Consecutive Interpreting Practice (EN to EN): Mr. Rosales' Diabetic Consult

Summary

In this medical consultation, Mr. Rosales discusses his diabetes management with his doctor. He reports taking his prescribed medications, including metformin for blood sugar, Synthroid for his thyroid, and baby aspirin, all under the watchful eye of his wife. Despite dietary improvements like eating more fish and vegetables, Mr. Rosales' blood sugar remains high. The doctor identifies an issue with his excessive consumption of cranberry juice, which contains significant natural sugar, and advises moderation and choosing sugar-free alternatives.

Takeaways

• 📅 Mr. Rosales is at a 3-month follow-up appointment for his diabetes.
• 💊 He is currently taking metformin for blood sugar, Synthroid for his thyroid, and baby aspirin.
• 🚫 Mr. Rosales forgot his pill bottles at his son's car.
• 🕗 He takes his thyroid medication upon waking, his diabetes pill after breakfast, and aspirin with his diabetes pill before bed.
• 👩‍⚕️ His wife plays a significant role in reminding him to take his medications.
• 🥚 For breakfast, he typically has hard-boiled eggs, oatmeal, coffee with cream, and sometimes avocado.
• 🥗 Lunch usually consists of a salad with chicken or tuna, vegetables, and a light lemon and olive oil dressing.
• 🐟 Dinner often includes fish, vegetables like cauliflower, and a small portion of rice.
• 📉 Despite dietary changes, Mr. Rosales' blood sugar levels are still high, and his A1C has not dropped as much as expected.
• 🍹 Mr. Rosales has replaced soda with cranberry juice, but he consumes a significant amount, which still contributes sugar to his diet.
• 🏥 The doctor advises moderation, suggesting sugar-free or diet options for juice to help manage his diabetes.

Q & A

What is the purpose of Mr. Rosales' visit to the doctor?

Mr. Rosales is at the doctor's office for a 3-month follow-up for his diabetes.

Which medications is Mr. Rosales currently taking?

Mr. Rosales is taking metformin for his blood sugar, Synthroid for his thyroid, and a baby aspirin.

Why did Mr. Rosales not bring his pill bottles to the appointment?

Mr. Rosales forgot his pill bottles in his son's car after his son gave him a ride to the doctor's office.

How does Mr. Rosales take his medications?

He takes his thyroid pill upon waking up, his diabetes pill after breakfast, and his aspirin and diabetes pill after dinner and before bed.

What role does Mr. Rosales' wife play in ensuring he takes his medications?

Mr. Rosales' wife reminds him to take his medications and won't let him eat or go to bed without taking them first.

What does a typical breakfast look like for Mr. Rosales?

His breakfast usually consists of hard-boiled eggs, oatmeal, coffee with a little cream, and sometimes avocado.

What does Mr. Rosales usually have for lunch?

He typically has a salad with chicken or tuna, containing tomatoes, carrots, broccoli, and two types of lettuce, dressed with lemon and olive oil.

How has Mr. Rosales' diet changed since his last visit to the doctor?

Mr. Rosales has given up soda, beer, and fast food, and now eats more fish, vegetables, and less carbohydrates.

What is the issue with Mr. Rosales' blood sugar levels despite his dietary changes?

Although his A1C level has come down, it hasn't decreased as much as expected, which might be due to his high consumption of cranberry juice.

What is the doctor's advice regarding Mr. Rosales' consumption of cranberry juice?

The doctor suggests that Mr. Rosales should cut down on his juice consumption and opt for sugar-free or diet options with lower sugar content.

What does the doctor mean by 'everything in moderation'?

The doctor is advising Mr. Rosales that he doesn't have to completely eliminate his favorite foods but should consume them in reasonable amounts to maintain his health.

Outlines

00:00

💼 Doctor's Appointment and Medication Review

Mr. Rosales visits his doctor for a 3-month follow-up on his diabetes treatment. They discuss his current medications, which include metformin for blood sugar, Synthroid for his thyroid, and baby aspirin. Mr. Rosales admits to forgetting his pill bottles at his son's car but confirms his adherence to the medication schedule with the help of his wife's reminders. The doctor praises Mr. Rosales for taking his medications correctly and inquires about his compliance with the medication regimen.

