Hypertension, high cholesterol and triglycerides, type 2 diabetes, sleep apnea are actual health risks that Mr. C. has. He is also at risk for cancer, cardiovascular disease, stroke, and death as a result of his obesity as well (Cleveland Clinic, 2018).
~Is bariatric surgery an appropriate intervention? Why or why not?
At 68 in. and 134.5 kg Mr. C. has a BMI of 47.8. According to the Cleveland Clinic a BMI greater than 40, and negative health effects such as hypertension, diabetes as a direct result of this morbid obesity, makes you an ideal candidate for bariatric surgery (2018). As Mr. C. has many of these negative health effects it would be appropriate for him to have the gastric surgery.
Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:
Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
Ranitidine (Zantac) 300 mg PO at bedtime.
Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.
Problem number one that I identified for Mr. C is the desire for bariatric surgery without any expressed attempts at losing weight. He has been heavy most of his life which may indicate some genetic predisposition but even with the surgery it is very important that patients practice self-control in making better choices with diet and exercise (Mayo Clinic, 2017). Problem number two is type two diabetes. Mr. C would require some more testing to diagnose (A1C) but with the lifestyle choices he has made he along with other comorbidities such as obstructive sleep apnea, low HDLs and high triglycerides, he is definitely at risk for decreased insulin sensitivity leading to a whole host of problems (Mayo Clinic, 2017). Problem number three is the hyperlipidemia as evidence by the lab values provided. Hyperlipidemia can lead to atherosclerosis, which in turn can lead to much more serious problems like stroke, heart attack, and death (Lewis, Bucher, Heitkemper, & Harding, 2017). Problem number four is the potential for coronary artery disease (CAD). Mr. C displays a lot of risk factors associated with CAD such as obesity, sedentary lifestyle, hyperlipidemia and hypertension (Lewis, Bucher, Heitkemper, & Harding, 2017). Problem five is his mental well-being. Stress is a risk factor for all of the other problems listed before this point. Physiologically cortisol levels increase the way the body stores fat, decreases metabolism, decreases the secretion of testosterone all of which contributes to Mr. Cs eating habits, weight gain, blood glucose, and perpetuates the whole negative state of health and of consciousness (American Psychological Association, 2018).