hair loss, painful scalp.

Patient ID: going_bald (Sam) Sex:F Age:51

Please answer the following questions in a descriptive manner after careful analysis and recollection of previous experiences and happenings.

1. What brings you to the forum? Describe all your problems, including those that may not exactly be on the top of your mind now, in as much detail as possible.
My hair is falling out severely. It is extremely long (below my knees) and WAS very thick, but is now only about 1/4 of thickness. The falling started a few years ago, then slowed down and almost stopped, but now is just terrible. I must keep it tied up and at this rate I will be bald in a few months. My hair also smells bad quite soon after washing it. I used to be able to wash it once a week and now it gets greasy after only a day. My skin is different now too, greasy and bumpy, sort of scaly. The greasiness is sticky and hard to wash away. Hair is thinning all over but more in the front. When I sweat my scalp sweats excessively and itches. Sometimes my scalp is very scaly and itchy, but not now. In the last three months I've had a very sore scalp when I move my hair. There are defined spots on my scalp that feel very bruised. Washing it with warm water relieves some of the pain but it comes back, usually in a different spot. It is painful to wear it braided now.

I also have had a problem with a rye neck for the last few months. I have back pain between my shoulder blades since I was 14, but it is worse now. I have had some episodes of bad vertigo in the past, but not now.

At times (not now) I experience a period of severe fatigue, weakness, and the muscles in my thighs are painful and tendons in my feet get very tight. It is painful to walk. I sometimes have swelling of ankles, fingers and eyelids. I have a couple of sore pressure points on my thighs but doctors say I do not have fibromyalgia and do not have antibodies for lupus. In the past I never sweated, but now I sweat easily and excessively and the sweat smells very bad, sometimes like urine. There are periods of time when I am very thirsty all day for a couple of weeks and then back to normal. I have been tested for diabetes and thyroid but results were normal. My b12 and iron levels are in normal range, but I take a b12 shot twice a month and that does help the fatigue but not completely. If I don't take the b12 I suffer for it.


2. How do these problems affect you mentally? How does it affect your family life and inter-personal relations with friends and colleagues? I sometimes think I should shave my head and get my hair made into a wig before it is all gone. I feel terrible when people notice my braid is much smaller. The hairloss is depressing. My energy level is very low, I am not very productive and I don't like to go out or do things because I'm tired, thus my relationships have suffered and I have very few people in my life. I live alone and rarely see people.


3. What time of the day your problems trouble you the most? Describe the time modalities properly for all your problems. When I'm having a period of muscle aches, then it is worst in the mornings.


4. Normally, when you are in a healthy state, what time of the day you are most active and what time you feel lazy and tired? I hardly remember a healthy state, but I have more energy in the mornings and notice my energy is low at about 2pm.


5. Generally, is there some time in the day when you feel extremely irritable? Late afternoons.


6. When did it all start? Can you connect it to any past event or disease? Give proper details. I don't know.


7. What are the things which aggravate your suffering and which are those which ameliorate the same? I don't know.


8. Do you think your sufferings have relation to any external stimuli (like, change of place) or any internal biological changes in the body, like, menses (in females)? I am perimenopausal and hormones seem to be all over. Sometimes I don't have a period for 6 months, then I will have regular periods for a year. My hairloss used to better or worse as my monthly hormones fluctuated, but now it is always falling out and very bad.


9. Which weather worsens your complaints – wet, hot or cold? When I go out in the cold, it makes me very tired and I must sleep when I get home, but heat also bothers me, though not as much.


10. Which weather do you generally prefer the most? Dry and warm. I am sensitive to both heat and cold.


11. Describe yourself as a person in as much detail as possible. Discuss general personality traits; the way you express yourself in social settings, family and work environment, with friends, etc. I am an introvert, somewhat reclusive, uncomfortable in social situations. I need a lot of time alone. Anxious, awkward but compassionate and a good listener. I don't smile easily, even when I'm quite happy. People say I don't show much emotion in my face. I am untrusting.


