Tom decided to seek help to lose weight and to discuss his fatigue and stress and planned to visit the GP.

Enigma 1

Tom decided to seek help to lose weight and to discuss his fatigue and stress and planned to visit the GP. He delays this as he is nervous about what will said. Lan, his wife, booked an appointment for Tom with the practice nurse. Lan is increasingly concerned about Tom’s weight gain and the stress he is under. 

Tom, reluctantly, visited the practice nurse for a check – up and a discussion regarding his main concerns: his increasing weight, fatigue and stress. Lan did not go with him.

Of note from the consultation are the following areas:

Tom has a BMI 35 – height 5ft 11inches, weight 18 stone

He looks exhausted – he stated he that hates his job, feels stressed all the time. Eats as bored.  Never exercises. Feels tired but not sleeping. His wife tells him he snores.

Tom discloses that he is worried about his son as he is not studying and goes out all the time. Henry recently had a seizure, no diagnosis re this at present as medical team are still investigating the cause, Tom is worried that he has epilepsy like he did at that age.

Blood sugar is 18mmol

Vital signs reveal:

Oxygen saturation- 97% on rom air

Pulse – regular 96bpm

B/P – 142/87mmHg

Temp 36.3 tympanic

Resp rate – 16bpm

The practice nurse would like the GP to see Tom

Prepare an evidenced based handover to the GP

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