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|---|---|---|---|
36_126
|
They certainly do.
|
other
|
communication behavior
|
36_128
|
Mm-hmm.
|
other
|
communication behavior
|
36_130
|
Right.
|
other
|
communication behavior
|
36_132
|
Okay. Okay. And have there been any times over the last four years that you've noticed any significant changes in your symptoms? For example, have there been any times when things have been better for you?
|
question
|
communication behavior
|
36_134
|
Right.
|
other
|
communication behavior
|
36_136
|
Mm-hmm.
|
other
|
communication behavior
|
36_138
|
Mm-hmm.
|
other
|
communication behavior
|
36_140
|
Mm-hmm.
|
other
|
communication behavior
|
36_142
|
Right.
|
other
|
communication behavior
|
36_144
|
Right. And how were you tummy symptoms then?
|
question
|
communication behavior
|
36_146
|
Right. Okay.
|
other
|
communication behavior
|
36_148
|
Right. Right.
|
other
|
communication behavior
|
36_150
|
Right. That's interesting.
|
other
|
communication behavior
|
36_152
|
And are there any times when your-your tummy symptoms bother you more? Seem particularly bad?
|
question
|
communication behavior
|
36_154
|
Right.
|
other
|
communication behavior
|
36_156
|
Right.
|
other
|
communication behavior
|
36_158
|
Right.
|
other
|
communication behavior
|
36_160
|
Uh-huh.
|
other
|
communication behavior
|
36_162
|
Right. So you notice it's a bit worse when your husband's not around? Okay.
|
reflection
|
communication behavior
|
36_164
|
Right. I know you've been seeing Dr. Brown about this for the last few years.
|
other
|
communication behavior
|
36_166
|
What is it that he's said that he thinks might be wrong with you?
|
question
|
communication behavior
|
36_168
|
Right.
|
other
|
communication behavior
|
36_170
|
Right. Okay.
|
other
|
communication behavior
|
36_172
|
And what do you think?
|
question
|
communication behavior
|
36_174
|
Right.
|
other
|
communication behavior
|
36_176
|
Mm-hmm.
|
other
|
communication behavior
|
36_178
|
And have you had any thoughts yourself about what you think might be causing it?
|
question
|
communication behavior
|
36_180
|
Mm-hmm.
|
other
|
communication behavior
|
36_182
|
Right.
|
other
|
communication behavior
|
36_184
|
Right.
|
other
|
communication behavior
|
36_186
|
Right.
|
other
|
communication behavior
|
36_188
|
Mm-hmm.
|
other
|
communication behavior
|
36_190
|
Right.
|
other
|
communication behavior
|
36_192
|
Oh, dear.
|
other
|
communication behavior
|
36_194
|
Right. Right.
|
other
|
communication behavior
|
36_196
|
Right.
|
other
|
communication behavior
|
36_198
|
So you're- you-you're kind of prodding, having a feel at night?
|
reflection
|
communication behavior
|
36_200
|
To see if you can feel anything?
|
question
|
communication behavior
|
36_202
|
Right.
|
other
|
communication behavior
|
36_204
|
Right. Okay.
|
other
|
communication behavior
|
36_206
|
Okay. So just to-to make sure that I've got the-the story straight, you've-you've seen Dr. Brown for a couple of years.
|
reflection
|
communication behavior
|
36_208
|
You've-you've tried a variety of medications-
|
reflection
|
communication behavior
|
36_210
|
- some prescribed, some-
|
reflection
|
communication behavior
|
36_212
|
- from the-the herbal shop. None of them really made a great deal of difference. You've had some investigations-
|
reflection
|
communication behavior
|
36_214
|
- but you perhaps feel you've not had enough investigations. And at times, you worry that this could be something quite serious like a-
|
reflection
|
communication behavior
|
36_216
|
- a cancer. Is that-- Have I got the-
|
reflection
|
communication behavior
|
36_218
|
- story right?
|
reflection
|
communication behavior
|
36_220
|
Okay.
|
other
|
communication behavior
|
36_222
|
Okay. Barbara, what was it that you were hoping that I'd do for you today?
|
question
|
communication behavior
|
36_224
|
Mm-hmm.
|
other
|
communication behavior
|
36_226
|
Right.
|
other
|
communication behavior
|
36_228
|
Right.
|
other
|
communication behavior
|
36_230
|
Right. Right. So you were hoping that I'd send you for more tests?
|
question
|
communication behavior
|
36_232
|
Okay.
|
other
|
communication behavior
|
36_234
|
Right.
|
other
|
communication behavior
|
36_236
|
Right. Okay. Well, I think, Barbara, having-having heard your story, and heard about the symptoms, I'm not sure that actually sending you for more tests at this point would be the most useful thing that we could do for you. And the reason for that is because you've-you've had some of the main investigations in the last couple of years, and-and they've not shown anything. And your symptoms haven't really changed that much. So it's very unlikely that if we were to send you for more tests now that-that they'd show anything different than what we already know. So a bit-- I think it would be a waste of time for you to go for more tests.
|
other
|
communication behavior
|
36_238
|
Uh, no. I think that you clearly have pain, and clearly you have lots of physical symptoms, and they're clearly getting in the way of-
|
other
|
communication behavior
|
36_240
|
-your life and causing you a lot-
|
other
|
communication behavior
|
36_242
|
-of disability.
|
other
|
communication behavior
|
36_244
|
I guess- I guess the way I think about these things is that they're not necessarily either all in the mind or all in the body.
