D: So what uh, brings you here today?

P: I am here with uh, with my daughter, who has just been having a cough for the past um, two weeks. 

D: Okay, um, and can you describe the cough a little bit? Is it a dry cough or is she bringing anything up? 

P: Um, it is a, it is a dry cough, um, but she just keeps coughing and coughing and, and then she just, you know, once she'll start coughing she just doesn't stop. And then um, there's been times when she just turns blue, she's coughing so much. Um, and then it just gets, gets better um, on its own. But yeah, it's a dry cough.

D: Okay, and um, what does the cough sound like? Is it like a harsh cough, a barky cough?

P: Um, it's just, she just makes this noise when she's like breathe, trying to take a breath in. It's, it's yeah.

D: Okay, is it kind of a wheeze?

P: Yeah, sure.

D: Okay. Um, and so there's episodes where she also turns blue? 

P: When she's coughing a lot, yeah, she does.

D: Okay. 

P: She's also vomited once or twice. 

D: Oh, I see, okay. Um, any blood in the vomit? Or is she coughing up any blood?

P: No.

D: No, okay. Um, any, so this started two weeks ago, any kind of symptoms of runny nose or um, cold-like symptoms before then? 

P: Yeah, yeah she did have a bit of a runny nose. It was just uh, watery, uh, since discharge. And at that time her cough, she had a cough as well. Um, but I thought it was, you know, it's nothing. It was just like another flu and it would get better, but then she just, the runny nose got better without, in a couple of days, but the cough stayed. And it got, got pretty worse, uh, it got worse. 

D: Okay, um, other than the cough uh, any, any fevers or chills?

P: No, I don't think she's had fevers. I haven't checked, though.

D: Okay. And the cough is pretty constant, or is it, does it come and go?

P: Yeah, she just has these episodes where she just coughs and coughs and coughs, and then she'll either vomit or just turn blue, or just um, get better in a couple, couple minutes. This kind of comes and goes like that.

D: Okay. And is there anything that has helped her at all? Like any over the counter medications or anything like that?

P: I haven't tried anything, I'm just worried about, you know she's my first child and I don't know what to give her and what not to give her at this age. So I just decided to come in and not try anything over the counter. 

D: Okay. Um, and so, has this happened before at all?

P: No.

D:  No, this is the first time, okay. Um, any so, she, she is vomiting. Um, is the vomit like green in colour? Or is she just vomiting up what she has eaten? What's the content of the moment?

P: It's usually just what she's eaten.

D: Okay, um, any sick contacts recently or any travel?

P: No, I don't think so. Not, nothing really.

D: Um, and how about her behaviour? Does she seem like uh, very tired or fatigued, or more irritable?

P: She does get tired, especially after, and then she's irritable and crying after, you know, she has these fits of coughs.

D: Okay.

P: Yeah. 

D: Okay. Um, any symptoms of diarrhea or constipation?

P: No.

D: Okay. Any um, any trouble with urinating at all?

P: No.

D: No. How's her sleeping like?

P: Uh, not great. It's just the cough keeps uh, waking her up and she just doesn't, can't fall asleep. 

D: Okay, any uh, exposure to dust or fumes, or animals or pets at home?

P: We, we did get a cat um, about a month ago. 

D: Okay. Um, and any, has she been diagnosed with any medical conditions in the past?

P: No.

D: Um, and any allergies that you know of?

P: Um, no.

D: And um, any previous hospitalizations or surgeries? 

P: No.

D: And how was your pregnancy, your pregnancy with her, like any complications at all?

P: No, no complications. It was uh, it was very, yeah, it went well.

D: And was she at term or premature?

P: She was at term, she was born at term.

D: Was it a vaginal delivery or uh, a c-section?

P: Uh, vaginal.

D: And did she have to stay in the NICU at all, at the hospital afterwards?

P: No.

D: Okay. And is she feeding well, like what does she usually eat?

P: She's feeding well. She's doing uh, she eats everything, yeah.

D: Um, and any family history of any medical conditions?

P: No.

D: Um, and does anyone smoke in the house?

P: Um, her dad, but he, he doesn't smoke in front of her.

D: And what's her living situation like? Who does she live with? And do you live in a house, apartment?

P: Oh yeah, we live in an apartment. It's uh, me, my partner, her and the cat.

D: Okay. And any difficulties or complications with her growth? Like in terms of her weight or her height?

P: No, no complications. She's doing okay.

D: Okay. And in terms of her milestones, has she been meeting all of them on time?

P: Yes.

D: Okay. Alright, so I think those are all the questions I have for you today. Do you have any questions or concerns? 

P: Uh, no.

D: Yeah, so based on the symptoms, oh yeah, sorry I forgot to ask one other question. Has she, are her immunizations all up to date?

P: Oh no, no. I don't, I don't get those. My friend's, my friend's daughter developed autism and I'm just, I don't want that, you know, so no. I don't vaccinate my kids. Or I don't vaccinate my daughter and I haven't been. Yeah, uh no, I won't be doing that.

D: And have you been vaccinated throughout your life?

P: Um, maybe when I was young, but I, yeah I don't, I just don't believe in vaccinations. I, yeah, no, I don't, I don't get those.

D: Yeah, so there is definitely uh, there's a lot of research done beside, behind vaccinations and a lot of prevention goes into them, but definitely there is some anecdotal evidence of very loose associations to autism that have been found to be invalid and like they have been invalidated by the research. So definitely, it's very important to get your child vaccinated. In fact, the sum of the symptoms that your child may be having right now can be caused by something called pertussis, and um, there's usually a vaccination for that. Like after pregnancy as well, so that's something that is definitely on the differential, and at this time we definitely need to make sure she's okay and get her vitals done, see her oxygenation saturation, and just do supportive care while she's in the hospital, and we may need to admit her, but we'll do the full physical examination today, get a COVID swab done as well. And usually it, she's currently in the, it seems to be the second phase, where she's vomiting and coughing a lot, and then it usually, after that phase, two or three more weeks of just coughing. And so, we're going to do some supportive care for her right now, but yeah, definitely, you should consider vaccinating your child. We recommend that to every parent as there's a lot of diseases out there that can be completely prevented if you vaccinate your child.

P: Okay, I'll think about it.

D: Alright, so, so for now we're gonna just make sure that she's doing well, okay?

P: Sure.

D: Alright, take care.