What do I do if I have swelling in the neck: Mumps, Lymph nodes, Goiter, Thyroid enlargement.

A person with neck swelling has enlargement of the soft tissues that covers the neck. A neck swelling can also occur as accumulation of fluid, lymph, or inflammatory, or tumor cells in an area under the skin of the neck. Clinically speaking swellings in the region of neck are of great importance as they not only help in diagnosing some serious underlying disease but are also easy to treat if they are benign. Most of the times a simple surgical procedure is all we need.

Neck swelling may be caused by an injury, inflammation, infection, or a benign / malignant tumor. In mild cases of neck swelling, treatment may not be required. If the neck swelling is bothersome, over-the-counter medications such as anti-inflammatory drugs or pain medications or cold compresses may help reduce discomfort and swelling. In more serious cases, a visit to a medical professional may be necessary to determine the cause of neck swelling and appropriate treatment. Seek medical attention if your symptoms of neck swelling, or those of someone you are with, are accompanied by sudden swelling of the face, lips, or tongue, or breathing problems such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking. These symptoms may be signs of a severe allergic reaction.

Anatomy of the neck

Benign skin conditions can cause small areas of the neck to appear swollen. Swelling of the lymph nodes in the neck is a common symptom of many different types of viral and bacterial infections as well as many benign and malignant disorders. Lymph nodes are small organs distributed in the body which collect fluid. They get swollen if inflammatory fluid deposits in them. They are also swollen if cancer cells from an organ reach them in case they are said to have metastasized. In the neck they are present in distinct groups and are almost always show as medium to small size swelling mostly on the sides of the neck and / or under the jaw. Have a look at this illustration, it shows different groups of nodes in and around the neck.

you can see different sets of these lymph nodes like sub-mandibular, and occipital. So their enlargement is either benign or malignant. These nodes are also swollen in cases of TUBERCULOSIS (TB). TB is a treatable disease which affects millions of people all over the world. A biopsy result of the neck swelling, from a pathology laboratory is all you need.

If the swelling is on one or both sides of

Lymph nodes in the neck

the neck just below the ear lobe, it may be MUMPS. In that case immediately consult your doctor. Mumps is a viral infection and can have serious side effects long after the swellings have disappeared. This viral attack  can lead to swelling and pain in the salivary glands (Parotid glands), along with fever, loss of appetite, and fatigue. It mostly occurs in children but can affect us in later life. Remember there is a vaccine against Mumps which protects us from this viral infection.

MUMPS: A viral illness which causes swelling of Parotid glands.

There are some skin causes of neck swelling:

Neck swelling may be caused by a variety of skin conditions including:

  • Acne
  •  Boils
  • Cyst (a benign collection of fluid)
  • Lipoma (collection of fatty tissue under the skin; a benign condition)
  • Skin infections

Other causes of neck swelling

Neck swelling can also be caused by a variety of other conditions including:

  • General infection leading to swollen lymph nodes in the neck region
  • Goiter (an enlarged thyroid gland)
  • Mumps (viral infection of the salivary glands in the neck)
  • Recent neck injury or trauma
  • Recent neck surgery

Other causes of lymph node swelling in the neck are the blood cancers like Leukemia, Lymphoma and Hodgkin disease.

In some cases, neck swelling may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Anaphylaxis (severe allergic reaction)
  • Angioedema (a severe swelling beneath the skin that can cause breathing difficulty)
  • Cancer of the throat, thyroid gland or other structures in the neck

LUMP IN THE NECK WHICH IS DUE TO THYROID ENLARGEMENT (GOITER):

A goiter is an enlarged thyroid gland. Some people with a goiter (but not all) have an under-active or overactive thyroid.  A goiter can mean that all the thyroid gland is swollen or enlarged, or one or more swellings or lumps develop in a part or parts of the thyroid.
The thyroid gland is in the lower part of the front of the neck. It lies just in front of the trachea (windpipe). It has a right and left lobe which are connected together by a narrower band of thyroid tissue. (It is roughly the shape of a butterfly.) You cannot usually see or feel a normal thyroid gland. If the thyroid enlarges it causes a swelling in the neck which you can see – a goiter. There are various causes of goiter and treatment depends on the cause. As such the thyroid swellings can also be classified as benign or malignant. The benign swellings do not cause spread of the disease and are mostly fluid collection in some part of the gland. Hemorrhage in the gland is another example where a neck swelling is observed. Thyroid swellings are prominent and are always situated in front of the neck (see illustration). They may be mobile (moving with swallowing) or fixed. If the swelling is benign   and is mobile, there are chances that it is not dangerous at all and a simple surgical procedure will correct it.

In case of more than one swelling (lumps) in front of the neck which are due to thyroid enlargement, they are called as Multinodular goiter while a single swelling (lump) is termed as simple nodular goiter.

CAUSES OF SIMPLE OR NODULAR GOITER:

Always remember that a thyroid swelling does not mean there is an element of dysfunction also (please see previous blogs about hypothyroidism and hyperthyroidism).

Simple diffuse goiter

They may be there due to IODINE DEFICIENCY in which case they are termed as IODINE DEFICIENCY GOITER. In most of the cases they are diffuse (no nodularity is seen). When there is no nodule palpable in the neck and there is diffuse swelling, it is SIMPLE GOITER. It can also occur at puberty in young girls and is called PUBERTY GOITER.

Diffuse/Simple goiter:

This means that the entire thyroid gland is larger than normal. The thyroid feels smooth but large. There are a number of causes. For example:

  • Grave’s disease – an auto-immune disease which causes the thyroid to swell and make too much thyroxine.
  • Thyroiditis (inflammation of the thyroid)
  • Iodine deficiency. The thyroid gland needs iodine to make thyroxine(T4) and T3. If you lack iodine in your diet the thyroid swells as it tries to make enough of its hormones which are so vital for our bodily functions like metabolism and control our heart rate and many other functions
  • Some medicines can cause the thyroid to swell as a side-effect. For example, lithium and treatment of Hepatitis C
  • Hereditary factors – some people inherit a tendency for a thyroid to swell. In particular, it may swell at times of life when you may make more thyroxine and T3. For example, when you are pregnant, or during puberty.

