Dangerous Dan’s Dangerous Dan’s Road To RecoveryRoad To Recovery
By: Dan Zukiwsky, Keri By: Dan Zukiwsky, Keri Gerlach, Will Inkley, Jayme Gerlach, Will Inkley, Jayme
Kelly, and Will DechertKelly, and Will Dechert
Lifestyle ScheduleLifestyle ScheduleMonMon TuesTues WedsWeds ThurThur
ssFriFri SatSat SunSun
InterviewInterview PhysicianPhysician pedorthistpedorthist Golf Golf scheduled scheduled (No CART)(No CART)
Family Family recreation recreation dayday
-Lifestyle -Lifestyle meeting #1meeting #1
MonMon TuesTues WedWedss
ThurThurss
FriFri SatSat SunSun
Abrupt QuitAbrupt Quit
Introduction Introduction of patchof patch
PhysioPhysio
Scheduled Scheduled Relapse Relapse (morning (morning coffee coffee break)break)
Hypnosis Hypnosis sessionsession
lifestyle lifestyle counseling counseling #2#2
-learn self -learn self observationobservation
-Learn self--Learn self-efficacyefficacy
Golf Golf scheduled scheduled (No CART)(No CART)
Family Family recreation recreation dayday
Client Objectives/GoalsClient Objectives/Goals
Initial goal of 10 % decrease in body weight (20 lbs)Initial goal of 10 % decrease in body weight (20 lbs) Implement a smoking cessation programImplement a smoking cessation program Lower Blood pressure (Diastolic)Lower Blood pressure (Diastolic) Lower Cholesterol (LDL)Lower Cholesterol (LDL) Implement small incremental nutritional changes Implement small incremental nutritional changes
(Lower protein and fat, add substantial amount of (Lower protein and fat, add substantial amount of carbs and vegetables etc.carbs and vegetables etc.
Decrease red meat intakeDecrease red meat intake Reduce stress overall through management Reduce stress overall through management
techniquestechniques Decrease symptoms in shoulder and backDecrease symptoms in shoulder and back
Behavioral Prescription-Behavioral Prescription-SmokingSmoking
Smoking CessationSmoking Cessation Self Evaluation of tobacco cravingsSelf Evaluation of tobacco cravings Recall interview info (BP, cholesterol)Recall interview info (BP, cholesterol) Approach: Approach:
Counseling in conjuction with a 24 hour Counseling in conjuction with a 24 hour transdermal patchtransdermal patch
Smoking FactsSmoking Facts Five stages of smoking: Preparation, initiationFive stages of smoking: Preparation, initiation, ,
habitualhabitual, stopping, and resuming (Snyder 1989), stopping, and resuming (Snyder 1989) Smoking can play a central role in the control of Smoking can play a central role in the control of
emotions: anxiety, boredom, stress depression may emotions: anxiety, boredom, stress depression may cue smoking.cue smoking.
Cravings can be triggered by external stimuli: Cravings can be triggered by external stimuli: seeing others smoke, drinking a cup of coffeeseeing others smoke, drinking a cup of coffee
Acute withdrawal symptoms occur 7-10 days after Acute withdrawal symptoms occur 7-10 days after quitting. These include headache, heightened quitting. These include headache, heightened anxiety, irritability, ability to concentrate, and anxiety, irritability, ability to concentrate, and fatigue.fatigue.
Nicotine symptoms occur long after it has been Nicotine symptoms occur long after it has been used by the body. So will experience cravings used by the body. So will experience cravings
Within min after smoking nicotine levels fall in the Within min after smoking nicotine levels fall in the blood = more cravingblood = more craving
Behavioral Prescription-Behavioral Prescription-SmokingSmoking
Refer to Hypnotic Specialist (decreases Refer to Hypnotic Specialist (decreases relapse when used with counseling)relapse when used with counseling)
80 % relapse without counseling80 % relapse without counseling
Potholes Along The RoadPotholes Along The RoadFrequent causes of potholes/slip-upFrequent causes of potholes/slip-up Eating (coffee)Eating (coffee) Times of stressTimes of stress AlcoholAlcohol Social SituationsSocial Situations BoredomBoredom When you feel good (Sex) or bad (No sex)When you feel good (Sex) or bad (No sex) Food substitutionFood substitution
POTHOLES ARE OK, EVERYONE EXPERIENCES THEM!!!!!POTHOLES ARE OK, EVERYONE EXPERIENCES THEM!!!!!
