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

assistant: Ok. And do you have any family history of respiratory or heart problems? 

user: Yeah, my dad actually had a heart attack. He was in his 70s. I think my mom had high blood pressure, but other than that, no. 

assistant: OK, um and do you have any allergies?
user: Yeah, it's uh, for the last maybe three days, um it's not really pain, not in any specific spot, it just feels a bit tight in my chest area when I breathe in especially, and it just gets a bit harder to breathe and it feels more tight like especially when I go for my walks, which I do everyday, uh I try to walk my dog. So I was just, you know, worried that it could be something serious and I wanted to come and get checked out. 

assistant: OK, for sure. So you said it started about 3 days ago. Have you noticed it's been getting better, worse or about staying the same?
user: I think it's staying the same. 

assistant: OK, was there anything that happened 3 days ago that you can recall where you first noticed it? 

user: No, nothing in particular um yeah, it just kind of came on and now it's been pretty steady. 

assistant: OK and when it came on three days ago, what were you doing?
user: Uh I think I first noticed it when I was gone for my walk. 

assistant: OK, now when you're walking, you say you have some chest tightness, do you have any chest pain? 

user: No, there's not there's not pain, it just feels like, when I breathe in it feels tight. 

assistant: OK, did you feel anxious or sweaty or the feeling of impending doom at all?
user: Uh, no I can't say that I did. 

assistant: Nothing like that, OK, and did you feel yourself becoming out of breath at all?
user: Uh I I feel like it was kind of harder to get a whole breath, um so yeah, yeah, I guess. 

assistant: OK, and was this tightness all across your chest or was it in one particular area?
user: Kind of just all over. 

assistant: OK. And since then, that happened when you were out for a walk, how many times does it happen a day would you say?
user: Well, I feel like it's kind of always there, but it gets worse when I go for my walk. Um and well sometimes I go for more than one walk, right, 'cause I walk my dog. It's always kind of there, and especially when I'm like getting up out of the chair, I can feel it more, or when I take a big like a big breath in, as I said. 

assistant: OK, so it's been there pretty constantly for the past three days, but it's more noticeable, if not worse, when you're going for a walk?
user: Exactly. 

assistant: OK. Have you had any cough at all in the last little while?
user: Uh no like I feel a little more hoarse and like there's maybe some more phlegm, like I'm clearing my throat more, but I haven't actually been coughing. 

assistant: OK, any fevers?
user: No, can't say that, no. 

assistant: OK, any night sweats, so waking up and the sheets are soaked? 

user: No. 

assistant: Any chills?
user: No. 

assistant: Any unexplained weight loss at all?
user: Nope. 

assistant: OK, and have you ever had anything like this happen to you before? 

user: Uhm, I mean I have asthma um so I've had some trouble breathing before, it, this feels feels uh different than other times. I I guess it could be related, but uh I don't know, this this feels a bit different, that's why I wanted to come in and get it checked out. 

assistant: OK, so you have asthma, do you use any puffers at the moment?
user: Yeah, I just use the one that um I take every day. I don't really use the uhm, the one thats as needed because I just haven't had to in a really long time so I didn't refill my last one. 

assistant: OK, so you don't have any anymore of the as needed, but you have used it in the past? 

user: Yeah, exactly like it's been a couple of years since I needed that, but I still I still take the daily one. 

assistant: OK. And you haven't stopped taking the daily one in last three days either?
user: No, I always take it um so I'm supposed to actually take it morning and night, um for a while though sometimes I was skipping the night one because I didn't feel that I was needing it. Um so so lately I've been taking it everyday, but I've just been taking it in the morning. 

assistant: OK, uh, what makes you say you haven't really needed the one at night? Have you just been doing well without it?
user: Exactly, like I haven't needed the rescue one in a few years and even when I was just taking it in the morning, I I haven't had any problems. 

assistant: OK, understood. And then have you had, I should have asked, do you work currently?
user: Uh I I, I'm a financial advisor, I'm like semi retired so I do some stuff from home. 

assistant: OK, got it. I suppose just, has this kind of chest tightness stopped you from doing activities that you normally would do, any missed time from work? 

user: I haven't missed any work, but I'm not I'm not doing a ton of work right now. I don't think it would stop me, it just would make me uncomfortable um during work and it keeps me, maybe this, the last few days, it's kept me from, I usually go on a couple of walks a day, the last couple days I've just gone on one usually so yeah, it's a little bit, yeah. 

assistant: So it's really not stopping too much of your day to day functioning, but it's noticeable?
user: Exactly, yeah. 

assistant: OK. Now, is there any other issue that you see your doctor regularly for aside from the asthma?
user: Uhm, I have uh high blood pressure, I don't really see my doctor very much, I just am on um medication. 

assistant: OK, how about we just talk about your medications a little bit? What are you taking currently? 

user: Uh I take the, uh, salbutamol. 

assistant: Yeah.
user: That we talked about, and I take um Ramipril. 

assistant: Yep.
user: And, uh, sometimes a Tylenol if you know, if I have a headache or something, but not very often. 

assistant: OK understood, so aside from the high blood pressure you're really not taking medications for much else? 

user: No, no. 

assistant: OK. Do you have any other lung issues or any trouble with your lungs in the past?
user: No, nothing major, just the asthma. But you know, like I said, it's been a few years since it has bothered me. 

