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CORONARY ARTERY DISEASE AND HOW TO MANAGE IT

'A>3D2C


Order this book from : PRITCHETT & HULL ASSOCIATES, INC. 3440 OAKCLIFF RD NE STE 126 ATLANTA GA 30340-3006 or call toll free: 800-241-4925 Copyright© 2001, 2017 by Pritchett & Hull Associates, Inc. All rights reserved. No part of this book may be photocopied, reprinted or otherwise reproduced without written permission from Pritchett & Hull Associates, Inc. Published and distributed by: Pritchett & Hull Associates, Inc. Printed in the U.S.A.

This book is written to help you understand coronary artery disease. It should not be used to replace any of your doctor’s advice or treatment.


1


>A>=0AH0AC4AH38B40B48BC74=D<14A>=420DB4>5340C7 8=1>C7<4=0=3F><4=8=C74+) !C>22DAB<>A4>5C4=F74= H>D70E47867;4E4;B>527>;4BC4A>;8=H>DA1;>>3DB4C>1022> >A4 2860A4CC4B70E438014C4B>A78671;>>3?A4BBDA40=3 >A0 50<8;H78BC>AH>5740AC38B40B4  !5H>D70E4>A0=H>5C74A8B:502C>AB5>A64CC8=68CC78B1>>: 20=74;? *>?A4E4=C>AC><0=0648CH>D=443C>:=>F

 F70C8C8B  F70C20DB4B8C  C74B86=B0=3 BH<?C><B  C74A8B:502C>AB  F70CH>D20=3> %>>=4;8:4BC748340>570EE8=6 C>M<0=064N038B40B4 + +*J C74502C8B85H>D3>=OC<0=064 H>DA740;C78C20=64CF>AB4 4

Thhis book is to helpp youu undersstand what CAD is andd what you can do abouut it. It is onlly too heelp you leaarn more about CAD. It is not meant as a substitute for your doctoorâ&#x20AC;&#x2122;ss advice and treatm mennt.

2


The food line to your heart *742>A>=0AH0AC4A84B0A4C741;>>3E4BB4;BC70C20AAH1;>>3>GH64= 0=3>C74A=DCA84=CBC>H>DA740AC *74B4B<0;;0AC4A84B0A4;>20C43 >=C74>DCB834BDA5024>5H>DA740AC<DB2;4  *74740AC=443B0BC403HBD??;H>51;>>3>GH64=0=3>C74A =DCA84=CBC>F>A:0B8CB7>D;3 &E4AC8<4C74B40AC4A84B20=142><4 2;>6643>A1;>2:431H27>;4BC4A>;0=350C34?>B8CB20;;43?;0@D4  -74=C78B70??4=BC74H=0AA>F0=33>=>C;4C4=>D671;>>364C C7A>D67C>H>DA740AC

TA

artery wall

AO

R

*78B8B2>A>=0AH0AC4AH38B40B4>A 

blood clot fatty plaque

Blocked artery

Right coronary artery

Left coronary artery

* It is also called atherosclerosis, hardening of the arteries, CHD (coronary heart disease) or cardiovascular disease.

3


The cholesterol connection .>DA1>3H<0:4B27>;4BC4A>; !C8B0F0GH50C ;8:4BD1BC0=24C70C>22DAB =0CDA0;;H8=C741;>>3 !C74;?B20AAH50CBC7A>D67H>DA1;>>3E4BB4;B  .>D0;B>64C8C8=B><45>>3B  .>DA1>3HDB4B27>;4BC4A>;C>74;?F F8C7=>A<0;1>3H5D=2C8>=B  >F4E4AF74=C74A48BC>><D27>558C8=H>DA1;>>38C20= 20DB4?;0@D4C>5>A<8=B834H>DA1;;>>3E4BB4;B  .>DA1;>>327>;4BC4A>;;4E4;8B<03 34D?>50E0A84CH >51;>>350CBF78278=2;D34  ##;>F34=B8CH;8?>?A>C48= HDL

  #786734=B8CH;8?>?A>C48= =0=3 CA86;H24A834B05>A<>550C #8?>?A>C48=B0A42><?;4G <>;42D;4B<034D?>550CB ;8?83B0=3?A>C48=B 7>;4BC4 4A>; 0CC0274BC>?A>C48=B8=H>DA 1;>>30=3<>E4B0;>=60B C74B4;8?>?A>C48=B

LDL triglycerides

##27>;4BC4A>;8B=82:=0<43 M10327>;4BC4A>;N1420DB48C C4=3BC>1D8;3D?8=0AC4A84B0B?;0@D4  -74=C78B70??4=BH>DA1;>>3E4BB4;B142><4 =0AA>F430=33>=OC0;;>F0B<D271;>>30=3>GH64=C>64CC7A>D67

#27>;4BC4A>;8B=82:=0<43M6>>327>;4BC4A>;N1420DB48C?82:BD? B><4>5C74##0B8C?0BB4BC7A>D67H>DA1;>>3E4BB4;B0=3A4<>E4B 8C DC85C740<>D=C>5##8BC>>7867C74 #20==>C64C0;;>5C74< 0=3H>DA1;>>3E4BB4;BBC0ACC>2;>6 

