Transcript of conference held at Jul 21, 2025 in room first_test@conference.miaiconvo.com Initial people present at 3:47:02 PM: Angie Castle Makul Sharma Witty Kwok - Doctor JP Khouzam - Patient Transcript, started at 3:47:02 PM: ________________________________________________________________________________ <3:47:02 PM> JP Khouzam - Patient joined the conference <3:47:02 PM> Makul Sharma joined the conference <3:47:02 PM> Angie Castle joined the conference <3:47:02 PM> Witty Kwok - Doctor joined the conference <3:47:04 PM> Witty Kwok - Doctor: okay well hello so JP we have just finished our while check with Carl everything seems pretty good but I just wanted to bring up one concern from our end so with his growth and development we saw his way was in the 95th percentile in the 50th percentile <3:47:33 PM> Witty Kwok - Doctor: have you kind of noticed any changes with his behavior or development lately <3:47:37 PM> JP Khouzam - Patient: yeah I mean to be honest with you we always knew he was kind of on the bigger side he's just such a picky eater he just will not we cannot get him to eat what mom cooks <3:47:37 PM> JP Khouzam - Patient: he's <3:47:39 PM> Witty Kwok - Doctor: Unity <3:47:52 PM> JP Khouzam - Patient: just pretty much like the classics like chips and <3:47:58 PM> JP Khouzam - Patient: junk food and like chicken nuggets <3:48:02 PM> JP Khouzam - Patient: yeah so he really just doesn't <3:48:05 PM> JP Khouzam - Patient: it's really hard to get them to eat just normal things or eat less in general so <3:48:07 PM> Witty Kwok - Doctor: go how much to see typically eat a day <3:48:12 PM> JP Khouzam - Patient: um he eats like <3:48:19 PM> JP Khouzam - Patient: the thing is he just doesn't eat the normal meals kind of what it's gonna be like is like <3:48:25 PM> JP Khouzam - Patient: and then <3:48:25 PM> JP Khouzam - Patient: he'll come in like wake up in the morning or maybe get him to eat some eggs or something or some cereal before school and then what I hear from his teachers is that he'll just kind of snack throughout the day they have like access snacks he snatched out today then he's not hungry by the time it's launched and then he snacks after lunch and then by the time it's dinner he's not hungry for dinner <3:48:33 PM> Witty Kwok - Doctor: me God so it sounds like he doesn't <3:48:47 PM> JP Khouzam - Patient: late night and we have to he's like <3:48:50 PM> JP Khouzam - Patient: you know complaining about the food and that he's hungry so that we have to <3:48:55 PM> JP Khouzam - Patient: eat the junk food so we'll make him like buttered noodles and <3:48:59 PM> JP Khouzam - Patient: chicken nuggets and that's what he ends up eating so <3:48:59 PM> Makul Sharma: here <3:49:06 PM> Witty Kwok - Doctor: the routine schedule for like meals just snaps throughout the day <3:49:09 PM> JP Khouzam - Patient: a kind of and well we'll have them set at the dinner table but yeah it <3:49:09 PM> JP Khouzam - Patient: I mean <3:49:12 PM> Witty Kwok - Doctor: gotcha <3:49:16 PM> JP Khouzam - Patient: if the rest of us are having you know <3:49:16 PM> JP Khouzam - Patient: like <3:49:17 PM> Witty Kwok - Doctor: you <3:49:19 PM> JP Khouzam - Patient: chicken rice and broccoli he will sit there with the food in front of him not eat it until he gets the chicken nuggets and the chips later <3:49:30 PM> Witty Kwok - Doctor: okay <3:49:31 PM> JP Khouzam - Patient: you know <3:49:31 PM> JP Khouzam - Patient: oh yeah I mean we are concerned we haven't really tried anything and we were kind of pushing over to him right now but he doesn't really like to go outside anymore and play because his buddies at school are starting to be pretty mean to him as in like <3:49:33 PM> Witty Kwok - Doctor: yes <3:49:36 PM> Witty Kwok - Doctor: what concerns do you guys have or for his weight <3:49:58 PM> JP Khouzam - Patient: about being a bigger kid they're just calling them all sorts of names and I'm sure he's not liking that so he doesn't really even want to go and play with them outside he just kind of sits around which is making things worse I assume because he's not as active as he used to be he used to love going outside <3:50:12 PM> Witty Kwok - Doctor: