Dealing with a bunch of symptoms: stomach pain, low-grade fever, and a cough...

I am actually going to lose my mind—and I mean completely lose it!!! I desperately need some urgent advice or if anyone has dealt with anything even remotely similar to this!
my story starts with...
On Monday, Oct 31, I started taking Doxycycline for 15 days, twice a day, because of some chronic small intestine inflammation (which, honestly, is kind of irrelevant right now)
By Wednesday, Nov 2—only the third day of the Doxycycline treatment—I had sex with my boyfriend for the first time (I hadn't been intimate with anyone in two and a half years). It hurt during intercourse, and it kept hurting every time we were together. At first, I just chalked it up to being out of practice—you know, thinking maybe things were just a bit too rough since it had been so long
Then came Wednesday, Nov 9, and Friday, Nov 11. Basically, about a week after the pain first started—during those two specific days when we had sex—it wasn't just "pain" anymore. It was this deathly, agonizing cramping. I couldn't move. Literally, I just collapsed into bed. That first Wednesday, it lasted about 15 minutes before dulling slightly, though it lingered for another two hours. But by Friday? It happened all over again, and this time the cramp lasted an hour and a half. I was in tears. I can't even describe the agony; I couldn't move a single millimeter. Once it subsided just enough to breathe, I rushed to the ER. Maybe it helped that I’d popped a heavy-duty painkiller an hour prior, but anyway, the staff there was so dismissive. They barely touched my abdomen—just one finger—even though it was rock hard, painful, and bloated, like I was six months pregnant. They gave me some Smazmex which did absolutely nothing. Things eased up a little after three or four hours, but I was in pain all weekend. By then, after those two days, I realized for certain that this had nothing to do with sex....
On Monday, Nov 14, I went to see my gynecologist. He did an exam and told me I have salpingitis (inflammation of the fallopian tubes). He ran an ultrasound just to be safe, but he said the ultrasound wouldn't show much unless there was an abscess, a cyst, a tumor, or a rupture—so he figured the inflammation wasn't at an advanced stage yet. He handed me a lab slip for blood work and told me to come back ASAP with the results so we could start treatment (though it still makes zero sense to me why he waited for blood work instead of just starting antibiotics immediately or taking swabs right then and there)
On Wednesday, Nov 16, I went back with my results. Everything was within the normal range. He also ordered a CRP test, which wasn't elevated, though he didn't order an ESR (sedimentation rate), which feels incredibly weird to me because my OBGYN textbook clearly states that CRP isn't the primary indicator—you look at the ESR to detect inflammation. Anyway, he prescribed Erythromycin for eight days since I'm allergic to penicillin and cephalosporins.... so I took it until Thursday, Nov 17, for the full eight days
On Friday, Nov 18, I had a clinical session with another gynecologist. I explained the whole situation to him, and he performed a 3D/4D ultrasound. He told me that, in his opinion, I don't have salpingitis because if I did, he would have seen it on the scan. He suggested it's more likely cervicitis and told me to get swabs done. It was nice of him, and he wrote it down in a way that my regular doctor couldn't just brush off
On Monday, Nov 21, I went back to my original gynecologist. He took the swabs, and the results came back on Friday, Nov 25. Everything was negative. Negative for Chlamydia, Mycoplasma, Ureaplasma, and aerobes... which made me realize—did he just forget to test for anaerobes?
I was planning to go see him this week to ask why he didn't test for anaerobes, but he ended up leaving early on Wednesday for a meeting, and he’s out again today and tomorrow. Honestly, on Monday and Tuesday, I just didn't have the mental energy to go because I'm so fed up. And truthfully, I had started to convince myself that maybe it was nothing and I had healed, since I hadn't felt pain all week. But then, I finally had sex with my boyfriend today, and the pain is back. I don't even know what to do anymore.... I can't even remember if it used to hurt like this before. I wondered if it's because I had an orgasm—could that be causing the cramping? I think I read somewhere that some women can't continue having sex after an orgasm because of the pain... It seems unbelievable that I could have salpingitis or cervicitis caused by anaerobes, especially since everything I read says cervicitis is frequently caused by them too......
Oh, and I forgot to mention—ever since that Friday, November 11th, when I ended up in the ER, I’ve been stuck with this low-grade fever hovering between 99°F and 99.5°F. I honestly thought it was just some lingering inflammation in my fallopian tubes or cervix, but now I’m wondering if it isn't actually something else... because I caught a nasty cold back on Sunday, November 23rd, and had a fever then too, which just wouldn't quit. I eventually needed to see a doctor for antibiotics, and at that point, I figured—why take two different antibiotic courses if I already have to take Doxycycline regardless?—so I just started the Doxycycline immediately. But even then, I had a fever for about ten days, which finally broke by the third day of the Doxycycline, only for the fever to come screaming back right when I finished up at the ER...
And now, to top it all off, my mom is looking at me—since I've still got this lingering cough from the 23rd—and she’s convinced I might have pneumonia and that's where the fever is coming from. Honestly, I am completely lost on what to do next...
For instance, it's been about an hour since I had sex, and I'm still feeling some pain—though it's mild—and I can't help but wonder if it's being triggered by the orgasm. It shouldn't last this long, right? Or would it?

