OSCE 23 Post-Op Flashcards
(27 cards)
Name
Matthew Bright
DOB & Age
- 29/05/1970
- Age 53
Immediate history (3)
- Hospital for 24 hours
- Emergency operation to remove a strangulated hernia
- Operation went ok
Post-operation?
- Not in pain
- Been told I can eat and drink again
Alcohol use (4)
- six glass of wine a day
- 250ml glasses
- 14%
- 14 bottles a week
Drinking pattern during day (6)
Over the last couple of months
- a drink first thing in the morning
- otherwise I feel unwell (tremor, sweating, anxious)
- don’t drink at work
- start drinking again when I get back from work
- drink until I go to bed
Drinking pattern over time (4)
- first drink with friends aged 16
- used to drink only a pint or two socially
- last year began drinking at home to cope with stress
- glass of wine a night, but gradually increased
Trigger for increased drinking? (3)
- New manager at company who is very critical of my work
- Been in company for over twenty years
- Had a very good relationship with previous manager
My views about my drinking (5)
- Need to cut down
- Unsure how because I feel unwell when I wake up and need a drink first thing
- Haven’t tried giving up yet for this reason
- My family are concerned
- Feel guilty about the impact my drinking is having on them
Current alcohol withdrawal: (5)
- Last drink about 48 hours ago
- Been feeling nauseated, sweaty, anxious
- Very slight tremor
- A few minutes ago thought I could see bugs crawling over my hospital bed
- No odd sensations of things crawling on my skin or heard anything unusual no-one else has heard
Physical health:
- No other problems
- Avoiding seeing GP as worried about impact of drinking
- No seizures
Relationships (5)
- Wife concerned
- Wife has thrown drink away which has led to arguments
- Children (13 & 15) are worried and asked me to get help
- Started avoiding kids school events and parents evenings so I can drink at home
- Haven’t physically hurt any of my family
Job (4)
- Dread going into work
- Occasionally call in sick as I can’t face the day without alcohol
- Manager becoming more frustrated
- Have been warned the company will be making some staff redundant soon
Driving (4)
- Live in a rural area
- Only way to/from work is driving
- Had a minor accident recently where I swerved and hit a bush.
- Unwitnessed and trying to take more care driving since
Diet (2)
- Not eating much in mornings or evenings due to the nausea
- Have lost weight but not sure how much
Mental Health (5)
- Feel low in mood since stress at work
- Alcohol helped initially but only for a few weeks
- Sleep ok - alcohol helps with this
- Don’t enjoy doing much at the moment
- Have stopped socialising, which I used to enjoy
Suicidal/harmful thoughts? (4)
- Occasional thoughts of ending life, but wouldn’t act on these because of my family
- No self harm or suicide attempts
- No thoughts about harming others
- Never had any contact with mental health services before
Family history
No history of alcohol abuse
Family (4)
- Wife - 20 years
- Kids - 13 & 15
- Good relationship with them
- They are trying to be supportive
Work
HR for small family-run business
Smoke
No
Illegal drugs?
No
Gamble?
No
What do you think is going on?
Struggling to cope in hospital without being able to drink alcohol
