Shoshanna Tillman Follow Up Sick Visit: Musculoskeletal Shadow Health

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Table of Contents

Greet 05/24/23 12:15 PM EDT

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Hi.

Why are you here today?

Question 05/24/23 12:34 PM EDT

I’m here to follow up on my last visit, about my joint pain, and how tired I’ve been.

Sorry about that

Empathize 05/24/23 12:34 PM EDT

Thank you.

How long have you had joint pain?

Question 05/24/23 12:35 PM EDT

The joint pain started about 3 months ago, now.

Where is the joint point located?

Question 05/24/23 12:36 PM EDT

In my hands and wrists, mainly, but also I have this all-over sort of pain.

Is your pain like? (Clarified to Can you describe your pain?.)

Question 05/24/23 12:38 PM EDT

I feel sort of stiff and achy all over. And my hands and wrists are stiff — there’s this dull, throbbing sort of pain. (Clarified to what the pain is like.)

What worsens your pain?

Question 05/24/23 12:38 PM EDT

Holding my coffee cup in the morning is tough on my hands and fingers, and my wrists. Also typing and holding my art tools hurts after a while.

What relieves your pain?

Question 05/24/23 12:39 PM EDT

Long, hot showers can help a little. Also, the diclofenac has been helping some.

Can you rate your pain on a scale of 1 to ten? Shoshanna Tillman Follow Up Sick Visit: Musculoskeletal Shadow Health Transcript

Question 05/24/23 12:40 PM EDT

Conditions of the Hematologic System Anita Douglas Shadow Health

I still have pain, but since starting the diclofenac, maybe a 2 out of 10. Before it was a 3 or 4.

How long have you had fatigue

Question 05/24/23 12:41 PM EDT

Going on 3 months now.

Is your fatigue constant?

Question 05/24/23 12:41 PM EDT

Always, yeah.

Does your fatigue worsen?

Question 05/24/23 12:42 PM EDT

Yeah, the fatigue feels worse as the day goes on.

What makes your fatigue worse?

Question 05/24/23 12:44 PM EDT

Nothing, I don’t think . . . but I am pretty stressed regularly.

I am sorry about that

Empathize 05/24/23 12:44 PM EDT

I appreciate that.

Are you able to do your daily activities?

Question 05/24/23 12:45 PM EDT

I guess so, yeah. I can do everything I need to. I just take a little longer these days, ’cause I’m so tired. And I sometimes just feel drained after everything.

What causes your fatigue?

Question 05/24/23 12:45 PM EDT

I don’t know why I’m so tired. I haven’t noticed anything that makes me particularly tired. Maybe it’s hormones or something. Or stress, I’m very stressed these days.

Any allergies?

Question 05/24/23 12:45 PM EDT

Yeah, a codeine allergy.

Any food allergies?

Question 05/24/23 12:46 PM EDT

Nope.

How frequent is your pain?

Question 05/24/23 12:46 PM EDT

It’s constant, honestly. It can feel the worst when I wake up in the morning.

Any current health problems?

Question 05/24/23 12:48 PM EDT

Follow Up Sick Visit: Musculoskeletal Shoshanna Tillman Shadow Health treatment plan

Besides my joint pain, and how tired I am all the time, I don’t have anything I’ve been diagnosed with.

Have you had any mental condition?

Question 05/24/23 12:48 PM EDT

I don’t have any clinical disorders or anything, but I’ve been feeling kind of down lately, and pretty anxious.

I’m sorry about that (No matching questions found.)

Question 05/24/23 12:50 PM EDT

I’m sorry about that

Empathize 05/24/23 12:50 PM EDT

That’s kind of you.

Have you been hospitalized?

Question 05/24/23 12:50 PM EDT

Just for my 3 deliveries.

Have you had surgeries?

Question 05/24/23 12:51 PM EDT

No.

Are you using any medications?

Question 05/24/23 12:51 PM EDT

Yep, diclofenac. I used to take ibuprofen. And I have an IUD, if that counts.

What is the dose to the diclofenac?

Question 05/24/23 12:51 PM EDT

The dose is diclofenac sodium 50 mg.

Why do you take the diclofenac?

Question 05/24/23 12:52 PM EDT

I was prescribed diclofenac at my last visit for my joint pain.

What is the dosage of Ibuprofen?

Question 05/24/23 12:52 PM EDT

I was taking 400 milligrams at a time, 2 or 3 times a day.

Which IUD are you using?

Question 05/24/23 12:54 PM EDT

My IUD is levonorgestrel.

Do you take your medications

as prescribed?

Question 05/24/23 12:54 PM EDT

Yes, very.

When did you last take your medication Shoshanna Tillman Follow Up Sick Visit: Musculoskeletal Shadow Health Transcript

Question 05/24/23 12:55 PM EDT

This morning. I took my diclofenac.

Do you use tobacco?

Question 05/24/23 12:55 PM EDT

I never have, no.

Do you drink alcohol every day? (Clarified to Do you drink alcohol?.)

Question 05/24/23 12:55 PM EDT

Sure, yeah. (Clarified to if I drink alcohol.)

What is your typical diet

Question 05/24/23 12:56 PM EDT

I try and eat pretty healthily. Breakfast, I’ll have fruit and yogurt, or I’ll make the kids and I eggs and pancakes on the weekends. Lunch, I really like salads, soups, tacos, and wraps. Dinner, we’ll have salmon or chicken, often with a side of veggies and a grain, pasta, or legumes. If I really need a snack, maybe I’ll have some almonds, or some fruit . . . maybe a granola bar, or some hummus with carrots.

How much water do you drink per day?

Question 05/24/23 12:57 PM EDT

I’ll usually have between, say, 6 to 8 glasses a day.

Do you take caffeine?

Question 05/24/23 12:58 PM EDT

I do. I’ll have somewhere between 2 to 3 cups of coffee in the morning, then another one or two in the afternoon.

OK, but too much caffeine is not good for your health

Educate 05/24/23 12:58 PM EDT

Ah, OK.

Do you exercise?

Question 05/24/23 12:58 PM EDT

I probably could be exercising more. I just don’t have a lot of time or energy. I’ll walk the dog 3 or 4 times a week, which is something. But I used to do these yoga classes, and spin classes, but those don’t really make sense for me now.

I understand your concern but you should always exercise

Educate 05/24/23 1:00 PM EDT

Ah, I see.

How many hours of sleep do you get per day?

Question 05/24/23 1:00 PM EDT

5 or 6 hours a night.

What is your occupation?

Question 05/24/23 1:00 PM EDT

I own and operate an art gallery called Bricolage with my husband. I’m also an artist, and sometimes I contribute pieces to the gallery.

What is your occupation?

Question 05/24/23 1:01 PM EDT

I own and operate an art gallery called Bricolage with my husband. I’m also an artist, and sometimes I contribute pieces to the gallery.

What is your level of education?

Question 05/24/23 1:02 PM EDT

I have a BFA in studio art and a BA in art history.

Do you make enough money at your job?

Question 05/24/23 1:02 PM EDT

Now, the gallery is turning a profit and we’re making sufficient income. It’s still a new business, so it’s taken a while to get it here, but that could change. Running a small business is hard and uncertain, especially in the art world.

Any stress? Shoshanna Tillman Follow Up Sick Visit: Musculoskeletal Shadow Health Transcript

Follow Up Sick Visit: Musculoskeletal Shoshanna Tillman Shadow Health treatment plan