Anyway, the real question is: has anyone here dealt with anything remotely similar? Did any of you experience cervicitis or salpingitis caused by anaerobes? Has anyone actually had anaerobes isolated in their tests? Does anyone deal with pelvic pain during intercourse even when nothing has been isolated yet? Or specifically, does it hurt after an orgasm?

Ugh, I feel like I'm losing my mind! I have clinical rotations tomorrow, and I'm planning to bring this up with the doctor at the hospital, though I have a sinking feeling he’ll just brush me off... I really don't know whether I should be aggressive with my gynecologist about running a swab for anaerobes or if I should just go get a chest X-ray to check my lungs. Good grief!

And as for how I've been obsessively researching all of this—looking into the Doxycycline and Erythromycin I've been taking—those aren't even effective against anaerobes! And since they haven't been isolated in my case yet (because, let's face it, I was being a bit manic and cross-referencing every single pathogen that causes salpingitis with my current prescription), I feel like I'm just spinning my wheels! I'm going to work myself into an early grave!😢
Sorry for dumping all this on you guys.😢
Medicine is such a headache sometimes—here I am, a sixth-year medical student, having to scour the internet and pester forum users for answers!😢

urbanlynx23 said:I am seriously about to lose my mind—like, completely snap!!! I need some urgent advice or if anyone has gone through something similar right now!
(...)

I’ve never even heard of "corinic" inflammation of the small intestine. There's Time disease and UC, plus a few other rare ones.
Now where on earth is pneumonia coming from?!🤷
Just give us a quick two or three lines about what symptoms you're actually dealing with right now.
CRP rises much faster than ESR, and it's a far better indicator anyway.

vividsailor7 said:I’ve honestly never even heard of Crohn's disease before—talk about a learning curve. From what I gather, you’ve got Crohn's, Ulcerative Colitis, and then a whole handful of even rarer conditions lurking out there. It’s quite the medical rabbit hole, really.
Where on earth did this pneumonia come from out of nowhere?!🤷
Just give me a quick rundown—maybe two or three lines—of what symptoms you're actually dealing with right now.
Honestly, if you ask me—and I know, I know, my unsolicited medical opinions are a staple around here—the CRP is a much more responsive indicator than the SE. It just climbs faster. It’s a far better way to track what’s actually happening in the body when things start going sideways.

So, I just got my PhD results back from the EGD—duodenitis... and if you look at the fine print, the histological picture apparently matches "mild chronic non-specific changes" (duodenitis grade 1). This diagnosis originally popped up late last April. Since then? It’s been an absolute marathon of testing—celiac disease, various parasites, you name it—and everything came back negative. Nothing. Zilch. Now, from what I understand, duodenitis in the small intestine usually happens as part of gastritis; it’s rarely a standalone thing unless we're talking about celiac, Crohn's, or UC—none of which apply to me, thank God—but it can also be triggered by drug allergies, H. pylori, or certain parasites (I can't recall them all right now). Basically, it's often just a side note to gastritis because it rarely causes symptoms on its own... yet, in my case, it was causing total gastrointestinal chaos. Anyway, after all that diagnostic madness, the latest word from the doctors earlier this year was that I have food intolerances and should start cutting things out one by one. But then—and this is where it gets complicated—I found out there’s actually a specific food intolerance test. We spent months scraping money together to afford it, and I was finally set to go last month, but then some gynecological issues cropped up and—well, nothing happens until I resolve that first. The reason I pushed for the testing is that I absolutely refused to spend six months guessing and cutting foods out blindly, only to find out I was wrong. I mean, the sheer logistical nightmare of switching diets—not to mention the cost and the time—is enough to make anyone lose it. So, while waiting for the official test, I tried a little DIY experimentation at home. My doctor suggested dairy might be the culprit since that's the usual suspect, and honestly? When he said "milk," my world just collapsed. I couldn't deal with that reality yet, so instead of waiting for the test, I just cut out all flour from my diet—because, deep down, I suspected it was wheat/gluten anyway, given how much trouble bread, pasta, and snacks cause me. I lived without flour for four months, and for the first time ever, I actually felt good. Then, over the next two months, I tested the waters by eating flour just once to see if I'd crash—and yep, I did. So, I think I’ve basically cracked the code myself, but—as a cautious person—I’m still going to go through with the official testing just to be absolutely certain.
As for this whole idea that chronic inflammation isn't mentioned in the textbooks—well, it’s actually true. I mean, I’ve practically scoured every medical library from Boston to San Francisco, and honestly? You won't find a single mention of it anywhere...
But anyway—I won't drag this out any longer... that’s a whole different story entirely.