Nodular goiter

A thyroid nodule is a small lump which develops in the thyroid gland, in front of the neck. There are two types:

  • A multinodular goiter. This means the thyroid gland has developed many lumps or ‘nodules’. The thyroid gland feels generally lumpy.
  • A single nodule. Causes include:
    • a cyst (swelling with fluid in it)
    • an adenoma (a solid lesion in the gland composed of glandular cells)

      large multinodular goiter

    • a benign or malignant tumor
IF I HAVE GOITER DOES IT MEAN MY THYROID GLAND IS MALFUNCTIONING?
  • In many people with a goiter it does not affect the amount of thyroxine T4 or T3 that they make. You are then Euthyroid which means you make the correct amount of these hormones.
  • In some people, the goiter is associated with an abnormality of thyroid function. You may make too much thyroxine or T3 (hyperthyroidism) or too little thyroxine or T3 (hypothyroidism) For details please see related posts in this blog.

WHAT STEPS ARE TAKEN TO ASSESS / DIAGNOSE A GOITER:

1. Blood samples are taken to evaluate the amount of circulating thyroid hormones in the body. Normal T4, T3, and TSH means you are Euthyroid while over active and under active thyroid gland is also established and then the treatment starts according to the condition.

2. An ultrasound scan of the thyroid is done. This may be done if you have a single nodule. An ultrasound scan is a safe and painless procedure which uses sound waves to create images of organs and structures inside your body. It can tell if a nodule is a cyst or a solid lump.

3. A radioactive iodine scan. This scan is done (details given in the next post) to establish the uniformity or nodularity of the gland and whether some part of it is HOT or COLD. The hot spots on a radionuclide scan mean this portion of the gland is making more hormones (T4 and T3) than the surrounding gland and a COLD nodule means this area of the gland is not properly functioning. If on scan results there is a COLD NODULE, it is usually suggestive of malignancy (Thyroid cancer) and appropriate medical opinion must be sought immediately.

4. Biopsy: A small piece of tissue (a biopsy) may be taken from a nodule to look at it under the microscope. The biopsy is done by inserting a fine needle into the nodule. (It is like taking a blood sample but the needle is smaller.) It is a simple and safe procedure.

TREATMENT OF GOITER:

  • If you have a small goiter, and your thyroid is making the correct amount of thyroxine and T3, then you may not need any treatment. It happens in patients who has simple diffuse goiter
  • You will need treatment if you make too much or too little thyroxine T4 or T3
  • An operation to remove some or all of the thyroid may be an option in some cases
  • Radioactive iodine treatment may be an option for a goitre causing an overactive thyroid. This involves taking a drink, or swallowing a capsule, which contains radioactive iodine (I-131). The radioactive iodine builds up in the thyroid gland. As the radioactivity is concentrated in the thyroid gland, it destroys some thyroid tissue mainly by it beta emissions. If too much of thyroid is destroyed, there is replacement therapy in the form of thyroxine tablets. Their use and the fact that radioactive Iodine treatment is not particularly harmful (it is not given in pregnant or lactating mothers or prospective mothers), this form of treatment for Grave’s disease (toxic goiter) is very useful.
  • If you have cancer of the thyroid, you will probably need an operation to remove the cancer and some of the thyroid gland. The strategy to deal with this cancer will be outlined by an Oncologist with the aid of a surgeon.
  • Iodine replacement, if the goiter is due to lack of iodine in the diet.

NOTE: If you have any questions, you can always ask the author who is a thyroid diseases consultant.

About Dr. Afaq Ahmad Qureshi

Physician, writer, broadcaster, journalist, translator, free lance writer, poet, political and social analyst and critic. Writes plays and features for electronic media, interested in numerous things from sociology to medicine to history and art. interest in books and internet, writes for http://www.blogcritic.com also; editor for Internet journal; at http://twitter.com; had so many traumatic experiences blah blah blah...
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136 Responses to What do I do if I have swelling in the neck: Mumps, Lymph nodes, Goiter, Thyroid enlargement.

  1. sharon says:

    Hi Doc,
    I have hypothyroid and take a non-synethtic medication prescribed by my doc and prepared by a compound pharmacy. I have been taking this for 10 yrs. One of my problems is that three years ago I started being unable to do a clean sweep of swallowing, by that I mean I could still feel some saliva in my throat even after swallowing hard. No problem eating though. I still have this today. I went to the doc last yr and he said, “it was just a temporary condition that happens sometimes as one ages (I’m now 59) and it occures sometimes when one is anxious”. (?) I knew this didn’t seem right because the symptom never went away, I don’t have insurance so couldn’t get a second opinion. But I do see a chiropractor from time to time over the past many years. He is able to get my cervical spine off of the nerves that have plagued me for 15 years. I seem to have a bout of radiculitis (sp) every yr from July to early Sept. and the adjustments help immensely. Now today and for the past four months the adjustments are not staying set and I have a VERY out of alignment C-3 and 4. It is a bulge to the right side of my neck and is starting to impinge my signal column. My chiropractor said I need an MRI to see whats going on in there since his adjustments no longer hold. This now is causing a crawling sensation radiating to my ear and top of deltoid and covers the side of my neck and just under my ear lobe. It has this sensation every time I look down or lean my head to the right. It started July 4th 2013 and has progressed. The chiropractor called it hyperestia. (again spelling) and degeneration of the cervical spine. I never relayed the swallowing problem to my chiropractor, so he has no input on that…as far as putting all this together.
    I just wondered if you have heard of all of this in one person.
    Thanks!

  2. Melb123 says:

    Hello doctor! Thank you for your intriguing blog posts and advice to so many people, you are such a help!!

    I am 25 and suffered through many symptoms/issues for many many years from depression to upset stomach to anxiety to cold intolerance to acne to anemia to rashes to aches & pains to swelling of legs etc
    Finally I was tested for Celiac by blood/endoscopy and was told YES have it this year.
    BUT Prior to this (year or two)I insisted my TSH levels be checked, they were hypo, and then hyper (both just few numbers over high end or just under low end) they wanted to watch and wait for awhile each time with 6 months in between testing. I had lower end of normal ranges for t4 and t3.
    Finally I did research and asked for “Antibodies test” someone finally agreed and came back In the 250s.

    Went back to this endo who had been dealing with (not pleasant) he says “oh yes i know you have had hashimotos, this is not new information”.
    say I have hashimotos, and said it was probably for awhile & leaving now as tsh is now more on hypo side but just over at 7.

    Now want me to take medicine immediately. I am hesitant it is full picture but i will…

    >>>MY CONCERN is right where my Neck meets my Jaw line there is 2 round big nodes (possible swelling of submandibular glands is what one doc thought).
    But i did ultrasound 5months ago of neck, nothing showed up In those (a lab did it not endo). But lab also US my thyroid too as mentioned about my issues/ & she saw the appearance of THYROIDITIS and mentioned “increased vascularity also.

