Which Specialist to Consult for Post-Stroke Symptoms?

I'm not sure which specialty to see?

Hello Doctor, my mother-in-law fell and had brain surgery five years ago.
For the first two to three years after the surgery, her movements were slower, but she was still able to move and live independently.
However, over the past year, she seems to be gaining more weight and has been complaining of headaches and feeling very cold.
Even in this hot weather, she wears several long-sleeved shirts, refuses to take a shower, and is reluctant to move, even getting out of bed feels like a chore! We initially thought it might be a thyroid issue, but all her test results came back normal, and the doctor is unsure where the problem lies.
We are quite troubled and would like to know which specialist we should consult.
Thank you for your help! ^_^

Lin Qi, 30~39 year old female. Ask Date: 2016/05/04

Dr. Gao Chunde reply Neurology

A consultation with a neurologist can be considered to assess for cognitive decline in the elderly or other neurodegenerative diseases, or to evaluate if the aforementioned conditions are accompanied by emotional issues.
However, it is crucial to first rule out any related side effects caused by medications.

Reply Date: 2016/05/04

More Info

When dealing with post-stroke symptoms, it is crucial to consult the appropriate specialists to ensure comprehensive care and management. In your case, your grandmother has experienced a decline in her physical activity and has reported symptoms such as persistent headaches, a sensation of coldness, and a reluctance to engage in daily activities. Given her history of a brain surgery following a fall, these symptoms could be multifactorial and may require a multidisciplinary approach.

1. Neurologist: The first specialist to consider is a neurologist. They specialize in disorders of the nervous system, including the brain, and can assess whether her symptoms are related to her previous stroke or any new neurological issues. They can conduct a thorough neurological examination and may recommend imaging studies like an MRI or CT scan to rule out any complications from her past surgery or new strokes.

2. Geriatrician: Given your grandmother's age and the complexity of her symptoms, a geriatrician could also be beneficial. Geriatricians specialize in the health care of older adults and can address multiple health issues that may arise in elderly patients, including cognitive decline, mobility issues, and chronic pain management. They can provide a holistic approach to her care.

3. Endocrinologist: Although her thyroid function tests came back normal, if there are still concerns about metabolic issues or hormonal imbalances, consulting an endocrinologist might be warranted. They can evaluate her symptoms in the context of other hormonal disorders that could be contributing to her fatigue and weight gain.

4. Pain Management Specialist: If her headaches are persistent and affecting her quality of life, a pain management specialist could help. They can provide interventions such as medication management, physical therapy, or other modalities to alleviate her pain.

5. Psychiatrist or Psychologist: Given her reluctance to engage in activities and possible depression or anxiety stemming from her health issues, consulting a mental health professional could be beneficial. They can assess her mental health status and provide therapy or medication if needed.

6. Physical Therapist: If her mobility has declined, a physical therapist can help design a rehabilitation program tailored to her needs. They can work on improving her strength, balance, and overall physical function, which may also help alleviate some of her discomfort.

7. Occupational Therapist: An occupational therapist can assist in helping her regain independence in daily activities. They can provide strategies and tools to make her daily tasks easier and more manageable.

In summary, your grandmother's symptoms warrant a comprehensive evaluation by a neurologist, and possibly a geriatrician, to address her neurological health. Additionally, considering her physical and mental well-being, involving specialists in pain management, endocrinology, and mental health may provide a more rounded approach to her care. It is essential to communicate openly with her healthcare providers about all her symptoms and concerns to ensure she receives the best possible care.

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