He denies taking these meds for any other reason but to be able to stay awake at work. He also admits that he is not in the position he thought he would be in at this age in his life. Approximately five years ago, he was laid off as the manager of a local distributing company. Since that time (which is also the time of his son's birth), he feels that he has become increasingly stressed as well as disappointed in himself. He used to go to church, but he has not been since his mother died. He believes that going to church helps him feel more grounded and at ease. It is recommended that Mr. Sinatra learn to release his stress in positive manners such as exercising in the pool, walking, and stretching, attending counseling, and going to church. Values and Beliefs

Mr. Sinatra and his family are members of the local Episcopalian church. Mr. Sinatra has a strong belief system which he says oftentimes gives him the strength to carry on when he begins to despair. In fact, Mr. Sinatra used to volunteer at the local homeless shelter as a cook. He says it is selfish on his part because he always wanted to be a chef and he takes away more than he gives. Since his mother's death, he worked more and has not volunteered. It is recommended that one of his occupational therapy consults be geared toward the kitchen. While Mr. Sinatra is nervous about finances and time off from work, he does seem to be amenable and open to using the time to connect with the people and things that used to bring him happiness. He has a strong work ethic and a strong dedication to his family.

Based upon all that he has to live for as well as his spirituality, work ethic, and dedication to family, it seems that with the proper follow-up care and support for his family and himself, Mr. Sinatra has a good prognosis for regaining a healthy and positive quality of life.

Nutritional-Metabolic

Mr. Sinatra's diet generally consists of fast food when he is on the road. A typical daily food intake might be a donut/Danish for breakfast, snacks throughout the day (e.g., potato chips, candy bars, licorice), and then a fast food meal...

Additionally, Mr. Sinatra drinks approximately six-ten sodas per day as well as approximately 4-6 cups of coffee per day. He rarely drinks water and he does not take vitamins or supplements.
He presents as 5'11" and 265 pounds with a significant amount of his weight carried in his abdomen. In the past five years, he has gained approximately thirty pounds, but he denies a significant difference in his eating habits. The major life change is that he switched jobs from one in which he was walking quite a bit to one which is completely sedentary. Additionally, he went from living at home and eating relatively healthy home-cooked meals at regular intervals to living a life on the road and eating a significant amount of fatty foods devoid of nutritional content. He denies skin problems, but admits to needing to see a dentist. It is anticipated that a return to home cooking and eating regular portions at regular intervals will greatly assist Mr. Sinatra in his weight management and overall health. Accordingly, we will order a nutritional consult with follow-up care to ensure that Mr. Sinatra and his family receive adequate support with regard to healthy lifestyle changes.