    Because of increased swelling in throat neck areA, I am having problems swallowing, eating anything usually feels like it is stuck / in throat and not swallowed properly, even my medicine gets stuck.

    >>> I called endos secretary (new one I got) to ask about getting FNA due to increasing growing swelling of those nodes. She would let me know. Called her to check up on status as want to do, says well hmm I didn’t check because “you never had ultrasound of thyroid”??
    She doesn’t speak very good English. To sum up, she makes it sound like my neck ultrasound results are not correct or helpful as i wasnt there for purpose of thyroid When got ultrasound (was for the glands).
    Is this the case?
    Is there a different ultrasound for just the thyroid area or does the secretary not know what she is talking about? Maybe she means that the doctor wants me to get a ultrasound with a specific look at thyroid by someone familiar with those issues?
    Any advice on how to move fwd?

    I am really worried as i have gotten steadily worse and my wbc is 3.5 now, my anemia is 5(highest its been in years, waiting for IV iron appt),
    And along with other abnormal tests like ana (weak positive) to muscle enzymesck300, to below normal compenent c3… Etc.
    My symptoms have increased dramatically and have become very random & i also now have auto immune related issues like alopecia(very soon need to buy wig at 25, been wearing hats) , ( rheumatologist thinks have sjorgens, and raynauds also, possible lupus to watch out for).

    I am so unsure of how to move fwd!!!
    I am demanding FNA and ultrasound or whatever I need to do to figure out why my left and right nodes? Under my jaw/where neck meets is swollen, the right side more so then left and its embarrassing and really noticeable as well.

    Any help on what to ask for, tests or anything?
    What would you think could be causing the nodes/that area?
    Should I take thyroid meds or wait till after FNA of that and us of thyroid (when they let me do that, though had prior)? Should I ask for specialist like ENT or more experienced thyroid surgeon/doc then my endo (few years into being doc)

    Thanks so much for any response!! Respect and appreciate your help

  3. dishu purja says:

    i had a lymph node tb n i did my treatement of tb for 6 month bt the lymph node didn’t went when my treatment was finish. What is that sign? Is i m suffering from thyriod cancer

  4. Larissa says:

    I had the mumps around the time I turned 18. I am now 22. My mumps were never treated by a doctor, I just treated it myself at home. The double chin out caused me never went away while all other symptoms did. Is this something to worry about?

  5. Madiha says:

    Doctor,
    I have had this pain under my left ear, in my left gum which feels like it keeps swelling up, even though my wisdom tooth has been removed, the pain radiates in my throat, and I feel a very little lump in my neck on the left side. This feels like all this pain is in one line, travels under my jaw. And recently I feel like that side of my neck is swollen, although it doesn’t look that way, but I feel it when I lay down the most. Any idea what this can be?

    • Without physical examination it is really very hard to tell the cause of the pain. Age/sex also matter in establishing a disease. It can be due to a coronary if you are a smoker/ hypertensive/ has family history of heart disease. Viral causes can also be there like Herpes. Best idea would be to consult the nearest surgeon/doctor.

  6. Mary Martindale says:

    I have already had my lump checked out and its not cancerous but I have been having troubles sleeping. Tonight I’m having troubles breathing. I try to sleep but I feel like I can’t get enough air in while laying down. I’m up now but still having troubles. I have an appointment in a month to see the specialist because my blood work said I was hyperthyoidism. Should I ask to be seen earlier because of my breathing?

  7. Ohuoba chidinma maureen says:

    Have something like a ball like structure on one side of my nick sometimes i feel hot that sumtimes is dear, when i touch it, it will be rolling like a ball righ dear,please i want to know what is it?

  8. Hello doctor. What kind of drugs should i take to reduce swelling of a node just below my ear lobe?

  9. Huy Truong says:

    Dear Dr.,
    I went to the bathroom this morning to shave. When I raised my neck to save under my chin, I suddenly felt a pain. Then I checked my neck in the mirror and I discerned that there is a lump right in the middle of my neck. It is not very clear, but I still can tell that it’s abnormal. Could you please tell me what is going on with me? I am very concerned. I didn’t do anything wrong with my health.

    Thank you in advance!

  10. david says:

    Dear Dr, i wanted to know if my thyroid can swell along with my lymph nodes in my neck when I’m sick. Been really worried lately that it’s something really bad. Because i caught the flu a couple days ago, and my thyroid and lymph nodes started swelling. Thank you.

  11. Amal catherine says:

    dear doctor
    iam 23yrs old and iv been noticing for almost a yr now tat my neck is swollen and its painless ,last week i checked with my doctor she had asked me to take thyroid test and it turned out normal and without any further test she asked me to just gargle every morning with salt water it didn’t help and im worried could you plz tell what this could be.

  12. sam44sam says:

    Hi Doctor,
    I’m 22 years old and about a month ago I noticed some swelling on the right side of my neck when i ate. The more I ate the bigger it got. After a few days it disapeared and I thought nothing of it. But now it has returned suddenly, but only when i eat, its quite a hard lump and as I get more it seems to spread across my neck. I feel perfectly fine otherwise and I’m relativly healthy.
    What do you think the problem could be?
    Thanks.

  13. TheRealDeal says:

    Dear Dr. I just had general liposuction surgery for my lipoma I had on the back of my neck. The surgeon sucked the fat out and stitched me up. Now my neck is swollen and I don’t have a post surgery checkup until next week. I have iced it and and taken pain medicine but the sweeling has not went down yet do you have any suggestions and I want to know generally if someone has this type of work done does the swelling go down or is it going to stay like this and is there anything I can do to help the swelling go away or does it just take time.

