Arun Patel shadow health – Focused Exam: Hypertension and Type 2 Diabetes
Transcript
Started: Mar 31, 2020 | Total Time:51 min
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hi, i am danielle
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Greet |
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Hey.
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whats the primary reason for your visit
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I’m here to check up on some numbers that I have for my diabetes and my hypertension. Guess they’re not looking too hot.
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I know that a diagnosis can be frightening, and that keeping your diabetes under control is difficult and stressful. However, this is a manageable condition, and you have the chance to greatly improve your situation with diet and exercise
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Alright. I get it.
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how long have you had these conditions
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I got diagnosed with diabetes five years ago, and hypertension a year ago. But for the more recent stuff . . . over the past three or so months, I’ve gained some weight and felt pretty fatigued. And for probably a month now, I’ve had to pee way more and drink way more water.
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do you check your blood sugar
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I check my blood sugar . . . sometimes. I know with diabetes, you have to check it every day, but I don’t have a lot of time, and needles are tough for me.
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you need to check you blood sugar regularly and keep a record. I know that you dint like needles but if you dont monitor your diabetes you could end up needing insulin, which involves injections. you should aim to use your glucometer at least four times a week
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Yeah, youre probably right.
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do you have any allergies
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I don’t have any allergies that I know of.
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any recent hospitalizations
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I haven’t ever been hospitalized in that sense of the word. But I have seen a doctor before, about my hypertension and diabetes numbers, and I’m here to check in about them.
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what are your home medications
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Hydrochlorothiazide for my hypertension, metformin for diabetes, and escitalopram for anxiety.
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what dosage do you take (Clarified to What doses are your medications?.)
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Let’s see . . . the water pill is a 50 milligram . . . the anxiety pill is a 20 milligram . . . and the metformin is an 850 milligram tablet. (Clarified to what dose my medications are.)
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do you miss any does (Clarified to Do you miss doses of your medication?.)
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I’m good about taking all my doses. I just take my metformin with breakfast, lunch, and dinner. And I take the water pill and the anxiety pill just with breakfast. I’ve been on metformin for 5 years, and I don’t think I’ve missed a dose. (Clarified to if I miss doses of my medication.)
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do you exercise
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I don’t exercise. I just don’t have the time.
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tell me about your diet
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My diet could be better, to be honest. I eat a lot of carbs and fried foods, and I tend to go for pizza when I’ve had a really bad day. I don’t feel like my diet is out of control exactly, but I’ve been thinking about cutting down.
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do you drink
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I never drink.
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what level of income do you make
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I make around $25,000 off of my graduate school stipend. I have to be pretty careful with my budget.
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family history
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My folks have some stuff going on, which is probably why I’ve got some stuff going on. My dad has hypertension like me, and my mom has diabetes like me. She has high cholesterol, too.
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i am sorry to hear that you are having a hard time with your family. I am sure that is adding to current stress and anxiety
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Empathize |
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Ha, thanks.
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i am sorry about your financial difficulties
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Thank you.
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difficulty urinating
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I can pee just fine. In fact, I’ve been having to pee way more these days.
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any chest pain
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I never really have chest pain.
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how you deal with your anxiety
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Usually when I’m anxious, I just breathe slow and take a few minutes, but I’ve been so much more worried lately it doesn’t work very well. Honestly, the only new thing I’ve been doing to deal with all this stress is eat comfort food. I’ve probably gained 15 pounds since I last came to the doctor three months ago.
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managing you anxiety can be challenging, and I’m sorry it has made such a huge impact on your life
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Empathize |
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Thanks for saying that.
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a healthy diet is important to control your hypertension and disbetes
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Educate |
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Good to know.
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in order to manage your diabetes and hypertension, you will need to manage your weight
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Educate |
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I hadn’t thought of that.
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i need to educate you on your new medications
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I appreciate it.
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take at same time everyday
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Yeah. Got it.
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stop taking your previous medications
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Alright. I’ll stop taking my other medication.
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monitor for signs of low blood sugar
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I’ll start keeping snacks in my school bag.
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monitor for signs of an allergic reaction
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I’ll let you now right away if I see anything like that.
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it is important to check your blood sugar
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Alright – I can do that.
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stop taking your other medication
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Alright. I will.
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report signs of cough fatigue and headache
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Thanks for the heads up.
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contact us immediately if your tongue swells
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Ah. Alright.
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avoid salt substitutes
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Gotcha.
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and standing too quickly
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Hmm. Alright.
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can i help you with anything else.
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Ok. See you later.
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