D: What brings you in today?

P: Yeah, so I've had this cough that started within the last day and uhm, I've also been particularly short of breath as well.

D: OK. Can you tell me about the, the cough, how, is it dry cough or wet cough?

P: It's wet, I've been bringing up, uh, sputum that's uh, It's just, it leaves a really bad taste in my mouth when bringing it up.

D: What color is the sputum?

P: It's kind of, uh, like, yellowish green, type color. 

D: Havey you noticed any blood?

P: No, I haven't seen any blood.

D: And it only started yesterday. What about the difficulties breathing, when did that start?

P: Yeah, that started really within the last twelve hours or so.

D: And can you tell me if it's gotten better or worse since then? 

P: Yeah, it's been, it's been getting worse, uhm, and the phlegm, also smells really bad.

D: OK. When do you have difficult, like, is there anything that makes the, shortness of breath, worse? 

P: Yeah, if I, uhm, when I was having a cigarette earlier today, it got a bit worse and when I went out to get the Mail today I, I just couldn't do it. I, I had to just sit down.

D: And that what happened to you before, right?

p: No, I usually uhm, am able to go out and get the mail, no problem, yeah.

D: OK. Uh, and say two days ago, were you feeling perfectly fine?

P: I was yeah, I wasn't sick at all.

D: OK, so you've had this bad cough and you've had some difficulties breathing since yesterday. Have you had a headache at all?

P: No, no headache.

D: Any, uh, runny nose?

P: No, it's really, no.

D: Any congestion?

P: No.

D: No, OK. Have you had any pain in your chest? 

P: Uh, no pain.

D: When you're breathing in or breathing out any pain at that time? or deep breathing?

P: No, I haven't had any pain.

D: OK, have you had any palpitations or you feel like your heart's racing?

P: Uh, yeah, I do. I feel like my heart has been beating a little bit faster.

D: OK. And any pain in your belly?

P: No.

D: Nausea or vomiting?

P: Uh no, but, well I guess I have felt a little nauseous with the, uhm, bad taste in my mouth.

D: OK, and any uh diarrhea or Constipation?

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

D: OK, any sore throat? 

P: Uhm, no.

D: OK alright uhm, any other symptoms that I haven't talked about, that you experienced over the past day?

P: No, it's really been, uhm, yeah, this cough and bringing up this, this sputum and being short of breath.

D: OK, uhm, can you tell me about your past uh, medical history, do you have any medical conditions?

P: Uh yeah, I have uhm, high blood pressure.

D: Mhm.

P: I also have acid reflux, so uh, gerd I think, think it's called?

D: Yeah.

P: And, uhm, high cholesterol as well.

D: OK, ok.

P: And I've also been, had issues with anxiety in the past as well.

D: In terms of medications, are you taking any? 

P: Yeah, I take uhm, an ACE inhibitor, statin, uhm, and uh, medication for my stomach, I think, like Pantoprazole.

D: OK, and uh, how well has your gerd been controlled?

P: Uh, it kind of, it bugs me most days, its not so bad, I mean, sometimes I'll get a little bit of heartburn and acid in the, in my mouth, but it depends on what I eat so I really try to stay away from some, some foods.

D: So the PPI hasn't completely curbed the, the acid reflux, you still get it?

P: Yeah, I still get it. It's definitely helped though it was a lot worse before, uh starting it. I've been on been on it now for a few years.

D: OK, and as for your anxiety, do you ever get panic attacks?

P: No, I haven't had any, any panic attacks.

D: OK, alright. Do you have any allergies?

P: No. 

D: OK, so you said that these symptoms started yesterday and they were quite sudden, uh, was there anything that you were doing yesterday or the day before that was different or unusual?

P: Well, yeah, I mean yesterday I, or, yeah, I had a bit more to drink than, uh, usual, more alcohol I mean. So, I mean, could that have something to do with it? I'm not sure.

D: It could potentially. Did you, were you, were you drunk and did you pass out?