I know that CRP tends to spike way faster—it’s basically the sprinter of inflammatory markers—but I was digging through my OB-GYN textbook (V. Šimunić) and found something interesting. Apparently, when it comes to Pelvic Inflammatory Disease, doctors aren't even looking at CRP much anymore. Instead, they're leaning heavily on ESR. The reasoning provided—which, by the way, matches what I've been seeing scattered across medical sites online—is that CRP just hasn't proven itself to be a reliable marker for either making an initial diagnosis or tracking the progression of the disease. It turns out that elevated ESR levels are significantly more frequent in these cases than anything you'd see with CRP. Just one of those things where the "standard" metric isn't always the most useful tool in the kit, I suppose.

So... why on earth did my mother jump straight to pneumonia? Well, looking back, I had this massive bout of the flu around November 23rd—I remember the date vividly because the night before, I’d gone out with friends and felt absolutely sweltering. I stepped outside for maybe fifteen minutes without a jacket just to catch some air, and wouldn't you know it? By the next morning, I was hit with a fever, a stuffed-up nose, and a scratchy throat. That quickly spiraled into a week of hacking coughs and sinus issues. Now, here’s the weird part: back on October 31st, my GI doctor actually prescribed me Doxycycline. It sounds bizarre, right? Every single one of my parasite tests came back negative, but both my GI specialist and a second doctor insisted I take it anyway—though, honestly, I still have no clue what the actual rationale was if there were no parasites involved. Anyway, fast forward to this latest sickness. This wasn't just a little sniffle; I was dealing with nasty, yellowish mucus and a cough that felt much deeper than usual. I figured, since I already had that Doxycycline sitting there waiting to be used, I might as well start it now rather than trekking back to the clinic to ask for a different antibiotic entirely. But then—get this—on the third day of the antibiotics, my fever finally broke. Just as it dropped, though, I started feeling this pain in my chest. And then, after a week of thinking I was over the hump, I realized the fever is back. Great. Just great.

Ugh, I am rambling again! My bad! 😢 Long story short: my mom is convinced I have pneumonia because of this cough—well, "coughing" by my definition, anyway—that’s been lingering for nearly seven weeks now (since November 23rd). And since I’ve been running a fever every single day, and I check it multiple times a day, it’s constantly hovering between 99.0 and 99.5 degrees Fahrenheit. I’ve only had one week in this entire stretch where my temperature was actually normal... so, naturally, my mom keeps badgering me that it’s definitely pneumonia, even if the cough isn't "heavy" enough, because that's exactly how it started with my dad two years ago. He was just coughing, coughing, constant low-grade fever, only to end up three or four months later unable to catch his breath because of the coughing, eventually seeing a pulmonologist only to find out he had pneumonia and COPD...

As for my actual symptoms—which kicked in on the third day of taking Doxycycline (Nov 2nd)—it started like this: at first, it was just pain during intercourse. (Actually, that's how I realized there was an issue, since I hadn't been sexually active in about two and a half years, and when I finally was, it hurt right around the appendix area—exactly there—and felt almost like some sort of uterine cramping? I don't even know how to describe the location of the pain—you know, where we have ovaries and fallopian tubes on both sides? It's right in the middle, along the entire length of the vagina and uterus—at least, that's how our female reproductive system looks in an anatomy atlas). Then, about a week after that, during that second week, I had these two instances during sex where I got hit with such a cramp, it felt like someone was stabbing me with a knife in that exact same spot. My whole uterus just seized up. They were like period cramps, but unlike period cramps, they wouldn't stop; it was more like one continuous, unrelenting spasm. After that second intense episode, ever since November 11th, I've had this dull ache right where the appendix is. It’s not sharp or spasmodic, but it's a constant presence—not strictly constant, but it lingers for three or four hours, eases off, and then comes back. It's been doing that ever since that second attack...
Then, last week, the pain actually stopped, only for it to flare up again today during sex (and keep in mind, I haven't had sex since that second major attack!). It wasn't as violent or spasmodic as those first two times, but the pain started during the act and lasted for about two hours. It felt basically like it did the very first time I slept with my boyfriend and felt that pain—that stabbing sensation near the appendix combined with cramping throughout the length of the vagina and uterus...
And yeah... besides all that, there's the fever...
And it was painful during the bimanual exam too...