assistant: OK, got it, and just in terms of your life itself, so do you smoke at all? 

user: No, never. 

assistant: OK, so no smoking, any other recreational substances, drugs?
user: Oh no, no. I mean I I have um you know a few beers on the weekend, but I don't do very, I don't do any drugs and I don't drink much other than that. 

assistant: OK, got it. Any allergies that you have? 

user: Uhm no, no, like I, uh, when I was younger I got some seasonal allergies sometimes in the springtime, but other than that, I I like I, it's really been uh many years since I've noticed that. 

assistant: OK, and so nothing new in the environment? You haven't changed where you've been living or you haven't introduced a new pet or a new dog?
user: Exactly. 

assistant: OK, so sounds like you're pretty much staying the course last little while, just kind of a new onset of this new chest tightness, and aside from that, seems that it comes on mainly on walks outdoors, but you've kind of been limiting the, some of the medication you're taking for asthma the last couple of years because you haven't really felt that you needed it as much.
user: Yeah, like just the morning was, it was enough. 

assistant: OK. Alright John, I think I've got most of the information I need just to go talk to the doc and talk about your story. Next of course we're going to do a quick physical exam, going to take a listen to your lungs and see what else we might want to do in terms of investigations. I have a feeling that this actually might be your asthma reoccurring in some capacity or that would be on the top of the differential for now, barring any other new findings. So I think maybe what we would like to do is, we'd like to try having those rescue puffers available to see if that helps at all when you are on walks, and if they don't help, then we'll come back to the table and see what other possible directions we could head in in order to help you next. Does that sound good John? 

user: Sounds great, I'm just, you know, glad to know that it's probably not my heart. 

assistant: No, it sounds well, I suppose you said that you didn't really get out of breath with exercise, more sounds like a chest tightness, and you haven't had any pain associated with it, so that puts more cardiac ischemic pictures kind of lower on the differential. But of course we're going to try one thing at a time, and then we'll come back to the table um depending on how you're feeling after that, OK?
user: Sounds great, thank you. 

assistant: No problem. OK, I'll go talk to the doctor, I'll be back with you in a moment.
user: Hi uh nice to meet you. I've just uh been experiencing um a cough for the last few weeks and uh I also recently started noticing that I'm coughing up some blood as well, like it's mixed into like sputum. 

assistant: I see, alright, so you said a few weeks for the cough. Is this more than three weeks, more than four weeks, or a few months?
user: I would say it's almost I would say almost like three weeks now. 

assistant: OK, when the cough started uh were you bringing up, um were you bringing up sputum or phlegm at that time?
user: Uh yeah, initially it was just like um kind of white too, sometimes yellowish phlegm, but now over the last week I've been also noticing um some blood in it as well. 

assistant: OK, and how much blood have you been bringing up? Um just trying to think in maybe uh teaspoon sizes if you can.
user: Uh yeah, I would say maybe half a half a teaspoon. 

assistant: OK. And, um have you been having any shortness of breath?
user: um no, I don't think so. But kind of like I do feel some discomfort in my chest like I just associated it with the cough. 

assistant: I see, have you had any uh any chest pain?
user: Uh, no. It's more of just the discomfort with the coughing. 

assistant: OK, and um have you had any changes to your breathing like like wheezing?
user: Uh, no, nothing like that. 

assistant: Alright. Um and have you had any infectious or viral type symptoms like itchy eyes, or runny runny nose, sore throat?
user: Uh no, nothing like that. 

assistant: OK, and um how has your energy been? Any any fatigue? 

user: Um it's kind of been a bit low over the last few weeks, just I feel more tired. Um yeah I had to miss a few days of work as well. 

assistant: I see, alright. Um have you had any fevers or chills?
user: Uh definitely I feel like I have had some chills over the last week. Um I haven't had a chance to measure my temperature though. 

assistant: OK, have you felt feverish? Or have you felt hot at any point?
user: Um, yeah I would say like a few times this week, I've also felt like hot. 

assistant: Alright, have you had any um like night sweats?
user: Uhm now that you mention it like I I would say two two days out of the last week I've had night sweats where my sheets were kind of just drenched when I, and then I woke up noticing that. 

assistant: Alright. And how about your um your weight? Have you had any changes to your weight over the last several months? 

user: Yeah, I think I've lost maybe 10 pounds in the last couple months. 

assistant: OK, that sounds like some, uh, some weight lost significant weight loss, have you been trying to lose weight?
user: No, not really. 

assistant: OK. Uhm and have you felt as though um like your heart's racing or beating really fast? 

user: No, nothing like that. 

assistant: Have you had any uh like fainting or dizziness?
user: No, nothing like that. 

assistant: OK um and how about any nausea or vomiting?
user: No, no, no nausea or vomiting. 

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

assistant: Any urinary problems like pain or or going often? 

user: Uh no, nothing like that. 

assistant: OK. Uh have you noticed any rashes anywhere?
user: No, no rashes. 

assistant: Have you had any muscle aches or joint pains?
user: Um no, nothing like that. 

