Transition of Care Document

Patient Kathryn Brown Preferred Language Unspecified
Date of birth March 3, 1978 Sex Female
Race Unspecified

Ethnicity Unspecified
Contact info Primary Home:

1457 Sedalia Dr, ,

Flower Mound, TX 75028, US

Tel (Mobile): +1(972)-977-4511

Tel (Primary Home): +1(972)-977-4511

Mail: Kathryn_d_brown@yahoo.com

Patient IDs 534426 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101

13106 2.16.840.1.113883.3.3710.3

Ellkay 2.16.840.1.113883.3.3710.200.501

13106 2.16.840.1.113883.3.3710.200.500

Document Id test-id-917767480 2.16.840.1.113883.3.3710.0
Document Created: April 5, 2024, 13:54:47 +0000
Performer Jaime Schwartz
Author Diana Tagaban, Jaime S. Schwartz, MD
Contact info Work Place:

240 S La Cienega Blvd Ste 200

Beverly Hills, CA 902113324, US

Tel (Work Place): 3108825454

Encounter Id 4560185 2.16.840.1.113883.3.3710.999.44.88800115636.7770000111
Encounter Date  From January 29, 2024
Encounter Participant Jaime Schwartz
Contact info Work Place:

240 S La Cienega Blvd Ste 200

Beverly Hills, CA 902113324, US

Tel (Work Place): 3108825454

Legal authenticator Diana Tagaban signed at April 5, 2024, 13:54:47 +0000
Contact info Work Place:

240 S La Cienega Blvd Ste 200

Beverly Hills, CA 902113324, US

Tel (Work Place): 3108825454

Document maintained by Jaime S. Schwartz, MD
Contact info Work Place:

240 S La Cienega Blvd Ste 200

Beverly Hills, CA 902113324, US

Tel (Work Place): 3108825454

Table of Contents


Social History

Code Activity Start Date End Date
266919005 (SNOMED) Never smoker
Birth Sex female
Sexual orientation Don’t Know
Gender identity Unspecified

Problems

Problem Code Type Status Date of Diagnosis Date of Resolution
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 01/29/2024
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 12/15/2023
Disorder of connective tissue (disorder) 105969002(SNOMED) Diagnosis active 12/15/2023
Iron deficiency (disorder) 35240004(SNOMED) Diagnosis active 12/15/2023
Mast cell disorder (disorder) 397007003(SNOMED) Diagnosis active 12/15/2023
Allergic rhinitis (disorder) 61582004(SNOMED) Diagnosis active 12/15/2023
Generalized skin eruption caused by drug and medicament (disorder) 200892002(SNOMED) Diagnosis active 12/15/2023
Immunodeficiency disorder (disorder) 234532001(SNOMED) Diagnosis active 12/15/2023
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 12/15/2023
Lymphedema (disorder) 234097001(SNOMED) Diagnosis active 12/15/2023
Peripheral venous insufficiency (disorder) 20696009(SNOMED) Diagnosis active 12/15/2023
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 12/15/2023
Hypermobile Ehlers-Danlos syndrome (disorder) 30652003(SNOMED) Diagnosis active 12/15/2023
Lymphedema (disorder) 234097001(SNOMED) Diagnosis active 12/15/2023
Mast cell disorder (disorder) 397007003(SNOMED) Diagnosis active 12/15/2023
Varicose veins of lower extremity (disorder) 72866009(SNOMED) Diagnosis active 12/15/2023
Peripheral venous insufficiency (disorder) 20696009(SNOMED) Diagnosis active 12/15/2023
Iron deficiency (disorder) 35240004(SNOMED) Diagnosis active 12/15/2023
Anxiety (finding) 48694002(SNOMED) Problem active
Asthma (disorder) 195967001(SNOMED) Problem active
Circulatory care for venous insufficiency (regime/therapy) 386238003(SNOMED) Problem active
Depressive disorder (disorder) 35489007(SNOMED) Problem active
Easy bruising (finding) 424131007(SNOMED) Problem active
Emotional abuse (event) 371773006(SNOMED) Problem active
Fibromyalgia (disorder) 203082005(SNOMED) Problem active
Functional visual loss (disorder) 313165001(SNOMED) Problem active
History of asthma (situation) 161527007(SNOMED) Problem active
History of bronchitis (situation) 275528007(SNOMED) Problem active
History of depression (situation) 161469008(SNOMED) Problem active
History of obesity (situation) 161453001(SNOMED) Problem active
History of pneumonia (situation) 161525004(SNOMED) Problem active
History of anemia (situation) 275538002(SNOMED) Problem active
History of gastritis (situation) 691501000119103(SNOMED) Problem active
Lipedema (disorder) 234102003(SNOMED) Problem active
Abdominoplasty (procedure) 177250006(SNOMED) Problem active
Reduction of batwing arms (procedure) 24298005(SNOMED) Problem active
Acne (disorder) 11381005(SNOMED) Problem active
Eczema (disorder) 43116000(SNOMED) Problem active
History of skin disorder (situation) 161560005(SNOMED) Problem active
Ehlers-Danlos syndrome (disorder) 398114001(SNOMED) Problem active
Lymphedema of limb (disorder) 439500002(SNOMED) Problem active
Lymphedema of lower extremity (disorder) 403385000(SNOMED) Problem active
Victim of verbal abuse (finding) 225825002(SNOMED) Problem active