Hopefully, I managed to explain everything a bit more clearly this time. 🙂

urbanlynx23 said:So, I just got my PhD endoscopy results back, and here’s the deal: duodenitis. The report says the histological picture shows mild chronic non-specific changes—basically, Grade 1 duodenitis. It sounds like one of those medical terms designed to sound much more intimidating than it actually is, doesn't it? "Mild chronic non-specific changes"... it’s such a vague way of saying, "Yeah, there's some irritation there, but we can't pin it down to one specific cause." It’s frustrating when you're looking for a clear answer and all you get is this clinical, lukewarm description. Still, I guess knowing exactly where the inflammation is helps, even if the "Grade 1" label feels almost underwhelming after the stress of the procedure itself.

I hope I managed to lay everything out more clearly this time.🙂

Here’s what I have left from yesterday.
Regarding this whole chronic small intestine inflammation issue—and I’m only being this blunt because you're a medical student, otherwise I wouldn't bother correcting you so aggressively (if I had to fix everyone's mistakes, I'd have to be on forum 0 twenty-four hours a day)—it’s perfectly normal that you won't find it in Vrhovac's textbook since it simply doesn't exist there. The only mention you'll find is in Vucelić, where it's listed as ulcerative jejunoileitis, but that primarily shows up in celiac disease cases. It's rare. And even rarer is seeing it alongside Crohn's disease specifically localized in the small intestine.
Why on earth was Doxycycline prescribed? I honestly have no clue. My parasitology and bacteriology results came back totally negative, so the whole thing just doesn't add up to me.
Wait, hold on a second. Are you telling me that when they talk about the PHD bulb, there isn't a single mention of eosinophils or mononuclear cells? Seriously? That seems like a massive oversight to me.
This is most likely the fallout from some kind of food sensitivity. Honestly, it’s almost certainly an allergic reaction to something you ate.
Why on earth did you feel the need to go trekking all over Vrhovac like that? You could have just stuck to the GI portion and called it a day.🙂
If they could just sort out the issues with the lungs and that part of the kidney, things would actually start looking up. Just get a standard CBC, CRP, and a complete metabolic panel done—and for heaven's sake, someone actually listen to me! Based on those results, we might also need to get some imaging done on the lungs, like a chest X-ray.
You really need to get a meaningful GI workup done, including potential swabs if necessary. Until that happens, my advice would be to stick with Spasmex plus some NSAIDs.
If I actually called this one, then write it down. Put it in writing.

vividsailor7 said:Here’s my follow-up from yesterday.
1. Regarding this chronic small bowel inflammation—and I’m only being pedantic because you’re a med student, otherwise, I wouldn't bother correcting you so much (because if I corrected everything, I’d have to be on forum 0 twenty-four seven)—standard textbooks like Harrison's don't even list it since it doesn't exist as such; the only thing mentioned by similar authorities would be ulcerated jejunoileitis, but that primarily shows up with Celiac disease, which is rare, and even rarer when combined with Time localized to the small intestine.
2. As for why Doxycycline was prescribed—honestly, I have no clue if the parasite and bacterial panels came back negative.
3. And regarding the duodenal bulb, aren't eosinophils or mononuclear cells mentioned at all?
4. This is most likely a consequence of hypersensitivity to some food item.
5. Why were you combing through Harrison's top to bottom? You could have just looked at the GI section.🙂
6. If the lung issues—and part of the gyno stuff—get sorted out, just get a standard CBC, CRP, and ESR, and for heaven's sake, let someone actually listen to you; based on that, maybe an X-ray should be done too.
7. A meaningful gynecological exam needs to happen, potentially including swabs; until then, I’d suggest Spasmex plus maybe some NSAIDs.
If I predicted anything correctly, let me know.

Well, you didn't really predict anything.🙂 I need to learn how to cut to the chase and get to the point.🙂