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

user: No. Um I've been fairly healthy. 

assistant: OK, that's good, and have you had any surgeries or any reasons to be hospitalized before?
user: No. 

assistant: Do you take any medications or any over the counter, supplements?
user: Um no. 

assistant: Alright, any allergies that you're aware of?
user: Not that I know, no. 

assistant: OK, and um are your immunizations up to date? 

user: Um immunizations are all up to date, yeah. 

assistant: Alright, and currently um can you tell me a little bit about who you're living with and uh where you're living?
user: Yeah, currently I'm living uh just in um it's kind of like a a home with just a, I don't really know the people too well, just kind of like a home where um a bunch of guys are just living and working separately. I just actually recently moved here from um The Philippines six months ago. 

assistant: I see, OK. Um do you interact with many of the people in the house and and has anybody else been sick? 

user: Uhm I don't know if anyone else has been sick, I haven't really noticed that. I don't really see them too much. 

assistant: OK, and six months ago prior to um yeah coming from the Philippines, was anybody sick there or did you hear of anybody that you spent time with having um tuberculosis?
user: Um yeah, there's been, not anyone that I know of, but there's definitely like even where I worked and things like that, there's definitely people who have had tuberculosis in the past. 

assistant: I see, OK. Um and, uh do you smoke cigarettes? 

user: No. 

assistant: And uh how about smoking cannabis or using any products?
user: No, nothing like that. 

assistant: OK, and you use any recreational drugs? 

user: Uh, no. 

assistant: OK, um and are you currently sexually active?
user: Uh currently, no. 

assistant: OK, um so no concerns for a sexually transmitted infection at this time?
user: No. 

assistant: OK, um and um have you traveled anywhere recently? 

user: Um not recently, no. 

assistant: OK, but uh, and anybody in the family um have uh heart or lung conditions?
user: No. 

assistant: OK, um and any cancer that run in the family? 

user: Not that I know of. 

assistant: OK, um so, uh I think that's everything I wanted to ask on on history today, so it sounds like you've been having this cough um that's been going on for just over three weeks now and starting with some um whitish clear sputum and more recently even started to be coughing up some blood as well. And you've also been really um fatigued and have had some malaise over the last several weeks. Um and any other symptoms or, oh and also yeah, you've had some night sweats, chills, and uh been feeling feverish as well, so we'll certainly check your temperature today too. OK, so anything I missed?
user: Yeah, so I just came in today uh a bit concerned. Uh I've been just having this nasty cough for like the last week and then today morning uh, like I thought the cough would just go away, but today morning I also noticed I'm coughing up some blood. 

assistant: Oh, OK.
user: Yeah. 

assistant: So when did you first start coughing?
user: Um, so let me think uh I just returned from a mission trip uh to the Philippines 2 weeks ago. This cough started uh just last week, so I would say around six to seven days. 

assistant: OK. And that and the blood in your cough, um that was about yesterday, you said? Or? 

user: Yeah today, uh. 

assistant: Today, OK. OK. Um are you bringing up any phlegm at all, besides the blood?
user: Uh no it's just uh like I saw it on my hand, like there wasn't anything, like my cough is like pretty dry. 

assistant: OK, are you short of breath at all? 

user: No, I'm not short of breath. Um just, it's just the cough. 

assistant: OK, and are you having any wheeziness?
user: Uh no wheeziness. 

assistant: OK. Um any runny nose or stuffy nose? 

user: No, no uh runny or stuffy nose. 

assistant: Changes in vision, hearing, smell, or taste?
user: Nope. 

assistant: Uh weight loss? 

user: Um I have noticed uh weight loss over the last uh, I would say few months. So I've been I've been doing like like I I came back from Philippines last week, but um, I had gone earlier, like during this year or two and I've kind of noticed this weight change, probably lost around 15 pounds within the last few months. 

assistant: 15 pounds OK. Wow, that's a lot, yeah. Um any night sweats?
user: Um no, I don't think so, no. 

assistant: Any fevers or chills?
user: I did have a, I did have some chills over the last week, um but I didn't really think too much of it. 

assistant: OK, we'll take your temperature today just to make sure. Um any rashes? 

user: No. 

assistant: Any chest pain?
user: No chest pain. 

assistant: Uh swelling in your limbs?
user: No. 

assistant: Fainting spells or dizziness?
user: No, nothing like that. 

assistant: Confusion or memory loss? 

user: No. 

assistant: Headaches?
user: No headaches. 

assistant: Uh, joint pain?
user: No. 

assistant: Fatigue?
user: Uh, no. 

assistant: Um, changes in your bowel movements? 

user: Uh, no. Not at all. 

assistant: No, changes in your urine?
user: Nope. 

assistant: Uh, nausea or vomiting?
user: No nausea or vomiting. 

assistant: OK, how about abdominal pain?
user: No, nothing like that. 

assistant: OK, are you otherwise healthy? Do you have any longstanding medical conditions? 

user: Yeah no, I'm otherwise I um I don't, I'm really healthy. I don't take any medications so this was something that happened out of the blue. 

assistant: OK, any um hospitalizations or surgeries in the past?
user: No. 

assistant: No, um medications, are you on any?
user: No, I haven't um tried any medications. 

