jshargo/medical-interview-conversations2 huggingface dataset:
user: 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. 

assistant: 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? 

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

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

assistant: Thats good, thats good. Do you have any allergies?
user: Uh, no, no. 

assistant: No, no allergies to medications ? 

user: No. 

assistant: OK, OK, good and. Do you, just a couple more to general questions. Have you traveled anywhere outside the province recently?
user: No. 

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

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

assistant: Any change in your sense of taste?
user: Uhm? No, I don't think so. 

assistant: Any confusion or fuzzy feeling? 

user: Nope. 

assistant: No OK, any muscle aches in your body?
user: Uh no. 

assistant: 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?
user: Uh my husband. 

assistant: OK and. Do you currently work? 

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

assistant: 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?
user: I don't think so. 

assistant: And do you drink alcohol?
user: Oh, very rarely . 

assistant: OK do you smoke? 

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

assistant: OK, OK, and do you consume marijuana or any recreational drugs?
user: No. 

assistant: OK, uh, alright, well I guess one more question, are there any lung diseases or heart conditions or cancers that run in the family?
user: No, nothing that I can think of. 

assistant: 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? 

user: Yeah, that sounds great. Thank you. 

assistant: Your welcome.
user: Hi, yeah, I'm here because I'm over the past like couple of months I've been losing a lot of weight. Uhm, but I didn't really have any other symptoms, but since like 2 weeks ago I've been coughing up some blood and now I have a fever as well. 

assistant: OK, so you mentioned you notice the weight loss first. How much weight have you lost? Or roughly? 

user: I've lost about 30 pounds in the past, past like 8 months. 

assistant: OK. So, and have you been trying to lose weight?
user: No. 

assistant: OK and, any, like any changes to your diet or exercise? 

user: No, nothing like that. 

assistant: OK, and more recently you started to have a cough. When did that start?
user: The cough started two weeks ago. 

assistant: OK. And prior to this, did you have a cough?
user: No. 

assistant: No. And are you bringing bringing up any sputum or phlegm? 

user: Uh yeah it's yeah, there's sputum for sure and it looks bloody. 

assistant: OK. So you're, you're, you're coughing up blood as well.
user: Yes, that's right. 

assistant: OK, uh, and that's been going going on for the last two weeks too? 

user: Yes. 

assistant: OK. And how much blood have you been bringing up roughly? If you can think of it in like terms of tablespoons or teaspoons.
user: Like every time I cough, it's about the size of a teaspoon. 

assistant: OK, and are there any triggers for your cough that you can think of?
user: Uhm, I don't think so. They just happen throughout the day. 

assistant: OK, and have you tried anything for the cough? 

user: I tried this cough suppressants. I tried like salt water rinses, like just like at home remedies and over the counter products, but nothing is helping. 

assistant: OK. And so have you had any like viral infectious type symptoms, such as like eye, eye discharge or red eyes or runny nose or even a sore throat?
user: No, nothing like that. 

assistant: OK. And, and have you had any any headaches? 

user: No, no headaches. 

assistant: OK. Have you had any, have you had a runny nose?
user: No. 

assistant: OK, how about any, have you had any loss of smell or, or taste?
user: No. 

assistant: OK, have you had any shortness of breath? 

user: Uh, no. 

assistant: Have you had any wheezing?
user: Uhm, no. No wheezing. 

assistant: OK, have you had any chest pain? 

user: No. 

assistant: OK. Have you had any dizziness or fainting?
user: Uhm, no, nothing like that. 

assistant: Heart palpitations?
user: No. 

assistant: OK. And have you had any any nausea or vomiting? 

user: No. 

assistant: Have you had any abdominal pain?
user: No. 

assistant: Have you had any diarrhea or constipation? 

user: No. 

assistant: Have you had any pain with urination or, or frequency?
user: Uh, no. 

assistant: OK, have you had any rashes?
user: No. 

assistant: How about muscle aches or body pains? 

user: Uhm, muscle aches, yeah. Yeah, that's been happening. 

assistant: Any particular muscles? Or is it more general?
user: It's more general. 

assistant: Have, have you been having any bone pain like any in your back or anything like that?
user: No. 

assistant: OK, and, uh, how has your energy been? 

user: Ah, pretty low. 

assistant: OK, and how is your appetite been?
user: Uhm, also pretty low. 

assistant: OK. And in the in the past have you been diagnosed with any medical conditions?
user: Uhm, no, I've been pretty healthy so far. 

assistant: OK. Uhm, so do you take any medications regularly for anything?
user: No. 

assistant: OK. And do you have any allergies to medications or, or anything environmental?
user: Uh, no. 

assistant: OK, and have you had any prior hospitalizations or surgeries? 

user: Uhm, no. 