05:03

🍽 Dietary Changes and Blood Sugar Concerns

The conversation shifts to Mr. Rosales' diet, with a focus on his breakfast of hard-boiled eggs, oatmeal, coffee, and sometimes avocado. Lunch typically consists of a salad with chicken or tuna, tomatoes, carrots, broccoli, and a simple lemon and olive oil dressing. His wife's influence has led to healthier eating habits, including more fish and vegetables for dinner. Despite these changes and Mr. Rosales' efforts to avoid soda and fast food, his blood sugar levels remain high. The doctor expresses surprise at the continued high levels given Mr. Rosales' dietary efforts and adherence to medication.

10:05

🍹 The Impact of Cranberry Juice on Blood Sugar

Mr. Rosales reveals that he has replaced soda with cranberry juice, which he believes to be a healthier option due to its 'no added sugar' label. However, the doctor explains that cranberry juice still contains natural sugar and can significantly contribute to blood sugar levels. Mr. Rosales consumes multiple bottles of juice daily, which the doctor identifies as a potential reason for his persistently high blood sugar. The doctor advises Mr. Rosales to either reduce his juice intake or opt for sugar-free alternatives, emphasizing the importance of moderation in all aspects of diet.

Keywords

💡Diabetes

Diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). In the video, Mr. Rosales is seen undergoing a follow-up for his diabetes, indicating that it is the central health issue being addressed. The theme of the video revolves around managing diabetes through medication, diet, and lifestyle changes.

💡Medication

Medication refers to the drugs prescribed to manage or treat health conditions. Mr. Rosales discusses his current medications, including metformin for his blood sugar, Synthroid for his thyroid, and aspirin. The video emphasizes the importance of proper medication management and adherence to the prescribed regimen.

💡Diet

Diet is the type of food that a person habitually eats. In the context of the video, Mr. Rosales's diet is a significant factor in managing his diabetes. His wife has made substantial changes to his diet, including preparing healthy meals like oatmeal, hard-boiled eggs, salads, and fish, which are low in carbohydrates and sugar.

💡A1C

A1C, or glycated hemoglobin, is a blood test that indicates the average level of blood sugar over the past 2 to 3 months. It is mentioned in the video as a measure of how well Mr. Rosales's diabetes is being managed. Despite his dietary changes, his A1C level is still high, suggesting that further adjustments are needed.

💡Carbohydrates

Carbohydrates are a macronutrient found in foods like rice, pasta, and bread, which can raise blood sugar levels. The video highlights the reduction of carbohydrates in Mr. Rosales's diet as a strategy to control his blood sugar. His previous high intake of rice and tortillas is identified as a problem area.

💡Soda and Beer

Soda and beer are high in sugar and calories, which can negatively impact blood sugar levels. Mr. Rosales mentions giving up these beverages as part of his dietary changes to manage his diabetes, demonstrating a commitment to healthier lifestyle choices.

💡Cranberry Juice

Cranberry juice is a type of fruit juice that Mr. Rosales has turned to as a substitute for soda. However, the video reveals that even though it is perceived as a healthier option, it still contains a significant amount of sugar. This highlights the importance of reading nutritional labels and being mindful of sugar content in all beverages.

💡Moderation

Moderation in the context of the video refers to the concept of balancing food and drink intake to maintain health, particularly for those with conditions like diabetes. The doctor advises Mr. Rosales that while he doesn't need to completely give up his favorite foods, he should practice moderation to manage his blood sugar levels effectively.

💡Physical Exam

A physical exam is a routine procedure performed by healthcare providers to assess a patient's health. In the video, the doctor mentions conducting a physical exam after discussing Mr. Rosales's medication and diet, indicating that it is a standard part of the follow-up process for monitoring his diabetes.