The swabs were done and they are all negative—specifically negative for Chlamydia,
Mycoplasma, Ureaplasma, and aerobes. My doctor hasn't taken a swab for anaerobes yet, though in my estimation, anaerobes might actually be the culprit since neither Doxycycline nor Erythromycin works on them...
But, on the other hand, I highly doubt I could have such severe inflammation—I mean, I've had this fever for so long and I'm still in pain—if it were caused by anaerobes. The pain actually subsided about ten days ago, but then after a three-week break, I had intercourse last Thursday, and the pain started right during the act. It made me wonder if it’s some kind of psychological block, or if I’m turning into one of those girls who experiences pain specifically after orgasm, though I doubt that's it since those girls don't usually hurt for several hours afterward...
What I mean is—and this is just my thought, mind you—that if it *were* an anaerobic infection, logically my condition should be getting worse since it isn't being treated, rather than just stagnating... That’s actually what the second gynecologist at the hospital told me when I went to ask his opinion because I didn't know whether to go back to my own doctor and demand anaerobic swabs or something else. Anyway, he said that in his estimation, I probably don't even need the anaerobe tests; if I actually had that kind of inflammation, I would be feeling significantly worse medically. He suggested I might need to check my CA 125 because it could be early-stage endometriosis that isn't visible on an ultrasound, and that the pain could stem from that, while the fever might be coming from something entirely different...
So, I'm going to the gynecologist tomorrow to ask about testing the CA 125 and to see if he'll run the anaerobic swabs. Knowing him, I suspect the answer will be no, but since I have a good relationship with my gynecologist, I can propose it myself. If I insist on the swabs, he'll do them, but I just don't know if I should pester him with it...
As for the ultrasounds, I've had two done by two different gynecologists. The second one used a seriously high-end machine, and the doctor performing it is supposedly the best ultrasound specialist in the whole city, so I feel like if there was something there, it definitely would have shown up...

Hehehe... honestly, it never made sense to me either—why prescribe Doxycycline when there aren't even any parasites present? I could never quite get a straight answer out of anyone... but, well, I’m heading back to my gastroenterologist soon, and this time I plan on absolutely cornering them until they explain themselves.
And oh, please... they actually think we're looking at an intolerance... which is just great. Anyway, I'll be headed to a clinic in Chicago next month to finally run some tests on that.
The pathology report mentions lymphocytes (specifically, up to 25 lymphocytes per 100 IEL in the biopsies), and then the lamina propria shows a moderate to moderately abundant inflammatory infiltrate, mostly lymphocytes along with some plasma cells and a few eosinophils...

Ugh, I swear, I avoid medication like the plague because my allergy list is basically a "Who's Who" of pharmacy shelves—penicillin, cephalosporins, aspirin, acetaminophen, iodine, plus some stupid preservative, and even insect bites. So, the only thing I ever touch is ibuprofen, and even then, it’s just once a month when I get my period because the first day is absolute torture—especially since for the last four months, the pain has been so brutal I had to take four pills a day for the first three days 😢 just to survive. I'm terrified to take anything because every single one of those allergies popped up within a six-year span starting when I was fifteen, and ever since, I've just stopped taking everything. I end up just white-knuckling through the pain and fevers as long as I possibly can... my only solace has been drinking Smirnoff Ice.

And clearly, I am just falling apart here, because I got my hormone results back today and my cortisol, prolactin, and testosterone are all elevated. I don't even know what to think anymore, other than the fact that I am going to lose my mind—completely.

On top of all that, I've been dealing with high cholesterol for two years now, despite having zero reason for it—I mean, I eat as healthy as humanly possible. But my doctor keeps insisting it's just genetic and that I don't need treatment, acting like she studied forestry instead of medicine... I can't seem to make her understand that even if it *is* genetic, it's still causing atherosclerosis, which is objectively bad news, but apparently, she couldn't care less.

Then, about a month ago, I realized that my blood sugar drops down to 3 in the afternoons and evenings. Thank God it isn't diabetes, though, because I went to get checked—I monitored my levels before meals and then two hours after eating, and it was 5.6. Okay, fine, I know that isn't the exact same thing as a clinical glucose tolerance test done at a hospital, but if it were actual diabetes or glucose intolerance, I'm pretty sure my numbers would be significantly higher.

Honestly, I feel like some ancient grandmother. 😢 And what irritates me most of all is how none of my doctors take me seriously when I say I'm gaining weight rapidly. They act like I'm not overweight, which is a complete lie—if I want to avoid gaining more, I can't eat more than 1,000 or maybe 1,500 calories, and if I actually want to lose weight, I have to drop down to a 500-calorie diet and exercise for an hour and a half every single day, only to lose a measly pound a week. And nobody believes me. Not about the weight, not about the fact that I am perpetually exhausted, or that I can sleep for nine hours and still wake up feeling completely drained.

urbanlynx23 said:You didn't predict a single thing. Not one bit.🙂 I really need to learn how to cut the fluff and just get straight to the point.🙂
...

