Transcript of conference held at Jul 21, 2025 in room first_test@conference.miaiconvo.com Initial people present at 2:12:52 PM: Emma Gunn - Doctor Jake Trzybinski-Viars - Patient Evan Hartman Paul Hershberger Transcript, started at 2:12:52 PM: ________________________________________________________________________________ <2:12:52 PM> Jake Trzybinski-Viars - Patient joined the conference <2:12:52 PM> Emma Gunn - Doctor joined the conference <2:12:52 PM> Paul Hershberger joined the conference <2:12:52 PM> Evan Hartman joined the conference <2:12:52 PM> Emma Gunn - Doctor: all right so Jake you're telling me that you're feeling really frustrated with all the medications that you have to take <2:13:07 PM> Jake Trzybinski-Viars - Patient: yeah yeah you could say that <2:13:13 PM> Emma Gunn - Doctor: yeah tell me more about that frustration <2:13:20 PM> Jake Trzybinski-Viars - Patient: I just <2:13:23 PM> Jake Trzybinski-Viars - Patient: it's a lot to remember I'm taking what seven eight medications I can't even keep track anymore some of them once a day some of them twice a day I have to remember some of them I have to wait an hour before I can eat some of them I have to take right after I eat and it just feels like my <2:13:41 PM> Jake Trzybinski-Viars - Patient: these <2:13:41 PM> Jake Trzybinski-Viars - Patient: all day revolves around <2:13:44 PM> Jake Trzybinski-Viars - Patient: medications and I don't really even <2:13:47 PM> Jake Trzybinski-Viars - Patient: know what half of them do <2:13:49 PM> Emma Gunn - Doctor: hmm yeah it can be a lot to remember and I know you told me that you're having trouble remembering to take them all the time when you're supposed to <2:13:56 PM> Jake Trzybinski-Viars - Patient: oh yeah I mean sometimes <2:14:04 PM> Jake Trzybinski-Viars - Patient: I forget I'm having in my little pill box but organizing that takes up time and sometimes they don't get to that on the weekends and <2:14:04 PM> Jake Trzybinski-Viars - Patient: sometimes <2:14:13 PM> Jake Trzybinski-Viars - Patient: I wake up and I'm just <2:14:15 PM> Jake Trzybinski-Viars - Patient: so fed up with it even if I do remember it <2:14:18 PM> Jake Trzybinski-Viars - Patient: I don't want to take them <2:14:22 PM> Jake Trzybinski-Viars - Patient: mm-hmm <2:14:24 PM> Emma Gunn - Doctor: yeah I can see that this frustration is really impacting you <2:14:29 PM> Emma Gunn - Doctor: what do you think would make it easier for you to remember to take your medications <2:14:33 PM> Jake Trzybinski-Viars - Patient: up just having less of them really like I said I've got the pillbox I've got my schedule <2:14:46 PM> Jake Trzybinski-Viars - Patient: it's just <2:14:47 PM> Jake Trzybinski-Viars - Patient: a lot to manage <2:14:49 PM> Emma Gunn - Doctor: yeah there are quite a few medications <2:14:54 PM> Emma Gunn - Doctor: so <2:14:56 PM> Emma Gunn - Doctor: what do you think it would take to reduce the medications that you're on <2:14:57 PM> Jake Trzybinski-Viars - Patient: how I don't know I mean <2:15:05 PM> Jake Trzybinski-Viars - Patient: I know <2:15:07 PM> Jake Trzybinski-Viars - Patient: that they're helping my heart and hypertension <2:15:07 PM> Jake Trzybinski-Viars - Patient: so if <2:15:13 PM> Jake Trzybinski-Viars - Patient: get rid of <2:15:13 PM> Jake Trzybinski-Viars - Patient: I thought and check maybe we can <2:15:16 PM> Jake Trzybinski-Viars - Patient: but <2:15:16 PM> Jake Trzybinski-Viars - Patient: I feel <2:15:17 PM> Jake Trzybinski-Viars - Patient: to come so far down this hole and I'm 60 years old I can't <2:15:22 PM> Jake Trzybinski-Viars - Patient: exercise like I used to <2:15:25 PM> Jake Trzybinski-Viars - Patient: and <2:15:27 PM> Jake Trzybinski-Viars - Patient: yeah so I don't I don't know specifically <2:15:31 PM> Emma Gunn - Doctor: what do you think is the biggest barrier to you addressing these changes <2:15:39 PM> Jake Trzybinski-Viars - Patient: it just <2:15:42 PM> Jake Trzybinski-Viars - Patient: seems like a lot it's overwhelming I don't know how I would <2:15:47 PM> Jake Trzybinski-Viars - Patient: the time to <2:15:47 PM> Jake Trzybinski-Viars - Patient: cook <2:15:49 PM> Jake Trzybinski-Viars - Patient: three varied meals every day and go to work and exercise and it's <2:15:57 PM> Jake Trzybinski-Viars - Patient: and then still remember all the medications throughout the day it's just too much <2:15:59 PM> Emma Gunn - Doctor: hear that this is a lot for you <2:16:06 PM> Emma Gunn - Doctor: if you were to take it one step at a time what do you think might be one small change that you could make <2:16:08 PM> Jake Trzybinski-Viars - Patient: I have <2:16:08 PM> Jake Trzybinski-Viars - Patient: I don't <2:16:17 PM> Jake Trzybinski-Viars - Patient: you know I said like I suppose I can walk around my neighborhood I may have enough time for that but <2:16:25 PM> Jake Trzybinski-Viars - Patient: that's not going to <2:16:28 PM> Jake Trzybinski-Viars - Patient: decrease the number of pills I have in a week you know <2:16:31 PM> Jake Trzybinski-Viars - Patient: I just don't see it's going to take I feel like years <2:16:32 PM> Emma Gunn - Doctor: okay so you think by making this one small change it's not going to be enough to make any progress <2:16:36 PM> Jake Trzybinski-Viars - Patient: where I see any progress <2:16:39 PM> Jake Trzybinski-Viars - Patient: yeah I just don't see a point of it now <2:16:48 PM> Emma Gunn - Doctor: oh okay but now without making any changes how do you think that will affect your progress <2:16:52 PM> Jake Trzybinski-Viars - Patient: a there won't be any progress I suppose <2:17:05 PM> Jake Trzybinski-Viars - Patient: that <2:17:05 PM> Jake Trzybinski-Viars - Patient: yeah I I don't think other than a miracle <2:17:12 PM> Jake Trzybinski-Viars - Patient: reduced the amount of medications I'm taking <2:17:12 PM> Emma Gunn - Doctor: a other than a miracle <2:17:15 PM> Jake Trzybinski-Viars - Patient: mm-hmm I just yeah it seems <2:17:18 PM> Emma Gunn - Doctor: if you don't make the changes okay <2:17:22 PM> Jake Trzybinski-Viars - Patient: possible <2:17:23 PM> Jake Trzybinski-Viars - Patient: if I don't make the change definitely <2:17:30 PM> Emma Gunn - Doctor: okay so how motivated are you let's say on a scale of 0 to 10 <2:17:37 PM> Emma Gunn - Doctor: to start making let's start with one small change <2:17:43 PM> Jake Trzybinski-Viars - Patient: I mean <2:17:45 PM> Jake Trzybinski-Viars - Patient: I don't know I <2:17:45 PM> Jake Trzybinski-Viars - Patient: if <2:17:47 PM> Jake Trzybinski-Viars - Patient: I knew <2:17:47 PM> Jake Trzybinski-Viars - Patient: that <2:17:49 PM> Jake Trzybinski-Viars - Patient: would make a difference in my health and if I knew I could get off of <2:17:55 PM> Jake Trzybinski-Viars - Patient: two of these damn meds <2:17:58 PM> Jake Trzybinski-Viars - Patient: I'd be pretty motivated <2:18:00 PM> Jake Trzybinski-Viars - Patient: yeah yeah <2:18:02 PM> Emma Gunn - Doctor: so it would take you seeing some change to feel motivated <2:18:07 PM> Emma Gunn - Doctor: okay and that change would look like getting off the medications <2:18:09 PM> Jake Trzybinski-Viars - Patient: yeah that would be so nice if I could <2:18:15 PM> Emma Gunn - Doctor: mmm <2:18:19 PM> Jake Trzybinski-Viars - Patient: stop <2:18:19 PM> Jake Trzybinski-Viars - Patient: just be able to manage it a little easier and <2:18:22 PM> Jake Trzybinski-Viars - Patient: taking so much <2:18:27 PM> Emma Gunn - Doctor: okay I hear you <2:18:29 PM> Emma Gunn - Doctor: here and <2:18:31 PM> Emma Gunn - Doctor: if you continue to be on these medications long-term without making any changes <2:18:37 PM> Emma Gunn - Doctor: what do you what do you think that might look like <2:18:39 PM> Jake Trzybinski-Viars - Patient: a frustrating um I don't know <2:18:46 PM> Emma Gunn - Doctor: it so how important is it then for you to reduce the number of medications you're on on a scale of zero to ten <2:18:47 PM> Jake Trzybinski-Viars - Patient: I don't know I feel like it would just be a lot of work <2:18:54 PM> Jake Trzybinski-Viars - Patient: not much gain <2:19:01 PM> Jake Trzybinski-Viars - Patient: oh <2:19:07 PM> Emma Gunn - Doctor: okay so you're telling me it's it's really important for you to reduce the number of medications you have <2:19:10 PM> Jake Trzybinski-Viars - Patient: a nine or a 10 <2:19:20 PM> Emma Gunn - Doctor: but you're also telling me that your motivation to start making changes is pretty low <2:19:21 PM> Jake Trzybinski-Viars - Patient: yeah <2:19:25 PM> Emma Gunn - Doctor: what do you think about that <2:19:27 PM> Jake Trzybinski-Viars - Patient: I guess <2:19:30 PM> Jake Trzybinski-Viars - Patient: if <2:19:33 PM> Jake Trzybinski-Viars - Patient: if you really think that <2:19:36 PM> Jake Trzybinski-Viars - Patient: there's something I can do that would decrease it I would it would be worth a shot <2:19:41 PM> Jake Trzybinski-Viars - Patient: I yeah I just don't know where I would start <2:19:45 PM> Emma Gunn - Doctor: okay that's something we can talk about <2:19:53 PM> Paul Hershberger: let's go ahead and stop stop here <2:19:54 PM> Emma Gunn - Doctor: everyone <2:19:56 PM> Paul Hershberger: he Emma let's first of all hear from you ________________________________________________________________________________ End of transcript at Jul 21, 2025, 2:20:04 PM