question: i have three 62 year old males in office with chf, cad, dm2, ckd2, hypothyroidism, anxiety and a-fib. one is on lasix had 2 stents placed in 2009 on metoprolol. on metformin and lantus and lisinopril for dm2. last bun and creatine was 24/1.3 in may 2017. taking synthroid with a tah of 3.1 in may. anxiesty is uncontrolled and no kedications for 2 months. a-fib on metoprolol and coumadin with a inr of 3.7 in may having complaints of more anxiety, bleeding on and off with bowel movements and diarrhea woth augmentin for his sinuses. the second patient had an echo in febuary with an ef of 50% on lasix and kci. had 3 stents in 2001 and 4 in 2012, and on lisinopril. dm2 uncontrolled with humalog and levemir. last a1c was 8.9 in april. last bun and creatine was 29/2.1 in april, tsh 1.2. ablation in january nsr now and no medication. having complaints of palpitations several times a day. he has been very thirsty but has been working in his garden alot. he no longer has to get up at night to uriniate and is now having more lef cramps. the third patient had an echo in 2015 with an ef of 30%, currently not on medication for it but has taken lasix in the past. last cath was in 2015, with 40% stenosis, lad. dm2 improved with diet. last a1c 6.1 in june 2017. previouslt on levothyroxine for hypothyroidism with a tsh of 4.1 in march 2017. was taking lexapro for aniexty now controlled wirh excercise. a-fib controlled heart rate of 65 today worh no medications. patient states he has been working hard to change his lifestyle and changed to a 100% wholefood, plant based doet. stopped taking his meds four months ago. complaining of being more lethargic recently. have constipation again and his memory is getting worse. who is the most important patient of the three patients and why?