jshargo/medical-interview-conversations2 huggingface dataset:
user: I live in a house with my husband.  

assistant: OK, and has your husband been sick or anybody you've been around been sick?  

user: No.  

assistant: OK. And are you currently working?
user: Yeah, so I. I'm working in construction. Um I used to work in shipyards before, but recently I've I've been doing some construction, nothing heavy, ah just working on some old buildings. I’ll ust take the odd job or something that comes up. It's not full time.  

assistant: OK. And any concerns for like exposures while you're at work in terms like breathing in any dusts or any fumes.
user: Um were given a um personal protective equipment um for those concerns, but when I was younger I used to work a in shipyards and constructions and like old buildings and stuff, and I know there was some concern for not being ah properly equipped with the right equipment for protection and safety at that point so. Uh yeah, it's possible. I've been exposed to some things.  

assistant: I see is there a chance that there could have been asbestos at any of those places that you worked?
user: Yeah, asbestos or mold. Yeah, you name it. Probably everything.  

assistant: Yeah, I see this was like 10 years ago 20 years ago or or longer?
user: Yeah, and so it would have been. Yeah, about like 30 years ago or yeah 30, 40 years ago and. I worked in those places for 30 to 40 years, so. Around that time.  

assistant: OK, and do you smoke cigarettes?
user: Um I quit recently since I found out that I might have COPD.  

assistant: Oh congratulations, it's not easy to quit.  

user: Thank you.  

assistant: Uh and do you drink alcohol?
user: Uh once in a while? I’ll have a glass of wine once a week.  

assistant: OK, and do you use recreational drugs?
user: Um no I don't.  

assistant: OK. Um and uh are there any heart or lung conditions that run in the family?  

user: Uh no.  

assistant: OK, are there any cancers that are in the family? Like anybody who's had lung cancer?
user: Um. No, not that I can think of.  

assistant: OK. And um have you traveled anywhere recently?
user: No.  

assistant: OK, and are you currently sexually  active?
user: I am.  

assistant: OK um and can you tell me about your partner or partners? Is it's at your husband or um anyone else?
user: Just my husband yeah.  

assistant: OK and any concerns for ah sexually transmitted infection?  

user: No.  

assistant: OK. And I think that was everything that I wanted to ask on history today. Um was there anything else that you wanted to add that I maybe forgot about?
user: Um no that was it, but how like what can I take to make these symptoms go away?  

assistant: Well yeah, so at this time It will be important to get some lung imaging and and possibly, some other investigations as well because of your exposure uh to inhalants and fumes, and possibly asbestos. So I’m concerned there could be possibly an asbestos related lung illness that that you have. Um and so it will be important to investigate for, yeah possibly a asbestos related lung cancer, 

user: OK?  

assistant: Yeah.
user: Hi, I'm Rob and I just feel like I can't catch my breath. 

assistant: OK, how old are you Rob? 

user: I'm I'm 50 I'm gonna be 50 soon. 

assistant: OK, OK, when did this start?
user: Well, like last night I kinda had like an ache on my chest, kind of like here like on the left. I just I didn't do anything really last night and you know I just went to sleep and I got to sleep fine like I just thought maybe I pulled a muscle on this side. But then I woke up and I was like walking up the stairs and I like was kinda having a hard time breathing and I took some Tylenol. It didn't really do anything. Um, and then it just got worse and then a few hours ago is like I could barely walk. And if I'm breathing deep it's like it just hurts. And I feel like I can't like catch my breath like I can't get a good like a good breath in. 

assistant: Um, OK, so I just want to state at this point I would do ABC's, like I would do the vitals and make sure you're stable and then do airway breathing circulation if you weren't before I continue with the history. OK, so. OK, so that's how it started. Um, are you having any chest pain at all associated with that?
user: Like when I breathe in, I get like and it's like an ache. And then if I breathe really deep it feels like a little sharp. 

assistant: OK. 

user: I have never had anything like this before. 

assistant: No? OK, that was going to be my next question. On a scale of 1 to 10, how severe is your shortness of breath, 10 being the worst?
user: Um, I don't, I don't know, um. Like I can breathe right now, I can't get like a deep breath, like... 

assistant: Does it? Oh sorry, go ahead.
user: Maybe like you know five or six. 

assistant: OK, OK. Does it hurt when you take a deep breath in? 

