Mr. C. is a 32-year-old male who seeks information regarding possible bariatric surgery. He is overweight and has a number of related complications. The examination showed that his health parameters, including BMI, blood pressure, blood sugar level, cholesterol level, serum creatinine, and blood urine nitrogen, are abnormal. Based on Mr. C’s history, his clinical manifestations, risks, functional health patterns, potential diagnosis, interventions, and prevention options are discussed in this paper.
Clinical Manifestations
Mr. C is overweight, and all his numbers indicate that he has diabetes and a high risk of cardiovascular disease. His height is 68 inches, and his weight is 134.5 kg (296.5 pounds), which means that his body mass index (BMI) is 44.9 (“Adult BMI calculator,” n.d.). That puts his weight into the obese category for adults of his height (“Adult BMI calculator,” n.d.). His blood pressure is 172/98, which indicates Stage 2 hypertension (“Know your numbers,” n.d.). The normal blood sugar levels are 70–99 mg/dL, and Mr. C’s sugar level of 146 mg/dL indicates diabetes (“Know your numbers,” n.d.). His total cholesterol level is 250 mg/dL, which is high; the level of HDL cholesterol is lower than normal (below 40 mg/dL), and his level of triglycerides is extremely high (“Know your numbers,” n.d.). The high level of serum creatinine and blood urea nitrogen indicate that Mr. C’s kidneys are damaged. He also has 3+ pitting edema in both feet and ankles and reports sleep apnea, shortness of breath with activity, and pruritus.
Potential Health Risks for Obesity
People with obesity are at increased risk for many health conditions. The most common of them, as identified by the Centers for Disease Control and Prevention, are hypertension, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, and many types of cancer (“The health effects of overweight & obesity,” n.d.). Judging by Mr. C’s clinical manifestations, he has Stage 2 hypertension and diabetes and is at high risk of developing cardiovascular disease. According to Kovesdy et al. (2017), obesity, diabetes, and hypertension are also major risk factors for kidney disease. Mr. C’s increased BUN and creatinine levels indicate that his kidneys are not working properly, and he should be checked for kidney disease.
Bariatric Surgery
Bariatric surgery involves making changes to a patient’s digestive system to help them lose weight. To be eligible for bariatric surgery, a person needs to have a BMI of 40 or higher and, if lower, an obesity-related condition (“Bariatric surgery,” 2020). They also need to have a history of successful participation in a weight management program and the willingness to make lifestyle changes (“Bariatric surgery,” 2020). Contraindications include severe eating disorders, excessive use of alcohol, mental health problems, severe systemic diseases, diseases affecting the upper digestive tract, and the need for continuous use of some types of drugs (“Bariatric surgery,” 2020). Judging by Mr. C’s health history, he qualifies for bariatric surgery, and it should be considered as an appropriate intervention option.
Functional Health Patterns Assessment
Mr. C’s health history provides limited information on his functional health patterns. Some conclusions can be made regarding his nutrition-metabolic and activity-exercise patterns, and a list of potential problems can be identified. The first is a lack of physical activity due to a sedentary lifestyle and pitting edema. The second is poor dietary habits, which is evident from Mr. C’s BMI. The third is the poor quality of sleep because of sleep apnea. The fourth is low self-esteem and negative self-perception, which are generally connected with overweight (Robinson et al., 2020). The fifth problem is the dissatisfaction with sexual relationships, which can be assumed from Mr. C’s health history.
End-Stage Renal Disease
End-stage renal disease (ESRD) is the final stage of chronic kidney disease. The stages are identified based on the estimated glomerular filtration rate (eGFR), with each stage indicating a level of decline in kidney function. Stage 1 is associated with an eGFR of 90 or greater; Stage 2 with an eGFR between 80 and 89, Stage 3 with an eGFR between 30 and 59 (“Stages of Chronic Kidney Disease,” n.d.). At Stage 4, an eGFR is between 15 and 29, which means severe kidney damage, and at Stage 5, an eGFR is less than 15, and the kidneys are close to failure (“Stages of Chronic Kidney Disease,” n.d.). The contributing factors to the development of ESRD are diabetes, high blood pressure, obesity, certain medication, and some habits, such as smoking and drug use. Judging by Mr. C’s health history and numbers, he has an increased risk of developing chronic kidney disease.
ESRD Prevention and Resources
To prevent progression to ESRD, a number of recommendations can be provided to a patient. They include losing weight, increasing physical activity, eating a balanced diet, controlling blood pressure and blood sugar level, and getting regular check-ups (“End-stage renal disease,” n.d.). Considering the severity of Mr. C’s condition, these recommendations are difficult for him to observe, and he needs professional guidance and support to improve his well-being. A list of resources and relevant information needs to be provided to him on the limitations, risk factors, and complications of his condition. A multidisciplinary approach needs to be adapted, which involves a team of health professionals from different fields, such as endocrinologists, nephrologists, and psychologists.
Conclusion
Based on Mr. C’s health history and examination, it can be concluded that he has diabetes, Stage 2 hypertension, kidney disease, and a high risk of cardiovascular disease. Bariatric surgery is an appropriate option in his case, providing that he is willing to make changes in his lifestyle based on the analysis of his functional health patterns. Mr. C has an increased risk of developing chronic kidney disease, which needs to be addressed by providing him with professional guidance and support.
References
Adult BMI calculator. (n.d.). Centers for Disease Control and Prevention. Web.
Bariatric surgery (obesity surgery). (2020). EBM Guidelines. Web.
End-stage renal disease. (n.d.). Mayo Clinic. 2021, Web.
The health effects of overweight & obesity. (n.d.). Centers for Disease Control and Prevention. Web.
Know your numbers. (n.d.). Illinois Department of Public Health. 2021, Web.
Robinson, E., Haynes, A., Sutin, A., & Daly, M. (2020). Self-perception of overweight and obesity: A review of mental and physical health outcomes. Obesity Science & Practice, 6(5), 552-561. Web.