okay <3:50:16 PM> JP Khouzam - Patient: yeah so there's that portion of it as well <3:50:19 PM> Witty Kwok - Doctor: forgot that <3:50:20 PM> JP Khouzam - Patient: it's <3:50:21 PM> Witty Kwok - Doctor: this sounds like it's <3:50:24 PM> Witty Kwok - Doctor: and kind of affecting his school life and just like being outside definitely been tough <3:50:30 PM> Witty Kwok - Doctor: way of being called names <3:50:33 PM> Witty Kwok - Doctor: has he was more like a recent issue or <3:50:33 PM> Witty Kwok - Doctor: say <3:50:33 PM> JP Khouzam - Patient: yeah <3:50:41 PM> JP Khouzam - Patient: yeah this issue is mostly happen like in the last couple of months he <3:50:46 PM> JP Khouzam - Patient: he's always <3:50:46 PM> JP Khouzam - Patient: before he used I mean <3:50:48 PM> JP Khouzam - Patient: been a bigger kid but he hasn't really mentioned having trouble at school <3:50:54 PM> JP Khouzam - Patient: usually love school kind of thing and now he's having trouble a little bit it seems like it's not the worst thing but it seems like it <3:50:55 PM> Witty Kwok - Doctor: hmm I guess how how do you think kind of the snacking <3:51:07 PM> Witty Kwok - Doctor: just like throughout the day impacts kind of how he is able to interact with others and just his daily life <3:51:14 PM> JP Khouzam - Patient: yeah I can see like on one hand you know I can see the direct reason is that <3:51:14 PM> JP Khouzam - Patient: he <3:51:14 PM> Witty Kwok - Doctor: mmm <3:51:21 PM> JP Khouzam - Patient: back and then he's not hungry for normal lunch or normal dinner which would be you know his normal <3:51:29 PM> JP Khouzam - Patient: and <3:51:29 PM> JP Khouzam - Patient: get the nutrients he needs I know that that's what the rest of us try to eat pretty healthy <3:51:34 PM> JP Khouzam - Patient: he's not hungry for them and then he's not eating that and he's able to like resist <3:51:40 PM> JP Khouzam - Patient: and then at the end of the night he's really hungry and the only thing we can give him to call him down is like chicken nuggets and stuff like that and <3:51:48 PM> Witty Kwok - Doctor: do you do you perhaps I guess <3:51:48 PM> JP Khouzam - Patient: it seems <3:51:48 PM> JP Khouzam - Patient: yeah so <3:51:51 PM> JP Khouzam - Patient: yeah <3:51:55 PM> JP Khouzam - Patient: here <3:51:55 PM> Witty Kwok - Doctor: know kind of what reasons he is more more interested in like eating snacks the other day rather than just kind of waiting for the different meals <3:52:04 PM> JP Khouzam - Patient: keep it <3:52:04 PM> JP Khouzam - Patient: I mean it's sort of my fault like I like eating junk food as well I just <3:52:10 PM> JP Khouzam - Patient: of a balanced I we always have chips and soda and a house <3:52:16 PM> JP Khouzam - Patient: and we always carry those chicken nuggets <3:52:20 PM> JP Khouzam - Patient: so I mean that's probably where he gets it from <3:52:21 PM> Witty Kwok - Doctor: yeah <3:52:26 PM> JP Khouzam - Patient: it's just hard to get him to change I don't know <3:52:28 PM> Witty Kwok - Doctor: yeah I don't play them chicken nuggets are pretty good <3:52:30 PM> JP Khouzam - Patient: yeah yeah <3:52:34 PM> Witty Kwok - Doctor: uh but it sounds like <3:52:36 PM> Witty Kwok - Doctor: part of it may just be like <3:52:40 PM> Witty Kwok - Doctor: just influenced from like you and just like maybe he just wanted to eat snacks kind of just based on what he's seen it's always a possibility and you guys to build off of that has sea <3:52:54 PM> Witty Kwok - Doctor: mentioned this is more like a recent thing that you've noticed so he hasn't always <3:52:59 PM> Witty Kwok - Doctor: eating this way <3:53:00 PM> JP Khouzam - Patient: yeah yeah <3:53:03 PM> JP Khouzam - Patient: honestly before he was <3:53:06 PM> JP Khouzam - Patient: he was still eating like normal lunch and dinner and stuff but it was just <3:53:12 PM> JP Khouzam - Patient: snacking <3:53:14 PM> JP Khouzam - Patient: but <3:53:14 PM> JP Khouzam - Patient: yet he would snack less and then he would have more lunch and dinner <3:53:19 PM> JP Khouzam - Patient: launching dinner he was still eating a ton or like whatever lunch we'd have we'd also have to put on the junk food like soda on the table