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Diagnosis The patient has complaints of pain in her ankle and it makes her unable to do much physical activity. Also, the patient has poor eating habits that could contribute to future problems. Although the patient has these minor problems, they also have very high cholesterol, which could lead to a heart attack. Therefore, the diagnosis is a case of high cholesterol. Key Heart-Related Medical Issues and Risk FactorsAs a computer programmer, we have noticed that the patient spends countless hours at their desk and only get up for certain occasions. This could provide many future problems for they are lacking physical activity. They need to get at least 30 minutes a day so that they do not become too obese. We have also noticed that they snack on chips and candy and they drink 4-6 cans of coke a day. Eating habits like this will also cause obesity. To prevent this problem, we will recommend a nutritionist to help balance your diet and improve your eating habits. The patient has also felt sluggish and unmotivated. This is due to a previous broken ankle,To help this, we can request a trainer and help ease her back in to physical activity, but not at too fast of a rate. Lastly, the patient has been on blood pressure medication for 8 years. The blood pressure is at a good level now, but could eventually increase. We will continue to prescribe the blood pressure medication to keep rates near the location where they are. Recommendations for Medications Due to the patient’s family’s history of high blood pressure, we recommend that the patient continues to take their high blood pressure medicine to keep levels where they are now. We have also noticed that the patient’s cholesterol is above the correct level, to lower this we recommend a Cholesterol Absorption Inhibitor. This is a device that decreases LDL and triglycerides, which is good because they are both high. This device also increases HDL, which will be all right because their levels are at 50 (mg/dL) when the average is 50 to 59 (mg/dL).We will also recommend pain medicine for their ankle so that they will be able to be more active. Plan for Achieving Heart HealthIn order to reduce cholesterol we recommend that you should: Lose weight- If the patient exercises each day and they should weigh themselves to see if they are making progress. During the daily workouts, they should allow themselves a 30 minute cardio workout with a warm-up and cool-down. Eat heart-healthy foods- High cholesterol in food, saturated fats, and trans fat are in most foods and can raise cholesterol. If they base each meal of the day around a healthy diet, we can reduce their cholesterol.Continue to refrain from smoking- If they attempt to stay away from cigarettes in total, their cholesterol will lower over time. Lifestyle ModificationsIn order to achieve heart health, the patient must start a healthy diet. We recommended that she begin eating a diet low in saturated fats and high in unsaturated fats. Saturated fats are found in animal products and processed foods. The patient should consider alternatives to her normal sodas, chips, and candy. The patient should consider water, avocados, and nuts. These will increase unsaturated fats, which will lower her bad cholesterol and her overall cholesterol levels.Also, the patient should begin to exercise more frequently.As a result of sitting down all day, the patients LDL, or bad, cholesterol levels are higher. Exercise will lower these levels by increasing HDL (good cholesterol), which clean up the LDL in the blood.SchedulePost-Intervention TestingFirst, we recommend a cholesterol home test kit. With this, they should test their self at least once a week so that we can have an idea of where their levels are over time. Also, make sure they record your levels. We also recommend that they should come into our office at least once a month so that we can examine their blood pressure, cholesterol, heart, and weight. GoalsBlood Pressure- Right now, their blood pressure is right where we want it. We still want to monitor their pressure though.Cholesterol Levels- Their cholesterol is 245 (mg/dL) whenever it should be below 200 (mg/dL). With the inhibitor that we are expecting to have the patient use, this will hopefully lower their levels over time. Within the next few months, we expect the patient’s levels to be below 200 (mg/dL).Physical Fitness- We expect the patient to get at least 30 minutes of physical activity each day to help strengthen their body and heart. The physical activity will also help the patient lose weight. ProgressWe will measure and track the progress they make with logs so that we can see how much they’ve advanced in their pursuit of being completely healthy. Below will be an example chart. MonTuesWedThursFri Sat SunCholesterolBlood PressurePhysical FitnessThe patient doesn’t HAVE to chart each day, but it’s preferred. ................
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