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

user: Uh I I've been yeah, pretty up to date with all my immunizations. 

assistant: OK, uh, allergies, do you have any?
user: No. 

assistant: Sorry, forgot to ask, immunizations. Did you get the flu shot this year?
user: Yeah I did. 

assistant: OK, good. Any family history of lung conditions? 

user: No, not at all. 

assistant: No, any lung cancers?
user: No. 

assistant: No, OK. Do you smoke?
user: No, I have never smoked a day in my life. 

assistant: OK, recreational drugs?
user: No I would never take drugs. 

assistant: OK. Do you drink alcohol? 

user: No, no, not at all. 

assistant: OK. Um where do you live right now?
user: So I I just live in a small apartment by myself, uh just been moving around a lot. 

assistant: OK, for sure. Um any like asbestos, mold, or like old carpets, dust, anything like that at your apartment? 

user: No, I don't think so. 

assistant: No, any sick contacts recently?
user: Um not uh, I don't think so like we um, maybe in the Philippines, we do provide a, so I go on like these mission trips with the Church and um we do sometimes go to the hospital as well. 

assistant: OK. 

user: Sometimes yeah, we we do see some sick people. 

assistant: Mhmm, OK.
user: But other than that, not since I've been here, no. 

assistant: Any travel outside the Philippines recently? 

user: Uhm, so I think. So this year has just been the Philippines, before I used to go to India as well. Um but recently nothing outside of the Philippines. 

assistant: OK. OK, um those were all the questions that I had for you. Do you have any questions for me?
user: Yeah, I I was very worried um uh about the blood. I was just reading some things up and uh, about tuberculosis, so I was really stressed out today. 

assistant: Yeah so um, that's definitely high on our differential. So, we'll do a couple of things. We'll do a Covid swab on you um just to rule that in or out, you should hear back for, about those results, in 24 to 48 hours. While you're here in the hospital, we're also going to do a chest X-Ray and or like an AFB smear to see if you have active TB or latent TB. If those come back positive um we will require you to isolate because this uh, because TB is highly infectious and it's airborne. Um so we have a couple of uh, we have like a regimen that we'd put you on. It's called the RIPE medications that we keep you on for two months and then we continue a couple of those for another four months. Um but we will uh keep you here until we have more answers on um like from this TB standpoint. How does that sound?
user: I've been having this pain in my knee and it's been going on now for a few weeks. It's kind of right at the, I could feel it right below my kneecap and at first it it was really only bothering me after activity, but now it's starting to hurt during as well, and so it's, it's trying to limit my ability to play basketball. 

assistant: OK, and so you said this started just two weeks ago? 

user: Yeah, about about a few yeah few weeks ago. 

assistant: OK, and has the pain so it's been getting a bit worse and with activity and it's right below your kneecap, is it the right way or the left leg?
user: Yeah, it's on the right side. It's my right right side. Yeah. 

assistant: OK. And what kind of pain are you experiencing, is it kind of a sharp pain or is it a dull aching pain? 

user: It's, uh, it's pretty achy. 

assistant: Yeah, it take you. OK, and does the pain travel anywhere else or does it, it's just right below your kneecap?
user: It's right below my kneecap, yeah I feel like it's just over a kind of a small area it's a pretty specific spot and if I press on that area at all it gives me a pretty, it's a sharp pain if I if I press on it sharp pain. 

assistant: OK. And on a scale of zero to 1010 being the worst pain you felt in your life, how much would you rank the rate this pain?
user: I it's about about a six or seven. 

assistant: Six or seven OK. And is it a constant pain, or like do you get the pain when you're not playing basketball or doing other activities?
user: Um I'll get it if I'm. Like sometimes I'll feel it if I'm going upstairs like walking upstairs or. Like if I'm sitting for a long, long time and I I get up, it'll feel a bit sore. But it's mostly if I'm like doing activities like running or jumping, doing like strenuous stuff like that. 

assistant: OK I see, an has this ever happened before? 

user: No, I haven't had any any issues with my knee before. 

assistant: OK. And otherwise, are you having any other symptoms besides the pain, like any numbness, tingling?
user: No, nothing like that. It's just the pain. 

assistant: OK, and any weakness in your legs? 

user: Um no, no weakness. 

assistant: OK, and uh. Have you tried anything that improves the pain at all or anything that makes it worse?
user: Um I I have tried taking some like Tylenol and Advil and that or or and NSAIDs that and it has helped with the pain. I've tried icing it too, like after practice and stuff like that which does seem to help a little bit, but uh. Yeah, that's about it. 

assistant: OK. OK, and other than that, did you like have a fall or did you have any injuries recently before you started having this pain?
user: No, it's kind of come on on its own, no falls or like trauma to the knee. 

assistant: OK. And other than that, are you healthy, do you have any medical conditions at all?
user: Um, yeah, I don't have anything I am healthy. 

assistant: OK, any medications that you take on a regular basis?
user: No, not not. Nothing. I don't take anything. 

assistant: OK. Any allergies?
user: No allergies. 

assistant: OK, and have you been sick recently at all with fevers, chills, any cold or viral symptoms? 

user: No, I haven't had anything like that. I've been feeling well. 

assistant: OK, uhm. Any changes in your skin, like any rashes?
user: No, I haven't had any any rashes. 

assistant: OK, and any kind of shortness of breath, chest pain? 

user: Nope, nothing like that. 

assistant: OK. And any changes in your bowel movements or urinary patterns?
user: No, I haven't had any changes there. 

assistant: OK, OK. And do you have any recent or like past history of any hospitalizations or surgeries? 

user: No, I I haven't had anything like that. 

assistant: OK, and any family history of any musculoskeletal conditions or any anything that runs in the family?
user: No, not nothing like that, no. 

assistant: OK, OK. And currently right now. Do you do you go to school or do you work at all? 

