AS is a 71-year-old woman diagnosed with fibromyalgia. Initial Assessment of AS:
ID: 139289 • Letter: A
Question
AS is a 71-year-old woman diagnosed with fibromyalgia.Initial Assessment of AS:
B/P: 130/82 (on several blood pressure meds)
Height: 5’4”
Weight: 174 lbs
BMI: 29.9
History:
AS was diagnosed with fibromyalgia approximately 10 years ago and her symptoms have gotten progressively worse. She is currently in excruciating pain. She complains of multiple pain locations including: neck, upper back, bilateral hips, bilateral arms to fingers, bilateral legs both anterior and posterior to foot, bilateral feet, bilateral anterior and inferior rib cage pain. She is in pain! She is exhausted. She is frustrated that she can’t spend much time out of bed. She is desperate to get help, but currently feels hopeless.
Medication and supplements:
Atenolol- 25 mg daily
Hydrochlorothiazide-25 mg daily
Verapamil- 180 mg
Crestor- 20 mg daily
Lyrica- 150 mg twice daily
Aspirin- 81 mg daily
Prevacid- 15 mg daily
Zyrtec- 10 mg daily
Osteo Bi-Flex (triple strength)- 2 caplets daily
Vitamin D3- 400 IU daily
Laboratory Data:
AS brought these lab results with her. They were ordered by her primary care physician:
Standard lab tests are below
Dietary Intake:
Day 1
Breakfast
2 cups coffee with cream and sugar, 3 pieces rye toast with butter, large glass OJ
Lunch
Macaroni and cheese (Stouffers), diet ginger ale
Dinner
2 chicken legs, 8-10 wheat crackers
PM
2 pieces cold chicken with salt, tea with cream and sugar
Day 2
Breakfast
2 cups coffee with cream and sugar
Lunch (out with friends)
Quiche, mesclun salad, 2 slices bread with butter, berry cobbler with ice cream, diet coke, coffee with cream and sugar
Dinner
1 orange, 2 pieces cold chicken, tea with cream and sugar
PM
1 piece cold chicken, “bunch” of crackers, diet ginger ale
Day 3
Breakfast
2 cups coffee with cream and sugar
Lunch
Large tossed salad with Italian dressing, 2 pieces sour dough bread with butter, diet coke
Dinner
3 slices rye toast with butter, large OJ
PM
1 snickers bar, 2 cups popcorn, tea with cream and sugar
Questions
1.What is the chief complaint to be addressed with AS?
Based on the available lab data, suggest additional issues that can be addressed nutritionally. It is not necessary to describe your therapeutic plan here. The intent is to identify potential areas to address nutritionally and explain your rationale for each suggestion.
2.What is your assessment of AS’s diet?
3.What further information would you elicit? Keep in mind the four types of nutritional assessment- clinical, anthropometric, dietary, and biochemical. Explain your rationale for the assessments you suggest. Qsest Repert Status: Fina Specimen DOB: 05/21939AGE:7 Cender F in Range Out of angeterenes Range CHOLESTEROL TOTAL 249 RGA CHOLESTEROL 53 LOL, CROLES diabetes and «W /dL for diabetic pacient S with. knom heart disease 4.7 scinG reference SEEva 0-100 ng/ OND3 indiestes boch endogenous productson and ources such as diet o supplesentaton. Tharapy s .20 ngNL indicative of vicanin D detiel.sey, while levels betveen 20 rg/el and 30 n/t sugest nsutticiency Optimal levels aceo -30 ng/ ETANEN D. 25-ON, ng/s Endnote /t Endaote 40-4.50 aceordingly ot establ Lshed PERFORMING SITE DOCTOR'S CHOICE AGE OF
Explanation / Answer
Rye toast and wheat crackers may have gluten which may enhance the pain symptoms. Coffee is also a food which should not taken by a fibromyalgia patient as the caffeine content is more which flare up fibromyalgia symptoms.refer Coffee and Fibromyalgia – A Bumpy Relationship by Fibro Jedi,2017 and Gluten Intolerance in Fibromyalgia & Chronic Fatigue Syndrome,Adrieene Dellwo,2017.
A common mineral found in leafy greens, nuts, and whole grains, it plays an important role in muscle and nerve function. Some experts believe supplements may help ease the muscle pain, stiffness, and cramping caused by fibromyalgia.(WebMD2018)Fibromyalgia sufferers should eat a diet that’s high in lean protein and fiber, and lower in carbohydrates. Foods that help fibromyalgia include fruits with a low glycemic index, vegetables and whole grains. A well-balanced diet can improve energy level, and staying physically active can lead to better overall health.(Vitalmotion,2018)
FOODS HIGH IN ANTIOXIDANTS:
FOODS HIGH IN AMINO ACIDS:
FOODS CONTANING COENZYME Q10:
FRUITS WITH LOW GLYCEMIC INDEX:
ANTI-INFLAMMATORY VEGETABLES:
These food items included in diet are advisable for patients with fibromyalgia as they are mild and helps in providing good nutrition and overall serves as a balanced diet which decreases the pain symptoms and also decrease frustration.She should take foods rich in magnesium which helps in muscle relaxation and pain reduction. Vitamin D3 supplements helps in reducing pain so it should be taken regularly refer The 6 Best Supplements for Fibromyalgia,everyday health.
Ref:
THE CONNECTION BETWEEN FIBROMYALGIA & FOOD,Vitalmotion,2018
Sharon Liao,2018,Can Supplements Help With Fibromyalgia,WebMD