4


Assess your risk 420DB47867;4E4;B>527>;4BC4A>;8=H>DA1;>>3;403C> C74A40A4A42><<4=343;4E4;B5>A03D;CB>E4A064

Lipid blood tests

Goals in coronary artery disease or diabetes

My test results

Total cholesterol

Less than 200 mg/dL

_____mg/dL

Bad cholesterol (LDL)

Less than 100 mg/dL*

_____mg/dL

Good cholesterol (HDL)

40 mg/dL or more (men)

My blood lipid goals

_____mg/dL 50 mg/dL or more (women) Non-HDL cholesterol

Less than 130 mg/dL*

_____mg/dL

Triglycerides

150 mg/dL or less

_____mg/dL

* If you are at high risk for heart attack, your goal may be an LDL less than 70 mg/dL and a non-HDL less than 100 mg/dL.

*74>=;HF0HC>:=>FH>DA27>;4BC4A>;;4E4;B8BF8C701;>>3C4BC *0;: F8C7H>D3>2C>A01>DCF70CH>DA27>;4BC4A>;;4E4;BB7>D;314L10B43>= H>DAA8B:502C>AB8=2;D38=6H>DA50<8;H78BC>AH E4AH>=48BD=8@D40=3 H>DA3>2C>ACA40CB.&+

5


How will I know if I have CAD? .>D<0H=>C70E4B86=B>5786727>;4BC4A>;D=C8;70B34E4;>?43  !5C74A48B0;02:>51;>>35;>FC7A>D67H>DA2>A>=0AH0AC4A84B8C<0H 1468=C>B7>FD?0B>=4>A<>A4>5C74B4  =>BH<?C><B  0=68=0 740AC0CC02:

 D=DBD0;BH<?C><B

No symptoms )><4?4>?;4F8C72>A>=0AH0AC4AH38B40B4 <0H70E4=>BH<?C><B *7 74H<0H=>C70E4 0=H274BC?08=38B2><5>AC> >A>C74AB86=B >50=68=0>A0740AC0CC02: &C74AB70E4 ?820; !5H>D BH<?C><BF78270A4=>CCH? 0A4=>CBDA485H>DABH<?C>< <B0A4 B><4C78=6C>142>=24A=4301>DC 3>=OCF08C2742:F8C7H>DA3 3>2C>A

-8C7>DC0=HBH<?C><BC7438B40B4 20=6>0;>=6D=2742:43 )>;40A= H>DA27>;4BC4A>;;4E4;B0=3> >C74A A8B:502C>AB8=20B4H>D0A4 >=4>5C7>B40CA8B: 

6


Angina !5C741;>>3BD??;HC>H>DA740AC8B2DC>555>A0B7>ACC8<4H>DA 740ACC8BBD420=1430<06431HC74;02:>5>GH64=  !=<>BC20B4BC78B20DB4B0=68=0LC74<08=BH<?C><>5  =68=08B274BC?08=C70C20=544;<8;3<>34A0C4>A4GCA4<4  -70C3>4B0=68=0544;;8:4  544;B;8:403D;;740EH?A4BBDA4>=H>DA274BC  0?08=C70C6>4B>DCC>H>DA=42:90F;45C>AA867CB7>D;34A 0A<>A102:  0<8;31DA=8=68=H>DA274BC;8:4740AC1DA= !C20=20DB4  B7>AC=4BB>51A40C7  50C86D4148=6E4AHC8A43  ?0;?8C0C8>=B5;DCC4AH>A8AA46D;0A740AC140CB C70CH>D20=544;8=BC403>5?08=

7


Heart attack =68=0C70C3>4B=>C2;40AD?>=8CB>F=>A05C4AC0:8=6<43828=40=3 ;0BCB5>A>E4A <8=DC4B8B<>BC;8:4;HC74B86=>50740AC0CC02:  -74=C74>GH64=BD??;HC>C74740AC8BC>C0;;H1;>2:438=02>A>=0AH 0AC4AH740AC24;;B384 &5C4=C78B70??4=BF74=01;>>32;>C5>A<B  *78BB40;B>55C740AC4AH0=3=>1;>>320=64CC7A>D67 *74;02:>5 1;>>35;>F20DB4B0740AC0CC02:

*74?08=54;C5A><0740AC0CC02:E0A84B5A><?4AB>=C>?4AB>=  =H>5C74BH<?C><B>50=68=00BF4;;0BC74B4<0H>22DA  BF40C8=6M2;0<<HN544;8=6B:8=  B:8=544;B2>>;>A2>;3

NOTE

 0544;8=6>58=3864BC8>=>A740AC1DA=

Your body cannot create new heart cells after they die from lack of blood and oxygen.

 B70A?1DA=8=6>A2A0<?8=6?08=C70C BC0ACB8=>AB?A403BC>C74C74274BC =42:90FC7A>0CB7>D;34AD??4A102: 0A<B>AFA8BCB  4GCA4<450C86D405C4A02C8E8CH  =0DB40>AE><8C8=6  38II8=4BB544;8=6;867C 740343  B7>AC=4BB>51A40C7

Women, eldderly people and diabetics often doo not have "claassicc" hearrt atttack sympttom ms. They may have lesss intensee sym mptoms and moore nauseaa.

