Week 8 _ Assignment: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders
Training Title 151
Name: Katarina Bykov
Age:41 years old
T- 97.4 P- 74 R 120 100/70 Ht 5’8 Wt 117lbs
Background: Moved to Washington State from Russia with her parents when she was 12 years
old. She has 2 brothers, 2 sisters. Denied family mental health or substance use issues. No
history of inpatient detox or rehab denied self-harm hx; Menses regular. Has chronic pain
issues. She works part time cashier at Aldi Grocery Store. Dropped out of high school in 11th
grade. Sleeps 4–9 hours on average, appetite good.
Symptom Media. (Producer). (2018). Training title 151 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-151
TRANSCRIPT OF VIDEO FILE # 151
>> I see in your chart that you asked your family physician to prescribe oxycodone for your elbow pain,
and that your family physician is worried that some of other medications, drugs you may use may interact with the oxycodone?
>> Oxycodone is that’s the same as OxyContin?
>> Yeah. Oxycodone is the generic name.
>> Yeah, I did ask for OxyContin, but I don’t take any other medications or drugs.
I’m opposed to putting anything unhealthy in my body.
>> Okay. What else have you tried?
>> Nothing else works.
>> Ibuprofen, acetaminophen?
>> Not even close.
>> Yeah. I mean,
I’m allergic to codeine.
>> Yeah, like in Tylenol three.
A little while back, my friend was in a motorcycle accident and had some leftover, and I tried one of those, and I was way allergic.
>> What was the allergic response you had?
>> My face flushed like real bad, besides it didn’t work.
>> Have you tried morphine?
>> Well, that’s addictive, isn’t it?
>> Yeah, well all the pain medications or most of them are addictive.
Anti-inflammatory medications are not usually addictive.
>> Yeah, I tried morphine and the codeine, didn’t work.
>> Yeah, I get headaches too, so ideally I need something that works for both.
I’d rather not take two medications if I don’t have to.
Less medications the better, that’s what grandma always said.
>> Grandma? Okay.
>> Have you ever tried Dilaudid?
>> Yeah. They gave that to me in the ER once, but just made me dizzy and constipated.
Constipated for like a month.
>> Oh, wow.
>> I almost had to go back to the hospital for constipation.
Can you imagine having to go to the hospital for constipation?
>> Oh my goodness.
>> Yeah, that’s how bad it was.
>> Have you tried Demerol?
>> Yeah, it kind of worked for my headache.
It comes in a shot, right?
>> Yeah. An injection.
>> Yeah, they gave that to me at the hospital.
But that’s the thing, you can only get it at the hospital, so it’s not like it’s going to work for me everyday. It didn’t do anything for my elbow.
OxyContin it’s the only thing that works for both. The only thing that works for both.
>> You do seem set on the oxycodone?
>> Because it works.
>> What else have you tried other than medications?
>> Other than medications?
>> Yeah. Tried that. Other kinds of meditation. I mean, that’s the thing with meditation is, it works while you’re doing it, but then as soon as you stop, zilch. Biofeedback.
>> One doc tried that, same thing. Works while you’re doing it, but then when you stop doesn’t help at all. What else?
Like warm, hot compresses, candles, long walks on the beach, massages.
>> My boyfriend is really good at massages actually. He’s studied with this guru in India.
>> Oh, wow. Yeah, swear to God
>> You have tried a lot of solutions.
Let me ask you more about your medication history.
> I only take stuff for my headache and my elbow.
>> Like I said, I don’t like putting unhealthy things in my body.
Vitamins, I take vitamins.
>> Yeah? Okay.
>> Like fish oils, some supplements, but nothing corporate, nothing pharmaceutical.
I don’t want to put that in me. Even coming here today, asking for this, it goes against my values.
>> I see. Okay.
>> But I got to function.
>> Do you drink alcohol?
>> On special occasions like weddings, funerals, birthdays.
I got a ton of friends, so whenever we have a birthday we’re going to drink.
Let me think, like holidays, New Years, and Christmases.
There’s Christmas and then we also celebrate Russian Orthodox Christmas on January 7th.
>> How often on the average?
>> When you add it all up, once, maybe twice a week, I guess.
>> Will you drink enough to get intoxicated?
>> Depends on who I’m drinking with. As Zane, that’s my boyfriend, he drinks a lot, so
I drink a little more when I’m with him.
>> Any legal problems from the drinking?
>> Once. So dumb.
