Meet Brian

This is Brian.

Brian is new to your practice. He presents as a formerly smart businessman who now looks a little down-at-heel. He seems a little irritable and anxious, constantly rubbing his hands together. 

"I know you are busy today, doc. I won't take much of your time. I just need some painkillers for my feet. They are driving me crazy."

When you ask him what he has been taking so far, he tells you that he takes a few Tylenol with Codeine for his pain. He first noticed the pain about 4 months ago and it seems to be getting worse. 

He describes burning in his feet, along with some numbness. He seems a little jumpy and twitchy. You wonder if he using some other substances to address his pains. When you ask him about alcohol, he says:

"Oh, I quite often have a nightcap or two. It seems to help the pain a little and gets me off to sleep."

When pressed about the amount he drinks, he remains vague and non-committal. 

What do you want to ask about next?