Meet Mr. Hake
Now that you’ve learned about detox, cravings, relapse, and prescribing practices, let’s take a look at all this in action with a patient.
Meet Mr. Hake. He is a 62-year-old male well-known to you who comes to the clinic for a 6-month follow up of his diabetes, hypertension and hyperlipidemia. He also has a history of stage II diastolic dysfunction. All of his medical problems are typically well-controlled which is why you are surprised when you receive his chart and see that his blood pressure today is 166/92 and his fingerstick blood glucose is 278. Upon questioning, he tells you that he is taking all of his usual medicines but is feeling fatigued & not sleeping well. He denies chest pain, peripheral edema, orthopnea, paroxysmal nocturnal dyspnea, shortness of breath, polyuria and polydipsia. His vitals reveals a 10-pound weight loss, a regular pulse of 88 and an oxygen sat of 98%. The rest of his exam is unremarkable except that his affect is sad and he is more withdrawn than usual.