Stomach pulsation

age,sex,weight,body and face appearance, country, occupation.
ANS.
Age: 60 Sex: F Body: Big (big belly due to 2 caesareans so it’s a big lump hanging down) Quite obese Face appearance: Large face, sunken eyelids drooping, long nose, big cheeks. Country of origin: Pakistan. Occupation: none - housewife
2.
2. Main complaints and other associated troubles.
a)Where is the trouble; The exact locality of the complaint like hands,legs etc; duration of trouble.
ANS.: Trouble in belly, she says theres a ball in her belly behind her belly button, she describes there is a ball which moves upwards because she is obese, and she is better for standing and walking around and apparently salt is good because when she in takes salt then she has an urge o urinate a lot and that relieves the symptoms.
b)What exactly do you feel, Sensation as pain, how pain feels or burn etc.
ANS. Suffocation feels like she wont be able to breath anymore especially when she coughs, because it pulsates also.
c)What are the factors that causes this trouble according to you.
ANS. Sitting down a lot aggravates, and because she is obese that is also a factor.
d)Condition under which the complaint is reduced or you feel better like,cold or hot application,cold or hot weather,position as standing,walking,rest etc.
ANS. Better for standing, better when takes salt (but because she will get high blood pressure she refrains from this) better for walking especially with heavy shoes on.
e)Condition under which the complaint is increased like,cold or hot application,cold or hot weather,position as standing,walking,rest etc.
ANS. Only worse when she is sitting down or lying down, motionless.
f)Any other complaint any where in the body.
ANS. Other complaints are, high blood pressure, type 2 diabetes, arthritis, cholesterol, stomach disorder when she eats
g)Onset time of troubles in detail, i.e which came first, after that what problem and so on.
ANS. Apparently it’s a family thing it also happened to her mum her aunt etc, this problem has been occurring since about 10+ years, then came the arthirtis then one time we went on holiday back home – when we came back she was diagnosed with diabetes and all the other problems
h)Treatment method adopted and its result.
ANS. A lot of trips to docs, gave her a lot of antibiotics, gastric problem medicines, gaviscon, and a whole load of diabetes blood pressure related medicines – some were good but it would give her a lot of side effects, and therefore she doesn’t take them regularly at all, in fact only when shes at her worst then she takes them to give herself temporary relief, she takes nux vomica some times as well, but that only gives her some sort of relief not much at all.

3. History of diseases in family.
ANS. Diabetes, and this problem she describes runs on her mothers side apparently.

4. Personal History.
a)About childhood.
ANS. Grew up in Pakistan, quite happy childhood, spent most of her time being active playing etc
b)Academic performance.
ANS. Didn’t complete school , culturally back then women were not encouraged towards education, but she had the will to learn.
c)Any major incidents in life and the effect of it on life.
ANS. Second youngest in family, one of her brothers has passed away, she has been divorced before because she couldn’t have children and therefore her first husband divorced her, however with her second marriage she has 4 children and is very happy with her life. Her eldest son got married and so did her eldest daughter, however both their partners were siblings, and because of that there were problems in their marriage which caused them to separate for 2 years and during that time the patient went through menopause.
d)How you are satisfied with your sex life, friends, family members, company etc.
ANS. Quite satisfied, few ups and downs in the family but overall happy with her llife. However she can be very stubborn, if she doesn’t get her own way she will emotionally black mail you, however she has the softest and kindest heart, and does cry at anything, it won’t be her problem it could be someone elses problem and she will start crying, shes sensitive like that

5. Habits/Addiction.
a)Smoking, Alcohol,Sleeping pills, Laxative etc.
ANS. N/a
b)Masturbation and frequency.
ANS. N/a

6. How is your Appetite and Thirst.
ANS. Likes to eat delicacies, even though she controls the sugary ones, she likes fatty foods. She tends to keep water on her a lot because she is diabetic and needs to drink when she is feeling hungry to keep herself hydrated.

7. Likes and Dislikes.
a)Alcohol Bread Butter Bitter Salt Sweet Sour Fats Milk Mud Chalk Egg Spicy food Meat Fish Fruits Fried Food
Warm food-drink Cold food-drink Ice Ice cream Chocolates Tea Coffee.
ANS. Likes tea, fried foods, foods that have a kick to it, so a lot of asian food, spices, loves Cod fish, some vegetables like turnips aubergines etc, not a fan of potato
b)Anything else about like and dislike of any activity with you or surrounding.
ANS. Likes to walk because she feels better physically and health wise.

8. Bowel movements.
a)Nature of stool, frequency, satisfactory or not.
ANS. She goes regularly once a day, normal brown stool
b)Any discomforts associated with stool.
ANS. no

9. Urine.
a)Frequency, nature, volume.
ANS. Due to her age she can’t really hold her urine in when she has the urge to go, so she urines often, she can hold it until she reaches the toilet though, but also a little incontinence when she coughs.
b)Any discomfort before, during or after urination/odour
ANS. no

10. For men.
a)Any difference in erection/want of erection/weak erection/Ejaculation early/late.
ANS.
b)Any other trouble in sex.
ANS.