P: Yeah, I think so. My, my friends, uh yeah, that's what my friends were, were saying anyway.

D: OK, and uh, talking about alcohol, how much do you usually drink?

P: I usually, like, like four to six beers a day, but uh, yeah, yesterday was certainly more than that.

D: Have you considered reducing the amount of alcohol you drink? Has it affected you in any way?

P: I mean I, I'm retired now so, uhm, I don't know, I, I feel like it's been fine maybe, uh, I feel like it's been fine.

D: OK, OK, I suppose we could talk a little bit more about that later if you want uhm, as four to six beers is quite a lot actually, and it can affect your health in certain ways, but we can, we can chat more about that later.

P: OK.

D: And, uh, do you smoke?

P: Yeah, I smoke, uhm, a half a pack of cigarettes per day. It was well over a pack before, so I've cut down a little bit.

D: No, that's great. OK, do you plan on cutting it down further or do you wanna stay right there?

P: Yeah I have been, have been trying, just too, too darn expensive these days, so, been trying to cut back.

D: Yeah, yeah, that's fair, alright. What about marijuana? Do you consume marijuana?

P: No, I don't.

D: Any recreational drugs?

P: Nope.

D: Alright, do you have any family history of any medical problems?

P: Uh yeah, my, my father had, uh, he ended up having liver disease actually, he passed away from that I think. And he had heart problems too. He was a lifelong smoker and didn't really, didn't really take care of himself.

D: Hmm, I see. Do you, do you have a family doctor?

P: Uh, I do. I haven't seen my family doctor in a number of years now though.

D: Yeah, well, you know it's, it's a good idea to see your family doctor on a regular basis, specially when you're getting older, because sometimes you might need changes in your medications, or there might be checkups or screenings that they might want to do. It's for your own benefit, you know, maybe even just seeing them once a year would be a good idea. I would definitely recommend that you book an appointment with them just for a checkup in the next couple of weeks. Is there a reason why you don't see your family doctor too often?

P: I just haven't been, uhm, sick and I've been able to, to refill my prescriptions, mostly from just calling in, so.

D: OK, ok, I see, uhm, alright, and do you live alone or do you live with other people?

P: Yeah, I live with my wife.

D: OK, alright, and are you able to take care of things like groceries or finances, or shoveling snow or cleaning the house, or do you need any assistance with those sort of household activities?

P: Yeah, we moved, uhm, actually into an apartment last year. It's made it a lot easier in terms of the housework and that sort of thing. But I've been able to, uhm, I do the the grocery shopping and share the the chores around, around the house. I do, I'll use a cane sometimes. I, I injured my knee a number of years ago, but other than that, things are OK.

D: OK, OK, good to hear. That reminds me, have you had any surgeries in the past?

P: Just on my, my left knee. I had a left knee replacement a few years ago.

D: OK alright and have you any had, had any hospitalizations?

P: No.

D: OK, alright, uhm, so sounds like you've had a day of this wet cough with the, this, a bad smelling sort of sputum that's, that's yellowish green in color, and you've also had difficulties breathing for the past twelve hours, uh, so much so that you can't even go out to get mail and your hearts been racing. It's possible that while you were drunk that you might have, and given that you have acid reflux, that you might have accidentally have something go inside your breathing tube from, from your mouth or something that came up from your stomach and sometimes when that happens, food items can or other things can get lodged in your lungs and can become, uhm, can attract bacteria to, uh, to replicate and cause a bacterial infection, so it's possible that, that's what happened But it could also be a viral pneumonia or a viral infection in your chest. we'll get a chest x-ray done, we'll have some labs done as well, and we'll likely start some antibiotics. Have you recently been on any antibiotics?

P: No, I haven't.

D: And you don't have any allergies to any, correct?

P: Correct.

D: Alright, OK, we'll also do a physical exam just to give a listen to your, to your lungs and see how they're doing and then go from there. Do you have any questions for me?

P: No, that sounds good. Thank you.