D: What brings you in?

P: Hi Faiha, I've been very concerned lately. This past week I, first just started having this really bad headache and then my body, just completely all started hurting after completely rest, and then three days ago I just started having a lot of chills and I had a pretty high fever, just two days ago of almost like I think it was like 38 or 39, yeah, I was just very concerned and I came here today.

D: Yeah, it's good that you came in. Lets rewind a little bit and get a full history. So you said the, what started first, the fever or the headache?

P: So, the headache started first, so that was around four days ago.

D: OK 

P: And three days ago, like my body just started aching all over the place and then just two days ago I noticed that I had a fever and I've been getting a fever since then, as well, like even today, I was having chills.

D: OK, OK, and you said your highest recorded temperature was 39?

P: Like 38 to 39.

D: OK, so headache started four days ago. Is it persistent or constant or does it come and go?

P: It was pretty constant, the headache kind of got better yesterday but last few days it's just been constant headache Pretty much every day. 

D: OK, OK. Does anything make it better or worse?

P: Just some rest and, uh, I tried to take some Tylenol to get rid of it, took some Advil as well. It did help a little bit, but it just kind of came back after the medication wore out.

D: How long does the headache last when you get it?

P: If I don't take medications, it can last honestly, the whole day. 

D: OK, yeah, um, and if you were to describe it, is it sharp, dull, achy?

P: It's just achy and it's kind of all over the front of my forehead. 

D: OK.

P: Sometimes it's just like a throbbing pain.

D: OK, and, alright, and you said it's mostly at the front of your head. How about near the Crown of your head, temples?

P: It can go to the temples sometimes, but mostly it's my forehead.

D: OK, OK, and severity-wise 1 to 10, 10 being the worst headache you've ever, worst pain you've ever felt. How bad is it?

P: Right now it's not that bad, probably like a two or three, but when it was, just a few days ago, it was like probably an 8 or 9.

D: Yeah, and then have you ever experienced something like this before?

P: No, I'm not usually one to get headaches. My wife, she gets migraines, but like I rarely ever have headaches.

D: Yeah, OK, and then you mentioned the headache is getting a little bit better now?

P: Yeah, the headache has improved a bit, the body aches are still there and the fever is still there but like the headaches I feel have gone down.

D: OK, alright. Have you had any fainting spells or dizziness?

P: No, nothing like that. 

D: Any confusion or memory loss?

P: No. 

D: Any neck pain?

P: Uhm, not neck pain but like just below my neck, like my back, upper back hurts as well. 

D: OK, and, any weight loss recently?

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

D: Any excessive fatigue?

P: Yeah, I have been feeling pretty tired and just, uh, I haven't even gone to work this whole week, just kind of laying in bed honestly with all the pain and the fever and headaches, just yeah, it's exhausting.

D: OK, any changes in your hair, nails or skin, like rashes?

P: No, nothing that I've noticed.

D: How about changes in your vision or hearing?

P: No. 

D: No OK, how about a stuffy nose or runny nose? 

P: Uh, I do feel a bit more stuffy like today, but there's no like runny nose or anything like that, but I do feel a bit more pressure and stuffiness in my face today. 

D: OK, OK, how about changes in smell or taste?

P: Yeah, I think, just last night dinner, it was just kind of a funky like, different taste. I couldn't really tell, uh, everything was kind of a bit bland. Yeah, I think my taste buds are acting all weird too.

D: OK, um, any coughing or shortness of breath?

P: Uh, no, no, I haven't been coughing or no shortness of breath at all. 

D: OK and how about wheezing?

P: No, no wheezing?

D: OK, any chest pain?

P: No.

D: How about feeling like your heart's racing?

P: No, nothing like that. 

D: No, OK. Any swelling that you've noticed in your limbs? 

P: No.

D: No, ok. Any issues with your bowel movements or urine?

P: No, nothing. 

D: OK, how about nausea or vomiting? 

P: uh no, no nausea or vomiting.

D: OK, and those were all the questions I had about your symptoms. Are you otherwise healthy or do you have any longstanding medical conditions?

P: Yeah, I have a couple conditions that I see my family doctor for. I do have diabetes, then I have high cholesterol. I also have this thing called fatty liver but that's that's about it, and a high blood pressure.

D: OK, when were you diagnosed with all of these things?

P: Yeah, probably like, it all kind of went down in my 40s. I did gain a lot of weight at some point during my 40s and that's when all these things started happening.

D: OK, so you said diabetes, high blood pressure, fatty liver, and sorry, what was the other one?

P: High cholesterol. 

D: High cholesterol, OK, are you on medications for all of these things? 

P: Yeah so I am on a statin medication for the cholesterol, then I'm on metformin, and then I'm on a blood pressure medication as well. I can't recall the name. Uh, so yeah, those are the medications that I'm on.

D: OK. And do you take your medications regularly as prescribed?

P: Yeah, I don't miss any doses.

D: OK, good. And, are you up to date with all your immunizations?

P: Yeah, I think so.

D: OK, good. Do you have any allergies?

P: No, no allergies.

D: How about family history of lung conditions or heart conditions?

P: Yes, I have a pretty significant family history for heart conditions. My father passed away from a heart attack in his 50s. My mom has high blood pressure. Diabetes is also pretty big in my family as well.

D: OK, well I'm sorry to hear that. Any cancers in the family?

P: No, no cancers.

D: OK, do you smoke?

P: I used to when I was in my 30s. I quit a pretty long time ago. 

D: OK, how much did you smoke before that?

P: I probably smoked up until I was 35, so for probably like 10 years from 25 to 35 and probably smoked a pack a day at that time. 

D: OK, yeah, and do you drink alcohol?

P: I've been told like, not to for my liver, but I sometimes maybe have the rare red wine maybe once a month.

D: Once a month, OK, any other recreational drugs?

P: No, no recreational drugs.

D: OK, no recreational drugs, and where do you live right now?

P: I just live with my wife in an apartment in the city, and yeah.

D: OK, any old carpet, dust, mold, anything that is concerning from that standpoint? 

P: Nope. 

D: No, and have you been in contact with anyone who's been sick recently?

P: Not that I know of.

D: Do you still go to work?

P: I just have like a desk job. I have my own room. It's not like, I don't see too many people and like, when I do I'm wearing a mask so I don't think so. 

D: OK.

P: I have stopped going to work though like, just in case.

D: OK, good and have you traveled to anywhere recently?

P: No, we've been pretty homebound.

D: Pretty homebound, OK, alright, well that's good and those are all the questions that I had for you. Did you have any questions for myself?

P: Yeah, I don't know, what do you think is causing all of this?

D: Yeah, it sounds like you have some sort of infection, so the first thing we need to rule out is covid, of course. So we'll do a swab and those swabs should come back to you in about 24 to 48 hours and until then, it's important that you do isolate and you isolate for 14 days at least, and that includes from other people at home. And if those swabs come back negative, you could possibly have like, another infection. But if your symptoms worsen, like you start getting neurological deficits like weakness or seizures or anything like that, you should come back to the ER and we'll get that checked out. And, so that's where we'll start for now, because your presentation is acute, we think it's likely infection related.

P: OK, that sounds good to me and should I be staying in my own room or anything like that at home?

D: Yeah, if you can like, it's recommended that you try to isolate in your own room for the next 14 days because your symptoms do overlap with that of covid, yeah.

P: OK, sounds good.Thank you.

D: Yeah, no worries, take care.

P: Thank you.