Lipedema Diagnosis

Lipedema

Ojas Aesthetic, Plot no. 275, Kavuri hills, Madhapur opp: police station, above ICICI bank, Hyderabad, Telangana 500081

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Lipedema Diagnosis

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Lipedema Diagnosis

Personal Information

Name *

Contact Number *

Age *

DOB *

Gender

Address *

When did you begin to notice abnormal weight gain/ contour problems

Weight at puberty (Kg):

40-50
51-60
61-70
71>

Present weight (Kg):

50-60
61-70
71-80
81>

Weight gain during pregnancy (Kg):

5-10
11-15
16>

Weight loss after pregnancy (Kg):

5-10
11-15
16>

Weight gain noticed in which part of body: (more than 1 area can be ticked)

abdomen
buttocks
thighs
legs
arms

Attempts History

Did you attempt to lose weight *

Methods practiced for weight loss

No of attempts:

Selected Value: 0

Weight Loss Achieved:

Which part of body did not reduce with weight loss:

Any remarks:

Weight loss achieved:

Age at menarche:

Menstrual irregularities:

PCOD?

History of features:

Obesity
Hirsutism
Menstrual Irregularities
Infertility

History of consumption of oral contraceptives/ hormone pills:

Name & No of pills & duration

Gravida(No. of pregnancies)

No. of abortions:

Para (No. of living children)

Age At Menopause:

Family History

No. of members in family

Males:

Females:

Response of body size to weight loss measures:

Diet

Have you ever gone on diet?

Benefit of going on diet

What kind of diet you have been on?

Exercise/b>

Do you exercise regularly?

What kind of exercises do you do and duration?

What are the benefits observed so far?

Sleep Pattern

Time of sleep:

Time of waking:

Any sleep disturbance: (Please explain)

Presence of skin folds (Areas affected):

Measurements

Height

Weight

Waist Circumference

Hip Circumference

BMI

Waist/Hip ratio:

Waist/Height ratio:

Mid-arm circumference:

Wrist-cuff circumference:

Mid-thigh circumference:

Calf circumference:

Ankle cuff circumference:

Medical Info

Do you have any of the following:
Diabetics
Hypertension
Asthma
Cholesterol
Gall stone
Peptic ulcer
Kidney stones
Breathlessness
Obstructive sleep apnea (snoring)
Thyroid disorder

Duration of disease:

Past Medication:

Presence of pain / tiredness:

Buttocks *

Thigh *

Legs *

Arms *

Others area specify:

Other Area Specified

Presence of bruising: *

Presence of spider veins and telangiectasia: *

Presence of varicose veins: *

Stemmer’s sign (Can you pinch skin of foot below 2&3 toes): *

Presence or absence of lymphedema (pitting on finger pressure) *

Knock knees (Genu Valgum): *

Abnormal fat deposits adjacent to Tibial Tubercle: *

Abnormal fat deposits on either side of lower thighs (above knee joint): *

Appearance of nodular irregularities in thigh and gluteal area (looking like cellulite): *

Any firm & painful swellings in the body: *

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LIPEDEMA IS THE ABNORMAL DEPOSITION OF FAT MOSTLY IN THE LOWER HALF OF THE BODY AND IN THE ARMS IN CERTAIN SITUATIONS. GET YOURSELF DIAGNOSED

Opening Hours

Monday - Thursday

10.00 AM - 20.00 PM

Friday

10.00 AM - 20.00 PM

Saturday

10.00 AM - 20.00 PM

Sunday

Closed

Support

Email Address
srinageshvk@gmail.com

Phone Number
+91 95151 06591

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Lipedema