  14. avinash pandey says:

    dear doctor i am 21 year old and already suffering from tuborculosis(T.B.), now i have a problem is that there is swelling in neck under jaw it is in the center of the neck . i want to know what is it?and what treatment should be taken????plz reply

  15. Janet Davies says:

    dear docter im not used to useing a computer so im just adding to what i wanted to ask you as i said dr gibbs quoted a dr rhodri evans to my gp stating that a woman of my age 62 will have a 50 percent of having nodules and that the ultrasound is of no consequences i am so confused with all this cos i know my own body and something is wrong i can not understand how both scans are saying differant things pleascan you tell what i can do now please

  16. Janet Davies says:

    dear docter i would be realy grateful for some advice i feel like i am banging my head on the wall with the hospital im under i had a ssb total thyroidectomy for a multinodular goitre in 1991 they said that both lobes of the thyroid was enlarged the left the worst with a non functionning area nodular prominent within the mid zone of the left lobe they removed the right side but left a remenant on the left for the last few years the swelling in the front of my neck has got realy big and i chock eating cut up food and taking my medication and i get a bad pain on the left side of my neck my gp sent me for a ultrasound in march 2013 and it said that thier was a moderate enlargement of the left rement which contains a few echopoor nudules consistant with a multi nodular goiter then my gp sent to see a dr gibbs endocrinolgy consultant but i did not see him i saw his regitra and she sent me for a ct scan which they said was normal ct scan with no goitre or retrosternal extension also dr gibbs wrote to my gp and quoted a dr rhodri evans

    • Dear Jaent,

      I think there is huge administrative confusion in the medical system. If you have symptoms and ultrasound exams prove the presence of goitre then by all means it should be taken out or radiated. May be your GP / Endocrinologist are thinking that at this age another surgery would not be good but honestly I don’t see any harm in that because your symptoms are pretty disturbing. I think you should go to the GP and tell him straight that you won’t mind if there is another minor surgery. Good luck.

      • Janet Davies says:

        thank u docter for replying so quickly but my gp and endocrinology said because the ct scan said normal that i should take no notice of the ultrasound results but im not happy with this because i know my own body and the swelling in my neck is worst now then 1991 and the pain in my neck is horrible my gp is trying 2 say it could be fatty deposits due 2 steroids i was on last year 4 chest infection but dr afaq i do not believe them i feel that they are fobbing me of so please what can i say 2 my gp 4 them 2 take some action 2 do something 2 help me thank u once again dr afaq 4 replying 2 me so quickly

        • Is it possible for you to change doctors? Its absurd that a patient who has symptoms and a visible swelling is being labelled as ‘normal’ because CT says that.

          • Janet Davies says:

            thank you dr afaq for replying so quickly again im going to tell my gp that im not happy with what they are saying and that i want a second opinion i would like to say dr afaq that your blog is very interesting and thank you once again for your advice

            • Janet Davies says:

              dear dr afaq i spoke to my gp today and i told him that i am going to take things further about the way they are trying to fob me off and i also told him what you said and now he is taking notice he told me that he asked for a review of my scan and the report came back and it says that it is a multinodular with several nodules and that it was 2 small 4 the ct scan to pick it up so he is going to speak to a more senior docter at my surgery to see what to do next . so dr afaq thank you so much 4 your advice because now my gp knows that i messaged u he told me about the report he had done , i do not think that he would have done until i told him what u said . so with some luck they might stop fobbing me off so thank u once again dr afaq i am realy grateful to u, i think it is a wonderful thing that u are doing by helping people with there worries. because there is not many people like u in this world theses days.

            • Dear Janet,

              Thank you for the kind words. I earnestly hope that after review your doctors agree to get rid of your symptoms. Good luck:)

              Afaq.

  17. kingjames says:

    Hello Dr
    I developed a smaill growth in feb on the right hand side of my neck and this was small up until May. By May it started to grow and I went to see my doctor who said it might be a cyst, lipoma or lymphoma and he referred me to a genera hospital and at the hospital they drained abt 60ml of pus which they said they are going to test for tubercolosis and what worries me is the thing is still growing ….what can it be and can TB come in such a way…I had night sweats late last year with a cough and I can say I have lost. A lil bit ow weight .please help!

    • You have not mentioned about the results. Please remember that TB is treatable disease these days and there is nothing to fear. The swelling you have mentioned swelled because the fluid taken out tends to re form. Nothing to worry. Good luck.

  18. Melissa says:

    Dearest Dr. Afaq Ahmad Qureshi,
    I want to take the time to profusely thank you for taking the time to write this article BUT mainly I want to thank you for taking the time to answer the posts.
    Two of them I have printed out to take to my doctor.
    First, I want to express that I Love my doctor; however, I am starting to believe that she may not know what to do next for me.
    I was diagnosis with Hashimotos Thyroiditis over ten years ago; with an enlarged thyroid (I never noticed the thyroid was big, never felt a thing). No worries, I take a small dose of thyroid meds for it (thus stopped worrying about it year ago).
    Last year in July my thyroid swelled to double the size! I felt this and it was scary! Along with feeling like I chocking when I ate or drank. I was highly alarmed and since I have had no issues for years, I no longer had an Endo to go to “right away” (all appointments for a new patient was a four month wait).
    Then I came down with Mono Dec 2012. Well, the thyroid swelling was blamed on the Mono. No big deal, I can deal with this diagnosis (I thought). However, it is now June 2013 and both of my lymph nodes in the front of my neck are swelling to the point that they cause serve pain. (And the thyroid is swelling a little bit). I have seen my family doctor and she said it was not the mono, but “thought” it was the Hashimoto. I called my endo and he said it was not the Hashimoto.
    I read your posts today. I have received ultrasonography of the thyroid yearly (use to have numerous lumps and nodules, now I only have one nodule). However, I think I may ask my doctor about the isotope scan or a biopsy of the lymph (you suggested this to other posts).
    Thank you Sir for your advice and kindness to others,
    Best Wishes

    • Dear Melissa,

      Many thanks for reading my humble post. The diagnosis of Hashimoto’s in the past and Mono recently gives detailed picture of the situation. Having enlarged nodes in these conditions is not uncommon. Please consult your endo & then see if she recommends a biopsy. There is need to be sure of the constituents of the swelling and biopsy is the only option. Of course it can be fine needle aspiration also (called FNA). Good luck.

  19. Rasha says:

    hello Dr.
    Its been a week since i noticed a swelling on the lower mid right side of my neck. it is soft to the touch and i do not have any pain. I was encouraged by a friend to go to a doctor for a check up. when the doctor saw me he said it feels like goiter and ordered a blood test to check TSH level. But the problem is that i had the same test done about 3 months ago and was told it is normal. i just wanted to ask what you think it could be? Should i just ignore it? Thanks in advance

    • Rasha, three months ago the test was normal but I gather that there was no swelling either. So with the swelling a test becomes meaningful. Please let it be done. Moreover ask your doctor whether an isotope scan would be helpful in diagnosing the exact nature of swelling. That might also help. Good luck.

