D: What brings you in today?

P: So I so I have COPD and it's usually like pretty manageable with my puffers and that. But just in the last like 3 days I feel like it's gotten a lot worse. You know, I, I feel like I'm coughing more often and I'm now, uh, kind of producing more sputum. Kind of like a green yellowy sputum uhm. I even notice that there is like a little bit of blood a couple times when I was like, really coughing hard. I’ve been finding it like harder to breathe than usual. I don’t have home oxygen or anything, and I'm not. I didn't think I was quite there yet, but this these last few days it's been. It's been really hard to breathe. 

D: I see OK, so this is happened in the past three days. Have your symptoms gotten better or worse over this time?

P: I feel like they've been get maybe maybe getting a little worse. They definitely haven't gotten better, 

D: OK, and has this ever happened to you before?

P: I’ve had I had some troubles like when I've been sick before where the cough is gotten pretty bad. This is probably this is probably the worst that I've had, but I have like I have had in my COPD been made worse by being sick.

D: I see OK. Well, I guess the first thing we're going. So how's tbad, how bad is your shortness of breath?

P: Like I I walked here fine, but I normally like can walk around the block and I go for a walk, usually a couple times a day to walk my dog and it's been just it's been a little bit trickier to do that.

D: I see OK. And uh have you ever had any hospitalizations in the past specifically for COPD exacerbations?

P: Um I haven't. Uhm, like stayed over in the hospital. I like come to emerge a couple times.

D: Alright um. How many times?

P: I think twice maybe over the last like three years. 

D: Uhm when were you diagnosed with COPD?

P: Uhm 4, 5 years ago?

D: Was it formally diagnosed using the proper testing?

P: Yeah, they referred me to a lung, a lung doctor. 

D: I see OK. And have you had any fevers or chills?

P: I feel like I may have had a fever last night. I felt really hot. 

D: Did you check your temperature?

P: I I don't have a thermometer at home.

D: No problem. We can now check your temperature.

P: Here by the bed. I would say had a fever. 

D: Sure. And. Have you had any other symptoms? So have you had like a runny nose or stuffy nose? Any pain in your sinus?

P: I think I think I have a I've had a bit of a like this pressure in the sinus area, but it's been the cough has been the thing that's been the most bothersome.

D: I see and have you had a sore throat at all?

P: Oh no. 

D: OK. A headache? 

P: Uhm? Maybe a little bit, yeah.

D: OK and any nausea or vomiting? 

P: No. 

D: Diarrhea or Constipation? 

P: No. 

D: Abdominal pain.

P: No.

D: OK. In have you recently lost weight unintentionally?

P: No no, I wish but no. 

D: OK. Have you had any night sweats where you feel like you're drenched in sweat at night?

P: Uh, no, nothing like that.

D: Alright. And have you had any exposures to anyone who could potentially be sick?

P: Um. Let me think I I meet my I meet a couple of friends to walk our dogs together outside and one of them was a bit sick for a bit. We try not to get too close, but maybe I don't know. Maybe sometimes we walk a little too close. We feel too safe 'cause we're like outside. 

D: OK, OK um. And did your friend get a covid test done?

P: Uhm? I don’t know.

D: That's OK. OK, and you mentioned that you had COPD that was diagnosed four or five years ago. Any other medical conditions that you've been diagnosed with?

P: Um. Yeah I have a high blood pressure.

D: OK, and are you taking any medications?

P: I’m not, I'm not I we talked about it, but I decided to try to change my lifestyle as much as I could 1st and I've also done that for the COPD. It's generally pretty like I've been really trying to take care of it, but um I feel like I maybe got sick or something this time, yeah, so my blood pressure is like OK right now.

D: OK, OK.

P: My pressure and then I lost weight and started this walking more.

D: That's great. That's really, really good that you're taking better care of yourself. Should definitely continue doing that.

P: Right?

D: And you've mentioned that you have some puffers. How often do you use those?

P: Oh like I have the one that I use every day. That I'm supposed to just use no matter what, and then the one that I use when kind of just when I need it. I probably use it like once every two weeks.

D: OK. OK. Uhm? And you mentioned that your COPD’s are getting better. Do you find that it's affecting your life in any way affecting the way that you're doing your daily activities at at home or at work, if you are working?

P: I like pretty OK except for like if I get sick I so yeah, it's been.

D: I see.

P: So I think it's like pretty well managed like I stay on top of my lifestyle now. 

D: Thats good, thats good. Do you have any allergies? 

P: Uh, no, no.

D: No, no allergies to medications ?

P: No.

D: OK, OK, good and. Do you, just a couple more to general questions. Have you traveled anywhere outside the province recently? 

P: No.

D: You, I guess I should have asked you earlier, but have you noticed any change in your sense of smell?

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

D: Any change in your sense of taste?

P: Uhm? No, I don't think so.

D: Any confusion or fuzzy feeling?

P: Nope.  

D: No OK, any muscle aches in your body?

P: Uh no. 

D: OK, alright, and just kind of some questions about your living situation. Do you currently live alone? And I you mentioned that you have a dog? Are there any is there anybody, anyone else in the house?

P: Uh my husband. 

D: OK and. Do you currently work?

P: Yeah, I uh, like I've been working from home. I worked for the municipality. 

D: I see. Do you think you might have had any exposures to say dust or smoke or anything like that that could have worsened your symptoms?

P: I don't think so.

D: And do you drink alcohol?

P: Oh, very rarely .

D: OK do you smoke?

P: I used to. I quit once they said I have COPD. I smoked 1/2 pack a day for probably 20 years.

D: OK, OK, and do you consume marijuana or any recreational drugs?

P: No.

D: OK, uh, alright, well I guess one more question, are there any lung diseases or heart conditions or cancers that run in the family?

P: No, nothing that I can think of.

D: Alright, well that's those are all the questions I had for you. I will now do it physical exam and look at your vitals and listen to your chest. It's likely that what you have right now is COPD exacerbation, maybe just a like an infection that you got, which worsened some of your COPD symptoms. We would also have to rule out covid, so we'll be doing a covid swab and will decide based on the on your labs in your vital signs. It's instead of other things whether you need to stay in the ER and be admitted, or if you are good to go home, I will also talk to my attending and will make those decisions together and come back and talk to you. Does that sound good to you?

P: Yeah, that sounds great. Thank you.

D: Your welcome.