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I dont know if i ever kentioned how all these started. Let me tell you so you can have a holistic understanding. In aug last year i was diagnosed hypertensive and started medication. Bp was well controlled with meds until oct when i woke up with a panic heart attack, dizzy, palpitations, it was as if i was going to faint. I was rushed to the clinic and was given lexotan, pregabalin and neurovitr forte. I was also being treated for ulcer, malaria and high cholesterol. After doing urinalysis, lipid test kft, xray, ultra scan, ecg and everything came back normal, the cardiologist asked me to stop all medications and take only my bp meds by the next day all symptoms disappeared . I started feeling well and ky bo was okay and even dropping so ny medication was reduced. Until may this year when i woke up ine night with dame feeling of oct last year. I couldnt sleep because of the fear if being woken up with palpitations and fainting feeling. I went to the clinc again and was given lexotan and antimalarial injections. I felt a bit better but immediately i finished the lexotan, i couldnt sleep. I noticed something like a boil in left armpit. It was painful, grew but didnt burst. I put sheabutter on it and tried to put some pressure on it. It only disappeared on its own. By the next week another boil appeared in right armpit. This time around i didnt apply pressure and it removed pus and disappeared. There was a night i woke up with burning feeling in my mod body. It was as if the organs in my mid body was in fire. I was feeling serious fatigue and loss of appetite so i could eat much. I also thought it was a cardio issue and we did an echo test which was normal. After close consideration of my symptoms which included the muscle pain, the cardio clinic sent me to gynaecologist who asked me to do a thyroid and hormonal test. The thyroid was ok but the hormal showed i am in perimenopause. I was placed on premarin and when i still couldnt sleep, i was given lexotan for 3 days again. After i stopped the lexotan, sleep didn't stabilize so after some days i was given a week dose. Al this while the muscke pain and weight loss continued. I was feeling heaviness in my legs and couldnt walk smartly. After i stated the premarin the heaviness reduced. One major thing i noticed was severe muscle pain. After a period of this pain in a localised part of my body, i notice i loose weight there. All the places where i had this kind of pain, hurt when exposed to cold like my shoulders, lower legs and hand. There is obvious evidence of loss of fat in these places as the viens are showing. I did a scan and was told ny liver measured 16.7cm and i have small fibroid . I was also placed on vit c 500mg, bco, vit d3, amino pep forte, omega h3, vut b12 and i added magnesium and occasionally some teas like chamomile, soursop, green tea. I have done all major tests which all came back okay lft, kft, pcv, lipid, fasting sugar, h.pyloric How do i feel now? Bp is okay. I sleep sone nights and some nights i dont, i eat often, appetite returning gradually, sometimes i feel unwell one minute and after feel better. Have muscle twitching in upper arm, muscle pain not severe anymore. Apart from the cbc and a repeat of chest x-ray. I had a rapid HIV test and the result wa non reactive. What if it is advanced already

Age: 47Gender: femaleLanguage: UkrainianDate: 6/30/2025

🩺Professional Medical Assessment

📋Medical Analysis

Evaluación Profesional (en español): El cuadro clínico sugiere un síndrome climatérico perimenopáusico como diagnóstico principal, caracterizado por síntomas vasomotores, alteraciones del sueño y cambios en la composición corporal, típicos en mujeres de edad media. Los síntomas neuroendocrinos (palpitaciones, ansiedad, fatiga) y musculoesqueléticos (dolor muscular, pérdida de masa) son consistentes con los cambios hormonales de la perimenopausia, aunque el componente ansioso-depresivo parece estar exacerbando la sintomatología. La presencia de hipertensión arterial y los cambios metabólicos son factores de riesgo importantes a considerar en esta etapa, requiriendo un manejo integral que incluya terapia hormonal, control cardiovascular y apoyo psicológico. Estudios adicionales recomendados incluyen: - Densitometría ósea para evaluar masa ósea - Perfil hormonal completo de seguimiento - Evaluación psicológica formal - Monitoreo continuo de presión arterial y perfil metabólico

⚠️Urgency Level

EVALUACIÓN DE NIVEL DE URGENCIA: Nivel de urgencia: MODERADO - Los síntomas descritos, incluyendo palpitaciones intermitentes, dolor muscular, pérdida de peso y alteraciones del sueño en una mujer de 47 años en perimenopausia, requieren seguimiento médico programado pero no constituyen una emergencia inmediata dado que los signos vitales y pruebas básicas están estables. Banderas rojas: Monitorear cambios súbitos en presión arterial, episodios de palpitaciones severas con síncope, dolor torácico agudo o dificultad respiratoria que requeriría atención de emergencia inmediata. Marco temporal: Se recomienda consulta con médico de familia dentro de 1-2 semanas para evaluación integral y ajuste de tratamiento hormonal/perimenopausia, con seguimiento por especialista (ginecólogo/endocrinólogo) en 2-4 semanas. Indicaciones para urgencias: Acudir inmediatamente si presenta dolor torácico intenso, dificultad respiratoria severa, síncope o alteraciones significativas de presión arterial. Para síntomas actuales, mantener seguimiento ambulatorio programado.

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💊Treatment Recommendations

Recomendación de tratamiento: Considerando los síntomas perimenopáusicos y la hipertensión, se recomienda continuar con la terapia hormonal (Premarin) junto con el control regular de la presión arterial, complementado con ejercicio moderado diario y técnicas de relajación para manejar la ansiedad y los problemas del sueño. Para los síntomas musculares y la fatiga, se sugiere mantener la suplementación actual con vitaminas y minerales (especialmente vitamina D, B12 y magnesio), además de implementar una dieta balanceada rica en proteínas y omega-3. Se recomienda también mantener un registro diario de síntomas para ajustar el tratamiento según sea necesario. Para recomendaciones de tratamiento adicionales, pregunte en el chat.

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📝Medical History

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