assistant: OK. And, uh, could you tell me a little bit about your living situation currently? Like who you're living with an ah, whereabouts you're living?
user: Uhm, I live alone by myself. I live in an apartment downtown. 

assistant: OK, and are you working currently or in school or?
user: Um, I'm working from home right now. 

assistant: OK, have you been around anybody who's been sick? 

user: No. 

assistant: Have you traveled anywhere recently?
user: No, not since I moved here. 

assistant: OK, when did you move here and where did you move from?
user: I moved here a year back from Sri Lanka. 

assistant: OK. And, and in Sri Lanka, were any of your family members or people that you spent time around ever diagnosed with tuberculosis? 

user: I mean, it's pretty common in Sri Lanka. None of my immediate family members were. 

assistant: OK. And do you smoke cigarettes?
user: No. 

assistant: And ah, do you smoke cannabis or use any cannabis products?
user: No. 

assistant: OK. And do you drink alcohol?
user: I don't. 

assistant: OK, how about the use of any other recreational drugs? 

user: Uh, no. 

assistant: OK. And uh, any family history of heart or lung problems?
user: Heart or lung? Uh, no, not that I know of. 

assistant: OK, and how about any cancers in the family? 

user: No, no cancers. 

assistant: I see, alright. Did you have any other questions for me today? I think that was everything I wanted to ask about for now.
user: Ah no, what do you like, what do you think I have, and how do you think I should treat it? 

assistant: So, uh, yeah, it's sounding like, like it could be tuberculosis based on the kind of timeline of your symptoms and so and cough and hemoptysis and so we'll do a test for that, like an acid fast test of the sputum. Get a chest X Ray. And if it is tuberculosis, it will require a prolonged course of antibiotics, so that I'll be over several months. Umm, and so I we'll get the infectious disease team involved to help kind of guide our management with the appropriate antibiotic choice, if it does come back to be tuberculosis.
user: Sure, I've been coughing for the past three days and it I can't seem to stop. It's affecting my sleep, so I just really like to get this fixed. 

assistant: OK, ah is the cough, with the cough have you been bringing up any sputum? 

user: No, it's it's dry. It's very dry. 

assistant: OK, have you brought up any blood?
user: No no blood. 

assistant: OK and the cough started three days ago. Has it gotten worse, gotten better, stayed the same? 

user: Ah you know, it seems to be getting worse, and now I even feel hot like I have a fever or something. 

assistant: I see. Is there any triggers associated with the cough like going outside into the cold, smoke inhalation or or dust or pets?
user: Um, no, not that I noticed. 

assistant: OK, have you tried anything to you help with the cough?
user: I tried over the counter cough syrup, but it's it's not helping. 

assistant: OK, and you mentioned the coughs interrupting your sleep. Has is the cough constant all day or are there particular times of the day that it's worse? 

user: It's just all day. 

assistant: Let's see OK, Um, and you mentioned that you started to feel hot when when did you notice that?
user: That was just today. 

assistant: Just today, have you taken your temperature? 

user: No, I haven't. 

assistant: OK, and have you been experiencing any other symptoms?
user: Mmm. I've been really tired but I don't know if that's because I can't get any seem to get any sleep. 

assistant: Well, because the coughs been keeping you up OK. Um, so have you had any headaches? 

user: Maybe a slight headache, but also I'm not too sure if that's because I've been coughing and it's putting strain on my head. 

assistant: OK, how about any discharge like mucus or tears from your eyes or ears?
user: No, nothing like that. 

assistant: OK, how about any pain around your eyes or ears?
user: No. 

assistant: OK, have you had a runny nose? 

user: Mmmm, no no. 

assistant: Alright. And within the last month or so, have you had any cold like symptoms with a runny nose, headache, sore throat, and or a cough?
user: Ah no. 

assistant: OK, so it's just been these last few days? 

user: Yes. 

assistant: Um, alright, and do you have a sore throat now?
user: Um, no. 

assistant: OK and, and how is your appetite been?
user: My appetite's been OK. I also it's just hard to eat because I'm coughing so much. 

assistant: OK, have you had any troubles with swallowing, like being painful? 

user: No, well, no no. I would say no. 

assistant: OK, um an in the last several months. Have you had any weight loss?
user: Um no weight loss. 

assistant: Alright, and have you had any chills? 

user: Maybe a little bit last night now that I think about it. 

assistant: OK, and how about any night sweats?
user: A little bit last night. 

assistant: OK, so you were a bit chilly and and then sweaty late last night?
user: Yes, a little bit. 

assistant: OK and feeling hot today? 

user: Yeah. 

assistant: Have you had any chest pain?
user: Um no, no chest pain no. 

assistant: Alright, and how about shortness of breath?
user: No. 

assistant: Alright, any wheezing?
user: No. 

assistant: Alright, and have you had any instances where you felt as though your heart was racing or beating out of your chest? 

