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	Question 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	Question 03/31/20 1:34 AM CDT
	Alright – I can do that.
	stop taking your other medication	Question 03/31/20 1:34 AM CDT
	Alright. I will.
	report signs of cough fatigue and headache	Question 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.

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