jshargo/medical-interview-conversations2 huggingface dataset:
user: No, no I don't think so. 

assistant: OK, and have you had any difficulties breathing or short of breath? 

user: No. 

assistant: OK. And have you had any symptoms like this before?
user: No, nothing like this. 

assistant: OK. And how has your energy level been? Have you been fatigued?
user: A little bit, yes. 

assistant: OK. Have you had any changes to your vision or or hearing?
user: No. 

assistant: Any mucous or pain or discharge from either your ears or nose?
user: No. 

assistant: OK, so your nose hasn't been runny, but has it felt congested? 

user: umm, no. 

assistant: OK, have you had any fevers or chills?
user: I don't know about fevers. I guess I was feeling a little bit hot last night, but I didn't take my temperature. 

assistant: OK, so possibly a fever. I will certainly check your temperature today to investigate that. Have you had any night sweats?
user: Umm, no night sweats. 

assistant: Alright. And have you had any weight loss in the last few months? 

user: No. 

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

assistant: Have you noticed any heart palpitations or heart racing? 

user: No. 

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

assistant: Alright. And have you had any abdominal pain?
user: No. 

assistant: OK, how about any urinary problems? 

user: No. 

assistant: Problems like diarrhea or constipation?
user: No. 

assistant: OK, and any muscle aches or or body pains?
user: No. 

assistant: Have you had any rashes?
user: No. 

assistant: OK, so the cough started 5 days ago, you had a sore throat, you've been feeling a bit more tired and haven't been able to taste your food for the last couple of days. 

user: Yes. 

assistant: OK. Have you been diagnosed with any medical conditions before?
user: Um, no, I don't think so. 

assistant: OK, nothing you see a physician regularly for?
user: No. 

assistant: Alright, do you take any medications? 

user: No. 

assistant: Alright, do you know if you have any allergies to medications?
user: Umm, possibly penicillin. 

assistant: OK, do you know what the reaction was? 

user: I think I had a rash. 

assistant: OK. Are your immunizations up to date?
user: I think, yeah, I think so. 

assistant: Excellent and any surgeries before? 

user: Umm, no. 

assistant: And have you been in the hospital for any reason?
user: Umm, no, no. 

assistant: OK. And are you in school now? 

user: I'm in grade 6. 

assistant: OK, cool, what's your favorite class?
user: I would say it's math. 

assistant: Awesome and has there been anybody in your class who's been sick?
user: No, everything's virtual right now. 

assistant: OK cool, so have you traveled anywhere? 

user: Umm, no. 

assistant: Alright, and who are you living with?
user: I live with two of my younger siblings and my mom and dad. 

assistant: OK, and is there any physical or verbal abuse in the home?
user: No. 

assistant: OK, so you do feel safe in the home?
user: Yes yes. 

assistant: OK. And do you smoke cigarettes?
user: I don't. 

assistant: OK and I know some people in your age group might even start using other types of substances. Have you noticed anything like that, or have you used anything like that? 

user: Umm, no. 

assistant: OK. And so do you drink? do you drink alcohol?
user: I have had a sip of wine, but that's that's about it. 

assistant: OK, great. And has anybody in your family had had similar symptoms?
user: No, I don't think so. 

assistant: OK, um and anybody in the family have asthma or lung conditions? 

user: I think my aunt has asthma but I was I was checked for asthma when I was younger and it turns out I don't have it. 

assistant: OK, and any diseases that run in the family like genetic or congenital?
user: I think Crohn's disease. 

assistant: OK, and umm, who in the family has that? 

user: My father. 

assistant: OK, so that was everything that I wanted to ask today, was there anything else you wanted to tell me?
user: This afternoon, I'm just here because I've been experiencing some breathlessness as well as a bit of cough. 

assistant: OK, when did it start?
user: So I think it's a it started around three months ago and I believe it's just been getting worse. 

assistant: OK. Um, how often are you experiencing the shortness of breath? 

user: I feel it like a lot of the time, especially outside when I'm in the cold or at at night when I go outside at night, my chest feels a little tight too at the same time. 

assistant: OK, and how long does it last?
user: I would say it lasts up to an hour every time I'm out in the cold and then once I come back in. So I'd say it lasts at least one hour. 

assistant: OK, does anything else make it worse, like dust? You know, laying down anything like that?
user: Sometimes when I'm near dust, sometimes when I'm running during gym class, increased activity does make it worse. 

assistant: OK, OK. And if you were to describe the quality of your breathing difficulties, is it more like a burning kind of feeling? Is it like you can't catch your breath? What does it feel like? 

user: I think it's more just a I can't catch my breath and it feels like my my throat is just kind of like closing off and I can't take deep breaths. 

assistant: OK, yeah, that's scary. And one to 10, 10 being the worst, how bad is your shortness of breath?
user: It can get up to I would say like an 8 at times. It can get pretty scary. And sometimes, like I feel like heaviness in my chest too when it happens. 

assistant: Yeah, and the coughing, has it been going on for as long as your breathlessness?
user: I would say around the same same time frame like 3 months, but I'm not always coughing. It comes and goes. 

assistant: OK, and for your coughing, is it kind of like the same triggers, the cold, dust, things like that? 

user: Yeah, I would say so. 

assistant: And do you ever have do you ever cough up blood?
user: No, I don't. It's mostly just a dry cough. I don't cough up anything. 

assistant: OK so no sputum or phlegm, no? OK, do you ever feel wheezy? 

