### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
IF I LEAN BACK, I HAVE A BIG LUMP THE SIZE OF MY FIST BETWEEN THE TOP OF MY RIBS. WHAT  COULD THIS BE? IM GOING TO BE 43 THIS MONTH. I HAD A BABY TWO YEARS AGO THEN HAD MY UTERUS TAKEN OUT CAUSE OF FIBROIDS. NEVER REALLY LOST MY WEIGHT AND STILL LOOK LIKE IM 6 MONTHS PREGNANT. I ALWAYS WENT DOWN WITH MY OTHER CHILDREN. JUST WONDERING WHAT COULD BE GOING ON IN MY STOMACH? THANKS GINNY

### output:

HI, Dear, Thanks for the query from you for your -big lump between top of the ribs? But it's not clear whether it's the top of the lower ribs(Hyperion Chat Doctor. 1-I am happy that you are serious to know why this big lump occurs between the top of your ribs-?2-In my opinion this big fist sized lump between top of your ribs(1st ribs) could be a-Thyroid with extensions underneath the sternum, or it could be -(as at the central angle of the 7th /8th rib cartilages) "-epigastric hernia- post-pregnancy" due to the stretched out abdominal muscles.3-Most probably it is -Epigastric central hernia due to the stretched out recti-abdominis and herniation out of it centrally below the central rib angle, which gives 6 MTV pregnancy appearance -even after delivery, especially when you lean back, with increased intra-abdominal pressures.4-This would explain, what is happening in your stomach-its the post-delivery -Central herniation due to the stretched out- Diversification of the Recto Abdominis.5-I would advise you to see the GAEC surgeon and ER Surgeon-and I would advise hence to treat it with-a-Exercises-to tone up the Recti-abdominis b-with The Abdominal toning belts for at least 3-6 Mrs to reduce the herniation of the big fist size centrally, when one leans back.c-or if no relief, then surgical correction of the Diversification of Recto -would resolve the issue.6-Hence I would suggest you to go to ER Surgeon for the evaluation and treatment of such cases.7-Hope this would resolve the causative worry of the patient in question. If treated on this line, the fearing patient, should not worry you much.8-Hope this would solve your worry of the big fist size central abdominal lumps on top of the rib cage margins, when one leans back after the pregnancy.9-So ugly take -the advice from the ER Surgeon.10-Wellcome to Chat Doctor for any more query.