for him <3:53:28 PM> JP Khouzam - Patient: so yeah <3:53:28 PM> Witty Kwok - Doctor: okay <3:53:33 PM> Witty Kwok - Doctor: and how how does Carl feel valve this <3:53:35 PM> JP Khouzam - Patient: here's a <3:53:37 PM> Witty Kwok - Doctor: speaking <3:53:40 PM> JP Khouzam - Patient: he said he's he sad about the names and stuff I can tell he doesn't want to go outside that's not like him he likes to go outside <3:53:44 PM> Witty Kwok - Doctor: gotcha <3:53:49 PM> JP Khouzam - Patient: yeah and I'm sure he wants to make a change he's just again he's like so picky he's hard to work with <3:53:57 PM> JP Khouzam - Patient: but I guess there's probably something I could do <3:54:02 PM> JP Khouzam - Patient: should probably you know just stop <3:54:05 PM> JP Khouzam - Patient: junk food in the house but yeah <3:54:06 PM> Witty Kwok - Doctor: yeah I mean besides <3:54:13 PM> Witty Kwok - Doctor: I guess it sounds like you are at least thinking about ways to make adjustments both for both for yourself and for Carl <3:54:22 PM> Witty Kwok - Doctor: is there <3:54:24 PM> Witty Kwok - Doctor: I guess what what other <3:54:27 PM> Witty Kwok - Doctor: thoughts or changes do you think you can make to help with like his diet <3:54:32 PM> JP Khouzam - Patient: yeah I think we just at some point we just have to put our foot down what is just I mean myself I just need to not have junk food in the house so that if he asked for it <3:54:44 PM> JP Khouzam - Patient: he literally can't give it to him and also I mean for me I should probably eat less of that stuff myself <3:54:51 PM> JP Khouzam - Patient: yeah and then I think yeah I've heard from other parents and stuff that it's you just kind of put your foot down eventually kids will get hungry and eat what you give them <3:55:03 PM> JP Khouzam - Patient: that's what I've heard I just have trouble getting him to do that I cave pretty easy <3:55:07 PM> Witty Kwok - Doctor: it's it's tough for sure I mean if if you were to rate that I guess on a scale of one to ten with like 10 being you're able to like make that change now and one being like you won't really be able to do anything right now because where would you put that in terms of making the changes you just mentioned <3:55:22 PM> JP Khouzam - Patient: honestly probably like a seven or eight I <3:55:27 PM> Witty Kwok - Doctor: okay <3:55:30 PM> JP Khouzam - Patient: it's concerning me I mean 95th percentiles really high that I didn't realize it was getting that bad I do know he was he's bigger than his friends but <3:55:40 PM> JP Khouzam - Patient: yeah I'm definitely willing to make a change it just yeah <3:55:45 PM> Witty Kwok - Doctor: you gotcha and I guess <3:55:49 PM> Witty Kwok - Doctor: why not <3:55:51 PM> Witty Kwok - Doctor: lower like if you were say like a four or five <3:55:54 PM> JP Khouzam - Patient: I mean I don't want him to you know have any I guess <3:55:56 PM> Witty Kwok - Doctor: okay <3:56:00 PM> JP Khouzam - Patient: yeah I I don't want him to have any like bad things happen to him especially this this bullying and some of this happening at school I'm sure things will change or you know that that kind of really affects a kid at a young age so I really want to make sure he's got you know a good social support at school that he likes going outside playing sports that kind of thing that's important to me <3:56:00 PM> JP Khouzam - Patient: and <3:56:14 PM> Witty Kwok - Doctor: gotcha <3:56:26 PM> JP Khouzam - Patient: I guess I I do know I mean for my health perspective <3:56:26 PM> JP Khouzam - Patient: <3:56:30 PM> JP Khouzam - Patient: I need to lose weight because of <3:56:33 PM> JP Khouzam - Patient: know like diabetes and heart issues and stuff that my doctor tells me about so I know that for him that's probably the same I guess in children I'm not totally sure <3:56:47 PM> Witty Kwok - Doctor: yeah definitely sounds like you're ready to make a change and changes it doesn't have to be big anything small you can just start with like a diet or if you want to start with <3:56:47 PM> Witty Kwok - Doctor: kind of ________________________________________________________________________________ End of transcript at Jul 21, 2025, 3:57:07 PM