user: I I I do hear like a like a weird sound when I breathe out sometimes, I I think it might be wheeziness. 

assistant: OK, OK. Do you have a sore throat?
user: Uh, no I don't have a sore throat, no. 

assistant: No? Um, how about a runny nose or stuffy nose?
user: No, nothing like that. 

assistant: Any changes in your smell?
user: No, no changes in my smell, no. 

assistant: OK. How about hearing? 

user: Uh, no hearing is fine. 

assistant: OK and like no pus or liquid's coming out of your ear or anything like that, right?
user: No. 

assistant: No ear pain?
user: No. 

assistant: OK, and how about your vision, everything OK there? 

user: Yeah, everything is OK. 

assistant: OK, any fevers?
user: I don't know about a fever, I haven't checked, but some nights I do, especially in the last week I have woken up feeling a bit chilly. I haven't really checked. 

assistant: OK, so you woke up feeling chilly, any night sweats?
user: Uh no. 

assistant: OK, any weight loss?
user: No no. 

assistant: How about changes in your skin? Like have you noticed a rash anywhere? 

user: Uh, not that I've really noticed no, no rashes. 

assistant: OK and any chest pain at all?
user: No, just sometimes when I I'm coughing a lot I feel a little bit of just tension and heaviness in there. But that's just when I'm like really coughing a lot. 

assistant: Yeah OK, and any any feelings like your heart's racing? 

user: Nope. 

assistant: No? OK. And how about swelling? Have you noticed swelling anywhere in your body?
user: No, nothing like that. 

assistant: No? OK um, OK, how about um, does your shortness of breath get worse when you're falling asleep?
user: No, nothing like that. I think it's mainly just worse if I go out in the cold or I'm like running around, doing more activities. 

assistant: Does it ever wake you up at night? 

user: No never. 

assistant: OK and any nausea or vomiting?
user: No, no nausea or vomitting. 

assistant: OK, how about changes in your in your bowel movement? 

user: No, bowel movements are normal. 

assistant: How about in terms of urinating, any changes there?
user: No no. 

assistant: OK any headaches?
user: No. 

assistant: No? Any dizziness or fainting spells?
user: No. 

assistant: Confusion, memory loss? 

user: No, nothing like that. 

assistant: OK, good are you otherwise healthy?
user: Yeah, I don't have any other condition, I I do remember my doctors saying I have hay fever before, but that's about it. 

assistant: When was that?
user: I think that was like more than three years ago. 

assistant: OK, um, any recent surgeries?
user: No. 

assistant: No? Are you on any medications?
user: I just take some Tylenol sometimes for the like Tylenol cold, sometimes for the symptoms. I don't think it has really helped. 

assistant: No? OK, do you have any allergies? Not just to medications, but to anything else?
user: Uh just like hay fever but nothing, nothing else that I can think of, no. 

assistant: OK. Um, are you up to date with all your immunizations? 

user: As far as I know, yeah everything's up to date. 

assistant: OK, any family history of lung conditions?
user: Uh, don't think so. My sister, I think she they were saying she might have asthma and she also has eczema. No one else in the family has any other conditions. 

assistant: Not not even like heart conditions, cancer?
user: No, uh no, not that I know. 

assistant: OK, OK, have you been in contact with anyone who's been sick recently?
user: No. 

assistant: No, OK, and any travel recently?
user: No, I've been here in Ontario. 

assistant: OK, and where do you live? 

user: So I currently live in London, but I just recently moved into a new flat around two months ago. 

assistant: Two months ago, OK. Um, is it more is it an older flat?
user: Uh, no, it's fairly new. But one thing I did notice, I don't know if this has anything to do with it, but my flatmate actually smokes. Sometimes that can really irritate and make me cough more sometimes at night. 

assistant: Yeah, any any pets? 

user: Oh no, I don't have any pets. 

assistant: OK and and do you smoke?
user: No, I don't smoke, no. 

assistant: OK. And do you smoke marijuana? 

user: Nope, never tried marijuana. 

assistant: OK, any recreational drugs?
user: No, I don't smoke marijuana or cigarettes. 

assistant: OK, how about alcohol? Do you drink alcohol?
user: Um, just like, maybe sometimes at parties, but very rarely. Maybe I would say once a month. 

assistant: OK, OK. Um, and is there anything that you wanted to discuss today that I missed? 

user: Uh, so no, I think that that was all like just the shortness of breath was scaring me a lot. But yeah, just the coughing, but other than that I just want to know what's going on. 

assistant: OK, yeah, and you mentioned you are otherwise healthy so you don't have any history of asthma or anything like that, right?
user: No, no ones ever told me that, but my sister has asthma, so I was wondering, maybe? 

assistant: Um, have you ever experienced shortness of breath when you were younger with like exercise? 

user: Uh, not really. Just maybe like the normal amount. Like if I'm running around too much, I feel shortness of breath, but I think it just got worse over the last few months. 

assistant: OK and then have you ever had any imaging done in the past like a chest X-Ray or investigations like a pulmonary function test?
user: No, I don't recall having any of that done. 

assistant: OK alright well those are all the questions I had for you. If you didn't have anything else to add, I guess we will conclude by saying that what you have, we have a differential diagnosis for this. Um, it sounds like what you have is asthma. Since your symptoms started three months ago when you moved into a flat with your friends, and it seems like this smoking and cold is triggering that and so we'll work you up with a pulmonary function test to start and we'll see if bronchodilators will help with your symptoms. And if it doesn't, we'll also rule out other things like pneumonia or like allergic rhinitis. How does that sound? 