💡Monofilament

A monofilament is a single, thin filament used in medical examinations, often for testing skin sensation. The doctor in the video plans to use a monofilament for Mr. Rosales's physical exam, which is a common practice for checking for neuropathy, a complication of diabetes.

Highlights

Mr. Rosales is at the doctor's office for a 3-month follow-up on his diabetes.

The doctor plans to discuss Mr. Rosales' medications, diet, and perform a physical exam.

Mr. Rosales has made significant lifestyle changes since his last visit.

He is currently taking metformin for blood sugar, Synthroid for his thyroid, and baby aspirin.

Mr. Rosales forgot to bring his pill bottles to the appointment.

He accidentally left his medications in his son's car.

Mr. Rosales takes his thyroid medication upon waking up, followed by his breakfast.

He consumes metformin after breakfast and takes his aspirin and diabetes pill before bed.

His wife plays a crucial role in reminding him to take his medications.

Mr. Rosales' breakfast typically consists of hard-boiled eggs, oatmeal, coffee, and sometimes avocado.

For lunch, he usually has a salad with chicken or tuna, containing vegetables and a light lemon and olive oil dressing.

His wife has taken over meal preparation, focusing on healthy options and avoiding unhealthy foods.

Dinner often includes fish, vegetables like cauliflower, and a small portion of rice.

Mr. Rosales has stopped consuming rice or tortillas with every meal, which was previously high in carbohydrates.

Despite dietary changes and medication, Mr. Rosales' blood sugar levels are still high.

His A1C levels have decreased but not as much as expected with the current treatment plan.

Mr. Rosales has given up soda, beer, and fast food, opting for healthier alternatives like cranberry juice.

The doctor points out that cranberry juice, despite being a better choice, still contains a significant amount of sugar.

Mr. Rosales admits to drinking multiple bottles of cranberry juice daily at work.

The doctor advises Mr. Rosales to cut down on juice and consider sugar-free or diet options.

The doctor emphasizes the importance of moderation in Mr. Rosales' diet.

The doctor prepares to conduct a physical exam after discussing Mr. Rosales' diet and medication.

Transcripts

Good afternoon, Mr. Rosales.

Nice to see you again!

Good afternoon, doctor.

Likewise.

So you're here today for your 3-month follow-up for your diabetes.

Today we're going to go over your medications, how you're taking them, your diet, and then

we'll give you a physical exam, ok?

Great.

I've changed a lot of things since the last time we talked.

I'm glad to hear that, Mr. Rosales.

To start with, what medications are you currently taking?

Well, I take the one pill for my blood sugar, that other little pill for my thyroid, the

little aspirin...

Did you bring your pill bottles with you today?

No, I forgot them in my son's car.

Oh, your son's car?

Do you always leave your medications in your son's car?

Oh, no.

I had them in a little plastic baggie to bring them here and my son gave me a ride.

I accidentally left them in his car when he dropped me off.

Oh, I see!

That makes sense.

That seemed like a very strange place to store your medications!

Well Mr. Rosales, please try to remember to bring them next time, ok?

Yes, doctor.

I'm sorry.

It's ok.

So, you said the medication for your diabetes, right?

Was that metformin?

Yes!

Metformin.

I remember it started with an M. I also take my thyroid pill.

It's the little round one that I have to break in half.

Synthroid?

Maybe.

You refilled it for me the last time I was here.

Ok, that's synthroid then.

And you're taking the baby aspirin?

Yes, doctor.

And how are you taking your medications?

I take my thyroid pill right when I wake up.

Then I take my shower, brush my teeth, and get dressed.

By then my wife has my breakfast ready and I eat.

Okay, what next?

I take my sugar pill right after I eat breakfast.

At night, right after dinner and right before bed, I take my aspirin and my diabetes pill

again.

Well Mr. Rosales, it sounds to me like you're taking you medication exactly how you should

be.

How often would you say you forget to take a dose of your medications?

I don't forget because my wife always reminds me.

She won't let me eat in the morning unless I've had my medication, then she won't let

me leave for work until I take my sugar pill!

