,PAST MEDICAL HISTORY:,  Reactive airway disease; rheumatoid arthritis, recent surgery on her hands and feet; gravida 4, para 5, with one set of twins, all vaginal deliveries; iron deficiency anemia; osteoporosis; and hypothyroidism.
,PAST MEDICAL HISTORY : , Reactive airway disease ; rheumatoid arthritis , recent surgery on her hands and feet ; gravida 4 , para 5 , with one set of twins , all vaginal deliveries ; iron deficiency anemia ; osteoporosis ; and hypothyroidism .