Your Symptoms: When to Seek Medical Help in Family Medicine

Is it considered a disease?!

It seems that about a year or two ago, I started experiencing sudden chest tightness, making it difficult to breathe and causing rapid breathing.
It felt like I was struggling to get air.
Later on, it seemed to improve somewhat, but recently, I have started feeling that way again, struggling to breathe.
My chest feels really uncomfortable.
Recently, I've also been experiencing frequent urination; just drinking a little bit makes me run to the bathroom several times, and I often feel very thirsty.
I frequently feel like I’m not hungry, even though my appetite is quite large.
However, as soon as I take a bite of food, my stomach starts to hurt a lot, even though I eat slowly.
I have also been feeling a dull pain at the back of my head.
I went to see a doctor and had blood tests done, which came back normal.
Should I see a doctor again? If so, which specialty would be most appropriate?

Ting, 10~19 year old female. Ask Date: 2006/07/17

Dr. Cai Jueren reply Family Medicine

Hello, your concerns can be explained in two aspects.
The first issue may be related to arrhythmia or emotional chest tightness.
If there is no family history of similar symptoms or heart disease, then based on your age, it is likely to be emotional chest tightness, which typically resolves on its own after an episode.
If you are still concerned, I recommend getting an electrocardiogram (ECG) for clarification.

Regarding the second issue, doctors usually suspect diabetes if there is a family history.
In that case, you should return to the hospital to consult with a family medicine physician for further testing.
If there is no family history and assuming you have a normal body weight with normal blood test results, I suggest adjusting your lifestyle, which should help improve your condition.
However, if you are part of the obese population, it is advisable to return to the hospital for a follow-up with a family medicine physician.
I hope the above answers can help alleviate your concerns.

Reply Date: 2006/07/17

More Info

It sounds like you are experiencing a range of distressing symptoms that are affecting your quality of life. Based on your description, you have been dealing with chest tightness, difficulty breathing, frequent urination, increased thirst, abdominal pain, and persistent headaches. These symptoms can be quite concerning and warrant further evaluation.

First and foremost, it's important to understand that while some symptoms may seem isolated, they can often be interconnected. For instance, chest tightness and difficulty breathing could be related to anxiety or panic attacks, especially if they have occurred in episodes. However, they could also indicate a more serious underlying condition, such as a cardiovascular issue or respiratory problem. Frequent urination and increased thirst could suggest a metabolic issue, such as diabetes, especially if you are experiencing changes in appetite and weight. The abdominal pain you describe could be related to gastrointestinal issues, which could also be exacerbated by stress or anxiety.

Given that you have already seen a doctor and had blood tests that came back normal, it may be beneficial to seek a second opinion or further evaluation. Sometimes, symptoms can be subtle or not easily identifiable through standard tests. A comprehensive approach is often necessary to get to the root of the problem.

In terms of which specialty to consult, it may be wise to start with a family medicine physician or a general practitioner. They can perform a thorough evaluation, including a detailed history and physical examination, and may order additional tests if needed. If they suspect a specific issue, they can refer you to a specialist, such as a cardiologist for heart-related symptoms, a pulmonologist for respiratory issues, or a gastroenterologist for digestive concerns.

Additionally, considering the psychological aspect of your symptoms, it might be helpful to consult a mental health professional. Anxiety and stress can manifest physically, and addressing these issues through therapy or counseling could provide relief from some of your symptoms. Cognitive-behavioral therapy (CBT) is particularly effective for managing anxiety and can help you develop coping strategies.

It's also essential to keep a symptom diary. Documenting when your symptoms occur, their severity, and any potential triggers can provide valuable information to your healthcare provider. This can help them understand the pattern of your symptoms and guide them in making a diagnosis.

In summary, while your initial tests may have come back normal, your ongoing symptoms should not be ignored. Seeking further medical evaluation is advisable, and starting with a family medicine physician would be a good step. They can help coordinate your care and refer you to specialists as needed. Additionally, consider addressing any psychological factors that may be contributing to your physical symptoms. Remember, your health is important, and advocating for yourself in the healthcare system is crucial. Don't hesitate to seek help until you find the answers you need.

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