user: Yeah. 

assistant: Yeah?
user: Yeah, it's like it's like sharp. 

assistant: OK, sorry, sounds like you're having some pleuritic chest pain. Do you have any coughing associated with that?
user: No no. 

assistant: No? You're not coughing up any blood? 

user: No. 

assistant: Any swelling in your legs?
user: I I don't think so. 

assistant: No? OK, how about on exertion? Like when you walk or run, or you know, does it hurt more or does I mean sorry, does your shortness of breath get worse?
user: Oh yeah, it was like going up the stairs, can't really breathe in after. 

assistant: OK, how about when you're laying down? 

user: I don't know. I don't think that's any different. No, I slept fine last night. I got up and when I went up the stairs I was like holy... 

assistant: OK. How about wheezing? Are you experiencing any wheezing?
user: I don't think so. 

assistant: OK, how about fevers or chills?
user: No, not that I've noticed, no. 

assistant: OK. Any abdominal pain? 

user: Uh, no, no, it's like it aches kind of it, but it's all up here and like kind of in my back a little bit. 

assistant: OK and, do you think anything triggered this?
user: I don't know. 

assistant: No? OK. And you said this has never happened to you before, right?
user: Right, yeah. 

assistant: Does it get better with you sitting forward? 

user: I don't know, like I, I feel like that it's still kind of aching like it doesn't, it's not really like changing very much. 

assistant: OK. OK. OK, any changes in your vision, hearing or smell?
user: No. 

assistant: No? Any rashes?
user: No. 

assistant: No? Weight loss? 

user: I, I mean, I've been trying to to lose weight. 

assistant: OK.
user: They told me a year ago I have like high blood pressure so I've been cutting out like salt and trying to walk more. 

assistant: OK, OK, good.
user: So I've lost like 15 pounds but like not... Like I've been trying to. 

assistant: OK, OK. 15 pounds, that's good. Are you experiencing any dizziness or you feeling faint?
user: No, just like a I can't get like a good breath. 

assistant: OK, and are you otherwise healthy? You mentioned you have high blood pressure, anything else? 

user: No, that's that's like it. I've never had any like chest problems. 

assistant: OK. Have you had any investigations done for your chest like pulmonary function tests, ECG's, chest X-rays?
user: No, no, they just they just put the thing on my arm. But my doctors office and said that it was high. So they said to you know, eat better and I don't I don't wanna start any drugs so, I didn't do anything. I've been fine ever since. 

assistant: OK, so you're not on any medications? 

user: No, just yeah, no that's it. I mean I, you know sometimes take like a Tylenol if I'm not feeling well but... 

assistant: And do you smoke?
user: I, like I, smoke a little bit. Maybe like a pack a week. 

assistant: A pack a week, OK? For how long? 

user: Oh like since college. 

assistant: OK OK. Um, do you smoke marijuana?
user: Uh. No, no and I I smoke, I'm trying to smoke less, you know, since they told me I have the high blood pressure. So I used to smoke a little more but this is this is less but not since I've been having trouble breathing. Is it, yeah. 

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

assistant: No, OK. How about alcohol? Do you drink alcohol?
user: Oh like, maybe you know, a beer on the weekend. 

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

user: Like I don't I think I got all the ones when I was like a kid. What else should I have? 

assistant: OK, so like the flu vaccine every year?
user: Oh, I get that, like my wife, my wife makes me get that. 

assistant: OK that's good. Any family history of lung or heart disease?
user: Oh like my, uh, my mom and dad have high blood pressure too, so I wasn't surprised when I heard that I did. 

assistant: OK. OK. Um, OK so Rob, is there anything that you wanted to tell me that I haven't asked you already today? 

user: I am really like nervous 'cause I haven't felt anything like this before. Um, like it's scary, like do you think it's like cancer or something like I don't I don't really know? 

assistant: Um, I mean, it's hard to tell right now what it is. It sounds like it's it started pretty suddenly, um, like it started a day ago, correct?
user: Mhm. 