user: No. 

assistant: Alright, and any instances where you felt like you were gonna faint, or maybe blackout?
user: No. 

assistant: OK and, have you felt dizzy at all?
user: Um no, no dizziness. 

assistant: Alright and have you had any loss or of your sense of taste or loss of your sense of smell?
user: Um no. 

assistant: OK. And have you had any diarrhea?
user: No diarrhea. 

assistant: Alright, and then how about any nausea or vomiting?
user: No. 

assistant: OK um. And so you have been fatigued? Have you had any muscle aches or or body aches? 

user: A little bit of both, yeah. 

assistant: I see OK and have you had any painful urination or feeling the need to urinate frequently?
user: No. 

assistant: OK, and any skin rashes or or skin changes? 

user: Ah no. 

assistant: Alright, um in regards to your past health. Have you been diagnosed with any medical conditions before?
user: I have hypothyroidism. 

assistant: I see OK and um, are you taking any medications for that? 

user: I'm on Synthroid. 

assistant: OK, great, when was your last TSH checked?
user: I believe I did it six months ago. 

assistant: OK, and were there any concerns with the range at that time?
user: No, I think it was normal. 

assistant: Alright excellent, do you take any other medications or over the counter? 

user: I I take this multi vitamin. I can't remember the name of it, but it's just something that I take every day. 

assistant: OK, any any allergies to medications?
user: No. 

assistant: Alright, and have you had any surgeries before?
user: Um, I had my appendix removed when I was a teenager. 

assistant: OK, and any complications with that surgery? 

user: No. 

assistant: Alright, um so next I was wondering if you could just tell me a little bit about your living situation?
user: Sure, I live with my husband and two children who are both teenagers. I, we live in a in a townhouse, and we moved recently. 

assistant: OK, and anybody in the home been sick?
user: My husband has been throwing up for the past two days and I think he was feeling a little hot too. 

assistant: OK, has he been assessed by a physician?
user: No, I tried to bring him today, but he refused. 

assistant: I see OK. Has he been around anybody who's been sick that you're aware of, like at work or anything?
user: He works at this IT company. There aren't a lot of them and they all have their own cubicles, so you know, maybe in the lunch room or something, but other than that, I don't think so. 

assistant: OK, and how about yourself? Any other exposures or sick contacts or maybe at work or something like that? 

user: Um so I do marketing stuff online, but I I work from home. 

assistant: OK. Um and your kids have been well?
user: Oh yeah, they've been. They've been healthy. 

assistant: Alright. And do you smoke cigarettes? 

user: No. 

assistant: And do you drink alcohol?
user: I'll have a glass of wine with dinner once in awhile. 

assistant: OK, do you and what's once in awhile?
user: Maybe every three or four days. 

assistant: OK, so a couple of drinks per week?
user: Yeah. 

assistant: Alright, and do you smoke marijuana? 

user: I have smoked marijuana. I don't regularly do it. 

assistant: No, OK, um and do you use any other recreational drugs?
user: No. 

assistant: OK um and has anybody in the family had a lung condition or or a heart condition before? 

user: My sister, who's 15 years older than I am, she had a heart attack quite recently. 

assistant: Oh, I'm sorry to hear that. Do you know what happened?
user: Um, you know, I'm not too sure she doesn't always eat the healthiest, and she doesn't do a lot of exercise. So I think maybe that had something to do with it. 

assistant: OK, um and did your parents have any heart problems? 

user: No, they were both healthy and they passed away a few years ago, but they died of old age, I guess you can say. 

assistant: OK. Any cancers in the family?
user: No. 

assistant: Alright so I think that's all I wanted to cover on the history today. Was there anything that you wanted to tell me I maybe didn't ask? 

user: Um no, I was just curious if you think I had COVID? 

assistant: Certainly one of the top things that I'm considering after hearing about your symptoms of having this cough and fever and being tired these last few days, especially with your husband being sick with nausea, vomiting, and not feeling well. That being said, it could be another type of viral illness, or possibly a bacterial infection. But certainly we will order some investigations, some blood work, a PCR nasal swab that will actually test for COVID as well as a chest X Ray to start with. Um and we will wait for some of those results to come back.
user: OK, yeah, that sounds good. 

assistant: Alright, so we'll get that started.
user: Well, I've had this cough but the biggest issue is that I've been really short of breath. 

assistant: OK, um, when did the cough start?
user: I would say about 3 days ago. 

assistant: Three days ago, OK, and uh, around that time did you also start feeling short of breath?
user: Uh, the shortness of breath has come on, I don't know within the last day or so. It's come on after that, the cough started first. 

assistant: OK, and the cough, is it a dry cough or is it a wet cough?
user: Well, I've been bringing up some yellowish green, kind of like phlegm, so um I guess a wet cough. 