Honestly, she’s acting like some old lady who thinks she knows everything! If you really want to fix that impression, go get a second opinion from another specialist. Seriously.
Look, let’s be real about CA 125—it’s way too vague and honestly doesn't give you enough to go on. If you actually want clarity, an ultrasound is a much better bet.
Don't even think about sliding into my DMs.
The lymphocyte count is right on the borderline. Honestly, if those IEL levels were over 25, we’d actually have something to worry about. At this stage, the only logical next step is to get a PHD from the stomach.
At the end of the day, my gut feeling is that we’re looking at gluten enteropathy—specifically celiac disease.
Look, let’s be real here: there is absolutely no substitute for a biopsy of the colon if you want a definitive answer. Everything else is just guesswork.
And what about those famous numbers you mentioned? Cholesterol, LDL, HDL, uric acid... you said the blood sugar was all normal, but give me the actual breakdown.

vividsailor7 said:Honestly, you’re acting like some old lady who thinks she knows it all—if you want to be absolutely sure, just go see another specialist.
Using CA 125 is far too imprecise and frankly insufficient; an ultrasound is much more reliable.
And there's zero mention of DM.
The lymphocyte count is borderline—it would actually be concerning if it were >25. If they were IEL, we'd need to take a biopsy from the stomach.
In short, this whole thing looks like gluten enteropathy—aka Celiac disease—to me.
But the only way to get a definitive answer is a small bowel biopsy.
By the way, you mentioned your cholesterol, LDL, HDL, urate, and blood sugar levels were all normal.

Look, I realize an ultrasound is way better, but I’ve already had two of them—with two different doctors now—and neither of them saw anything. So, they suggested I check my tumor markers just to be safe...
They actually took a small bowel biopsy during my last endoscopy... which, mind you, I've already done, and it turned out it wasn't Celiac, and my antibodies were negative too...

My cholesterol is 6.4, triglycerides are 2.0, and HDL is 1.4... but the real kicker is that based on what I eat, those numbers shouldn't even be possible...

Anyway, I'm heading back to the gastroenterologist tomorrow, and I'm going to tell them I need another endoscopy since my last one was over a year and eight months ago...

I also have appointments with an endocrinologist and a hematologist next week, plus I'm scheduled for a pituitary MRI and an abdominal ultrasound... because I've been running a low-grade fever for eight weeks straight. I haven't stopped coughing, and my chest feels tight—like my lungs actually ache. I had a chest X-ray this week and there's no pneumonia, so the radiologist told me to see a hematologist and get an abdominal ultrasound. Then my primary care doctor echoed that—even though I'm totally confused by the logic... I mean, I thought you could have pneumonia without it showing up on an X-ray, especially since I'm still coughing and my "lungs" hurt. But apparently, I clearly failed biology class... and besides, why am I being sent to hematology instead of a pulmonologist? I understand the hematology part, sure, but a pulmonologist makes more sense for a chronic cough, right? Still, the doctor insists on this route.
As for the endocrinologist, it's because my cortisol, testosterone, and prolactin are all elevated, which is why I need the pituitary MRI.

urbanlynx23 said:Look, I get it—an ultrasound is way more precise—but I’ve already gone twice for one, seeing two different doctors, and neither of them saw a thing! So they told me to just play it safe and check my tumor markers...
They actually did a biopsy during my EGD... and let me tell you, they've done that before too, and it wasn't Celiac, and my antibodies came back negative as well..

My cholesterol is sitting at 6.4, triglycerides at 2.0, and HDL is 1.4.. but here's the kicker: I eat so poorly I shouldn't even have numbers like this....

Whatever, I'm heading back to the gastroenterologist tomorrow. I'm going to demand they redo the EGD since my last one was over a year and eight months ago..

Plus, I've got appointments with an endocrinologist and a hematologist next week, and I'm scheduled for a pituitary MRI and an abdominal ultrasound... because I've been running a low-grade fever for eight weeks straight. I've been coughing non-stop and my chest feels tight, like my lungs actually ache. I had a chest X-ray this week and there's no pneumonia, so the radiologist told me to see a hematologist and get an abdominal ultrasound. Then my primary care doctor agreed and sent me there too (even though I don't really get it... I honestly thought you could have pneumonia without it showing up on an X-ray, because I was so convinced that was what it was given the constant coughing and that "lung pain." And since I've been coughing for eight weeks now, it's officially a chronic cough. I just don't understand why I wasn't referred to a pulmonologist instead of hematology. I mean, I totally get why I need the hematologist, but why no pulmonologist? I assumed an X-ray might miss some inflammation, but apparently, I clearly failed biology class..
And I'm seeing the endocrinologist because my cortisol, testosterone, and prolactin are all elevated, which is why I'm getting that pituitary MRI

1. I have no idea why they're sending you to a hematologist.
2. That cholesterol level isn't a crisis, but it definitely needs a closer look with some follow-up testing.
2. My advice? Get that EGD redone.
3. As for your lungs, it wouldn't hurt to get a CBC, CRP, an ANA, and spirometry done.
4. The most important thing is exactly how high those levels actually are.

vividsailor7 said:1. I’m not entirely sure why you were referred to a hematologist.
2. Your cholesterol isn't alarming, per se, but it should probably be looked into further—you know, more follow-up testing.
2. I’d suggest scheduling another EGD.
3. As for the lungs, it wouldn't hurt to get some blood work done—specifically SE, CRP, CBC, absolute counts, and maybe spirometry.
4. Ultimately, the level of elevation is what matters most.