assistant: Yeah, so it's unlikely that cancer would present itself like this so acutely, you know? And, but it could it could be a number of things like, it could be something like a pulmonary embolism, but you said you don't have any swelling. Um, but you did say you have some chest pain when you're breathing pretty, when you take a deep breath in. So I mean, that's a possibility. It doesn't sound like it's an infection because you don't have a fever or chills or any any other symptom really. And you mentioned there weren't any triggers like no trauma to the area. And then, other things could be like COPD because you which is a chronic obstructive pulmonary disease because you have been smoking since college and that's basically just inflammation in your lungs that causes your airways to narrow, and so you may have a hard time breathing. So for all of these things, we first start by doing some blood work and then we'll do some imaging like a chest X-ray and a pulmonary function test if indicated, and so that will give us a better idea of what you have and how we can best help you. Sounds good? 

user: Yeah yeah, I just really want to get a good breath so yeah, whatever we can do. 

assistant: Yeah for sure, and then in the meantime we'll keep monitoring you to make sure your vitals are OK and if we need to give you oxygen, we will.
user: So yeah, I've just been having a cough for the last week and I think I had a little bit of a fever in the last few days. 

assistant: OK, so you said the cough started a week ago?
user: Yeah, around a week ago OK and the fever started two to three days ago. Yeah, I haven't really measured it, but like I definitely have been feeling chills.I've been wearing like multiple blankets over the last few days. 

assistant: Ok, have you taken your temperature? You said you haven't taken your temperature right?
user: No. 

assistant: OK. So let's focus on the cough. Is it persistent or does it come and go?
user: I think the cough is pretty persistent over the last week. 

assistant: OK, and does it get worse with like cold air or dust? Like maybe pets or anything like that? 

user: No, I think it stays around the same. 

assistant: OK, umm, does it get better with anything? Have you tried any over the counter cough syrup?
user: Yes, I tried tylenol cold and liked it. I think it made it a bit better, like it helped me sleep. Other than that, during the day, it's still around the same. 

assistant: OK, and how would you describe this cough? Is it barky? Is it harsh? Does it sound muffled?
user: How I would say is that it's kind of like it's not too harsh. It's more like a wet cough. I'm definitely bringing up some some sputum. 

assistant: OK, um, what color is the sputum?
user: It's usually like a, uh like a white and sometimes like a little bit yellow as well. 

assistant: OK, is it ever green or do you ever see blood in there? 

user: No, I haven't seen any of that. 

assistant: OK. And have you ever had a cough like this before?
user: Umm, yeah, probably like in the last year, maybe I have gotten sick like once and had a similar cough. 

assistant: OK, do you have a sore throat?
user: No, I don't have a sore throat. 

assistant: Is this cough getting worse?
user: It's, I think not really, it stayed around the same and I definitely feel a bit better with the tylenol cold. 

assistant: OK, good. Any changes in your taste or smell? 

user: No, no changes. 

assistant: OK, any changes in hearing or vision?
user: Nope. 

assistant: And did you have in the past week a runny or stuffy nose?
user: No. 

assistant: OK, any weight loss over the past month? 

user: Umm, no, not really. 

assistant: How about changes in your hair, nails or skin like rashes?
user: No, no changes to the skin. 

assistant: OK, any shortness of breath?
user: No, no. 

assistant: How about wheezing?
user: No, I don't think I've recently. 

assistant: OK, chest pain? 

user: No chest pain. 

assistant: How about swelling? Have you noticed any swelling in like your legs or arms or your belly area?
user: No, I don't think so. 

assistant: OK, how about you feeling like your heart's racing? 

user: No, no, nothing like that. 

assistant: OK, how about a calf pain?
user: No, no. 

assistant: Any dizziness or fainting spells? 

user: No, nothing like that. 

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

assistant: Have your bowel movements been normal?
user: Yeah, I like go three times a day and I don't have any diarrhea or anything. 

assistant: OK, how about urinating wise?
user: Everything normal there. Yeah, no trouble. 

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

assistant: Joint pain or muscle ache?
user: No, I don't think so. 

assistant: OK. Any Contacts with sick people around you recently? 

user: My wife was actually just sick last week, but she recovered. She did have a fever for one of the days and she also had a cough. 

assistant: OK, did she get it checked out in a clinic?
user: No, I don't think so. She did get that COVID test done, but it came back negative and she didn't go to the doctor or anything. It kind of just went away on its own. 

assistant: OK, any travel recently? 

user: No. 

assistant: Are you otherwise healthy? Do you have any longstanding medical conditions?
user: Just as a child. I had, probably in my teens, had my appendix removed, but nothing other than that. 