user: Yeah, I go to school. And, uh, I play on the, uh soccer team and the basketball team. It's basketball season right now. And, uh, in grade 10. 

assistant: OK in grade 10 OK. And school going well, any issues at all with bullying or anything like that?
user: No school's been been going well. I have been doing well in my courses and have a good group of friends so I enjoy it. It's fun. 

assistant: OK. And what's your home situation like, do you, who do you live with? 

user: So I live with both of my parents and I have a a younger sister as well. She's in grade grade 7 and we have a dog as well. 

assistant: OK, and do you generally feel safe at home as well as outside of your home environment?
user: I do, yeah my I get along well with my parents and we. Yeah, but my parents are great. 

assistant: That's good and and this is just wanted to let you know that anything that you talk about in here with us stays confidential and won't leave this room unless there is potential harm to yourself or others. So have you tried any recreational drugs like marijuana, have you tried smoking or alcohol at all? 

user: No, I've been trying. I stay away from that, that sort of thing. I've I know about other people in my class who have and stuff, but I always just, I'm just trying to stay as ready as I can for the sports. 

assistant: OK, that's good. And yeah, so and are you up to date with all your immunizations?
user: Yeah yeah, my mom made sure that I got all of that stuff done. 

assistant: OK. Alright, so yeah, those are some questions I had. I just have a few more questions with regards to just examining your knee. Are you able to walk or do you have any kind of a limp? 

user: No limp I can. I can walk OK. 

assistant: OK and are you able to run?
user: Yeah I can. I can run, but when I do it it causes some pain. I'm able to still run but yeah it it hurts. 

assistant: OK and. So when you palpate your lower knee just under the patella, you said it's a sharp pain, right? 

user: Yeah exactly and then when I it's, and it feels kind of achey or when when, like after practice or something like that, but if you press on it it it's sharp. 

assistant: And, uh. Any any kind of like are you able to flex and extend your knee right now if you tried?
user: I can yeah. 

assistant: OK and have you noticed any kind of rotation of your knee at all?
user: No, nothing like that. 

assistant: No OK. OK, and no weakness below your knee, right?
user: No weakness. I just feel like my muscles are really tight like my fly and my hamstring muscles. Think I need to stretch them out some more, they do just feel tight. 

assistant: OK, and do you notice any kind of swelling or redness or bruising in the area? 

user: No. 

assistant: no OK, and your ankle and hips you don't have any pain or issues with movement, right?
user: No, not at all. No, no problems with my ankle or hip. 

assistant: OK alright yeah. So those are just all the questions I had for you today. Do you have any questions? 

user: I was just wondering what I can do to make this go away. 

assistant: Yeah, so definitely this is something that is what we call Jumpers knee. It's fairly common, uh, amongst younger athletes, especially those that play sports like volleyball or basketball. But right now we don't really need to do any kind of imaging or anything like that. It seems like you're in the earlier phases and it's good that you came in. We definitely do need to manage it with some conservative management where we're going to keep having taking a look at it as well as I would recommend icing it every, like for half an hour, like around four to six times a day, especially after you're doing your activities. Then you can you can take the, continue taking the Tylenol and Advil, as well. As long as you're following the maximum amount per day depending on if you're taking extra strength Tylenol for example versus the regular strength. And then I will also refer you to some physiotherapy that will kind of a teach you some strengthening and stretching exercises that you can do to help what we call like that you will you might be having is just um some inflammation in your patellar tendon, right below your patella. So we need to strengthen the muscles around it. So we'll do some referral to physiotherapy and then we'll see how you you do based on all those treatment options and then if it gets worse and if or if it doesn't get better, we might need to do some imaging, either ultrasound or an MRI and then see where to go from there. But for now does that sound OK with you?
user: Yeah, so I've been coughing for a few months now and so that's the problem. 

assistant: OK, and how many months have you been coughing for? 

user: Just over two, I would say, and it's been I've been bringing up this yellow, greenish sputum. It's kind of gross. 

assistant: OK, and how, how much of the sputum would you say you're bringing up in an average day? Like a teaspoon? Tablespoon?
user: : Oh I see OK. I don't know, maybe a few teaspoons throughout the day. 

assistant: OK. 

user: At first I thought I I I had a, a chest infection, but even after antibiotics from my GP, or or my family doctor, It never cleared up. 

assistant: OK, and so when did you go on the antibiotics?
user: Ah so this is about, uh, about a month ago. 

assistant: Mhmm. 

user: And yeah, so I went to see my family doctor about the cough then and dad was prescribed some antibiotics. I think azithromycin and it, it still didn't, it didn't do anything. 

assistant: OK, I see. And do you find that your cough has been getting worse since then?
user: Uh, I would say the cough has been about the same. 

assistant: OK. But how about the sputum that you're bringing up, has that increased?
user: Uh, it's about the same, but it definitely I would say there's a pink tinge in the sputum now. Every once in awhile I've noticed more than than before. 

assistant: OK. And did this all start after the chest infection or did you have something like this occur before? 

user: Um, yeah, this all started after. 

assistant: OK, I see. Was there anything that happened around that time? Any new environment that you were exposed to?
user: Ah, well, I did go to India a few months ago. 

assistant: OK, and how many months was that? Was that also like two months ago? 

user: Yeah, about that, probably closer to three or four, but yeah, right around the time that that I think this, uhm cough started or just before I got back. 