assistant: OK, so yeah, yellowish green you said.
user: Yeah. 

assistant: OK, any blood in the sputum?
user: I haven't noticed any blood. 

assistant: OK, and how much sputum are you coughing up each time? Like is it kind of the size of your fingertip or does it fill your whole palm?
user: Um, yeah, probably more like the size of like a thumb tip. 

assistant: OK, OK um, and do you notice any, like pus or froth in the sputum?
user: Nothing like that I noticed. 

assistant: OK, and if you were to describe the sound of your cough, does it sound like it's barky or like a hacking cough?
user: I don't know, I guess hacking. 

assistant: Alright, and do you hear any wheezing at all? 

user: No, well, maybe I guess when I'm really short of breath, yeah, wheezing, yeah. 

assistant: OK, and the shortness of breath, how severe is it? 1 to 10, 10 being the worst?
user: Maybe a 7? 

assistant: At seven OK, are you having issues sleeping because of your shortness of breath?
user: Uh, well I can't tell if it's that or the cough. I mean between those two things it's been definitely interrupting my sleep. 

assistant: OK, and do you find there are any triggers to your coughing like like um, a particular time of the day? Triggers like you know pollen or things in your environment like pets?
user: No the cough has been kind of going on all day. Um, right when I get up in the morning and goes on all night, it's been getting worse to these last few days. 

assistant: OK yeah, um yeah, that doesn't sound great in terms of your shortness of breath. Do you find that certain positions make it worse? Or like exerting yourself makes it worse? 

user: Um, not really. 

assistant: OK, and have you ever experienced anything like this in the past?
user: No, I haven't. 

assistant: OK. And any other symptoms that you have along with your coughing and sputum? 

user: As soon as I breath, well, I just haven't felt good like, tired, kind of weakish. 

assistant: OK yeah um, along with your fatigue and feeling weak, have you experienced any dizziness or fainting spells?
user: No dizziness and I haven't fainted or anything like that. 

assistant: OK, any confusion or memory loss? 

user: No concerns with my memory. 

assistant: OK. And how about um, muscle aches or any sort of body aches?
user: Alright, yeah, maybe a bit, kind of, and weak. 

assistant: Yeah, alright, so let's go back to your shortness of breath. Do you have any chest pain associated with that?
user: Uh, no. 

assistant: OK, and do you ever feel like your heart's racing? 

user: No, nothing like that. 

assistant: OK, and how about changes to your bowel movements?
user: No, those have been normal. I haven't had any diarrhea or constipation. 

assistant: OK and no blood in your stool? 

user: I haven't noticed any blood, no. 

assistant: OK, how about abdominal pains?
user: Oh yeah, I don't know why, yeah, my belly's been a bit achy maybe. 

assistant: OK, and how about a sore throat?
user: No, my throat felt OK. 

assistant: OK, good and have you experienced any loss of taste?
user: No loss of taste, but I've noticed, yeah, my smell has been kind of funny. 

assistant: Your smell has been kind of funny, like you can't smell or do things smell differently than you expect them to? 

user: Yeah, there was a candle on earlier today and I guess I couldn't really smell it, so I guess I haven't been able to smell. 

assistant: Ok, do you have a runny nose or a blocked nose?
user: No, I haven't had to blow my nose or anything. 

assistant: OK, any changes in your vision or hearing?
user: No, that's been normal. 

assistant: OK, any discharge or pain in your eyes or ears? 

user: No, that's been OK. 

assistant: OK, and then any changes to your urine?
user: No, I haven't had any pain or anything like that. 

assistant: OK, and are you otherwise healthy? Do you have any medical conditions?
user: Yeah, I have atrial fibrillation. And I do take Metoprolol for that. 

assistant: OK, how long have you had A. fib?
user: It was like 4 years ago I think it was. It was having that like, felt like my heart was racing you were asking about earlier and they did an ECG and I was told I had atrial fibrillation. So yeah, I've been on a beta blocker for three years now. 

assistant: OK, four years, and when was the last time you had an ECG? 

user: Uh, maybe just a couple of months ago. I think every time that I come in to see my family doctor, they they do one. 

assistant: OK, and the last time that it was done, was it normal?
user: Yeah, they said yeah. My heart rate's been around 80 beats per minute which is good and I haven't had any symptoms so things have been stable. 

assistant: OK, good. And then have you had any hospitalizations or surgeries in the past?
user: I had an inguinal hernia repair about 15 years ago. 

assistant: OK, any complications from that? 

user: Um no. 

assistant: OK, and then besides the Metoprolol, are you on any other medications?
user: Oh yeah, I take a statin and baby aspirin. 

assistant: OK, and is that for the A. fib as well, the aspirin? Or is that just for other cardiovascular issues or some sort of preventative measure?
user: Yeah, I heard it was good for people who have atrial fibrillation so I started taking it. 