Thanks 🙂
I actually went ahead and did all of those tests—referring to the stuff under point 3 🙂—and everything came back perfectly normal.
As for the EGD, I have that scheduled for next week...
The reason I was sent to the hematologist in the first place was because of this persistent low-grade fever—it's been hanging around for three months now—and they discovered I have a high IgG antibody titer for CMV; it hit 500 AU/ml, whereas anything over 6 is considered positive. My IgM antibodies are normal, so my pulmonologist suggested that might be why I’ve been running this fever for so long. However, the hematologist basically told me there’s no treatment available since antiviral therapy is reserved only for severe cases—and apparently, I'm fine, except for the fact that I'm constantly running a fever...
And now—get this—I’ve started noticing that my temperature actually drops. Out of seven or eight times I'd measure it, I can now catch it dropping about twice. So, my pulmonologist is asking if I'm even still "subfebrile" if the fever is actually breaking at all? Makes sense, I guess, but it's confusing.
To top it all off, it turns out I have allergic rhinitis. Even though my RIST and RAST levels aren't elevated and my nasal swab for eosinophils came back normal, my doctor insisted it's allergic rhinitis. In my specific case, she calls it "atopic" because it isn't accompanied by the typical lab markers, but she can see the changes in my nasal mucosa—so she prescribed some therapy for it. Since I have a history of dust mite allergies (which was confirmed via skin prick testing), she wants me to treat it with sprays, while my pulmonologist thinks the whole thing is nonsense—arguing that I shouldn't be treated unless my eosinophils are high in a nasal swab or my RIST and RAST levels show an increase. So, yeah... I really don't know what to think anymore 😁 one expert says one thing, the other says the exact opposite 😁

urbanlynx23 said:thanks 🙂
I’ve gone through all those steps and everything looks fine (meaning the stuff under point 3 🙂).
I have an EGD scheduled for next week...
The hematologist referred me because of this persistent low-grade fever that’s been hanging around for three months. It turns out my IgG antibody titer for CMV is high—it was at 500 AU/ml, while anything over 6 is considered positive. My IgM antibodies are normal, so my pulmonologist suggested that might be why I've been running this fever for so long. But then the hematologist tells me there's no treatment needed because antiviral therapy is only reserved for severe cases, and apparently, everything else is perfectly fine except for this damn subfebrile temperature....
And now, I've started noticing the fever actually dropping. Out of 7 or 8 times I check it, I can catch it falling maybe twice now. So my pulmonologist is asking if I'm even "subfebrile" anymore if the temperature is actually coming down?
On top of that, it turns out I have allergic rhinitis, even though my RIST and RAST levels aren't elevated and my nasal swab for eosinophils came back normal. My doctor claims I still have it—she calls it "atopic" in my case since it lacks the typical lab markers—but she says the changes in my nasal mucosa prove it, so she prescribed some treatment. Since I have a history of dust mite allergies confirmed by prick testing, she insists I treat it with sprays, but my pulmonologist thinks the whole thing is nonsense! He says I need elevated eosinophils in the swab and high RIST/RAST levels to call it an allergy. So, here I am, completely lost 😁 one specialist says one thing, the other says something else entirely 😁

I’m with the pulmonologist on this one. If the IgE, spec.IgE, and prick tests all come back clear, you don't have allergies.
Is it possible that doctor is an ENT instead?

urbanlynx23 said:You’re out here acting like you own a medical degree while I’m sitting here in my sixth year of med school, forced to scavenge the internet and bug people on forums just to get a straight answer.😢

I’ve been through just about the same thing, urbanlynx23. Honestly, you don't really get it until you're the one actually dealing with the illness—then you realize modern medicine is basically just one big pile of S*****.

Honestly, you probably need to stop obsessing over the medical jargon for a bit and just focus on what’s actually going down in this thread. If you can manage to tune out the clinical stuff and pay attention to the vibe here, you might actually start feeling better.

