Room 17: "Breast pain x 2 weeks"
Yaquelin and her little boy are waiting for me, she on the exam table, he sitting quietly on the chair, with new Spiderman shirt. After shaking hands ( always necessary in Mexico, even with children), she begins to describe the problem. Over the past few weeks her breasts are painful all the time. She's not missed a period and doesn't believe she is pregnant. I give her a moment to change quickly, and then verify that there are no unusual lumps. She does have a little fibrocystic change in both breasts, but it is symmetric and mild. There is one small nodule that feels like a cyst to me. It is round , smooth and a little tender to touch. At age 31, it's almost certainly a benign cyst.
Yaquelin goes onto say she's been tired lately, sleeping poorly. She looks a little tense, worried, so I ask her to expand on that. She's not been sleeping well, and is worried. She's worried about her daughter in Mexico. Daughter? Yes, she admits, maybe she was egoista, selfish, but she and her husband decided to leave their 1 year old daughter in the care of his parents, so that they could make it in the US. They send money, clothes, and talk on the phone frequently. But lately their daughter has been asking to come to the US to be with her parents. A tear appears as Yaquelin talks, looking downward. Continuing, she mentions that their daughter is developing too fast -- she already looks 14 and she's only 10. She's so worried that she can't sleep at night, and so now is drinking about 3 cups of coffee to get up and get to the factory at 5 am.
I explain to Yaque that the most common cause of breast pain in women, other than pregnancy and menstruation, is caffeine use. I think she is drinking more coffee to compensate for her lack of sleep. In turn, this is causing her breast pain. Breast cancer almost never presents as pain. This is the most important thing for her to know.
Secondly, I must tell her, not to discard her daughter's call for help. I suspect her daughter desperately needs the love and acceptance of her parents, and the window will soon close on the ability to reconnect and re-develop the maternal child bond. Soon her daughter will be fully developed, and will seek attention, care, acceptance, and love from any source she can get it. Unfortunately for many children abandoned in Mexico by their parents, this means sexual precocity, and early pregnancy. It's often a stormy relationship that lasts a short time.
I encourage Yaque to find a way to reunite with her daughter. I also give her some primrose oil capsules to reduce breast pain; also she will reduce her caffeine intake. We will recheck her progress in a month.
Yaquelin and her little boy are waiting for me, she on the exam table, he sitting quietly on the chair, with new Spiderman shirt. After shaking hands ( always necessary in Mexico, even with children), she begins to describe the problem. Over the past few weeks her breasts are painful all the time. She's not missed a period and doesn't believe she is pregnant. I give her a moment to change quickly, and then verify that there are no unusual lumps. She does have a little fibrocystic change in both breasts, but it is symmetric and mild. There is one small nodule that feels like a cyst to me. It is round , smooth and a little tender to touch. At age 31, it's almost certainly a benign cyst.
Yaquelin goes onto say she's been tired lately, sleeping poorly. She looks a little tense, worried, so I ask her to expand on that. She's not been sleeping well, and is worried. She's worried about her daughter in Mexico. Daughter? Yes, she admits, maybe she was egoista, selfish, but she and her husband decided to leave their 1 year old daughter in the care of his parents, so that they could make it in the US. They send money, clothes, and talk on the phone frequently. But lately their daughter has been asking to come to the US to be with her parents. A tear appears as Yaquelin talks, looking downward. Continuing, she mentions that their daughter is developing too fast -- she already looks 14 and she's only 10. She's so worried that she can't sleep at night, and so now is drinking about 3 cups of coffee to get up and get to the factory at 5 am.
I explain to Yaque that the most common cause of breast pain in women, other than pregnancy and menstruation, is caffeine use. I think she is drinking more coffee to compensate for her lack of sleep. In turn, this is causing her breast pain. Breast cancer almost never presents as pain. This is the most important thing for her to know.
Secondly, I must tell her, not to discard her daughter's call for help. I suspect her daughter desperately needs the love and acceptance of her parents, and the window will soon close on the ability to reconnect and re-develop the maternal child bond. Soon her daughter will be fully developed, and will seek attention, care, acceptance, and love from any source she can get it. Unfortunately for many children abandoned in Mexico by their parents, this means sexual precocity, and early pregnancy. It's often a stormy relationship that lasts a short time.
I encourage Yaque to find a way to reunite with her daughter. I also give her some primrose oil capsules to reduce breast pain; also she will reduce her caffeine intake. We will recheck her progress in a month.
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