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Treating Depression In Conjunction With Chronic Disease Case Study

Health Issues for Mrs. A It seems as if Mrs. A, who states that she has been suffering from both menorrhagia and dysmenorrhea, is presenting classic symptoms and signs of anemia due to blood loss. Blood loss which has been taking place over a long period of time is also a classic symptom of anemia and she is also feeling fatigued and light-headed when she is golfing. Considering all the above signs, it is likely that Mrs. A can be diagnosed with anemia especially considering that she has also consistently and constantly been taking aspirin over the last twelve years which can result in ulcers and gastritis (WebMD, 2014) and lead to chronic bleeding, another sign of anemia. An early study (Hotz-Behofsits et al., 2003) concluded that non-steroidal anti-inflammatory drugs (NSAIDS) "cause intestinal ulcers" (p. 367) which can also be a contributing factor leading to anemia. The case study on Mrs. A also provides the results of her blood tests showing that her red blood cell count (RBC) was out of whack, as was her hemoglobin. Ford (2013) determined that RBC morphology is a factor that should be considered by medical personnel when recommending appropriate and effective follow-up treatments after the diagnosis. Additional factors to consider when providing a diagnosis is that anemia is oftentimes presented or exacerbated by extended exercise (golfing), thin atmospheric pressure found in the mountain terrain, and extensive and long-term ingesting of aspirin or NSAIDS. It would seem, therefore, that Mrs. A is at the behest of a number of factors all pointing to the onset of anemia. The problem, of course, is implementing a treatment program that assists Mrs. A in addressing her healthcare issue in an effective and efficient manner.

Recommended Treatment

Establishing and recommending a specific...

In this case, tests to determine existing conditions such as ulcers, gastritis, cancer or hemorrhoids are all problems extending from or related to anemia; tests to reveal these potential problems should be undertaken. Implementing an effective treatment usually means addressing the problem in a manner that is immediate. Mrs. A shows no signs of a large loss of blood, instead she has been losing blood in a long-term manner (over time). Determining whether she needs additional blood at this time should be a good first step and if needed, a blood transfusion would address this problem. Of course, if Mrs. A was not low on blood, then this would be an unnecessary step, but fluids, oxygen or iron could all be deficient and need to be replaced due to anemia. Kansagara et al. (2013) determined that iron delivered intravenously was beneficial in assisting patients by alleviating their anemia symptoms. Of course, other forms of iron replacement could be just as helpful in this particular case. Recommended treatment should be to replace the iron as quickly as possible either through a transfusion or by iron supplements, this is especially true in Mrs. A's case due to the fact that the blood results determine that the patient is experiencing mehorrhagia and dysmenorrhea both of which are exacerbating conditions that can lead to anemia. Additionally, Mrs. A shows chronic blood loss which must also be addressed. A medical discussion with Mrs. A outlining her treatment options and addressing her treatment in a comprehensive manner would be most beneficial at this point. Follow-up appointments for her would be beneficial as well.
Health issues for Mr. P

Mr. P seems to be suffering…

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Works Cited

Denton, W.H.; Carmody, T.J.; Rush, A.J.; Thase, M.E.; Trivedi, M.H.; Arnow, B.A. & Keller, M.B.; (2010) Dyadic discord at baseline is associated with lack of remission in the acute treatment of chronic depression. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 40(3), p. 415 -- 424.

Dilated Cardiomyopathies (2000) New England Journal of Medicine, 342, p. 1077-1084

Hotz-Behofsits, C.M.; Walley, M.J.M.; Simpson, R. & Bjarnason, I.T.; (2003) Cox-1, Cox-2 and the topical effect in NSAID-induced enteropathy, Inflammopharmacology, 11(4-6) p 363-370

Ford, J.; (2013) Red blood cell morphology, International Journal of Laboratory Hematology, Vol. 35, Issue 3, pp. 351 -- 357
WebMD (2014) Anemia -- The basics; accessed on May 21, 2015 at http://www.webmd.com/a-to-z-guides/understanding-anemia-basics
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