D: so I hear you've been having some some nausea vomiting, diarrhea. Can you tell me a little more about that?

P: Yeah, so uh, like around three or four days ago I started, uh to get really nauseous and since then I've been vomiting every few hours and really I don't know. Just yesterday started to started to have some diarrhea as well.

D: OK, so that's three or four days ago for the nausea and vomiting, is that correct?

P: Uh yeah yeah the nausea start kind of started three or four days ago and then after that that the vomiting came. So yeah maybe the vomiting was more like 2 days ago it started, and then diarrhea kind of the last day. 

D: OK OK. OK, and before that you were feeling well?

P: Yeah, well I was feeling maybe like a little tired for a day or two before, but um, I don't know. Sometimes you just feel like that, so I didn't really think much of it, but.

D: Sure, OK. And since it started, have, I know these all kind of started at different times but has have your symptoms gotten worse overtime?

P: Yeah, they they. They've gotten worse. At first they were kinda really spread it like far enough apart that I would thought it was just going to go away on its own and then it it hasn't so has me concerned.

D: OK, I'm just going to ask you a few more questions about the vomiting. Have you noticed any blood in your vomit?

P: No, it's been kind of yellowish.

D: OK, and just if you notice like a like a really bright kind of yellow green substance in your vomit.

P: Umm not really bright, but I mean maybe more like dark green or yeah nothing bright.

D: OK And you said now it's it's happening every couple hours for you?

P: Um yeah every few every few hours it's been ah. It seems to be what I'm like like after eating, it is just making me making me nauseous. 

D: OK, OK, so have you been able to eat anything? When's the last time you actually had something to eat?

P: Yesterday I did, I had some soup and was able to to keep most of it down, but um. But it's been mostly liquid's I've been drinking.

D: OK.

P: My appetite really hasn't been there.

D: OK, uh. In terms of diarrhea, so that started a couple days ago, if you only had diarrhea since then, or have you had like any form stools?

P: No, it's it. It was started more like yesterday and it's really only been diarrhea since. So yeah, like twice last night and then like three to three times this morning. 

D: OK. Have you ever had anything like this before?

P: No, I haven't been sick like this before.

D: OK, have you traveled anywhere recently?

P: I just got back from a trip in the US was there for work.

D: OK, and how did you travel there?

P: I I. Traveled by a train.

D: OK, and how long were you there for and when did you get back?

P: I was there for one night and got back five days ago.

D: OK. Um, OK, five days ago and when you were there, were you in contact with anyone?

P: I well, I stayed in a hotel so. I, I guess that the people, uh, that um yeah, the people that were staying at the hotel.

D: OK. Have you been in contact with anyone since coming back that's been sick?

P: Um No. I I, I haven't been in contact with anybody, anybody who's been sick. 

D: OK. In addition to the symptoms that you're describing to me, have you had any fevers?

P: I've I started to feel hot this morning.

D: OK, have you had any chills?

P: Nothing like that. 

D: Any shakes?

P: No. 

D: K night sweats? 

P: Um no night sweats.

D: Have you had any cough?

P: Umm no, I haven't really had a cough by my throat's felt a little like scratchy though.

D: OK, scratchy throat OK. Have you had any sore throat?

P: No, I wouldn't really say it's sore, but. Yeah, I mean we just kinda like like itchy.

D: OK. OK, have you noticed any changes to your sense of smell or taste?

P: No, I haven't noticed any changes to those. 

D: OK. Mmmm. And you live, do you live alone or with family?

P: I I live with family. I live with my wife and two children.

D: OK there. How are they feeling right now?

P: They were. They've been feeling fine.

D: OK. OK, um, so just in terms of your general health, are there any conditions that you see your family doctor for regularly?

P: I have anxiety and back pain. So, uh, I do get ah. Some hydromorphone for for that. 

D: OK 

P: For the back pain anyway.

D: OK. Um, and what medications do you take besides the hydromorphone?

P: Uh, uh, Escitalopram. 

D: OK. 

P: And that we've been working on trying on decreasing the hydromorphone now over the last year. So it's a work in progress though.

D: OK, and have you ever had any surgeries?

P: Uh, yeah on my on my back I was in an accident a few years back. So, um. Well, that's where the pain is from.

D: OK, sad to hear that. Do you have any allergies?

P: Um yeah, to penicillin. I had a hives when I was a kid.

D: OK Um, OK um. Let me see, uh, so in terms of your family history. Do you have any family history of your digestive system problems or respiratory problems? 

P: Um Yeah, no one in my families had any problems with their stomach or I haven't heard of any like colon cancer. I mean my my dad had a heart attack when he was in his late 60s, but that's kind of the only thing that I can think happened in my family in terms of health.

D: OK. And it sounds so. It sounds like you live at home with your family, do you? What do you do for work?

P: Yeah, I I work for a tech company so I was going down to meet a potential buyer for one of our products.

D: OK. OK, and just in terms of your lifestyle. Do you drink alcohol?

P: Um yeah I will have wine. Maybe one or two glasses on on the weekend.

D: OK, do you smoke cigarettes?

P: Umm no but I I used to, I I quit about seven years ago. Yeah, so I quit about seven years ago. 

D: Um OK. So do you use any other substances, like cannabis?

P: Um I will have a joint every once in awhile if I with friends, but that's been it's been awhile. 'cause of the pandemic haven't really been hanging out with anybody. 

D: Sure. Um OK, I think that's all the questions that I had for you today. So it sounds like there's probably some kind of infection going on. What it is exactly, it's hard to say. There are some cases of COVID-19 that, that are more like GI symptoms then than simply respiratory symptoms. So I think we should probably give you a COVID swab and then we ask that you and everyone in your house self-isolates for a few days until you've got it in a negative result and in a few days without symptoms.

P: OK, that sounds good.

D: So yeah, we'll get that started for you, and otherwise, really, we want to know if it's COVID is just for infection control purposes, but I think that essentially you should be drinking lots of fluids and getting a lot of rest. And it's something that likely should go away on its own. I mean, if things start to become a lot worse and you get really dehydrated and you have fevers that you can't control with Tylenol, then please come back to the emergency Department. But I think in general it will just be kind of supportive treatments for what you're experiencing.

P: OK, that sounds good. I'll get some Gatorade on the way home.

D: Perfect. Actually, don't go into the store. Have someone else get it for you, but.

P: OK will do. Thank you.

D: Have a good have a good day. Thanks for chatting with me.

P: Thank you.