Transcript of conference held at Jul 24, 2025 in room first_test@conference.miaiconvo.com Initial people present at 5:46:37 PM: Brian Lam - Doctor Joseph Kirby - Patient Paul Hershberger Fellow Jitser Transcript, started at 5:46:37 PM: ________________________________________________________________________________ <5:46:37 PM> Paul Hershberger joined the conference <5:46:37 PM> Joseph Kirby - Patient joined the conference <5:46:37 PM> Brian Lam - Doctor joined the conference <5:46:37 PM> Joseph Kirby - Patient: this is a lot of <5:46:37 PM> Joseph Kirby - Patient: yeah yeah I am frustrated <5:46:45 PM> Brian Lam - Doctor: Okay so <5:46:54 PM> Brian Lam - Doctor: you know what do you <5:46:56 PM> Brian Lam - Doctor: like <5:46:58 PM> Brian Lam - Doctor: you're a little frustrated at the moment <5:47:01 PM> Brian Lam - Doctor: tell me <5:47:05 PM> Joseph Kirby - Patient: us to take <5:47:06 PM> Brian Lam - Doctor: and tell me a little bit more about this frustration <5:47:06 PM> Joseph Kirby - Patient: well I mean I can hardly remember the names of any of them <5:47:11 PM> Brian Lam - Doctor: okay <5:47:16 PM> Joseph Kirby - Patient: and you guys just rattle them off and I don't know what they are <5:47:16 PM> Joseph Kirby - Patient: and <5:47:20 PM> Joseph Kirby - Patient: and I can't remember what they're for half the time <5:47:23 PM> Joseph Kirby - Patient: and that makes it hard to even even remember when to take them because there's so many of them <5:47:23 PM> Brian Lam - Doctor: okay and how many medications are you taking at the moment <5:47:29 PM> Joseph Kirby - Patient: all right I don't know it must be like <5:47:33 PM> Brian Lam - Doctor: okay <5:47:36 PM> Joseph Kirby - Patient: be like 30 or something <5:47:39 PM> Joseph Kirby - Patient: list is crazy I don't even know <5:47:40 PM> Brian Lam - Doctor: okay and <5:47:42 PM> Joseph Kirby - Patient: stuff well I mean sometimes I just get so frustrated I just I just give up and I just don't take them sometimes you know because I'm just trying to sort through and figure out <5:47:44 PM> Brian Lam - Doctor: what do you what have you done <5:47:49 PM> Brian Lam - Doctor: to have you how do you deal with this frustration so <5:48:02 PM> Brian Lam - Doctor: this is <5:48:07 PM> Joseph Kirby - Patient: it's the one I already took the earlier this morning or not <5:48:11 PM> Joseph Kirby - Patient: and I'm trying to figure out like <5:48:14 PM> Joseph Kirby - Patient: it should I be taking this or not or do I only take this when like <5:48:19 PM> Joseph Kirby - Patient: when I like field chest pain or something or you know <5:48:24 PM> Joseph Kirby - Patient: so many and all the side effects to so I don't know <5:48:28 PM> Brian Lam - Doctor: it so it sounds like you're frustrated because there's a lot of medications and <5:48:28 PM> Joseph Kirby - Patient: yeah I mean I'd say I say that's a good summary <5:48:34 PM> Brian Lam - Doctor: you're kind of not sure what's going on <5:48:37 PM> Brian Lam - Doctor: these medications <5:48:40 PM> Brian Lam - Doctor: okay okay and then on a scale of 1 to 10 how frustrated are we with the Curt like with having all these medications <5:48:45 PM> Joseph Kirby - Patient: oh definitely like a nine or a 10 <5:48:54 PM> Brian Lam - Doctor: like like a nine or ten <5:48:57 PM> Joseph Kirby - Patient: yeah I'm pretty frustrated about it <5:48:59 PM> Brian Lam - Doctor: okay <5:49:01 PM> Brian Lam - Doctor: okay <5:49:01 PM> Brian Lam - Doctor: okay <5:49:02 PM> Joseph Kirby - Patient: lower the frustration to a five <5:49:03 PM> Brian Lam - Doctor: and what do you think it would take for you to <5:49:08 PM> Brian Lam - Doctor: lower that frustration down to maybe a five <5:49:12 PM> Brian Lam - Doctor: yeah <5:49:15 PM> Joseph Kirby - Patient: oh doc we'd have to cut back on the number of meds that's for sure <5:49:15 PM> Brian Lam - Doctor: mm-hmm <5:49:20 PM> Joseph Kirby - Patient: so <5:49:20 PM> Joseph Kirby - Patient: I think <5:49:22 PM> Joseph Kirby - Patient: that's the only solution <5:49:23 PM> Brian Lam - Doctor: mm-hmm <5:49:26 PM> Brian Lam - Doctor: okay and <5:49:31 PM> Brian Lam - Doctor: but what do you think about these meds <5:49:33 PM> Joseph Kirby - Patient: yeah I know I have heard it <5:49:35 PM> Brian Lam - Doctor: that you have to take or give him because you kind of need them <5:49:41 PM> Brian Lam - Doctor: okay <5:49:45 PM> Joseph Kirby - Patient: that if I don't take them you know there's a whole list of things that <5:49:45 PM> Joseph Kirby - Patient: that <5:49:49 PM> Joseph Kirby - Patient: happened to me but <5:49:51 PM> Joseph Kirby - Patient: you know most days when I take them don't take them I feel fine so <5:49:51 PM> Brian Lam - Doctor: and what have you heard what are these bad things that will happen to