Short of breath
  Too tired
  The dwindles
  Weight loss
  Mom to be
  Very sociable
   Thanks To
 Mark W. Braun, MD

   Nutrition and Diagnosis-Related Care



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.

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