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English, 23.04.2020 18:58 goreeefk4939

Bao Chan is 80, a Chinese American who is widowed and a retired seamstress. For 10 years she has suffered from arthritis, but up to a few months ago her suffering was manageable. Her daughter brought her in twice in the last two months because her joints were so painful that she could not visit family 2 blocks away. At those occasions you helped relieve the pain with short courses of a new medicine. Now she has worsened again for the 3rd time, and as you speak with them today you recall that relatives visited from China about the time her pain initially flared up. A nephew is a Chinese traditional healer, and you wonder whether he may have prescribes something that caused the decline. Which sequence of questions/ statements is recommended to address the issue?

A. "Did your nephew bring you any herbs or pills that may interfere with your treatment in my office? ...Have you been taking them together with or instead of my medication?"
B. "It seemed to me that the medication I prescribed helped with your arthritis—did you think so? ... Sometimes patients take natural medicines or herbs in addition to or instead of the medication we prescribe. ...Has this been the case with you? ... It would be helpful for me to know more about it, can you bring them in?"
C. "Many of my Chinese patients take traditional herbs in addition to or sometimes even in place of the medications I prescribe. ...I bet so have you! ... In order for me to help you best, I'd like to know what they are."
D. "I remember you told me that your nephew is a traditional herbalist. ...Sometimes herbalists give out medicines that can be dangerous. ...They might be creating problems with your arthritis. ...Please bring them in so that I can see what they are.
E. "I remember you told me that your nephew is a traditional herbalist. ...Sometimes those medicines are not as carefully tested as the medications that we prescribe. ... Sometimes they are even dangerous if taken instead of or in addition to the medications we prescribe. ...This is probably the cause of the current arthritis flare up."

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