52 yo f. CBC within Normal limits. TSH within normal limits. Negative DM. 5 5 250 lbs. (Was maintaining 208 lbs until after 4 surgeries for Basal Cell Carcinoma. Moh s under and into R Nares positive results. Other 3 surgeries without clear parameters and was stated deep extensive BCC.) Dx with Depression and elevated cholesterol. Present meds; Effexor xr 75mg daily, Wellbutrin 100 mg twice daily, Pravastatin 20 mg daily. Problem; Constant fatigue, decreased ROM with L arm after surgery in 2012, constant pain L arm and feels as if bone will break (upper arm), Pain area increasing L arm then to L shoulder to both shoulders, Left neck with noted lumps, also lumps along collar bone bilat, pain at tongue base. No redness in throat and is not scratchy sore but yes noted pain, also head aches and pain was not relieved with 800 mg Ibuprofen and rest. Now I am noting bilat lower extremity edema and feels tight. Had the BCC for 4 years prior to surgery thinking is was psoriasis. L arm area was size of a quarter and increasing, L arm was greater than a nickle in size and a horn noted R deltoid area. Thank you