Case: 53 y.o. female
Complaints: 1.) hot flashes 2.) severe vaginal dryness 3.) Bloating 4.) Insomnia
1.) Hot flashes 8: When she gets hot flashes, she will feel dizzy and light headed. Worse at night, she has trouble sleeping. She doesn’t sweat. Internally, she feels as though she is “evaporating” The sensation lasts for a couple of minutes and then it goes away.
2.) severe vaginal dryness 8: Pain with sex, dryness in more superficial than internal
3.) Bloating 3: new development. bloating after meals.
4.) Insomnia 7: Wakes always at 3am
Hx: Stage 2 Breast cancer ®, lumpectomy with 6 weeks of chemotherapy and radiation (2014). ERP positive.
Other concerns: Right 3rd MCJ - trigger finger - she feels a slight bulge in her finger, usually worse in the am, has to wear a brace on her finger
Right knee pain
Pulse: Rapid, thready
Physical appearance: bright eyed, thin with bloated belly, skin not too dry
Personality: polite, cheerful, self proclaimed constant thinker/high productivity
1st tx: LV+/r SP+/l : Hot flashes subsided alot, vaginal dryness less painful but still dry, felt bodily
heaviness after tx.
2nd tx: ST+: hot flashes still mild 2x/day, slow pulse vaginal dryness better, but now increased
QUESTION: what to do about contradicting sa’am characteristics and conformations?
ie: hot flashes but slow pulse
high degree of productivity/work (LI) but has vaginal dryness