Station 83
Thomas Reid
Age: 39 years old male
Patient
Patient's Story (Role player’s brief)
Patient’s Story
You are here today to discuss restarting your methotrexate medication for rheumatoid arthritis (RA), which was stopped a few months ago.
You’ve noticed increasing pain, stiffness, and swelling in your hands over the past 5 days, which is now affecting your work and daily routine. You’re especially struggling to type and manage documents, which is frustrating as your work as a criminal lawyer is very demanding.
Four months ago, you were due for routine blood monitoring for your methotrexate, but you missed the appointment because of a very busy period at work — you had several complex cases and court appearances, and things got overwhelming. You received a letter from the GP saying the methotrexate would be stopped if the bloods weren’t done, but you didn’t find the time to follow it up.
Your symptoms have gradually worsened, and you now want to restart the methotrexate as it previously kept your RA well controlled. You’ve been taking paracetamol regularly and only started using ibuprofen yesterday. You haven’t contacted your rheumatology team yet.
Social history: Non-smoker, you do not drink alcohol, you live with your wife and 2 kids. You work as a criminal lawyer and your symptoms are impacting your work
Ideas: You think your Rheumatoid arthritis is flaring up because methotrexate was stopped and you now want to restart it as soon as possible.
Concerns: You’re worried your symptoms will keep getting worse and impact your ability to work effectively.
Expectations: You’d like the GP to restart your methotrexate prescription today so your symptoms can be brought back under control.
Say NO to any other questions asked outside of the details already provided in the scenario.