Rachel is a 55-year-old woman with hypertension and type 2 diabetes mellitus who came to the clinic for a same-day sick visit because of worsening leg swelling. She also reports mild headaches and insomnia. Her last office visit was three years ago, and at that time her chronic conditions (hypertension, hyperlipidemia, and diabetes) were under control. At the current visit, her blood pressure is elevated to 175/110 mm Hg and her A1C is 9.3%. Her current medications include lisinopril, atorvastatin, and metformin. She has a full-time job and lives with her husband. She cannot think of any potential triggers or factors that might have contributed to her worsening chronic conditions. When you ask if she's been under a lot of stress lately, she sighs wearily and nods “yes.”