Then at night, she won't let me come to bed unless I've taken my pills!

Wow, it sounds like your wife has got this under control.

Well, let's talk about your diet.

What does a typical breakfast look like to you?

My wife makes me hard-boiled eggs and oatmeal.

Do you have anything else with your oatmeal and eggs?

I have a coffee with a little bit of cream and no sugar.

Sometimes I have avocado with my eggs.

Okay, and what about lunch?

I almost always have a salad with chicken or tuna.

What's in your salad?

And what kind of dressing do you have with your salad?

Tomatoes, carrots, broccoli, and I think my wife uses two different kinds of lettuce.

I don't like a lot of salad dressings.

I usually just use lemon and some olive oil with a little bit of salt and pepper.

Wow, that sounds like a healthy lunch!

My wife doesn't let me eat anything unhealthy anymore!

She makes all my food and won't even buy unhealthy things at the store.

Well it sounds like your wife really cares about you.

Does she make you dinner, too?

Yes.

We've started to eat a lot of fish.

She likes to cook fish for dinner now.

We always have a side of vegetables like cauliflower.

She also lets me have a little bit of rice.

But not a lot!

A little bit of rice is okay, Mr. Rosales.

The problem before was that you were having rice or tortillas with almost every meal,

and a big part of your meal was comprised of carbohydrates.

That was what was making your blood sugar so high.

So, with these dietary changes and the medication, I would expect your blood sugar to be going

down.

How was my blood sugar today?

It was still high today, Mr. Rosales.

We also checked your A1C, which gives us an average of your blood glucose over the past

3 months, and even though it came down, it didn't come down as much as we would expect

with the dietary changes and medication.

But I've been doing everything you've asked me to.

I don't understand.

I gave up a lot of my favorite foods.

I stopped drinking soda and beer.

I stopped going to McDonald's.

Every time my coworkers go to the 7-11 to get food and drinks on their break, I tell

them NOT to bring me Takis and a Coca-cola, but to bring me a cranberry juice instead!

Well, I think you've made a lot of important changes.

You certainly don't have to give up your favorite foods entirely, and a few sips of a soda or

a beer here or there is okay.

Everything in moderation.

Cranberry juice is definitely a better choice than Takis and a Coke, but it still contains

quite a bit of sugar.

But it's natural.

It says, "No added sugar."

Well, that just means they didn't add any EXTRA sugar.

Cranberry juice contains almost the same amount of sugar as a small can of Coke.

Do you just have the one cranberry juice a shift?

... No.

How much juice are you drinking, Mr. Rosales?

I stopped drinking the soda and the beer.

So, in a typical day, what do you drink instead?

I have coffee with breakfast.

NO sugar, only a little bit of cream.

Yes, we've established that.

No sugar.

What about for lunch?

I have... juice.

How much juice?

Cranberry?

Cranberry juice is my favorite.

Sometimes I'll have the kind with apple or raspberry.

I'll have... one, with lunch.

Just one?

You sound unsure, Mr. Rosales.

Two.

What about if you get thirsty after lunch when you're at work?

What do you drink?

Cranberry juice.

Hmm.

So how much cranberry juice do you think you drink at work a day?

Four bottles...

And when you get home?

Oh no, we don't have juice at home.

Only water.

And coffee, no sugar.

Yes.

Well Mr. Rosales, I think we've gotten to the bottom of this.

You've got to be careful with the juice.

You're doing a really good job with your diet, cutting out sodas, beer... but juice contains

sugar, too.

So I can't drink juice either?!

Not necessarily.

I'd say try to not only cut down on the juice, but also find a "Sugar-free" or "Diet" option.

You can check the sugar content on the back of the bottle.

A lot of juices have diabetic-friendly options with little to no sugar.

Thank god.

Juice is all I have left!

Like I said, Mr. Rosales: everything in moderation.

Tell you what, I'm going to go grab a monofilament and be right back for your physical exam,

okay?

It seems my nurse may have moved them!