  20. Antonia says:

    Hello. I am very stressed right now, since I ve just come back form the hospital. I noticed 20 days ago that my thyroid gland was a bit swallen (equally on both sides and the center). My GP thought it would be just a multinodular goiter, but he referred me to the hospital for ultrasound and assessment anyway. Well, blood tests and ultrasound are perfectly normal, so no problem with the thyroid. So the doctor suggested that we should run a few more tests (since I told her I have a difficulty swallowing) to see what caused the swelling. [I have had this difficulty in swallowing for over a year now, I checked it once last year, the doctor put something up my nostril and the camera showed nothing more than concentrated fluid that is not diluted well due to my crooked nose diaphragm and my not drinking enough water]. What are my chances here? The doctor suggested a test where I will be given something to swallow and they will be taking x-rays and of course a CT scan, which sounds serious…. Please tell me your opinion…. I have no other symptoms, but I am a smoker (I am 38 years old, have been smoking for 20 years). Thank you…

    • Hello Antonio. Your narrative tells me that the tests ordered by the GP didn’t reveal any thyroid problem. In that case a CT scan is mandatory but who told you there is something serious associated with it. Believe me it is a easy test, just like taking X-rays. So please get it done so that your doctor can reach a conclusion and treat your swelling. Good luck.

      • Antonia says:

        Goodmorning and thank you very much for the answer. I was wondering: isn’t a CT scan ordered when we are looking for cancer? Could we be looking at something else here, other than cancer? Thank you.

  21. angie says:

    hello doctor,
    I have a lump above collar bone from my childhood. I just thought that it was fat since i was chubby then. Now i’m 18 yrs still have the lump in it. Many friends asked me about that sometimes i feel embarrased with it. My menstrual period is also irregural. Between my first menstrual was when i was late 15/ 16. I read lot articles about thyroid disease and it says who suffering from this have slow growth. I have pain in my back (below backside of neck). I told my parents that may be i have thyroid disease but they just ignore say that it was from childhood nd no need to worry.
    What to do doctor?? And i still have chubby cheeks but my body size is normal, i’m just 5’2 and don’t look of my age.
    Thanks.

    • Dear Angie. The site of swelling is not likely to be a Thyroid swelling but it could be an enlarged lymph node for which a biopsy is definitely needed. May I suggest that you visit a doctor and tell him about it. Another thing you need (considering your concern of not looking your age) there is no harm if Thyroid function tests are carried out. That same doctor should be able to order those tests. Rest assured, there is nothing serious and you will soon get over these problems. Good luck and best wishes.

  22. neeraj says:

    hi sir,
    One of my friend is suffering from lymph node in right neck,for which she is taking medicine(r-cinex and e-cox ) for more than a year ,but she still feeling pain in her neck and she have mild fever almost every day.

  23. Winnie says:

    Dear doctor,I recently felt like a numb on my lower right side of the neck( if you would rest your hand on the collarbone, the bump is somewhat resting in between the fore and middle finger)
    I am wondering whether this would be a thyroid issue.
    And if so is there any non-medical treatment to correct it. Thanks

    • The lower right side of the neck is least likely place for a thyroid swelling. Whatever it is, there is no non-medical treatment to my knowledge. I’m sure a visit to doctor would help you get out of this worry. Good luck.

  24. Jane says:

    Dear doctor
    I have had a swelling on the front lower part of my neck almost like a half tyre for quite some time now. It does not hurt but almost feels as if it is filled with water. It’s soft. I am 51 years old and have very bad hot flashes due to menopause. I am 63 kilos so not overweight. I am unsure as to what this is and after reading other posts think it could be a goiter. I am very conscious of it as it shows now. What do you think and what should I do? Thankyou

  25. Francesca says:

    Hello Doctor, I have had swelling in the front of my neck on both sides just above my collar bone. It is almost as if a tube was placed inside my skin, around the front of my neck and inflated. A NP and my family physician both felt my thyroid. It is not swollen so they did not seemed concerned. I am concerned, however, because it is not normal. It appeared 5 months ago and is not going away. When I awake in the morning it is sometimes very swollen as is my throat. After being up for awhile, the swelling goes down, but not completely. I know that you can not tell without examining me what it could be. However, could you give me an idea of what I may be dealing with and what I should say to my doctor so that this is taken seriously. Thank you very kindly.

    • Francesca I feel that biopsy or FNAC should be performed. These procedures will confirm the reasons of these swellings. I’m afraid without them there is hardly any chance to categorize them. Good luck.

  26. Jessica says:

    I’ve had a hard painless lump behind my left ear and one on the right side of my neck for almost 3-4 months now. I went to the doctor and they gave me a antibiotic to take for ten days. That was 3 weeks ago I took the last antibiotic. There has been no change in either lump but for the past 3 days I have had sort of a pain down the right side of my neck and a little swelling. It doesn’t hurt when sitting up or turning my neck but only when I try to lay on that side. It is a very tense, tight feeling. Could this be my thyroid gland, and why doesn’t my doctor seem concerned. I’m not able to afford to go to another doctor or ENT for a second opinion so any thoughts would help!

    • Jessica is it possible to take time from a surgeon in a hospital and visit him without a lot of expenditure. I feel this is his domain and he needs to have a look. Lab can do a FNAC (taking out the sample from the swelling and testing it). That will confirm what is causing these swellings.

  27. Bmack says:

    Great articles. I have had some swelling in my neck off and on for the last ten years or more.I have had my thyroid tested both blood and FNA .During the FNA they did find a goitor and small node’s but at that time the surgeon said it was too small to worry about.now fast forward 10 years, i have had dry skin,itchy skin,break out,hair falling out,eye site is bad,achy joints and muscles,trouble sleeping, i am gluten intolerant (6Months G free) weight loss (30lbs in 7months) and my neck is swollen more then it ever was..i have problems turning my neck sometimes,i cant wear anything around my neck it feels like its chocking me. I had a blood test at the my drs back in October 2012 he noticed one side of my thyroid was enlarged so we tested..Test came back fine.should i push my dr to do an ultra sound and FNA of my thyroid again??(last one was 10 years) i also have swollen lymph’s around my throat is this normal with the swelling of the thyroid and or goiter?could this have anything to do with the gluten intolerance?
    Thank you.

