D: What brings you in today?

P: Hi, I am just coming in because for the last couple of months but I've been having this, these coughing fits. Are there like when I'm going to the gym or even at home, like during the weekends when we're vacuuming and cleaning the house.

D: When did this start? 

P: Um, I would say started, uh probably 3 months back, but it's gotten worse, so like before I used to like just have some irritation in my throat and cough a little, but now, I would say probably every other day I'm having these episodes where I can't stop coughing when I'm exercising.

D: Hmm, um and is this cough a dry cough, or do you bring up some mucus?

P: It's usually, it's usually a dry cough and sometimes I do bring up like this light material, but usually it's mostly a dry cough.

D: You never notice any blood, right?

P: No, no blood.

D: OK and uhm, it started about three months ago, I guess before that did you ever have a problem when you would exercise or when you were vacuuming or cleaning, has this been a problem that has occurred for years and that's just something that you that got worse and now it's come to your attention? Or was it just very new and sudden, three months ago? 

P: Um, it's fairly new. I've never really had this issue before although I have been like so like after the new year in the winter I, I, I wasn't much of the person who ran or exercised a lot. But I, I kind of needed a new goal to become more fit and active. So I notice that, I don't know, maybe that's why like, it is something new that I've been trying, but yeah, it's not been an issue before.

D: OK, and other than the the cough, have you noticed any other symptoms like a sore throat or itchy eyes? Itchy nose? Stuffy nose or runny nose? Anything like that?

P: No, none of those, but I did it, initially I used to get just an irritation in my throat. But now it's just more of a cough.

D: OK. Do you have, do you get any pain in your chest at all?

P: Uh, when I'm usually it goes away in 10-15 minutes but when I'm coughing a lot I do get some tightness.

D: OK. Do you ever feel like you're short of breath when you're coughing or otherwise?

P: I do find that it's harder to take a breath at those times.

D: Ok. Uhm and how long do these last for? Episodes last for?

P: Probably, uh 15 to 20 minutes and yeah, it's it's mainly just after I like often times over the last few weeks I've had to just stop doing what I'm doing, like exercising and just come home and rest.

D: Do you feel like your hearts beating really fast when that happens or you're sweating?

P: Yeah, yeah, I I feel like it's usually, I don't know if it's because of the exercise, but I have like a Fitbit and it's my my heart rate is much faster. 

D: Uhm, OK. Alright. Have you had any other symptoms so anything, any pain in your belly or any nausea or vomiting?

P: No, nothing like that.

D: Any changes in your bowel movements or any urinary symptoms?

P: Nope.

D: Any headaches or fevers or chills?

P: No, nothing like that.

D: Unintentional weight loss?

P: No. 

D: Any night sweats?

P: No. 

D: Muscle aches, joint pain?

P: No. 

D: Have you been diagnosed with any medical conditions?

P: No, I've I've been very healthy.

D: Uhm, you mentioned that you started going to the gym more often earlier this year, and that is when you sort of notice some of these symptoms? Is there anything else that changed in your life? Any big changes that you think could be related to this?

P: Um no, not really, I've I've been really, umm, I moved back to my parents' home just for a bit right now. 

D: Ok.

P: Now, while the University has closed down, and by that I've lived there all my life before, so I don't know if that had anything to do with it.

D: Do you feel like they may have put new curtains or or like there's old carpets or new a new pet, or something that could have caused some irritation for you?

P: No, but I have noticed that when I when we vacuum. I, I do get some of those symptoms as well. Just more of an irritation mores than the cough.

D: OK. OK, and do you feel that you're particularly anxious when these episodes are occurring? Do you have any new stressors in life?

P: Uh, no, not really.

D: Any medical conditions that run in the family?

P: Uhm, I don't think so. Not that I know of.

D: OK, and I guess a little bit more about you. So have you had in the past when you were younger, did you have a rash like eczema or did you have allergic rhinitis where you would sneeze and, to feel ill when you were outside or at certain times of the year? Anything like that?

P: I didn't have a, I didn't have any like exam or rashes, but I do generally have umm, get allergies during the spring time when I go outside.

D: Do you take any medications for that?

P: I just take Reactine usually during the spring.

D: Do you have any other allergies? To food or medications?

P: No, not that I know. 

D: And other than Reactine, do you take any medications, including over the counter meds?

P: No. 

D: Nothing else? OK. And. In your family, you said no one has asthma or allergic rhinitis or eczema or anything like that, right?

P: Not asthma, my dad also gets those allergies and irritations just like me.

D: Uhm, OK. And you mentioned that you're staying with your at your parents place. Are you uh, are you doing things from home? Are you like doing school from home or working from home?

P: Yeah, I'm not currently working, just studying from home.

D: OK, and have you had contact with anyone who might have been sick?

P: No. 

D: Traveled anywhere outside the province, recently?

P: No.

D: OK, and do you smoke or have you ever smoked?

P: No, never smoked.

D: Marijuana?

P: No. 

D: Any recreational drugs? 

P: Nope.

D: Uh, do you drink alcohol or have you ever had alcohol in the past?

P: Yeah, alcohol I've had like at University, but generally, maybe just on the weekends. Not anything regular. 

D: Alright. OK, well, uh, those are all the questions I had for you. We will do a physical exam now and I'll go talk to my attending and we'll uh come talk to you right after. I guess before before I do So what exactly are you hoping to get out of today's visit?

P: I just wanted to like I really do you want to become fit and it's just these symptoms are stopping me and kind of affecting my daily routine, so I just wanted to know what I can do to stop like having these symptoms.

D: Have you ever tried any puffers?

P: No, I haven't. 

D: No, ok. Right, yeah, let's talk a little bit. 

P: OK.