user: Yeah, that sounds good. 

assistant: OK, sounds great. Well, we'll see you soon then.
user: Alright, thank you. 

assistant: Take care.
user: Hey, so I just for the last couple days I've just been feeling really short of breath really rundown. Just like super tired and you know, normally really active and I'm just, I'm just having a rough go. 

assistant: Is there is the shortness of breath knew for you?
user: Yeah yeah, it's just like just like I can't. I don't know like I can't catch up. I kind of just feel I feel a bit weak like I've just been feeling really tired and then because of that I haven't really been eating a lot so. Yeah, I don't know. 

assistant: So. You've just been feeling very tired, can you I guess, like tell me a little bit more about your difficulty with breathing. When does it happen? 

user: I think just like overall, I'm finding it like it's hard to hard to get like super deep breaths it's not like I I can't. I don't get the feeling that I can't breathe. It's just that everything's a little bit more like laborious. 

assistant: OK. And you said that it started a few days ago. Have you had any other symptoms other than the difficulty breathing and the fatigue?
user: I mean. I felt I think I felt really hot yesterday. I don't know the thermometer, but I had my wife put her put her hand on my forehead and she got a I felt pretty warm. And come to think of it, I this morning I, I really I didn't eat much because I just haven't been that hungry, but I don't really feel like I couldn't really taste my breakfast. 

assistant: Has that ever happened to you before? 

user: No never I like, I like my food. 

assistant: Me too, um OK, what about your sense of smell? Do you feel like you're not you are not able to smell well either?
user: I haven't thought about it too hard, but yeah, kind of. 

assistant: OK. And have you had a cough? 

user: Uh I don't know I. I feel like I maybe could be starting starting one. 

assistant: Sure.
user: Like it's when it feels dry like it's on its way. Haven't really been coughing much. 

assistant: I see, what about a sore throat?
user: I’m starting to feel a little bit like that. Like I don't know if I'm imagining it, but yeah, I I think so. 

assistant: I see OK. Have you had a runny nose or any congestion? 

user: No. 

assistant: Any headaches?
user: Uh. Good question, I I kind of I get I get headaches fairly often I don't think I'm getting any more than usual, but I have had a little bit. 

assistant: OK. Is the headache that you've had different in quality from the headaches that you usually get? 

user: I mean, I don't know, I don't know. I usually get kind of difficult stress headache, you know? 

assistant: Yeah yeah.
user: Pretty well. I am stressed, just that I you know, might be sick. 

assistant: And have you had any changes in your vision or hearing?
user: No. 

assistant: In the past three four days, no OK. Any nausea or vomiting? 

user: No, no, I haven't. 

assistant: Have you had any chest pain?
user: Uh, like it's. No, yeah no. No chest pain. 

assistant: Any do you feel like your heart's beating really fast? 

user: No, I wouldn't say so. 

assistant: OK, have you had any pain in your belly?
user: No. Cause I I meant I haven’t really been eating but yeah. 

assistant: OK, any urinary symptoms? 

user: No, I don't think so. 

assistant: OK. And you mentioned you have muscle aches, is it, so all over your body or is it a specific part, specific area?
user: I would just say I feel kind of overall achy. 

assistant: OK, 

user: Um not any one spot. 

assistant: Any numbness or tingling in your arms or legs?
user: Uh, no. 

assistant: OK. All right, have you had any exposure to anyone who could potentially be sick?
user: Well. My grandkids, uh, visited last weekend and my grandson has a cold. He goes to daycare. Yeah, so I'm not really. I'm not really sure like he's been staying home and they didn't. They didn't really know that when they came to visit. 

assistant: OK, that's yeah, uhm OK. And have you traveled anywhere outside the province?
user: No no. 

assistant: OK alright. Do you have any medical conditions that you've been diagnosed with?
user: Uhm? I'm pretty, I'm pretty healthy. I have some um like reflux that I see my doctor for. And I've had I've had some difficulties like with like urinating a little bit. Yeah, my my prostate's a little big like it's not cancer but. So just those two things that aren't that aren't there that really big deal they don't affect my life too much. 

assistant: Are you taking any medications for either problem? 

user: I take avodart. 

assistant: OK.
user: And for the the reflux I take a tums here and there I used to be on a medication, but it seemed like I kind of figured out the foods that were going to help, so I stopped. 

assistant: Great, that's great. Any allergies to medications, foods, or environmental allergies? 

user: Uh no, no 

assistant: No, and any medical conditions that run in the family? Specifically, anything related to the lungs?
user: No, not that I can think of. 

assistant: And do you you mentioned that your grandkids have came to visit. Do you live alone? 

user: Uh no. I live with my wife. 

assistant: And are you currently working or are you staying at home?
user: Uh, I'm working from home. I I, I've gone out a few times to see clients. I work as a financial advisor. I've gone to see a couple clients that are really old and have a hard time doing stuff over the phone or over the computer, but I'm like 95% from home. 

assistant: Have you gone to see any clients in the past three or four days or in the past week? 

user: No, no, it's probably been a couple weeks since I saw anyone . 

assistant: Sure OK. And do you smoke? Or did you ever smoke at the past?
user: No, I I maybe did for maybe like three years in my 20s. It wasn’t heavily yes. 

assistant: Any marijuana or recreational drugs? 

user: No. 