Yeah, just one little charge for drinking. I was the tiniest little bit over the limit.
So yeah, I got that and I had to take that course, that stupid, boring course.
But I learned my lesson. If you’re a little bit over the limit, stick to the back roads.
>> So you will still drive?
>> Well, yeah, but I’m super careful.
>> You think after you’ve been drinking, that’s an okay idea to drive?
>> It’s better than letting Zano drive.
>> Zane, Zano, same person. Yeah. He doesn’t even have his license anymore.
Not that it stops him.
>> What about marijuana?
>> Do I use it?
>> Marijuana medically helps with my headaches, so yeah, I use it.
It’s my right. Yeah, it’s your right. It’s everybody’s right.
>> How often?
>> Not often. Two, four times a week, sometimes none.
It’s expensive. Then when you do get some, suddenly everybody is your best friend and you
got to share, you know how it is.
>> Do you ever grow marijuana?
>> I used to. But then we moved and it’s not legal in this backward state.
Where we live it’s pretty public, its not really private.
>> Do you ever have any side effects from using marijuana like memory problems?
>> I was born with memory problems, Doc, I don’t think it’s from the marijuana.
>> Any legal trouble with the marijuana?
>> Once. I mean, I’m super careful. But Zano, he went away for a year for selling
the tiniest little bit to an undercover cop, which is total entrapment, which is how I lost custody of Camper.
>> My son.
>> Yeah. He’s staying with my ex husband’s parents right now. They take good care of him.
>> How long have you been divorced?
>> Oh no, I never married that guy.
>> No way I would marry that jerk.
No, I don’t know. It’s been like four years since I’ve even seen him. Something like that, four years.
>> What happened?
>> Lucas, my ex, he freaked out because he caught me doing just a few lines of coke,
but everybody was doing it back then.
Anyway, his mom found the mirror, and the razors, and Lucas said I had to quit.
For whatever I lied, and when he caught me, I know it was bad to lie about that, but I don’t know it’s in the past.
Water under the bridge. You live, you learn, you move on.
>> Right. Do you use cocaine now?
>> No, hardly ever. I don’t know, it’s been like a month maybe, or two months or something since I have.
>> Any legal problems from using cocaine?
>> No, we hardly ever do it.
>> Have you thought about stopping altogether?
>> I hardly ever do it. Hardly even counts. I don’t know, when I do it, It’s just to relieve tension or it’s this thing Zano and I do to bring each other closer together, but I could quit anytime I wanted, easy.
>> Does your boyfriend have children?
>> Yeah, he’s got two kids. Yeah, but we don’t see them much. His other with his ex.
>> She’s a real snobby type. You know the type? It is a freaking tragedy because I see his two kids just going down that same path.
They’re just two little snobs. It’s a real shame. We’re not allowed to see them anymore though,
so I guess like what’s the difference?
She went to court and said we were unsuitable. Not suitable.
Says it all real nice in court, and then not so nice over the phone,
if you know what I mean? She’s a real bitch.
>> Any other drugs?
>> This is going to make me sound like I’m some 1970s hippy, druggo person.
I’ve tried ecstasy twice, just twice, and LSD once, last year.
That was a bad trip. I am not doing that again.
>> Anything else?
>> Like what?
>> Like power drinks if I need to stay up?
> Caffeine, I drink a lot of coffee.
I don’t know if cigarettes, do they count as stimulants?
>> Yeah, I’m trying to cut back. Two packs a day.
>> Ritalin, Dexedrine?
>> Oh, stimulants?
>> Oh, yeah. Not a lot. Like hardly ever.
I mean, if Zano and I are down for whatever reason, or sluggish from smoking pot, or just like if I need to get back up again.
Yeah, Adderall, just 20 helps.
>> Do you ever take prescription medications
that are not prescribed for you?
>> Well, are you kidding me?
Why would I do that? I told you I don’t like medications in the first place.
>> Klonopin, Ativan, Xanax?
>> Yeah. Yeah, if my anxiety is acting up,
if my meditation isn’t working? Yeah, a couple Xana bars, but not a lot.
>> How often would you estimate that is?
>> I don’t know. Two? I don’t know.
I need like a freaking calendar to keep up with
all your questions, Doc, God.
>> So in the past,
who prescribed the oxycodone for you?
>> No one yet. Zano he takes them because he’s got shoulder and back problems, and I tried one and it really works.
To be honest it works fantastic.
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