Can you help narrow down what sort(s) of doctor(s) to see and what to investigate, given these symptoms? All symptoms have cropped up within the last two years. Before that, I felt healthy most of the time. Primary care doc has been little help, and most of the specialists seem to focus only on the symptoms within their own areas of expertise.
posted by anonymous to Health & Fitness (28 answers total) 3 users marked this as a favorite
Hi, I'm a 30 year old woman, and I need medical help. YANMD, but I need to figure out who should be and what I should ask her/him about. I've tried to give a comprehensive (and therefore, long) picture of my health so that any of you who have been through this sort of thing or know more about getting good medical care than I do can make good suggestions.
The problem is that I have a number of different symptoms, all new in the last two years or so, and no idea what's connected and what isn't. My primary care doctor doesn't have any ideas what's going on with me and seems to think all of this must just be a coincidence. He keeps referring me to specialists for my symptoms, but they focus on the symptoms that are within their respective specialties, and no one has been able to tell me whether there might be something systemic going on that explains multiple symptoms. I'm hoping that some of you might be able to suggest a type of doctor or specialist who would be willing to explore causes of multiple symptoms (or help me rule out any connection) rather than just offering treatments for the symptoms.
- Psoriatic dermatitis (red, scaly, flaking, itching skin on my scalp, face, and neck). OTC treatments and prescription shampoo help some, but it hasn't gone away.
- Weight gain (about 50 pounds in the last 18 months). This may just be aging metabolism, but cutting calories and exercise haven't helped at all. If it's just age, I'm willing to accept that. I am not interested in diet or weight loss suggestions. I am not willing to entertain weight loss recommendations. I only want to know whether this is a symptom of a medical condition I should be concerned about.
- Excessive sweating. Basically, every time I do anything remotely aerobic (including walking a few blocks), I get pretty sweaty on my face, chest, armpits, and groin. I'm in relatively good shape and exercise regularly, and I'm not out of breath, so it's not just exertion. I get as sweaty walking the 15 minutes to work in the morning as a do during my hour-long evening workout. Something else seems to be going on.
- Fatigue. I've always had a bit of insomnia, so I'm used to being tired sometimes, but this seems to crop up frequently regardless of how much sleep I get.
- Muscle injuries in my extremities. I've been diagnosed with tendinitis in my wrists and plantar fasciitis in my feet. Standard exercises and braces help, but haven't cured the problem yet. It seems strange to me that my connective tissues would all get injured at the same time.
- Frequent sinus infections. I had these as a kid, then they went away, and now they're back at a rate of 4-6 per year. I had a sinus CT, which showed no blockages that would explain the issue. I'm already doing handwashing to prevent illness, daily sinus rinsing/neti pot, and all the standard stuff.
- Lower back soreness and pain: yoga helps some, but doesn't cure it. I only spend about half the day sitting and the rest standing or moving around. Just got a new mattress, which has also helped a bit. Still, some days, it hurts to move.
- Difficulty concentrating. I have trouble sitting through an hour-long TV show without getting distracted. I end up missing big chunks of story when I'm reading because my mind wanders. I took prescription stimulants for ADD in my early 20s, but didn't like the side effects and found that I worked better without it. This doesn't feel like ADD symptoms. It's less frantic and exciting than that, more like when you're too tired to focus properly, except it happens even when I'm not tired.
- (not sure whether this is relevant, but I'm anonymous, so I might as well say everything) My poo is really soft. I've always had regular, firm, clean poo. Now I get soft, messy poo, I have to go more often, and I sometimes have diarrhea.
Doctors I've already tried:
- Primary care: as I said, very nice man, very willing to refer me to specialists, but not able to offer many big ideas. Do I just need a new primary care specialist? My options are limited because I'm in a restrictive health plan, but I'm willing to look for someone good if anyone can tell me what to look for.
- Dermatologist: gave shampoos/creams/ointments for dermatitis. (I'm assuming that's what it is based on her diagnosis, and my symptoms seem to fit the descriptions and photos I've seen, but I'm willing to entertain other possible explanations.) No help on the sweating (she just said "some people are naturally sweatier than others.")
- Allergist. I have environmental and pet allergies, but I manage them by staying away from animals and taking prescription medication. Food allergy tests were negative.
- ENT. Great for treating the sinus infections, but can't find a good way to prevent them. I am not, my ENT tells me, a candidate for sinus surgery or other drastic measures.
- Endocrinologist: Tests for vitamin deficiency, Cushing syndrome, thyroid disorders were all negative. He had no further suggestions.
- Sleep specialist: I had a sleep study, and while I wake up slightly more than normal, I don't have apnea or any other treatable sleep disorder. She said I should sleep and wake at the same time every day, which I try to do, but I still oversleep a lot and feel fatigued.
Current health stats:
30 years old. BMI: 33 (2 years ago, I was at 28, which looked and felt like a good weight for my body).
Pills taken: allergy pills (prescription), multivitamin, iron supplement, fish oil, vitamin D. I have tried taking B vitamins, with no effect. I am not on hormonal birth control.
Lifestyle: Vegetarian diet, perhaps a bit more sugar than ideal, but plenty of plants and other healthy stuff. I eat fish often enough that I'm not worried about protein deficiency. Yoga 2x/week, exercise classes (boot camp style or boxing) 2x/wk. Walk about 4 miles a day. Spend a lot of time online, though I've been cutting back since the tendinitis in my wrists. I wear sensible shoes. I drink a lot of water. I don't have one of those sedentary jobs where I sit 8 hours a day; I'm up and moving about half the time.
If it turns out that I'm just unlucky and have a lot of unrelated medical symptoms, I can learn to live with that. It could be a lot worse. But given that all of this has started in the last two years or, so, it feels like too much to be just a coincidence. So, any thoughts?
I'm not looking for a diagnosis over the internet (I'm not stupid). I'm also not looking for anything other than scientific, evidence-based medicine. No homeopathy or hypnosis or magic spells. But I would like to brainstorm some ideas about how to get to the bottom of these symptoms. But if anyone can think of anything that I and my doctors haven't tried, I'm all ears. So, what sort of doctor should I see, and what should we try?