assistant: OK. and let's revisit your medications at the end of today's session. I just want to make sure that you're on the medications and I just want to make sure you're on the right dose.  Does that sound good?
user: Yeah, certainly. 

assistant: OK great. And ok, so we talked about your past medical history and medications. We will talk a little bit about any allergies that you have, if you have any.
user: I think it's like a sulfa allergy. I received an antibiotic like that many years ago and had a rash. 

assistant: OK, OK and have you had any reason to suspect that you may have taken any sulfas recently? 

user: No, I haven't had any antibiotics so no, really no changes. 

assistant: OK, OK, good and are you up to date with all your immunizations?
user: I am yeah. I've received the Zoster vaccine for shingles and also the one for pneumonia. 

assistant: OK, good, good yeah, those two we definitely recommend if you're over 65. OK, and do you know of any family history of lung conditions or heart conditions? 

user: No, I think my aunt had lung cancer but she smoked her entire life. 

assistant: OK, OK and how about other cancers?
user: No other cancers. 

assistant: And have you been in touch or do you think you've been in contact with any anyone sick recently? 

user: Well, I visited my mother at a long term care facility just this past weekend, so I guess about just over a week ago I visited there. 

assistant: OK, and have there been any COVID outbreaks at the long term care?
user: Yeah, there has been, I thought I was like away from those areas but I have heard about outbreaks there. 

assistant: OK, OK and any travel history?
user: No travel. 

assistant: And do you smoke?
user: I used to smoke a pack of cigarettes a day, but I quit about, uh, about five years ago. I know four years ago it was when I found out I had atrial fibrillation. I quit. 

assistant: OK, OK, well that's good. Good for you for quitting. How about marijuana? 

user: No, I don't smoke it, but I'll use some edibles I buy from the Ontario stores a couple of times per week. Just the CBD stuff. 

assistant: The CBD stuff OK. And how many milligrams?
user: I'm not sure, I know it's their lowest dose though. 

assistant: OK, OK if it's lowest dose, it might be 2.5 milligrams. 

user: Sounds familiar. 

assistant: OK good. Is there a particular reason you take these CBD edibles?
user: It helps me sleep. 

assistant: OK, if it's specifically to help you sleep, we can actually try and see if there are other options for you. You know there are pills, like they are sleep aids. Or even things like melatonin that can help regulate your sleep so we can revisit other options for you if you're open to that as well.
user: OK for sure. Yeah I will. Um, yeah we can talk about that later. 

assistant: OK, that sounds good and do you do any other recreational drugs? 

user: I do not. 

assistant: OK, how about alcohol?
user: Uh, no, I don't drink anymore. 

assistant: OK, and did you used to drink before?
user: Yes, I just stopped a few years ago, 

assistant: OK, and what's your living situation like right now?
user: I live in a house with my wife. 

assistant: In a house, OK. Any concerns for like old carpets, mold or asbestos in your house?
user: No, we've renovated it over the years. 

assistant: OK, good and I apologize, but I would like to clarify three more symptoms with you. Did you say you felt like you had a fever earlier?
user: Um, maybe I've been feeling a little hot, but it's been really more the cough and shortness of breath that's been bugging me. 

assistant: OK, well we can take a temperature today just to make sure. Have you been feeling like you have night sweats or chills? 

user: Um, not really. No, I haven't noticed that. 

assistant: OK, and how about, um, any weight loss over the past few months?
user: No, it's been been stable. 

assistant: OK, alright good, so that brings us to the end. Do you have any questions or concerns that you would like to clarify before we end the interview?
user: No, nothing today.  I was just really hoping to get, uh, whatever this is sorted out. 

assistant: Yeah, you know, um, right now it looks like, it sounds like it could be an upper respiratory viral illness, so that includes COVID.  So we will do a swab for you and then send it off to the lab for PCR results. In the meantime, because you have symptoms that overlap with COVID symptoms, we do encourage isolation for 14 days. Until your symptoms are gone, sorry,  until your symptoms are gone, even if they're gone, we do suggest isolating for 14 days just to make sure you're not a carrier or could spread COVID so we do encourage that, and that includes from your husband. If possible, we will get those results in a day or two. If they are positive, we will send your results to public health who will be in touch with you to do some contact tracing to see where you may have gotten it from. If it's not COVID, it could be other viral illnesses that are going around this time of year. And if your symptoms aren't getting better on their own, and there's reason to suspect you may have a bacterial infection or bacterial pneumonia, we will follow up with you and possibly prescribe antibiotics. How does that sound? 

user: Yeah, that sounds like a great plan. 

assistant: OK, great so um, I will see you at the next appointment.
user: Um, I've just had difficulties with breathing for the past, I want to say eight, nine months. And um, my wife just told me to come in. It's just, she was worried about it and uh, I thought I'd just come in and have it checked out. 

