C10009171 / invoice 10000

Reason: BeransaAppointment Notes: ------- Sms reply: YReason: Client Present: Sandra Nurse: Kirra O thinks going as well as can be expected. No change since last visit. Here for Beransa with JM__________________________________________________________________________History:Presented for repeat Berenza injection. Doing well on current medications including Gabapentin and 4CYTE.Examination:Multiple small adenoma-like lesions on face, varying 3-4mm to 0.5cm diameter. No bleeding or ulceration noted. Multiple large lipomas present on sternum and ventral abdomen.Assessment:Dermatological lesions stable. Current medication regimen well tolerated and effective.Treatment:Repeat Berenza injection administered.Supplied Gabapentin 100mg, 200 caps. Plan:Discussed natural progression of facial lesions - more will develop over time. Potential debulking of lipomas discussed for future consideration, not urgent. Owner concerned re Beransa and potential side effects. Package insert provided. Advised independent research. Explained occasional adverse reactions possible but risk-benefit assessment important. Owner to make decision regarding future procedures. RTC 1/12.Consent has been given to the client to proceed - Yes, for repeat injection.Client communication:Discussed progression of facial lesions. Debulking surgery options explained for lipomas. Anaesthetic risks and potential complications discussed. Package insert provided. Encouraged independent research. Risk-benefit analysis explained. Owner to decide on future surgical intervention.    Vital Signs    Weight: 12.1;       HeartRate: 92;       DentalGrade: 1;       RespirationRate: 18;       CRT: -2s;       MMColour: PMG;       BodyScore: 6;