OSCE 23 Post-Op Flashcards
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
What are you most worried about?
Getting through the next few hours.
What are you expecting to get from this consultation?
- Been told I need to stay in overnight
- Would like to be discharged so I can have a drink.
Medication for help with withdrawal symptoms?
- Would stay in hospital if symptoms were more bearable.
- Don’t want any more information on this.
- Don’t want any longer-term support to stop drinking at this point.
