Systemic Pain and Allergies: Seeking the Right Specialist

Generalized tingling, itching, and numbness?

Hello, Doctor: I was diagnosed with severe allergic rhinitis in mid-September last year, and I have experienced many symptoms including sneezing, runny nose, chest tightness, chest pain, palpitations, abdominal pain, tingling in the soles of my feet, headaches, brittle nails that grow quickly, tingling in my palms, joint pain in my hands, and difficulty breathing.
I also have erythema and atopic dermatitis.
In the morning, I wake up with thick mucus in my mouth and white hair, my skin is rough, and I have memory issues.
The doctor said I have dementia.
I have symptoms similar to osteoporosis and menopause, but when I consulted a gynecologist, they said I am not experiencing menopausal symptoms and advised me to supplement with soy milk and protein-rich foods.
I also visited an allergist and rheumatologist, but they couldn't identify any allergens and only prescribed medication for allergic rhinitis.
I am sensitive to fragrances and scents; the doctor suggested I take showers with a three-point method and wash my hair with plain water, avoiding all skincare products.
Although I am feeling somewhat better, I continue to experience frequent sneezing and a runny nose.
I have visited all relevant specialty clinics, but my most severe issue now is difficulty breathing, with phlegm stuck in my throat and nose that I cannot expel, and my primary physician mentioned that I have autonomic nervous system dysfunction.
I would like to ask which specialty I should consult for these symptoms.
Thank you.

Yang Shuzhen, 60~69 year old female. Ask Date: 2024/06/15

Dr. Li Jiaxuan reply Otolaryngology

In the field of otolaryngology, it is recommended to examine the sinuses to differentiate the diagnosis of chronic sinusitis.
Nasal irrigation may also be considered, as postmenopausal changes can lead to thinning of the nasal mucosa.
Allergic conditions may be more pronounced in some individuals.
It is advisable to avoid overly irritating odors or foods in daily life.
Wishing you well.

Reply Date: 2024/06/15

More Info

It sounds like you are experiencing a complex array of symptoms that are affecting your daily life significantly. Your symptoms, including severe allergic rhinitis, chest tightness, palpitations, abdominal pain, and joint pain, among others, suggest a multifaceted health issue that may involve both physical and psychological components.
Given the variety of symptoms you are experiencing, it is crucial to approach your situation holistically. Here are some insights into your symptoms and recommendations for specialists you might consider consulting:
1. Allergies and Immunology: Since you have been diagnosed with severe allergic rhinitis and have experienced various allergic symptoms, it would be beneficial to continue working with an allergist or immunologist. They can perform comprehensive allergy testing to identify specific allergens that may be triggering your symptoms. Additionally, they can provide you with a tailored treatment plan, which may include medications, allergy shots, or lifestyle modifications to minimize exposure to allergens.

2. Pulmonology: Your symptoms of chest tightness, difficulty breathing, and phlegm accumulation may indicate an underlying respiratory issue. A pulmonologist can evaluate your lung function and determine if conditions such as asthma, chronic obstructive pulmonary disease (COPD), or other respiratory disorders are contributing to your symptoms. They can also provide treatments such as inhalers or nebulizers to help manage your breathing difficulties.

3. Rheumatology: The joint pain and other systemic symptoms you mentioned could suggest an autoimmune or inflammatory condition. A rheumatologist specializes in diagnosing and treating conditions like rheumatoid arthritis, lupus, or fibromyalgia, which can present with systemic pain and joint issues. They can perform specific tests to rule out these conditions and offer appropriate treatment options.

4. Neurology: Given your mention of cognitive issues and symptoms that may suggest autonomic nervous system involvement, a neurologist could help assess whether there are any neurological conditions contributing to your symptoms. They can evaluate your cognitive function and provide insights into managing symptoms related to memory and concentration.

5. Psychiatry/Psychology: Chronic illness can often lead to psychological distress, including anxiety and depression, which may exacerbate physical symptoms. A mental health professional can help you develop coping strategies and may recommend therapy or medication to help manage any psychological symptoms you may be experiencing.

6. Nutrition and Dietetics: Since you mentioned dietary recommendations, consulting with a registered dietitian could be beneficial. They can help you create a balanced diet that supports your overall health and addresses any specific dietary needs related to your symptoms.

7. Physical Therapy: If you are experiencing joint pain and stiffness, physical therapy may help improve your mobility and reduce discomfort. A physical therapist can design a personalized exercise program to strengthen your muscles and improve your overall physical function.

In summary, your symptoms are complex and may require a multidisciplinary approach for effective management. It is essential to communicate openly with your healthcare providers about all your symptoms and concerns. Keeping a symptom diary may also help your doctors understand the patterns and triggers of your symptoms better. This comprehensive approach can lead to a more accurate diagnosis and a tailored treatment plan that addresses both your physical and psychological health.

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