Seeking Effective Solutions for Chronic Health Issues in Elderly Patients - Neurology

I hope you can read this letter?

---

Dear Doctor,
I apologize for disturbing your valuable time, but I hope you can read this letter and provide us with some advice.
As the saying goes, "An elder in the family is like a treasure," we are deeply concerned about my mother-in-law's ongoing health issues and feel at a loss about what to do.
Below is a summary of her long-term ailments and our worries.
My mother-in-law is 54 years old.
She had two abortions at the age of 29 and subsequently gave birth to five children.
One year, she experienced pain in her lower abdomen and noticed blood clots in her menstrual flow.
After consulting a doctor, she was diagnosed with chronic pelvic inflammatory disease, which was deemed incurable and only manageable with pain medication.
By the time she turned 34, the pain worsened, and her menstrual cycle became irregular, occurring every 11-12 days with heavy bleeding and large blood clots.
An ultrasound at another clinic revealed a 5 cm benign uterine fibroid.
During this period, she suffered from severe anemia and fatigue, leading her to undergo surgery at Linkou Chang Gung Memorial Hospital to remove her uterus and one necrotic ovary.
Since then, her once cheerful personality seemed to change drastically; she felt weighed down, experienced palpitations, insomnia, and persistent body aches.
Despite numerous examinations, no clear diagnosis was found.
After enduring these issues for over a decade, at the age of 49, she began hormone therapy, which alleviated all her symptoms.
She continued this treatment for over four years until she read media reports indicating that taking hormones for more than five years significantly increases the risk of breast cancer, prompting her to stop.
It has been nearly a year since she discontinued hormone therapy, and recently, she has felt unwell again.
Initially, she experienced urethral dryness and painful urination, followed by anal fissures.
She also suffers from dry eye syndrome, migraines, and itchy rashes on her hands when exposed to cold water.
Additionally, she has been experiencing intermittent nosebleeds from her left nostril to the throat, with varying amounts of blood, and we are unsure if this is also related to dryness.
Previously, the bleeding would stop after 2-3 days, but this time it has persisted for almost a month.
Various examinations at Changhua Hospital, Show Chwan Hospital, and China Medical University’s ENT and pulmonology departments have yielded no findings.
Last night, she experienced sudden pain in her groin lymph nodes, and the feelings of palpitations, insomnia, and anxiety returned.
Over a decade ago, she had a 2 cm benign tumor removed from the right side of her neck, and now she has multiple benign tumors ranging from 1 cm to 3 cm in size on the front of her neck.
The doctor mentioned that she had already undergone surgery on one side of her thyroid and cannot have surgery again casually.
About ten years ago, after a minor car accident, she began experiencing lower back pain, which worsened due to heavy lifting at work, leading to spinal issues.
Despite seeing various traditional and Western medicine practitioners, she found no relief.
After two years of rehabilitation, the pain intensified, and over a year ago, she underwent a high-frequency thermal coagulation procedure that severed a nerve.
Now, even slight bending, lifting heavy objects, or doing small household chores causes her significant pain.
We are wondering if severing another nerve on the left side could lead to recovery or if she will only be able to continue rehabilitation.
Is there a risk in undergoing this procedure again?
Throughout this time, my mother-in-law has consulted countless doctors, hospitals, clinics, and even alternative medicine practitioners, but none have provided substantial results.
Many doctors have hastily concluded that her issues are primarily psychological without fully listening to her concerns.
As her children, we understand that she tends to worry about her health and her family, but the existence of her ailments is a visible reality.

1.
We have witnessed her vomiting and expelling fresh blood; how can we not be concerned? Is it truly impossible to determine the cause of her symptoms?
2.
Are her various physical issues, such as palpitations, insomnia, urethral dryness, anal fissures, dry eye syndrome, migraines, and itchy rashes from cold water, possibly due to a lack of hormones?
3.
My mother-in-law has benign tumors on her neck and chest, and many new ones have appeared, causing her great anxiety about the possibility of malignancy.
The doctors have advised that surgery carries risks and that regular monitoring is sufficient.
However, after her last check-up, new tumors have developed, leaving her uncertain about what to do.
This has made her hesitant to resume hormone therapy, yet there are no alternative medications without side effects.
Words of comfort from family are not as effective as a medication that alleviates her physical and psychological suffering, along with a positive encouragement from a doctor.
Therefore, I am sending this letter in hopes of receiving an effective treatment plan or medication that can relieve my mother-in-law's prolonged suffering.

Thank you very much in advance!

---

cherry, 20~29 year old female. Ask Date: 2003/03/22