But we will teach you methods that will help you get over themBut we will teach you methods that will help you get over them-Positive outlook-Positive outlook- No self blame- No self blame-Relaxation-Relaxation-Hypnosis-Hypnosis-Self efficacy-Self efficacy-Self Observation-Self Observation-Understanding Coping strategies-Understanding Coping strategies
Potholes ContinuedPotholes Continued
Pothole is basically a high risk smoking Pothole is basically a high risk smoking situation and an inadequate coping situation and an inadequate coping response.response.
2 approaches2 approaches Motivation to avoidMotivation to avoid Coping skills to maintain avoidanceCoping skills to maintain avoidance
Strategies include aversion, and self Strategies include aversion, and self controlcontrol
Stress ManagementStress Management Self Evaluation of stressSelf Evaluation of stress Excess stress may contribute to the development Excess stress may contribute to the development
of Cardiovascular diseaseof Cardiovascular disease Breathing ExercisesBreathing Exercises StretchingStretching WalkingWalking Progressive relaxationProgressive relaxation Go to relaxing spot when at work on lunchGo to relaxing spot when at work on lunch Alcohol, caffeine, sugar, fats, and tobacco all put Alcohol, caffeine, sugar, fats, and tobacco all put
a strain on your ability to cope with stress.a strain on your ability to cope with stress. ExerciseExercise FishingFishing
MonMon TuesTues WedsWeds ThurThurss
FriFri SatSat SunSun
InterviewInterview PhysicianPhysician pedorthistpedorthist Golf Golf scheduled scheduled (No CART)(No CART)
Family Family recreation recreation dayday
-Lifestyle -Lifestyle meeting #1meeting #1
MonMon TuesTues WedWedss
ThurThurss
FriFri SatSat SunSun
Abrupt QuitAbrupt Quit
Introduction Introduction of patchof patch
PhysioPhysio
Scheduled Scheduled Relapse Relapse (morning (morning coffee coffee break)break)
Hypnosis Hypnosis sessionsession
lifestyle lifestyle counselling counselling #2#2
-learn self -learn self observationobservation
-Learn self--Learn self-efficacyefficacy
Golf Golf scheduled scheduled (No CART)(No CART)
Family Family recreation recreation dayday
Lifestyle ScheduleLifestyle Schedule
Second Lifestyle SessionSecond Lifestyle Session
Check up on smoking cessationCheck up on smoking cessation Recap cravingsRecap cravings Initial response to hypnosis Initial response to hypnosis
treatmenttreatment Recap of physioRecap of physio
Behavioral Prescription- Behavioral Prescription- SmokingSmoking
Family Intervention SessionFamily Intervention Session Interactive processInteractive process Recap discussion of smoking facts and Recap discussion of smoking facts and
consequences of smoking on family consequences of smoking on family Schedule family intervention per Schedule family intervention per
unscheduled relapseunscheduled relapse
Family Counseling Family Counseling InterventionIntervention
Benefits of quitting smoking include: Benefits of quitting smoking include: easier breathingeasier breathing Improved taste and smellImproved taste and smell More energyMore energy More refreshing sleepMore refreshing sleep Monitary savings (you could save $1400 dollars Monitary savings (you could save $1400 dollars
annually and go and a vacation)annually and go and a vacation) Pride of accomplishmentPride of accomplishment Personal satisfactionPersonal satisfaction
Family Counseling Family Counseling ContinuedContinued
Additional Benefits related to family members:Additional Benefits related to family members: Children decreased exposure to smoking Children decreased exposure to smoking
toxinstoxins Asthma symptoms will decreaseAsthma symptoms will decrease Cardiovascular disease etc. associated with Cardiovascular disease etc. associated with
smoking. Genetic predisposition towards smoking. Genetic predisposition towards health related problems (CVD). Decreased health related problems (CVD). Decreased risk if smoking decreased.risk if smoking decreased.
Decreased Second hand smoke risk. Decreased Second hand smoke risk. Problem because smoke is unfiltered, Problem because smoke is unfiltered, greater risk associated with this type of greater risk associated with this type of smoke.smoke.