assistant: OK, I see. And how often are you coughing in a day?
user: Ah. a few times an hour. 

assistant: OK. Anything that makes your cough go away now you've tried?
user: Uh, no nothings really helped it go away. 

assistant: OK, and is it better or worse? During good morning as opposed to night? 

user: Uh, it's pretty, it's pretty bad all day actually and it's been impacting my sleep because I've been coughing at night too. 

assistant: I see. And, um, in terms of things that make it worse, anything you do around the house or at work that makes the coughing worse?
user: Uh yeah, I guess if I'm just moving around a little bit more it might bring it on a little bit more, but it's pretty bad all day. 

assistant: I see. And in terms of any other symptoms you might be having, uh, do you have any shortness of breath, runny nose, any chest pain?
user: Um, no, not really. 

assistant: OK. Besides the pain tinged sputum, have you ever coughed up blood, like red blood? 

user: Not anything that was really bright red. More pink. 

assistant: More pink. OK. Yeah, so you traveled to India just two months ago. Do you remember what kind of place you stayed in India? Was it a, a in a crowded place or were you by yourself?
user: Well, I mean there is a lot of people around. Yeah, there was not a lot of room where I was was staying, so it was pretty crowded. 

assistant: OK, and was there anyone that was ill around you or any exposure to tuberculosis?
user: Uhm, not that I'm not aware of. I was around my family but, umm, I guess it's possible. 

assistant: OK. And once you came back did anyone else, in your family get sick? Or was it just you?
user: Oh yeah, I spoke to my relative went when I got back and they they didn't tell me about one of my cousins there that was feeling sick. 

assistant: OK. And have you been having any fevers or chills?
user: Yeah, I feel I feel like I've been pretty pretty hot sometimes. 

assistant: OK, and how about night sweats?
user: Yeah, the coughs been messing with my sleep, and I've been waking up with night sweats. 

assistant: OK. And have you been having any headaches? 

user: Ah no headaches. 

assistant: Any do you feel that you've lost any weight recently?
user: Uh, maybe a few pounds, but um. 

assistant: Have you tried to lose weight, or was that unintentional?
user: No, I, I was kind of surprised. I thought I would have gained weight 'cause I've been a bit more lazy recently, but the weight seems to be down anyway. 

assistant: I see, OK. Have you noticed any wheezing sounds when you breathe out, or breathe in?
user: No wheezing. 

assistant: OK. And you mentioned no chest pain, right?
user: Yeah, no chest pain. 

assistant: OK, have you noticed any kind of swelling in your legs or hands or anywhere else in your body? 

user: No swelling. 

assistant: OK. Any bowel movement changes, any constipation or diarrhea? Any of those?
user: No. 

assistant: OK, any urinary problems? 

user: Uh, no. 

assistant: OK, any changes in your appetite at all? Do you feel that you've lost any appetite?
user: Um yeah, yeah maybe eating a little bit less. 

assistant: OK. And in your current environment right now, are you exposed to any fumes or dust or any animals?
user: Uhm, we have a dog, but um, no fumes or anything like anything like that. 

assistant: OK, have you experienced any kind of dizziness or fainting spells?
user: No. 

assistant: OK. In terms of your past medical history, have you been diagnosed with any medical conditions?
user: Um, yeah I meant, uh, high blood pressure. Type 2 diabetes and high cholesterol. 

assistant: I see. And are you taking any medications for any of those? 

user: Yeah, I'm taking uhm, a few medications for blood pressure and uh, and and diabetes right now, and I think I Rosuvastatin for for the cholesterol. I'm not sure of the other ones though. 

assistant: OK, no worries. And do you know if you're allergic to any medications or do you have any environmental allergies?
user: I think I I got a rash to penicillin when I was when I was younger, but that's it. 

assistant: OK, any previous hospitalizations? 

user: Uh, nope. 

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

assistant: OK, and in your family has anyone ever had any cancers or died of a heart attack? 

user: Yeah, my mother out a heart attack when she was 48. 

assistant: OK. And has anyone ever had anything like pulmonary fibrosis or any autoimmune conditions?
user: Uhm. What are those? 

assistant: So pulmonary fibrosis is a condition in your lung where you start getting like these nodules. 

user: I see. 

assistant: And it can run in the family and that can cause some of the symptoms like a chronic cough. It can cause sometimes shortness of breath and it can sometimes be associated with the like some connective tissue disorders that can run in the family. Umm, any of those ring a bell?
user: No, I haven't heard of anything like that in my family. 

assistant: OK. Yeah, and other than that, where do you currently live? Do you live by yourself or with anyone else? 

user: Yeah, I live with my husband and three sons just outside of town here. 

assistant: OK. And have any of them been sick?
user: No, everybody's been feeling well at home. 

assistant: OK. And do you work currently?
user: Uh, no, I'm I retired. 

assistant: OK. And currently do you smoke? Cigarettes? 

user: Yeah yeah, I smoke about a half a pack of cigarettes per day and ah, I've been trying to cut down. 

assistant: OK, and how long have you been smoking for?
user: Ah probably like 30 years. 

assistant: I see and do you use any recreational drugs like marijuana or cocaine?
user: Ah, no I've never used anything like that. 

assistant: OK, and how about alcohol? Do you drink alcohol? 

user: Uhm, no. 

