D: What brings you in?

P: Yeah, so I just came in because I've been having this cough that's getting worse over the last uh one and a half week and uh, I've also just recently in the last few days been getting some shortness of breath. Um and I also noticed uh my bowel movements have changed a little bit as well over the last week.

D: OK, so yeah, let's break this down. The cough, when did that start?

P: The cough, I think it started uh probably like around 10 days ago.

D: 10 days ago, OK, and how about the shortness of breath?

P: That just started in the last uh I think 3 days.

D: OK, and then the the bowel bowel changes, when did that start? 

P: Yes, I think it also started in like, I would say, for the last three days I've been getting uh diarrhea. 

D: OK OK, so let's go back to the cough, is it constant or um is it triggered by certain things like the cold air, dust, um you know, um, certain times of the day, like morning, evening?

P: Um, I would say it's pretty pretty constant since the last like 10 days, uh it's, there's no real pattern to it, and I've mostly just been inside my house. I don't think there are any triggers or I don't own any pets or anything like that, no new rugs, like uh, no no new changes really in my house.

D: OK, OK and um have you tried anything to make it better?

P: Um, no, not really. I I've done some uh home remedies like trying to do one of those steam steam masks and see if that helps, but it didn't really do anything.

D: OK. Um and how about um the quality of that cough? Is it, does it sound harsh?

P: Um, yeah I would say it's getting a little bit harsh. It's more just like, I'm not bringing anything up, it's more like a dry cough um, but yeah, I would say it's getting worse, definitely.

D: OK. Um, is it a dry cough then, or are you producing a little bit of sputum or blood or anything like that?

P: No, no, I haven't seen any blood at all and rarely do I bring like up some sputum, but like most of the time it's just a dry cough.

D: OK, it's a dry cough. Um and would you say the cough's getting worse?

P: Yeah, I'd definitely say in the last um three to four days I've been just coughing nonstop, it's very irritating. 

D: Yeah, have you experienced anything like this before?

P: Um, probably a few years ago, I think I caught the flu or something and got really sick with a fever and just a lot of coughing. But since then, nothing else. 

D: OK. Um the shortness of breath, 1 to 10, 10 being the worst, how bad is it?

P: Uh probably like a five. It kind of just started out with uh, three days ago, was kind of like I just
couldn't take deep breaths like I noticed that my breathing was getting a little bit more more shallow and now it's, especially when I'm coughing, it's like I really have to sit down and catch my breath.

D: Yeah, um does anything make the shortness of breath worse? Like I guess um you know exertion, uh laying down, anything like that?

P: Um, not really. Maybe like sitting down helps sometimes, but even when I'm sitting down I'm still coughing. 

D: OK. OK and um do you have any wheeziness?

P: No, I don't think so. 

D: OK, any chest pain?

P: Um, maybe from all the coughing, sometimes I feel like there's some pain there, but it's not not anything that's too painful.

D: OK, um do you feel like your heart's racing at all?

P: Uh no, not really. 

D: OK. Um have you noticed any swelling in your limbs?

P: No, I didn't notice anything like that.

D: OK, how about um pain in your calves when you walk a few blocks?

P: No, I've been fine that way. 

D: OK. Dizziness or fainting spells?

P: Uh no, not really, I I thought maybe with the shortness of breath that would happen, but like so far that hasn't happened to me.

P: OK, any fevers or chills?

D: Uh no I, maybe like a few chills, like I'm not sure actually, it was hard to tell, but I haven't had any fevers.

P: OK, we'll take your temperature today just to make sure. Um any weight loss over the past few weeks?

D: Uh no, probably weight gain.

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

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

D: OK, any changes in your vision or hearing?

P: Uh no, no, that that's all been fine.

D: How about um loss of smell or taste?

P: No, I haven't had uh, I think my taste and smell are still pretty good. No, no issues there.

D: OK, um have you had a runny nose or stuffy nose?

P: No, no, no no congestion really.

D: OK, and um have you had a sore throat at all?

P: No, no sore throat. 

D: OK. Um any issues swallowing food?

P: No.

D: No, changes in your appetite?

P: Maybe just a little bit, like I don't really feel like eating when I'm coughing all the time, but other than that, no, not really.

D: OK. How about nausea or vomiting?

P: No, nothing like that.

D: OK um constipation?

P: No, diarrhea.

D: Diarrhea, right. Um how often are you having a bowel movement right now?