  28. Glory says:

    I had tooth decay but was told not to extract it so i kept using home remedies lyk brushing with oral b toothpaste n usin pain relievers and though teeths hv holes i stoppd experiencing pain for almost a year. Recently,i experiencd pain again and i took relief tab and got better but now its ma jaw. wat i dnt knw is if its TMJ or mumps/goiter cos i cnt open my mouth well,bt cn do dat nw wit little pain. Also i cant swallow saliva cos i feel pain inside ma cheekbone/under ma tongue and i discoverd dat ma ryt side jaw is getting swollen ,dats under ma chin/cheekbone. i’m scared of surgery what do i do? tnx

    • Glory I’m afraid the tooth problems have increased in intensity and you have to consult a dentist as soon as possible. The symptoms you have mentioned would mean a surgeon need to have a look on TM joints and neck swellings. Good luck.

  29. Anu Kumolu-Johnson says:

    Got this swell on the left side of my neck for the past three years. Done CT Scan and biopsy. Yet they find nothing. Am tired and feeling sad about this all the time. God help me. Need advise.

    • If even after the CT and biopsy, there is nothing of the disease process then there is no harm in asking a surgeon to remove it. Biopsy usually means taking out the whole tissue and then examining it. That should be done to make things even clearer. Don’t be sad please.

  30. Josh says:

    Hello Dr, I was looking for a little extra advice on my swollen glands, I’ve only had them for four days but I’m concerned as I have four in the neck region all on the right side. I have a medium sized boil on the back of my neck slighlty to the right which I have a feeling may be connected, I have had no other symptoms at all. I eat healthy and exercise three or four times a week. Should I seek medical advice or wait it out? Many thanks Josh.

    • Josh the boil on the back of your neck may be the culprit and causing the lymph nodes to swell. Ideally one of the swellings (other than the boil) should be taken out (there is a procedure called Fine Needla Aspiration – FNA) by which a gland is removed painlessly and then subjected to pathological examination. That would allay all your fear for now and for the future. Good luck

      Afaq A.Q.

  31. Jay says:

    Hello Dr. Afaq,
    I came across your article while trying to look up some type of hypothesis for a problem of mine relating to what might possibly be a Goiter. I’m going to seek medical advice but I just wanted to know if I have either Hashimoto’s/Graves/Hypo/Hyperthyroid. About a week ago I started feeling very small aches throughout my body (leg, arm, upper chest, right side of neck) and paid no mind since the ache was so mild, and then a few days after I started noticing I have been getting more sensitive to cold, and whenever I would lay down my shoulder and left side of my chest would have small pangs of aches, but still I paid no attention. It was until two nights ago I looked in my bathroom mirror and examined my neck carefully, and the bottom portion of my neck was puffy. I would say the left and right side of my neck is puffy but the center is not, at least I think it’s not when I feel it. The puffiness is not hard, but soft and there is no pain whatsoever, not even when I touch it or press it lightly. Today I had an episode of dizziness but that may be due to the fact that I’m stressing a lot over it. What could it be? I know I can’t be for sure but I would love to know your insight on this. I’m really hoping I won’t have to rely on Thyroid medicine for the rest of my life.

    • Dear Jay,

      Most important thing to remember is that there are very very rare chances that you’d be on a medication for the rest of your life.
      By the description of it, it can be Thyroiditis. Accurate diagnosis can only be made through a biopsy for which I am sure you have contacted an ENT or Thyroid surgeon.
      Good luck.

  32. I am 34, male working as managerial editor in a publishing house. I have been having an approx. 3cm-long painless lump in the right, lateral neck area for the past two weeks now. I have a history of chronic tonsilitis since age 11 years and hyperacidity since age 14 years. I smoke 2-3 times a day. I am a non-alcoholic and a vegetarian. I have already taken a 5-day course of antibiotics (Cefuroxime Axetil 500mg + Potassium Clavulanate 125mg), with no visible change. Can you kindly advise?

  33. zoopoo says:

    Hey doc, I am 15 years of age so far these nodes have been swollen for around maybe 8 months, they are movable and only 2 of them are swollen, it doesn’t cause all that much pain but more or less just annoyance, I’ve been to two doctors both of which have said I’m fine. Just a little concerned. They are both under my neck near my adams apple.

    • Dear Zoopoo, consult your nearest ENT doctor and tell him/her that you need to know the exact nature of these swellings and hence want a scan done. Once you have the scan results, you’d know what is it that you are dealing with. Whatever it is, I am sure it is benign and non troubling. Good luck.

      • zoopoo says:

        Thank you for the help! I did have labrinthitis at a young age (Unsure of spelling sorry) not sure if that could be the cause of anything, I was informed that it would take up to 10 years to fully recover from

        • What would take upto 10 years to heal? Labyrinthitis? That is an ear disease and can be very troublesome. Good thing you don’t have any complications:) But as far as I know that infection can only be remotely connected to present day problems. So do see a doctor and explain things to him. Good luck.

          Afaq A. Q.

  34. ritvika says:

    hello
    i had 2 wisdom teeth removed in the right side 3 months ago.After that i had swelling in my right cheek and pain in right side jaw for which the dentist treated me for TMJ. i went to ENT specialist too and he told me there is nothing to worry about the swelling and gave me some antibiotics. From past 2 weeks i have on and off pain in my right jaw and swelling in right side of my neck and shoulder. After i take a painkiller, the swelling in my neck goes away. Recently my dentist cleaned my teeth and i am using a night guard coz i have bruxism and teeth clenching habit due to stress. My teeth are fine but i experience pain in right side jaw,ear and there is swelling in my right side neck for which i am worried. All this started after the tooth extraction. Lately m under a lot of stress and worried about my health. please tell me what are the possibilities. I have seen 4 dentists and 1 ENT specialist so far. My left side is absolutely fine whereas right neck swells up and goes down. Please help me i am worried and scared.

    • Dear Ritvika, Thanks for sharing and commenting. In my opinion the problem lies in TMJ of the right side. You need not worry or be scared because may be after the tooth extraction there was some trauma to TMJ which takes some time to heal. If you know somebody working in Ultrasound department, contact him/her, and ask for an ultrasound of your neck. That will clear any doubts in your mind about the swelling.
      Good luck.

