Dangerous Dan’s Road To Recovery

1. Dangerous Dan’s Road To Recovery By: Dan Zukiwsky, Keri Gerlach, Will Inkley, Jayme Kelly, and Will Dechert

2. Lifestyle Schedule

3. Client Objectives/Goals • Initial goal of 10 % decrease in body weight (20 lbs) • Implement a smoking cessation program • Lower Blood pressure (Diastolic) • Lower Cholesterol (LDL) • Implement small incremental nutritional changes (Lower protein and fat, add substantial amount of carbs and vegetables etc. • Decrease red meat intake • Reduce stress overall through management techniques • Decrease symptoms in shoulder and back

4. Behavioral Prescription-Smoking • Smoking Cessation • Self Evaluation of tobacco cravings • Recall interview info (BP, cholesterol) • Approach: • Counseling in conjuction with a 24 hour transdermal patch

5. Smoking Facts • Five stages of smoking: Preparation, initiation, habitual, stopping, and resuming (Snyder 1989) • Smoking can play a central role in the control of emotions: anxiety, boredom, stress depression may cue smoking. • Cravings can be triggered by external stimuli: seeing others smoke, drinking a cup of coffee • Acute withdrawal symptoms occur 7-10 days after quitting. These include headache, heightened anxiety, irritability, ability to concentrate, and fatigue. • Nicotine symptoms occur long after it has been used by the body. So will experience cravings • Within min after smoking nicotine levels fall in the blood = more craving

6. Behavioral Prescription-Smoking • Refer to Hypnotic Specialist (decreases relapse when used with counseling) • 80 % relapse without counseling

7. Potholes Along The Road Frequent causes of potholes/slip-up • Eating (coffee) • Times of stress • Alcohol • Social Situations • Boredom • When you feel good (Sex) or bad (No sex) • Food substitution POTHOLES ARE OK, EVERYONE EXPERIENCES THEM!!!!! But we will teach you methods that will help you get over them -Positive outlook - No self blame -Relaxation -Hypnosis -Self efficacy -Self Observation -Understanding Coping strategies

8. Potholes Continued • Pothole is basically a high risk smoking situation and an inadequate coping response. • 2 approaches • Motivation to avoid • Coping skills to maintain avoidance • Strategies include aversion, and self control

9. Stress Management • Self Evaluation of stress • Excess stress may contribute to the development of Cardiovascular disease • Breathing Exercises • Stretching • Walking • Progressive relaxation • Go to relaxing spot when at work on lunch • Alcohol, caffeine, sugar, fats, and tobacco all put a strain on your ability to cope with stress. • Exercise • Fishing

10. Lifestyle Schedule

11. Second Lifestyle Session • Check up on smoking cessation • Recap cravings • Initial response to hypnosis treatment • Recap of physio

12. Behavioral Prescription- Smoking • Family Intervention Session • Interactive process • Recap discussion of smoking facts and consequences of smoking on family • Schedule family intervention per unscheduled relapse

13. Family Counseling Intervention • Benefits of quitting smoking include: • easier breathing • Improved taste and smell • More energy • More refreshing sleep • Monitary savings (you could save $1400 dollars annually and go and a vacation) • Pride of accomplishment • Personal satisfaction

14. Family Counseling Continued • Additional Benefits related to family members: • Children decreased exposure to smoking toxins • Asthma symptoms will decrease • Cardiovascular disease etc. associated with smoking. Genetic predisposition towards health related problems (CVD). Decreased risk if smoking decreased. • Decreased Second hand smoke risk. Problem because smoke is unfiltered, greater risk associated with this type of smoke.

15. Nutrition Info and Habits • Recap physician findings • Exam should take place at least once a year • Eating habits (frequency) (5 likert scales for food groups) • Cholesterol level (LDL) 130 mg/dl • Eggs and butter have most cholesterol • Increase risk for heart disease

16. Nutrition Modification • Acidic foods such as oranges, grapefruit, lemons, limes, etc will help lower the pH balance in your blood and help decrease nicotine cravings. • Reduction of red meat (allow once per week on day of choice)= decreases LDL • Substitute fish, chicken, turkey for red meat= Increase HDL, especially fish which have omega 3 unsaturated fatty acids • Include at least one (moderation) serving of fruits and vegetables per meal (broccoli, cauliflower, asparagus, zucchini, sweet potatoes). Are all high in vitamins • Eat fruit for dessert • Choose healthy snacks (handful of almonds, dried fruits) • Prepare meals for family during the week. Increase frequency of cooking. Try family preparation of foods. • Include glass of red wine with dinner (1 glass per day) = helps cardiovascular health through cholesterol

17. Nutrition Modification Con’t • Prepare lunch for work, no take-out (Peanut butter and jelly on whole wheat bread) • During breaks at work consume water ( at least 1-1.5 litres per day) (Nalgene good) • Decrease alcohol consumption, substitute light beer • Decrease coffee intake to two cups per day (moderation) • Foods high in Vitamin B-6 which increase metabolism- split peas, banana, chicken, beans, and advocado. Do not overcook • Reduction of portion size slowly (Serving size), and increase vegetable integration • How do you think you could decrease fat through cooking methods?

18. Cooking Tips • Cooking tips: Bake, broil, steam, grill • Bake fries instead of frying • Invest in an indoor grill • Use sweet potatoes instead of white potatoes. They have Vitamin B and Fibre

19. Physical Prescription • No cart for golfing • 10 % weight loss goal (20 lbs). Minimum of 10 wks, about 2 lbs a week. • Incorporate family walks (one to two walks per week, 30 minutes minimum) • Slow integration of winter activities, core strength and aquatic activities.

20. Physical Prescription Take home information for Dan: acidic foods, Canadas food guide, goals and objectives, etc.