The authors recommend that the patient, a women of 35 years, should drink no more than 14 units (where one unite is half a pint of beer or two thirds of a small glass of wine) of alcohol per week or three units in a given day. Ideally, 1-2 units per day are recommended. While the patient does not drink during the week, she does tend to drink somewhat excessively over weekends. Her goal is to reduce her alcohol intake gradually towards only one or two units per day on weekends, while maintaining her non-drinking habit during the week. To reach this goal, the patient has enlisted the help of her friends. Specifically, she will reduce her exposure to alcohol by at first reducing her times at pubs and parties. She has asked her friends to help her by holding parties at their homes or in restaurants rather than in pubs and other high-alcohol venues.
The patient has taken several actions to reach each of her four goals. She has enlisted the help of both professionals and her friends, made lists of her short- and long-term goals, and taken personal action like joining a gym, avoiding pubs, and replacing the unhealthy foods in her home with a healthier selection. All four goals represent fairly radical changes for her, and setbacks could be a problem.
The greatest areas of concern is maintaining the exercise regime and the reduction of alcohol intake. In order to maintain the first goal, it is recommended that the patient also enlist the help of friends. Many find exercising with a friend more pleasant than attempting the regime themselves. This has both psychological and social benefits. Indeed, exercising with a friend over weekends can also supplement the new low-alcohol lifestyle. Friends also serve as a motivating factor in maintaining the exercise regime. When setbacks in this regime then occur, the patient can ask her friends to help her maintain a mindset that is conducive to regaining her momentum and motivation.
In terms of her lowered alcohol intake, the patient may experience a setback when being tempted to drink too much during a dinner or a party with friends. Here also she can rely on her friends for support. She can for example identify one or two friends as close companions to help her find and maintain a habit of lower alcohol consumption over the weekends.
In terms of dietary changes, it is recommended that the patient ensures that the majority of foods available in her home are healthy and low in calories. She should also maintain a list of food intake for each day, which she can then consult whenever she feels like eating.
The ideal outcome is that the patient do not develop either diabetes or high blood pressure. When these conditions do however arise, the success of the patient's strategies can be measured by how easily she is able to manage the conditions. Only minor adjustments to her diet should be necessary in addition to the prescribed medical treatments.
Of course the plan should be adjusted to fit the patient's age with the passage of time. The exercise regime may be maintained in terms of time, for example, but should be adjusted in terms of impact, particularly for aerobic activities. Further adjustments can be made in terms of calorie intake as the patient advances in years and becomes less active. Less active persons need fewer calories. The possible future need for insulin treatments should also be taken into account in this regard.
In conclusion, it is vital to take into account all the factors relating to the patient's condition before a dietary and exercise plan is recommended. It is therefore important that the help of professionals be enlisted, while the help of friends can be enlisted in terms of personal support to maintain a healthy regime of diet and exercise.
Connection-Fitness (2007). Benefits of Exercise. http://www.connection-fitness.co.uk/health-fitness/health/benefits-exercise.aspx
Delahanty, Linda M. & McCulloch, David K. (2008, June 13). Patient Information: Type 1 diabetes and diet. Up to Date. http://www.uptodate.com/patients/content/topic.do?topicKey=~P8PrVHkHijO4w
Henderson, Roger. (2008). Exercise, heart disease and high blood pressure. NetDoctor. http://www.netdoctor.co.uk/heartdisease/exercise.htm
Kenny, Tim & Kenny, Beverley. (2008). High Blood Pressure (Hypertension). EMIS&PIP. http://www.patient.co.uk/showdoc/23068761