Allergies

Substance RxNorm Reaction(s) Severity Status Start Date
ragweed pollen Fatigue, Headache moderate to severe active 10/15/1994

Medications

Medication Generic Name RxNorm Strength Strength Unit Route Dose Dose Form Frequency Date Started Date Ended Status Indication Sig
Sudafed Sinus 12Hr Pressr-Pain naproxen-pseudoephedrine oral active
Zyrtec-D cetirizine-pseudoephedrine 1014583 5-120 mg Oral tablet extended release 12 hr active

Instructions

Results

No data

History of Procedures

Code Site Date Diagnosed Status
Repair of inguinal hernia (procedure) completed
History of bypass of stomach (situation) completed
Documentation of past medical history (procedure) completed
Bypass of stomach (procedure) completed
Surgical biopsy of skin (procedure) completed
Roux-en-Y gastrojejunostomy (procedure) completed
Bypass of stomach (procedure) completed
History of bypass of stomach (situation) completed
Repair of inguinal hernia (procedure) completed
Roux-en-Y gastrojejunostomy (procedure) completed
Surgical biopsy of skin (procedure) completed
Documentation of past medical history (procedure) completed
Roux-en-Y gastrojejunostomy (procedure) completed
Bypass of stomach (procedure) completed
History of bypass of stomach (situation) completed
Repair of inguinal hernia (procedure) completed
Surgical biopsy of skin (procedure) completed
Documentation of past medical history (procedure) completed
Bypass of stomach (procedure) completed
History of bypass of stomach (situation) completed
Repair of inguinal hernia (procedure) completed
Roux-en-Y gastrojejunostomy (procedure) completed
Surgical biopsy of skin (procedure) completed
Documentation of past medical history (procedure) completed
Bypass of stomach (procedure) completed
History of bypass of stomach (situation) completed
Repair of inguinal hernia (procedure) completed
Roux-en-Y gastrojejunostomy (procedure) completed
Surgical biopsy of skin (procedure) completed
Documentation of past medical history (procedure) completed
Bypass of stomach (procedure) completed
History of bypass of stomach (situation) completed
Repair of inguinal hernia (procedure) completed
Roux-en-Y gastrojejunostomy (procedure) completed
Surgical biopsy of skin (procedure) completed
Documentation of past medical history (procedure) completed
Abdominoplasty (procedure)
Reduction of batwing arms (procedure)
Roux-en-Y gastrojejunostomy (procedure)
Surgical biopsy of skin (procedure)
Documentation of past medical history (procedure)
Bypass of stomach (procedure)
Repair of inguinal hernia (procedure)
History of bypass of stomach (situation)

Vital Signs

No data

Plan of Treatment

Future visit PRN - Follow up PRN for: Preoperative Appointment, Discussion of Procedure, Additional Consultation, Preoperative Marking

History of Past Illness

Problem Code Type Status Date of Diagnosis Date of Resolution
Acne (disorder) 11381005 FINDING
History of skin disorder (situation) 161560005 FINDING
Eczema (disorder) 43116000 FINDING
History of obesity (situation) 161453001 FINDING
History of depression (situation) 161469008 FINDING
History of pneumonia (situation) 161525004 FINDING
History of asthma (situation) 161527007 FINDING
Asthma (disorder) 195967001 FINDING
Fibromyalgia (disorder) 203082005 FINDING
Victim of verbal abuse (finding) 225825002 FINDING
Lipedema (disorder) 234102003 FINDING
History of bronchitis (situation) 275528007 FINDING
History of anemia (situation) 275538002 FINDING
Functional visual loss (disorder) 313165001 FINDING
Depressive disorder (disorder) 35489007 FINDING
Emotional abuse (event) 371773006 FINDING
Circulatory care for venous insufficiency (regime/therapy) 386238003 FINDING
Ehlers-Danlos syndrome (disorder) 398114001 FINDING
Lymphedema of lower extremity (disorder) 403385000 FINDING
Easy bruising (finding) 424131007 FINDING
Lymphedema of limb (disorder) 439500002 FINDING
Anxiety (finding) 48694002 FINDING
History of gastritis (situation) 691501000119103 FINDING

General Status

No data

Assessments

1.Lipedema Counseling - Lipedema

Immunizations

No data

Functional Status

No data

Mental Status

No data

Reason for Referral

No data

Encounters

Service provided at Jaime S. Schwartz, MD, 240 S La Cienega Blvd Ste 200, Beverly Hills, CA 902113324. Office phone number is 3108825454.

