rest, fluids, hand hygiene, advil/tylenol prn
rtc if persistent fever >38 not responsvie to antipyretics or new CP/SOB/lightheadedness/hemoptysis
reviewed possibility of Covid+ as rapid antigen tests are not 100% accurate, reviewed public health guidelines and advised to self-isolate until symptoms resolve
interested in OCP for contraception
No contraindications to estrogen:
unexplained vaginal bleeding: N
migraines with aura or neurological symptoms: N
VTE/PE or hypercoagulability: N
liver/gallbladder disease: N
uncontrolled HTN (SBP>160, DBP>100): N
ischemic or valvular heart disease: N
smoking age >35: N
personal history of breast ca: N
Last Pap:
Last STI check:
Interested in stacking pills to skip menses:
Other indications (HMB/dysmenorrhea, cycle regulation, PCOS, acne):
counselling provided re:
- OCP does not provide protection against STIs
- common s/e including GI upset, mood changes, breast tenderness, and serious adverse effects including risk of VTE/ATE
- adequate trial 3mo, normal to have breakthrough bleeding/spotting during this time
- back-up contraception for 1mo
- advised that starting Sunday after period (e.g. if period starts Friday and still bleeding on Sunday, STILL start pack) would be ideal as it can offer reassurance that she is not currently pregnant and decrease chance of periods extending to weekends on the weeks she is taking placebo pill
- aware that she can skip placebo week if she would not like to have periods
- f/u in 3mo
- headache started:
- location:
- severity:
- frequency:
- duration:
- associated N/V:
- associated photophobia/phonophobia:
- associated aura:
- progression: gettinig worse/better/no change
- effect on QoL & time away from work/school:
- change in environment:
- change in medications:
triggers:
- brought on by valsalva maneuver: no
- association with activity: no
- associated with food: no
- associated with alcohol: no
- associated with caffeine: no
- relation to menstrual cycle: no
red flags:
- sudden & maximal at onset: no
- associated with exertion (exercise, sex): no
- associated with trauma: no
- GCA: no age >50, no visual changes, no jaw pain, no scalp tenderness, no PMhx PMR
- infection: no fever, no neck pain, no PMhx of immunocompromised (cancer, steroids, splenectomy, HIV/AIDS, no constitutional symptoms)