assistant: Okay, so it's been going on for the last eight to nine months. Has it been getting worse at all?
user: Yeah, I would think so. I would say so, yeah. So, 

assistant: Sorry, go on.
user: So, it was just um, I feel like I just get short of breath more easily now. 

assistant: Okay, and is it short of breath with activities? Or are you getting short of breath with uh, sitting or resting as well?
user: So when I'm, when I'm, with activity. 

assistant: With activity, okay. And the cough that you're getting, is it a wet cough or a dry cough?
user: It's a dry cough. 

assistant: Okay. And are you bringing up any material at all, like any um, yellow or green sputum?
user: No, no. 

assistant: Any blood?
user: Um, no, no blood. 

assistant: No blood, okay. And with your shortness of breath, is it, are you having difficulty taking deep breaths, or do you find that you're taking more fast, shallow breaths? 

user: Um, just, I guess, just uh, shallow breaths. 

assistant: Okay, okay. And um, so this is over the last eight or nine months. Have you noticed any other symptoms at all, like chest pain, dizziness or fainting? No?
user: No. 

assistant: Okay. And do your symptoms get, get worse at all when you're lying flat, like when you're sleeping?
user: No. 

assistant: No. And do you ever wake up gasping for air? 

user: No. 

assistant: Okay. Um, and have you tried anything that's helped you uh, relieve some of these symptoms?
user: Sorry, could you say that again? 

assistant: Uh, have you tried anything like over the counter, to help you relieve these symptoms?
user: No, no I haven't. 

assistant: Um, have you traveled at all recently? 

user: No. 

assistant: Have you been in contact with anyone that's been sick?
user: Um, no, not really. I, I did go out to the pharmacy to get my medications, but that's, that's the only time I actually interact with anyone outside of my home. 

assistant: And what, what medications do you take? 

user: Um, I just take aspirin. 

assistant: Aspirin, okay. Have you been diagnosed with any medical conditions?
user: I had a heart attack. 

assistant: Oh okay, well when was that? 

user: Last year. 

assistant: Last year, well I'm so sorry and um, did they give you any medications to go on after that?
user: Yeah yeah, yeah there, there were a couple of other medications as well. Something um, something, something -pril. And uh, I think there's uh, uh, rosuvastatin. 

assistant: Okay, and do you still take those? 

user: Yeah, I take those. Sometimes I forget that I do, I try to take them as much as I can. 

assistant: Okay, and you also take the aspirin. Alright, have you noticed any fevers or chills?
user: No. 

assistant: Nausea or vomiting? 

user: Nope. 

assistant: And any chest pain?
user: Uh, no. 

assistant: No, okay. Any increased fatigue? 

user: No. 

assistant: Any diarrhea or constipation?
user: No. 

assistant: Any numbness or tingling anywhere? 

user: No. 

assistant: Any confusion or memory, like memory loss?
user: Um, no, I don't think so. 

assistant: Any trouble urinating?
user: Um, no. 

assistant: Okay, have you noticed any swelling um, in your feet, ankles, legs at all?
user: No. 

assistant: Okay. Um, and how's your appetite been like? 

user: Um, it's been, it's been the same. 

assistant: Okay, and any um, significant weight changes? Have you lost any weight?
user: No. 

assistant: No. Um, any exposure to fumes or dust within your environment? 

user: Um, not right now. When I was young, yeah. 

assistant: Okay, now did you, so did you have exposure to fumes or dust?
user: Um, I used to work in a mine so. 

assistant: A mine? 

user: Yeah, lots of chemicals and things like that. 

assistant: Okay. And any exposure to any pets or animals?
user: Uh, no. 

assistant: Besides your medical history of having a heart attack and some blood pressure, um, any other medical conditions? 

user: Uh, I just have high blood pressure. 

assistant: Okay, any allergies to any medications or any environmental allergies?
user: No. 

assistant: Okay. Um, any hospitalizations besides when you had a heart attack, previously?
user: No. 

assistant: Okay. Did they tell you at all what the cause of your heart attack was? 

user: Um, they just uh, they said it was my, my diet. 

assistant: They said diet, okay.
user: Yeah, something about cholesterol. 

assistant: Did you require any stents, or did you have to get a bypass surgery or anything like that?
user: Uh, they put in, I think they put in stents. 

assistant: Stents, okay. Um, any family history of any heart or lung conditions?
user: Yeah, um, my um, mom had heart failure. 

assistant: Okay, um, and how old was she when she had her heart failure? 

user: She was young, she was uh, 55. 

assistant: 55, okay. Um, and currently, right now, or sorry, do you have any family history of any cancers, any lung cancer or anything like that?
user: No. 

assistant: And currently do you work or are you retired?
user: I'm retired. 

