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good morning missus anderson so nice to see you again
Dr. Schindler! tell me what brings you here today! well
my back has been acting up I had to miss
a couple days work I called your office and they said I had to come in to see
you before I could get no
I'm glad you were able to come in today I really haven't seen you since the
accident
which I guess was about six months ago yes how things been going for you since
then
well I i've been seeing orthopedist and
physical therapy every six to seven weeks and
physical therapy in between there and has that helped
I'm not I don't think it's to be honest
iced I still have as much pain now as I did back then
and so what do you do to help the pain
having yourself more comfortable the only thing that really helps is
is the medication pain what kinda medication taking
percocet purposes okay and can you tell me how often you taking
said well when it acts up maybe
maybe two or three times a day and
is that every day here can take it couple days in a row Intel that
and tell it feels better and pain gets better
and how long can you go without taking percent arm
sometimes a couple days maybe three or four
and he said you take it a couple times a day
me taking could you tell me a little bit more about us
when you take it during the day well
you know so I can make it to school in the morning
maybe hey depending on how bad it is in the afternoon and
and then you know so I can sleep at night easy to use it helplessly
can you tell me a little bit about the trouble the Chipettes sleeping
I we gotta wake up with in a lot of pain
it wakes me up and
what do you do when you wake up well if I have a medication or take it then
by if not I have to write it out some
you don't sound like you don't always have an educational
now who's been prescribing
my husband he's a doctor cardiologists
here's he is here and anybody else been prescribing
arm once in a while the orthopedist
but it sounds like there times when you're right now
right and my doctor and my husband said I should probably
come to you so you described
home the pain and in what's happened since the accident
anything else going on in your life while having a classroom this year
they transferred me from my school that I locked
I was in elementary teacher now I'm in high school
have a sec pretty months what's happening
last that's upsetting difficult other high schoolers they're like
man and there's like 45 I
perhaps group behavior problem have know-how
no teachers aid this year so it's its very out of control
and you've been missing a number of days yes
because %uh the painters because work it's been difficult
I came home page my heart you know I can't get in there because my back P
so it's mostly the back is keeping
anything else that you've noticed thats
that's changed for you last six months since his accident well the only other
thing is my
my 15-year-old I noticed him
his some same behaviors as these these high schoolers that I
he worries me hanging around the crowd that I really don't want it to end
I think you might be smoking there nation
well you know he comes in jolly one minute and
very tired the next 10 eats non stop in
and you know the wrong like about sixteen I'm afraid
driving and having an actual bath
that is a worry and you have to
virtual yes and how are they doing we're doing pretty well
their income he did both in college now so that's cool so we talked a little bit
about you back pain in about the travel agent
sleeping are you having any other symptoms
you concerned now how should be
passion I'm
mom I'm I'm here just feel very me
how would you describe I just
I I'm not very positive thanks to be like enthusiastic and
I don't feel that way and
are you able to enjoy things it usually enjoyed
hasher concentration
I guess it's pretty poor it's hard for me to stay focused even at school in
teaching and
you know I blame it on the kids I think it's me as well
revealing this actions I do feel nervous
yeah and how would you sing
much sums not not real good
I mean I don't feel like I'm doing the best I can
can do
he have times we feel when you're feeling down
you feel like life's not worth living parts
arms no now honey
house now now so itself but you could be depressed as well as
you now struggling spanking strong situations
have you had problems with depression past hiding call it depression
but I did feel very down after
after to love my purse
to my children so in the best price
hard time period and what was that like who is really tough
I I couldn't even get
yeah what kinds said have two sides
nothing well very tired no energy
just felt really bad about myself my mom had to come
page I could have done it without her depression tends to run in families
I'm wondering your family had problems
russians my mom yeah yeah
she had you have a period
be feeling really down Mike like I and you know
treatment to ever talk about
not really she can can be justly now
yeah so we talked a little bit about your family history
depression your mom's district Russian anybody else
family engine Grampians uncles cousins
systems I'm not that I know
and because problems with addiction tend to run
families as well
run in families that have problems be and depression
tell me a little hatch family history me
10 problem pens homes
well my father drink a lot T
and should s
no cirrhosis
rice and when he was ill
to the doctors talking on that one that was related to his
drinking yes the family the time
he had a problem all yes want me
bad well he was mean
he had a mean streak abuse here
as and that only happen after he drink a lot so when he was drinking
news well let's come back and talk a little bit about
mine came in today Singh
doctors can you tell me a little bit more about
what you'd like to be able to help you
well i I me the doctor's note to get back to school why I did have to take
off the couple days
and and then if I could have the percocet
to take away the pain so I can get back to
to work well let's talk a little bit percocet
it sounds like you've been taking it you know sometimes a couple days in a row
sometime
much she said you've taken companies of from using
have you found you're needing to use more of it
then he hadn't passed I don't think so
and have you
filter all like you need to cut down this well i
I think I'm at the minimum asset is in it still
the back pain doesn't go away a cell if I come back
it's just gonna be worse and his
any money pitcher close to my family
been talking to you matching use a percocet express concern
well only my husband and I
he's just so busy he would rather me see you then
and hingis writing prescription and that's what he's been doing
home and have you fell
guilty at all using guilty
now give find some time situation happened morning
feeling kinda shaky be to take percocet 27 himself down
well i do I do for myself
nervous and shaky is the is what it is but
II don't use that to to calm myself down I do use it for the back pain
what do you use to congress of tax it sounds like
you know between sleep problem nervousness
depression must be feeling
pretty awful times well arm once in awhile how go and have some drinks with
with friends after work and then
I do smoke marijuana in the evening
so that I can sleep calm down it does relax me
is that something pretty much
and how about other times during
night usually now and he said you drink with your friends
cation here how of see
now more than a
couple times a week and
to do at home and restaurant
usually well-used usually at a restaurant that has a bar
and so how many drinks using
just a couple maybe two or
three well
itself like you're struggling with a lot of things right now
I'm certainly the stress were back pain
you know resulting accident which you know at this point should begin batters
six-month using hard doing physical therapy
to try how it also sounds on top of that
like you have some reason sign so they're
your number things on right playing
sounds like you may be depressed one of the things that we know is that
women who have problems with depression some sometimes impact
mornin sometimes will turn to drugs or alcohol
help medicaid your depression my wonderful maybe something
be going and it may be why
needed used percent continued person
despite your back should be healing why I don't think so doctor
improve it does hurt my back is
is you know in a lot of pain and I don't think that
I'm questioning in all back teacher you're having paying
are having is feeling very painful but we do know
pain painful symptoms
sometimes a pain can be very calm have two passions
one other thing said I think we need to try this one out together
here's how much in is happening
maybe read passion which
you can't reach for more whether
in fact is as a secondary problem now
develops independence on pain medication
I don't I can stop me
I mean I I quincy that I was dependent on but what would I do about my back
pain
okay well I think that's something that we need to talk about
continue to work on one other thing certain families
if you start to treat depression that very often the back pain starts to get
there
but we also have to find out how dependent Jimmy be on pain medication
and caper you of it death
in fact case what I'd like to do missus anderson is right now
a prescription for an antidepressant for you today
and we'll talk a little bit about on how you take it
what some other side effects potentially could be
and also right now description
schedule for taking you slowly of purpose
okay okay