Patient
HM

Height: 5 ft 5 in

Weight: 260 lbs

BMI: 43.3

Registered Dietitian

Sarah Hall, RD

Insurances: Aetna,United Healthcare

Diagnosis and Treatment Plan

Changes / challenges since last visit

Weight: 258lbs, 5'5

Would like to be under 200. End goal 180 - 200lbs

Celiac, allergic to shellfish, soy and intolerant to fish. Limits dairy and eggs, slightly intolerant

The hunger is new, used to be straight nausea, now she is getting really hungry.

higher protein.

Talking about how to tackle medication side effects.

Was prescribed an anti-nausea, only sometimes helps.

Tried peppermint for nausea, helped a bit.

usually 30-35 days, lately 15.

She is on birth control to try to regulate.

Uses apps to tracks.

Mix of she is cooking out of an air fryer and crock pot, mini fridge in the laundry room

Grandpa does not understand celiac, making it very difficult.

Cross contamination knocks her out for 5 days, last time was ER.

More hungry lately.

A lot of meds right now

Has previously needed 4-5 rounds of steroids to clear out pneumonia.

Has 15 big assignments, 5 in person classes, 5 big in person projects.

Prepping everything one day after internship.

Mon/wed she can get ready.

Reading helps to calm her down.

If she gets so engaged in a book, she will read all night.

teaches full days m/w

Summer classes will be on zoom

3 weeks left of semester.

Unsure of Az or Co

Maybe staying in Az.

Apple + sinigle serve almond butter

lentil prepared packets.

Nausea is much better in the mornings with apples.

Evening meds are late,

Incorporating a snack before night snack.

Tomorrow is movie day:

Bringing 3 tupperwares of food.

Grilled chicken breast + fried rice.

PBJ

Bringing extra snacks.

Getting apartment with friend in June.

M-F will be full school days, will have consistency, this will help a lot for meal planning.

Talks to psych next week.

Looking at depression med alternative for nausea and energy.

This week:

Waking up ~8am.

Not eating right away, indecisive,

Dinner has been nice, big dinner early, uses leftovers all week

Brunch sandwiches. no set lunch / dinner

Feeling more sweet and savory.

More of a dinner person.

Pastas and rice

Favorite dishes are rice based.  At brunch today did sweet pancakes.

Sheet pan pancakes.

Meal plan updates

Go-to snacks

Homemade trail mix bags

Go-go squeeze applesauce

Cuties, bananas

15 pills morning and night.

Talked about ginger for anti nausea

Has been trying to get breakfast down, morning meds making her so much more nauseous getting things down.

She has been feeling this way before, had been improving, recently really turned around, after the antibiotics.

1.) Wake up, immediately eating banana, take 1/2 the meds, get ready, take 2nd half of the meds.

2.) Maybe taking capsule meds, emptying powder into water bottle

Making hard boiled eggs or bacon to have in the morning.

Didnt eat breakfast today, hard on sub days to split medications apart.

If she takes the meds consistently, she will throw up, taking them sporadically its only nausea.

The concentration adds up throughout the week.

She will get PB packets and bring packets.

Snack box ingredients lately: 4 containers, fruit in one, veggie (carrots / snow peas), almonds / trail mix, pretzels / crackers

Doing more asian meals.

Beef and broccoli, rice noodles or rice.

Lots of asian food is gluten free which she likes.

Getting breakfasts in now is so much easier.

She actually struggles a lot more to miss food and snacks now..

Next few weeks should be easier.

Internship M/W

3 more classes, all assignments due thurs

Summer classes are 16th of may, online

Student teaching in the fall.

Has been liking chicken, sweet potato, broccoli crockpot meals

Doing some rice based meals.

Sunday doing grocery shop and meal prep.

Ground beef, corn, cabbage, avo, rice.

Give her variations of tacos, taco bowls, burritos.

Likes regular over sweet potato

Stuffed sweet.

Diced regular potato.

Coconut yogurt parfaits,

Breakfast pancakes

Cobb salad

taco

breakfast tacos.

Can't eat eggs every

Is set on snacks.

This week:

Same snacks, dinners are big rice crockpot meals,

Breakfasts, a couple of easy lunch wraps.

Supplemets.

Goals

3 non negotiable meal reminders a day, Bfast snack, L and D

1. Adding in a snack every day

2. 1 serving of omega 3's each day

3. Protein/fiber emphasis

Prep breakfast, easy lunch sandwich / wraps, meal prepped dinners.

6/14, 4pm.

Send breakfast ideas.

Send her berberine.

Topics Discussed

Diabetes,Autoimmune,Weight Loss

Appointment History

Number of Sessions: 17

Last Updated: May 31, 2024