8


The difference between men and women )><4C78=:C70C<4=0A4C74>=;H>=4BF7>=443C>F>AAH01>DC  >F4E4A0A>D=3C74B0<4=D<14A>5F><4=0=3<4=3844027H40A 5A><740AC38B40B4 =3=40A;HCF> C78A3B>5F><4=F7>384BD334=;H 5A><740AC38B40B4703=>F0A=8=6BH<?C><B -><4=0;B>70E4 B42>=3740AC0CC02:B<>A4>5C4=C70=<4=

*7438554A4=248B=>CF74C74AF><4=>A<4=0A4<>A4;8:4;HC>64C 740AC38B40B41DCF74=C74H64C8C B0AD;48CC0:4BF><4=01>DC H40AB;>=64AC>140CC74B0<4A8B:5>A740AC38B40B4C70=8C3>4B <4= %0CDA0;4BCA>64=<0H74;??A>C42CF><4=5A><C74A8B:145>A4 <4=>?0DB4 5C4A<4=>?0DB47>F4E4AC7460?=0AA>FB

F><0=OBBH<?C><B>5<0H=>C14CH?820;<0:8=68C70A34AC> 3806=>B4 =3>C74A?A>1;4<B<0H20DB4BH<?C><BB8<8;0AC>740AC 38B40B4 >AC74B4A40B>=B8C8B=>CD=2><<>=5>A740AC38B40B4C>6> D=34C42C438=F><4=

9


Itâ&#x20AC;&#x2122;s risky business (8B:502C>AB0A4C78=6BC70C033C>H>DA270=24B>564CC8=6038B40B4  )><4>5C74B4C78=6B20=142>=CA>;;43B><420==>C  *74A48B=>C<D27H>D20=3>01>DC 50<8;H78BC>AH>540A;H740AC38B40B4 0A;H740AC38B40B4 <40=B KH>DA50C74A>A01A>C74A703740AC38B40B4145>A4064 K H>DA<>C74A>A0B8BC4A7038C145>A4064 .>DA064 .>D0A40CA8B:5>A85H>D0A4 K 0<0;4>E4AC74064>5 K 054<0;4>E4AC74064>5 >F4E4AC74<09>A8CH>5A8B:502C>AB5>A2>A>=0AH0AC4AH 38B40B40A4=>CC74A4BD;C>5068=60=350<8;H78BC>AH

10


$0=HA8B:502C>AB0A4A4;0C43C>H>DA;854BCH;4102:6A>D=3 0=34=E8A>=<4=C *74B40A4A8B:502C>ABH>D<0H70E4 B><42>=CA>;>E4A

#$!(&14B8CH8BA4;0C43C>7867

1;>>3?A4BBDA438014C4B786727>;4BC4A>;;4E4;B 0=3;02:>54G4A28B4 ;;>5C74B420=;403C> 740AC38B40B4

# !C>C0;27>;4BC4A>;

>E4A

<6 3;0=3##M103N27>;4BC4A>;>E4A

<6 3;  *78B8BC74<08=20DB4>5

#$M6>>3N  !#

14;>F <6 3#5>A<4=>A14;>F <6 3#5>A F><4=  0E8=6 #;4E4;B78674AC70= 20= >554AB><4?A>C42C8>=5A><64CC8=6740AC38B40B4

!& &!#(48=68=02C8E4

;403BC>148=6>E4AF4867C70E8=6;4BB<DB2;4 C>=40=3BCA4=6C78=2;D38=60F40:4A740AC 0=30;>F4A #;4E4; (46D;0A04A>1824G4A28B4 74;?B;>F4AH>DAA8B:5>A740AC38B40B4 B:H>DA 3>2C>AF70C:8=3>54G4A28B4B0A414BC5>AH>D

11


Higgh cholesteerol leevels, highh blood pressuure and obbesityy often starrt in childdhood.

# " 78674AC70=    

-74=H>DA1;>>3?A4BBDA48B78675>A0;>=6C8<4H>DA 740AC0=3>C74A>A60=B20=1430<0643

#! ('4>?;4F8C738014C4B70E4 C>C8<4B<>A4A8B:>5740AC38B40B4

"! $ ( %82>C8=48=0=H5>A<30<064BC74740AC0=3=0AA>FB C740AC4A84B *78B8=2;D34B4 2860A4CC4B

12


Begin today 468=C>30HC>;40A=<>A401>DCH>DAA8B:502C>AB *74=;40A=7>FC> 2>=CA>;C74>=4OBH>D20= .>DO;;70E4C740=BF4AC>M-70C20=!3>N !=443C> :44?<H38014C4BD=34A2>=CA>;B44?064B K  BC>?B<>:8=6B44?064  2>=CA>;<H78671;>>3?A4BBDA47H?4AC4=B8>=B44?064  A43D24<HC>C0;1;>>327>;4BC4A>;B44?064B   A43D24<H10327>;4BC4A>;##B44?064B   8=2A40B4<H6>>327>;4BC4A>; #B44?064B   2>=CA>;<HF4867CB44?064BK 14<>A4?7HB820;;H02C8E4 B44?064BK <0=064<HBCA4BB14CC4A B44?064BK 3A8=:;4BB0;2>7>; B44?064 

