Hello Dr Jim,
Please accept my apologies for not replying you all these days.
I did my consultation with the patient last week. Her three main concerns were irregular menstrual cycles, high creatinine levels and high blood pressure.
He was also evaluated by a Nephrologist and was found to have scarring on the Kidneys, where is the right was functioning only 64% and the left kidney was functioning 36%. So they came to the conclusion that - high creatinine levels are due to reduced kidney functioning. The cause of scarring in the kidneys is yet to be ascertained.
The heamatologist also felt that there is a problem with the bone marrow which is contributing towards thrombocytosis.
My analysis was this - she has had very long standing emotional problems right from the childhood due to incompatibility between her parents, so had to live with grand parents along with his brother. Another brother who lived with her parents, passed away due to mental and emotional problems along with alocoholism.
Even though she had all kinds of problems, fared well in academics and worked hard to get a good job. In this event, she lost her grandmother also suddenly which left her very insecure and vulnerable emotionally.
Following this, she developed these conditions. But her menstrual cycles were always an issue right from menarchy. Presently her cycles are very irregular, occuring once in 2 - 3 months. Whenever she gets her cycle, it is very heavy for the first 3 - 4 days with severe back pain and pain in the abdomen with cramps. She also has lots of clots passing. She need to take rest and some how manages to work with pain killers, which she has been taking for many years now.
This irregular cycles are not allowing her to convieve, which she is quite eager. At the same time, husband also is suffering from Migraine, Oligo asthenospermia with sperm count being 2 million/ml, when the normal counts should be around 20 million/ml.
Has also been suffering from Migraine headache very frequently. Presently, it is under control after she started to take aspirin tablets for her thrombocytosis. The migraine was usually triggered by exposure to sun, missing meals, lack of sleep, stress, emotional upsets. It was also associated with nausea and vomitting.
The other main concern for her is that of high creatinine levels. She is eager to get this corrected.
She is not much concerned about her high blood pressure, as she is taking anti-hypertensives which has controlled her blood pressure within normal limits.
She also has sleep disturbances, feels that she hasn't slept the whole night. Feels like she has been in dreaming state through out the night. Feels tired in the morning.
She also is a very perfectionist, leading to fights with husband and stress on herself.
Her pulse was deep, weak and wiry. Tongue had some white coating all over.
This was my reading. Do let me know your opinion on the same.