Transcription: patient’s interview part 1
D: Good Mrs Stone, you’re 68 y.o…..1 meter 62 centimetres high… and you
weigh 72 kilograms…. What brings you here?
P: Well…You know, I have my problems.
D: But what is actually happening? Do any of your diseases become specifically
bothering?
P: I’ve never suffered from any serious diseases. But with my age have arrived
some problems. My family knows nothing about that, but my vision has worsened.
I have some problems with digesting, sometimes my blood pressure is too high.
My doctor thinks that diet change would be somehow beneficial.
D: Is your vision worse after dusk or in dark places? Have you contacted your
ophthalmologist?
P: I don’t think so, it’s rather equally bad during daylight and nighttime. I’m having
an appointment with my eye-doctor next week.
D: Do you take any medicines for these problems?
P: I took a whole list of all the drugs I take… so this one’s for blood pressure…
there is one supplement for heart….. There is one I take when I have heartburn, I
also take this supplement for my eyes. And I take something called… statins? I
think that’s what it’s called.
D: Okay… have you been diagnosed with atherosclerosis? or dyslipidemia? any
other heart disease? or pre-diabetes, for example?
P: No. My LDL-cholesterol level was high in few of the blood tests. But nothing…
D: If you are not diagnosed with these diseases - diet change, definitely, can be
very helpful in reducing elevated cholesterol levels before they develop into
something dangerous. I’m glad you are showing up now! But still - I’d like to see
your recent blood tests, do you actually have them now?
P: Actually, yes!
D: Great, can I have a look... I see. Just like you said, everything is fine except
the LDL-cholesterol, and total cholesterol levels.
Hm… Are these supplements prescribed by your GP?
P: Yes, they’re just some plant extracts, omega-3 fatty acids… I do not take
multivitamin supplement or anything without informing my doctor.
D: How about Vitamin D?
P: No, I don’t take this one either.
D: Mhmm...And tell me, how would you describe your physical activity? Are you
often outdoors, do you do some kind of sport?
P: Not really. I am not very active. I am retired. I don’t have any pets. My son
doesn’t need help with his children. My only activity is doing shopping once a
week and cleaning my apartment, sometimes I meet with my friends.
D: I see...Do you smoke?
P: No, I never did.
D: How about alcohol?
P: I drink red wine on special occasions, maybe twice, three times a year, but not
too much.
D: And how would you describe your appetite? Has it changed recently?
P: Not recently, but I’m eating much less than few years ago. I don’t get hungry
very often, actually. My gums hurt a little, it’s because of my tooth bridge doesn’t
fit perfectly.
D: You have a bridge… so can you bite properly?
P: Not really, my gums hurt. So I prefer eating soft food.
D: What does your dentist say about that?
P: She says my gums are fine, but the bridge change will be helpful, but unfortunately - I can’t afford it right now.
D: I understand…so let’s move on to these digestion problems you’ve mentioned.
Are you experiencing constipation or bloating - if so, on a regular basis or after
eating certain products?
P: I don’t go very often to the toilet. Two… maybe three times a week. And I am
bloated after a big meal, but it’s not connected with anything specific, I guess…
D: How much do you drink every day?
P: Usually, I’m not very thirsty, I don’t drink a lot. I drink earl grey tea with some
milk in the morning, a glass of warm water around noon, another tea in the
afternoon together with my butter cookies, and a cup of tea in the evening.
D: Are you cooking for yourself?
P: Sometimes. But I had a few accidents with forgetting to put my casseroles out
of the oven. My neighbors had to call firefighters once. So now my daughter-inlaw cooks for me, but occasionally I do it myself. My daughter-in law comes to my
apartment every two weeks with a lot of frozen dishes to heat in a microwave. But
I have to admit - I’m not a big fan of her cooking. I’m trying to eat them, but I
never finish the plate. I eat sandwiches very often. But I also like apples from
microwave.
D: So you’re living only by yourself?
P: Yes. I wish my children came visit me more often, but they are all so busy.
D: I see… How would you describe what you eat during the day?
P: Hmm, I wake up early, around 5-6 a.m. But I don’t eat my breakfast right away.
I am not really hungry just when I wake up. I eat about at 7-8 a.m. – sandwiches
with a slice of white bread each - with some ham or cheese, at noon - I try eating
lunch from Betsy, my daughter-in-law. It is usually something like chicken stew
with potato puree, but I don’t eat much of it. It’s tasteless… and then around 5
o’clock I eat some cookies, with tea, than at 7-8 o’clock I eat the same
sandwiches with ham or cheese.
D: Do you add any vegetables to your sandwiches? like lettuce? tomatoes?
cucumbers, pickles maybe?
P: Not really, It gets hard to bite when there are some veggies on top.
D: You told me you feel bloated after big meals, but from your description of your
typical eating behavior, I can see that your portions are quite small. How often do
these big meals happen?
P: I don’t eat much also because of the bloating problem. I’m trying to avoid it. I’m
eating more on Christmas for example, on Thanksgiving. I think it’s just because
my stomach got smaller overtime. When I was young there were no problems
with eating more.
D: And do these new eating patterns make you feel worse? Have you noticed any
weight-loss for the past 3 months?
P: I don’t know… I can’t remember when I’ve checked my weight for the last time,
but I think I lost some kilos. I certainly feel much weaker than a few years ago, but
I think it’s normal when you get older.
D: Good, I suggest that we measure your body composition. But before we do
that - I have to ask - do you have any metal parts in your body? Like a
pacemaker?
P: No, I’m good.
D: Do you have epilepsy?
P: No.
D: When was your last meal?
P: I ate about 7:00 o’clock, so it’s been about … 4 hours now.
D: Have you drunk anything today?
P: I drank a glass of water about half an hour ago, is that okay?
D: Good, so we can conduct the BIA test. It’s completely harmless, you won’t feel
anything. I just have to measure your weight and your height first.