Comprehensive Guide to Common Health Concerns in Family Medicine

Question Set

Dear Dr.
Tsai,
Hello! Please take a look at the following information.
I have many questions regarding medical knowledge, and I would appreciate any information you can provide to help me understand what I should do.
Thank you!
Medical History: I do not smoke, drink alcohol, consume spicy foods, or eat sweets often, and I rarely eat ice.
I have regular meals.
1.
Question One: I have a thyroid nodule (detected three years ago during a school check-up).
Recently, I felt itching near the lower right side of my throat, and upon examination, it was found that I have a nodular goiter with one large nodule on the left and one small nodule on the right (I had blood tests that were normal, ultrasounds at two different hospitals, and a fine needle aspiration once that was benign).
However, the doctor mentioned that the nodules may grow larger.
I would like to have another aspiration at a different hospital because the findings from the two ultrasounds were inconsistent; one doctor mentioned two nodules on the left and one on the right, and they both noted that the right nodule appeared unusual, although it is benign.
Should I proceed with another aspiration? I am concerned whether this could be metastatic from another site, as the doctor seemed puzzled and did not provide much explanation.
Do you recommend seeking a second opinion at another hospital, or do you know of any specialists with more experience? Are there other methods I should consider?
2.
Question Two: I have gastritis (three gastroscopies).
I am very sensitive to spicy foods, and when I experience stomach pain, I also feel pain in my abdomen.
I had an abdominal ultrasound that showed no issues.
What dietary precautions should I take? What exercises can strengthen my stomach and abdomen?
3.
Question Three: Regarding periodontal health, can I use dental floss? Will it cause my gum spaces to widen? Are there other methods to manage this?
4.
Question Four: My eyes are prone to dryness (the sclera appears slightly yellowish and red).
I have been diagnosed with eye stones and conjunctivitis.
Is fatigue the main cause? Are there dietary recommendations to strengthen my eyes and reduce fatigue?
5.
Question Five: I have mild otitis media.
Sometimes I hear a buzzing sound in my ear, and I feel like there is water in my ear.
Can I use a hairdryer to dry it out?
6.
Question Six: Recently, I have been experiencing pain in my right tooth, and the skin around it often appears swollen (as if there is heat).
What could be the cause?
7.
Question Seven: I often experience sudden emotional tension.
When I am anxious, my heartbeat feels irregular, I am sensitive to noise, and I feel restless.
I tend to overthink and feel sleepy during the day (my eyes are dry or I yawn frequently).
I dream every night (often remembering my dreams clearly) and feel easily fatigued.
Is this related to my anxiety? What exercises or dietary supplements should I consider?
8.
Question Eight: I have persistent pain in my lower back (specifically the lower right side).
Does jogging help with back and lower back pain?
9.
I am sensitive to cold (sometimes my hands and feet feel cold and numb).
I tend to shiver easily when swimming, and my lips turn purple.

These are the symptoms I am experiencing.
What dietary supplements should I consider? I would like to know about vitamins or nutritional content if you have any information to share.
Thank you! What could be the reasons for my frequent fatigue? What adjustments should I make? Is practicing Tai Chi beneficial? Please advise me on which specialist I should see.
Thank you!
Weight: 47 kg, Height: 163 cm.

lily, 20~29 year old female. Ask Date: 2004/04/09

Dr. Cai Jueren reply Family Medicine

Your questions are quite broad and not suitable for online discussion; it would be best to visit a clinic in person.

Reply Date: 2004/04/09

More Info

Dear [Name],
Thank you for reaching out with your health concerns. It's clear that you have a variety of symptoms and questions that need to be addressed. I will do my best to provide you with a comprehensive guide based on the information you've shared.

1. Thyroid Nodules
You mentioned having thyroid nodules that were found to be benign after ultrasound and fine-needle aspiration. It's understandable to feel anxious about the possibility of these nodules changing or being indicative of a more serious condition. Generally, benign nodules do not require aggressive treatment, but they should be monitored regularly. If there is any uncertainty or if the nodules are changing, seeking a second opinion from an endocrinologist or a thyroid specialist is advisable. They can provide a more detailed evaluation and may recommend additional imaging or follow-up procedures.

2. Gastritis
For your gastritis, avoiding spicy and acidic foods is crucial, as these can exacerbate your symptoms. Eating smaller, more frequent meals can also help reduce irritation. Incorporating foods that are gentle on the stomach, such as bananas, rice, applesauce, and toast (the BRAT diet), may be beneficial. As for exercise, low-impact activities like walking or yoga can help improve digestion without putting too much strain on your abdomen.

3. Dental Health
Using dental floss is essential for maintaining gum health, and it should not cause your gaps to widen if done correctly. However, if you are experiencing significant gum issues, consider consulting a dentist for a professional cleaning and advice on proper flossing techniques. Regular dental check-ups are crucial for preventing periodontal disease.

4. Eye Health
Dry eyes can be exacerbated by fatigue and environmental factors. To alleviate dryness, consider using artificial tears and ensuring you stay hydrated. Foods rich in omega-3 fatty acids, such as fish, flaxseeds, and walnuts, can support eye health. Additionally, taking regular breaks from screens can help reduce eye strain.

5. Ear Health
For your mild ear infection, it’s best to avoid using a hairdryer in your ear as it can cause burns or worsen the condition. Instead, consult an ENT specialist if symptoms persist. They can provide appropriate treatment and advice on managing ear health.

6. Dental Pain
The pain you’re experiencing in your right tooth and surrounding area could be due to various factors, including dental decay or gum disease. It’s essential to see a dentist for a thorough examination to determine the cause and appropriate treatment.

7. Anxiety and Emotional Health
Your symptoms of anxiety, including palpitations and fatigue, may be interconnected. Regular exercise, mindfulness practices, and a balanced diet can significantly improve mental health. Consider consulting a mental health professional for strategies to manage anxiety effectively.

8. Back and Lower Back Pain
Running can be beneficial for overall fitness, but if you have chronic back pain, it’s crucial to ensure you have proper form and footwear. Strengthening your core and back muscles through targeted exercises can also help alleviate pain.

9. Cold Sensitivity
Feeling cold and having numbness in your extremities can be related to circulation issues or other underlying conditions. It’s advisable to consult a healthcare provider to rule out any serious issues.

Nutritional Considerations
Given your concerns about fatigue and overall health, consider a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Vitamins such as B12, D, and iron are essential for energy levels. A registered dietitian can provide personalized dietary advice based on your specific needs.

Conclusion
Given the complexity of your symptoms, it may be beneficial to establish a relationship with a family physician who can coordinate your care and refer you to specialists as needed. Regular check-ups and open communication with your healthcare providers will be key in managing your health effectively.

If you have further questions or need clarification on any of these points, please feel free to ask. Your health is important, and taking proactive steps can lead to significant improvements.

Best wishes for your health journey!
Sincerely,
Doctor Q&A Teams

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