Which Specialist Should I See for My Health Concerns?

Which department should I consult?

Hello Dr.
Chen! I have three symptoms: 1.
About a year ago, after giving birth to my second child and completing my postpartum confinement, I started experiencing stiffness in the joints near my heels every morning upon waking, along with heel pain that makes it difficult to walk normally.
However, after forcing myself to walk for a short while, it improves within five minutes.
If I take a long nap during the day, I experience the same issue upon waking.
Interestingly, when I stayed overnight at a relative's house in Taipei during the Lunar New Year, I did not experience these symptoms.
2.
Additionally, I had a sharp pain on the left side of my scalp that felt like being cut with a knife, followed by a dull, shifting pain.
Prior to this, I had occasional dizziness and have been experiencing significant forgetfulness that seems to be worsening.
I struggle to recall familiar words or names, often taking a long time to think of them.
3.
Recently, during a wave of cold weather, I experienced shortness of breath and chest tightness.
Several years ago, I had two episodes of angina that felt like the sharp pain I described earlier.
After seeking medical attention, the doctor diagnosed me with severe arrhythmia.
However, I did not take medication due to concerns about potential effects on my child during pregnancy.
Now that I am not working, the doctor said I could manage it without medication.
Given these symptoms (1, 2, and 3), I am unsure which specialty I should consult.
Should I see a rheumatologist, a neurologist, or a cardiologist? I am worried that high cholesterol may be causing these issues.
I would greatly appreciate your detailed response.
Thank you very much! Sincerely, Kǎi Kǎi's Mom, 2008/03/12

Kai Kai Ma, 30~39 year old female. Ask Date: 2008/03/12

Dr. Chen Yuchao reply Family Medicine

1.
About a year ago, I gave birth to my second child.
After completing my postpartum confinement, I started experiencing stiffness in the joints near my heels and pain in my heels every morning about six months after delivery, making it difficult to walk normally.
However, after forcing myself to walk for a few minutes, the pain subsided.
I also noticed the same issue if I took a long nap during the day.
Interestingly, when I stayed overnight at a relative's house in Taipei during the Lunar New Year, I did not experience these symptoms.

2.
Additionally, I once had a sharp pain at the top of my left head, as if it had been cut with a knife, followed by a dull, shifting pain.
Prior to this, I had occasionally experienced dizziness.
I have also been particularly forgetful, and the situation has worsened, making it difficult for me to recall familiar words or names without taking a long time to think.
3.
Recently, with the waves of cold weather, I experienced shortness of breath and chest tightness.
Several years ago, I had two episodes of angina, which felt like the sharp pain I described earlier.
After seeking medical attention, the doctor informed me that I had severe arrhythmia.
However, I did not take medication because I was concerned about the effects on my unborn child, and now that I am not working, the doctor said I could manage it without medication.

Given the above points 1, 2, and 3, I am unsure which specialist I should see.
Should I consult a rheumatologist, a neurologist, or a cardiologist? I am very worried that high cholesterol might be causing these issues.
I have various symptoms and would like to see a family medicine physician, who will take a detailed medical history and refer me to the appropriate specialist for further evaluation.

Reply Date: 2008/03/12

More Info

Hello, and thank you for reaching out with your health concerns. Based on the symptoms you've described, it seems you may benefit from consultations with multiple specialists to address the various issues you're experiencing. Let's break down your symptoms and the appropriate specialists to consider.

1. Joint Pain and Stiffness: Your description of ankle stiffness and pain, particularly after periods of inactivity, suggests a possible musculoskeletal issue. This could be related to conditions such as arthritis or tendinitis, which are common after pregnancy due to hormonal changes and physical stress. A Rheumatologist would be a suitable specialist to evaluate your joint symptoms, especially if there is a concern about autoimmune conditions or inflammatory arthritis.

2. Neurological Symptoms: The sharp pain on your left head and the subsequent dull pain, along with dizziness and memory issues, indicate potential neurological concerns. These symptoms could be related to migraines, tension headaches, or even more serious conditions. A Neurologist would be the appropriate specialist to assess these symptoms. They can perform necessary imaging studies, such as an MRI or CT scan, to rule out any serious conditions affecting your brain.

3. Cardiovascular Concerns: Given your history of chest pain and heart issues, including previous episodes of angina and irregular heartbeats, it is crucial to consult a Cardiologist. They can evaluate your heart health, possibly perform an echocardiogram, stress test, or other diagnostic tests to assess your cardiovascular status, especially since you have concerns about cholesterol levels.

4. General Health and Preventive Care: Since you have multiple health concerns, it may also be beneficial to see a Primary Care Physician (PCP). They can provide a comprehensive evaluation of your overall health, coordinate care among specialists, and help manage any preventive health measures, including monitoring cholesterol levels and other risk factors.

Given your recent pregnancy, it’s also important to consider that hormonal changes can affect various bodily systems, including the musculoskeletal and cardiovascular systems. Your PCP can help determine if any of your symptoms are related to postpartum changes.

In summary, I recommend the following steps:
- Schedule an appointment with a Rheumatologist for your joint pain and stiffness.

- Consult a Neurologist for your head pain, dizziness, and memory issues.

- See a Cardiologist to evaluate your heart health and any cardiovascular symptoms.

- Consider visiting a Primary Care Physician for a holistic view of your health and to coordinate care among the specialists.

It's understandable to feel anxious about your health, especially with multiple symptoms. Make sure to communicate all your concerns to each specialist, as they can provide tailored advice and treatment options. Additionally, keeping a record of your symptoms, including when they occur and their severity, can be helpful for your doctors.

Take care, and I hope you find the answers and relief you need soon!

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