Seeking Medical Advice: Which Specialty to Consult for Unexplained Symptoms?

If you're feeling unwell and are unsure which department to visit, I recommend starting with a general practitioner or family medicine physician. They can assess your symptoms and refer you to the appropriate specialist if necessary. Thank you?

Hello: My mother, Chen Li-Man (A201736404), informed me a few months ago that she has been experiencing a sensation of oily granules between her teeth, which felt like small pebbles.
Initially, we thought it was a psychological issue, but a few days ago, we discovered that the substance she is expelling resembles a smaller version of fish liver oil.
She has been consuming a significant amount of Quaker Oxygen Ginseng Chicken Essence, having taken over 100 bottles.
Is it possible to test this product? It appears to be an oily substance, and we still have about 30 to 40 bottles at home, so I temporarily advise her not to consume it.

The doctor suggested that she could swallow it, but she might choke.
Recently, this issue has caused her some depression.
Over the past few months, she has seen specialists in otolaryngology, dentistry, oral medicine, neurology, family medicine, and infectious diseases.
Blood tests have been conducted, and the results were normal.
I inquired about the possibility of a saliva test, but the responses from the doctors were negative.

The doctors have been unable to determine the cause of her symptoms, and now I would like to ask the Ministry of Health and Welfare how to proceed with further examinations.
We do not want to keep going to the hospital for unnecessary medical resources or ineffective medications.
Recently, I received a voice notification from the National Health Insurance Administration regarding unusual usage of her health insurance card, but I am unsure if it is related to a fraud group.

Could the Ministry of Health and Welfare please provide guidance on which department to consult and how to proceed with effective treatment? Thank you.

Miss Chen, 30~39 year old female. Ask Date: 2013/12/10

Dr. Liao Yaopan reply Family Medicine

Hello, based on the information in your letter, it is currently not possible to determine the cause of the symptoms presented or to make a diagnosis.
You should have already arranged for several basic blood tests, and no specific abnormalities were found.
As for the saliva analysis you mentioned, there is currently no such clinical test available.
If you are looking for analysis of specific substances, I recommend consulting the Clinical Toxicology Laboratory at Taipei Veterans General Hospital, which offers self-paid testing services.
However, the decision should still be based on the patient's symptoms and made by a qualified physician.
You can start by calling for a consultation, and I hope this suggestion is helpful.
Thank you for your letter.
Changhua Hospital cares about you.

Reply Date: 2013/12/10

More Info

Hello,
I understand that you are facing a challenging situation regarding your mother's unexplained symptoms, particularly the unusual oily substance that is being expelled from her mouth. It’s commendable that you are seeking further medical advice and trying to ensure that she receives the appropriate care.

Given the complexity of her symptoms and the various specialists she has already consulted—ENT, dental, oral, neurology, and infectious disease—it seems that a multidisciplinary approach may be necessary. Since her symptoms have not been clearly diagnosed, I recommend considering a few options for further evaluation:
1. Gastroenterology: Since the symptoms involve the mouth and could potentially be related to digestive issues, a gastroenterologist may be able to identify any underlying gastrointestinal problems that could be causing these symptoms. They can perform tests such as an endoscopy or imaging studies to assess the digestive tract.

2. Allergy and Immunology: If there is a possibility that the symptoms could be related to an allergic reaction or an immune response, consulting an allergist might be beneficial. They can conduct tests to determine if there are any allergens contributing to her symptoms.

3. Internal Medicine: An internist can provide a comprehensive evaluation of her overall health and help coordinate care among the various specialists. They can also perform a thorough review of her medical history and current medications to identify any potential interactions or side effects.

4. Oral Medicine or Oral Pathology: These specialists focus specifically on diseases of the mouth and may have more insight into unusual oral symptoms. They can perform biopsies or other diagnostic tests to determine if there is a pathological cause for the symptoms.

Regarding the product your mother has been consuming, it is wise to stop its use until you can determine if it is contributing to her symptoms. If you suspect that the product may be harmful, you can contact the manufacturer for information on testing or consult with a toxicologist for advice on potential risks associated with its ingredients.

In terms of further testing, if saliva tests are not being offered by her current providers, you might want to inquire about the possibility of a referral to a specialized lab that can conduct such tests. Additionally, if you feel that her symptoms are causing her distress or impacting her mental health, it may be beneficial to consult a psychiatrist or psychologist who can provide support and coping strategies.

Lastly, regarding the concerns about the healthcare system and the potential misuse of her health insurance, it’s important to keep a close eye on her medical records and any communications from the health insurance provider. If you suspect fraud, you should report it to the appropriate authorities.

In summary, I recommend consulting with a gastroenterologist, allergist, internist, or oral medicine specialist for further evaluation of your mother's symptoms. It’s crucial to continue advocating for her health and seeking answers, as unexplained symptoms can often require persistence to diagnose and treat effectively. I wish you and your mother the best in finding the answers and care you need.

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