Should I See a Doctor? Navigating Multiple Health Concerns

Should I seek medical attention? Which specialty should I consult?

Hello, Doctor: I have some questions I would like to consult you about.

1.
Menstrual irregularities.
My symptoms include periods that last over a week each time.
The longest has been two to three months, with varying flow—sometimes heavy, sometimes light, and occasionally fluctuating between the two.
I have never had a regular cycle, making it impossible to predict when my period will come.
Often, my period returns one to two weeks after it ends, and sometimes it stops for one to three months.
This has been going on for over ten years.
2.
I have developed hemorrhoids that protrude whenever I use the restroom or squat.
Although I can push them back in with my hand, a small portion remains outside the anus and cannot be reinserted.
3.
I experience sharp pain in my ear that lasts only a few seconds and occurs infrequently, but it has been happening more often recently.
4.
I have been constipated for at least ten years, and my lower abdomen is distended.
No matter how much I try to lose weight, I cannot seem to reduce it, even though my BMI is only around 17.
5.
A previous health check at school indicated that I have no hepatitis B antibodies, so I received one vaccine dose but have not returned for further vaccinations.
6.
I have persistent allergic rhinitis, which forces me to breathe through my mouth because nasal breathing is difficult.
This is especially problematic when I run, as I feel oxygen-deprived, struggle to breathe, and experience dizziness and instability.
Should I seek medical attention? Do I need to get the hepatitis B vaccine again? If I need to see a doctor, I believe I should consult obstetrics and gynecology, gastroenterology, proctology, and otolaryngology, but I am unsure where to start.
If medication is necessary, I am concerned that taking multiple medications might harm my liver and kidneys.
Additionally, I worry that this might waste healthcare resources.
Is there a way to thoroughly improve all of my symptoms without seeing a doctor or taking medication? I apologize for the many questions, and I appreciate your help! Thank you!

Xing Er, 20~29 year old female. Ask Date: 2009/12/10

Dr. Cai Mengru reply Family Medicine

Dear Ms.
Hsing,
Your concerns can generally be categorized into several areas:
1.
Menstrual Issues: It is advisable to consult a gynecologist to rule out any structural problems (such as tumors or endometriosis).
Additionally, your dizziness and shortness of breath may be related to anemia, which also needs to be addressed by managing the gynecological issues first.
2.
Hemorrhoids: Given your situation, hemorrhoids are unlikely to resolve on their own, and they are significantly related to your constipation.
Therefore, it is recommended to consult a colorectal surgeon for proper management of both constipation and hemorrhoids.
3.
Ear Pain: If the occurrence is infrequent or not severe, immediate medical attention may not be necessary.
Upper respiratory viral infections or allergic rhinitis can cause Eustachian tube dysfunction, leading to ear pain, which usually resolves on its own.
However, if the pain persists or worsens, you should see an otolaryngologist.
4.
Hepatitis B Vaccine: There is a standard vaccination schedule.
If you received your first dose a long time ago, you will need to restart the series.
The complete vaccination requires doses at 0, 1, and 6 months.
5.
Allergic Rhinitis: While it can be challenging to cure, in addition to oral antihistamines, there are steroid nasal sprays that are quite safe and effective.
You may want to discuss this option with your physician.
Many of your issues may not necessarily require medication, but delaying medical consultation can turn minor problems into major ones.
It is best to take a more proactive approach regarding your health!
Wishing you safety and health,
Dr.
Tsai Meng-Ju
Attending Physician, Family Medicine
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2009/12/10

More Info

Navigating multiple health concerns can be overwhelming, especially when symptoms are chronic and varied, as you've described. It’s essential to approach your situation methodically to ensure you receive the appropriate care without feeling burdened by the healthcare system. Here’s a breakdown of your concerns and recommendations on how to proceed.

1. Menstrual Irregularities
Your experience with prolonged and irregular menstrual cycles over the past decade is concerning. Such symptoms can be indicative of various underlying conditions, including hormonal imbalances, polycystic ovary syndrome (PCOS), or other gynecological issues. It is crucial to consult a gynecologist who can perform the necessary evaluations, such as hormone level tests and possibly imaging studies, to determine the cause of your irregularities.

2. Hemorrhoids
The presence of hemorrhoids that protrude during bowel movements is another issue that warrants attention. While they can often be managed with lifestyle changes and topical treatments, persistent or severe cases may require surgical intervention. A consultation with a colorectal surgeon or a gastroenterologist would be appropriate to assess the severity of your condition and discuss treatment options.

3. Ear Pain
The intermittent ear pain you experience could be related to several factors, including ear infections, Eustachian tube dysfunction, or even referred pain from dental issues. An ENT (ear, nose, and throat) specialist can help diagnose the cause of your ear pain and recommend appropriate treatment.

4. Chronic Constipation
Chronic constipation can significantly impact your quality of life and may be related to dietary habits, hydration levels, or underlying gastrointestinal disorders. A gastroenterologist can help identify the root cause and suggest dietary changes, medications, or other interventions to alleviate your symptoms.

5. Hepatitis B Vaccination
Since you mentioned that you lack antibodies for Hepatitis B, it is advisable to complete the vaccination series. This vaccine is crucial for preventing Hepatitis B infection, especially if you are at risk. You should consult your primary care physician or a specialist in infectious diseases to discuss your vaccination status and any follow-up doses you may need.

6. Allergic Rhinitis
Your allergic rhinitis, which is causing difficulty in breathing through your nose, can be managed with antihistamines, nasal corticosteroids, or other allergy medications. An allergist can help identify specific triggers and recommend a tailored treatment plan, which may include allergy testing.

Should You See a Doctor?
Given the complexity and duration of your symptoms, it is advisable to seek medical attention. While it may seem daunting to visit multiple specialists, addressing each concern systematically is essential for your overall health. You might consider starting with a primary care physician who can coordinate your care and refer you to the appropriate specialists based on your most pressing issues.

Managing Multiple Medications
You expressed concern about the potential for medications to harm your liver and kidneys. This is a valid concern, especially when managing multiple health issues. A healthcare provider can help you navigate this by reviewing your medications, considering potential interactions, and monitoring your liver and kidney function through regular blood tests.

Conclusion
While it may feel like a burden to seek medical care, addressing these issues is crucial for your long-term health and well-being. It’s understandable to worry about utilizing healthcare resources, but your health should be the priority. By consulting with the appropriate specialists, you can develop a comprehensive treatment plan that addresses all your concerns effectively. Remember, early intervention can often prevent more severe complications down the line. Don’t hesitate to reach out for help; you deserve to feel better.

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