D: What brings you here today?

P: Yeah I had last night um so I'm having this pain in my right wrist. Yeah, but last night. I I tripped over something and I I ended up like landing on my hand to help break the fall and this morning I woke up and I have some like bruising on my hand and it's it's really sore to touch it.

D: OK, and which right, which hand is this?

P: It's my right hand.

D:  OK, and when you had your fall, when was your fall?

P: So it was last night, probably like at 10:00 PM, something like that. Went out with a few friends for dinner and drinks.

D: OK, and do you remember how high you fell from or what what you fell onto?

P: Yeah, I was standing height. We were just kind of walking down the street and I tripped over something on the curb. I think there is that yeah maybe like a pothole or something like that and so I felt right onto the concrete with my hand.

D: OK, did you hit your head at all or lose consciousness?

P: No, nothing like that.

D: OK, so it was. It was mainly your hand that got injured.

P: Yeah, it was just it mostly right my hand.

D: OK and are you having any pain on movement or if you press on it?

P: Um yeah, I do get some pain pain if I'm trying to move the wrist around and it hurts her to press on it as well.

D: OK, and do you notice any kind of swelling or bruising?

P: I do, yes. There's some swelling and bruising.

D: OK, and if you had to describe where the swelling and bruising in the pain are, how would you describe it?

P: Um so I have a sharp pain right at my wrist. I kind of. I feel it mostly at the base of my thumb, kind of right at the wrist, and that's where the swelling and bruising is as well.

D: OK and, is it right under your palm or uh at the back of your hand on the wrist?

P: At the back of the hand, at the wrist and base of the thumb.

D: OK, OK, alright, and what kind of pain are you feeling? Is this sharp, is it a dull aching?

P: Oh yeah, it's really sharp. It feels like sorry just stabbing me in the hand.

D: OK, and how how much would you rate the pain on a scale of zero to 1010 being the worst pain you felt in your life?

P: If I'm not moving it around, it's a three, but if I move it, it goes up to like a 9 out of 10.

D: OK, and is it radiating or moving anywhere else onto your hand?

P: No, I don't feel it anywhere else.

D: OK, and do you have any kind of pins and needles sensation tingling or numbness anywhere in your hands?

P: No, nothing like that.

D: OK, anything that makes the pain worse or better?

P: Um yeah I tried some anti-inflammatories that did help with taking the edge off a little bit and. But the pain just came right back and then also like just moving it at all hurts even texting on my phone was really bugging me.

D: OK. Yeah, so we definitely, uh, you went, so you had the fall yesterday or?

P: Yeah it was yesterday. 

D: OK, OK. Alright. So when did it start hurting? Did it start hurting right away or has it gotten worse at all?

P: Yeah it started hurting right away and it's. Well, this morning it's a a bit worse yeah.

D: OK. Do you have any other symptoms at all like fever, chills, headache, anything like that?

P: No. 

D: Any dizziness or fainting? 

P: No.

D: OK, any diarrhea, constipation?

P: No.

D: Any changes in your vision, hearing a balance? 

P: Nope, nothing like that.

D: OK, but yeah, so your main concern today is this pain in your wrist?

P: Yeah exactly. 

D: OK, alright and do you have any past medical conditions you've been diagnosed with?

P: Yeah I do. I have a Asthma and I use an orange inhaler daily. It's been well controlled, I'll use, I haven't used the blue one in awhile.

D: OK, so it's pretty well controlled. Yeah, and do you take any other medications at all?

P: Just a Multi vitamin.

D: OK

P: And vitamin D as well.

D: OK, alright, and have you been hospitalized in the past or had any surgeries?

P: Yeah I had my my tonsils out and my wisdom teeth out when I was a teenager and or tonsils when I was a kid actually. Um and a c-second for my son.

D: OK any complications at all with that at all?

P: No no every every that was OK.

D: OK, OK, and have you injured your right hand or broken any bones before?

P: No, I haven't.

D: OK, so this is the first injury on your right hand?

P: Mmm

D: OK and do you have any family history of any medical conditions at all?

P: Yeah my my uncle died of a heart attack when he was in his 60s and I think my Grandfather also had had a heart attack as well. Um yeah, that's about it. 

D: OK. And in terms of your work, do you work currently?

P: Um yeah I do, I I work um in a restaurant and so. And this will be a difficult for my job coming up with an injured wrist I and hand. I I just restarted and I'll have to be carrying a lot of different things, and so I just hope it's not broken.

D: Oh, I see. Yeah, it might definitely that's that might be concerning if you know well, we'll get that check though on X Ray and everything, but we just need to do a few few more questions and some examination as well. How would you describe your living situation right now?

P: Oh so. I'm living on on my own actually in an apartment. 

D: OK. And do you currently smoke?

P: Um no, I've I. I've never smoked, I couldn't with having asthma so I just stayed away from all of that.

D: OK, OK, and do you drink alcohol?

P: Yeah I do I. I have a couple of bottles of wine per week. 

D: OK. Alright, uh, a couple of bottles a week, so how much would you have in an average day?

P: I'll probably I guess, probably like two or three glasses of wine a day.

D: OK. Yeah, so we definitely recommend for women. Uh to limit themselves to an maybe one to two, max 2 glasses of wine a day as it can have health effects in the future in terms of drinking and on your liver. OK, and other than that I just had a few questions. Do any recreational drugs like marijuana?

P: No, stayed away from that as well.

D: OK, OK, so I'm just going to ask you questions about specifically to examine your wrist so you notice. So can you. Are you able to move your wrist around? Are you able to make a fist?

P: I I can but it I can't really bad my thumb and it it it hurts a lot. So I can bend my fingers but my thumb is kinda out.

D: OK, due to the joints in your thumb hurt at all. 

P: Um no.

D: OK. An any pain anywhere else like on your fingers or your elbow?

P: No. 

D: OK, and. What movement would you say hurts the most?

P: I I. Probably just moving the the wrist like flexing and extending the wrist

D: OK and where the swelling you said is at the base of the thumb, right?

P: Yeah, exactly at the base of the thumb on the on the back of the hand there are some bad bruising and swelling there.

D: OK is it warm at all to touch?

P: No, it doesn't feel warm.

D: OK, OK, and if you press on are you getting any bony pain in that area, like if you press on a bone?

P: Yeah, like, I mean, if I there's one spot that if I press down on it, it's like 10 of the 10 pain. It hurts really bad if I press at the base of my thumb there.

D:  OK, alright, so those are all the questions I had for you today. We definitely need to, since you're having pain on, just tell palpate palpating the area, there swelling redness, and you did have a fall and you landed on your you caught yourself with your hand. There is a common fracture that can happen in those circumstances to your wrist. And so we need to do an X-Ray and we will see if you have a fracture or not. But we also need to see if we need to get a cast for you or if if we can manage your injury with a splint or. And then based on what we see and if your physical examination we will determine how long you need to be in a cast or splint, and then we'll go from there.

P: OK, that sounds good, thank you.