assistant: Any alcohol?
user: I usually have a whiskey or two on the weekends. 

assistant: OK alright. Uh so it sounds like you have some sort of an infection with the fevers and fatigue and muscle aches, and then the difficulty breathing, of course, and then your sensation, that sensation that you are having a very cool sort of a sore throat and cough that you might be getting. We can't necessarily rule out covid just yet. 

user: Thats what I was worried about. 

assistant: Yeah, and given that you're having difficulties breathing, we're also going to have a look at your chest and do it physical exam, but also do a chest X Ray just to make sure, or just to see if there's anything a infection that is settling in your chest, and a covid swab and then uh go from there. We’ll decide whether you need to stay in the, you need to stay in the hospital and if you can go home based on those results, but if you are to go home, we would request that you stay away from from everyone, so including your wife. Try to self isolate as much as possible and your results should come out in 24 to 48 hours and then the public health nurse should tell you what to do if your results are positive.
user: OK, OK no, that sounds fair, 

assistant: All right. Well, let's do a physical exam and then go from there.
user: Hi, I've just had a runny nose and a cough for the past uh week. 

assistant: OK, um so for the past week you said, did the cough start first, or the runny nose? 

user: Uh it started with the cough. I usually don't come in when I have symptoms like this uh, but I've just been, uhm, I just heard of someone who passed away due to Covid and I'm just like very scared and I just decided to come in. 

assistant: Yeah, for sure that's understandable. Um With the cough, is it a dry cough or are you bringing up some phlegm?
user: Um it's mostly a dry cough 

assistant: Dry cough. OK, um and is it persistent or does it come and go?
user: It comes and goes. It does get better when I um take um like over the counter medications for for um like the antitussive pills. 

assistant: OK yeah yeah. Um and does anything make it worse like the cold air or certain times of the day or like when you're laying down? 

user: Um the cold air does make it a little bit uh worse. 

assistant: OK. And have you experienced something like this in the past?
user: Uh yeah, I usually I do get a cold um couple times a year. 

assistant: OK yeah, that makes sense. Um and any shortness of breath?
user: Um no, no I don't think so. 

assistant: No, any wheeziness? 

user: Um no. 

assistant: Chest pain?
user: No. 

assistant: Um, how about a stuffy nose?
user: Yeah, I do have a stuffy nose. 

assistant: OK, when your nose does run, do you notice that it's like uh yellow in colour or red? 

user: No, no. 

assistant: No, OK, so it's clear?
user: It's clear, yeah. 

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

user: No. 

assistant: Smell or taste?
user: Um I I can't smell as as much, but I think maybe it's just because my nose is so stuffy, but also that made me a little bit concerned about Covid, but no problems with taste. 

assistant: OK, good any weight loss recently? 

user: Um I've been trying to lose weight, but nothing unintentional I guess. 

assistant: OK yeah, and then any fevers?
user: Uh no. 

assistant: No fevers huh, OK. Any like excessive fatigue? 

user: I am tired but not, I guess it's not too bad. 

assistant: Yeah OK, and how about like rashes?
user: No, I haven't noticed any. 

assistant: No rashes, OK. Um any uh, sorry, I asked you if you had chest pain, uh do you ever feel like your heart's racing?
user: No. 

assistant: No, OK. Any changes to your bowel movements? 

user: No. 

assistant: No, um nausea or vomiting?
user: Uhm, no. 

assistant: No, OK. Uhm how about headaches?
user: Uhm, no. 

assistant: Fainting spells or dizziness? 

user: No. 

assistant: Joint pain?
user: Um no. 

assistant: No, OK.
user: Just my body feels a little achy, but. 

assistant: Yeah. 

user: No like specific joint pains. 

assistant: OK, and then any uh major illnesses that are longstanding?
user: Um I don't know does depression count? I do have depression. 

assistant: OK, yeah, for sure. How, when were you diagnosed with depression? 

user: Uh when I was 15 years old. 

assistant: 15, OK. Um are you on any medications?
user: I'm I'm on Prozac. 

assistant: Prozac, OK. And when were you diagnosed uh, prescribed that? 

user: Um I've just been on different medications uh over the past few years. Um this one seems to be working well. I started this about a year ago. 

assistant: OK good good, any allergies?
user: Uhm, no. 

assistant: Are you up to date with all your immunizations?
user: Mhmm. 

assistant: Um any family history of lung or heart disease? 

user: Uh, just um high cholesterol. 

assistant: OK. Um how about smoking, do you smoke?
user: No. 

assistant: Um any other recreational drugs like marijuana? 

user: Um yeah, sometimes. I'll just have a joint um maybe um two or three times a week. 

assistant: OK, OK. And is that for like medical purposes or just like recreationally?
user: Uh just you know just to relax. 

assistant: OK, sure. Um alcohol? 

user: Uh no. 

assistant: No, OK. And have you been around any sick people recently?
user: Um I went to I went grocery shopping and and someone near me was coughing. I was still like six, you know, I was away from them but, I don't like, yeah, I don't know. 

assistant: Yeah, for sure. I think that you're, it's fair that you're concerned about that. And how about travel to anywhere? 

user: No, I haven't traveled anywhere. 

assistant: No, OK. OK, well those are all the questions I had for you. Did you have any questions of your own?
user: No. 

assistant: No, OK. So we'll do a covid swab anyways today because your, some of your symptoms do overlap with that of Covid and you should hear back in about 24 to 48 hours. But in the meantime you should self isolate for 14 days.
user: Sure. 