assistant: No, OK. Alright, so yeah those are all the questions I had for you today. Do you have any questions for me or any questions or concerns?
user: Um, not right now. 

assistant: OK, so we'll be doing some investigations since you recently traveled to India, we need to make sure that you don't have tuberculosis, as that's prevalent in some parts of India. So we will do some, we might get like a chest X-Ray for that, you may have a pneumonia as well and then we'll go from there. Does that sound good?
user: Yeah, for sure. 

assistant: OK alright well, yeah, well, after those tests have come back, we'll see you in the next appointment for follow up.
user: Yeah, I've had this sore throat. It started, really, yesterday and I've been having problems with eating and drinking. 

assistant: OK, so it just started yesterday. Has it occurred before?
user: Not this painful before. 

assistant: OK, are you were having any trouble swallowing just solids or liquids as well?
user: It hurts to swallow both. When I have something really cold it helps, I mean, it's easier to drink, but it still hurts. 

assistant: OK, and are you having any other symptoms besides the sore throat? 

user: Yeah, I've been nauseous and I vomited a couple of times. 

assistant: OK, just within the last day?
user: Yeah, this is over the last day. I vomited three times yesterday and once today. 

assistant: OK, and uh, what was the color of the vomit? Was it just food that you had eaten? Or was it green? Can you describe it a little bit?
user: Yeah, so the first two times it was more of what, like, the food that I had eaten and then the last two times it's been more yellowish green, cause I haven't really eaten much since yesterday afternoon. 

assistant: OK, and did you notice any blood in it at all? 

user: No blood. 

assistant: OK, and do you have any idea what caused the nausea or vomiting? Was it after eating? Or, like, were there any triggers?
user: I think the first time was associated with like, after eating, but I'm not sure about the other ones. 

assistant: OK, and with your sore throat, are you having any kind of like a gag reflex or anything like that?
user: Yeah, maybe a little bit, maybe that's what prompted it. 

assistant: OK. And has your sore throat been just constant or does it come come and go? 

user: It's been pretty constant, yeah. 

assistant: And how much would you rate the pain out of 1 to 10? 1 being the least pain you've felt in your life, 10 being the worst.
user: Uh, I would say, uh, a 6, it's pretty painful. 

assistant: OK, um, have you noticed any kind of like swelling around your neck? Or any redness in your throat?
user: Yeah, I felt my neck this morning in the front of it, it does feel swollen. 

assistant: OK. And are you coughing at all?
user: No, I haven't had a cough. 

assistant: OK, so no cough but are you producing any sputum or yellow material?
user: No, nothing like that. 

assistant: OK, are you coughing up any blood at all? 

user: No. 

assistant: Is there anything that makes it better or worse that you have tried?
user: Just cold drinks. 

assistant: OK. And, uh. So you've also had nausea and vomiting. Are you having any kind of diarrhea or Constipation? 

user: No, but I've had a sore stomach. 

assistant: OK, and did that also start yesterday?
user: Yeah, it's just been, like, fairly generalized. Feels sore. 

assistant: OK, so not in any particular area, just kind of all over your stomach? 

user: Yeah, like, I mean, I guess sort of like in the center, more so, but I can't really put one finger on the spot. 

assistant: OK, and is it constant or does it come and go?
user: It kind of comes and goes. 

assistant: OK, and uh, is it associated with eating food at all, or does it get better when you defecate?
user: I haven't noticed anything like that, maybe it's worse after vomiting, those few times. 

assistant: I see OK, yeah. So yeah, sometimes with the vomiting you can also get some some discomfort. So no diarrhea or Constipation though, right?
user: No. 

assistant: Uh, so are you having any other symptoms like shortness of breath or chest pain, or like a runny nose? Any any of those symptoms? 

user: No, nothing like that. I've just had a headache as well, but it's pretty mild. 

assistant: OK, have you tried any medications at all, over the counter?
user: yeah, I took a Tylenol cause I started feeling a little bit hot as well, to help me sleep last night 

assistant: OK, have you been having any fevers or chills? 

user: Yeah, I felt hot but no chills. 

assistant: And did you manage to get like a temperature at all?
user: No. 

assistant: OK, we can do that here today. So you just felt like a bit hot last night?
user: Yeah, last night I felt pretty hot, sweaty. 

assistant: OK, have you been in contact with anyone who's been sick, or any recent travel at all?
user: I mean, not that I can think of. 

assistant: OK, uhm, so I'm just going to list a few symptoms just let me know if you have any of them. Do you, do you feel fatigued? 

user: No. 

assistant: Do you feel that you have any kind of swelling in your extremities, or any rashes or skin changes?
user: No, I haven't noticed anything like that. 

assistant: OK, any changes in your urinary pattern? 

user: No. 

assistant: OK, any changes in your sleep or appetite?
user: No. 

assistant: OK, any significant weight loss over the last month?
user: No, my weight has been the same. 

assistant: OK, and have you, before this all started, have you had any like, Congestion, runny nose, or any other cold like symptoms?
user: No, I've felt well otherwise. 

assistant: OK. Uhm, do you have any past medical conditions like asthma Or anything else?
user: Uh, no. 

assistant: OK, so you're healthy?
user: Yes. 

assistant: OK, do you have any allergies? 

user: No, I don't. 

assistant: OK, are you currently taking any medications regularly?
user: No. 