you <5:49:55 PM> Joseph Kirby - Patient: well I know I know what the sugar <5:50:00 PM> Brian Lam - Doctor: mm-hmm <5:50:04 PM> Joseph Kirby - Patient: you know they say if my Sugar gets high then <5:50:07 PM> Joseph Kirby - Patient: like burning in my feet or just keep getting worse <5:50:10 PM> Joseph Kirby - Patient: um and then the you know with the all the heart stuff and all the heart meds you know there's always the chance that I that I end up in the hospital again and all that <5:50:21 PM> Joseph Kirby - Patient: so <5:50:22 PM> Joseph Kirby - Patient: know I know that could happen but <5:50:25 PM> Joseph Kirby - Patient: yeah I mean it it hurts you know and <5:50:25 PM> Joseph Kirby - Patient: they <5:50:28 PM> Brian Lam - Doctor: and this burning sensation in your feet does it bother you <5:50:33 PM> Brian Lam - Doctor: yeah <5:50:38 PM> Joseph Kirby - Patient: another Med for it too <5:50:40 PM> Joseph Kirby - Patient: but I don't think it works <5:50:41 PM> Brian Lam - Doctor: is <5:50:42 PM> Joseph Kirby - Patient: so <5:50:43 PM> Brian Lam - Doctor: and are you concerned about you know ending up in the hospital again <5:50:44 PM> Joseph Kirby - Patient: I mean yeah I was it wasn't very fun last time that's for sure I don't want to go back <5:50:52 PM> Brian Lam - Doctor: okay and what do you think the benefits of taking the medications are <5:50:53 PM> Joseph Kirby - Patient: the benefits <5:50:59 PM> Joseph Kirby - Patient: well I mean I earn you a lot of money that's for sure <5:51:04 PM> Joseph Kirby - Patient: but I mean I guess it's supposed to keep me from they say that if I take it I won't go to the hospital again <5:51:13 PM> Joseph Kirby - Patient: so <5:51:14 PM> Joseph Kirby - Patient: hmm <5:51:15 PM> Brian Lam - Doctor: and then also maybe the burning sensation will <5:51:22 PM> Brian Lam - Doctor: not get worse <5:51:26 PM> Joseph Kirby - Patient: that's true yeah maybe it won't <5:51:28 PM> Brian Lam - Doctor: it sounds like that sensation kind of bothers you a decent amount <5:51:29 PM> Joseph Kirby - Patient: yeah <5:51:33 PM> Brian Lam - Doctor: and then <5:51:35 PM> Joseph Kirby - Patient: the scale 1 to 10 <5:51:36 PM> Brian Lam - Doctor: call on a scale of 1 to 10 how much does it bother you <5:51:40 PM> Brian Lam - Doctor: yeah <5:51:43 PM> Joseph Kirby - Patient: I don't know I feel like it's a it's a six most days but <5:51:44 PM> Brian Lam - Doctor: how do you <5:51:48 PM> Joseph Kirby - Patient: I don't know so that's worse <5:51:50 PM> Brian Lam - Doctor: how do you feel we went from a six to a 10 <5:51:50 PM> Joseph Kirby - Patient: oh six to attend <5:51:54 PM> Brian Lam - Doctor: yeah on how much like your feet are bothering you because of the burning sensation <5:51:57 PM> Joseph Kirby - Patient: oh I wouldn't want that at all <5:52:02 PM> Brian Lam - Doctor: he wouldn't want that at all <5:52:03 PM> Joseph Kirby - Patient: yeah <5:52:03 PM> Joseph Kirby - Patient: no <5:52:06 PM> Joseph Kirby - Patient: I I don't want that <5:52:07 PM> Brian Lam - Doctor: mm-hmm and then and <5:52:12 PM> Brian Lam - Doctor: how do you feel about not wanting that burdens sensation to get worse <5:52:19 PM> Brian Lam - Doctor: but not taking like the medication at the same time <5:52:22 PM> Joseph Kirby - Patient: hmm <5:52:26 PM> Joseph Kirby - Patient: yeah I mean <5:52:29 PM> Joseph Kirby - Patient: it's a good point I guess like if I if I don't take it you're saying that this Burning could just keep getting worse <5:52:31 PM> Brian Lam - Doctor: mm-hmm and then <5:52:37 PM> Joseph Kirby - Patient: so <5:52:41 PM> Brian Lam - Doctor: you'll get a lot more uncomfortable so <5:52:45 PM> Brian Lam - Doctor: I know that <5:52:47 PM> Brian Lam - Doctor: lot of medications and I know it's not fun taking them <5:52:52 PM> Brian Lam - Doctor: but I think <5:52:55 PM> Brian Lam - Doctor: like what you've already told me that <5:52:58 PM> Joseph Kirby - Patient: yeah I mean I I would agree with that <5:52:59 PM> Brian Lam - Doctor: it'll be helpful down the line do you agree with that <5:53:02 PM> Brian Lam - Doctor: okay so what do you think <5:53:06 PM> Joseph Kirby - Patient: you know at least like maybe I'll just take that that diabetes Med then <5:53:08 PM> Paul Hershberger: for you <5:53:11 PM> Joseph Kirby - Patient: well I guess I'll take the diabetes Med so that I can not get that burn in and I'll <5:53:11 PM> Joseph Kirby - Patient: try <5:53:12 PM> Brian Lam - Doctor: he should be doing moving forward <5:53:15 PM> Paul Hershberger: we'll stop here <5:53:24 PM> Joseph Kirby - Patient: take some of the ones I don't end up in the hospital too <5:53:27 PM> Joseph Kirby - Patient: so ________________________________________________________________________________ End of transcript at Jul 24, 2025, 5:53:36 PM