assistant: Um but it I think it does really sound like you have a common cold um so just like another viral illness, um so just treat it supportively you know um keep yourself hydrated, if you feel like you're getting a fever, take like Tylenol. Um if you have like pain like a headache or like sinus pressure or something you can take again an Advil or Tylenol. Um And if your symptoms worsen, or if you have any neurological symptoms, then you should see the ER um right away.
user: Yeah, um I haven't been feeling very well over the past two days. I have had this cough, I'm feeling very short of breath and I'm feeling very feverish as well. 

assistant: Okay, uh, have you checked your temperature?
user: No, I haven't actually checked it, but I'm just feeling hot and I'm having chills. 

assistant: Okay, were you having like night sweats as well?
user: Um, yeah, last night I did get sweaty. 

assistant: Okay, and when uh, when did you start feeling feverish?
user: Feverish, maybe around the same time like right after the cough and shortness of breath started, maybe like a day and a half ago. 

assistant: Okay. It's um, so the cough started about a day and a half ago as well?
user: Yes. 

assistant: Okay. Uh, did you have a cough prior to this or is it new? 

user: It's new. 

assistant: Okay, is it a dry cough? Or are you bringing up sputum or phlegm?
user: Um, it's uh yeah, it's um, it's dry most of the time, but once in a while I'll see some like yellow phlegm. 

assistant: Okay, have you noticed any blood? 

user: No, no blood. 

assistant: All right, and have you had any chest pain?
user: No chest, well actually, when I try to take a really deep breath in, it, it hurts, my chest hurts. 

assistant: Okay, where do you feel the pain? 

user: Uh, it seems to be central on my chest. 

assistant: Do you feel it radiating anywhere, like to your back or to either side?
user: No. 

assistant: Okay, how would you describe the pain? Like sharp, dull?
user: Um, it's pretty sharp when I take a deep breath in. 

assistant: How long does the pain last for, and is there anything that you do that makes it go away?
user: It was like less than a minute um, and, and it goes away when I like, if I try not to take a deep breath in. 

assistant: Okay, so it sounds like that it, the, the breathing is a trigger there, when you're breathing in deeply. 

user: Yeah. 

assistant: Alright. And have you had any wheeze?
user: Uh, a little bit, yes. 

assistant: Alright, and uh, is the wheeze new as well? 

user: Um yes, that also started after the coughing and the shortness of breath. 

assistant: Alright. And have you had any episodes of feeling like your heart's racing, or is it speeding really fast?
user: No. 

assistant: Okay, and you said it, yeah, you've been short of breath as well. Um, are you really short of breath now, and what sorts of things have been really bringing it on for you?
user: Um it's, yeah, I'm still a little bit short of breath and I, I guess the shortness of breath gets worse when I'm walking or doing something physical. 

assistant: Okay and did, is this new or did you have this before? 

user: It's new. 

assistant: Okay, have you noticed any swelling in your in your legs or extremities?
user: No, nothing like that. 

assistant: And do you get short of breath if you lie down flat?
user: Uh, no, not that I've noticed. 

assistant: And how many pillows do you sleep with? 

user: Uh, just the one. 

assistant: Okay um, and have you had any headaches?
user: No. 

assistant: And how about any eye redness or discharge?
user: Uh no. 

assistant: Have you had a runny nose or felt congested? 

user: Um, yeah a little bit. Yeah, I've been, yeah, I've been feeling a little congested. 

assistant: And when did that start?
user: Um, that started a little bit before the cough, actually. 

assistant: Okay, and you're still feeling that now?
user: Yeah. 

assistant: Okay. Have you had a sore throat? 

user: No sore throat. 

assistant: Okay, and um, have you had any um, muscle aches or body pains?
user: Um I, yeah, I guess my muscle aches a little bit um, it's very dull though, it's not sharp. 

assistant: Okay, and uh, how has your energy been? Have you been fatigued? 

user: Yeah, my energy's been pretty low. Um, I've been feeling very tired. 

assistant: Okay, and how long has that been going on for?
user: Um, for about the same amount of time. Like three days, yeah. 

assistant: Alright, and have you had any abdominal pain?
user: No. 

assistant: How about nausea or vomiting?
user: No. 

assistant: And any changes to your urinary habits, like pain or?
user: Uh no, nothing like that. 

assistant: Okay, and um, how has your appetite been?
user: Um, it hasn't been the greatest because I haven't been feeling well, but I've still been eating. 

assistant: Okay, have you had any weight loss over the last several months? 

user: Um, no, not that I've noticed. 

assistant: And uh, how about any changes to your sense of smell or sense of taste?
user: Sense of smell or taste, no, no changes there. 

assistant: Okay, um and then any skin changes or rashes?
user: No. 

assistant: Alright, um, so you've been experiencing this cough, uh, started a couple of days ago with um, shortness of breath, and you're bringing up sputum sometimes and, and a fever that's started a bit more recently, as well as having some night sweats. 

user: Yeah. 

assistant: Have you experienced any other symptoms?
user: Uh, no. Other than that, no symptoms. 

assistant: I see, and have you tried anything to make, make the symptoms better?
user: Um, I've tried some Tylenol, I've tried some, um like, cough suppressants, but nothing seems to be helping. 

assistant: Okay, um, and have you been diagnosed with any medical conditions before? 

user: Um, no, not um, well actually, I have, I had, I have osteoporosis, for which I'm taking calcium and vitamin D, as well as like um, alendronate, alendronate, some sort of bisphosphonate. 