assistant: Okay. And what's your living situation like right now? Do you live with anyone? 

user: I live with my wife. 

assistant: Okay, and do you smoke?
user: Uh, no. 

assistant: Have you ever smoked?
user: I did when I was young. 

assistant: How long would you say you smoked for? 

user: Um, I'd say 45 years. 

assistant: And how much would you smoke in an average day?
user: Um, about a pack a day. 

assistant: Um, any recreational drugs like marijuana?
user: Yeah I do. Um I'll, I'll drink a glass at night, every night. 

assistant: And a glass of, what would you drink?
user: Oh just a, a glass of wine, white wine. 

assistant: Okay, so those are all the questions I have for you today. Any questions for me?
user: No. 

assistant: Okay, so yeah, there's definitely like the coughing and shortness of breath are definitely concerning, and they've been going on for a pretty long time. Do you ever have any night sweats or anything like that? 

user: No. 

assistant: Okay. So there's a few things that we think about with the chronic shortness of breath and a cough. One could be just a COPD diagnosis with your long history of smoking. And this pulmonary function test, get an x-ray, chest x-ray as well. Um another thing that we need to look out for is uh, lung cancer. And since you have been smoking for a pretty long time, even though you may have quit, which is really great, but that long history of smoking, especially also with um, you working in a mine, those are some things that means we can test as well, and so we may require like a chest x-ray, and even um, a CT scan of your lungs as well. Um, so yeah, first we'll just do a couple tests, do a physical examination, get your vitals, do some blood work and do some of those tests and then we'll also get a COVID swab test done for you as well, just in case. Does that sound good?
user: Hi I umm, so I started to have this cough that started like 2 days ago and also these last couple of days I've just had this headache and feeling really achy all over. 

assistant: OK, I'm sorry you said it started a day, two days ago?
user: Yeah, it's more like one to two days. All of this is kind of started. I think the the cough started 1st and then the headache and achiness has come after. I felt a bit feverish as well. I haven't checked my temperature but I, I felt feverish. 

assistant: OK. The cough, is it dry, or are you bringing up any phlegm?
user: It's pretty dry. 

assistant: Dry, OK, so no blood and no sputum? 

user: No blood or sputum. 

assistant: OK, do you feel short of breath?
user: No thats I haven't been short of breath. 

assistant: OK, how about wheezing? 

user: No wheezing. 

assistant: OK. And any chest pain?
user: No, I haven't had any chest pains. 

assistant: OK, alright. And the headache one to 10, 10 being the worst head, worst pain you've ever been in. How bad was it?
user: I'd say a four. It's just been kind of there the whole, so it's really annoying. I've tried some Tylenol and it's taken a little bit off the the I mean the edge off a little bit, but it's just been kinda there still. 

assistant: OK. And is it a throbbing kind of pain or is it a dull, achy pain? 

user: It's a kind of a dull, achy pain. 

assistant: OK. Uhm, alright and where is it located?
user: Uh kind of in the front of uh I have my over my head and on both sides as well. 

assistant: OK, OK. Any feelings of feeling like your heart's racing? 

user: No, I haven't felt like that. 

assistant: OK, any dizziness or fainting spells?
user: No, I haven't had anything like that. 

assistant: Confusion or memory loss?
user: No, nothing like that. 

assistant: OK, and any neck pain or stiffness? 

user: No, nothing like that. 

assistant: OK, running or stuffy nose?
user: No, my, I haven't had anything like that. 

assistant: Sore throat? 

user: No. 

assistant: No, OK, how about that loss of smell or taste?
user: Uh yeah I have actually. Yeah, I have. 

assistant: OK, both? 

user: Yeah, both it's uh, I've actually yeah, I notice that in the last day, it's kind of weird. I didn't even think of it until you until you asked there. 

assistant: OK.
user: But yeah, I have haven't really noticed being able to smell or taste. 

assistant: OK, any changes in your vision or hearing? 

user: No. 

assistant: OK. Weight loss?
user: No weight loss, I've been, that's been stable. I wish. 

assistant: OK and you mentioned you might have had a fever so we'll check your temperature today as well. Any fatigue?
user: Uh, not really. That's been OK, but been achey, so certainly doing less. 

assistant: OK. Any rashes? 

user: No rashes. 

assistant: OK, any changes to your bowel movements?
user: No, that, everything has been normal there. I haven't had any diarrhea or no blood in the stool. 

assistant: OK. Any nausea or vomiting?
user: No nausea or vomiting. 

assistant: OK. Changes to your appetite? 

user: Yeah, I've been, less interested in food for sure. I think I've been been, been, had a decreased appetite. 

assistant: OK. Changes in your urine?
user: No, I haven't had any any pain or any anything changing to my urinary habits. 