assistant: OK. OK, no hospitalizations other than that too, right?
user: No, No. 

assistant: Are you on any medications?
user: No, I just take some multi vitamins. 

assistant: OK, and are you up to date with all your immunizations?
user: Yeah, as far as I know. 

assistant: OK, how about allergies? 

user: I do have like some, I get some runny nose around spring time probably I think I'm allergic to pollen. 

assistant: OK. And any family history of lung conditions?
user: No, not that I know. 

assistant: How about heart conditions?
user: No, I think my father has high blood pressure if that's like a heart condition. 

assistant: OK, sure. And how old was he when he got that? 

user: He's around like 60s right now, so probably like in his 40s. 

assistant: OK. Any cancers in the family?
user: I do have an aunt on my mother's side who had ovarian cancer. 

assistant: OK, how old was she when she was diagnosed with ovarian cancer? 

user: I think probably in her 50s. 

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

assistant: How about marijuana? 

user: Marijuana just maybe like one or two joints in a month, just when I'm feeling that I need to relax a little. 

assistant: OK, sure and by joint, you said once a month right?
user: Yeah, once per month. 

assistant: OK, any other drugs?
user: No, no other drugs. 

assistant: And where do you live right now?
user: I live in London right now. I live with my wife in an apartment. 

assistant: OK, any reasons to think you have old carpet mold or asbestos?
user: No, it's a fairly new apartment. 

assistant: OK, and well those are all the questions that I had for you today. Did you have any questions for me?
user: You don't think it could be COVID right? Like my wife got tested and it was negative. 

assistant: Are you concerned about that?
user: I um. I just haven't been feeling very well over the past couple months. And I have decided I just come in and see what's happening, so I've just I've been feeling short of breath. And I kind of passed out sometimes and I'm really worried about it. 

assistant: OK. Uh, so when the shortness of breath start. 

user: I say about five or six weeks ago. 

assistant: OK, and and do you get short of breath at rest?
user: No. 

assistant: And has it been getting worse or staying the same?
user: Uhm? Kind of the same maybe a little bit worse, but I yeah maybe the same. Definitely not getting better. 

assistant: OK, how far are you able to walk or exert yourself before you're short of breath? 

user: I can walk quite a bit, um, but I, I guess like when I go for my my runs in the morning, I start feeling short of breath. It's maybe like, two blocks or three blocks. 

assistant: OK, and any any symptoms where you get short of breath at night and where you had to get up and and put your feet over the bed?
user: No. 

assistant: Are you able to lay flat without being short of breath?
user: Uhm, yeah 

assistant: Or does it.. OK. And every had any swelling in your feet or ankles.
user: No. 

assistant: OK, and you mentioned that you you passed out as well. Can you tell me a little bit about a little bit about that?
user: Yeah, uh, it just happened two or three days ago. And I was just, I was-I wasn't really doing much I was I guess just like going up the stairs. And when I got to the top, I just kind of suddenly collapsed. And then I got back up. 

assistant: Were you really short of breath at the top of the stairs? 

user: I felt like my heart was like beating kind of fast. And I felt little bit dizzy. 

assistant: OK, see, where you sweaty at the time as well?
user: I don't remember, maybe? 

assistant: OK, did you feel like you were going to pass out?
user: Yeah. 

assistant: OK, has anything like that happened to you before? 

user: No. No. 

assistant: OK and did you bite your tongue during this or?
user: No. 

assistant: OK, and did you wet yourself at all? Like pee your pants or anything like that?
user: No. 

assistant: OK. And how long did it last for? 

user: Maybe a couple of seconds, it's. Yeah. I don't know, I I can't really tell. I was alone at home at the time. And I'd like I couldn't tell how long it took for me to get back up. 

assistant: OK, you picture that your heart was racing. Did it feel like it was like did you have heart palpitations or is your heart beating really fast?
user: Yeah it was. 

assistant: OK. And did you hit your head or or hurt yourself when you fell?
user: No, no. 

assistant: OK, and recently, have you been otherwise feeling well or if you had any viral infectious symptoms like red eyes or itchy eyes or runny nose, sore throat? 

user: No. 

assistant: OK, nothing like that and have you had a cough?
user: No. 

assistant: OK. And have you had any wheezing? 

user: No. 

assistant: And if you had any chest pain.
user: No. 

