| Patient | Lindsey Anne Carver | Preferred Language | en |
| Date of birth | March 26, 1989 | Sex | Female |
| Race | White
|
Ethnicity | Not Hispanic or Latino |
| Contact info | Home:
2720 Tryon Pines Dr Raleigh, NC 27603, US Tel (Mobile): +1(757)-880-2206 Tel (Primary Home): +1(757)-880-2206 Mail: Lindsey.a.carver@gmail.com |
Patient IDs | 3089726 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101
MM0000001162 2.16.840.1.113883.3.3710.3 MODMED 2.16.840.1.113883.3.3710.200.501 115636PAT000001172 2.16.840.1.113883.3.3710.200.500 |
| Document Id | test-id-108783325 2.16.840.1.113883.3.3710.0 |
| Document Created: | April 5, 2024, 22:44:35 +0000 |
| Performer | Karen Herbst | ||
| Author | Diana Tagaban, Total Lipedema Care - Arizona |
| Contact info | Work Place:
240 S La Cienega Blvd Ste 200 Beverly Hills, CA 902113324, US Tel (Work Place): 3108825454 |
| Encounter Id | 4398455 2.16.840.1.113883.3.3710.999.44.88800115636.7770000111 | ||
| Encounter Date | From January 4, 2024 | ||
| Encounter Participant | Karen Herbst | ||
| Contact info | Work Place:
6365 E Tanque Verde Road, Suite 200 Tucson, AZ 857153830, US Tel (Work Place): 3108825454 |
||
| Legal authenticator | Diana Tagaban signed at April 5, 2024, 22:44:35 +0000 |
| Contact info | Work Place:
240 S La Cienega Blvd Ste 200 Beverly Hills, CA 902113324, US Tel (Work Place): 3108825454 |
| Document maintained by | Total Lipedema Care - Arizona |
| Contact info | Work Place:
6365 E Tanque Verde Road, Suite 200 Tucson, AZ 857153830, US Tel (Work Place): 3108825454 |
| Code | Activity | Start Date | End Date |
|---|---|---|---|
| 266919005 (SNOMED) | Never smoker | ||
| Birth Sex | female | ||
| Sexual orientation | Bisexual | ||
| Gender identity | Unspecified |
| Problem | Code | Type | Status | Date of Diagnosis | Date of Resolution |
|---|---|---|---|---|---|
| Mast cell disorder (disorder) | 397007003(SNOMED) | Diagnosis | active | 01/04/2024 | |
| Localized obesity (disorder) | 270486005(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Lymphedema (disorder) | 234097001(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Peripheral venous insufficiency (disorder) | 20696009(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Localized obesity (disorder) | 270486005(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Hypermobile Ehlers-Danlos syndrome (disorder) | 30652003(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Lymphedema (disorder) | 234097001(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Obesity (disorder) | 414916001(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Autonomic neuropathy (disorder) | 277879009(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Varicose veins of lower extremity (disorder) | 72866009(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Peripheral venous insufficiency (disorder) | 20696009(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Mast cell disorder (disorder) | 397007003(SNOMED) | Diagnosis | active | 11/10/2023 | |
| Autoimmune disease (disorder) | 85828009(SNOMED) | Problem | active | ||
| Circulatory care for venous insufficiency (regime/therapy) | 386238003(SNOMED) | Problem | active | ||
| Easy bruising (finding) | 424131007(SNOMED) | Problem | active | ||
| Increased blood pressure (finding) | 24184005(SNOMED) | Problem | active | ||
| Gastroesophageal reflux disease (disorder) | 235595009(SNOMED) | Problem | active | ||
| History of obesity (situation) | 161453001(SNOMED) | Problem | active | ||
| History of anemia (situation) | 275538002(SNOMED) | Problem | active | ||
| History of fall (situation) | 428942009(SNOMED) | Problem | active | ||
| Hypercholesterolemia (disorder) | 13644009(SNOMED) | Problem | active | ||
| Hypothyroidism (disorder) | 40930008(SNOMED) | Problem | active | ||
| Pain in female genitalia on intercourse (finding) | 81712001(SNOMED) | Problem | active | ||
| Postural orthostatic tachycardia syndrome (disorder) | 371073003(SNOMED) | Problem | active | ||
| History of clinical finding in subject (situation) | 417662000(SNOMED) | Problem | active | ||
| Eczema (disorder) | 43116000(SNOMED) | Problem | active | ||
| Anxiety (finding) | 48694002(SNOMED) | Problem | active |
| Substance | RxNorm | Reaction(s) | Severity | Status | Start Date |
|---|---|---|---|---|---|
| Cefzil | 224901 | unspecified | active | ||
| Neosporin Plus | 466479 | unspecified | active |
| Medication | Generic Name | RxNorm | Strength | Strength Unit | Route | Dose | Dose Form | Frequency | Date Started | Date Ended | Status | Indication | Sig |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Acid Reducer (famotidine) | famotidine | 310273 | 20 | mg | Oral | tablet | twice daily | 01/04/2024 | active | Take 1 tablet orally twice daily. | |||
| Claritin | loratadine | 206805 | 10 | mg | Oral | 1 Tablet | tablet | Twice a day | 01/04/2024 | active | Take 1 tablet orally twice a day. | ||
| liothyronine | liothyronine | 903456 | 10 | mcg | Oral | tablet | active | ||||||
| metformin | metformin | 861007 | 500 | mg | Oral | tablet | active | ||||||
| Quviviq | daridorexant | 2599098 | 50 | mg | Oral | tablet | active | ||||||
| Ajovy Syringe | fremanezumab-vfrm | 2056700 | 225 | mg/1.5 mL | Subcutaneous | syringe | active |
| Code | Site | Date Diagnosed | Status |
|---|---|---|---|
| Documentation of past medical history (procedure) | completed | ||
