Dr Miriam Shah
Consultant Obstetrician
Royal Hospital
Lowtown
06 April 2019
Dear Dr . shah
Re: oliva hawthorne, aged 40
I am writing to refer mrs. hawthorne who requires further assessment and investigations from your service to confirm whether IUD is shifted or fallen out .
mrs hawthorne was diagnosed with menorbagia and dysmenorrhoea since 2009 and was presmibed cerazette which was cased after 2 yrs to consceive her first child . her symptoms become worse and combined was commenced on 26 september 2012 which was also caused after few months to consecive her second child. mirena coil was inserted on 10 april 2015 as her menarrbage a became with vaginal thrush along with constant in last year.
currently , mrs hawthorne was presented with complaints of menstmeal spothing along with menorrbasia and dysmmorrboea for last 3 months . she has symptoms such as biruitsm and increased sluo greasiness also. removal of IUD was adviced which was unsuccessful due to inability to locate the strings .
mrs.hawthorne is a yoga teacher with active life style . she is a social dribkes and following a is following a vegan diet . she is on ferrow sulphate 200mg daily for iron deficiency anasnic.
Based on the above circumstances it would be extremely beneficial if you evaluate her for following studies .
If you have any queries , do not hesitate to contact me.
Yours Sincerely,
Nurse
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