Answer 30

 

Answer emailed by Dr. Amira Hussien:
"..Reduction of weight is the solution. Sleep disorder and fatty liver are sequelae of obesity..."

-Thanks Dr. Amira,

 

Answer From Dr. Ali Abu Taleb:

"...must decrease his body weight because obesity may be cause of snoring and hepatomegaly .."

-Thanks Dr. Ali

 

 

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The answer:

First you can revise the situation in: Situation 2

This is a case of morbid obesity complication causing snoring and sleep apnea.

 

So to deal with the patient is to clarify the condition to him, so that he may take a positive action towards his treatment. Also to associate the hyperbilirubinemia to the same cause which is obesity re-enforcing positivity and to clarify that he will benefit a little from the surgery he was recommended to do.

So treatment involves: weight reduction, stoppage of smoking and psychological support.

 

N.B. He must know to be lucky to be saved from un-necessary surgeries.