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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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High BP, Indigestion, Obesity. On High Fat Diet. Ruled Out MI. Should I Get CBC, EEG Done?

I am in nursing school and have a scenario question. 48y/o male B/P of 202/142, Pulse 106. He comes in the ER with c/o indigestion and is admitted for a rule out MI. He is obese ( beer belly, large wt circumference) with high fat diet, 36pk/yr smoker He is treated with O2, IV of NTG and ASA 325. I have ordered CBC, EEG, Chem 7, PT/PTT There is also the option to order a bilirubin and a UA but I am unable to find a correlation between MI and Bilirubin. I can see the rationale to get a UA for measurements of electrolytes. Are either of these appropriate for this situation?
Mon, 25 Nov 2013
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General & Family Physician,  's  Response
hello there!
Thank you for asking. this obese diet generous needs lifestyle and diet modifications. No CBC and EEG is required. No doubt indigestion is the issue.

It would be better to undergo a repeat endoscopy to confirm the status of gastritis / H.pylori infection. But more than that you need some life style modifications; here are some

1. Lose weight make BMI below 25.
2. Avoid alcohol, chocolate, citrus based fruits,tomato based products
3. Avoid pepper mint coffe and possibly the onion family
4. Eat small freequent meals rather than large meals.
5. Wait at least 3 hours after the meal to lie down or sleep.
6. Refrain from ingesting food (except liquids) with in 3 hours of bed time.
7. Elevate the head of your bed at least 8 inches
8. Avoid bending or stooping positions
9. Don't use pain killer tablets
10. Don't smoke
11. have a proper sleep routine
12. use cold milk as drink avoid all hot beverages and carbonated ones
13-Take some antispasmodics to relieve the spasm.

No need for PT APTT Bilirubins .

Just modifications and reassurance

Regards
S Khan
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High BP, Indigestion, Obesity. On High Fat Diet. Ruled Out MI. Should I Get CBC, EEG Done?

hello there! Thank you for asking. this obese diet generous needs lifestyle and diet modifications. No CBC and EEG is required. No doubt indigestion is the issue. It would be better to undergo a repeat endoscopy to confirm the status of gastritis / H.pylori infection. But more than that you need some life style modifications; here are some 1. Lose weight make BMI below 25. 2. Avoid alcohol, chocolate, citrus based fruits,tomato based products 3. Avoid pepper mint coffe and possibly the onion family 4. Eat small freequent meals rather than large meals. 5. Wait at least 3 hours after the meal to lie down or sleep. 6. Refrain from ingesting food (except liquids) with in 3 hours of bed time. 7. Elevate the head of your bed at least 8 inches 8. Avoid bending or stooping positions 9. Don t use pain killer tablets 10. Don t smoke 11. have a proper sleep routine 12. use cold milk as drink avoid all hot beverages and carbonated ones 13-Take some antispasmodics to relieve the spasm. No need for PT APTT Bilirubins . Just modifications and reassurance Regards S Khan