Nutrition Info and HabitsNutrition Info and Habits
Recap physician findings Recap physician findings Exam should take place at least once a yearExam should take place at least once a year
Eating habits (frequency) (5 likert Eating habits (frequency) (5 likert scales for food groups)scales for food groups)
Cholesterol level (LDL) 130 mg/dlCholesterol level (LDL) 130 mg/dl Eggs and butter have most cholesterolEggs and butter have most cholesterol Increase risk for heart diseaseIncrease risk for heart disease
Nutrition ModificationNutrition Modification Acidic foods such as oranges, grapefruit, lemons, limes, etc Acidic foods such as oranges, grapefruit, lemons, limes, etc
will help lower the pH balance in your blood and help will help lower the pH balance in your blood and help decrease nicotine cravings.decrease nicotine cravings.
Reduction of red meat (allow once per week on day of Reduction of red meat (allow once per week on day of choice)= decreases LDLchoice)= decreases LDL
Substitute fish, chicken, turkey for red meat= Increase Substitute fish, chicken, turkey for red meat= Increase HDL, especially fish which have omega 3 unsaturated fatty HDL, especially fish which have omega 3 unsaturated fatty acidsacids
Include at least one (moderation) serving of fruits and Include at least one (moderation) serving of fruits and vegetables per meal (broccoli, cauliflower, asparagus, vegetables per meal (broccoli, cauliflower, asparagus, zucchini, sweet potatoes). Are all high in vitaminszucchini, sweet potatoes). Are all high in vitamins
Eat fruit for dessertEat fruit for dessert Choose healthy snacks (handful of almonds, dried fruits)Choose healthy snacks (handful of almonds, dried fruits) Prepare meals for family during the week. Increase Prepare meals for family during the week. Increase
frequency of cooking. Try family preparation of foods.frequency of cooking. Try family preparation of foods. Include glass of red wine with dinner (1 glass per day) = Include glass of red wine with dinner (1 glass per day) =
helps cardiovascular health through cholesterolhelps cardiovascular health through cholesterol
Nutrition Modification Nutrition Modification Con’tCon’t
Prepare lunch for work, no take-out (Peanut butter Prepare lunch for work, no take-out (Peanut butter and jelly on whole wheat bread)and jelly on whole wheat bread)
During breaks at work consume water ( at least 1-1.5 During breaks at work consume water ( at least 1-1.5 litres per day) (Nalgene good)litres per day) (Nalgene good)
Decrease alcohol consumption, substitute light beer Decrease alcohol consumption, substitute light beer Decrease coffee intake to two cups per day Decrease coffee intake to two cups per day
(moderation)(moderation) Foods high in Vitamin B-6 which increase metabolism- Foods high in Vitamin B-6 which increase metabolism-
split peas, banana, chicken, beans, and advocado. Do split peas, banana, chicken, beans, and advocado. Do not overcooknot overcook
Reduction of portion size slowly (Serving size), and Reduction of portion size slowly (Serving size), and increase vegetable integrationincrease vegetable integration
How do you think you could decrease fat through How do you think you could decrease fat through cooking methods?cooking methods?
Cooking TipsCooking Tips
Cooking tips: Bake, broil, steam, Cooking tips: Bake, broil, steam, grillgrill
Bake fries instead of fryingBake fries instead of frying Invest in an indoor grillInvest in an indoor grill Use sweet potatoes instead of white Use sweet potatoes instead of white
potatoes. They have Vitamin B and potatoes. They have Vitamin B and FibreFibre
Physical PrescriptionPhysical Prescription
No cart for golfingNo cart for golfing 10 % weight loss goal (20 lbs). 10 % weight loss goal (20 lbs).
Minimum of 10 wks, about 2 lbs a Minimum of 10 wks, about 2 lbs a week.week.
Incorporate family walks (one to two Incorporate family walks (one to two walks per week, 30 minutes walks per week, 30 minutes minimum)minimum)
Slow integration of winter activities, Slow integration of winter activities, core strength and aquatic activities.core strength and aquatic activities.
Physical PrescriptionPhysical Prescription
MonMon TuesTues WedsWeds ThurThurss
FriFri SatSat SunSun
WalkWalk WalkWalk Scheduled Scheduled golfgolf
Scheduled Scheduled fishingfishing
Take home information for Dan: acidic foods, Canadas food guide, goals and objectives, etc.