D: What brings you all in today?

P: Essentially, when he, so today is Friday, when he got home from school on Wednesday, he seemed fine, but he, I don't know that night he started to have a bit of like a cough. It just seemed like a little dry cough, but obviously I just wanted to keep him home, keep him safe and not like spread anything if he was sick, so he stayed at home on Thursday and he was like having a bit of a cough. Um and then, yesterday it seemed to get a little bit worse and he was really tired, or sorry it's today, today is Friday, um, he was like his cough is like getting a bit worse and I've been taking his temp the whole time and it got like a little high today. What was it? My thermometer says it was high. I'm just like trying to remember. It was it was, it was like over 100 though. 

D: Oh OK.

P: 101 or something or maybe 100.1. But anyways, it was, so I I just thought I should probably bring him in 'cause I was really worried about him and you know thought he could have maybe got COVID and get school or something.

D: Yeah for sure. Um, OK, so just to clarify, he's had this cough and fever for the past five 5 days. 

P: Mhmm.

D: OK. OK, so let's focus on the cough. 

P: Sorry, it's been more like 3 three days like Wednesday is when he came home and then, and then today's Friday, so yeah, sorry. 

D: Today is Friday, OK. Um, OK, yeah sure. So, is this cough a productive cough, or is it kind of a dry cough?

P: Ah I think it's dry. I haven't noticed him like spitting up anything. Umm, yeah, he yeah, it's just been like little coughs.

D: OK, and he, is he, he's not bringing up any sputum or blood?

P: No.

D: No OK good. OK, and does he sound wheezy at all to you?

P: No, no, not that I've noticed.

D: OK, how about short of breath?

P: Um, I don't think so like he, usually he's a really active kid and he has, he hasn't been running a lot outside in the past couple days, so maybe he maybe he could have been having a harder time breathing but also I think he's just been tired in general.

D: OK, yeah. OK, and is his coughing getting worse with certain times of the day? Like is it worse at night in the morning?

P: I think it kinda just there the whole day. 

D: OK um. And does it, how does it sound? Does this sound like a barky cough? Does it sound? Um, like harsh, what is, what would you say the quality of it, of the sound of the cough is?

P: Uh, I just sounds kind of dry. It's not like super loud. 

D: OK. OK, and has he ever experienced anything like this in the past?

P: I don't like he's had colds before, but I haven't like, I haven't like you, this time he kind of had the fever, which is different than you know, having a regular cold. 

D: OK. And are his symptoms getting worse?

P: I think so. Because yeah, he first day he just seemed like little dry and then yesterday is coughing and today he actually has a fever.

D: OK, and um, is he complaining of anything like chest pain? Or feeling like his heart's racing?

P: No, I don't think so. 

D: No OK. Does he have a sore throat?

P: I don't think so.

D: OK, and is he having any issues swallowing food or fluids?

P: I don't know if he's having trouble swallowing, but he doesn't seem to have a big appetite right now.

D: OK, um, and is he, does he have a blocked nose or runny nose?

P: Maybe a bit of like a runny nose.

D: OK, and does he have any issues with smell or taste?

P: Ah, this morning he really seemed like he wasn't like into his breakfast and I wonder if he's losing his sense of taste a little bit.

D: OK, how about vision or hearing?

P: I think those are fine. 

D: OK, and is he complaining of any chills or night sweats?

P: No. 

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

P: No, I haven't noticed anything like that.

D: OK, any changes in his bowel movements?

P: Uh, no.

D: Pardon? 

P: I'm sorry, no changes.

D: OK, no diarrhea, no constipation, no blood in the stool.

P: No. 

D: OK, any nausea or vomiting?

P: No. 

D: OK, any changes in his urine? 

P: Really been looking, but I don't think so.

D: Any dizziness or fainting spells?

P: No, just like fatigue.

D: OK, any confusion or memory loss?

P: No. 

D: And is he an, is he an otherwise healthy child?

P: Yeah, absolutely, he hasn't like decide to like vaccines, he hasn't had to go to the doctor like ever. I mean, he broke his arm once but that was it.

D: OK, so no past illnesses and I guess no hospitalizations or surgeries except for the broken arm?

P: Exactly, like nothing.

D: OK and were things normal with your pregnancy with him?

P: Yeah totally

D: OK. Ah, and then how about as a newborn, any complications after birth?

P: No, no, like everything was things really good.

D: OK and then did he hit all his milestones? Up till now?

P: Yeah totally

D: OK. And does he have any allergies?

P: Uhm, no, no, I don't think so. I mean like he hasn't really taken a lot of medicine, so it's hard to say, but like nothing, so far.

D: Is he up to date with all his immunizations?

P: Yep. 

D: Yeah, OK. And in terms of family history, are there any lung conditions or heart conditions?

P: Uh, no, everyone is really healthy.

D: OK, and um, are there, and who does he live with and where does he live?

P: He lives with me and my husband, and he has a little sister like just in town here.

D: OK, and is she healthy?

P: Yeah I like she, yeah she's healthy.

D: OK an any concerns for old carpets, mold, asbestos or any environmental issues like that in the home that you're in?

P: No. 

D: No OK, um has he been around any sick contacts recently?

P: Not not like outside of school. I like we know for sure, not outside of school but he goes to school right now so kind of hard to say. They haven't like contacted us about anything. 

D: OK, sure. And has he traveled anywhere recently?

P: No.

D: No, OK. OK, well those are all the questions I had for you today. Were, was there anything that I missed that you wanted to chat about today?

P: I don't think so. Like I realized that I can often times like we don't really do much for kids when you know, when it's just like a virus or something. But we do, I guess, need to have a COVID test to go back to school, even if you know either way 'cause they want us to be able to say it's like the other kids have had uh an exposure.

D: Mhmm.

P: So yeah yeah, like. Sorry, go ahead.

D: No go ahead.

P: So I just wanted to basically see if it was that and I mean he does receive you're so scared. That's kind of what made me come in, like it's scaring me a little bit.

D: Right, yeah, OK, so first thing is, first we need to do a COVID swab just to make sure that he either has it or it doesn't have it and those results will come back in 24 to 48 hours. Umm we do suggest because his symptoms overlap with symptoms of COVID that he isolate for 14 days and that includes from his his younger sister if possible. And then if the swap comes back negative, there is a chance for false negatives. But also it could be another viral illness that's going around nowadays. If his symptoms get worse, so if he has a really high temperature, if he has any neurological symptoms like seizures or if he's feeling weak, dizzy, if he has any fainting spells, please do take him to the ER and uhm, so for now I'll just wait for those COVID swabs to come back. How does that sound?

P: Yeah, sounds good.

D: OK great.

P: Thank you.

D: Yeah, no worries. Uhm and I should have mentioned if it was just the cough or if he was just short of breath or something like that and he didn't have the fever, we would add everything's like asthma to the list of things
he could be worked up for, but right now it sounds like a, it sounds like an infection.

P: OK yeah, that's good to know.

D: Alright, sounds great. Have a good day. 

P: You too, thanks.