Transcript of conference held at Jul 21, 2025 in room first_test@conference.miaiconvo.com Initial people present at 1:49:48 PM: Emma Gunn - Patient Jake Trzybinski-Viars - Doctor Evan Hartman Paul Hershberger Transcript, started at 1:49:48 PM: ________________________________________________________________________________ <1:49:48 PM> Jake Trzybinski-Viars - Doctor joined the conference <1:49:48 PM> Emma Gunn - Patient joined the conference <1:49:48 PM> Paul Hershberger joined the conference <1:49:48 PM> Evan Hartman joined the conference <1:49:48 PM> Jake Trzybinski-Viars - Doctor: all right Emma so thank you again for bringing John and he seems like he's doing great while he's off with the ma I did have one concern that I was hoping to bring up with you mainly about his weight is it okay if we discuss that together <1:50:10 PM> Emma Gunn - Patient: yeah it's okay <1:50:19 PM> Jake Trzybinski-Viars - Doctor: when we <1:50:19 PM> Jake Trzybinski-Viars - Doctor: Okay so <1:50:23 PM> Jake Trzybinski-Viars - Doctor: which <1:50:23 PM> Jake Trzybinski-Viars - Doctor: for checking his height and weight he was 50th percentile for height and 95th percentile for weight <1:50:32 PM> Jake Trzybinski-Viars - Doctor: those concern me as is physician because I want to make sure you know that he's getting getting a healthy lifestyle in childhood and that's this may not cause any other risks in the future is this something that you have been concerned about as well <1:50:33 PM> Emma Gunn - Patient: well I mean I've definitely noticed it <1:50:33 PM> Emma Gunn - Patient: and <1:50:49 PM> Jake Trzybinski-Viars - Doctor: mmm <1:50:54 PM> Emma Gunn - Patient: I guess I have been a little bit concerned just because I well it's been changing his behavior <1:51:00 PM> Emma Gunn - Patient: you know he's he's kind of struggling in school with making friends and <1:51:05 PM> Emma Gunn - Patient: he doesn't like to go outside and play with them anymore because he's having these issues and that just makes me feel really sad as his parent <1:51:14 PM> Emma Gunn - Patient: he used to be so outgoing and happy to play with his friends outside he was always asking me if he could go outside and play or see what his friends down the street were doing and now he's just he's sitting inside all day and <1:51:15 PM> Jake Trzybinski-Viars - Doctor: yeah I can definitely understand that <1:51:20 PM> Jake Trzybinski-Viars - Doctor: so when you're saying that his behaviors changing how how do you see that coming to fruition <1:51:29 PM> Jake Trzybinski-Viars - Doctor: it and when do you think that this change happened <1:51:42 PM> Emma Gunn - Patient: it just makes me sad that he's not out there and enjoying enjoying playing with his friends anymore <1:51:48 PM> Emma Gunn - Patient: well I think it's really been happening kind of slowly over the last year so <1:51:54 PM> Jake Trzybinski-Viars - Doctor: okay <1:52:01 PM> Emma Gunn - Patient: but it's just it's been getting worse and worse and worse and now I I can't hardly ever get him to leave the house <1:52:09 PM> Jake Trzybinski-Viars - Doctor: yeah so it does sound like you have had some concerns <1:52:14 PM> Jake Trzybinski-Viars - Doctor: about kind of his well-being both mentally socially physically <1:52:21 PM> Emma Gunn - Patient: yeah I I think that's fair um <1:52:25 PM> Emma Gunn - Patient: definitely emotionally I worry about him growing up and and not having that connection to to his peers <1:52:27 PM> Jake Trzybinski-Viars - Doctor: mm-hmm <1:52:34 PM> Emma Gunn - Patient: um but like it just it's so hard to get him to eat healthy and he he likes to throw temper tantrums and it makes it really hard for me to get him to do what I think you should be doing <1:52:36 PM> Jake Trzybinski-Viars - Doctor: okay <1:52:49 PM> Emma Gunn - Patient: mmm <1:52:50 PM> Jake Trzybinski-Viars - Doctor: um and again with the temper tantrums do you know of a specific time or when did those start do you think <1:52:59 PM> Jake Trzybinski-Viars - Doctor: mm-hmm <1:53:01 PM> Emma Gunn - Patient: it's been a couple of years it's just if I try to make him eat something he doesn't want he doesn't like anything green he will not eat salads or broccoli and if I try to make him then he'll throw a fit he'll start crying and and just saying he won't do it I don't know <1:53:21 PM> Emma Gunn - Patient: so I just let him eat what do you want to eat because that's easier <1:53:21 PM> Jake Trzybinski-Viars - Doctor: okay <1:53:26 PM> Jake Trzybinski-Viars - Doctor: um and then has John made any remarks to you about <1:53:34 PM> Jake Trzybinski-Viars - Doctor: of his friends or people at school or saying <1:53:35 PM> Emma Gunn - Patient: he doesn't really like to talk about it too much he gets really upset and starts crying but <1:53:46 PM> Emma Gunn - Patient: what he's told me is just that the other kids make fun of him