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Focus: Mental Health, the Limbic and Immune Systems

Patient Update

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Four weeks ago, Stevie-Rose Davis, 72 years old, was in a motor vehicle accident with her husband, Zane, and her grandson, Clay. She did not incur any serious injuries during the accident, and after an overnight stay in the hospital for observation, she was quickly discharged home. Since that time, she has been taking an antidepressant to help keep her calm and to help her to sleep at night (see Chapter 12). Stevie-Rose has a number of chronic medical conditions as well. She lives with arthritis, diabetes, and thyroid challenges, which affect her everyday quality of life. While she was in the hospital, some evidence surfaced to suggest that she also suffers from post-traumatic stress disorder. However, she denies this possibility. Adding to her stress level, her husband of more than 40 years has recently been diagnosed with asbestosis and he may also be facing criminal or traffic charges arising from the motor vehicle accident.

Stevie-Rose Davis is at Sumac Veterans Medical Center (Sumac Center) today. She has asked for an appointment with a nurse practitioner in the ambulatory care clinic there—the A.L. Murphy Clinic—to discuss some of her ongoing health concerns and to get a physical exam.

 

Stevie-Rose Davis arrived precisely on time at the Sumac Center for her 10 a.m. appointment. She skirted by the medical center's main doors and headed to the southeast door and the entrance to the "Audie Murphy Clinic," as she liked to call it. She checked in with the busy MOA at the reception desk and took a seat in the waiting room. After a short time, a tall, middle-aged woman who was professionally dressed in street clothes under an open lab coat appeared at the entrance to a nearby hallway. She called Stevie-Rose's name, and Stevie-Rose followed the woman to her office.

"Good morning," said the woman, as the two of them sat down in a small, windowless office full of books and health promotion posters. She looked up then and said, "I'm Ophelia Lambert, a nurse practitioner here at Murphy Clinic. I do the intake interviews and physical examinations." She smiled warmly. "And you're Stevie-Rose Davis?" The client smiled. The nurse opened Stevie-Rose's medical record on the computer at hand. "Yes, here you are. Good. And I see that you are a retired army lieutenant? And a nurse?" Ophelia looked back at Stevie-Rose inquisitively, and Stevie-Rose confirmed this information. The women talked very briefly about Stevie-Rose's years in the service. Then, to break the ice, the nurse said, "And how can I help you today?"

"I'm not really sure," answered Stevie-Rose. "I'm feeling run down. I've got no energy to speak of, I seem to have lost my sense of humor, and … well … I don't know. I just seem to be dragging myself through each day. I'd like to get some blood work done to check my thyroid and diabetes, ...

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