This project will be illustrated through patient centered case studies.
Our prior similar projects are published here :
Two case studies of today 5/4/2022
Case 1 :
Case 2:
Integrative medical education and practice twist :
Life style choices 1:
Psychosocial component :
Even as we started trying to change Case 1's life style and nutrition, we also got Case 1 to look after Case 2 as part of our life style modification program related to deaddiction and other life style changes toward giving our patients a better psycho social and metabolic profile enhancing their individual leadership and scholarship driving better collective societal gains. Above mentioned medical education project has been conceptualized earlier in this book chapter here : https://medicinedepartment.
We made Case 1 present the problem based requirements of Case 2 in our 11AM to 1PM morning academic session also attended by 100s of our graduate medical students. One of the medical students was already presenting one of her patients of alcoholic cirrhosis and following her presentation once our Case 1 finished his presentation around Case 2, we had a fruitful discussion around Case 2 as well as Case 1 where we tried to discuss the similarities between the alcohol addiction of Case 1 and the previously medical student presented Alcoholic cirrhosis patient in a non judgemental manner highlighting the complications the first patient suffered from alcohol addiction.
Our objectives and expectations from this patient driven learning exercise was manifold :
1) Demonstrate harms of a particular life style
2) Demonstrate the positive outcome possibilities of a changed lifestyle
3) Build confidence in the patient currently experiencing the harmful lifestyle that s/he can change for the better
Current life style challenges identified in Case 1 from the case report linked above :
1) Psychological debility due to tragic life events leading to attempted acute (organo phosphorus poisoning) self harm as well as chronic self harm (alcohol addiction)
2) Medical complications of psychological self harm manifesting in metabolic syndrome (type 2 diabetes) as well as recurrent pancreatitis and possibly type 3 diabetes.
Life style interventions instituted and ongoing along with expected outcomes:
1) Patient empowerment through practical hands on knowledge and learning of clinical problem solving that would enable scholarship and leadership and not only help to solve the patient's own life style challenges but also benefit many others facing similar challenges as demonstrated by Case 1 learning to help Case 2.
2) "Guided patient driven learning by patients under supervision of their academic institutional caregivers" can generate participant empathy and collaboration toward mutual well being.
Above is a work in progress and we need to watch this space.
Lifestyle choices 2:
Nutrition and physical exercise :
Current challenges identified in both the patients:
Lack of information :
What has been their diet and exercise levels till date and what has changed since pharmacological interventions began?
If their diet and exercise is suboptimal what are the factors responsible for it?
Definitive lifestyle interventions instituted :
Positive psychosocial gainful workflow along with proper nutrition and exercise with adequate monitoring of metabolic parameters and regular positive feedback.
Image based monitoring of patient nutrition where patient is asked to share an image of the pre and post meal plate regularly and offered feedback on the nutritional value of the plate consumed and suggested changes based on the nutrition image of the plate intake shared.
Case 1 plate image of lunch at hospital today:
Case 1 dinner today :
Case 2 dinner today :
Self recorded blood sugar values on full dose sulfonylurea Glimeperide 4 mg twice daily :
Please watch their data grow in the mirror image case report blog that is likely to be located in our elective student's learning portfolio here :
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