my symptoms, or disregard them in wilful blindness. I know at the back of my mind this could be serious, and thank you for putting it on the line. Yes, I will attend my doctor tomorrow.

Please click a positive rating on this post...that is the only way we are paid by ja for our expertise.
good luck.
Customer: replied 3 years ago.

Thank you both, I guess we got there eventually, I am still concerned snot my shin and the lump, but I suspect it is associated with whatever is already going on.

More reason to be seen.
I would do that immediately.
Please click a positive rating.
Come back if you have more questions.
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65671
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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