D: What brought you in today?

P: Yeah absolutely. I have had this awful, awful headache for the past, two days I wanna say, its horrible.

D: OK, has the headache, uhm, stayed the same, gotten worse, gotten any better?

P: It's only gotten worse over the past two days.

D: OK, and when the headache started, was it like a thunder clap, kind of worst headache of your life when it came on? 

P: No, no.

D: OK. Was there anything going on two days ago around the time of the headache, like did you hit your head or anything like that?

P: No, I just, uhm, I just went out for dinner, the night before and I know that there are certain foods that can trigger my migraines, but this really feels different. It doesn't feel like my migraine.

D: OK. Uhm, and have you had any other associated symptoms, with the headache.

P: I've been feeling really tired. I took the day off yesterday and today, I'm working from home, but I still decided not to get any work done today or yesterday. 

D: OK. Uhm, and the fatigue, when did that start?

P: I think that started yesterday morning.

D: OK. And sorry, back to the headache. Have you tried anything for it?

P: I took Tylenol and Advil, but, I guess it did get better for about an hour a little bit, but it was back on again. 

D: OK. And could you describe like where you feel the headache?

P: Sure, yeah, so it's like right in the front. Just kind of feels like a band, just like this pressure in the front of my head.

D: OK, and has there been anything that's made the headache worse, like lights or, or sounds?

P: No, no, like I said it's like nothing like my usual migraine headaches.

D: OK. And, I mean, the Advil or Tylenol, It helps the symptoms for a brief period, but has there been anything else that's helped your headache?

P: No, not really. 

D: OK. And is there any particular time of the day that the headache's worse, like, is, in the morning time when you're first waking up or later in the day?

P: I don't think so.

D: OK. And have you had any nausea or vomiting? 

P: No.

D: OK. And have you had any, like visual changes?

P: No. 

D: OK. Uhm, and have you had a runny nose or a sore throat?

P: Uhm, I've had a bit of a sore throat.

D: OK, have you, have you had a cough?

P: Yeah, but honestly the headache's been bothering me the most.

D: OK, and when did the cough start?

P: About the same time.

D: OK.

P: Maybe two days ago.

D: OK, and have you had any neck stiffness? Does it hurt if you, if you move your neck around?

P: No, nothing like that.

D: OK, uh and with the, with the cough, have you had any difficulties breathing or shortness of breath?

P: Maybe a little bit. 

D: OK, how about any wheezing?

P: No.

D: OK. Have you been bringing up any sputum with the cough? 

P: No.

D: OK, how about, any, any blood?

P: No.

D: OK. And have you had any changes to your sense of smell? 

P: No.

D: Any changes to your sense of taste?

P: No. 

D: OK. Uh, and have you had any changes to your weight recently over the last several months? 

P: I don't think so.

D: Alright, and how is your appetite been?

P: Uhm, it's fine. 

D: Any chest pain?

P: No.

D: OK. Uhm any lightheadedness or, or feeling dizzy?

P: No, no. 

D: Alright. Any nausea or vomiting?

P: No.

D: Any diarrhea? 

P: No.

D: Any urinary problems?

P: No

D: How about , uh, have you had any muscle aches or joint pains? 

P: A little bit.

D: OK. And any rashes anywhere?

P: No, no, no.

D: OK. And have you been diagnosed with any medical conditions before? 

P: Uhm, I have, uh, I have migraines and uh, I also have Polymyalgia rheumatica.

D: OK. Are you taking any medications currently, for either of those?

P: No.

D: OK. And have you had any hospitalizations?

P: No. 

D: OK, any surgeries?

P: No. 

D: OK, and, uh, do you smoke cigarettes?

P: no.

D: Drink alcohol?

P: No.

D: OK and do you use any other, use any recreational drugs?

P: No.

D: OK. And any family history of similar symptoms like, like, unusual headaches or anything like that?

P: Well, migraines kinda run in the family.

D: Migraines, OK.

P: Yeah.

D: And any heart conditions or cancers or anything like that in the family?

P: No no no. 

D: OK. And have you been around anybody who's been sick, recently? You went out for dinner a couple days ago.

P: Yeah, uhm, I don't think anyone was sick.

D: OK. And you didn't feel that you had any triggers to your migraines at that time?

P: No, I didn't. I did yes, I, I did meet up with my friends and we went out for dinner. I know we're not supposed to, but it's been such a long time. 

D: Yeah.

P: I don't think they were sick at the time, but I haven't really talked to them after.

D: OK. Have you traveled anywhere?

P: No.

D: Alright. And so I don't think I asked, did you have a fever or chills?

P: No, not really.

D: Oh OK. Uhm, so the symptoms you've been experiencing, you've had a headache that's been the most bothersome these, these last couple of days, which feels different than your migraines but you've also had a sore throat, a cough, shortness of breath as well as a little bit of muscle aches and fatigue over these last couple of days.

P: Yeah that sounds right.

D: Is there anything else?

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

D: OK, umm so, I'm going to get the attending and we'll go through a physical exam and get some investigations ordered so that we can try to figure out what's going on, ok.

P: OK, thank you.

D: You're welcome.