assistant: OK. Are you otherwise healthy? Do you have any longstanding medical conditions? 

user: Uh, I I do have high blood pressure and high cholesterol and I take a statin as well as a what is it, an ACE inhibitor, I think, for the blood pressure, yeah. 

assistant: OK, and are you up to date with your immunizations?
user: Uh, I am yes I think so. 

assistant: Yeah, OK. Alright, and are you allergic to anything?
user: No, I don't think so. 

assistant: No, OK. Alright, and any family history of lung or heart conditions. 

user: No, nothing like that. 

assistant: OK, umm, alright. Do you smoke?
user: I don't, no. 

assistant: No, OK. Any other recreational drugs?
user: Uh, no. 

assistant: OK. Do you drink alcohol? 

user: Yeah, sometimes I'll have a glass of wine on the weekend or something like that, but that will just be one or two, maybe with dinner. 

assistant: OK. And have you been in contact with anyone sick recently?
user: No, I I don't think so. I mean, I've been working from well, some days I've had to go into the office for work, but I've been mostly just working from, from home. 

assistant: OK. OK. Uhm and where do you live right now? 

user: So I live in a house downtown in the city here and I live with my wife and our two sons. 

assistant: OK, any are they, they're ok, they're all healthy?
user: Uhm, yeah they they, they uh, well my son actually had a cough and a sore throat I think like last week or something like that but it just went it went away. 

assistant: OK. Uhm, and do you have any old carpets? Asbestos, mold, anything like that in your home?
user: Uh, no, nothing like that. 

assistant: No, OK. Uhm alright, I think those are all the questions that I had for you. Did you have any questions of your own for myself? 

user: I was just well worried about Covid and was just wondering what I should do. 

assistant: Yeah, for sure. So we are, you're a lot of your symptoms do overlap with those of Covid, so we are going to take a swab today and you should hear back in about 24 to 48 hours, but you should isolate for 14 days. And that includes from family family members if possible. Uhm, and basically just keep an eye on your symptoms. If they get worse, or you're having like neurological symptoms, you should seek help from the ER, but otherwise keep yourself hydrated, eat well. If you have a humidifier in the basement, use it, and for your fevers you can take antipyretics like Tylenol. And just it's it's just a lot of supportive care. How does that sound and obviously like if your symptoms aren't going away after like a few weeks, call us back and it could be something like bacterial, in which case we can give you some antibiotics.
user: 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. 

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

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

assistant: 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?
user: 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. 

assistant: OK, I'm just going to ask you a few more questions about the vomiting. Have you noticed any blood in your vomit?
user: No, it's been kind of yellowish. 

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

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

assistant: OK And you said now it's it's happening every couple hours for you?
user: 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. 

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

user: 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. 

assistant: OK.
user: My appetite really hasn't been there. 

assistant: 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? 

user: 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. 

assistant: OK. Have you ever had anything like this before?
user: No, I haven't been sick like this before. 

assistant: OK, have you traveled anywhere recently?
user: I just got back from a trip in the US was there for work. 

assistant: OK, and how did you travel there?
user: I I. Traveled by a train. 

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

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

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

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

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

assistant: OK. In addition to the symptoms that you're describing to me, have you had any fevers?
user: I've I started to feel hot this morning. 

assistant: OK, have you had any chills?
user: Nothing like that. 

assistant: Any shakes? 

user: No. 

assistant: K night sweats?
user: Um no night sweats. 

assistant: Have you had any cough? 

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

assistant: OK, scratchy throat OK. Have you had any sore throat?
user: No, I wouldn't really say it's sore, but. Yeah, I mean we just kinda like like itchy. 

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

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

assistant: OK. Mmmm. And you live, do you live alone or with family?
user: I I live with family. I live with my wife and two children. 

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

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

assistant: OK. OK, um, so just in terms of your general health, are there any conditions that you see your family doctor for regularly?
user: I have anxiety and back pain. So, uh, I do get ah. Some hydromorphone for for that. 

assistant: OK 

user: For the back pain anyway. 

assistant: OK. Um, and what medications do you take besides the hydromorphone?
user: Uh, uh, Escitalopram. 

assistant: OK. 

user: 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. 

assistant: OK, and have you ever had any surgeries?
user: 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. 

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

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

assistant: 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?
user: 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. 

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

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

assistant: OK. OK, and just in terms of your lifestyle. Do you drink alcohol?
user: Um yeah I will have wine. Maybe one or two glasses on on the weekend. 

assistant: OK, do you smoke cigarettes?
user: Umm no but I I used to, I I quit about seven years ago. Yeah, so I quit about seven years ago. 

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

user: 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. 

assistant: 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.
user: OK, that sounds good. 

assistant: 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. 

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

assistant: Perfect. Actually, don't go into the store. Have someone else get it for you, but.
user: OK will do. Thank you. 

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