Unexplained Symptoms: Navigating Complex Health Issues in Family Medicine

Q: Unexplained Symptoms: Navigating Complex Health Issues in Family Medicine

Dear Mr. Lseedead： 1. Since you have been hospitalized and undergone many tests that all returned normal results, I believe that given your age, there shouldn't be any significant issues. 2. The pulmonologist and infectious disease specialist have reviewed your

Unknown etiology?

My normal body temperature ranges from 36.4 to 37.3 degrees Celsius.
I have a history of fatty liver disease, and my mother and her relatives have issues related to hypertension, hyperlipidemia, and gastrointestinal problems.
My father's side has a history of cancer.
I have not monitored my blood pressure regularly, but I generally feel fine.
Since July, I have experienced more severe coughing, chest pain, and an increase in body temperature.
Despite multiple consultations, my average body temperature has gradually risen to between 36.8 and 37.6 degrees Celsius.
Eventually, I was hospitalized for bacterial gastroenteritis, with worsening cough, a slow increase in temperature, and rapid weight fluctuations.
I underwent gastroscopy, blood tests, and stool examinations, which revealed bacterial gastroenteritis and fever, but no additional issues.

Starting from October 25, I continued to experience coughing and chest pain, with my body temperature maintained between 37.3 and 37.6 degrees Celsius.
My heart rate fluctuated between 100-120 beats per minute, and my blood pressure ranged from 100-130 over 80-100.
I continued to visit a general clinic and was referred to infectious disease and pulmonary medicine specialists, where I had chest X-rays taken.
My body temperature later increased to between 37.3 and 37.9 degrees Celsius, with a chance of subsiding in the early morning.
After observing for a few days without improvement, I returned to the clinic on November 11.
When I still did not see improvement by December 11, I was referred to a pulmonologist.
I was prescribed allergy medication and underwent pulmonary function tests, which showed no abnormalities.
My cough has been somewhat suppressed, but my temperature remains primarily between 37.5 and 38.0 degrees Celsius.
The pulmonologist indicated that this does not constitute a fever.
However, I am certain that the thermometer was not inserted correctly, as it mostly measured the ear canal.
Given my symptoms, which include metabolic syndrome, hypertension, hyperlipidemia, fatty liver, prediabetes, palpitations, slight dizziness, and fatigue while I am currently trying to lose weight and control my diet, which specialty should I consult, and what tests should I undergo?

lseedead, 20~29 year old female. Ask Date: 2024/01/06

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Lseedead:
1.
Since you have been hospitalized and undergone many tests that all returned normal results, I believe that given your age, there shouldn't be any significant issues.
2.
The pulmonologist and infectious disease specialist have reviewed your imaging and performed pulmonary function tests, which also showed no problems; I think there shouldn't be any major concerns.
3.
[Your current health status includes metabolic syndrome, hypertension, hyperlipidemia, fatty liver, prediabetes, palpitations, slight dizziness, weight loss, dietary control, and some fatigue]; given these issues, I recommend that you seek assistance from a physician who can help manage metabolic syndrome, hypertension, hyperlipidemia, and prediabetes.
In other words, it would be best for you to have a thorough discussion with your original physician! Your statements also require some clinical clarification.

Reply Date: 2024/01/06

More Info

Navigating complex health issues in family medicine can be quite challenging, especially when multiple unexplained symptoms arise. Based on the information provided, it seems that you are dealing with a multifaceted health situation that includes a history of metabolic syndrome, hypertension, hyperlipidemia, fatty liver disease, and prediabetes, along with recent respiratory symptoms such as persistent cough, chest pain, and fluctuating body temperature.

First and foremost, it is essential to approach this situation holistically. Given your family history of chronic diseases and cancer, it is crucial to maintain regular check-ups and screenings. Here are some steps and considerations that may help you manage your health effectively:
1. Comprehensive Evaluation: Since you have experienced a range of symptoms, it is advisable to consult a family medicine physician or a primary care provider who can conduct a thorough evaluation. This should include a detailed medical history, physical examination, and possibly a review of all previous test results. It may also be beneficial to gather all medical records, including imaging studies, lab results, and any notes from specialists you have seen.

2. Specialist Referrals: Depending on the findings from your primary care physician, you may need referrals to specialists. For instance, a pulmonologist can help evaluate your persistent cough and chest pain, especially if there are concerns about lung function or infections. An endocrinologist may be necessary to address your metabolic syndrome and any related endocrine issues, particularly concerning your prediabetes and lipid levels.

3. Lifestyle Modifications: Given your diagnosis of metabolic syndrome, lifestyle changes are critical. This includes adopting a balanced diet low in saturated fats and sugars, increasing physical activity, and maintaining a healthy weight. Regular exercise can significantly improve cardiovascular health and help manage blood pressure and blood sugar levels.

4. Monitoring Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and managing your condition. For instance, if your cough worsens at certain times or is associated with specific activities, this could provide clues to underlying issues.

5. Mental Health Considerations: Chronic health issues can take a toll on mental health. If you find yourself feeling anxious or depressed about your health, consider speaking with a mental health professional. They can provide support and coping strategies to help you manage the emotional aspects of living with chronic health conditions.

6. Regular Follow-ups: Ensure that you have regular follow-up appointments with your healthcare providers. This is crucial for monitoring your conditions and making necessary adjustments to your treatment plan. If you feel that your concerns are not being addressed adequately, do not hesitate to seek a second opinion.

7. Patient Advocacy: Be your own advocate. If you feel that your symptoms are not being taken seriously or that you are not receiving appropriate care, it is important to voice your concerns. You have the right to ask questions, seek clarification, and request further testing if necessary.

8. Family Support: Involve your family in your health journey. They can provide emotional support and help you adhere to lifestyle changes. Educating them about your conditions can also foster a supportive environment that encourages healthy habits.

In conclusion, managing complex health issues requires a comprehensive and coordinated approach. By working closely with your healthcare team, making necessary lifestyle changes, and actively participating in your care, you can navigate these challenges more effectively. Remember, you are not alone in this journey, and there are resources and support systems available to help you.

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