because they they say he's fat and he doesn't <1:53:48 PM> Jake Trzybinski-Viars - Doctor: yeah that must be very hard for him to have to go through such a young age very hard for you <1:53:54 PM> Emma Gunn - Patient: he doesn't want to be around them because that makes him feel bad <1:54:05 PM> Jake Trzybinski-Viars - Doctor: have to hear that as his parent um so I'm sorry that you both are dealing with that right now <1:54:11 PM> Jake Trzybinski-Viars - Doctor: um do you think that <1:54:16 PM> Jake Trzybinski-Viars - Doctor: excuse me let me kind of reword that what do you think <1:54:21 PM> Jake Trzybinski-Viars - Doctor: has led to John's Behavior with being a picky eater <1:54:26 PM> Emma Gunn - Patient: well <1:54:27 PM> Jake Trzybinski-Viars - Doctor: okay okay so kind of mirroring what he's saying dad do <1:54:28 PM> Emma Gunn - Patient: only has dad's fault I mean his dad is the pickiest eater I and so I think he just copies those behaviors and he says well if that isn't eating broccoli then why do I have to eat it <1:54:43 PM> Emma Gunn - Patient: yeah <1:54:44 PM> Jake Trzybinski-Viars - Doctor: okay <1:54:46 PM> Jake Trzybinski-Viars - Doctor: and what do you think <1:54:48 PM> Jake Trzybinski-Viars - Doctor: would be a way to kind of motivate him further to try new foods or to vary his diet a little bit <1:54:49 PM> Emma Gunn - Patient: mmm <1:54:58 PM> Emma Gunn - Patient: I mean well one I guess I could talk to his dad and try and <1:54:58 PM> Emma Gunn - Patient: you know <1:55:01 PM> Jake Trzybinski-Viars - Doctor: yeah that sounds like a great idea <1:55:01 PM> Jake Trzybinski-Viars - Doctor: and <1:55:05 PM> Emma Gunn - Patient: Tom that this is affecting our son the way that he's behaving our son sees it and then <1:55:11 PM> Emma Gunn - Patient: things that's okay I just I haven't really wanted to talk to him because you know he's an adult he can make his own decision about whether or not he wants to eat his broccoli but I mean it's really impacting our son and I guess as far as John <1:55:26 PM> Emma Gunn - Patient: I maybe I could come up with some sort of like reward system like a sticker chart or something and maybe he could get like a small like Prize or something if he eats vegetables for a week or I don't know maybe we could come up with something like that <1:55:45 PM> Jake Trzybinski-Viars - Doctor: what do you think about him being involved in <1:55:49 PM> Jake Trzybinski-Viars - Doctor: or is he involved in extracurricular activities or anything like that with his friends or call peers at school <1:55:57 PM> Emma Gunn - Patient: mmm not anymore he used to be he really likes soccer but he hasn't been doing it since since we started getting made fun of what I think it's kind of making things worse too <1:55:58 PM> Jake Trzybinski-Viars - Doctor: okay <1:56:09 PM> Jake Trzybinski-Viars - Doctor: mmm <1:56:11 PM> Jake Trzybinski-Viars - Doctor: yeah so this sounds a bit like a vicious cycle that he's going through right now that hopefully we can kind of get him out of and you can see that Joy with John again <1:56:21 PM> Emma Gunn - Patient: yeah I really like that <1:56:25 PM> Jake Trzybinski-Viars - Doctor: yeah <1:56:29 PM> Jake Trzybinski-Viars - Doctor: so because you are his caretaker some of the burden does fall on you to help help him make the work <1:56:39 PM> Jake Trzybinski-Viars - Doctor: is there I know you mentioned <1:56:43 PM> Jake Trzybinski-Viars - Doctor: but it's easier to just kind of give them the food but he would like <1:56:48 PM> Emma Gunn - Patient: oh I don't think it would help his health issues any you know I know he's overweight and <1:56:48 PM> Jake Trzybinski-Viars - Doctor: what <1:56:48 PM> Jake Trzybinski-Viars - Doctor: if we continue doing that <1:56:51 PM> Jake Trzybinski-Viars - Doctor: that what do you think that would look like for you and John <1:57:01 PM> Emma Gunn - Patient: and you would probably just continued to get worse and I need to still be facing the same social issues he is now with his friends <1:57:03 PM> Jake Trzybinski-Viars - Doctor: okay and then on the flip side of that if we were able to make a change in <1:57:08 PM> Emma Gunn - Patient: and I don't I don't think he would get better <1:57:21 PM> Jake Trzybinski-Viars - Doctor: eating vegetables once a day or whatever that change may look like for us <1:57:28 PM> Jake Trzybinski-Viars - Doctor: what what benefits do you see coming from that <1:57:30 PM> Emma Gunn - Patient: well I think hopefully he'd be able to feel good about going back out and playing with his friends again I mean he might even be able to start soccer again and I think he'd be happier <1:57:33 PM> Jake Trzybinski-Viars - Doctor: okay <1:57:47 PM> Paul Hershberger: we'll stop here ________________________________________________________________________________ End of transcript at Jul 21, 2025, 1:57:55 PM