| T: why miss Clark my name is Alan Lyme I'm a social worker at the Family Health Center | |
| C: dr. Sheila asked me if I would spend some time with you today | |
| T: I'm really glad that you here I'm just curious as to why he would send you to me | |
| C: well I came to see dr. Steele last week because of increasing stress and anxiety that's kind of getting the best of me and in the course of my appointment with him he was asking how I was dealing with that stress and I mentioned that my one or two glasses of wine a few nights a week is turning into more frequent in maybe three or four on some nights and he had some concerns about that and and felt like maybe you could help me with stress or something | |
| T: yeah so he he actually see me because he went to him for increased stress and he's concerned that your alcohol consumption may be a part of that increase and prior to prescribing you anything you want to make sure that you had someone to talk to about that | |
| C: I suppose okay I saw you filled in one of the pink sheets might take a little bit he told me to fill that out and bring it with me | |
| T: okay thank you so you say here that you have four or more drinks in one week you mentioned that you may be increasing that a little bit as well um and that you have one or two drinks in one setting typically yeah and maybe monthly you have more than that what what's what kind of drinks do you have what do you drink we need to drive | |
| C: winewith my meals um you know again one or two typically and more frequently three or four so my stress is increased | |
| T: so starting to increase this times drink a little more okay well based on what you put here you give it gives you six points on this scale scale ranges from zero to forty so six points will put you in what we consider an at-risk zone so if it's okay with you lots to talk a bit about that okay okay so that was sunset run zero to forty it's not it's not a super high risk but it certainly could be a risk for maybe increasing stress maybe some physical Emmas related to alcohol well could start to show up if you were to increase your drinking from there or you can stay there this is a typical standard drink size over here I'm not sure whether that fits your description of a glass of wine a lot | |
| C: I fill the glass up so maybe a little more than | |
| T: yeah maybe the little space that it's upside to drink drink and a half each one so that also increased a little bit more so perhaps maybe drinking more than you indicated on here and for women you healthy woman your age no more than three drinks in one setting is considered to be lower or no-risk and / in one week so in total how much total in the week and what you say here is that even on this sheet you're perhaps already drinking more than that mmm | |
| T: so what do you make of all that | |
| C: well that news to me you know I thought red wine with your meals is supposed to be healthy and you know no more than seven in a week that seems kind of prohibitive | |
| T: yeah it seems it seems a little less than perhaps you've been drinking with what you consider to be healthy drinking and certainly there's this conflicting information out there about what's healthy what's not healthy imagine the increased stresses what because we're concerned or to seal as your stresses increases and if you were to prescribe you anything maybe some interaction between the two but also build and serve them I would think so if you would what is it that you like about alcohol | |
| C: well you know it does at least in the moment temporarily reduce my stress and I you know like a good glass of wine I don't don't drink the cheap stuff I like the expensive what | |
| T: so you like the taste of it mm-hmm and it does help to lower the stress signal which is for that time you're drinking one of those not so good things about alcohol for you | |
| C: um well you know the nights that maybe I have a couple more glasses than I should I wake up feeling kind of yuck and of course part of my stress is finances and I mentioned I like the good stuff and so if I'm drinking more than I'm increasing my financial burden yeah | |
| T: so your financial stress may be increased by the fact that you're drinking | |
| C: yeah kind of defeating the purpose there the drinking to do stress and increasing stresses | |
| T: so the one hand it lowers it on the other hand it's increasing kind of a seesaw teeter-totter effect then what do you make of that give them that on one hand it lowers and the other had it increases and now it's increasing even more | |
| C: maybe I need to find some other way to deal with my stress | |
| T: yeah imagine you've had some thoughts of that what have you thought of trying well I've exercised in the past and that helps right now my schedule is kind of out of whack and I just really don't know what to do that's why I came to see dr. Steele | |
| C: I thought maybe he can prescribe me something that would help me you know when I'm feeling overwhelmed and he may be able to I'm not saying that he cannot | |
| T: I'm just imagine that he's concerned that if you continue to drink on the level that you are drinking that whatever he prescribes you there may be an interaction with the to imagine that she's concerned I'm not completely sure so you've had some success in the past with changing behaviors and if you were to decide to make any changes here it sounds like you could drop all that to make those changes how important would it be for you on a scale of through i below the visual here with that if zero is not important ten is very important to do something about your drinking | |
| C: way mm-hmm well I mean if if it means that it's increasing my stress and or he's not going to prescribe me anything because of my drinking then it's fairly important maybe about a | |
| T: mm-hmm let's put it up there why do you choose a or a or | |
| C: well again I've got to get things under control you know my kids are depending on me and I've got to go to work to help ease this financial stress and | |
| T: so you know all those responsibilities there's a lot riding on your decision in what to do this what if anything will bring up too late online on that scale | |
| C: um well the you know the risk that you mentioned about the drug interaction I certainly can't afford to you know have any more stress | |
| T: yeah so so you choose to lower your stress rather than increase it and if lo and your drinking would have that effect that something be willing to do right now how confident are you that you could do something about your drinking | |
| C: I'm pretty confident and you know probably about a seven or eight | |
| T: okay so it's pretty hot up there again and what if what if anything would you choose to do would be to cut down with a bit to quit | |
| C: just in case but you know I like I said like a good glass of wine I don't want to quit altogether I'd be willing to try cutting that but you know if it's going to if doctor seal would agree to prescribe me something for the anxiety and it meant that I had to not drink at all I'd be willing to do that at least for a period of time | |
| T: so you'd be willing to stop altogether that's what was indicated by the physician okay so so based on that how ready are you to do anything right now whether it's to cut back whether it is to quit | |
| C: well again you know if I can get something to help me manage if maybe I can find some other way to deal with the stress then then you know I be pretty ready I again maybe about in on that scale maybe an eighth okay so that's that's pretty hot there as well | |
| T: it sounds is that you'll be pretty motivated to do something about this right now given your responsibilities given your children relying at this point and just on on lowering anxiety in general it sounds and that's one of your goals as well well I'm pretty confident that once you decide to do whatever it is you decide to do you'll be able to follow through that based on your experience in the past of of making behavior changes imagine some things that you can draw upon what's one thing that you could do imagine you thought of some things might help to lower your stress | |
| C: well I you know the the exercise but again that's that's kind of difficult to fit in right now hoping that dr. seal will prescribe something for me to take when I'm feeling particularly overwhelmed and maybe just having somebody to talk to to bounce some things off of | |
| T: one of the things we can't offer here is for you to come in and talk to one of our behavioral health specialists may be able to help you talk talk through this there's a terrible stress and sound like responsibility there and we can make a point for you if you like before you leave today dad talk to someone that'd be nice right it also has some information here if you're interested some a pamphlet on alcohol and and how what healthy limits are and how it may be affected by medications that you took as well and I wish you lots of luck it sounds as though you really committed to making this shift in this change and imagined doctors still wanna fight with you and see how you do with your with your change within a few weeks again I look forward to speaking to in the future all right thank you very much you're welcome |