Transcript of conference held at Jul 24, 2025 in room first_test@conference.miaiconvo.com Initial people present at 5:26:36 PM: Brian Lam - Patient Joseph Kirby - Doctor Paul Hershberger Transcript, started at 5:26:36 PM: ________________________________________________________________________________ <5:26:36 PM> Paul Hershberger joined the conference <5:26:36 PM> Joseph Kirby - Doctor joined the conference <5:26:36 PM> Brian Lam - Patient joined the conference <5:26:37 PM> Brian Lam - Patient: all right <5:26:47 PM> Joseph Kirby - Doctor: okay <5:26:49 PM> Joseph Kirby - Doctor: so Ryan we've talked a bit about your <5:26:53 PM> Joseph Kirby - Doctor: article history but let's kind of move into your social history do you drink alcohol <5:26:59 PM> Joseph Kirby - Doctor: okay tell me more about that <5:26:59 PM> Brian Lam - Patient: I do <5:27:03 PM> Joseph Kirby - Doctor: okay and about how much do you drink on the weekends <5:27:05 PM> Brian Lam - Patient: don't drink during the weekdays <5:27:07 PM> Brian Lam - Patient: but I do drink on the weekends <5:27:10 PM> Brian Lam - Patient: oh maybe <5:27:16 PM> Joseph Kirby - Doctor: oh a bottle of vodka like per day or just over the whole weekend <5:27:18 PM> Brian Lam - Patient: I'll get through maybe like <5:27:23 PM> Brian Lam - Patient: of vodka <5:27:27 PM> Brian Lam - Patient: just over the weekend <5:27:32 PM> Joseph Kirby - Doctor: mmm <5:27:36 PM> Joseph Kirby - Doctor: um let's see how long have you been doing that for <5:27:43 PM> Brian Lam - Patient: for a long time since I think <5:27:49 PM> Brian Lam - Patient: yeah maybe it's been eight years now <5:27:57 PM> Brian Lam - Patient: and I know <5:27:57 PM> Brian Lam - Patient: yeah I mean I know I put on a little bit of weight recently <5:27:58 PM> Joseph Kirby - Doctor: and do you like any concerns about how that might be affecting your health <5:28:05 PM> Joseph Kirby - Doctor: mmm <5:28:11 PM> Brian Lam - Patient: you know like it's the the booze can put on the pounds <5:28:18 PM> Brian Lam - Patient: it's not concerned about that yeah <5:28:19 PM> Joseph Kirby - Doctor: so it's it's caused a little bit of weight gain <5:28:21 PM> Brian Lam - Patient: mm-hmm <5:28:23 PM> Joseph Kirby - Doctor: any other concerns you've noticed with it <5:28:31 PM> Joseph Kirby - Doctor: mmm <5:28:33 PM> Brian Lam - Patient: here I mean <5:28:36 PM> Brian Lam - Patient: sometimes I just can't <5:28:40 PM> Brian Lam - Patient: sometimes when plans happen I just feel unmotivated to go out or not unmotivated but not in a <5:28:53 PM> Brian Lam - Patient: place where I can go out like you know like you shouldn't drink and drive and all that and you know sometimes my friends will call me <5:28:56 PM> Joseph Kirby - Doctor: oh so you're saying that you might be a little how to drink or two and then you go for a drive <5:29:01 PM> Brian Lam - Patient: like 6 p.m. 7 p.m. saying like hey let's meet up and <5:29:07 PM> Brian Lam - Patient: I'm kind of <5:29:09 PM> Brian Lam - Patient: Tipsy already <5:29:11 PM> Brian Lam - Patient: you know <5:29:11 PM> Brian Lam - Patient: no I'm just saying like you know like I think maybe it's affected a little bit of my social life just because <5:29:22 PM> Joseph Kirby - Doctor: mmm <5:29:26 PM> Brian Lam - Patient: I'll be drinking and then it reaches a point where I don't feel comfortable like <5:29:32 PM> Brian Lam - Patient: going out to meet up maybe going over to a friend's house or you know go into dinner with this couple or that couple you know <5:29:40 PM> Brian Lam - Patient: mm-hmm <5:29:40 PM> Joseph Kirby - Doctor: so it sounds like it can <5:29:44 PM> Joseph Kirby - Doctor: yeah I can really affect your social life your ability to go out and have good time <5:29:49 PM> Joseph Kirby - Doctor: and what concerns do you have about this affecting your medical health too <5:29:50 PM> Brian Lam - Patient: I mean <5:29:59 PM> Brian Lam - Patient: I think everybody knows like <5:30:02 PM> Brian Lam - Patient: you know way is not <5:30:05 PM> Brian Lam - Patient: been like overweight it's not a good thing can lead to diabetes <5:30:11 PM> Brian Lam - Patient: blood pressure <5:30:14 PM> Joseph Kirby - Doctor: and you know I see we're saying like wait definitely disaffected by alcohol but what