| Kelly DID finally surface--briefly;
said something about soccer and then vanished into thin air....Luckily,
Inez got sick again! (Way to go Inez!)
So, now, I give you the second episode in
our exciting dramatization of, "I Can't Believe It's Not Butter!"
_________________________________
On Sun, 7 Jan 2007 19:01:21 EST LEWRA@aol.com writes:
Acute Case Questionnaire
1. Describe the complaint in your own words--and
tell when it started and whether it came on suddenly or gradually.
Inez has swollen tonsils and a fever of 100.6. She said
at school yesterday that she was not feeling well then slept (uncharacteristically)
at nap time for over an hour. She woke with the tonsils and developed
a fever by the time we got home (15 minutes). She has slowly been
losing the stuffy nose and cough that were left after her last bout
of tonsillitis(?) about 3 weeks ago.
2. Etiology--meaning, what caused it, if
you know. What was going on at, or around, the time of the occurrence?
Much illness at school. Assorted colds, fevers, sore throats, etc.
It has become quite cold for our temperate climate, so we are inside
more than usual. I think her tonsils are Inez's weak spot, her line
of defense against illness. If she gets sick, they will be the spot
where the illness shows most.
3. Sensation--describe the pain or other
feeling. Does it extend anywhere, does it shoot anywhere? For instance,
"It feels like there's a crumb in my throat, I'm constantly
trying to swallow. The pain shoots to my left ear."
It feels like knives in her throat. While eating, drinking and
while just sitting.
4. Appearance--what does the person, or the
part that's bothering the person, look like; anything remarkable?
Red skin, droopy eyes, etc.?
She is pale-ish. Her throat looks exactly like last time: tonsils
touching, slightly red with a dark red streak running through the
right side. No white spots.
5. Location--where on the body is the complaint
located?
Throat, tonsils. She says her whole neck hurts.
6. Modalities--what makes the complaint better
or worse? Consider: heat or cold, bathing, warm rooms, fresh air,
drafts, motion, time of day when person gets worse, what position
is best/worse; stimuli: conversation, noise, light, touch, pressure,
massage, music, company, consolation, etc.
She says she can't lie down, her neck hurts if she does. She must
sit up. I think her tonsils are so swollen that she feels anxious
about lying back, her breathing may be impaired some. Her voice
is certainly thick sounding.
7. Concomitants (additional symptoms that
came with the main complaint)--for instance, pain with crying; pain
with excessive salivation; pain with nausea--the things that have
come along for the ride, fellow-travelers, in other words.
She has a few itchy spots on her legs and one on her arm. They
look like bug bites that she has scratched open. They are slightly
red and bumpy around them. Not spreading to any other parts so far.
She was itching in the night 2 nights ago, the night before she
got sick.
8. Discharges--color, odor, consistency.
(A discharge is anything liquid that's coming out. So, for instance,
runny nose, diarrhea, lacrymation and so on.)
No runny nose, no sweating, very light colored and small amount
of urine when she woke this morning.
9. Generals--these are all the "I"
symptoms: I'm hot, I'm cold, I'm thirsty, I'm tired, I'm sad, I'm
irritable, I'm hungry, I want pickles, etc.
Not much here, just I don't feel good. I don't want to go to school.
She did say that she should stay home so that she didn't get her
friends sick.
10. The mentals: Have the mentals changed
from normal, in what way? What's different mentally and emotionally?
Droopier than usual. Knitted brow, a little anxious. Wants company
11. What does the person say? For instance:
"I'm fine, leave me alone." "Don't leave!" "I
wanna go home!" "I want ice", etc.
'No, I'm ok." When I offered her anything to eat or drink
last night she just kept saying that. She did eat of all things
at the meal, roast beef, a typical favorite of hers. Today she has
had only a scrambled egg and a small glass of limeade.
12. What is the person doing? For example,
tossing and turning, pacing, fidgeting, moaning and groaning, etc.
Sitting up still in bed. Quietly watching Sesame Street, she now
wants company. "I want some company" are her exact words.
13. Fever?
100.8
14. Sweating? When does the sweating occur?
Where on the body? What's it like?
none
15. Odors? Are odors an issue, such as bad
breath, foul odors of any sort?
Thick stale breath. She hasn't brushed her teeths ince yesterday
morning.
16. What is most striking about the condition or most peculiar--for
instance, person is cold but heat and covers aggravate; person has
burning pains but is better for hot drinks like tea.
Like I said, this seems very like her bout with sore throat 3 weeks
ago but I have twice given her pulsatilla 200c since last night
to no real effect. Last time her tonsils immediately shrunk and
the fever subsided. she did have a lingering cough and stuffiness
though.
She is not interested in any food, not even butter, which I jokingly
offered her last night to which she answered in all seriousness:
"no, I'm ok."
17. Is there a diagnosis? For instance,
flu, teething, etc.
Probably strep throat again.
18. Describe the patient's energy--is he
quiet, restless, agitated, sleepy, prostrated, collapsed, stuporous,
anguished, desperate, etc.
Quiet. Wants company but is sitting still in bed. She is a bit
anxious, her brow knits and she looks at me plaintitively when I
cuddle her.
19. Thirst--is the person thirsty, not thirsty,
what temperature drinks, what kind of drinks, does he only want
sips, or gulps, does he drink a little bit frequently or a lot infrequently,
and so on.
Not thirsty. Won't drink unless I offer the water.
___________________
Does anyone know the answer? Write to me at LEWRA@aol.com
and let me know!
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