Transcript of conference held at Apr 29, 2025 in room first_test@conference.miaiconvo.com Initial people present at 1:20:54 PM: Ryan_Patient Graham - Doctor Angie Transcript, started at 1:20:54 PM: ________________________________________________________________________________ <1:20:54 PM> Angie joined the conference <1:20:54 PM> Ryan_Patient joined the conference <1:20:54 PM> Graham - Doctor joined the conference <1:20:55 PM> Graham - Doctor: all right so we've kind of gone through your physical for work one concern we did have the survey that we gave you when you came in you circled that you've been drinking a good amount can you tell me about that <1:20:55 PM> Ryan_Patient: um that Circle a good amount <1:21:15 PM> Graham - Doctor: it says <1:21:21 PM> Graham - Doctor: let's just go through it then <1:21:23 PM> Ryan_Patient: like maybe like one or two days a week <1:21:25 PM> Graham - Doctor: how often would you say you're having a drink containing alcohol <1:21:33 PM> Graham - Doctor: okay and when you do drink how many drinks are you having each time <1:21:38 PM> Ryan_Patient: probably about five or six but usually on the weekends with my buddies were like tying one off after a work week or something <1:21:41 PM> Graham - Doctor: okay and when you do drink is it always five or six or is it more or less <1:21:46 PM> Ryan_Patient: I don't know it kind of depends like I mean if we're watching like a football game or something or if a bunch of people come out I mean <1:21:59 PM> Graham - Doctor: up <1:22:00 PM> Ryan_Patient: I <1:22:01 PM> Ryan_Patient: it like 10 <1:22:03 PM> Ryan_Patient: nine I don't know like just kind of just hanging out having fun <1:22:07 PM> Graham - Doctor: okay <1:22:09 PM> Graham - Doctor: so it seems like you're not really seeing a problem it's just more your way of unwinding after work and I understand that correctly <1:22:16 PM> Ryan_Patient: oh yeah I mean like I mean you probably know like you get home on the college or something and you work weeks done you're done studying and you go in Taiwan off <1:22:26 PM> Graham - Doctor: I can understand that how often would you say in the last year once you start drinking you were able to stop <1:22:38 PM> Ryan_Patient: I mean <1:22:39 PM> Graham - Doctor: how often in the last year on these weekends when you're hanging out with your buddies when you start drinking you feel like you aren't able to stop once you start <1:22:41 PM> Ryan_Patient: I don't know the question say that again <1:22:56 PM> Ryan_Patient: I mean I could stop whenever I want to um I usually don't want to because we're all hanging out <1:23:03 PM> Ryan_Patient: getting crazy but <1:23:06 PM> Ryan_Patient: I'm not gonna stop after like four or five if I'm like riding a steady buzz like and everyone keeps drinking if someone's buying shots I'm Gonna Take It <1:23:15 PM> Graham - Doctor: so when you do drink is it always shots is it beer is it a mix tell me more about that <1:23:21 PM> Ryan_Patient: um I don't know usually <1:23:26 PM> Ryan_Patient: God depends it depends on like what bar I'm at like if I'm at the American Legion which is where we usually go and drink usually having about <1:23:36 PM> Ryan_Patient: usually beer <1:23:38 PM> Ryan_Patient: usually maybe like one or two shots but probably about a pitcher of beer two pitchers <1:23:38 PM> Graham - Doctor: okay <1:23:44 PM> Ryan_Patient: know it's pretty cheap this place we go usually makes it pretty easy to it's usually why we go there because we can drink a bunch of them for a pretty cheap price <1:23:44 PM> Graham - Doctor: have you ever felt any Financial stress because of your drinking <1:23:56 PM> Graham - Doctor: okay and tell me a little bit more about how much your buddies drink when you go out with you <1:24:01 PM> Ryan_Patient: oh it depends on who I was I mean I usually try to match just about whatever my buddies are drinking so if my buddies are having six beers I'll try to have six beers if they're having <1:24:06 PM> Graham - Doctor: okay and how often the last year would you say you've not been able to do something that was expected to you because you're drinking <1:24:18 PM> Ryan_Patient: you know four I might have four take a break <1:24:22 PM> Ryan_Patient: then drink a little bit more like after if more people go out <1:24:27 PM> Ryan_Patient: he like <1:24:35 PM> Graham - Doctor: uh tell me a little bit more about those four or five times <1:24:38 PM> Ryan_Patient: four five I mean I usually if I have like things I have to do I usually do them before I like start drinking <1:24:47 PM> Ryan_Patient: um <1:24:52 PM> Ryan_Patient: let's think I can barely remember them they're so infrequent probably like I mean <1:25:00 PM> Ryan_Patient: probably gonna Simon or something or add some for work I needed to do <1:25:01 PM> Graham - Doctor: okay so it seems like kind of smaller things here and there but how would you say even just missing those small things of