  Please see note in chart essentially entirely positive including cardiovascular problems of shortness of breath, PND and palpitations, chronic lack of energy, weight gain, the dizziness for which she presented.  Tinnitus in the right ear.  Diabetes and hypothyroidism.  Chronic nausea.  Chronic severe musculoskeletal pains to all extremities as well as to chest and abdomen and back.  Right-sided numbness as well as complaints of bilateral lower extremity numbness and difficulty walking.  She says her mood is sad and may be depressed and she is also extremely anxious.  She has chronic shortness of breath and coughs easily when has to breathe deeply.  She also endorses poor sleep.