13


Diabetes 8014C4B70??4=BF74=C74?0=2A40B0=>A60=8=H>DA1>3H3>4B=>C <0:44=>D678=BD;8=>AH>DA1>3H20==>CDB4C748=BD;8=8C3>4B<0:4  !538014C4BAD=B8=H>DA50<8;HC0;:C>H>DA3>2C>A01>DCC78B38B40B4  -74=H>D70E4050<8;H78BC>AH>538014C4B8C8B4E4=<>A48<?>AC0=C C><08=C08=0740;C7HF4867C0=34G4A28B4A46D;0A;H

!5H>D70E438014C4BH>D0A4C>C8<4B<>A4;8:4;HC>34E4;>? C70=B><4>=4F7>3>4B=>C70E48C *78B8B3D48=?0ACC>8=BD;8= A4B8BC0=2478671;>>3?A4BBDA40=3>14B8CH  8014C4B8=2A40B4BC74;4E4;B>527>;4BC4A>;0=350CCA86;H24A834B8= H>DA1;>>3 B0A4BD;C<>A4C70= >5?4>?;4F8C738014C4B384 5A><B><45>A<>5 .>D0;B>=443C>140F0A4C70C0?4AB>= F7>70B38014C4B<0H=>C70E4274BC?08=3DA8=60740AC0CC02:  )>85H>D70E438014C4B8C8B8<?>AC0=C5>AH>DC><0=0648C  *78B<40=B :44?8=6H>DA1;>>36;D2>B4BD60AF8C78=H>DAC0A64CA0=64 2>=CA>;;8=6F70CH>D40C7>F<D27H>D40C0=3F74= 4G4A28B8=60BH>DA3>2C>AA42><<4=3B :44?8=6H>DAF4867C8=0740;C7HA0=64 +B4C74380AH>=C74=4GC?064C>74;?H>D<0=064H>DA38014C4B

My healthy blood glucose range is: before meals: _____ to _____ 2 hours after meals: _____ to _____ at bedtime: _____ to _____

14


This page may be copied by the patient.

ŠPritchett & Hull Associates, Inc.

15

Breakfast

Lunch

Followed meal plan = 0 Varied plan a little = 1 Varied plan a lot =2

Meal Plan

Date

Snack 2

Snack 1

Dinner

=0 =1 =2 =3

Medicines*

Write in blood glucose level before meal and 2 hours after

Exercise

Write in exact dosage taken and the time. Include herbs and vitamins.

Breakfast

No exercise Light exercise (20 min or less) Moderate exercise (20-45 min) Heavy exercise (45+ min)

Lunch

Blood Glucose

Bedtime *Medicines

_________ (dose____)

Exercise

Dinner

Blood Glucose _________ (dose____)

Meal Plan _________ (dose____)

Diabetes diary _________ (dose____)

Notes

Include signs of problems, medication reactions, how meals or activities varied from planned, etc.

Notes

_________ (dose____)


Smoking *>1022>B<>:4H>DAB>AB><4>=44;B4OB  ;>F4ABH>DA6>>327>;4BC4A>; #  =0AA>FBH>DA1;>>3E4BB4;B  20=20DB40AC4AHB?0B<B  30<064BH>DA;D=6B0=3A43D24B >GH64=H>DA1>3H=443B  8=2A40B4BH>DA740ACA0C4  B7>AC4=BH>DA;854B?0=  033B>C74AA8B:B=>CA4;0C43C>H>DA740AC )<>:4AB0A4C>C8<4B<>A4;8:4;HC>70E40740AC0CC02:C70= =>=B<>:4AB =3B<>:4ABF7>70E40740AC0CC02:0A4<>A4;8:4;HC> 384F8C78=C7458ABC7>DAC70==>=B<>:4AB  -74=H>D@D8CB<>:8=6H>DAA8B:5>A740AC38B40B4342A40B4B>E4AC8<4  )>85H>DB<>:4@D8C !5H>D3>=OCB<>:43>=OCBC0AC

16


High blood pressure 8671;>>3?A4BBDA48BB=40:H .>D20=70E48C0=3=>C:=>F8C  BDA4 8B B=40:H .>D 20= 70E4 8C 0=3 =>C :=>F 8C .>DDBD0;;H3>=OC544;0C78=6F78;48C30<064BH>DA0AC4A84B1H ;4CC8=650C0=327>;4BC4A>;1D8;3D? &E4AC8<40;>C>5 30<06420=143>=420DB8=6>A0740AC0CC02:

8671;>>3?A4BBDA4C4=3BC>AD=8=50<8;84B0=38=2A40B4BF8C7064  -74=H>D70E478671;>>3?A4BBDA40C58ABCH>DA740ACC782:4=B DC >E4AC8<48CBCA4C274B0=3F40:4=B *78B8B1420DB4C74740AC70BC> F>A:B><D2770A34A3D4C>C747867?A4BBDA4

