Andy williams, 65 yrs
BMI: 46.6 kg/m2
Type 2 Diabetes 1996
Hypertension 2002
Sleep apnoea 1998
BG levels 126- 130 mg/dl
Tryglyceride
Serum insulin 19 uIU/ml
Medications
30-70 UNITS NPH insulin
850 mg metformin twice daily
Lisinoril and nifedipine
Since childhood obesity and gaining weight every decade
Been in medical weight loss programs and discontinued them
Consulted a dietician
Not wanting to weight -loss surgery in past, because complications
3 lqrge mals/day
Dinner- largest meal
Reported bing eating triggered by stress- once a month
No alcohol
Pt concerned about health/ want to get life under control
Wants to learn about surgical options
Partner supportive
Recommendatiosn for treatment (Referral to North Westen Weight loss surgery)
Will consider surgery if the hospital recommends it
15/ 06/2019
Dr D Kurac
Surgeon
North- western Weight Loss Surgery
393 Victorian Road
Plumpton
Dear Dr. Kurac,
RE: Mr. Williams, 65 years
Mr. Williams requires your evaluation and possible treatment since he is concerned about
their weight and health problems and is willing to know about surgical options.
Mr. Williams came to our clinic on 15/6/2019, with the following medical history of
relevance BMI that suggest obesity, diabetes type 2 (1996) and uses NPH insulin and
metformin twice daily, hypertension (2002) medicated with lisinopril and nifedipine. He
also has blood test records which says BG levels 126-130 mg/dl, Triglyceride high, and
serum insulin of 19 uIU/ml.
He has been with weight problems since childhood, also mentioned that gained weight
every decade and during adulthood was their highest. He had been in medical weight- loss
programs but have quitted, he has tried to consult a dietitian and at that moment he was
reluctant with their weight -loss surgery because the complications about that one.
Their diet consists in 3 large meals every day and the dinner is the largest, he has limited
their fast- food consumption for 4 months and also mention binge eating triggered by
stressed once a month.
We refer this patient to your care since you could provide him the better evaluation and
possible treatment for this patient.
If you have any further queries, do not hesitate to contact me.
Yours kindly regards, Luis Angel Hernandez Zarate
General Practitioner