other things are affected by it <5:30:16 PM> Brian Lam - Patient: mm-hmm <5:30:21 PM> Brian Lam - Patient: a <5:30:23 PM> Joseph Kirby - Doctor: hmm <5:30:23 PM> Joseph Kirby - Doctor: yeah <5:30:25 PM> Brian Lam - Patient: liver I think <5:30:27 PM> Brian Lam - Patient: am I right <5:30:29 PM> Brian Lam - Patient: okay <5:30:29 PM> Joseph Kirby - Doctor: yeah it does actually affect your liver <5:30:33 PM> Joseph Kirby - Doctor: them <5:30:35 PM> Joseph Kirby - Doctor: and what's like the typical <5:30:37 PM> Joseph Kirby - Doctor: number of drinks that <5:30:39 PM> Joseph Kirby - Doctor: that <5:30:41 PM> Joseph Kirby - Doctor: oh sorry this thing popped up what's the number of typical number of drinks that someone can have before it starts to sort of cause damage to your liver <5:30:47 PM> Brian Lam - Patient: maybe like <5:30:53 PM> Joseph Kirby - Doctor: in one night <5:30:55 PM> Joseph Kirby - Doctor: typically for men it should be less than four drinks in terms of like standard drink <5:30:58 PM> Brian Lam - Patient: seven or eight <5:31:01 PM> Brian Lam - Patient: oh <5:31:07 PM> Brian Lam - Patient: oh <5:31:08 PM> Joseph Kirby - Doctor: um with that in mind how does that change your thoughts about this <5:31:09 PM> Brian Lam - Patient: I mean I think <5:31:20 PM> Brian Lam - Patient: I think I've known this but I think that kind of puts it into perspective like the damage I'm doing to my body <5:31:30 PM> Joseph Kirby - Doctor: hear that you're saying it can cause damage you know we've talked about like with your liver with your weight and even with your social life it seems <5:31:42 PM> Joseph Kirby - Doctor: with those in mind do you have any thoughts about changing your alcohol usage <5:31:48 PM> Brian Lam - Patient: yeah <5:31:50 PM> Brian Lam - Patient: I've tried <5:31:52 PM> Brian Lam - Patient: hide in the past I think <5:31:52 PM> Joseph Kirby - Doctor: okay <5:31:58 PM> Brian Lam - Patient: some points it's been better at some points it's it's been worse and I think <5:32:04 PM> Brian Lam - Patient: you know I do know that <5:32:05 PM> Joseph Kirby - Doctor: what have you tried in the past <5:32:07 PM> Brian Lam - Patient: not good so <5:32:09 PM> Brian Lam - Patient: you <5:32:12 PM> Joseph Kirby - Doctor: yeah so like avoiding the <5:32:17 PM> Brian Lam - Patient: just kind of <5:32:19 PM> Brian Lam - Patient: going to the store and like avoiding you know the <5:32:24 PM> Brian Lam - Patient: the alcohol <5:32:27 PM> Brian Lam - Patient: yeah <5:32:29 PM> Brian Lam - Patient: yeah or just going to a store that's not near like another liquor store or something like that so <5:32:33 PM> Joseph Kirby - Doctor: like the wine and beer and vodka section and all that <5:32:37 PM> Joseph Kirby - Doctor: yeah and have you ever had any periods where you <5:32:37 PM> Joseph Kirby - Doctor: not <5:32:44 PM> Brian Lam - Patient: yeah yeah definitely think about mid-twenties <5:32:48 PM> Joseph Kirby - Doctor: or maybe <5:32:48 PM> Joseph Kirby - Doctor: drink alcohol this heavily <5:32:50 PM> Joseph Kirby - Doctor: been off of it <5:32:59 PM> Brian Lam - Patient: when I was working like six days a week I just be tired wouldn't drink <5:33:06 PM> Paul Hershberger: okay <5:33:07 PM> Brian Lam - Patient: and then <5:33:08 PM> Joseph Kirby - Doctor: mmm <5:33:09 PM> Brian Lam - Patient: maybe when <5:33:11 PM> Brian Lam - Patient: when my kids were born <5:33:16 PM> Joseph Kirby - Doctor: what made you quit then <5:33:19 PM> Joseph Kirby - Doctor: mmm <5:33:20 PM> Brian Lam - Patient: I think <5:33:22 PM> Brian Lam - Patient: you know you just don't want to drink in front of kids right it's not a good it's not a good example to them <5:33:29 PM> Brian Lam - Patient: yeah and you don't want to be drunk handling with your kids and all that like you don't want you know your son and be like Oh Daddy strong so <5:33:30 PM> Joseph Kirby - Doctor: yeah I see what you're saying like you don't want to <5:33:32 PM> Paul Hershberger: here <5:33:35 PM> Joseph Kirby - Doctor: yeah you don't want to set a bad example for your kids <5:33:39 PM> Joseph Kirby - Doctor: mmm <5:33:47 PM> Joseph Kirby - Doctor: okay ________________________________________________________________________________ End of transcript at Jul 24, 2025, 5:33:54 PM