assistant: Any previous hospitalizations or surgeries? 

user: No. 

assistant: Any family history of any lung conditions or heart conditions or any cancers?
user: No, nothing like that. 

assistant: OK, and currently do you work? 

user: No, I'm just going to school. 

assistant: OK, and so, currently where do you live and Who do you live with?
user: Yeah, so we live in a house with my parents and younger brother and we've been both back at school now Part time and doing some of it at home online as well. 

assistant: OK, so anyone at all that you notice at school that was sick around you? 

user: No, not that I am aware of. 

assistant: OK. So yeah, this is just a question that we ask everyone. Do you drink alcohol or smoke cigarettes or use any recreational drugs?
user: Uh, no. 

assistant: Ok, so those are all the questions I had to ask you. Anything that I may have missed or anything you want to tell me?
user: No, that's everything that's been happening over the last couple of days. 

assistant: OK. Alright, so yeah it seems that, from your age and some of your symptoms we will definitely do a testing for strep throat. It seems that you meet that criteria. And we also want to make sure that, since you're having other symptoms as well, just to do a covid test, just in case. We'll take your temperature as well, and we might give you some antibiotics as well to treat you and relieve some of those symptoms. So yeah, just hang tight, we'll get the swab done for you for the Covid test, as well as strep throat and then we'll go from there.
user: Hi, I'm I'm coming in because um I've had a lot of shortness of breath and I I've had this cough that won't seem to go away.  

assistant: I see alright, so when does the shortness of breath happen it? Do you have it at rest or is it on exertion?  

user: Mostly on exertion.  

assistant: OK, how far are you able to walk before you get shorter breath? Or how many flights of stairs are you able to do?
user: Uh maybe like 2 flights of stairs?  

assistant: OK. And when did you notice that the change?
user: So I've had this shortness of breath like at first it was pretty mild. It started about, four months ago, but over the past month or so, it's been it's been worse.  

assistant: OK, so a bit so it's been going on for a bit of time now.
user: Yeah,  

assistant: OK um. Do you, are you able to lie down flat without experiencing shorter breath?
user: Yeah, I think so. I think that's fine.  

assistant: OK, um so so it sounds like no orthop is what they call it, and have you had any episodes where you wake up in the middle of the night and you're short of breath and you need to sit up an end to catch it?  

user: Uh no.  

assistant: OK, and have you had any leg swelling?
user: No.  

assistant: OK. Any, you mentioned that you've had a cough as well. How long have you experienced a cough for?  

user: Uh, the cough also around the same time it started off pretty mild, but now I like I have it all the time.  

assistant: OK, are you coughing up any sputum or any phlegm?
user: Uh no it's it's pretty dry.  

assistant: Are you coughing up any blood?  

user: No.  

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

assistant: OK. How how about any chest pain?  

user: Uh no chest pain, I guess with the coughing 'cause I'm coughing so much it hurts but not chest pain in the sense like it's in the area of my heart or anything like that.  

assistant: OK, so does that. Like how would you describe it? Is it like sharp, achy, uh dull or pressure like?
user: Um it's a. It's kind of like a tugging feeling.  

assistant: OK, um it does it go away after you're done coughing,
user: Yeah.  

assistant: I see OK. And have you experienced any um any headaches?
user: No, no headaches.  

assistant: OK, how about any um? Like eye redness or eye discharge?  

user: No.  

assistant: any ear pain or your discharge?
user: No.  

assistant: How about any changes to vision or hearing?
user: No.  

assistant: OK. Have you had a runny nose or sore throat?  

user: No.  

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

assistant: OK. And have you had a loss of appetite?
user: No.  

assistant: OK, and have you had any unexpected weight loss over the last several months?
user: Um I have had some weight loss actually. About 15 pounds over the past six months.  

assistant: OK, and have you been trying to lose weight?  

user: No.  

assistant: OK. Um have you had any fevers?
user: No.  

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

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

assistant: OK. Um and have you had any heart palpitations or feeling like your heart's racing?  

user: No.  

assistant: Have you had any fainting or lightheadedness or dizziness?
user: Um no.  

assistant: OK. Um have you had any abdominal pain?  

user: No.  

assistant: Have you had any nausea or vomiting?
user: Uh no.  

assistant: have you had any diarrhea or constipation.
user: No.  

assistant: And, have you had any skin rashes?  

user: No.  

assistant: Have you had any muscle aches or joint pains?
user: No.  

assistant: And have you had any ah confusion or memory loss?  

user: Uh No.  

assistant: OK, OK, and how is your energy been uh recently have you had any fatigue or malaise?
user: Um no.  

assistant: OK, alright so it sounds like this this dry cough and then and shortness of breath it is mostly what you been um experiencing and have you been diagnosed with any medical conditions?
user: Ah I have uhm a COPD.  

assistant: OK, um and do you use uh any medications or any inhalers?  

user: Um know it's very mild. I it’s yeah, so I haven't really. I was just recently diagnosed so uhm I haven't been started on any medications just yet.  

assistant: OK, did you, do I I pulmonary function tests where you're breathing into a tube,
user: yeah  

assistant: Alright. Yeah, and uhm do you have any allergies?
user: No.  

assistant: Um and have you had any hospitalizations or any previous surgeries?  

user: No.  

assistant: OK and could you tell me a little bit about your living situation? Like where you're living and who you're living with?