You can have low systemic inflammation, yet still have specific small areas of high inflammation, like in a node.
"mildly low B12 and MPV"
Did we ever talk about you taking a B12 supplement? I recall you're not a vegan, but maybe we discussed B12.
Low B12 can cause low MPV. But then we'd want to wonder *why* you have almost lowish B12.
I know we discussed that low WBC is not a concern to a doc unless you get constant colds etc, which you don't. Low WBC generally means low systemic inflammation, which is good. But we can and should wonder why yours is lowish, yes.
"Also she said I’m feeling the carotid bulb..."
That would probably be bilateral though, right? Yours is felt on one side only.
' “Suggests reactive etiology” again. Could that be true with no pain or tenderness?'
Yes. The biochemicals like bradykinin and Substance-P are different than the ones that mainly cause swelling and fibrosis.
"One thing of note; that terrible chest cold that caused these initially and that I needed antibiotics for, I haven’t had a cold since then. That was 3 years ago. I usually get 2 a year."
You're immune system is probably hyper now. There is a related idea that eating mushrooms (a fungus) will activate the immune system and thereby possibly maybe perhaps help against infections and even cancer. There was an approach long ago called Coley Toxins.
"no one has ever tried giving me more antibiotics even for a week"
You can outright ask them, I would. But an Abx has to match the pathogen and also be capable of getting into the location where the pathogen is at. So you have to decide if you think the occult infection is in the lungs or in the base of a tooth.
Another option is an anti-inflammatory like prednisone, to see if any nodes reduce in size.
"Is it possible some tiny remnant of the virus or infection could still just be stuck in limbo and my body has quarantined it so to speak?"
Absolutely. For being quarantined, that would be granulomas. Granulomas can break down and release what was inside - e.g., that happens when powerful anti-inflammatories (e.g. anti-TNF or anti-IL6) are given to somebody with latent TB and then they have active TB. For the base of a tooth, that would involve a location inaccessible to immune cells but still capable of leaking cytokines out.
Some bacteria go into a dormant state.
Take a quick look at this, which has to do with chronic Lyme. It's somewhat parallel to you, I'm not saying you have Lyme. The theories for chronic Lyme mostly center around either (1) there still being live Lyme bacteria present, even after initial Abx, or (2) the Lyme created an immune system dysfunction that persists even after all the Lyme is dead.
https://www.hopkinslyme.org/lyme-disease/treatment-and-prognosis-of-lyme-disease/
Chronic Lyme is a big topic for sufferers, though not well understood yet. One or more Abx might even be given for months. We'll keep in mind that Abx do not usually affect viruses, and anti parasite drugs are different still.
Hi, Spartan.
"...I feel she says is my jugular bulb but I find that hard to believe since well, the jugliodiastic node is right there too and that’s the one they say is enlarged that big."
I agree with you.
"She actually did a calculation of volume based on measurements"
I've seen that done for overall tumor burden (with many tumors), and yes it would also fit here.
"just shape shifted a bit which she said can happen given lymph nodes are soft tissue and often the probes push on them and can move them a bit."
That sounds reasonable and I can't think of any other explanation. It's actually a clever idea from her. Nodes wouldn't likely grow in one direction and simultaneously shrink in another direction.
"Is [all of] this worrying?"
Nope, but the size was enough to then consider other factors. If the US says the internal architecture is good and there are no signs (calcium flecks, wrong blood flow on Doppler, cystic areas, etc) that there is cancer, then there should be no worry.
"the shortest axis (in this case the 0.7cm) is considered short axis on their ultrasounds. Is that true?"
I disagree there. Let's say you have a 3D sono that shows 3cm x 2cm x 1cm. Then the next day you have a 2D sono which shows 3cm x 2cm. The "short axis" didn't grow from 1cm to 2cm.
"Anyway she says usually even low grade lymphomas will show on ultrasound..."
Yes.
"Also what she mentioned about volume, is that reassuring?"
Yep.
"It’s slightly more volume but is it true that there’s likely no real growth since the overall volume is still mostly the same?"
Yes.
Also, let's consider this: any fibrosis inside the node also contributes to size. For instance, if you have a node that would be 2.5cm in length because of being reactive alone, but then you also have .5cm of fibrosis in there, then the overall total length seems alarmingly big at 3.0cm. If a year goes by, and there is then .7cm of fibrosis, then the overall length becomes 3.2cm. Nodes can only get so big by being reactive alone, but maybe there is no limit to how much fibrosis can accumulate inside.
I do think that your nodes are reactive from some upstream location secreting inflammatory biochemicals. They are not dormant. But also they have fibrosis inside.
No, there is still no reason to think there is cancer inside.