*746>>3=4FB8B1;>>3?A4BBDA420=142>=CA>;;43  4A4OB7>F ;>B4F4867C85H>D =443C> A43D24C74B>38D< 8=H>DA384C

4G4A28B4A46D;0A;H  C0:4H>DA7867 1;>>3?A4BBDA4 <43828=4

A43D24H>DABCA4BB 0=3A4;0G 3>=OCB<>:4

NOTE African Americans seem to have high blood pressure more than other Americans

7867B>38D<B0;C384CB44<BC><0:478671;>>3?A4BBDA4F>AB4

17


Having high cholesterol *74<08=20DB4>58B70E8=678671;>>327>;4BC4A>;;4E4;B  -74=H>DA27>;4BC4A>;;4E4;B0A47867B44?0640=3H>D70E4 >C74AA8B:502C>ABH>D0A40C78674AA8B:5>A34E4;>?8=6  !5H>D70E478671;>>327>;4BC4A>;;4E4;B74A4OBF70CH>D=443 C>3>C>A43D24C74B4;4E4;B 40C0;>F 50C;>F 27>;4BC4A>;384C 8=2A40B4H>DA?7HB820;02C8E8CH ;>B4F4867C85H>D0A4>E4AF4867C BC>?B<>:8=6 C0:427>;4BC4A>; ;>F4A8=6 3AD6B85H>D=443C>C0;:C> H>DA3>2C>A01>DCC7414=458CB 0=3?>BB81;4B834 45542CB>5 C74B43AD6B

Your cuurreent cholesterol leevels andd whetheer you allready havve CAD will determine how mucch yourr dooctoor willl attempt to lowwer your level. Talk withh your docctor about what you needd to do.

18


A change of diet may do wonders 70=68=6H>DA384C2>=CA>;;8=6H>DAF4867C0=38=2A40B8=6H>DA?7HB820; 02C8E8CH0A4C7458ABCBC4?B8=CA40C8=678671;>>327>;4BC4A>; *7458ABC 6>0;8BC>A43D2410327>;4BC4A>;;4E4;B DCC78B6>0;8B=>C0C4<?>A0AH M384CNL8C8B0?4A<0=4=C270=648=C74F0HH>D40C  )C0AC1H40C8=6;4BBB0CDA0C4350CB0=3786727>;4BC4A>;5>>3B  )0CDA0C4350C5>>3B<08=;H2><45A><0=8<0;B DCB><40;B> 2><45A><?;0=CB;8:42>2>=DC>8;?0;<>8;>A2>2>01DCC4A  0C<>A45A4B75AD8CB0=3E464C01;4B *74B42>=C08=E4AH;8CC;4850=H 27>;4BC4A>;>A50C DC1420A45D;7>FH>D2>>:C74<>AF70CH>D033 C>C74< >A4G0<?;4010:43?>C0C>70B=>27>;4BC4A>; DC85H>D 0331DCC4A0=3B>DA2A40<H>DOE4033430;>C>527>;4BC4A>;0=3 B0CDA0C4350C 

19


The TLC diet (Therapeutic Lifestyle Changes diet*) *74*#384C8B0740;C7HF0H>540C8=65>AC74F7>;450<8;H !C8B0;>F B0CDA0C4350C;>F27>;4BC4A>;384C5>AH>DA20;>A84=443B !5H>D5>;;>F8C 8C20=74;?8=A43D28=6H>DAC>C0;1;>>327>;4BC4A>;0BF4;;0BH>DA## 27>;4BC4A>;;4E4;B  .>DB7>D;340C  ;4BBC70=>5H>DA308;H20;>A84B8=B0CDA0C4350C 8=?>;HD=B0CDA0C4350C0=3;4BBC70= 8= <>=>D=B0CDA0C4350C  K>A;4BB>5H>DA308;H20;>A84B8=0;;50CB B0CDA0C430=3D=B0CDA0C43  ;4BBC70=

<6<8;;86A0<B>527>;4BC4A>;402730H  14CF44= K >5H>DA308;H20;>A84B8=20A1>7H3A0C4B  14CF44= K 6A0<B>55814A402730H  01>DC >5H>DA308;H20;>A84B8=?A>C48=B  4=>D6720;>A84BC>64CC>>A:44?0740;C7HF4867CB:H>DA 740;C720A4?A>E834A7>F<0=H20;>A84BH>D=443  * From the Third Adult Treatment Panel (ATPIII), National Institute of Health

20


Food labels -0C278=6C740<>D=C0=3CH?4>55>>3BH>D40C8B8<?>AC0=C8=CAH8=6 C>A43D24H>DA27>;4BC4A>;;4E4;B0=32>=CA>;;8=6H>DAF4867C #40A= C>A4035>>3;014;B0=3:44?D?F8C7C740<>D=C>550CB0CDA0C4350C 27>;4BC4A>;0=3B0;CH>D40C402730H  $>BC5>>3;014;B;8BCC74B4AE8=6B8I40=32>=C4=CB5>A B4AE8=6>5C70C ?A>3D2C *74?4A24=C>5308;HE0;D48B10B43>=40C8=6

20;>A84B0 30H B:H>DA740;C720A4?A>E834A7>F<0=H20;>A84BH>DB7>D;370E4 402730H !5H>D=443C>40C>C74AC70=

20;>A84B;40A=7>FC> 039DBCC74;014;5>AH>DA20;>A84=443B

* The worksheet on the next page can help you do this. Please discuss with your doctor.