Encounter Diagnosis Location Date / Time Type
Lipedema (E65) Jaime S. Schwartz, MD 01/29/2024 18:00:00 UTC 99202

Review Of Systems

No Data

Goals

No data

Medical Equipment

No data

Health Concerns

No data

History of Present Illness

This is a 45 year old female who is being seen for lipedema follow-up lipedema affecting the legs, thighs, arms, forearms, abdomen, upper abdomen, buttocks, hip shelf, knees, and ankles. Since their last visit the lipedema is I’m now experiencing additional symptoms since seeing Dr Herbst in December 2023. My lower back is hurting & I’m having issues with both feet. I was diagnosed with tendinitis (left foot) & bunionette (right foot) by a podiatrist. He indicated the pain was resulting from inflammation.. Legs: - Location: Anterior and Posterior - Tenderness: Yes - Lipomas: Not that I’m aware of. I have numerous nodules covering multiple places on my body. I have a nodule that could possibly be a lipoma on my left buttock. - Bruising: Yes - Pain: Yes - Cuffing: Yes - Dimpling: Yes Thighs: - Location: Anterior and Posterior - Tenderness: Yes - Lipomas: Not that I’m aware of - Bruising: Yes - Pain: Yes - Dimpling: Yes Forearms: - Tenderness: Yes - Lipomas: Not that I’m aware of - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes - Cuffing: Yes Arms: - Tenderness: Yes - Lipomas: Not that I’m aware of - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes Abdomen: - Tenderness: Yes - Lipomas: I’m not sure - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes Upper Abdomen: - Tenderness: Yes - Lipomas: Not sure - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes Buttocks: - Tenderness: Yes - Lipomas: I believe I do - left side - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes - Dimpling: Yes Hip Shelf: - Tenderness: Yes - Lipomas: Not sure - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes - Dimpling: Yes Knees: - Tenderness: Yes - Lipomas: Not sure - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes Ankles: - Tenderness: Yes - Lipomas: Not sure - Thickened Tender Subcutaneous Fat: Yes - Spongy Adipose Tissue: Yes Duration: 35 years Associated Diagnoses: Lymphedema, Ehlers Danlos, Venous Disease, Varicose veins, Lipedema in the breast tissue (diagnosed by a healthcare provider or yourself), and Connective Tissue Disease Similarly Affected Family Members: mother and aunt Pedicures: No Do You Wear Boots: No Lipedema Worsened By: puberty, oral contraceptive pills, and My lipedema has significantly increased since 2021. I suspect that inflammation has spiked during this time - due to chronic stress & anxiety. Swelling Occurs With: standing, sitting, end of day, and summer Previous Treatments: Elevation (no change), Compression Garments for 12 weeks or more (Temporary pain relief & edema reduction ), Manual Lymphatic Drainage for 12 weeks or more (Temporary pain relief & edema reduction ), Sequential Pumps for 12 week or more (Temporary pain relief & edema reduction ), Diet (Low Carb (Helped with pain - no change with physical symptoms ), Fasting (no change), Keto (Helped with pain - no change with physical symptoms ), Calorie Restriction (no change), Intermittent fasting (no change), Small meals after bariatric surgery (no change), Mediterranean (Helped with pain - no change with physical symptoms ), Anti-inflammatory (I believe it has helped with inflammation, however, no change physically ), and Gastric Bypass (no change)), Medication (Phentermine), and Exercise, vibration plate, acupuncture, mayofascia release treatments, pneumatic pump, vein treatments, gastric bypass Difficulty Walking: Yes (trips easily and Leafs extremely heavy, I do not walk in proper form because I have lobules in between my tight. I’m extremely fatigued & in pain with walking even short distances) Flexibility: Very Flexible Cooler Areas: Feet & hands Easy Bruising: legs, thighs, calves, abdomen, buttocks, and arms Pain: all the time (Average Pain Score: 7 out of 10), with movement (Worst Pain: 8 out of 10), when touched (Lowest Pain: 4 out of 10), and when sleeping Ability to move a chair from one room to another: With some difficulty Ability to bend down and pick up clothing from the floor: With some difficulty Ability to to stand for one hour: With some difficulty Ability to do chores such as vacuuming or yard work: With much difficulty Ability to push open a heavy door: With much difficulty Ability to exercise for an hour: With much difficulty Ability to carry a heavy object (over 10 pounds /5 kg): With some difficulty Ability to stand up from an armless straight chair: With some difficulty Ability to dress yourself, including tying shoelaces and buttoning your clothes: With a little difficulty Ability to able to dry your back with a towel: With a little difficulty The patient understands and agrees that they must continue wearing compression garments after their surgery.

Family History

No data

Consultation Notes

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Laboratory Narrative

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Pathology Narrative

No data

Imaging Narrative

No data

Procedure Notes

No data

Progress Notes

No data

Care Team

Care Team Member Name Role Identifier location Telecom
Jaime Schwartz Doctor 1336397660 240 S La Cienega Blvd Ste 200, Beverly Hills, CA 902113324, US 3108825454

History And Physical Notes

No data