      • ritvika says:

        thank you for your prompt reply. I am using night guard and not taking stress at all and the pain has disappeared as of now. I got USG done a month back of my parotid gland on both sides and the reports are normal. I will get treatment done for TMJ. Its a big relief.Can u suggest me some exercises or home remedies for TMJ. thank u

  35. nash says:

    Hello doc. I must thank you for all the help and information available on this site found it really enlightening.
    I have a problem, I have had this swelling on the bottom right side of my neck for about four days now and there is a bit of discomfort associated with it. Prior to this I had a high body temperature for a couple of weeks(3) to be exact. I was certain that it was a thyroid gland swollen but a pharmacist told me that it is not … So what can it be doc. Thanks for the reply

    • Your pharmacist friend seems to be right in evaluating the nature of the swelling; but please keep in mind that in addition to thyroid gland swellings, lymph nodes are pretty common in the same areas of the neck and the site of swelling you have mentioned, could be an enlarged node. My suggestion is see the nearest doctor who might like to run some blood tests and if needed, a scan of the neck. Hope it turns out to be a minor problem. Good luck.

  36. Dear dr, i have a swelling first on my right neck, but then around 2 days later a swell suddenly grew on my left neck, so now i have a swelling on both sides of my neck. Te be honest with u after reading some articles im really starting to worry, im scared doctor, i havent told my parents cause i dont want to make them worried. I was not sick or anything but yes i had only about 3-4 hours of sleep before the swell started. Can this swell go away in a few days? Please let me know assap, please doctor. Im 17 years old n male btw. Im just really shocked about the things that could happen to me doctor, this swell i have started around 4 days ago, i really do not want to go to the doctor if this is not so serious doc, i really hope its not serious and it can go away.

  37. MidWestWingedOne says:

    Dear Doc – the glands in my neck have been swollen for over 2 years – I seem to feel little nodules around my throat as well – deep near the voicebox. My breathing has been more labored of late (I am a regular runner so I notice it) and I have a constricted feeling around under my jaw. BOTH of my parents died of surprise lymphoma in summer of 2010. We were told it was statistically impossible for them both to have the same cancer, in the same site appear at the same time (living separately for 3 years before). I haven’t checked it out because people may think I’m crazy. It has definitely affected my singing and breathing. Sound crazy to you?

    • No, it absolutely does not sound crazy. I wonder why the opinion that it is statistically impossible for both parents to have the same disease. My suggestion in this scenario is to go for a biopsy of one of these swellings because Lymphoma/ Hodgkin’s Lymphoma are notorious to have a very symptomless start. I wish you all the best for a happy new year and may your disease/ problem gets settled as soon as possible.
      Kind regards.

  38. Altaf says:

    Salaam doctor.
    I have had this swelling in the right side of my neck for more than 18 months now. Went to so many doctors but they seemed to find nothing serious. Had some thyroid tests done, T3 T4 TSH etc and they came out normal everytime. Docs would prescribe some anti-inflammatory medicines and nothing else, but the swelling never went away. To describe it properly- there is a slight swelling (not movable) on right side of my neck, below the ear lobe and it seems to come to the front right side slightly. Normally when i keep my head straight, it doesn’t show much swelling. But when i turn my head to the right, it does show up. At times (usually when i’m mindful of it) i feel discomfort and uneasiness while being still or when swallowing. The swelling doesn’t usually hurt when touched but feels uneasy. I’m really worried sometimes about it. I hope it isn’t something serious. What do you suggest?

    • Dear Altaf.

      Thanks for such a clear cut description of your swelling. Most probably it is a swollen lymph node which is why most doctors have told you not to worry about it. If at any time, it gives you pain or discomfort, do consult an surgeon and ask for excision biopsy. That should solve the problem. Best of luck and happy new year.
      Afaq.

      • Altaf says:

        thanx for the clarification doctor. But aren’t lymph nodes movable and somewhat concentrated at a point? (Because i have one on the left side of my neck and i can feel it move). But this swelling that i’ve earlier mentioned isn’t concentrated at one point! It’s, to say, diffused from the front of neck, rightwards and up till the back of the ear.

  39. prabhat says:

    Hi doctor
    I have developed pain in my left lower neck ( on starting of collarbone towards chest) from last 2 days.I dont have fever or any other prblm.
    there is swelling which can only felt by touchng it is not visible in mirror.
    there is very little pain and its when i touch it and a very smalll lump( dont know its a right medical word)just on start of my collarbone.
    shall i take it seriously?

    • Hello Prabhat.

      I read your message in detail. The site you have mentioned is more likely to be a seat of an enlarged lymph node. It can be very harmless and benign but ideally a physician must see it, palpate it and then tell you what exactly it is. May be he asks you for some lab tests, go for them, as they will help establishing the cause of this swelling. Good luck

      Dr. Afaq.

  40. Nicole says:

    Hello Dr. Qureshi,
    Thanks for your site and advice on here. For 3 months, I have had a rubber-band feeling around my upper neck (around the outside of my throat). My lymph nodes on both sides of my neck are swollen to grape size and there was no infection. I also have slight swelling of my left thyroid lobe. Do you think this lymph node swelling is the cause of the rubber-band constricting feeling in my upper neck?

    • Dear Nicole,

      The stretch feeling may well be due to the grape sized swellings on both sides of the neck. Ideally a surgeon should take a biopsy of one of these swellings and determine what is causing them. These may and may not relate to the thyroid swelling. Important thing is to have a FNAC (fine needle aspiration) of the gland as well. That will establish the nature of these swellings and the proper treatment will ensue.
      Kind regards,

      Dr. Afaq.

  41. Basil Varghese says:

    Hi Doctor,
    Thanks for your valuable advice through this site,and you doing a great job.I am suffering with a swollen area on my lower neck area. i went to the doctor and he said I am having a small enlargement in my thyroid, and sent blood for checking the TSH.Blood results come back normal and TSH value is 1.5. Can you just tell me is there any other possible cause? or there will be any goitre without making any changes in the TSH.

    Thanks
    Basil

    • Thanks Basil.

      I think there can be a Thyroid enlargement with the TSH levels you have mentioned. There is no contradiction. In my opinion you should go in for a thyroid scan (isotope or ultrasound) which will confirm the presence or absence of a mass in your lower neck.
      Good luck.
      with kind regards.
      Afaq.

  42. simeon says:

    Hello Doctor,
    Thank you for all the information, causes and treatment of swellings in the neck. I really appreciate it. I will be very grateful if u can advice me on what to do concerning my own situation.
    I noticed a swell on one side of my neck some days ago, one afternoon while. The swell is not too obvious but anytime I try to swallow spit while standing and looking at the mirror I notice movement up and down.
    This swell I think brought about me having cold and catarrh and feeling feverish after some days.
    Pls advice me on what to do.
    Thanks. Looking forward to hearing from you.