21


My daily diet worksheet "& ***********************

"!!

&& 

"! "#

*>C0;0C

/////// G    ///// P  //////6

)0CDA0C430C

/////// G



 ///// P  //////6

'>;HD=B0CDA0C430C /////// G 

 ///// P  //////6

$>=>D=B0CDA0C430C /////// G  

 ///// P  //////6

0A1>7H3A0C4B

/////// G    ///// P  //////6

'A>C48=

/////// G   ///// P  //////6

7>;4BC4A>; 

<6>A;4BB )>38D< 08<5>A 

<6 814A   C> 6 ,8C0<8= 

!+B ,8C0<8=   <6 0;28D< 

<6 !A>=  <6 Note: Keep in mind, this is not exact, but a way of keeping the food you eat in line with your needs.

*740=3C74+)F41B8C4B20=68E4H>DC74 5>>3;014;8=5>A<0C8>=01>DC8C4<BC70C0A4=>C ?A4 ?02:0643 *74B48=2;D345A4B7E464C01;4B 5AD8CB<40CB?>D;CAH0=3B405>>38C4<B  '02:064BC>>B<0;;C>70E40;014;B7>D;3 68E4H>D0=033A4BB>A?7>=4=D<14AC>64C C748=5>A<0C8>= $0:48CH>DA1DB8=4BBC> 58=3>DC01>DCC745>>3BH>D;8:4C>40C 

22


Being overweight BH>DA1>3HF4867C8=2A40B4BB>3>4BH>DAA8B:>578671;>>3?A4BBDA4  .>D0;A403H:=>F70E8=678671;>>3?A4BBDA48B0A8B:502C>A5>A740AC 38B40B4 )>:44?8=6H>DAF4867C8=0740;C7HA0=648B8<?>AC0=CC> ;>F4A8=6H>DA1;>>3?A4BBDA40=3A43D28=6H>DAA8B:>5  *74<>BC;>=6 ;0BC8=60=314BCF0HC>;>B4F4867C8BB;>F;H *>3>C78B H>D=443C>DB4D?<>A420;>A84BC70=H>D40C !5H>D2DC102:>=H>DA 20;>A848=C0:41H

20;>A84B030H0=33>B><44G4A28B8=6H>D20= ;>B401>DC ?>D=30F44: *70COB?>D=3B8=0H40ADC>DC

 B=02:20;>A84B030H0=3B44F70C70??4=B

!) !" !!!&&"!!!) !!(!+  ! "!&"!(*0:4B<0;;4A74;?8=6B>5786720;>A847867 50C5>>3B *0:4;0A64A74;?8=6B>55>>3BC70C0A478678=5814A1420DB4 5814AC4=3BC><0:4H>D544;5D;;B>H>D40C;4BB

23


#>B8=6F4867C0=3:44?8=68C>55<0H<40=0=4FF0H>540C8=60=3 0338=64G4A28B4C>H>DA;854  4A4OB7>FC>40C740;C7H0=364C>=H>DA F0HC>0;>F4AF4867C 7>>B45>>3B;>F8=20;>A84B0=3B0CDA0C4350C

7>>B45>>3B78678=5814A

#8<8CH>DAB4AE8=6B8I4B

42><4<>A402C8E4

 DC102:>=B=02:B !5H>D3>B=02:<0:48C5A4B75AD8C E464C01;4B>A08A ?>??43?>?2>A=F8C7>DCB0;C>A1DCC4A

24


>;;>FC74B4 C8?B5>AA43D28=6 C7450C0=3 8=2A40B8=6 C745814A 8=H>DA384C  10:41A>8;>A?>027<40CB  A4<>E4C74B:8=5A><2782:4=0=3CDA:4H  40C<>A458B70=3;40=2DCB>5<40CBD270B 2782:4=>ACDA:4H  DB4B:8<<8;: <8;:>A4E0?>A0C43B:8< <8;:8=BC403>5F7>;4<8;:>A<8;:  DB4;>F50C;>F B>38D<2744B4B  40C<>A45A4B75A>I4=>A20==435AD8C8=C748A>F=9D824B  40C<>A45A4B75A>I4=>A=>B0;C0334320==43E464C01;4B  DB4;4BB2A40<0=32744B4B0D24BC><0C>B0D24B0A4&"  40C?;08=A8240=3?0BC0=6;8B7<D558=B1064;BB0=3F827 1A403BB>5CC>AC8;;0B  40CF7>;46A08=24A40;B2>;3>A7>C  DB45>>3;014;BC>74;?H>D;40A=F78275>>3B0A4;>F8=50C 27>;4BC4A>;0=3B>38D<  40CF7>;4 6A08=1A403B0=3A8243AH?40B0=3140=B

