Sarah is having a difficult morning. her BP spiked to 176 106 72 over the course of a couple of hours (0545-0715). after talking out some emotional subjects (VA issues again) it was down to 153 82 71 (0745). then after ingesting Mj  down to 124 75 68 (0808). we will check it again after she eats and naps. the episode includes pain in her left inner thigh, left shoulder blade and along the left rib cage. that pain has persisted though the pressure is down. Episodes like this are infrequent, somewhat predictable (VA interactions) but frightening. We are waiting for J. Otterstrom, lcsw  to connect Sarah with another provider.  questions; at what point to we go into urgent or emergent care? should she take an aspirin?  what else should i look for, symptomatically speaking? what kind of damage is being done during these spikes? 
		Karen Hill, spouse

cc to J. Otterstrom

post food/nap 152 82 69 0900
                         94 64 74 0930 *
                       111 67 65 1021 *


notes:

stress induced
history of intense somatic issues
reg doc not available