12. Describe in detail if you harbour any negative emotions. I have some resentments about my early family life but I am in general a very tolerant and forgiving person. I have suffered a number of episodes of major depression but right now my primary mood is anxiety/fear.


13. How is your memory? My short term memory is significantly worse (very short) than it was in the past. Long term memory is fine.


14. Do you suffer from bouts of anger? If yes, which category do they fall in – frequent, occasional or rarely? Occasional


15. Which of the following words describe you the best – Moody, Arrogant, Mild, Agreeable, Changeable, Nervous, Suspicious, Easily offended, Quiet, Arguing, Irritating, Irritable, Lazy, Super-active, Tearful, Vindictive, Confused, etc. Suspicious, quiet, irritable, lazy, tearful, uncertain, sad.


16. Please answer the following clearly:
- Do you tend to weep easily? YES
- How is your memory? POOR
- How do you feel before or during a thunderstorm? Before I often have migraines and feel tension. After I feel better, I can think more clearly and breath better. I feel most 'normal' after a thunderstorm.
- Do you like being consoled during your tough times? YES
- How sensitive you are to external stimuli like smell, noise, light etc? Very sensitive to smells, sound, light, and even the feeling of my clothing.
- Do you have any typical habit or gesture like nail biting, causeless
weeping, talking to one self etc? Since I was a child, I have a habit of biting and picking the skin of my lips... sometimes until they bleed.
- How do you feel about your friends, family, your children and especially your husband / wife? I mistrust friends, not married, no children, rather isolated.


17. What are your chief fears? Having to move to a different home. It causes huge anxiety, and sometimes I fear being homeless.


18. How well do you sleep? Do you have a particular posture of sleeping? I only sleep on my side. It is hard to fall asleep and stay asleep. I wake very easily. I don't feel refreshed on waking.


19. Is there any pattern in your dreams? I don't remember the last time I had a dream. I rarely dream, or if I do I don't remember them.


20. What all food items do you crave for what all you simply hate to have? I crave kale, spinach and broccoli, and if I don't have vegetables for a few days I feel bad. I crave fruit juice too. I HATE fish and any kind of seafood. It tastes rotten and makes me gag. Orange juice gives me a stomach ache.


21. How is your thirst: Less, Normal or Excessive? Periods when it is excessive, but normal right now.


22. How is your hunger: Less, Normal or Excessive? NORMAL


23. Is there any kind of food which your body can’t stand? Very sensitive to caffeine and food with red dye makes me not sleep at night.


24. Is there any time or occasion when you feel an uncontrollable urge to eat? Yes, premenstrually.


25. How would you rank your sweat as– normal or less or more? Where does it sweat more: Head, Trunk or Limbs? Excessive, scalp and torso.


26. How is your bowel movement and stool type? Fine, no problems.


27. Do you think you are able to satisfy your sexual desires in general? Yes.


28. How do you think you are different from others, if at all? I have very low energy and am not very productive daily. I am uncomfortable in social situations.


29. What medications have been taken earlier by you to treat the diseases and do you have any particular symptom surfacing after the medication? I have tried various medicated shampoos and only Nizoral helped in the past but it does nothing now. I am currently taking Wellbutrin as maintenance for past episodes of depression.


30. Any major diseases running in your family? My family is quite healthy but with some lung weakness (asthma, lung cancser, COPD) and depression/bipolar.


31. Describe your overall appearance. I am very fair, tall, somewhat overweight with a large stomach.

32. (ONLY FOR FEMALES)
If you are not having normal menstrual cycles, please answer the following questions:

- Are the periods early, regular or late in general? How long do they last? I spot for 3-4 days, then 2 days of flow, then spotting for 3 days.
- Do you suffer from any kind of physical or mental discomfort before, during or after the periods? Much discomfort before and during my period. Back ache, food cravings, migraines, severe fatigue, constipation, irritability.
- Is the flow scanty, normal or excessive? Flow is sometimes scanty as I am perimenopausal.
- Is the blood thick bright red or pale watery? Typically thick, black, rubbery clots, sometimes pale and mucousy.
- Do you notice any clots in the flow? A lot of dark black clots, almost no fresh red flow except on the first morning of flow.