Module 4 Discussing Treatment
Making Recommendations

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Module Description and Content Goals:

Given topics on depression and treatment explanation to patients; texts that are varied and of a specialized and medical nature, which include information presented from dialogues and other sources (e.g. photographs, drawings, reference text /research information), the participant will use English with 70 % accuracy to:

1.  Identify and pronounce correctly vocabulary related to depression and its treatment. (Vocabulary)

2.  Identify and use gerunds.(Grammar)

3.  Identify and use phrasal verbs and adjectives followed by prepositions. (Grammar, Speaking)

4.  Listen for main ideas and details. (Listening)

5.  Identify and use expressions to give advice. (Vocabulary, Speaking and Writing)

6.  Identify and use the modal verbs of advisability. (Grammar, Speaking, Writing)

7.  Make recommendations about lifestyle changes. (Speaking, Writing)

8.  Identify lay terms that are used for some common medical terms. (Vocabulary)

9.  Identify and describe various depression treatments. (Reading)

10.  Identify dysthymia, its signs, symptoms and treatments. (Reading)

Module 4 ANSWER KEY H4:1

WORDS AND EXPRESSIONS TO KNOW:

A. The following words will be used in the dialogue you are about to hear. Read the words and make sure you understand all of them.

antidepressants urinary retention muscle spasms drowsy side effects blurred vision treatment chronic migraines tension headaches tremors weird sacrifice

pain killers pain relievers attainable goals counselor confused fulfilling life

magic cure

B. The following expressions will be used in the dialogue you are about to hear. Read them and then do the exercise that follows. After completing Exercise D, go back to B and write the meaning of the expressions in the chart.

Expressions: / Meaning
To suffer from depression / To experience, to have depression
We could start you off with some antidepressant medication. / The first thing we could give you is antidepressant medication.
Pills that will lift you up a bit / Pills that will improve your mood
I am not really good at (See D Grammar Note 1 and 2) / able to do something well
I have a lot on my plate as it is. / I have a lot to deal with right now. I have a lot of things to think about right now
To kill two birds with one stone. / To achieve two things with one action
Your energy level will perk up. / Your energy level will perk up.
To be aware of side effects / To know side effects
To watch out for side effects / Watch for the side effects carefully so that you are ready to deal with them when they happen
It may take up to 4 weeks before the medicine will kick in. / It may take up to 4 weeks before the medicine will start working.
If things are not settling down and you are not feeling your usual self within that time… / If things are not going to calm down and you are not get to feeling like you used to feel before….
To be in a better mood / To feel happier
To give up smoking, wine (or some other bad habit) / To stop/to quit smoking
I can’t remember off the top of my head. / If you provide the information off the top of your head, you do it immediately without checking the facts.
Pick up literature on the way out. / Go get literature on the way out.
To get rid of headaches / To take action so that you don’t have headaches anymore
You will start feeling better in no time / You will start feeling better very soon.
Easier said than done. / Used to say that it would be difficult to actually do what someone has suggested
To be dependent upon drugs / To need (to rely on) drugs in order to feel good and stay healthy
A happy camper / Someone who seems to be happy with his/her situation

C.  Complete the sentences from the conversation you are about to hear using the words and
expressions above:

1. This medication does have some side effects I want you to be aware of. The pills will help you fall asleep, but they could leave you feeling drowsy and confused in the morning. You may also have blurred vision, dry mouth, muscle spasms and increased urinary retention.

2. I want you to know that it may take up to four weeks before the medicine kicks in and your symptoms start to improve.

3. I expect you to start feeling better sooner, but if things are not settling down and you’re not feeling your usual self within that time, you should call the office and schedule another appointment.

4. Unfortunately, there is no magic cure for this condition.

5. Will you be able to give your wine up at night?

6. Hopefully, once you’re in a better mood and your sleep patterns improve, you will start feeling better in all aspects of your life: your energy level will perk up, you’ll be able to concentrate better, you will be more productive and enjoy a happier, more fulfilling life again.

7. Based on what you‘re telling me and on the questionnaire I gave you, I think you’re suffering from depression.

8. I am not really good at taking pills, doctor. I am very busy and have a lot on my plate as it is. I won’t remember to take them.

9. We could start you off with some antidepressant medication, you know, pills that will lift you up a bit.

10. I think these are all the major side effects, at least the ones that I can remember off the top of my head.

11. I often take painkillers to get rid of my headaches.

12. I like the second option a lot, and in combination with the pills, you will start feeling better in no time.

13. The counselor could help you deal with your feelings in a constructive way, and hopefully very soon you won’t be dependent upon the drugs. You will be a happy camper again, the Ms. Sandler I’ve always known!

D.  GRAMMAR NOTE I: Gerunds

A gerund is the –ing form of a verb. E.g. working, being, seeing
It can be used as a noun and, thus, as a subject or an object in a sentence.

E.g. I enjoy helping people. (object of the verb enjoy ) I like working at the hospital. (object of the verb
work)
Doing medical research can be really rewarding because it can help save people’s life. (subject)
I am interested in becoming a nurse. (object of a preposition in).

GRAMMAR NOTE II: to be good at

Gerunds or nouns are used after the preposition in the expression to be good at
to be good at + Gerund (verb+ing)
to be good at + Noun

E.g. I am not good at taking pills. I am good at Math. I am very good at taking care of the sick people.
Remember that at is the only preposition that can be used in this expression.

Write three things you are good at and three things you are not good at in the following chart. Then tell your partner about your abilities.

Things I am good at / Things I am not good at
1. Answers will vary. / 1. Answers will vary.
2. / 2.
3. / 3.

