Q. A 51-year-old man comes to your clinic with abdominal pain and palpitations. The abdominal pain started last night and is clicky. He has no vomiting or diarrhea, but he has long-term constipation. He has been a construction worker for more than 15 years. He noticed fatigue, decreased concentration, and palpitation about four months ago. In recent weeks, he had shortness of breath during manual work. His medical and family histories are not remarkable.
The patient's BMI is 28 kg/m2, and his vital signs are stable. The conjunctiva and nail beds are pale. The abdomen is mildly tender, with no organomegaly or mass.
The significant findings in lab tests include hematocrit 31%, hemoglobin 10.2 g/dL, mean corpuscular hemoglobin (MCH) 25.1 pg/cell, mean corpuscular volume (MCV) 79 µm3, serum iron 69 µg/dL, ferritin 22 ng/mL, transferrin 295 mg/mL, and the basophilic stippling on the peripheral blood smear. The blood lead level is 87 µg/dL (the normal level for blood lead level is <5 µg/dL).
What is the best plan for him?