11. For Females.
a)Menses, Regular, Irregular,Early, Late.
ANS.
b)Duration of menses.
ANS.
c)Nature of flow, Scanty, Blood colour, Consistency, Odour, Staining, itching/ when and what makes it worse/better.
ANS.
MENOPAUSE so no more periods, however she was very irregular before marriage because she had PCOS, however after marriage she became regular when she had treatment done, however after her 2nd child she was irregular again (absent menses for 6 months 3 months etc) then she had treatment done again from Pakistan and she became regular after her other 2 children and was regular up until menopause
12. Sleep.
a)The quality of sleep, the quietness or restlessness of sleep,
position of sleep, times of waking and reasons for waking,
need for cover over various parts of the body,
whether the window must be open or closed etc.
common dreams, peculiar sounds or gestures during sleep, etc.
ANS. Not so much of a heavy sleeper, noise has to be little to moderate for her to wake up, when shes feeling hot even in winter, she tends to uncover but she has the always has to keep her feet covered
otherwise she gets really cold. Curtains have to be closed, pitch black that’s when she can sleep. If she wakes up in the night then its probably because she needs to urinate, but this is hardly often as she tends to not drink anything before bed.
13. Sweat
a)How much, what parts, staining, Odour.
ANS. When her blood pressure is high or when she gets really hot, her face goes really red, her upper lip sweats her forehead etc, no staining and she is not really odourous unless it is very hot in which case her back and between her legs she sweats a lot and often between her legs she ends up getting two spots because of the rubbing motion due to the sweat

14. Weather
a)Tolerance to heat and cold, dryness, humidity, weather changes, sun,
foggy weather, wind drafts, closed rooms, etc.
ANS. Prefers warm weather as it ameliorates the stiffness in her legs she needs vitamin D to keep moving, so is better for sun. can’t stand humidity or too warm a room, it needs to be an ok temperature and not cold either. She is very homesick though.

15. Mental Status
a)The quality of the patient's life in relationship to loved ones, family, friends and colleagues. Overall quality of energy available to function in daily life, and under various circumstances.
ANS. Quite motivated for her age, can still get down and dirty to some chores. She is friendly and quite happy with everyone, doesn’t hold grudges at all, welcomes everyone.
b)Any mental/emotional shocks occurring in the patient's life-grief, major financial losses separation from loved ones, death, identity crisis and other stress in life.
ANS. Loss of mother, loss of brother, first marriage didn’t work out, Son ad daughters marriage troubles end up creating problems between her and her brothers and sisters relationships (all sorted out now)
c)Memory,ability to concentrate/comprehend.
ANS. No she is good with understanding
d)Are you fearful of anything eg: Animals, people, being alone, darkness, death, disease, robbers, thunder, storm, high places.
ANS. Fear of death in a way she thinks she will die before she sees her other 2 daughters get married, fear of their future. Fear of childrens future, fear of husbands death fear of fathers death, fear of snakes, fear of losing loved ones
e)Are you anxious about anything: if yes, give details.
ANS. Anxiety about other peoples problems, she loves sacrificing herself for others, even sacrificing her childrens happiness for others
f)Are you impatient.
ANS. When she wants her way she can get impatient, doesn’t like to wait for answers because she wants to please others
g)Are you doubtful or suspicious.
ANS. Sometimes, she is a superstitious person,
h)Are you hurt easily (emotionally)how do you react. Does it cause hatred/revenge.
ANS. No revenge or hatred, just gets hurt and cries about it or bitches about it
i)Does your pride get hurt easily.
ANS. Can’t really tell- probably
j)Are you depressed, if so, reason/circumstances.
ANS. Depressed if she cant get her way in some situations like her daughters marriage, she’ll get depressed and suspicious why her daughter isn’t agreeing to marriage and if its not to someone she wants
k)Do you like to share your problems.
ANS. She shared her problems with her youngest sister and her daughts
l)Effect of consolation.
ANS. she is alright with consolation, in a way she’ll appreciate it if its emotional black mail and she thinks her tears will work to control the other person, or shes alright with consolation benefiting motivation
m)Do you ever become suicidal when? How.
ANS. -
n)Memory- quality if poor, for what ( eg. Names, places, people, what you read).
ANS. standard good memory
o)Do you weep easily, effect of weeping, ie, does it make you worse or better.
ANS. YES! Better for crying it out
p)Are you easily irritated. What makes you angry, how do you express it.
ANS. when she cant get her way with people, and when no one listens to her
q)Are you destructive.
ANS. no
r)How good are you in making decisions.
ANS. alrightish, when shes thinking ahead of the future as well then alright
s)Do you like company or like to remain alone.
ANS. like company
t)How seriously are you affected by disorder and uncleanness in your surroundings.
ANS. likes to tidy up
u)How does failure appear to you?
ANS. cant fail - if you do then should’ve thought about what you have done in the first place and she wont let you live it down
v)Are there any matters that you deeply dislike?
ANS. prefers traditional methods and not modern methods
w)What activities you deeply like? How does it affect your mood?
ANS. loves walking about, as a kid she used to love being active and swimming and running around, now due to older age she can’t do much. Likes sewing clothes
x)Are you affectionate? How does others sorrow affect you?
ANS. shes affectionate, with sorrow she cries it out and cries at other peoples problems too
y)Any present fears in your life or future.
ANS. fear of she wont be able to see her daughters get married into good families and she’ll die before that
z)Any present life or future life desires.
ANS. desire to get both younger daughters married off before death