    • Thanks Simeon. The swelling on one side of the neck should always be taken seriously. At present, according to the symptoms and history it may be nothing but an enlarged lymph node and should go away after your catarrh and flu subsides. But it is advisable to get a doctor’s opinion. So please consult a nearest one. Good luck.
      Kind regards.
      Afaq.

  43. ally ivory says:

    I have been having neck problems since april 30 2012.I took a pill and it felt stuck. The doc used a scope and sent me home. Here it is july 2nd It still feel as if something is stuck I have problems eating. Can you please help doc

    • If the doctor have used a scope to check your throat, he must have told you something. For immediate relief you can use warm water gargles with aspiring dissolved in it. Make sure you are not allergic to Aspirin however. Good luck. Let me know the scope results.
      Kind regards.

  44. Rafatullah Sharqi says:

    Dear doctor,
    One friend of mine has had a swelling in the area around right neck and lower jaw for more than 15 days. He has had antibiotics, reduction and then enlargement again in their condition, CT scan but it has persisted. Now the doctors are lining up the MRI scan and biopsy if required after that.
    Could you suggest what could be the possible diagnosis and ould it be malignant in any way.
    Thanks,
    Rafat

  45. Teri says:

    Hello Dr.
    I have two swollen areas on either side of my neck that began 6 weeks ago after I took two prescribed Lyrica pills. The swelling was much more at that time, along with a rash in the center of my neck and upper chest. I was admitted to the hospital for 3 days with a severe allergic reaction and treated with steroids and benadryl. My eyes were very bloodshot and swollen too. Things have calmed down except i still have the swelling and feel like glands are swollen in my neck and i have quite a bit of ear pain. The swelling comes and goes. I have see more than one Dr. and they all say “wait it out” I also have RA, so I take 5 mg of predsisone everyday. No one seems to know what the swelling is and I am wondering when will it go away. Do you have any ideas of what I might do to help it go down?
    Thank you

    • Dear Teri.
      You probably had a severe allergic reaction which manifested itself in the form of red patches on skin and swollen glands. If there is concomitant ear infection there are chances that nodes (glands) in the neck get swollen. In that case, your physician is right, there is nothing much you can do except to wait it out. However you must be careful not to insert anything in the ear (if there is itching or pain). Is it possible that you can see an ENT doctor (the ear/nose/throat). I feel he/she will be in a better position to ascertain the cause of your neck swelling and hence treat them. Good luck.
      With kind regards and best wishes,
      Afaq.

      • Teri says:

        Hello again and thank you Dr. for answering me,
        Actually I saw an ENT yesterday who saw nothing in my ear to be concerned about. He has given me Nasonex to try though. I take steroids already for my RA. I think much of it is due to having my Auto immune issues. I have also been taking supplements to try and be as healthy as I can and maybe improve this situation.
        I just wish I could feel this ear open, it’s very hard to explain.
        All I can say to others is beware of Lyrica, and drug interactions!

        • Drug interactions and Autoimmune disorders can unfortunately, play havoc with our health. It is a wise thing to warn people of any possible side effects one may be witnessing due to a certain medicine. The pharmaceutical companies not always give us the full picture. I wish your RA keeps getting better. After prolonged use of Steroids sometimes there are spontaneous remissions in the process, I pray you go into one very soon and that it stays longer so that you are spared of the agony of arthritis.

          Good luck and thank you for keeping in touch.

          Kind regards,

          Afaq.

  46. NAZIA says:

    ASSALAM O ALIKUM IAM 35 YEARS OLD AND I HAVE 1 NODE IN MY NECK FROM 1 YEAR WHAT I DO PLZ TELL ME AND PLZ ALSO SAY ME IN WHICH THINGS IODINE I WAIT YOUR ANSWER

    • If there is a single nodule in the neck, it should be promptly examined by a doctor. So my advice is to consult one in your neighborhood. Items with Iodine are listed in the blog. It is found in fish, dairy products etc.

    • Wa alaikum Salam. You do not necessarily need Iodine. For the node in the neck, please consult the nearest doctor who would be in best position to guide you. Don’t delay in getting an appointment however because such a thing can be serious. Good luck.

  47. nat says:

    my child has been diagnosed with mumps,the swelling is in the right neck,I’m just wondering ,the swelling has been there for almost 9 days.How long does the swelling will subside if it’s in the neck? Your answer will be of great help,for me to ease my worry…thank you so much!

  48. ifeyinwa okike says:

    Pls wht can i do to gt. Rid of d mump in my child neck deres a litle swellg unda his ear region by d side on his neck hve given him antibiotic yet its there it disappears nd reappears nd hes alwaz hvg boil i dnt knw if its d cus .tans

    • Thanks for the comment. In my opinion you should consult a Pediatric surgeon for the boil/swelling you are talking about. Please visit the nearest hospital and ask them you need to visit a Pediatric surgeon. They will do the rest. Hope you get out of this very soon. Best of luck.
      Kind regards,
      Dr. Afaq Ahmad Qureshi.

  49. wordsfallfrommyeyes says:

    Hello doctor. First, I really appreciate the story I am telling – the truth I am letting free from my heart.

    Secondly, I thought I’d have a peek of your page & see what you’re about – this is excellent! People ALWAYS have physical grievances.

    You know, I had my tubes tied within the first year of my child’s birth. I have just recently been to a chiropractor and discovered (by xray) that one of the clips has moved FROM MY TUBE TO MY RIB. I don’t know how this happens! But obviously, I am not safe from being pregnant like I thought I was. This was ASTONISHING news to me. I guess you’d have nothing to say because it’s true mistakes happen – but what if they create a human being?!!!

    I still have no understanding, and in fact no apology.

    Great site, doc – very relevant.

    • Hello.

      Thank you so much for your kind words. I read with concern the tube blocking procedure and how the clips have landed onto the rib. I checked in with a gynecologist friend who was of the opinion that it needs to be looked by a gynae/ obs doctor who would endeavor to fix the problem. You are right that there is no guarantee that a pregnancy will not ensue. We can only hope and keep the fingers crossed till an expert in this area can explore the entire situation and take remedial measures. In the meantime let me tell you that you are such a gem of a person and I am so proud to be your friend.

      Love to everyone around you, merry Christmas and a very happy new year.

      Sincerely,

      Afaq.

  50. I’ve been surfing on-line more than 3 hours today, but I never discovered any interesting article like yours. It is lovely value sufficient for me. In my opinion, if all site owners and bloggers made good content material as you did, the web will likely be much more helpful than ever before.

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