P: I would say uh like I've been going, probably more than eight times a day, probably in the last few days like 10 times a day.

D: Oh wow, OK, and each time are you producing a lot of stool, or is it just a little bit each time?

P: Like a little bit, but it's mostly liquidy.

D: OK. Any solids at all? Like is it semi solid at all?

P: Um maybe a little bit, but mostly it's just liquid.

D: OK, um any blood in the stool?

P: No, I've been checking uh no, I didn't notice any blood or change in colour. It's mainly just um liquid diarrhea.

D: OK, any changes in your urine? 

P: No.

D: No, OK, um any confusion or memory loss?

P: No, not that I know of.

D: OK, um how about muscle aches or joint pains?

P: No, nothing like that.

D: OK, and are you otherwise healthy or do you have any long uh standing medical conditions?

P: Uh, so I do have diabetes and high blood pressure.

D: OK, do you take any medications for those conditions?

P: Yeah, so for diabetes I'm taking this medication called uh like I think metformin and then for the blood pressure, uh I think it's, I forgot the name, I think it's something like um ramipril or something like that.

D: Yep, OK, and you're taking that um as directed, right?

P: Yeah, I've been taking that regularly and my blood pressure, I've been measuring, it's been pretty steady, no changes. 

D: OK, that's good. Have you had any hospitalizations or surgeries in the past?

P: I did have my appendix removed, probably in my 20s, but uh that was the only thing. 

D: OK, um and do you have any allergies?

P: No, not not really.

D: OK. Are you up to date with all your immunizations?

P: Yep.

D: OK. Are you on any other medications besides the ramipril and metformin?

P: Just uh like multi vitamins for men over 50.

D: OK, OK. Um any family history of heart conditions or lung conditions that you know of?

P: Um yeah, so my family, like diabetes is pretty big, it runs in the family and uh my father in his 60s uh like died from a heart attack. Um other than that, not anything else I can think of, no.

D: OK, any cancers in their family?

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

D: OK, do you smoke?

P: I used to, I I quit probably five years ago, but before that I used to smoke probably a pack a day for more than 20 years.

D: Oh OK, well good job for cutting down and quitting, um.

P: Yeah.

D: Yeah, um do you do marijuana at all?

P: No, no no no drugs.

D: Any other recreational drugs? You said no, right?

P: Yeah no, no, I don't do any drugs.

D: OK, um do you drink alcohol?

P: Yeah, I probably have maybe um some whiskey maybe a couple times a week.

D: OK. Um and where do you live right now?

P: Uh, so yeah, I just live in the city in London uh in an apartment with my, just wife, my wife.

D: OK, um is she also sick or is she OK?

P: No, she's been completely fine, and I've been kind of isolating myself from her over the last week.

D: OK, well that's good and that's smart, um just because you don't know what you have, right?

P: Mhmm.

D: Yeah OK, do, can you think of any other sick contacts that you may have had over the past one or two weeks or even three weeks?

P: Um I go to the grocery store, then I go to work, I haven't noticed anyone being sick at work, but you know, you never know like who comes in asymptomatic and like they might be carrying it, with this
virus like mainly I'm worried about covid and you know just how fast that's spreading everywhere.

D: Yeah, for sure. Um yeah, for sure, have you traveled to anywhere recently?

P: No, uh we've been in Canada, Ontario, haven't left to go anywhere.

D: OK. OK, well those are all the questions that I had for you. Did you have any questions or did you have any concerns, anything that you wanted to discuss today?

P: Yeah no, I just uh was wondering if I can get the covid test, that would just, I wanted to make sure I don't give anyone covid if I do have it. 

D: Yeah, for sure, I think that's a good idea. Um so, and it's definitely something that we need to rule out, so we'll do a covid swab today um and you'll hear back within 24 to 48 hours, um but in the mean time, regardless of whether you actually have covid or not, because your symptoms overlap with covid, um it's good to isolate for 14 days and that includes trying to isolate from your wife as well if possible, and public health should be in touch if it's positive uh to do contact tracing. Um and if it's not covid, it's probably another viral illness that's going around at this time of year. Uh if your symptoms get worse, um you know you're having neurological symptoms or or if your fever gets really high, or you're having a lot of trouble breathing, then you should go see the ER. How does that sound?

P: My, if my breathing gets worse uh I'll just go to the emergency Department?

D: Yes, please do. 

P: OK, sounds good.

D: Alright, take care. 

P: You too, thank you.