Screen Shot 2014-06-04 at 2.17.20 PMI enjoyed working with this more rural population. The patients and
providers all seemed very receptive to and appreciative of our teaching. Many of the patients were very warm, and there were a few memorable interactions. I’d like to reflect on one of these.
About half way through the day, an elderly gentleman limped slowly into our
blood pressure screening and education room. He had previously been diagnosed
with hypertension and diabetes. His blood pressure was 160/100 on my check, and he reported that he had taken his medication in the morning. I discussed all of the
risk factors for hypertension with him and encouraged him to make healthy lifestyle
changes. As I went through the recommendations step-by-step (reduce salt, eat a
healthy diet high in fruits and vegetables and low in red meats and saturated fats,
get routine physical activity, manage weight, reduce alcohol consumption) he
nodded in agreement and assured me he had already made all of these changes.
However, when I reached my final recommendation—to quit smoking—he stopped
me and informed me he simply could not quit. He stated that everything good had
already been taken from him, and that he didn’t have too many years left anyway.
This made me think about just how hard it is to quit smoking, and how although this
is one of the most important modifiable risk factors for cardiovascular disease, it can
also be one of the most difficult lifestyle changes to make.

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