On the Floor, Part 1
A. Mr. Gomez and his Dietary Supplement History
After admitting Mr. Gomez, you go his room to do your history and physical exam on him. Upon walking into the room, you notice that the bed-side table is cluttered with magazines and a few bottles of dietary supplements.
Up close, you note that there of bottles of fish oil, yeast, acidophilus, and St. John's wort on his bedside table.
What do you do at this point?
Taking an HDS history
One of the first and most important things to do when talking to a patient is to obtain a complete and thorough herbal and dietary supplement history. As you have already covered this in "Case 2: Mrs. Nguyen", this section serves as both a summary and chance to review. There may be many reasons why Mr. Gomez may be taking supplements--your goal as his medical provider is to find out why without seeming judgmental or impatient. It will be vital to approach this dialogue openly, and to use questions that allow them space for comfort to engage in this discourse.
Below is a list of questions that you might ask Mr. Gomez to obtain his HDS history. Note that this is also review from the earlier modules of this course.
Click each of the following questions to ask Mr. Gomez and to obtain an answer.
How do you use this fish oil product?
Click for Mr. Gomez's reply
"I have used fish oil and yeast for years. When my dad died of a heart attack, my doctor at the health center put me on Lipitor and it gave me bad leg cramps so I stopped taking it. So I'm not taking the Lipitor any more. My friend from church said that I should take fish oil. I found it cheap at the whole sale warehouse. I take 2 capsules a day in the morning."
|
|
How do you use this acidophilus product?
Click for Mr. Gomez's reply
"I have constipation, so I went to the curandero and he gave me a tea from senna, manzanilla and tilia to drink. On TV, I saw a probiotics commercial and I decided to give it a try and you know what--my belly feels better. This bottle I got on the internet and I take 2 capsules with all my meals."
|
|
How do you use this St. John’s wort product?
Click for Mr. Gomez's reply
"When my dad died I got really depressed, but I wasn't going to take none of those antidepressant medications cause I'm not crazy…but a buddy from church he told me about an herb for grief. They sell it at the local pharmacy. Here is the bottle of Saint John's wort which helped me get through the tough times. I have to take the tablets three times a day but sometimes I forget so I take the three pills at one time in the morning with my other meds."
|
|
Who recommended the remedies or products to you?
Click for Mr. Gomez's reply
"I go to see a curandero (natural healer). My cousin told me about him. I have been going for about 5 years now. I also talk with my friends at church."
|
|
Where did you get the remedies or products?
Click for Mr. Gomez's reply
"Well, sometimes I get them on the Internet or from the curandero. But last time I was at the discount store, they had a two for one sale on the fish oil and the Saint John's wort, so I stocked up."
|
|
What teas are you drinking?
Click for Mr. Gomez's reply
"Personally I am a coffee man, but I also like green tea so I drink that, too. I get it from the vending machine at school."
|
|
Do you eat any special foods? Could you describe these foods to me?
Click for Mr. Gomez's reply
"I eat prunes and Raisin Bran (cereal) in the morning-keeps me regular because I get constipated.
I also put 2 tablespoons of Twinlab®'s Liquid Yeast on my cereal in the morning."
|
|
What over-the-counter medications do you use?
Click for Mr. Gomez's reply
"When I have headaches I use Tylenol. When I over do it with the coaching my back can ache so I take Motrin. I probably pop a couple of Motrin every 2-3 days. Oh, and my wife got me taking a multivitamin with iron but I don't take it cause it stopped me up and I got constipated."
|
|
Do you take your herbs the same time as your medications? (Dosage and timing of medications)
Click for Mr. Gomez's reply
"Well, to be honest, I am not good at remembering taking pills, so I take everything at once in the morning with my coffee."
|
|
How long have you been taking your supplements? (Dosage and timing of medications)
Click for Mr. Gomez's reply
"It's been about five years now since I started taking all of them."
|
Please answer the question below.
|