After analysing the details of Robert Reid from the case study, it is evident that some of the his risk factors for Coronary Heart Disease (CHD) and Hypertension include the fact that he is male, old age, has a family history of CHD and he is African-American. The other factors that predispose him to CHD and hypertension that he can control include obesity, long periods of physical inactivity, unhealthy eating habits and the low levels of High Density Lipoproteins (HDL) and high levels of Low density Lipoproteins (LDL) (Pedersen et al. p.1383). Complications that could result from the latter are that there will be reduced blood flow in his narrowed arteries hence an increase in blood pressure. This causes chest pains, shortness of breath and possibility of a heart attack due to a completely blocked coronary artery.
A one-day sample menu for Mr. Reid is presented in the table below, assuming his dietary needs are 2000calories per day (DASH Eating Plan).
Some of the lab tests that Mr. Reid can do to further assess his condition are: electrocardiogram, echocardiogram and cardial enzyme tests. These are important in assessing the heart muscle functions and rhythm. He can also benefit from weight loss and physical activity by decreasing his LDL levels, lowering his blood pressure and also having a strong heart muscle (Pedersen et al. p 1392). His frequent wine intake could increase the probiotic enzymes in the gut which improves digestion but also due to the alcohol content in the wine, there is possibility of liver cirrhosis or heart damage. If he doesn’t change his lifestyle and goes on to get a heart attack, Mr. Reid could benefit from a rehabilitation program that includes exercise with a professional instructor and a trained nutritionist, classes to teach about risk factors and support for dealing with anxiety and depression (Beckerman p 203).
John Todaro.
His weight loss could have been brought about by the fact that he cannot feed properly due to his condition. When the lungs are inflamed in a person with emphysema, the lung volume expands in size. This reduces the amount of space between the lungs and the stomach hence during eating, the two organs push against each other causing discomfort. This discourages the patient from feeding. Also, high-fibre foods, carbonated drinks, caffeine, salty foods and eating too fast trigger the symptoms of emphysema. The patient loses appetite for food in the long run and weight loss occurs (Haas p.23). The heavy breathing contributes to weight loss because much more calories are burned. Damaged lungs burn ten times more calories than normal lungs (Cleveland Clinics).
Oxygen therapy is a very important aspect in the life of a patient suffering from emphysema. It helps them breath better by increasing the amount of oxygen that flows in the lungs and finally in the bloodstream. This gives a patient more energy and less discomfort during feeding Miller p. 20).
Muscle wasting due to the weight loss resulting from the fact that feeding is a problem and in the long run, the body lacks some important nutrients like proteins which are essential in building and repairing the worn out body muscles.
There is also the slow to fast shift in fibre type composition resulting in weakness and an earlier onset in muscle fatigue.
His old age can also contribute to his tiredness as his bones are very fragile at this point and supporting his body weight is a great challenge.
Seeing as it is physical activity that is likely to cause shortness of breathe for Mr. Todaro, it is important for him to consult his doctor before doing any exercises. Regular physical activity is important in that it improves blood circulation, it facilitates more oxygen supply to the body thereby reducing the symptoms of the disease, and it strengthens the respiratory muscles and slows down the decline of lung function. Exercise when done under the keen eye of the care giver (in this case, his daughter) and the specialists involved, it improves the quality of life and enables the patient to live longer. Also, the fragile nature of Mr. Torado should be taken into consideration because he is well into his eighties.
Physical activity can be started from a modest level and build up from there depending on how well the patient adapts. It should not be overdone as it may increase incidences of shortness of breathe. A Rated Perceived Exertion (PCE) scale can be used to measure the intensity of physical activity (Miller p. 45).
Works Cited
Haas F and Haas S.S. The Chronic Bronchitis And Emphysema: Revised And Expanded
Edition. 2009. Print.
Miller W.G How I Reversed My Mum’s Emphysema. 3rd Edition. Oxford University Press. 2005. Print.
Pedersen T, De Backer G and Graham I. Prevention of Coronary Heart Disease in Clinical Practice. European Society of Hypertension. Eur Heart. 1994. Print.