25


Being physically inactive 48=68=02C8E4?DCBH>D0C03343A8B:5>A70E8=6  "04A>182 48=68=02C8E4?DCBH>D0C03343A8B:5>A70E8=6 % &&""&" 1H ;>F4A8=610327>;4BC4A>;## A08B8=66>>327>;4BC4A>; # ;>F4A8=61;>>3?A4BBDA4 A43D28=64G24BBF4867C C>=8=60=3BCA4=6C74=8=6<DB2;4B8=2;D38=6C74740AC A43D28=6BCA4BB ;>F4A8=61;>>3BD60A .>DB7>D;3 $!&"!&"  &"& !#!&(420A45D;85H>D70E4 78671;>>3?A4BBDA4 ?08=B>A?A4BBDA48=C74 274BC>AB7>D;34A 544;38IIH>A508=C 64C1A40C7;4BB05C4A<8;34G4AC8>= 70E4=>C144=02C8E4 0A4?;0==8=60E86>A>DB F>A:>DC?A>6A0<

26


(46D;0A<>34A0C44G4A28B420=74;?8<?A>E4C74F0HH>D;>>:544;0=3 F>A: '4>?;4F7>0A4=>C?7HB820;;H02C8E40A40;<>BCCF8240B;8:4;HC>BD554A 5A><0BC7>B4F7>0A402C8E4 $>34A0C404A>1824G4A28B4<40=B3>8=6 C7402C8E8CH5>A <8=DC4B030H<>BC30HB>5C74F44: G0<?;4B8=2;D34 1A8B:F0;:8=6 9>668=6 BF8<<8=6 182H2;8=6 ?;0H8=6C4==8B

E4=3>8=6;867CC><>34A0C402C8E8CH5>A054F<8=DC4B<>BC30HB <0H74;?H>D *AH C0:8=6C74BC08AB8=BC403>5C744;4E0C>A>A4B20;0C>A 3>8=6B><460A34=8=6 3>8=67>DB4F>A: 30=28=6 *0;:F8C7H>DA740;C720A4?A>E834A145>A4H>D1468=0=H4G4A28B4 ?A>6A0< =30;F0HBBC>?4G4A28B8=60C>=2485H>D70E40=H?08= 544;508=C>A;867C 740343>A64CA40;;H>DC>51A40C7F78;44G4A28B8=6  *4;;H>DA3>2C>A0BB>>=0BH>D20=01>DCC78B

27


Unmanaged stress $>BC>5DB0A42A40CDA4B>57018C -43>=OC;8:4270=64 )CA4BB8B 20DB431H4E4=CBC70C2A40C4270=64 *74B4270=64B<0H14B7>AC ;8E43BCD2:8=CA05582>A;>=6 C4A<340C7>50;>E43>=4  >FF4;;H>D 70=3;4270=6434C4A<8=4B7>FBCA4BB05542CBH>D '4>?;4F7>70E40 ?A>1;4<70=3;8=6270=64C4=3C>70E40;>C>5BCA4BB

!5H> >D20 0=02224?CCC70C 270=64 470B> >222DAA43 0=3 3<>EE4>= =CC74=BBCA4BB <0H=>C7DACCHH>D D *7 74 CA05582290 0<H> >DOAA4BBCD2: : 8=< <0H< <0: :4HH>D D;0C4 1DC0 0224? ?CC70CCCC74A4 4 8B=>CC<D27H>D20 0= 3>0 01>DCC8C !!5>=CC74 4 >C7 74A7 70=3H>D D3F4;; >=CC74B44E4=CB0 0=3BBC0 0H D?BB4C88C20=1A8=66>= 0=G84CHH274 4BC?08= >A550BC74 40AC140CB  ;C7>D67A4B40A274AB20==>CC4;;DBF7HBCA4BB8B0A8B:502C>A5>A C74H70E4=>C43C70CD=2>=CA>;;43BCA4BB?DCBH>D0CA8B:5>AC74 38B40B4 420DB4BCA4BBE0A84B5A><>=4?4AB>=C>0=>C74ABCA4BB ;4E4;B0A470A3C>9D364 !C<0H14C70CF74=H>D0A4D=34A<>A4 BCA4BBH>D3>D=740;C7HC78=6B;8:4B<>:440C>A3A8=:C>><D27  48=6A4;0G430=3544;8=66>>301>DCH>DAB4;58B6>>35>AH>DA740AC

28


.>DF8;;0;F0HB70E4B><4BCA4BB8=H>DA;854 .>D20=OC0E>838C .>DA 6>0;8BC>;40A=C>2>=CA>;8C0=3=>C;4C8C2>=CA>;H>D )><4C8<4BC78B 8B40BHC>B0H0=370A3C>3> )4485C74B4C8?B20=74;?H>D  *AHC>14?>B8C8E401>DCH>DA;854

 #40A=C>A4;0G .>D<0H=443C>DB4B><4A4;0G0C8>= C427=8@D4B;8:4344?1A40C78=64G4A28B4B   8=3C8<4C>?;0H -70C4E4AH>D;8:4C>3>L6>;5C4==8B B08;8=678:8=6A4038=6?>4CAH4C2 L<0:4C8<4C>4=9>H8C

 0C740;C7H   4C?7HB820; G4A28B48B06A40CBCA4BBA43D24A   70=64H>DAA>DC8=4

 *0:40F0;:F74=H>D544;MD?C867CN

 *0;:F8C705A84=3>A;>E43>=401>DC7>FH>D544;

 !5H>D=443C>64C>A60=8I430=320=OC64C74;?

