D: How may I help you?

P: Hi I um I just developed uh or I guess I just started having difficulties with uh breathing starting this morning. It was just very odd, I was fine yesterday night and then just this morning, I've had a really hard time breathing um and yeah, I thought I should come in and get it checked out. I don't know what's going on.

D: Yeah, certainly, and so uh like did this shortness of breath wake you uh like did you wake up, um like just like uh to kind of sit up to catch your breath, um or when did the shortness of breath start?

P: Um it was kind of after I woke up and I was sort of, um just walking around that I I noticed that I was feeling short of breath just walking around, which was so weird. You know that that doesn't really happen to me. 

D: OK. Um and with this, with the shortness of breath, have you had had a cough?

P: No.

D: OK, and um have you had any wheeze?

P: Um no. 

D: OK, and have you been having any uh any chest pain?

P: Yeah, I kind of, I guess it just hurts a little bit when I take a, when I breathe in.

D: OK is is this pain when you take a deep breath in?

P: Yeah, I guess so, yeah.  

D: And where do you feel the pain?

P: Um it's kind of on my um right side.

D: OK, does the pain uh like radiate anywhere or do you feel it just in that one spot?

P: It's just uh it's just in that one spot. It's just this sudden and like like this stabbing sensation um when I'm like taking a breath in. Uhm, actually now that I think about it, it's it's kind of there even when I'm like breathing normal, but it's not as bad. When I take a deep breath it's like really, really bad or when I um yeah, when I like cough or like I'm laughing or something, it just gets really bad.

D: And when did you first notice this pain?

P: Kind of um late this morning. 

D: OK uh have you tried anything for a for the pain?

P: Uh I don't know, it's just I just try not to take deep breaths, I'm just trying to just take a normal breath and try not to talk too much. And yeah, just like not doing anything that worsens the pain. 

D: OK, I see and um did you have any trauma to that to that area recently like a car accident or I don't know, getting hit in the ribs, or anything like that? 

P: No, no I didn't.

D: OK. Um and have you had any episodes where um or actually rather like, do you have any issues with lying flat and having shortness of breath?

P: No.

D: OK, and um have you had any headaches?

P: Uhm, no. 

D: Have you had any uh fevers or chills?

P: No. I don't think so.

D: OK, and have you had any night sweats?

P: No.

D: Have you had any changes to your weight recently? I mean, like over the last several months. 

P: Uh no.

D: OK, and um have you had any nausea or vomiting?

P: No. 

D: How about any changes to your sense of uh taste or your sense of smell?

P: No, those are OK. 

D: Alright, and have you had uh a runny nose or a sore throat?

P: No. 

D: Alright. Um and have you had any diarrhea?

P: No.

D: How about any urinary problems?

P: No. 

D: And have you noticed any skin changes or rashes? 

P: No. 

D: OK. Um and how about any uh muscle aches or body pains?

P: Um yeah, I kind of have uh, it's just my left leg hurts a little bit. I'm not quite sure why. But yeah, nothing else.

D: OK, whereabouts, uh where does it hurt um on your left leg?

P: Um kind of in the calf area. 

D: OK is it is it swollen or have you noticed any redness of the skin there?

P: Yeah it is. It is swollen actually, compared to my right leg. It's a little bit warm too.

D: OK, um have you had any uh like periods of time where you were bedridden over the last several days or or last several weeks?

P: No.

D: OK, any surgeries recently?

P: No.

D: Alright, and have you traveled anywhere over any long distances recently?

P: Oh yeah, yeah, I came back um two days ago. Um I went to um I went to India to visit my family, there was a death so had to to go. I came back yeah, two days ago.

D: OK, yeah, that's quite a long flight and I'm sorry to hear about um the loss of the family. Um OK, um oh and that reminds me, have you coughed up uh any blood at all? 

P: Uh no. 

D: OK. Um and um I just wanted to switch gears a little bit and ask about your past health. Have you been diagnosed with any medical conditions? 

P: Uhm I I've had um anxiety. And uh yeah, that's that's about it. I had asthma as a child, but nothing since then. 

D: I see, and do you uh take any medications for anxiety or have you?

P: Uh no, I'm just trying to um, just trying to reduce my stress and and trying other other ways to sort of handle my anxiety before I, I'm just trying to avoid builds actually.

D: I see, OK. So do you take any medications like either prescribed or over the counter?

P: Uh no.

D: Do you have any allergies to um to medications or or environmental?

P: No.

D: Alright, and um have you had any surgeries in the past or any hospitalizations?

P: Uh I had my appendix removed when I was uh 30 years old.

D: OK, um and any complications with that?

P: No.

D: Alright, and currently uh whereabouts are you living and uh who are you living with?

P: Um I'm just living with my sister. And uh yeah, we we live in an apartment together. 

D: OK, and has she been sick or have you been any, around anybody who's been sick? 

P: No.

D: OK, um and uh any potential exposures to uh TB, uh either in your on your travels or or anybody that you that you know of?

P: I don't think so, no.

D: OK. Um and do you smoke cigarettes? 

P: No.

D: And do you drink alcohol?

P: No.

D: Uh how about the use of any uh recreational drugs? 

P: No.

D: OK, um and in the family is there a history of any bleeding disorders or any uh clotting disorders? 

P: Uhm no, I don't think so.

D: OK, um and any heart conditions, lung conditions?

P: Um just a heart attack. Uhm both my grandparents on my dad's side uh had a heart attack and uh diabetes as well. Um I think both my parents have diabetes.

D: OK. Have you been tested for uh diabetes as well?

P: Uh yeah, yeah yeah I go to see my family doctor and my uh, he said my sugars were good.

D: OK, great. Um alright, so um you've been experiencing uh so this this chest pain when you breathe in deeply since this morning um as well as some more difficulty breathing, and some left pain uh left leg pain with with some swelling. Uh have you been, after travels as well, have you had any other symptoms?

P: No. I don't think so.

D: OK, so that was all I wanted to ask today on on history and before I went on to uh the physical exam, we want to check uh vital signs and have a listen to your heart and lungs and um measure the diameter of your of your shins as well. Um but um it'll be important to get uh some imaging of your of your lungs um to assess whether or not there's a pulmonary embolism um uh because that would be one of the more um life threatening, or potentially um complicating uh causes of what's going on right now.

P: Sure.