Week 2 case

1. Lifestyle Health Care Plan
3 Months Post Initial Visit
• Assess progress for each of the 3
scenarios
• Compliance with SMART goals
• Current Stage of change
• Identify barriers limiting factors
compliance
• Identify potential Motivators
• Identify health risks and/or benefits if
patient continues on the same
trajectory

2. Hi Mr. Garcia
It’s good to see you again.
So the last time you were here
we discussed some potential
strategies for you to focus on
your health and set some goals.
At our last phone conversation
you were tracking your progress.
How have things been going for
you?

3. Patient Statement:
Well I tried to write everything down but after the first couple of
weeks I sort of got off track. I kept forgetting and got frustrated.
I’m working so many hours and am just so tired at the end of the day.
I feel like I can’t keep up and haven’t even been going out as much
with friends or even walking the dog.
My wife has been trying to cook more on the weekend and I’ll usually
take my lunch on Monday but we still end up eating at restaurants or
grabbing fast food a few times during the week. I have not totally
switched to unsweetened coffee or tea but try to order it when I
remember.
I feel like I’m sleeping well and my wife says my snoring has gotten
worse.
SCENARIO 1

4. Scenario 1
INITIAL Current
Height 69 in 69 in
Weight 225 231
BMI 33 34
Waist
circumference
42 in 43 in

5. Scenario 1
BMI 33 34
Blood Pressure
w/ Lisinopril
139/90 142/94
TChol 218 mg/dL 223 mg/dL
HDL 33 32
LDL 154 155
Triglyceride 155 175
Fasting Glu 125 138
Hgb A1C 6.3% 6.5%

6. Patient statement:
Things are going okay. I’m still really busy and stressed at work but
try to get out and walk 15-20 minutes at lunch. It does help me clear
my head and my knee seems to be doing okay. I have been trying to
walk the dog on the weekends more regularly too and tracking
minutes on my phone.
My wife and I have also been trying to cook more on weekends so
that I have leftovers for lunch but I still usually grab fast food a few
times per week. I have switched to unsweetened tea but still have a
couple of beers and occasionally a cigar when I go out with the guys
…3 nights per week.
Some of the guys are talking about starting a Saturday morning golf
group.
SCENARIO 2

7. Scenario 2
INITIAL Current
Height 69 in 69 in
Weight 225 219
Waist
circumference
42 in 41.5 in

8. SCENARIO 2
BMI 33 32
Blood Pressure
w/ Lisinopril
139/90 135/87
TChol 218 mg/dL 205 mg/dL
HDL 33 35
LDL 154 145
Triglyceride 155 125
Fasting Glu 125 115
Hgb A1C 6.3% 6.1%

9. Patient statement:
Pretty well. I feel like my energy level has improved and my pants are a little
looser.
My wife has been helping me and we have been cooking more on the
weekends so I can bring leftovers for lunch and eat at home more often. I
have switched to unsweetened tea or diet soda and black coffee.
Work has still been really busy and I get stressed but I try to get out and
walk 20-30 minutes at lunch time. It helps clear my head and I find I’m not
dragging in the afternoon. I have been using the tracking app on my phone.
I meet the guys a few times per week for a beer and maybe one cigar per
week but try to get home by 9:00 so I can wind down and relax. My wife
says I don’t seem to be snoring as much.
Some of my friends say they’re in the same boat trying to lose a few pounds
so we were talking about starting a Saturday morning golf group.
SCENARIO 3

10. Scenario 3
INITIAL Current
Height 69 in 69 in
Weight 225 210
Waist
Circumference
42 39

11. SCENARIO 3
BMI 33 31
Blood Pressure
w/ Lisinopril
139/90 130/83
TChol 218 mg/dL 198
HDL 33 40
LDL 154 134
Triglyceride 155 122
Fasting Glu 125 112
Hgb A1C 6.3% 6.0%