GRAMMAR NOTE III: Phrasal Verbs

Such expressions as to pick up, to give up and to kick in are called phrasal verbs. Phrasal verbs are frequently used in informal, non-technical speech. Such words consist of a verb and a particle (a small word such as up, off, in, etc.) that together have a special meaning. E.g. give up something means “abandon, quit”, put up with something or somebody means “to tolerate, to accept a bad situation or person without complaining”.

Phrasal verbs can be separable and inseparable.

If a phrasal verb is inseparable, the particle has only one position in the sentence. It immediately follows the verb. E.g. I am suffering from migraines.
Watch out for the side effects when you take antidepressants.
I don’t feel good today. I think I am coming down with cold.
Separable phrasal verbs can be separated by a noun or a pronoun. If a pronoun is used, it must separate the parts of the verb (come between the verb and the particle). A noun can either follow the particle or come between the verb and the particle. E.g.

I can’t give up this habit. I can’t give it up.
I can’t give this habit up. I can’t give up it. – INCORRECT.

You are about to hear a dialogue which has a lot of phrasal verbs. Pay attention to how these structures are used. While listening to this conversation, pay attention to the phrasal verbs used in it. Write them here. The first one ha been done for you.

suffer from lift up perk up talk about kick in settle down give up pick up deal with watch out

Modules 4 ANSWER KEY H4:2
LISTENING:

A.  Listening for Main Ideas.
Dr. Howell is explaining to Ms. Sandler her condition and treatment. Listen to their conversation and answer the following questions:

1.  What two treatment options does Dr. Howell suggest?

·  Elavil, antidepressant pills

·  seeing a counselor

2.  Why doesn’t Ms. Sandler like the first option?

She is not very good at taking pills. She is very busy and is afraid she will forget to take them.

3.  Why does the physician say that by taking Elavil they will kill two birds with one stone?

The medicine will improve Ms. Sandler’s mood and will also help her fall asleep when taken at night. It should also provide some relief for her headaches.

4.  What side effects should Ms. Sandler watch out for taking Elavil?

feeling drowsy and confused in the morning, blurred vision, dry mouth, muscle spasms and urinary retention

5.  Why does Dr. Howell encourage his client to be patient?

There is not magic cure for her condition. It usually takes about 4 weeks before the medicine kicks in.

6.  Why won’t the second option be as easy as the first one?

The second option will require her to make some lifestyle changes and to alter the way she thinks, eats and reacts to stressors in her life. The physician suggests she sees a counselor to help her cope with this condition.

B. Listen to the conversation again. Some of the words are missing. During each pause, fill in the blanks with the words or phrases from the list.

fall asleep easier said than done fulfilling spasms confused increased side effects
suffer from antidepressant lift you up good at on my plate 25mg perk up
restless settling down kicks in weird optimistic productive retention
magic cure off the top of my head chronic tension pain killers give up sacrifice
in no time pain relievers stressors counselor happy camper tremors be aware of

Dr. Howell: Well, Ms. Sandler, based on what you‘re telling me and based on the questionnaire I gave you, I think you’re suffering from depression. There are a couple of options we can use here. We could start you off with some antidepressant pills, you know, pills that will lift you up a bit.

Ms. Sandler: I am not really good at taking pills, doctor. I am very busy and have a lot on my plate as it is. I won’t remember to take them.

Dr. Howell: Well, you won’t have to take too many pills throughout the day. There will be only two tablets, 25 mg each. You will take one in the morning and one at night – at breakfast and before you go to bed, so it shouldn’t be difficult. You want to get better, right? These pills may actually make you less forgetful and may help you organize your life. They will also help you fall asleep. So, in reality we’re killing two birds with one stone here.

Ms. Sandler: Twice a day is not that bad I guess. I think I can do that.

Dr. Howell: Good. Hopefully, once you’re in a better mood and your sleep patterns improve, you will start feeling better in all aspects of your life: your energy level will perk up, you’ll be able to concentrate better, you will be more productive and enjoy a happier, more fulfilling life again.

Ms. Sandler: What kind of pills are you talking about? Are there any side effects I should watch out for?

Dr. Howell: That’s an excellent question, Ms. Sandler. The medication is called Elavil. Yes, it does have some side effects that I want you to be aware of. The pills will help you fall asleep, but they could leave you feeling drowsy and confused in the morning. You may also have blurred vision, dry mouth, muscle spasms and increased urinary retention.

Ms. Sandler: Muscle spasms and urinary retention? I am not sure I know what you are talking about.

Dr. Howell: Well, muscle spasms or tremors are when you have restless muscle movements in your eyes, tongue, jaw or neck, uncontrollable shaking, you know. Urinary retention is inability to empty your bladder completely. These are the most common side effects, but it doesn’t mean you will develop all of them. I want you to call the office if you have any strange or weird symptoms.

Ms. Sandler: And how long would you like me to take this medication?

Dr. Howell: I want you to know that it may take up to 4 weeks before this medicine kicks in and your symptoms start to improve. I expect you to start feeling better sooner, but if things are not settling down and you are not feeling your usual self within that time, you should call the office and schedule another appointment.

Ms. Sandler: Four weeks is a long time. Well, I guess it took me a while to get so bad, it will take some time to get better now.

Dr. Howell: Yes, Ms. Sandler. Unfortunately, there is no magic cure for this condition. You have to be patient. I do believe you will see changes a lot sooner. Let’s be optimistic here. Another important thing I need to tell you about is alcohol. I know that you like to have a little wine before you go to bed, but I am afraid you won’t be able to do it any longer. It can cause dangerous side effects when taken together with Elavil. Will you be able to give your wine up at night?