Transcript

Okay, hello Kathleen, how are you? Good, how are you? Alright, so, you were referred because of painful period like cramps? Yes. Tell me more, why is that? So, back in like June, July, I started experiencing more period like cramps. It's been happening after sex as well. I'm in a lot of pain after that. They come and go, but it's like majority of the month I feel it. There's like, today's a good day. I've been taking ibuprofen. Does that help you? Not really, no. I had a pap test in September, maybe late August, and nothing came back abnormal. So, I'm just not sure what's going on. You gave me a uterine lesion, I think like 3 years ago, maybe 4 years ago. Bleeding is no longer a problem? Well, because I take Magexi progesterone like every single day, so that's to stop the bleeding. The tablet? Yeah. And that is not helping the pain? No. Okay. It has up until like earlier this year. Okay. Yeah. And you think, is it 5 milligrams? I don't know what it is. It's a little white pill. I'm not sure. I see in the record. Yeah, I'm not 100% sure what milligrams it is, but every day I take it. Okay. So, the pain that you have, does it come like about the time that you have period, but not really shown as period, but you're still experiencing? I don't know because it is like, a lot of times it's more than what my period would be. It's more than a week throughout the month, so like I'm not, that's what I kind of chalked it up to be in the beginning, but then it became more and more. Okay. And especially after 6 is concerning. Okay. And how about medical history? Any new medical problems? No. Okay. And I know you were on medication for any... I was on trazodone. I'm still on trazodone. Okay. I've been on trazodone for... Forever? Yeah, for like years and years. Okay. Any operation? No. Okay. Any new allergy? No. Okay. I think what we should do is to examine you and see, check your tummy first. Okay. It sounds to me like what we call post-ablation syndrome. Okay. Where some people, even though they are no longer having heavy period, the tiny endometriosis within the muscles might be giving them some period-like cramping, even when they are not even having period. Okay. The problem with that, for most people, like the Depo-Provera we are taking, the Metroxyl-Provera, for most people it helps them, suppresses them. But if that is not helping, the options we have is either go up in dose or we adjust their medication. That is one option. Okay. That is one option to avoid the hysterectomy. Okay. But let's check your tummy and see, is it okay to check your tummy? Yeah, yeah. Okay. Come over here. Examination of your abdomen. My hands might be a bit cold. Your tummy is soft. Yeah, right there. This is where, yeah. Yeah, yeah. Okay. Yeah, that is over the uterus. Have you had any ultrasound scan recently? No. When was the last? Back in 2022? Yeah, whenever you gave me the ablation. Okay. It might be reasonable for me to order your ultrasound scan. Okay. And then let's go up in the dose of your medication a little and see. If that is not helping, then we can consider swapping you to another type of progesterone only. Okay. But let's do ultrasound scan as well just to be sure that there is no new thing happening. Okay. Okay? Yeah. Come here. Any questions? No. Okay. So where do you want me to send the ultrasound scan request to? Pembroke? Yeah, yeah. Okay. So I'm going to stop this now. Done. Okay. Okay. Okay. Okay.