T:	there's great seeing you thank you for coming to diabetes clinic today my name is Mark Smith I'm a pharmacist I work with dr. Pham and I we run the diabetes clinic and we basically serve to educate our patients so that I can better manage their their diabetes and looking at your chart I see that you are pre-diabetic so what we're going to do now is kind of focus on nutrition mostly diet and exercise okay
C:	dr. Pham already made me get a nutritionist I know what you're going to tell me so Kyle Eve
T:	okay okay that's fine I'm glad you had the opportunity to talk with the nutritionist I'm she's a very nice lady and she has some very valuable information do you mind telling me some of the things that she discuss with you
C:	it's the same stuff you're gonna tell me
T:	okay well I will show you what I normally go through with my patients and then you can let me know if there's any information that you covered with the nutritionist or any of the material it's new to you then that would be great as well basically we feel that going over the nutrition aspect of diabetes and pre-diabetes is so important there's so much that we can do without taking medications and we've seen many patients that have benefited from making just minor changes to their diet that are greatly impacted their health in a very positive way so to start off I'm just going to ask you a few questions about what you eat to get a better picture of your diet so first what did you have for breakfast
C:	couple eggs bacon biscuits great
T:	okay all right and then what about lunch
C:	turkey sandwiches and chips
T:	okay chips and then for dinner
C:	spaghetti salad bread
T:	okay spaghetti salad and bread okay so tell me then what about any snacking that you do throughout the day like any snacks or anything like that
C:	I don't really snack but sometimes ice cream after dinner may be free in between meals benign occasion not very often
T:	okay and also what kind of beverages and things that you drink what are some of the things that you drink throughout throughout your day
C:	or constant constantly feeling hydrated some thirsty so I drink sweet tea all day long
T:	okay okay well thanks for sharing a bit of information within this patient this kind of gives us a better idea of what you throughout the day so now I'm going to give you some information or show you some information about nutrition okay
C:	all right know what you're going to say I need to eat less I've heard it all before it doesn't work for me so good
T:	okay all right so that's that's that's my ministrations but just just kind of bear with me so when I gather from your best far as that you know already you're fully aware of the things that you need to do in order to live a healthy lifestyle and take care of yourself however you seem to find it difficult and you don't think that it works for you is that that's kind of the fish that I'm getting so explain to me what are some of the barriers that you feel exists that prevents you from eating healthier and losing weight
C:	it's mostly the money it's expensive to buy foods that are healthy and I just can't afford it consistently also like foods it tastes good I hope these stuff doesn't taste good and I just don't want it and also my kids want the good taste in food so they wouldn't even eat it if I made healthy food
T:	okay okay then I understand completely that finances can be a potential issue and an issue especially when it comes to eating healthy more importantly picking out the right healthy foods for your kids to end and also to have good taste is also a priority to you so tell me about you know we're going to switch and transition from diet and talk about exercise tell me about your normal exercise routine
C:	honestly I only have one I haven't exercised in years just don't feel like it put all the money to join again
T:	okay okay and then what are some of the barriers you believe that prevent you from exercising on a regular basis
C:	well kids they take a lot of time group and money like I said gym memberships or there's several close to my home but they're too expensive for me to get and I just don't have enough time the kids take a ball a day of the day and then work
T:	all right and then what what ultimate benefits let's talk about benefits what benefits that you feel that you can ultimately gain by by seeking out more nutritious foods and incorporating exercise into a daily regimen regimen and an overall losing weight what do you think would be the benefits of doing all that
C:	I guess it's good for you dr. Pham always gets mad at me and says I'm not healthy and always talks about my weight
T:	okay
C:	maybe
T:	okay maybe yes yes ma'am well and and then those things are exactly correct on what I would like to do miss Fisher I know that you're pressed for time I'm not going to take too much of your time but I would like to schedule min and I and basically sit down with you and kind of go over some some helpful alternatives and basically look at some cost effective type thing since cost is an issue with you and then also look at some resources that we can channel into when it comes to exercise you'll soon find out that some of the exercises that you can do they don't even require a gym membership so you know if that's something deal at because you mentioned to me that time and money are contouring for you so we basically want to work with you together to see if we can get something that that better suits you you know and get you on the right track when it comes to your pre-diabetes and overall losing weight so would you like to come in and scheduling Pullman with us about a week from now
C:	yeah I mean you can help me with the finances and Ty
T:	yes ma'am yes ma'am I believe that so what what we do is we'll schedule a week from now and but it was it was a pleasure talking with you and I very much look forward to working with you okay all right yeah we good rest of the day okay all right