Transcript of conference held at Jul 18, 2025 in room first_test@conference.miaiconvo.com Initial people present at 2:37:58 PM: Angie Castle Jacob Mardovin - Doctor Matt Crudele - Patient Transcript, started at 2:37:58 PM: ________________________________________________________________________________ <2:37:58 PM> Angie Castle joined the conference <2:37:58 PM> Matt Crudele - Patient joined the conference <2:37:58 PM> Jacob Mardovin - Doctor joined the conference <2:37:58 PM> Jacob Mardovin - Doctor: burnt okay <2:38:02 PM> Matt Crudele - Patient: but <2:38:09 PM> Jacob Mardovin - Doctor: and <2:38:09 PM> Jacob Mardovin - Doctor: right so hey Matt and so I know today we're kind of following up about how things have been going with since we upped that last dose of your of the medication that you've been taking for the depression <2:38:21 PM> Jacob Mardovin - Doctor: so first thing is how things been going <2:38:23 PM> Matt Crudele - Patient: all right I guess <2:38:25 PM> Jacob Mardovin - Doctor: mm-hmm <2:38:29 PM> Matt Crudele - Patient: they've been fine I stressed out got a <2:38:35 PM> Matt Crudele - Patient: roommate moved out so it's hard to maintain things that two people used to do and now one person does it <2:38:44 PM> Matt Crudele - Patient: I got the valuation coming up in my job that's <2:38:45 PM> Jacob Mardovin - Doctor: mmm <2:38:47 PM> Matt Crudele - Patient: stress me out the medication kind of works <2:38:52 PM> Matt Crudele - Patient: I just talk I can't <2:38:55 PM> Matt Crudele - Patient: find myself to get up sometimes and do what I'm supposed to do <2:38:58 PM> Jacob Mardovin - Doctor: mm-hmm and so it sounds like so have some new stressors in your life and the medication isn't kind of keeping up with that is that what I'm kind of hearing from you <2:39:00 PM> Matt Crudele - Patient: so I guess I'm alive so <2:39:04 PM> Matt Crudele - Patient: I haven't really noticed a change maybe I sleep a little <2:39:18 PM> Jacob Mardovin - Doctor: okay so aside from like the sleeping better have you noticed any and any improvements <2:39:19 PM> Matt Crudele - Patient: better I don't know <2:39:21 PM> Matt Crudele - Patient: the same same old same old <2:39:26 PM> Jacob Mardovin - Doctor: same one same old <2:39:30 PM> Matt Crudele - Patient: same same symptoms different day <2:39:31 PM> Jacob Mardovin - Doctor: okay <2:39:33 PM> Matt Crudele - Patient: I feel like it's Groundhog Day just waking up same thing <2:39:33 PM> Jacob Mardovin - Doctor: mmm <2:39:37 PM> Matt Crudele - Patient: but <2:39:37 PM> Matt Crudele - Patient: I mean that made it worse <2:39:38 PM> Jacob Mardovin - Doctor: and that's been new since you since like all this stuff has been going on with it like your roommate moving out and all that <2:39:45 PM> Jacob Mardovin - Doctor: you know <2:39:48 PM> Matt Crudele - Patient: I wouldn't say I've really noticed a huge difference since even starting when we for the first time we talked the medication you put me on <2:39:56 PM> Matt Crudele - Patient: I haven't gone <2:39:56 PM> Jacob Mardovin - Doctor: mm-hmm and I know we had some referrals in the past to some like mental health like counseling and services and stuff like that what it what is happening with any of those have you gone <2:40:09 PM> Jacob Mardovin - Doctor: okay what were your thoughts on on any of the like those resources <2:40:10 PM> Matt Crudele - Patient: I just I mean I don't it was nice of you to put it out there I just don't know if it's gonna it's gonna help <2:40:15 PM> Jacob Mardovin - Doctor: okay what do you say that <2:40:21 PM> Matt Crudele - Patient: I don't know what talking about it I mean I talked to you about it and it doesn't change anything I don't know what talking to another person who I don't know is gonna <2:40:21 PM> Matt Crudele - Patient: really <2:40:24 PM> Jacob Mardovin - Doctor: mm-hmm <2:40:33 PM> Matt Crudele - Patient: change much about my mood or my the things that are going on in my life it's just <2:40:39 PM> Matt Crudele - Patient: seems like an empty conversation <2:40:39 PM> Jacob Mardovin - Doctor: mm-hmm and so what do you think would be like helpful for you at this point like what what would you want to do <2:40:50 PM> Matt Crudele - Patient: I don't know I just try I'm just trying to get through the week <2:40:53 PM> Jacob Mardovin - Doctor: mmm <2:40:57 PM> Matt Crudele - Patient: I mean I take my medication every day that there's I don't know if there's like a different medication there is or <2:40:57 PM> Matt Crudele - Patient: up <2:40:58 PM> Jacob Mardovin - Doctor: yeah and yeah we definitely have options and then it's ultimately up to you kind of what you want to get out of treatment and what directions you kind of want to explore and so if we were to stick on the medication route <2:41:03 PM> Matt Crudele - Patient: dose <2:41:04 PM> Matt Crudele - Patient: the work <2:41:06 PM> Matt Crudele - Patient: do all the right things <2:41:12 PM> Matt Crudele - Patient: yeah I don't see why not <2:41:24 PM> Jacob Mardovin - Doctor: is that something you'd be interested in doing <2:41:27 PM> Jacob Mardovin - Doctor: yeah okay and so with some of the medications so we have you on one right now but <2:41:27 PM> Jacob Mardovin - Doctor: and <2:41:33 PM> Matt Crudele - Patient: I mean I <2:41:36 PM> Jacob Mardovin - Doctor: dose we can go up a little bit on but that's <2:41:39 PM> Jacob Mardovin - Doctor: what are <2:41:39 PM> Jacob Mardovin - Doctor: there's potential for higher Doses and the side effects and stuff like that <2:41:44 PM> Jacob Mardovin - Doctor: your concerns about like if you start to notice any side effects how would that kind of be affecting or what our plan is <2:41:52 PM> Matt Crudele - Patient: depending on what the side effect is I'd probably just <2:41:55 PM> Matt Crudele - Patient: stop taking it to be honest I'm not really interested in any of the side effects I know you've counted on them before and I did I'm not interested <2:42:01 PM> Jacob Mardovin - Doctor: sure and what what are you most concerned about <2:42:04 PM> Matt Crudele - Patient: those <2:42:07 PM> Matt Crudele - Patient: just that I hear it can you know <2:42:12 PM> Matt Crudele - Patient: change your way change your libido change who you are I just want to feel <2:42:19 PM> Matt Crudele - Patient: to the point where I can get up you know and do things <2:42:22 PM> Jacob Mardovin - Doctor: know so it sounds like the main goal for you is just kind of being able to like get back to life get back to how things how you want things to be and be more engaged with kind of everything that's going on around you <2:42:23 PM> Matt Crudele - Patient: yeah I'm just tired of feeling like this <2:42:34 PM> Jacob Mardovin - Doctor: is that a fair kind of assumption to make <2:42:40 PM> Jacob Mardovin - Doctor: yeah and so you mentioned so that you said so if you were having any of those side effects or things weren't helping you just kind of stopped the medication have you or have you had that happen before is that something that's been going on <2:42:51 PM> Matt Crudele - Patient: I mean with other maybe other medications like my blood pressure medication but <2:42:59 PM> Matt Crudele - Patient: it's under control now so <2:43:01 PM> Matt Crudele - Patient: big deal <2:43:03 PM> Jacob Mardovin - Doctor: country and what happened what happened with that one <2:43:03 PM> Matt Crudele - Patient: and <2:43:03 PM> Matt Crudele - Patient: just made me feel weird so I stopped taking it focused on like my diet <2:43:06 PM> Jacob Mardovin - Doctor: what <2:43:06 PM> Jacob Mardovin - Doctor: gotcha and so given like your concert like you have that concern about like side effects and if we had medications or up the dose that's a possibility <2:43:10 PM> Matt Crudele - Patient: one <2:43:12 PM> Matt Crudele - Patient: what kind of alternative options <2:43:21 PM> Jacob Mardovin - Doctor: your thoughts be about if we were to go away from the medication and move towards some alternative options <2:43:28 PM> Jacob Mardovin - Doctor: so I know we talked about this the referral therapy and that was one thing that <2:43:37 PM> Jacob Mardovin - Doctor: if you're concerned about the medications could be beneficial going forward so that's one thing so what would you say about like potentially doing it there like trying at least that therapy session or something like that <2:43:38 PM> Matt Crudele - Patient: I mean What's It Gonna it's not just