Look, if I were in your shoes—especially with all those psychosomatic symptoms flaring up—here’s what I’d do. You might think I’m out of my mind, but hear me out. If you can swing it, just disappear for ten days. Find some peace out in the woods or somewhere quiet in the mountains, leave your phone completely dead, and just reset. Spend a few days strictly on veggie juices, then follow that up with seven days of nothing but water. Basically, do a total system reboot. And I mean it: no meds, no smoking, none of that stuff. Throw in a daily enema routine too—you can grab a kit for that at any CVS or Walgreens. Just take some damn time for yourself. At the end of the day, a human being isn't just a collection of physical matter.

You’ll be back to 100% after that, no question about it—but you're probably going to have to shake things up a bit and actually stick to a new routine if you want to keep it that way.

vividsailor7 said:I’m with the pulmonologist on this one—if the IgE, specific IgE, and skin prick tests all come back normal, then you aren't allergic.
Wait, wasn't that doctor an ENT?

Yes, she is—an ENT... didn't I mention that? I honestly thought I had already clarified... 🙂
Well, anyway, she told me I have allergic—or rather, atopic—rhinitis because my nasal mucosa looks exactly how it should for that condition. Plus, the skin prick testing actually *did* show an allergy to dust mites... which is interesting because while my total IgE and specific IgE levels are technically "normal," the prick test flagged the dust mites and some preservative—which makes perfect sense, since I break out in a rash whenever I use certain shampoos from brands like Dove or Pantene because they all use that same preservative...
So, the ENT basically said, "That's it, that's your diagnosis," and even claimed it would be the case regardless of what the prick tests showed...
Though, if I'm being honest, I lean a bit more toward the pulmonologist's side regarding the medication—specifically, why on earth I need to be taking allergy pills (she put me on Aerius)... I can wrap my head around the two nasal sprays she prescribed—since I clearly have localized inflammation—but those tablets feel totally unnecessary because I don't actually experience typical allergy symptoms, other than having a nose that's constantly stuffed up 😁 and running the second I step out into the cold air... I mean, there's no rash, no sneezing, no watery eyes, no shortness of breath—nothing like that. For the sprays, she gave me Avamys and some Sterimar, which isn't even prescription. And frankly, the cost is ridiculous; the pills are $13, the Sterimar is $20, and the Avamys is just as bad—we're looking at about $160-$57 a month. Thank God for my supplemental insurance, otherwise, this would be even more brutal. It feels absurd that there isn't a generic version or something with the exact same effect that won't drain my bank account... Don't get me wrong, I will pay for my health, but it feels foolish to think there isn't a comparable alternative that doesn't cost an arm and a leg
I'm just left feeling a little muddled now, seeing as the pulmonologist says one thing and the ENT says the complete opposite. 🙂

urbanlynx23 said:Yes, exactly—ENT... didn't I mention that? I thought I had! 🙂
Basically, she told me it’s allergic, specifically atopic rhinitis, because my mucous membranes look exactly how they should for that condition. On top of that, the prick testing confirmed I'm allergic to dust mites. My total IgE and specific IgE levels are actually normal, but the prick tests don't lie—dust mites and some preservative. And that makes sense, too, because I break out in a rash whenever I use Nivéa shampoos since they all use that same damn preservative...
The ENT basically told me "that's it," and argued it would be the diagnosis even if the prick tests had come back negative...
Though, I find myself leaning more toward what the pulmonologist said. Honestly, I don't see the point in taking allergy pills (she prescribed Aerius)... I can get behind the two nasal sprays she gave me, since I have localized inflammation, but those tablets feel totally pointless because I don't actually have typical allergy symptoms. Aside from my nose being constantly stuffed up 😁 and running the second I step out into the cold, I've got nothing. No rash, no sneezing, no watery eyes, no shortness of breath—nothing. For the sprays, she put me on Avamys and some Sterimar which isn't even prescription. Frankly, it feels overpriced. The pills are $13, the Sterimar spray is $20, and Avamys is just as bad. We're talking about $160-$57 a month. Thank God I have supplemental insurance, otherwise this would be even more ridiculous. It’s bizarre that there aren't any generics or something with the exact same effect that won't drain my bank account... Don't get me wrong, I will pay for my health, but this feels stupid. There has to be something similar out there that doesn't cost an arm and a leg.
I'm just a bit stuck now because the pulmonologist is saying one thing and the ENT is saying another. 🙂

ENT specialists deal with these kinds of lapses in judgment all the time. If I were you, I'd listen to the pulmonologist.
As for the treatment, you could try getting a blue prescription for something like rinolan + Tafen-na.

vividsailor7 said:ENT specialists—they’re usually pretty sharp when it comes to spotting these kinds of issues. Personally? I’d take the pulmonologist's word over anyone else's.
As for the treatment, you might be looking at something like a prescription for rinolan + Tafen-na.

haha 🤣
thanks again 🙂