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INSTRUCTIONS FOR THE DOCTOR
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Please take a focused history from Jack and answer his questions.
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Scenario
Jack is a 43-year-old man whose wife Julie and two children attend the practice. He saw you last week for a full check-up, including a physical examination, which was normal. He feels he can trust you and so made another booking to discuss something else.
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The following is on his summary sheet:
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Past medical history
Nil recorded
Medications
Nil
Immunisations
ADT 2019 after stepping on a nail last week
Unsure about childhood immunisations
Family history
Brother died MVA aged 35
Mother died of cirrhosis aged 57
Social history
Lives with his wife Julie and two children
Works as a manager at an electrical store
Non-smoker
Drinks four to six full-strength beers at the weekend.
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INSTRUCTIONS FOR THE PATIENT JACK KINGSLEY
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You have known you were hepatitis C positive since 2001 when you were diagnosed. You injected drugs in your twenties so think this is when you became infected.
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Julie and the children know about your diagnosis. You take precautions around them and they have never had any exposure to your blood. Julie is your only sexual partner since diagnosis and you no longer use drugs.
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You were diagnosed when in prison for car theft and were commenced on interferon. You only had about four weeks of treatment as it made you unwell and after leaving prison you wanted to get your life together and leave your past behind.
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The treatment didn’t work and you accepted that you would live with hepatitis C until it killed you as it did your mum. One of your friends from your drug days recently died of liver cancer. At his funeral another friend told you of his cure on a new treatment.
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You had a difficult childhood and ended up in foster care. As a young adult you were homeless and used IV drugs.
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You know you should have seen a doctor regularly but you have lived in fear of your past coming back to haunt you and just preferred to get on with your life. But now, with talk of a new treatment, you think it’s worth investigating the options and you want to ask the doctor about it.
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You feel fit and run three times a week and ride 10 km to work and back five times a week. You don’t smoke. You drink four to six stubbies of full-strength beer on the weekends.
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You have avoided your favourite sport of AFL due to the risk of injury and blood exposure for your teammates but would love to play again.
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You don’t take any other drugs and vow never to do that again.
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