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Diagnosis: Diabetes, hyperlipidemia, chronic liver disease
Background:
At time of referral, this patient had a history of high blood pressure and obesity and was just diagnosed as having type II diabetes. She was thought to have liver disease as her enzymes were elevated. The patient reported her total cholesterol level was elevated to 212, and triglycerides were also elevated. Her liver problems prevented her from taking a stating medication for cholesterol management. The patient had a poor understanding of dietary guidelines for cholesterol management. She described herself as Polish/Hungarian, and admitted to eating a large quantity of sausages, fried potatoes, pastries, and baked goods high in fats and cholesterol. She was obese, and had not been exercising. She had tried dieting in the past with little success. The patient was being considered for medication to treat her diabetes. More...
Diagnosis: Hypertension, obesity
Background:
At time of referral, this morbidly obese patient with poorly managed high blood pressure had made many failed attempts at quick weight loss, and felt discouraged about the prospect of having to be patient and lose weight through lifestyle changes. She was not taking Xenical as prescribed for weight loss as she had frequent bouts of diarrhea. She was eating foods, such as bacon and sausage, for breakfast that are high in fats. She seemed surprised that this medication required her to change her dietary habits. The patient was reluctant to exercise as she had numerous orthopedic problems, including osteoporosis of both knees and a recent torn rotator cuff injury. She had lost and re-gained over 30 lbs in 3 years, and stated she felt she was "ready to give up". More...
Diagnosis: Diabetes, hypertension, hyperlipidemia
Background:
Patient had multiple issues, including poorly controlled diabetes (finger sticks elevated to 180), hypertension, hyperlipidemia, chronic back problems, obesity, bronchitis, and sleep apnea. Despite having medication prescribed for diabetes and having been told by his doctor that he needed to monitor his finger sticks daily, he denied ever being told he was a diabetic. He demonstrated a poor understanding of dietary recommendations for managing his medical conditions. He was obese, but was not modifying his diet to promote weight loss and did not exercise. He was smoking one pack of cigarettes daily. More...
Diagnosis: Rheumatoid Arthritis, Type II Diabetes
Background:
This patient with a long history of rheumatoid arthritis and a relatively new diagnosis of type II diabetes was not taking good care of herself and was experiencing poor control of her diabetes and inadequate pain management as a result. The patient revealed she had lost both her husband and her mother over the past year and was having difficulty being motivated to care for herself. The patient stated she was overwhelmed by the many responsibilities that had suddenly become hers and was experiencing financial difficulties. The patient was not compliant with diabetic dietary recommendations, was gaining weight, and had stopped exercising. The patient admitted her eating habits have been poor since living alone, as she did "not feel like" preparing meals for just one person. As a consequence, she was often snacking on salty and sweet snacks, high in carbohydrates. More...