assistant: Okay, have you had any, uh, like bone fractures?
user: Um, I had um, a hip fracture, like uh, two years ago. 

assistant: Okay and um, and how is the recovery and mobility been? 

user: Um, pretty good now. 

assistant: Oh, that's great. And uh, do you have any other medical conditions besides osteoporosis?
user: No, not that I know. 

assistant: And have you had any surgeries prior, um, aside from the hip surgery two years ago? 

user: Um, I had my wisdom teeth taken out, I've had my gallbladder taken out, um, and I, I had like um, I had a PE um, a long time ago. 

assistant: Okay, and what happened around that time, with the pulmonary embolism? Did you, was there a trigger, like a surgery around that time? Or were you immobilized or anything?
user: Yeah, they think it happened right after my um, gallbladder removal 'cause I was in the hospital for a while. 

assistant: Okay, and so were you on any medication for a period of time after that? 

user: Uh, yeah, I was, but not anymore. 

assistant: Okay, um, okay. And um, are you taking any other medications besides the ones for your bones?
user: Um, no, no other medications. 

assistant: And do you have any allergies? 

user: Uh, no. 

assistant: Okay, uh, and then could you tell me a little bit about your living situation right now? Are you living with anybody and uh, whereabouts?
user: Um, I live in an apartment by myself and um, it's in London. 

assistant: Okay, great, and do you have any supports in the home that, that help you with uh, any activities of daily living, like um, either dressing or bathing or making food or even doing some of the shopping?
user: So I am pretty independent for most things. Um, there will be like a CCAC care worker who comes in, uh, once in a while just to help me clean the house. 

assistant: Okay, so once in a while, is this like once a week or once, yeah, how often? 

user: Yeah, once every two weeks. 

assistant: Okay, well that's great. It sounds like you're managing really well on your own. Um, do you have any other supports nearby, like family or, or friends?
user: Um, I have some family close by um, my son lives close by, uh, and my daughter lives about 2 hours away. I'll see them about once a month. 

assistant: Okay. Um, and do you smoke cigarettes? 

user: Um, yeah, I used to smoke, but I stopped about five years back. 

assistant: Oh, congratulations on quitting.
user: Thank you. 

assistant: So you quit five years ago, and how long did you smoke for and how much did you smoke? 

user: Um, I used to smoke, not a lot, just like one or two a day, uh, and I did that for about 25 years. 

assistant: Okay, and uh, do you drink alcohol?
user: Um, I'll have like a glass of wine once in a while. 

assistant: And how often is once in a while? Is this, or how many drinks per week would you say? 

user: Um, per week, maybe like three. 

assistant: Okay, um, and any uh, heart or lung conditions that run in the family?
user: Um, yeah so, there is um, like lung cancer, there's asthma, there's uh, COPD. All of that, someone, like my, both sides of my family had. 

assistant: Okay, and uh, anybody in the family have like a bleeding disorder? 

user: A bleeding disorder, no. 

assistant: Okay, anybody else in the family have either a deep vein thrombosis or, or PE?
user: No. 

assistant: Alright, um, and have you been around any, anybody who's been sick?
user: No, not recently. 

assistant: Alright, and have you traveled anywhere outside of the city, or? 

user: Uh, no. 

assistant: Okay, um, so that was everything I wanted to ask about today. Was there anything that uh, that you wanted to add?
user: No, those are all questions that I had. Um, do you think um, I need to be hospitalized, um, because I'm very short of breath, or do you think I can just um, stay at home? Do you think I need antibiotics? 

assistant: Yeah, so we'll, we'll check your temperature and, and confirm the fever and um, check your oxygen levels as well. You might need oxygen, um, you're mentioning, with your shortness of breath. Um, and we will get a chest x-ray, and if um, we're seeing consolidation there, suggestive of pneumonia, you may need antibiotics that will cover, cover those, those bugs. However, your symptoms do overlap with COVID as well, and so it will be important to get a, um, COVID swab. But to answer if you will need a hospital stay, I think we'll need to at least wait until some of the investigations come back and, um, that will help determine how severe the symptoms are and we'll observe you over the next few hours, and if you are getting any worse or um, anything like that, then it might be a good idea, um, to uh, to be admitted.
user: Yeah, I've had a shortness of breath, and even at at rest. Really, feeling like it's difficult to breathe, and when I take a deep breath I get a chest pain. 

assistant: When did this start? 

user: This started yesterday. 

assistant: How bad is your shortness of breath?
user: Like, I don't know. I feel like I'm OK, like n terms of being able to breathe, but I mean if I exert myself at all, there's no way I would be able to. It's, I just feel like even at rest it's hard to breathe. 

assistant: OK, has it gotten worse since yesterday or better, or kind of been the same?
user: It's mostly been that been the same or actually sorry it's got, got a little bit worse at first. It was more more with exertion, and now it's, at rest as well. So yeah, it's got worse. 

assistant: I see, OK. Are you able to talk in full sentences or do you need to take a deep like stop to take a breath? 

user: I could talk in full sentences. 

assistant: And the chest pain, does it only occur when you take a deep breath, or are there other times as well?
user: I pretty much yeah only when I'm taking a deep breath and say, I mean, maybe that's why part of the I can't take a deep breath so it's making me feel it's making the breathing more difficult making me feel more short of breath. 

assistant: OK. Any other symptoms that you've had? A fever or headache? 