impacted more probably on the school and work side of things <1:25:06 PM> Ryan_Patient: it's usually something minor usually all the important stuff I get it done during the week so maybe like making the bed or <1:25:15 PM> Ryan_Patient: cleaning up the kitchen or something like that <1:25:25 PM> Ryan_Patient: I'm not really I usually do on the next morning when I get up <1:25:32 PM> Graham - Doctor: okay <1:25:38 PM> Graham - Doctor: have you ever had anything done lately because you're drinking <1:25:38 PM> Ryan_Patient: mmm I mean aside from like those little things not really I usually try to get all the work stuff done it's not to worry about that <1:25:41 PM> Graham - Doctor: it's not too worried about work outside of your drinking then <1:25:51 PM> Ryan_Patient: no no it's all like I mean I try to get all my work done so that way I can go out on the weekend and get blasted <1:25:55 PM> Graham - Doctor: okay <1:26:03 PM> Graham - Doctor: oh we should get in all your stuff done before you're doing that it's have your priorities that's good to hear <1:26:04 PM> Ryan_Patient: yeah yeah <1:26:09 PM> Ryan_Patient: oh never <1:26:12 PM> Graham - Doctor: how often would you say you've had a drink first thing in the morning <1:26:16 PM> Graham - Doctor: okay that's good at least saving it for the evening <1:26:18 PM> Ryan_Patient: yeah I mean there's no reason to drink in the morning you know I just woke up I got stuff I got to do <1:26:23 PM> Graham - Doctor: mm-hmm <1:26:28 PM> Graham - Doctor: have you ever felt any guilt or more for your drinking <1:26:31 PM> Graham - Doctor: okay and how often in the last year have you felt like you haven't been able to remember the night before for drinking <1:26:32 PM> Ryan_Patient: know <1:26:35 PM> Ryan_Patient: maybe <1:26:35 PM> Ryan_Patient: haha <1:26:41 PM> Graham - Doctor: okay <1:26:44 PM> Ryan_Patient: like <1:26:45 PM> Ryan_Patient: once a month but like I mean I can remember most of the day if I'm like really getting out there then maybe like a couple hours before I get home <1:26:56 PM> Ryan_Patient: I forget that stuff <1:26:57 PM> Graham - Doctor: and how does that make you feel <1:26:58 PM> Ryan_Patient: a basically feel pretty hungover <1:27:02 PM> Ryan_Patient: oh <1:27:04 PM> Graham - Doctor: how does it feel that you can't remember the night before <1:27:10 PM> Ryan_Patient: not like <1:27:12 PM> Ryan_Patient: I pissed but not like <1:27:15 PM> Ryan_Patient: mad either it's just like whoa that got crazy last night you know probably shouldn't do one of those for a little while <1:27:15 PM> Ryan_Patient: that's usually <1:27:16 PM> Graham - Doctor: okay and do you feel like you're successful in cutting back after this happens <1:27:22 PM> Ryan_Patient: you know <1:27:22 PM> Ryan_Patient: what happens I usually it's like well I got real bad last night okay let's <1:27:27 PM> Ryan_Patient: let's <1:27:28 PM> Ryan_Patient: back a little bit not get that blasted the next time <1:27:38 PM> Ryan_Patient: I mean during the week yeah because I don't have work or anything <1:27:41 PM> Graham - Doctor: okay how about on the weekends <1:27:42 PM> Ryan_Patient: um <1:27:46 PM> Ryan_Patient: again the weekends it's still like <1:27:49 PM> Ryan_Patient: five or six but after five or six I'm like usually pretty good I mean like I'm writing a steady buzz but I'm not like <1:27:55 PM> Ryan_Patient: clearly out of my mind so blessed I can't remember anything so usually pretty good life that's why like once a month <1:27:58 PM> Graham - Doctor: mmm <1:28:03 PM> Ryan_Patient: maybe once every two months he gets like that bad and that's usually after it's been like if we all get done with a big work project or something we'll all go out <1:28:12 PM> Ryan_Patient: in Taiwan off but <1:28:15 PM> Ryan_Patient: not alone either like I mean my other buddies also get pretty pretty drunk <1:28:20 PM> Ryan_Patient: I've got a buddy who's an absolute idiot and yeah he heard himself the one time we were drinking he like slipped and fell on the on the sidewalk or something it was so stupid but now I've been pretty good I don't think I've ever really hurt myself before <1:28:21 PM> Graham - Doctor: have you or anybody's ever gotten hurt when you're drinking <1:28:32 PM> Graham - Doctor: okay was it in a significant injury or tell me more about that <1:28:39 PM> Ryan_Patient: oh no I mean like cut his hand up pretty good when he tried to cash himself on the fall but <1:28:45 PM> Graham - Doctor: you have to get stitches or anything <1:28:49 PM> Ryan_Patient: and all the he had to go to Lake the emergency room or anything <1:28:53 PM> Ryan_Patient: now <1:28:56 PM> Graham - Doctor: the you know how it affected his work life after that <1:28:58 PM> Ryan_Patient: I mean <1:29:04 PM> Ryan_Patient: I mean a little hard to type on his keyboard but nothing too crazy <1:29:09 PM> Ryan_Patient: I didn't hear much about it after that <1:29:10 PM> Graham - Doctor: it's a