A 32 yo female who presents to clinic with worsening generalized fatigue and malaise for 3-4 weeks. She is 6 months postpartum (uncomplicated pregnancy) and has help with the baby. She has difficulty with ADL s stiff, achey and sore. Sleep is fitful. No known allergies, hx of G3, P1, Anermia, Migraine headaches , Raynaud s disease, UTIs and 1ppd smoker up to right before becoming pregnant.