Arun Patel shadow health – Focused Exam: Hypertension and Type 2 Diabetes
Transcript
Started: Mar 31, 2020 | Total Time:51 min
hi, i am danielle
Greet
03/31/20 1:00 AM CDT
Hey.
whats the primary reason for your visit
Question
03/31/20 1:00 AM CDT
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.
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
Educate
03/31/20 1:03 AM CDT
Alright. I get it.
how long have you had these conditions
Question
03/31/20 1:04 AM CDT
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.
do you check your blood sugar
Question
03/31/20 1:06 AM CDT
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.
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
Educate
03/31/20 1:09 AM CDT
Yeah, youre probably right.
do you have any allergies
Question
03/31/20 1:10 AM CDT
I don’t have any allergies that I know of.
any recent hospitalizations
Question
03/31/20 1:10 AM CDT
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.
what are your home medications
Question
03/31/20 1:10 AM CDT
Hydrochlorothiazide for my hypertension, metformin for diabetes, and escitalopram for anxiety.
what dosage do you take (Clarified to What doses are your medications?.)
Question
03/31/20 1:10 AM CDT
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.)
do you miss any does (Clarified to Do you miss doses of your medication?.)
Question
03/31/20 1:11 AM CDT
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.)
do you exercise
Question
03/31/20 1:13 AM CDT
I don’t exercise. I just don’t have the time.
tell me about your diet
Question
03/31/20 1:13 AM CDT
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.
do you drink
Question
03/31/20 1:13 AM CDT
I never drink.
what level of income do you make
Question
03/31/20 1:15 AM CDT
I make around $25,000 off of my graduate school stipend. I have to be pretty careful with my budget.
family history
Question
03/31/20 1:15 AM CDT
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.
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
Empathize
03/31/20 1:16 AM CDT
Ha, thanks.
i am sorry about your financial difficulties
Empathize
03/31/20 1:17 AM CDT
Thank you.
difficulty urinating
Question
03/31/20 1:18 AM CDT
I can pee just fine. In fact, I’ve been having to pee way more these days.
any chest pain
Question
03/31/20 1:18 AM CDT
I never really have chest pain.
how you deal with your anxiety
Question
03/31/20 1:20 AM CDT
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.
managing you anxiety can be challenging, and I’m sorry it has made such a huge impact on your life
Empathize
03/31/20 1:21 AM CDT
Thanks for saying that.
a healthy diet is important to control your hypertension and disbetes
Educate
03/31/20 1:22 AM CDT
Good to know.
in order to manage your diabetes and hypertension, you will need to manage your weight
Educate
03/31/20 1:24 AM CDT
I hadn’t thought of that.
i need to educate you on your new medications
Question
03/31/20 1:31 AM CDT
I appreciate it.
take at same time everyday
Question
03/31/20 1:32 AM CDT
Yeah. Got it.
stop taking your previous medications
Question
03/31/20 1:32 AM CDT
Alright. I’ll stop taking my other medication.
monitor for signs of low blood sugar
Question
03/31/20 1:32 AM CDT
I’ll start keeping snacks in my school bag.
monitor for signs of an allergic reaction
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03/31/20 1:33 AM CDT
I’ll let you now right away if I see anything like that.
it is important to check your blood sugar
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03/31/20 1:34 AM CDT
Alright – I can do that.
stop taking your other medication
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03/31/20 1:34 AM CDT
Alright. I will.
report signs of cough fatigue and headache
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03/31/20 1:34 AM CDT
Thanks for the heads up.
contact us immediately if your tongue swells
Question
03/31/20 1:35 AM CDT
Ah. Alright.
avoid salt substitutes
Question
03/31/20 1:35 AM CDT
Gotcha.
and standing too quickly
Question
03/31/20 1:35 AM CDT
Hmm. Alright.
can i help you with anything else.
Question
03/31/20 1:36 AM CDT
Ok. See you later.