|
other
|
communication behavior
|
36_246
|
Sometimes these things can go together. Uh, I guess I'm thinking about how you told me that last year, when your son got married, uh, and you were very busy-
|
therapist_input
|
communication behavior
|
36_248
|
- and quite happy, that somehow your symptoms seemed less.
|
other
|
communication behavior
|
36_250
|
And, uh, when your husband's away, which is something you don't like very much, sometimes, somehow, your symptoms then will seem greater. So, I guess what I'm wondering, Barbara, is if there might be some kind of a link with you between how you're feeling in your mind, and what's going on in your life, and-and how much your symptoms trouble you. Do you think that's a possibility?
|
reflection
|
communication behavior
|
36_252
|
Mm. I'm not saying that the pain's in your mind. Um, I guess what I'm saying is that sometimes the way that we feel, and the way that our lives are going, can impact how we notice our symptoms. Given that we've tried medication for you, and we've tried investigations, and we've drawn a blank really, with those, none of those have really helped you-
|
reflection
|
communication behavior
|
36_254
|
- I guess I'm wondering whether now it would be a good idea to try a different approach to your problems.
|
other
|
communication behavior
|
36_256
|
Well, I guess, thinking a little bit about those other areas of your life, um, uh, I'm thinking about the fact that over the last four years, your life's really changed. It seems to have really shrunk down.
|
other
|
communication behavior
|
36_258
|
And it sounds as though you're not doing lots of the things that you used to do. That you-
|
reflection
|
communication behavior
|
36_260
|
- used to get pleasure out of. Is that right?
|
reflection
|
communication behavior
|
36_262
|
Yeah.
|
other
|
communication behavior
|
36_264
|
Yeah. And I guess I wonder-- Uh, it sounds as though you've-you've dropped doing those things because you felt you couldn't do them, but I wonder if, in a funny way, what's happened is the fact that you're not doing those pleasurable things now, has kind of fed into you feeling-
|
reflection
|
communication behavior
|
36_266
|
- unhappy with the way that-that your life is at the moment. And-and I guess I wonder whether that can then make your symptoms worse for you.
|
reflection
|
communication behavior
|
36_268
|
Mm.
|
other
|
communication behavior
|
36_270
|
Well, I guess what I'd be wondering is whether one of the approaches we need to be using now is thinking about what you do with your life, and what you do with your day, and maybe trying to bring back some of those pleasurable things, you know, even if it's just meeting up-
|
therapist_input
|
communication behavior
|
36_272
|
- with your-your female friends once a week, and whether actually doing those sorts of things might generally-
|
therapist_input
|
communication behavior
|
36_274
|
- improve your quality of life. I'm also thinking about the tablets that you're taking.
|
therapist_input
|
communication behavior
|
36_276
|
And the fact that you-you seem to be taking quite a lot of them, and I'm wondering whether it's worth, though, sitting and looking at them and-and maybe trying to rationalize them a little bit, and really decide which are helping you, which are doing nothing, and which may actually be making some of your symptoms worse, I guess.
|
reflection
|
communication behavior
|
36_278
|
What would you think about trying that slightly different approach for say-say two or three months, just to see whether or not it makes any difference?
|
therapist_input
|
communication behavior
|
36_280
|
Right.
|
other
|
communication behavior
|
36_282
|
Mm-hmm.
|
other
|
communication behavior
|
36_284
|
Well, I guess if we- if we did decide to-to work together like this-
|
therapist_input
|
communication behavior
|
36_286
|
- in this new approach, I'd be seeing you regularly. We can keep an eye on your symptoms, and if they change, then we can investigate as appropriate. But if they stay the same, then, you know, we can be-
|
therapist_input
|
communication behavior
|
36_288
|
- pretty clear that there's nothing new happening that-that we're missing.
|
therapist_input
|
communication behavior
|
36_290
|
How would that sound?
|
therapist_input
|
communication behavior
|
36_292
|
I think that would be a good idea. I think we've only just begun to talk about it-
|
therapist_input
|
communication behavior
|
36_294
|
- and I think perhaps you need to have a bit of time to think about it and then perhaps come back. Perhaps if you're booked in for a double slot next week, and that would give us a good chunk of time to think about this new approach.
|
therapist_input
|
communication behavior
|
36_296
|
And perhaps if you could also bring your-your tablets in or-or make a list of them, we can look at what you're taking and perhaps go from there. How would that sound, Barbara?
|
therapist_input
|
communication behavior
|
36_298
|
Yeah.
|
other
|
communication behavior
|
36_300
|
Yes.
|
other
|
communication behavior
|
36_302
|
Yes. I think so.
|
other
|
communication behavior
|
36_304
|
I think that would be a good- a good start.
|
other
|
communication behavior
|
36_306
|
Yeah.
|
other
|
communication behavior
|
36_308
|
Okay. All right.
|
other
|
communication behavior
|
36_310
|
So, shall I see you again next week?
|
question
|
communication behavior
|
36_312
|
Okay. All right. Thank you, Barbara.
|
other
|
communication behavior
|
36_314
|
Bye-bye.
|
other
|
communication behavior
|
37_0
|
Kia ora, Ricky, welcome back.
|
other
|
communication behavior
|
37_2
|
Good. Are you okay today?
|
question
|
communication behavior
|
37_4
|
All right. So where we left last time, you were going away to think about a few things and to, um, develop some sort of plan of action. How'd it go? What were you up to?
|
question
|
communication behavior
|
37_6
|
Right.
|
other
|
communication behavior
|
37_8
|
Good to know, excellent.
|
other
|
communication behavior
|
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