| Documentation of past medical history (procedure) | completed | ||
| Documentation of past medical history (procedure) | completed | ||
| Plastic surgery self-referral (procedure) | |||
| Documentation of past medical history (procedure) |
Future visit for 01/04/2025 - Follow up in 1 year
| Code | Detail | Instructions |
|---|---|---|
| 206805 | Claritin 10 mg tablet | Take 1 tablet orally twice a day. |
| 310273 | Acid Reducer (famotidine) 20 mg tablet | Take 1 tablet orally twice daily. |
| Problem | Code | Type | Status | Date of Diagnosis | Date of Resolution |
|---|---|---|---|---|---|
| Eczema (disorder) | 43116000 | FINDING | |||
| Hypercholesterolemia (disorder) | 13644009 | FINDING | |||
| History of obesity (situation) | 161453001 | FINDING | |||
| Gastroesophageal reflux disease (disorder) | 235595009 | FINDING | |||
| Increased blood pressure (finding) | 24184005 | FINDING | |||
| History of anemia (situation) | 275538002 | FINDING | |||
| Postural orthostatic tachycardia syndrome (disorder) | 371073003 | FINDING | |||
| Circulatory care for venous insufficiency (regime/therapy) | 386238003 | FINDING | |||
| Hypothyroidism (disorder) | 40930008 | FINDING | |||
| History of clinical finding in subject (situation) | 417662000 | FINDING | |||
| Easy bruising (finding) | 424131007 | FINDING | |||
| History of fall (situation) | 428942009 | FINDING | |||
| Anxiety (finding) | 48694002 | FINDING | |||
| Pain in female genitalia on intercourse (finding) | 81712001 | FINDING | |||
| Autoimmune disease (disorder) | 85828009 | FINDING |
All recommendations in this note should be evaluated by you and your primary healthcare providers to determine if they are appropriate for you. All supplements can have side effects similar to medications and all ingredients on the supplement package should be assessed by you before taking. This visit was 15 minutes with >50% time spent counseling on mast cell activation syndrome.
Service provided at Total Lipedema Care - Arizona, 6365 E Tanque Verde Road, Suite 200, Tucson, AZ 857153830. Office phone number is 3108825454. Office fax number is 3107475908.
| Encounter Diagnosis | Location | Date / Time | Type |
|---|---|---|---|
| Mast cell activation, unspecified (D89.40) | Total Lipedema Care - Arizona | 01/04/2024 18:30:00 UTC | 99212 |
No Data
Additional HPI Comments: Good morning, I am sharing some mold test results and context that Dr. Herbst may find helpful for the overall MCAS picture--one from summer 2022 and a repeat from this month (my doctor's office changed testing companies in between tests). I have taken a detoxification supplement and charcoal for months and use Biocidin in my Xlear nose spray regularly, and these things are clearly not working. I also did one hyperbaric chamber session in January 2023 that I hoped would help with migraines and mold, but it made me feel worse rather than better and I did not continue. My functional doctor has recommended Bioflm CLR twice daily to begin breaking down biofilms + twice daily prescription Nystatin for 3 months (she originally recommended Itraconzazole 200 mg daily for 4 weeks, but it interacts with the CGRP inhibitors I take for migraines). She and I wanted to run this plan by Dr. Herbst to get her opinion on it in the overall MCAS picture at my appointment next week. Thanks! ------------------------------ Savannah Sandoval, Dr. Herbst [Jan 02 2024, 3:24 PM] Hi Lindsey, Dr. Herbst reviewed those results and this is her response: "The ochratoxin likely activates mast cells. Is it possible to avoid the foods you are ingesting the ochratoxin from?" ------------------------------ Lindsey Carver [Jan 02 2024, 3:32 PM] Possibly, but I was also exposed to mold in my childhood home and at my previous job where the building was known to have mold. It seems to be in my sinuses. She continues to test positive for different molds ________________________________________________ She had COVID recently and has fatigue Supplements D and K She has active Epstein Barr and is on ortho Immune and vitamins to support the immune system Thiamine Occasional Meyer's cocktails Compounded allergy drops Claritin - other antihistamines do not seem to help Probiotics A detox supplement did not help with the mold Apple cider vinegar Cod liver oil MVI DIM and CDG for PCOS Licorice blend for GI issues Magnesium threonate She has psychophysiological insomnia and takes medication for this that helps She eats a lot of Mediterranean food and will pick up food that is gluten and dairy free
| Family history: Autoimmune disease (situation) - MOTHER |
| Family history of cancer (situation) - AUNT, GRANDMOTHER, FATHER |
| Family history: Anemia (situation) - GRANDFATHER, FATHER |
| Family history of headache disorder (situation) - GRANDFATHER, MOTHER |
| Family history of irritable colon (situation) - GRANDFATHER |
| Family history of seizure disorder (situation) - FATHER |
| Family history of dementia (situation) - GRANDMOTHER |
| Family history: Alzheimer's disease (situation) - GRANDFATHER |
| Family history of stroke (situation) - GRANDFATHER |
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| Care Team Member Name | Role | Identifier | location | Telecom |
|---|---|---|---|---|
| Karen Herbst | Doctor | 1114977840 | 6365 E Tanque Verde Road, Suite 200 Tucson, AZ 857153830, US | 3108825454 |
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