user: No, nothing like that. 

assistant: Any cough?
user: Yeah, I, I've had a cough as well over that the same same time period. 

assistant: Is it a dry cough? Are you bringing something up? 

user: It's dry, yeah, I haven't brought up any sputum or any any any blood. 

assistant: OK any other flu like symptoms, runny nose, stuffy nose, sore throat? Anything like that?
user: No, I just had um, yeah, the shortness of breath and chest pain. 

assistant: OK, uhm. And have you, I guess I just invited more general questions about others potential symptoms. Do you feel like your heart is racing or do you feel like you have, uhm, do you have any belly pain or any changes in your bowel movements? 

user: No belly pain or changes to bowel movements, but I do feel like my heart is beating really fast really fast though. 

assistant: Yeah, OK. Uhm, you said this started yesterday. Were you like completely fine the day before?
user: Uh I was yeah. 

assistant: Anything that's happened recently that's different or new?
user: I'm well it like uh, about two weeks ago I had a hysterectomy 'cause I, for abnormal bleeding. Yeah I had surgery 2 weeks ago. 

assistant: What have you been doing these past two weeks in terms of sort of physical activity? Have you been moving around or no? 

user: It's it's certainly been less I I've been moving a little bit, but I've had a lot of pain so I just haven't been doing as much activity, that's for sure. 

assistant: I I see and have you had any, I guess any pain in your legs. Or swelling in your leg? One or the other?
user: Yeah, I have had actually, yeah my right my right calf is pretty sore. 

assistant: Definitely have a look at that. Have you noticed that it's been bigger or more red or warm?
user: Um, no, I don't notice anything like that, just I, just really hurts. 

assistant: Uh, OK. Any medical conditions that you've been diagnosed with? 

user: Um, yeah, yeah and I have a high BMI. Type 2 diabetes and anxiety. 

assistant: Do you have any bleeding disorders?
user: Um other yeah, no. I think you're right. It said fibroids. 

assistant: OK, OK. And do you take any medication? 

user: Yeah, so uh insulin, well metformin. And then that's it. 

assistant: OK.
user: I'm sorry and then an SSRI. Like I said, low pram for anxiety. 

assistant: Alright. And do you have any allergies? 

user: No, I don't. 

assistant: And, who do you.. do you currently live alone?
user: Uh no, I live with my husband and and our two sons. 

assistant: OK and, do you, have anyone sort of come in to help you out over these past two weeks? Are you getting any outside help from nurses etc. Or are your are your family members being supportive and helpful?
user: Yeah, it's been mostly the the family members. My husband's been working from home and the kids have been helpful as well. They are 10 and 12 so they are able to do some things on their own so yeah they've been supportive. 

assistant: That's great. That's great. OK, and you smoke at all?
user: I do yes I I smoke about a half a pack per day. 

assistant: For how long? 

user: Um, yeah, but I I started in my, yeah, after the kids were born actually, uh so like 10 years ago. 

assistant: OK, have you tried cutting it down at all?
user: Yeah, I have. I've kind of gone through spurts of quitting and restarting, quitting and restarting. So yeah, I've tried before. 

assistant: OK, and what about marijuana or recreational drugs?
user: No, don't use anything like that. 

assistant: And alcohol?
user: Yeah I'll have some wine on the on the weekends, but maybe that's like a glass or two. 

assistant: OK, OK uhm, and do you have any medical conditions that long run in the family?
user: Just, uh, yeah, my father actually had a stroke when he was 68, and that's it. 

assistant: OK OK uhm. You haven't ever had one, have you?
user: No, I I haven't had anything like that. 

assistant: OK, alright. So. I guess come to in terms of smoking, you said that you've tried to quit a couple of times in the past. Do you intend on trying again? I know it can be very hard to, to quit smoking. 

user: Yeah, it's only something that is always kind of in the back of my mind. 

assistant: OK, if there's I'm happy to assist you and share resources and problems like medications and things like that that could help you if you're interested so we can talk more about that. talking about your I guess you mentioned that your weight is a little higher than or, its outside the normal range, is that something that you would like to cut down?
user: Yeah, I really try to eat more vegetables and have been trying to do that sort of thing. I've lost a few pounds, but not enough, definitely want to keep going. 

assistant: OK, good good, as long as you feel that you what you're currently doing is helping you and is helping you reduce weight. That's great. But also I'm here for you if you need more education or guidance on that. So, given what you've told me so far, it sounds like you might have developed a clot in your leg somewhere, simply because you had a surgery and you were not moving around very much. Sometimes that causes the blood to kind of, not move around your body is as as much as it usually does, and kind of stays in one place and get turned into a clot and that clot can sometimes get dislodged and settle into your lungs, and that can make it difficult for you to breathe. So, we'll do some tests that that's what my understanding is. Given what you've told me so far, but we do have to confirm it using a test. Also, the fact that you smoke and your weight, and your BMI is high, increases your risk of developing a clot, so I would definitely strongly recommend that you continue to try to reduce both and try to quit smoking. And so we'll do an ultrasound of your leg and we'll do a scan of your chest and see what's going on and then decide if we need to give you any medications, like any blood thinning medications. 

user: OK, yeah, that sounds really good. Thank you. 

assistant: Welcome.
user: I just came in here today, I've been having a lot of shoulder pain that's just kind of left me not doing any of my activities recently. Just in my left shoulder. 

