<s>[INST] My younger brother is experiencing extreme neck and shoulder pain. He also suffers from migraines. A family friend, a retired nurse, has felt the lumps in his shoulders and neck and says it s his glands that are swollen. He has no appetite. Has had significant weight lose. He was already thin to start with. He is also very fatigued. He is out of work, but is looking for something. That means...no insurance. Just trying to figure out what might be going on with him. [/INST] Lumps, glands, fatigue, loss of appetite. It shows infection somewhere, but fever is not mentioned. Any cough? Lump and glands could be due to some blunt trauma in nearby area too and in response, defense forces, the glands, lumps appear to fight any possible infection. This is natural mechanism. Blood tests for TLC, DLC and ESR are must decide the diagnosis. Even if insurance is not there, try to get these done as soon as possible. Till then if you can find Anchor and Hard Chat Doctor.  This will fight mild infection and lymphatic nodes will normalize. I suggest to my patients till they are advised to take heavy antibiotics for such problems. This will help you. But please do not ignore further tests. </s>