A 49-year-old African American male who is a house painter whom you haven’t seen in
several years presents with chronic fatigue and mild chest pain frequently relieved by
taking a break from painting. He’s married to a 47-year-old woman with MS and has two
married children and one grandchild living nearby. He also complains of frequent
eructation, flatulence, and indigestion after eating. He was told when he was 30 pounds
lighter that he could control his hyperlipidemia by diet. His past medical history includes
anxiety, cholecystectomy, and vasectomy.