assistant: OK and when, when did this pain start?
user: It started 5 days ago but it became pretty bad and I've been kind of having like a somewhat of a pain for the last couple weeks, but it got really bad just this week. 

assistant: OK, did you have any trauma to the shoulder like any any injuries or triggers that could have caused the pain?
user: Uhm I have been just going to the gym more frequently over the last few months and lifting weights and things like that. But just this week I wasn't even really able to do that either. 

assistant: OK, when you were lifting weights like a few days ago like was there an episode where there was an acute onset of the pain, where it got worse kind of like right away.
user: I think it was more progressive, but five days ago I do feel that there was like just. I was having some pain before that, but then I just noticed while working on I I started having more pain. But yeah I don't think there was anything like sudden that happened though. 

assistant: Oh OK, but it yeah it was progressing and then it got acutely worse with the weight lifting. It sounds like. 

user: Maybe like I did increase my weight like in the last two weeks. So I did feel like a little bit more pain with the increase last week. 

assistant: OK, I see an in the left shoulder do you feel the pain at the front at the sides or or back?
user: It hurts, particularly like in the front part of the shoulder. 

assistant: OK, do you feel that it's radiating anywhere else?
user: Just my whole left shoulder, nothing else really. 

assistant: OK. And could you describe the character or the quality of the pain? Is it sharp, or is it a key?
user: It's more achy. 

assistant: OK.
user: But but certain like some movements so it can get like kind of sharp. 

assistant: OK, and has there been anything that has made the pain worse?
user: Uhm, if I just if I carry anything with my left arm or if I have to lift anything or place it on my shoulder like it really hurts. 

assistant: OK, and have you done anything that's made it better? 

user: I just like resting it, not carrying anything. And trying not to lie on my shoulder. 

assistant: OK, so you're sleeping on the others on the right side then.
user: Yeah. 

assistant: OK alright, how would what would you say the severity of the pain is on a scale of 1 to 10. 

user: Uhm, if I'm not doing it, doing anything or not doing much, it's probably like a two or three, but if I try to carry anything it goes up to like probably like a 7. 

assistant: OK, uh, and um. Do you do any repetitive kind of like overhead activities? Things like playing basketball or just lifting things like above your head at the gym?
user: Um not recently just just like normal weight exercise, maybe with the bands I do some overhead exercises, but in terms of sports I I play or I used to play a lot of tennis. I did have some issues with the same shoulder, which is why I kind of stopped playing tennis. My doctor said it, I might have overused that shoulder, but that's that was like a couple of years back so I thought it must have healed by now. 

assistant: OK, so previous overuse injury of the left shoulder? 

user: Mmmm 

assistant: OK, and uh. I'm have you had any trauma to the shoulder?
user: Um no not that I know of. 

assistant: OK, have you had any fevers or chills? 

user: No. 

assistant: Have you had any night sweats?
user: No. 

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

assistant: OK so even over the area you haven't noticed any redness or like soft tissue swelling? 

user: No. 

assistant: OK. Have you had any chest pain?
user: Nope. 

assistant: OK, how about any shortness of breath?
user: No, not that I've noticed. 

assistant: OK, have you had pains and any other joints? 

user: No, just my shoulder. 

assistant: OK And. Um, Have you had any recent infections or or symptoms such as like a runny nose or sore throat or even a cough?
user: No, nothing like that. 

assistant: OK, and how about any nausea or vomiting? 

user: Um nope. 

assistant: OK. And um. How has your sleep been these past couple of nights? So you mentioned you haven't been able to lay on your left side?
user: Yeah, it's been pretty painful like I kind of wake up every time I accidentally go on to my left side. 

assistant: OK, so you're getting worse thing a pain at night?
user: Yup. 

assistant: OK. Have you had any weakness? Do you feel like you have less strength in your arm?
user: Um I do you feel that there might be some less strength in my left arm, but it's I'm not really using it much so it's hard to tell. 

assistant: OK,  And how about a range of motion. Do you feel as though you could lift your left arm up to like, scratch your head and back?
user: It does hurt like when I try to lift my arm up. 

assistant: OK, so it sounds like a range of motion is decreased?
user: Mmm 

assistant: OK, and have you had any altered sensation of your arms being like numbness or tingling?
user: No, I haven't felt any of that. 

assistant: OK. Um and have you had any changes to your bowel habits like constipation or diarrhea? 

user: Nope, nothing like that. 

assistant: Have you had any abdominal pain?
user: Nope. 

assistant: And have you had any urinary problems?
user: No. 

assistant: OK, and in the past have you been diagnosed with any medical conditions? 

user: Uh. No, I've been a pretty healthy actually just just that overuse injury like two years ago. 

assistant: OK, great and do you have any allergies to medications?
user: No. 

assistant: OK, do you take any medications regularly? 

user: Just recently I've been taking a lot more of the Advil, but that's about it. 

assistant: OK, I and have you had any hospitalizations or prior surgeries?
user: No, no prior surgeries or hospitalizations. 

assistant: OK, and could you tell me a little bit about your living situation currently, like who you're living with, and whereabouts? 

user: Yeah, so I'm living with with my wife in a small condominium in downtown. 

assistant: OK, and are you working currently?
user: Yeah, I'm working as a real estate agent. 

assistant: OK, uh, and do you drink alcohol?
user: Rarely just on some occasions, but not regularly. 

assistant: No. OK. How about smoking cigarettes or cannabis? 

user: No, I've never smoked. 

assistant: Do you use any recreational drugs or have you in the past?