KAREN FLOYD ABDOMINAL PAIN LATEST 2023 100% GRADED A

How can I help you? My stomach hurts Do you have any other symptoms or concerns we should discuss? I occasionally feel “bloated” although I’m not sure my belly is actually bigger when I feel that way. I…well pass a lot of gas and… even belch a lot compared to other people I know. Sort of embarrassing for a woman you know. Do you think that’s related to all of this? Is your pain affected by what, when, or how much you eat? It seems to be worse with rich foods. I haven’t really noticed it as associated with when or how much. Do you now or have you ever smoked or chewed tobacco? No, I never have. Are you taking any over the counter or herbal medications? I take a multivitamin daily, and acetaminophen from time to time for stress headaches Are you taking any prescription medications? No prescription medications Do you have any allergies? Not that I know of Have you ever been hospitalized? Just for the c-section and the bike accident thing Any previous medical, surgical, or dental procedures? I had a c-section at 27 without any complications. When I was 17, I had a bike accident and had a complicated fracture of my right tibia. They had to fix that with surgery. Can you tell me about any current or past medical problems you have had? I don’t know really what’s important. The only thing besides this stomach problem is that lately I’ve been getting occasional hot flashes and my skin is sort of dry. I also get headaches now and then which isn’t new and that probably isn’t important anyway. Is that the kind of things you want to know? Do you have diarrhea? Occasionally. Sometimes I’d say my bowel movement is loose and watery. Does that count? Is there any blood in your stools or with your bowel movement? Anything red? Not that I have noticed Do you have a problem with constipation? Definitely. For as long as I can recall in my adult life, I have alternating periods of constipation and just the opposite if you know what I mean that lasts several days. When I am constipated, I feel like I cannot get everything out, even after a BM. Have you been having fevers? I don’t think so, can you check that for me How often does this abdominal pain occur? It’s been coming and going for years now. It never really goes away entirely, but then it also doesn’t seem to be getting a lot worse. It’s just there all the time. So frustrating. How severe (1-10 scale) is your abdominal pain? It varies, sometimes it’s just mild and annoying, other times it stops me in my tracks it’s so bad Does the pain in your abdomen radiate someplace else? Where? No, it’s just in my stomach Where more precisely is your abdominal pain? All over, especially in the lower half of my belly. What does the pain/discomfort in your abdomen feel like? (Cramping, burning, stabbing, aching, tingling, squeezing). Usually like a bad cramp but sometimes it can be a stabbing feeling. Does anything make the pain in your abdomen better or worse? “Having a bowel movement sometimes makes it better. Then it starts up again if I’m stressed out or eating the wrong stuff”. When did your abdominal pain start? This problem started at least 10 years ago. It’s really been going on far too long. Do your symptoms occur after eating rye, wheat, or barley? No What are the events surrounding the start of your abdominal pain? I don't remember a particular event. Have you or any family member had a history of IBD? No, I’ve never heard that about anyone Are you now or have you ever been anemic? No one has ever told me that Do you avoid eating because you are worried about pain? Sometimes maybe I do. I mean when my stomach is hurting I don’t feel much like eating. Do you have any skin problems? Just a little dry. I haven’t noticed anything else. Do you have a history of a bowel obstruction? No, nothing that dramatic. Have you or any family member had a history of colon polyps or colon cancer? No, we do not. Do you have black tar-like or foul- smelling stools? No, I’ve never had anything like that. Have you lost weight? No How long does the pain in your abdomen last? Sometimes a few minutes, sometimes up to an hour Have you had the pain in your abdomen before? Yes, this same sort of pain on and off Do you have arthritis? No, I’m lucky with that Do you have heart disease and/or have you ever had a heart attack? No, I do not have heart problems. No, I do not have heart problems. Tell me about your work I am a manager at a local restaurant. I have very long workdays… I usually work late into the night. Have you had a recent endoscopy, colonoscopy, or biopsy? Uh… No. When and what was the result of your last mammogram? I haven’t had one yet. Too busy. Physical Exam Blood pressure 120/60, normal, normotensive Cognitive Alert and oriented x 4 Pulse 60, regular, normal RR 14, regular, unlabored Temp 98.6 Inspect skin overall Dry skin, otherwise unremarkable