Probable Outline and Diagnosis-
Mrs. Hart I have read over all of your papers and all of the categories that you fall into. The thing s that concerns me the most is your medical history. You had a stent inserted to open a blocked artery nearly 10 years ago but you stopped visiting your cardiologist. This I am afraid if not acted on could be a deadly decision. Another thing that concerns me are your regular episodes when you get back pain and feel nauseous. This indicates to me a instability somewhere in possibly your heart and is something that needs to be checked out a.s.a.p. Your family history of diabetes and death of stroke is certainly things that I believe you can be at serious risk for especially with your borderline high risk cholesterol levels. At this point there is a very real possibility that your stent can be currently more of a problem than a beneficial asset and I have a plan that I will discuss more in detail later in the report. Following up regularly with a cardiologist is going to be mandatory when pursing a heart healthy lifestyle and a healthy heart. If you do not follow up with a doctor regularly then do not expect to see significant results.
Lifestyle Modifications Role in Prevention-
Like I said early, you must, and I emphasize must, follow up with a cardiologist. This is going to essentially be the difference between life and death with the stand point you are at now. Living on the edge is not the healthy way to live and I think that if you follow my plan and regularly check up with a cardiologist then you will be heart healthy in no time. I also have a plan in which I will hopeful be able to replace the bad stent in your bad artery. For all I know this stent could be building up plaque causing more bad than good and bad is the last thing you need right now. The best thing that you can do for yourself and that you have control over is lowering you cholesterol levels. This can primarily be achieved by following the Nutrition and Exercise guide that you will be receiving in this file.
Heart Healthy Plan-
The plan that I have devised for you is one of strict doctor follow ups. I believe that every 2 months you should come in and get a entire updated body check. This will measure your blood pressure, blood sugar, cholesterol levels, etc. This information will not only be analyzed by the cardiologist by it will also be given to the trainer and nutritionist. This will allow for a very updated and very relevant plan 24/7. Personally I believe we should begin pursing getting a closer look at that 10 yr old stent and look at replacing it with a fresh new one. That procedure I will further detail later on in the case report. Mrs. Hart if you can simply follow up with your doctor and continue following up with all of the recourses at your fingertips then there is not a shadow of a doubt in my mind that your intervention will be successful.
Medications/ Procedures –
Like I mentioned early I firmly believe that we need to take a closer look at that 10 yr old stent. This can be done