Reflecting on Care for a Patient with Chronic illness; John Case Study

Running Head: CHRONIC ILLNESS 1
Reflecting on Care for a Patient with Chronic illness; John Case Study
Student’s Name
Institutional Affiliation

CHRONIC ILLNESS 2
Table of Contents
Description.......................................................................................................................................3
Feelings............................................................................................................................................3
Evaluation........................................................................................................................................4
Analysis...........................................................................................................................................4
Conclusion.......................................................................................................................................5
Action Plan......................................................................................................................................5

CHRONIC ILLNESS 3
Description
John is a 70 years old man with a history of type 2 diabetes for 5 years. He has recently
(2 years ago) shown symptoms of hyperglycemia. His blood glucose level is at 166mg/dl. John
has been previously advised to lose weight but presently shows an increased weight gain of 181
pounds with 32.6 kg/m2 BMI. He says that he has tried losing weight for the last one year by
engaging in exercises but that has borne no success. That gives him emotional distress as he fears
that his condition might worsen. He also complains of foot pains and dizziness (caused by the 2.5
mg glyburide he takes every morning). John takes atorvastatin (10mg every day) for his
hypercholesterolemia. He adheres to medication but argues that testing his blood glucose level at
home is not helpful. Even with this presenting condition, John insists that he has not been sick
even a single day of his life. It has also been discovered that John’s both parents had diabetes
mellitus. John has a weak knowledge about self-care diabetes management and is irritated by the
fact he has it and does not take sugars. He is married to one wife and has 4 children. John is an
active member in volunteer organizations.
Feelings
During the consultation, I had some feelings regarding John’s condition. The first was a
feeling of sympathy for him because out of his condition he looked utterly distressed especially
with the increased weight. John’s was disgusted by having to engage in exercises day in day out
without success. In a study, Al-Goblan, Al-Alfi, and Khan (2014) explain that body mass index
increases the resistance to insulin by cytokines increasing substances such as hormones,
nonesterified fatty acids, glycerol and cytokines among others. I also have a feeling of hope as
John is responsive to medications such as those for his elevated cholesterol, triglycerides, and
low HDL cholesterol. The hope is however limited by the fact that John questions the importance
of testing his glucose every day yet that does not heal or make the situation better. This brings
worry as John has to know the level of his blood sugar often so as to seek medical intervention or
perform self-management (with insulin) before the situation is worse. I felt a little bit of guilt not
to refer John for emotional counseling for his stress. I, however, felt proud of John as a member