Mr. JR Bullroar, age 44, comes for
evaluation of post parandial abdominal and back pain, plus
problems of balance and
ease of bruising.
- Mr. Bullroar is said to have a
drinking problem.
- He sees things differently; he's just a social drinker.
- Of course, he admits he's a
very socialable guy.
- He says he drinks "2 or 3 beers
a night and little more on weekends."
- You might want to talk to his
spouse separately.
- My personal rule is multiply the
lie by 5 and you'll be a lot closer to the truth.
- You do the math: 2 beers X 5 =
10 a day.
- Mr. Bullroar his 5' 10" and
weighs 200 pounds.
- He has a rather
protuberant abdomen
and little
red specks on his face and chest.
- We can trust his
SGA form,
only because his wife helped him fill it out.
- His SGA indicates he's gained 15
pounds in the last 6 months. Just fat?
- No, he's retaining fluid. Look at
his peripheral edema and abdominal fluid.
- How about a look at
his labs?
 Mr. Bullroar has several problems
not too uncommon among chronic alcoholics, namely
These conditions collectively cause
problems of
- Protein-energy malnutrition, and
- Multiple vitamin deficiencies
From a nutritional standpoint,
here's what's going on with
Mr. Bullroar. |