nothing anybody was too concerned about then <1:29:15 PM> Graham - Doctor: okay <1:29:16 PM> Ryan_Patient: yeah I just want to pay the medical bill <1:29:17 PM> Graham - Doctor: we always want to discourage getting <1:29:20 PM> Graham - Doctor: that drunk to where you or somebody gets hurt because maybe that time it wasn't too bad but it could have always been worse right <1:29:28 PM> Graham - Doctor: all right so how would you have felt that happened to you and maybe broke your arm or leg instead of just scraping up your hand <1:29:32 PM> Ryan_Patient: he pissed exactly have to pay it because I had saved all the money drinking at the bar at like to go to and it's cheap but now I have to pay a medical bill <1:29:39 PM> Graham - Doctor: okay has anybody ever suggested that you cut back on your drinking <1:29:45 PM> Ryan_Patient: um <1:29:49 PM> Graham - Doctor: nobody's ever done that <1:29:51 PM> Ryan_Patient: maybe when I was like in college when I was like tearing it up but not like now know <1:29:57 PM> Ryan_Patient: mmm <1:30:00 PM> Graham - Doctor: okay do you ever feel they need to cut back on your drink <1:30:02 PM> Ryan_Patient: yeah I mean like maybe when I was a young girl <1:30:06 PM> Ryan_Patient: are like throwing parties on Thursdays and Tuesdays and stuff but not not like now know <1:30:11 PM> Ryan_Patient: um <1:30:15 PM> Graham - Doctor: okay has anybody ever talked to you about what could happen if you drink a lot consistently <1:30:17 PM> Ryan_Patient: not really know <1:30:25 PM> Ryan_Patient: um read about a little bit online but like the liver cirrhosis and stuff like that but I'm definitely not drinking every day so <1:30:32 PM> Graham - Doctor: okay <1:30:36 PM> Ryan_Patient: of livers the most rejected of organ in the body so I think I'm pretty good <1:30:37 PM> Graham - Doctor: all <1:30:37 PM> Graham - Doctor: oh that is true but that doesn't always mean we should mess with it <1:30:42 PM> Ryan_Patient: it was I mean it was not Facebook's but <1:30:46 PM> Graham - Doctor: time either what did you read about tell me more about that <1:30:51 PM> Graham - Doctor: mm-hmm <1:30:56 PM> Ryan_Patient: was just like if you drink every day you know your liver is going to get hard and <1:31:01 PM> Ryan_Patient: erotic is what they call it but <1:31:04 PM> Ryan_Patient: acting like lead to different forms of like hepatitis and stuff like that <1:31:11 PM> Ryan_Patient: I don't drink nearly as much as like the other people that should be like <1:31:12 PM> Graham - Doctor: do you mind if I tell you a little bit more about that <1:31:17 PM> Ryan_Patient: worried about that stuff <1:31:19 PM> Ryan_Patient: let's do it <1:31:22 PM> Graham - Doctor: all right so the way the current guidelines are it's not necessarily how many days of the week that you drink it's the number of drinks that you have per week so even if you only drank once a week but you're having more than 14 drinks which is our current guidelines for males you are still at risk for these kind of problems so in your case when you're just drinking on the weekends and having five to six or nine to ten if you're currently over that 14 threshold so we would be a little bit concerned for these things that you read about even though you're not drinking every single day <1:31:22 PM> Graham - Doctor: how <1:31:55 PM> Ryan_Patient: um <1:31:56 PM> Graham - Doctor: make you feel <1:31:58 PM> Graham - Doctor: I think that would be a good place to start <1:32:01 PM> Ryan_Patient: I mean like I should be below 14 like I should make that my target goal <1:32:06 PM> Ryan_Patient: yeah I mean I would if that's the guidelines <1:32:08 PM> Graham - Doctor: you be open to cutting back a loop on your drinking to get below that 14 drinks per week threshold <1:32:14 PM> Graham - Doctor: okay <1:32:19 PM> Ryan_Patient: would try to at least try to just like hit that goal and not go above that <1:32:23 PM> Graham - Doctor: so on a scale of 1 to 10 how open do you think you'd be to doing that today 10 being you're willing to start today <1:32:25 PM> Ryan_Patient: like eight like like I'll do it I'll give it a shot <1:32:31 PM> Graham - Doctor: okay so an eight what's keeping you from being in the 10 <1:32:36 PM> Ryan_Patient: well I mean I'm <1:32:41 PM> Ryan_Patient: Marty at like well I guess I am at like a 10 I mean I'm already drinking like five to six drinks on a Saturday maybe a Friday so Marty kind of bordering that 14 lines maybe I'll just try to keep it down that low <1:32:56 PM> Graham - Doctor: do you think talking to your buddies about that if you guys were able to do it as a group would that be more helpful than just trying to do it on your own <1:32:57 PM> Ryan_Patient: I can mention it to them they're probably not gonna be very happy about it but I can bring it up to him they might be receptive ________________________________________________________________________________ End of transcript at Apr 29, 2025, 1:33:13 PM