“Help Me Doc ….. I’m tired all the time”

Its Friday 4:30, the end of the day, you skipped lunch to cut off a BCC, spent the first hour of the day organising retrieval of a patient you admitted late yesterday with chest pain who had a troponin leak overnight.

And you’ve almost caught with your schedule having benefiting from a couple of “just script” patients. The 35 year old farmhand booked a 15 minute appointment and you’ve never met him before.  In fact, a quick glance of his history shows he was last seen 10 years ago to have a laceration repaired. In all certainty his wife sent him in because she was tired of his complaining or falling asleep on the couch after dinner in front of the TV.

How do you start?

1. Take a big breath, listen briefly, ask a few questions then order a dozen blood…