{"history": [{"sno": "1466", "year": "2025", "answer": [{"options": {"value": "Stephanie C Delima", "optionId": "un4v"}, "questionId": "UNK-lowx"}, {"options": {"value": "C0009604800", "optionId": "unvvv"}, "questionId": "UNB-lowx"}, {"options": {"value": "1991-04-01", "optionId": "UNtdb"}, "questionId": "UNM-iz6p"}, {"options": {"value": "2025-11-23T19:44"}, "questionId": "UNW-iz6p"}, {"options": {"value": "6033185640", "optionId": "nuphno"}, "questionId": "NU-Phno"}, {"options": {"value": "h.bolling@focuscares.com", "optionId": "unb4v"}, "questionId": "UNQ-lowx"}, {"options": {"value": "Focus Care", "optionId": "unp4v"}, "questionId": "UNX-lowx"}, {"options": {"value": "Heidi Bolling", "optionId": "unq4v"}, "questionId": "UNN-lowx"}, {"options": {"value": "Other, Behavioral Health", "optionId": ["nuepq", "bhd"]}, "questionId": "NU-w165"}, {"options": {"value": "PCOS", "optionId": "UNC-MV65"}, "questionId": "UNC-MV65"}, {"options": {"value": "No", "optionId": "unl6D"}, "questionId": "UNB-que"}, {"options": {"value": "No", "optionId": "unl6B"}, "questionId": "UNA-que"}, {"options": {"value": "No", "optionId": "unqdp"}, "questionId": "UNQ-jtcz"}, {"options": {"value": "6084403000", "optionId": "uni4v"}, "questionId": "UNS-lowx"}, {"options": {"value": "Patient demonstrates good self-management with successful weight loss and dietary improvements, showing motivation for health behavior changes. Primary concerns include untreated PCOS with associated fertility issues causing significant emotional distress and relationship strain. Hair loss and back pain from breast size are impacting quality of life. Patient appears to have good insight into medical conditions and treatment needs. Chronic insomnia is being managed with current medication regimen. History of bipolar disorder appears stable without recent episodes. Patient expresses clear need for couples therapy to address fertility-related stress and communication issues with spouse.<br><br>Recommendations include: <br>1) Prioritize breast reduction consultation and placement on surgical waitlist, <br>2) Follow up with OB/GYN for PCOS management and progesterone therapy resumption, <br>3) Facilitate couples therapy referral to address fertility-related stress and relationship concerns, <br>4) F/U w/ endocrinology<br>5) Continue dermatology follow-up for alopecia management and wig prescription, <br>6) Maintain current pescatarian diet and weight loss efforts, <br>7) Continue current insomnia medication regimen.<br>7) MBR needs advanced directives<br>Patient expressed satisfaction with current approach and understanding of next steps.<br>", "optionId": "unl6l"}, "questionId": "UNP-gbms"}], "update": true, "clientId": "client_013", "memberId": "C0009604800", "referralId": "nuvu8", "submittedBy": "HBolling2", "sentToQADate": "2025-11-24T01:53:45.830Z", "submittedUserType": "nurse", "sentToHelpLineDate": ""}], "last_updated": "11-23-2025 20:53:45"}