Encounter — Karen Taylor

Established patient for fibromyalgia management. Widespread pain index 12, symptom severity score 8. Sleep remains disrupted despite sleep hygiene modifications. Fatigue 7/10. Current regimen: duloxetine 60mg daily, pregabalin 150mg BID. Tender points: bilateral trapezius, supraspinatus, gluteal, greater trochanter. Discussed graded exercise program. Referral to cognitive behavioral therapy for pain management. Return in 8 weeks.