calcified lymph node/ extreme chest pain

[msmibew683]

i am a 35 year old man. when i was 13 i was in a car accident. the hospital took x-rays of my spine, nothing out of the ordinary was found as it pertains to the spine. although they told me i had gall stones. after having an ultrasound the true diagnosis was a calcified lypmph node. at about the age of 18 i began to have a stabbing pain in the xiphoid process area that went all the way through me. this only happened in the mornings upon waking. i would have to take very short breaths for 20-30 minutes until the pain subsided. the pain was almost paralyzing. i went to see many specialists, i.e. gastrointestinal, pychologist, physical therapist, spine specialists. they could find nothing wrong with me. they told me the pain was in my head. so i went to a pain management clinic. they proformed a discography to try and replicate the pain. the report states " at t8 t9 i injected 2cc. we reached a pressure of 235. pressure held at 131. there was concordant pain, severe, in the same psoition as he always feels it, and we injected then .5cc of .5% bupivacaine with 40mg of depo-medrol. we followed that with 40mg of cefasoxime at each of the thoracic disks. the procedure ended".
the doctor then scheduled me for radiofrequency lesioning. after the lesioning the morning pain was gone. but over the next year i have found that it is not totally taken care of. i would like to give you an example; i was in the back yard buring some brush in a fire pit. i was using a large stick to stoke the fire. i turned to the flower bed behind me to do some weeding. i knealt down to pull some weeds with the large stick still in one hand. when i stood back up something in my chest pinched causing the same pain that was discribed above but more intense. for a split second i was paralyzed and my body crumbled. as i crumbled the stick that i was carrying stabbed me in the face just above the eye. this then threw my body backwards and i hit the back of my head on the clay fire pit. i have since seen a thoracic surgeon, because i believe this calcified lymph node is pinching nerves possibly to my diaphram. i wanted the surgeon to take the calcification out. he said he would not because the mri showed that my vena cava was wrapped around it, i could bleed out on the table.
is there anyway that this could be explored through scopes sent into the chest cavity between ribs. is it possible that some of the calcification could be removed if not all? is there any other way that this pain could be stopped? i am a construction worker and use ladders daily. if this paralyzing pain occurs when im on a 16' step ladder, i will have more problems than i wish to care about. do you have any advice for me? could this calcification be due to histoplasmosis? i do live in the ohio valley region. as you can see this has been a 23 year process with little answers to correct my pain. any help would be appreciated.

[John Kenyon, CNA]

Hi there -

Well we can be pretty certain the pain was never "in your head" and we can be fairly certain where it was coming from, which wasn't too far from where you were feeling it. The problem now is apparently the calcified lymph node, which may or may not have been caused by histoplamosis, but I fail to see whether that would make much if any difference at this point. What I think may be needed is for your thoracic surgeon to be involved in a conference with a vascular surgeon who does a fair amount of work with the great vessels. There is some question in my mind about your vena cava being "wrapped around" the offending cyst. This is a rather strange situation if the MRI's being read correctly, and the involvement of a vascular surgeon would be required to help correct this.

It would appear the problem has been isolated and identified, but there's no ready solution as things stand. You'll either have to get this corrected surgically, consider another line of work, or look at an awfully early disability. I'd certainly want to give the thoracic/vascular conference a shot first, myself, and if my thoracic surgeon was opposed to this then I'd definitely look for a second opinion or change of surgeon, since this doesn't seem like an unreasonable undertaking, at least from what I can gather. If some portion of the vena cava is torturous it may well be part of the problem anyway, and probably should be corrected.

I hope this is helpful. Please follow up with us as needed. Good luck to you, and be careful out there.

[msmibew683]

okay i have now seen a thoracic surgeon who claims that is mechanically impossible for the calcified lymph node to cause pain. i then saw a nuerologist who was able to replicate the pain that i experience by having me lay face down on the table and pushing down on the t8-t9 area. ( i do have a bulged disc at this area) he did this only after i asked him to. i experienced extreme pain and shortness of breath... he said " cool, ugh i mean for me, not for you. its not often we see something new." he believes that i am experiencing some type of diphragmatic spasm. so he thinks i should see a thoracic surgeon.. do you see where this is going.. each one of them seem to point to the other but noone wants to touch this one. they have told me not to get on a ladder, a lift, and to stay away from leading edges... im an electrician, how do they expect me to perform my job? they will sign off for temp. disability but not permanant disability.. any thoughts?