does a comma go before as well as?

Question

This is a 38-year-old female with a past medical history of degenerative disease of the cervical spine as well as migraine, who presents for her annual physical. 

 

Answer 1

You don't need a comma, because you don't need the phrase "as well." Flip the two medical conditions, because putting migraine second makes it sound as if she has degenerative disease of the migraines.

"This is a 38-year-old female with a past medical history of MIGRAINE AND degenerative disease of the cervical spine, who presents for her annual physical."

There are many ways to express a thought. When someone asks me to help punctuate a sentence, I try to use the sentence they have presented rather than presenting them with a completely new sentence.

Roberta H.

 

Answer 2

"This is a 38-year-old female." This sentence already restricts the meaning of female to "this" or to the implied "this (patient)." The relative clause beginning with "who" presents additional information and therefore requires a comma.

Answer 3

You are correct with no comma before "as well as".  You could clean up the sentence and eliminate a few unnecessary words, where it could read as:

 

"This is a 38 year old female presenting for her annual physical. Her medical history includes cervical spine degenerative disease and migraine."

 

Saying "past medical history" is redundant, where "medical history" means the same thing. I hope that is helpful.

Answer 4

No, because it is an essential relative clause. Only non-essential relative clauses need to be offset by commas.