The Lymph Node Mystery

I was feeling nauseated, so I lay down on my bed, closed my eyes, and tried to think of something—anything—besides the nausea. That’s when I noticed discomfort in my left groin area. Naturally, I did what any rational person would do: I palpated it. And, surprise, I found a lump. Suddenly, the nausea was no longer my main concern. Anxiety about this mysterious lump happily stepped in to take its place.

The next day, I checked again, hoping it was just some bizarre dream. You know, like when you dream that your teeth fall out, and the first thing you do when you wake up is run your tongue over them to make sure they’re still there. Unfortunately, the lump wasn’t a figment of my imagination.

The nausea persisted, and I felt fatigued, which, of course, made me wonder if these symptoms were somehow related to the lump. Being the responsible adult that I am, I went to work anyway. After consulting with some coworkers, I decided to allay my subtle (but persistent) anxiety by visiting the health clinic.

I saw a physician assistant (PA) who told me it could be an infection but that we should rule out cancer. (Because, of course, cancer had to be on the menu.) She palpated the lump herself and, for comparison, felt the other side of my groin. While I could make a joke here about how this was the most action I’ve had in a while, I won’t—lest I offend the overly woke.

Next, she ordered an ultrasound. When I arrived for it, a young woman introduced herself as a student and asked if she could observe. Despite knowing the ultrasound would involve my groin, I said, "Sure, why not?" Because awkwardness is just part of my charm.

After changing into a gown and lying down on the table, the ultrasound tech—someone I know from work because I have an office just down the hall—came in with the student. Nothing says “bonding with coworkers” quite like having them scan your groin.

A few days later, I got the results: not one, not two, but three lumps. Fantastic. The PA emailed me:

“Based on your labs and the ultrasound, there’s a possibility the lymph node swelling is due to an inflammatory process. However, I’d like to exclude lymphoma or metastatic disease. I’ve ordered a CT scan of your chest, abdomen, and pelvis for further evaluation and placed a referral for a biopsy with general surgery.”

Fun times, right?

Naturally, the first thing I did was check with my insurance to assess the financial damage. My share of the ultrasound? $500. Fine, knowledge isn’t free. The CT scan would be $800, and the biopsy? Around $1,500, give or take—because why not keep the suspense going.

Not thrilled about dropping that kind of cash, I decided to email my PCP for a second opinion. My pitch? Let’s try an antibiotic first and see if this lump vanishes on its own. His response was reassuringly bureaucratic:

"Dr. Kovas has reviewed the results and your concern. He states he believes it would be beneficial to move forward with the requested testing to rule out malignancy. Thank you."

In other words, “Nice try, but no.” Fine. On to the CT.

The CT scan came back unremarkable, which, in the medical world, is actually a good thing. Translation: the lumps weren’t caused by cancer elsewhere in my body. My PCP reviewed the scan with me, and I even got to see images of my internal organs—fascinating stuff. I reviewed them with my readers here. 

Next up was a visit to the surgeon, who also had to "cop a feel." (At this point, I’ve lost count of how many people have touched my groin, but it’s definitely more than my girlfriend—though I’m not confirming or denying anything for the sake of Google’s content rules.)

The surgeon explained that the swelling could be from an infection or one of a hundred other things. My ears perked up at the mention of antibiotics potentially solving everything without the need for a biopsy. But then, to my dismay, he added, “In my experience, the swelling usually doesn’t go away with antibiotics, and a biopsy is still needed.”

We agreed to try the antibiotics first and wait for three weeks. I asked the surgeon if waiting would be a problem if it turned out to be cancer. “No,” he replied casually, as if we were talking about the weather.

I read on Google about a needle aspiration that could be done at the bedside. I was hoping this would be the case—simple, just the doc, easy, go home, done. Find out it’s not cancer, and get on with life.

But, he explained that they’d need to remove the entire lymph node because a needle aspiration wouldn’t provide enough cells. This didn’t thrill me any more than discovering the lumps in the first place. “So, what does that mean?” I asked, hoping he might mention something about a quick, simple procedure. He didn’t.

“You’ll need to go to the operating room. We’ll put you under, and I’ll make a five-inch incision. It’s deep, so it might be painful if you were awake. But I’ll get it out quickly—so it’ll be a very fast procedure.”

I couldn’t resist asking, “When you take it out, do you have to reattach the loose ends?” Surprisingly, he said it was a great question. He explained that the lymphatic system is like a web, so if one node is removed, the fluid just finds another route.

As of now, I’m done with the 10 days of antibiotics. The lumps feel smaller and no longer burn, which gives me some relief. But they’re still there, so a biopsy might still be in my future.

So here I am, anxiously awaiting my next appointment. The lumps may be smaller, but the humor I use to cope remains as big as ever. Prayers are welcome.