Dr Miriam Shah
06 April 2019
Dear Dr Shah,
Re:Ms Olivia Hawthorne, aged 40
Ms Olivia Hawthorne, who is suspected have displaced IUD or fallen out, requires your assessment and further investigations to manage her condition. She is being reffered to your department.
Ms Olivia is married, who had three pregnancies and two live children. In 2009,menorrhagia and dysmenorrhea was diagnosed. She had an elective c-section in 2014.
On 21 April 2009,Ms Olivia complaint of 10 days duration of mentrual bleeding, for which she was commended on cerazette. After two years stopped the tablet to conceive hwr first child. In 2012 resented with deteriorated symptoms;therefore, was commenced on cliest. After a year she ceased the tablet and got pregnant of her second baby.
On 10April 2015,IUD was introduced due to persistent symptoms. Following years, her condition improved. Few days before, revisited with mentrual spotting for the last three months along with increased hairiness and greasiness of skin. IUD removal was recommended ;however, today, the procedure was unsuccessfull due to ineffective to find the strings and patient can not remember the last time when string was located. In addition, negetive pregnancy test was reported.
Based on the aforementioned circumstances, your valuable assessment and necessary investigations were greatly appreciated to improve Ms Olivia health condition.