like talking to you <2:43:51 PM> Jacob Mardovin - Doctor: potentially or talking about through like coping mechanisms or some of these Specialists have a lot of like strategies and stuff that they can share with patients that seem to have helped other people who are kind of in your similar situation <2:43:56 PM> Matt Crudele - Patient: I don't see how much different <2:43:58 PM> Matt Crudele - Patient: I could try it <2:44:09 PM> Jacob Mardovin - Doctor: okay so at this point like on a scale of like zero to 10 so 10 being gonna call the therap or going to set up an appointment sometime next week and 0 being you're not going to call them at all where would you say you're at at this point <2:44:20 PM> Matt Crudele - Patient: I mean like <2:44:32 PM> Matt Crudele - Patient: five <2:44:34 PM> Matt Crudele - Patient: still not convinced about it <2:44:36 PM> Jacob Mardovin - Doctor: sure <2:44:38 PM> Jacob Mardovin - Doctor: and so at this point so he said if I why not like like a four like a lower number <2:44:38 PM> Matt Crudele - Patient: I mean I just <2:44:46 PM> Matt Crudele - Patient: it's already hard enough for me to like get my <2:44:50 PM> Matt Crudele - Patient: problems out there to you I don't really want to tell another person about it or <2:44:55 PM> Matt Crudele - Patient: already talked with you you know I'm not sure what you're already a doctor I'm not sure what talking to another doctor is going to do <2:45:02 PM> Jacob Mardovin - Doctor: yeah yeah and that's something that we we tend to hear at some time so like and not wanting to kind of be bounced around to different places and so if you have those concerns what kind of same same scales like the zero to ten but with starting a new medication so 10 being <2:45:03 PM> Matt Crudele - Patient: you know <2:45:05 PM> Matt Crudele - Patient: oh that's like I would do that 10 <2:45:22 PM> Jacob Mardovin - Doctor: you really want to start at this point or 0 be in favor of another option what would you be at <2:45:28 PM> Jacob Mardovin - Doctor: okay <2:45:31 PM> Matt Crudele - Patient: a month or a new medication <2:45:32 PM> Jacob Mardovin - Doctor: yeah so it sounds like in your case so you find some medication might be more helpful than therapy so we might kind of go away from the therapy route focus on the medications and so with yours like concerned about the side effects there are some medications that we can try but any have you heard anything or seen any like about what are seen in like on TV or anything like that what you might want to try to get out of it <2:45:34 PM> Matt Crudele - Patient: um <2:46:02 PM> Matt Crudele - Patient: I mean like <2:46:05 PM> Matt Crudele - Patient: not really I'm just I'm <2:46:09 PM> Matt Crudele - Patient: get up the dose we could change <2:46:12 PM> Matt Crudele - Patient: I haven't had any side effects with this current one so maybe I mean we could just up it I would be I'd be willing to try that <2:46:19 PM> Jacob Mardovin - Doctor: sure and yeah that's definitely an option we can we can explore and so were there any side effects that you were I know you listed some before what if any are like you more concerned about compared to the others <2:46:20 PM> Matt Crudele - Patient: um <2:46:34 PM> Matt Crudele - Patient: nothing really I just don't want to I don't want any to be honest with you I don't want any <2:46:40 PM> Jacob Mardovin - Doctor: okay <2:46:42 PM> Matt Crudele - Patient: I can handle like a headache or <2:46:45 PM> Matt Crudele - Patient: deep like I don't know anything that changes my appetite that's I guess fine but <2:46:53 PM> Matt Crudele - Patient: and either I don't know I don't want I've been on medications in the past where you have to like check my blood pressure or my lipids what the fat in my blood I don't want to do that I don't forgot to come to the <2:47:04 PM> Jacob Mardovin - Doctor: sure <2:47:05 PM> Matt Crudele - Patient: yeah <2:47:05 PM> Matt Crudele - Patient: get my blood drawn every three months so I don't think I have to with that medication but <2:47:12 PM> Jacob Mardovin - Doctor: okay so it sounds like ________________________________________________________________________________ End of transcript at Jul 18, 2025, 2:47:17 PM