Are You Seeing The Wrong Doctor?
Are you seeing the wrong doctor? "There are approximately 60 different types of doctors and specialists, so [choosing the right one] can seem pretty overwhelming," E.R. physician Dr. Travis Stork says.
Ophthalmologist Dr. Brian Boxer Wachler, dermatologist Dr. Sandra Lee and cardiologist Dr. John Kennedy join The Doctors to explain how certain body conditions may require an appointment with a specialist. But which specialist should you see? The answers may surprise you.
Body Condition: Hiccups
Hiccups occur when an involuntary spasm contracts the diaphragm, the large sheet of muscle that separates the chest cavity from the abdominal cavity. The contraction causes an intake of breath that is stopped by the closure of the vocal cords, causing the hiccup sound. Hiccups can be triggered by eating too quickly, drinking too much alcohol, swallowing air, smoking, a sudden change in stomach temperature and emotional stress or excitement.
Dr. Boxer Wachler, Dr. Lee and Dr. Kennedy reveal their favorite home remedies to halt hiccups.
“In most cases, hiccups aren’t anything to worry about,” Dr. Travis says. “But every now and then, particularly when [hiccups] will not go away on their own and they’re constant, over days and weeks, you may be referred to one of these three specialists.” Dr. Kennedy explains why you may be referred to a cardiologist for prolonged hiccups.
“When we get exertional or effort-related hiccups, it can be an atypical presentation of angina, or blocked arteries,” Dr. Kennedy explains. “If you’re climbing a flight of stairs and you get hiccups, see a cardiologist. Don’t stand on your head and drink a glass of water.”
Body Condition: Blisters
Blisters are typically caused by friction, too much sun exposure, contact burns or an infection. “Normally, a fluid-filled blister is going to go away on its own," Dr. Travis says. "But, in the case of a blister on the tip of your nose, interestingly, this may be a reason to see your ophthalmologist."
“A [blister or] rash on the tip of the nose is actually a classic sign for early [onset] shingles,” Dr. Boxer Wachler explains. "The name of this sign is called Hutchinson's sign."
“A lot of people don’t realize that the chickenpox virus [lies] dormant in the back of our nerve root, by the spinal cord,” Dr. Boxer Wachler explains. "So, when we get older and the immune system starts to decrease, the virus comes out and [travels] down the nerve root.
“If [shingles] spreads and hits the eye, then we’ve got to start [really aggressive] treatment with anti-virals [and] oral steroids,” Dr. Boxer Wachler adds. “Try to keep your health and immune system up as you get older, because that helps keep that chickenpox virus [contained] so it doesn’t come out and cause all this damage."
Body Condition: Tender, Tingling Tush
Unlike sciatica, which causes sharp pains that radiate from the lower back and the side of the buttocks down into the legs, a painful, tingling sensation in the middle of your buttocks could signify something unexpected.
“Tingling in the [central] buttock area is actually a common way for dermatologists to [diagnose] genital herpes,” Dr. Lee says. “Genital herpes is more prevalent in the population than you would think."
Genital herpes, also known as herpes simplex virus 2, is the most common sexually transmitted disease. One out of five men and one out of four women is affected.
Herpes is caused by a viral infection, but can be an elusive disease as symptoms are not always present. The virus is very contagious and is spread through skin-to-skin contact and sexual fluids. There is no cure, and once the virus is in your system, it hides in the nerve cells. Outbreaks can occur as seldom as once per year or so often that they seem continuous. What triggers these outbreaks is unknown, but stress is often considered a contributing factor. Doctors can prescribe anti-viral medications to help control the outbreaks.
Dr. Lee explains how genital herpes can present itself around the buttocks, with sensitivity and/or a cluster of blisters.
"You can also do a serologic test, a blood test," Dr. Lee adds. "That will let you know if you've ever been exposed to this virus. Many of us would be surprised to know that we actually have been exposed to [the herpes virus], but we've maybe never shown signs of it."
“If you go see your primary care physician and they see [any of] these problems, they will refer you to the appropriate specialist,” Dr. Travis adds.
Non-Surgical Tummy Tuck
After three pregnancies, Kelly, 30, was left with loose, saggy skin on her stomach.
Plastic surgeon Dr. Drew Ordon asks, “Who do you go see for loose skin on your tummy? Is it the plastic surgeon or is it the dermatologist? [The answer is]: potentially both.
“Unfortunately, no amount of diet and exercise is going to cure [loose skin]. You are a good candidate for a tummy tuck,” Dr. Ordon explains to Kelly. “We could do a mini tummy tuck through a small incision: tighten those muscles and remove that little bit of overhang.”
However, other noninvasive or minimally invasive procedures can be performed to tighten sagging skin. Dr. Lee demonstrates how Viora Reaction ReFit, the latest radiofrequency device, is an alternative to surgery. The body-contouring machine features patented technology known as CORE (Channeling Optimized Radiofrequency Energy).
“With this device, you are able to treat at multiple frequencies, so you can be more specific with the [treatment],” Dr. Lee explains. “You can treat cellulite, you can tighten skin and it has a vacuum, so you can suck the tissue up and penetrate more deeply. [There is also] a specific hand-piece to actually target stretch marks, as well.
“You can [also] use this [radiofrequency device] to treat the neck, the thighs [and] the tush,” Dr. Lee adds.
For optimal results, the treatment requires six to eight sessions, spaced out over two-week increments. Single-session maintenance treatments are also recommended every six months to retain results.
Abbie, in Phoenix, Arizona, asks The Doctors what could be causing her husband’s right pectoral chest pain.
“Most of the time, for men, pain their chest area is musculoskeletal,” Dr. Travis says. “Musculoskeletal pain can [occur] from working out, pushing the lawnmower [or] moving furniture. That inflammation and strain should resolve on its own."
Redness and irritation around the nipples, usually associated with running, biking and surfing can cause sensitivity and pain around the pectoral muscles. Mastitis, or inflammation of the breast tissue, can also be an underlying cause of soreness, and can develop in both men and women.
“Breast cancer in men exists and it’s a pretty scary thing because it has a tendency to be more malignant,” Dr. Ordon explains.
“If you see [that] there are any unexplained masses or pains in your breast, go see a doctor,” Dr. Travis adds. “If it were breast cancer [for a male], you would see the same breast cancer specialist that you would see as a female.”
Finding the Right Specialist
Fourteen-year-old Christa experienced a debilitating bout of headaches over the course of two weeks in 2008. She underwent an MRI and doctors found a cyst in the pineal gland region of her brain, in the exact center of her skull.
“[The Doctors] really didn’t attribute the headaches to that cyst,” Christa’s mother, Heather, explains. “They said, ‘[She] must’ve had a virus, but while we were in there, we found this cyst and we should keep monitoring it.’”
Christa began to experience blurred vision and a stinging, burning sensation throughout her body. After seeing multiple specialists, such as pain management doctors, rheumatologists, ophthalmologists, dermatologists and neurologists, Christa and Heather received differing opinions on whether Christa’s symptoms could be attributed to the cyst. “The scariest feeling is not knowing,” Christa says.
Three years later, an updated MRI showed that the size of the tumor was significantly enlarged, and doctors finally agreed that Christa should undergo surgery to have the growth removed.
“It’s the most dangerous brain surgery there is,” Heather says. “So many doctors [said that] there was no way they could do it.”
Christa’s parents join The Doctors to discuss the trials and tribulations of finding the right neurosurgeon to perform Christa’s high-risk brain surgery.