 #0D67 #0D67C4A20=74;?A43D24H>DABCA4BB

29


Drinking too much alcohol A8=:8=6C>><D270;2>7>;20=A08B41;>>3?A4BBDA420DB48AA46D;0A 740AC140CB0=330<064C74740AC<DB2;4 !C20=0;B><0:478671;>>3 ?A4BBDA470A34AC>2>=CA>;

!5H>D3>=OC3A8=:C7414BCC78=68B=>CC>BC0AC !5H>D3>3A8=:;8<8C7>F <D27H>D3A8=: $4=B7>D;370E4=><>A4C70=3A8=:B030H0=3 F><4==><>A4C70= 3A8=:030H 3A8=:8B3458=430B Q>I>5 ?A>>5F78B:4H>A >I>5

?A>>5F78B:4H >A >I>5F8=4 >A >I>5144A ;867C>AA46D;0A !5H>D0A4CAH8=6C>;>B4 F4867C:44?8=<8=3 C70C0;2>7>;2>=C08=B 20;>A84BL C>  ?4A 3A8=:5A><C740;2>7>; 0;>=434?4=38=6>=C74 3A8=:  ;2>7>;0=3<0=H <43828=4B3>=>C<8G  742:F8C7H>DA3>2C>A >A3AD668BC01>DCC74 <43828=4BH>DC0:4 0=30B:01>DC3A8=:8=6 0;2>7>;F78;4C0:8=6C74<

30


Now you know what to do! ;C7>D67054F502C>AB20==>C14270=643H>D=>F :=>FF0HBC>2>=CA>;C74>C74AB !5H>D70E40=H A8B:B5>A74A4OBF70CC>3>  <0:4;854BCH;4270=64BL K ;>B4F4867C85H>D=443C> K 3>=OCDB4C>1022>?A>3D2CB K 2>=CA>;H>DABCA4BB;40A=C>A4;0G K ;8<8CH>DA0;2>7>;DB4 K BC0H?>B8C8E4 K 5>;;>F0;>F 50C;>F 27>;4BC4A>;384C K 3>B><404A>1824G4A28B4402730H  85H>D70E438014C4B:44?8CF4;;<0=0643  85H>D70E478671;>>3?A4BBDA42>=CA>;8C

31


What else can you do? ->A:F8C7H>DA3>2C>AC>74;?A43D24H>DAA8B:B5>A64CC8=6  "44?78<>A74A8=5>A<4301>DCF70COB6>8=6>=8=H>DA;854  "=>F01>DC0=H3AD6H>DC0:4LF70C8COB5>A0=37>F<D27C>C0:4  $0:4BDA4H>DA3>2C>A:=>FBC78BC>> *78B8=2;D34B 0;;<43828=4BL1>C7?A4B2A81430=3=>= ?A4B2A81433AD6B 4E4=0B?8A8= 74A1B E8C0<8=B )><4>E4A C74 2>D=C4A 3AD6B0=3?A4B2A8143 3AD6B20=A402C103;H F74=C0:4=0CC74 B0<4C8<4 *74B0<4 8BCAD45>AB><474A10; A4<4384B0=33AD6B  !5H>DA3>2C>A03E8B4B H>DC>C0:40<43828=4 C>74;?A43D240A8B: 502C>A;8:478671;>>3 ?A4BBDA4C0:48C0B ?A4B2A8143 !5H>D70E4 0=HB83445542CBF78;4 C0:8=68CC0;:F8C7H>DA 3>2C>A

.>D0=3H>DA3>2C>A B7>D;3F>A:C>64C74A  "44?H>DA3>2C>A 8=5>A<43

* Use the medicine chart on the next page.

32


Medicine name

Start date

How long to take it

This page may be copied by the patient.

How much I should take

'7>=4

'7>=4

What I take it for

33A4BB

33A4BB

 #'

() '

'

Side effectsComments

ŠPritchett & Hull Associates, Inc.

When & how to take it

'7>=4

33A4BB

&'

B:H>DA740;C720A4?A>E834AC>74;?H>D58;;8=C78B<43828=4270AC0=3C74=:44?8C F8C7H>D0;;C74C8<4 $0:4BDA40;>E43>=4:=>FB01>DC8CC>>8=20B4>50=4<4A64=2H

Medicine chart


C NS CO NSUL ULTA UL TANT TA NT:: NT Craiig S.. Thi Cr hiel ele, el e, MD Daayt yton on,, OH on H REVI RE VIEW VI EWER EW ERS: ER S: S: Jean Je anne an ne A. Ma Majo jors jo rs, MS rs MSN, N, RN, CS, CCR CRN N East Ea st Ind ndia iaana napo polililis, po s, IN Cher Ch eryl er yl Cor oris ish, is h, RN, MSN SN-C -CS, -C S, PhD Bowl Bo wlin wl ingg Gr in Gree een, ee n, KY Laur La uraa Sa ur Saue uerm ue rman rm an Mariririet Ma etta et ta,, GA ta

We believe that you have the right to know as much as you can about your health. Our goal is to give you enough facts to get the main points clearly in mind. We do this with medical accuracy, warmth and humor. The result for you: less tension, more healing and a good idea of what to ask your doctor, nurse or others.

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