assistant: OK, have you had any instances where you felt as though you were having heart palpitations at any other times? And not just during the time that you had the fainting episode?
user: Um, I kind of did when I was. When I was like running outside, but I just thought maybe maybe I was exerting myself too much. 

assistant: I see, alright. And any chest pain? 

user: No. 

assistant: And. Uh, OK. Have you had any, any nausea or vomiting?
user: No. 

assistant: Any abdominal pain? 

user: No. 

assistant: Any urinary problems?
user: No. 

assistant: OK, any muscle aches or body pains? 

user: No. 

assistant: Any fevers or chills?
user: No. 

assistant: Have you had any changes to your weight in the last several months? 

user: No. 

assistant: Have you had any changes to your appetite?
user: No. 

assistant: And have you notice any skin changes like rashes or or anything like that?
user: No. 

assistant: OK. And. Uh. In the past, have you been diagnosed with any medical conditions? 

user: No, I've been very healthy. 

assistant: OK, I do you so do you take any medications, either prescribed or over the counter?
user: Uhm, I just take some puffers for asthma, but I haven't had asthma in awhile. I actually thought maybe my asthma was getting worse over the past two three months. I didn't really. I just I didn't think too much of it. But then when I fainted, I was just kind of scared. 

assistant: Yeah, for sure. Umm, certainly would be frightening. OK, and do you use the inhaler everyday? 

user: No. I used to when I was young. I didn't have asthma for a couple of years for like, I'd say 20 years or so. So then I stopped taking inhalers. 

assistant: OK, so you haven't used them recently.
user: No. 

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

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

user: No. 

assistant: OK. And have you been pregnant in the past?
user: Uhm, I I was yeah. I have a son. About eight years ago. He was born eight years ago. 

assistant: Ok. Was this a vaginal delivery or a C-section?
user: Vaginal. 

assistant: And any complications, either during pregnancy or delivery or afterwards? 

user: Oh no, everything was good, no problems. 

assistant: OK, and could you tell me a little bit about where you're living and and who you're living with?
user: Yeah, I'm living with my husband and my son. We live in a house about 30 minutes from here. 

assistant: OK, uh, has anybody been sick in the house?
user: No, everyones been well. 

assistant: Alright, have you traveled anywhere recently? 

user: No. 

assistant: OK, any exposures in the house like carpets or rugs or it's like like things like that?
user: We do have carpets, but I mean I, I don't think that's a problem. Like we've had it for like years and we've had the same carpets for years and years. 

assistant: OK, I see and are you working currently or or at home? 

user: Yeah, I'm at home but I work from home. I'm a writer. 

assistant: OK cool, yeah I do you smoke cigarettes?
user: No. 

assistant: Do you smoke cannabis or use any cannabis products? 

user: No. 

assistant: OK, and do you drink alcohol?
user: I do, I'll just drink on the weekends. 

assistant: OK, and I like how many drinks would you typically have in a week? 

user: Uhm, not much. I'd say one or two glasses of wine. 

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

assistant: OK, And like you said, you're a writer currently. In the past, did you work any jobs where you were exposed to asbestos or like any chemicals or fumes in the air?
user: No, no, I haven't. 

assistant: OK, And in the family is there is there anybody who has any heart or lung conditions? 

user: No. 

assistant: How about any clotting disorders or or cancers?
user: Uhm, prostate cancer. My uncle had it. 

assistant: I see, OK. So it sounds like over the last little month, you've been having some more short shortness of breath as well as well this fainting episode more recently. So we will. Was there anything else that you wanted to add?
user: Hum, no. 

assistant: Alright, so we will do some pulmonary function testing and get some imaging of your lungs today as well as an ECG and maybe a monitor for your heart as well to just check your heart racing for the next 48 hours. Mentioning that your heart was racing and so to rule out that any abnormal rhythms of your heart, or to check for that. And we will kind of go from there, did you have any questions?
user: Hi, um, I'm here because I, I had this cough for a couple days and now my voice still hasn't recovered. It sounds really hoarse and I can't speak as well, so I was just wondering if you can give me something for that. 

assistant: Possibly we will see just gotta ask a few questions first, and we'll, we'll do a physical exam as well afterwards, but certainly, we'll look into what is causing your symptoms. So you mentioned a cough. When did that exactly start?
user: That started three days ago. 

assistant: Okay, and have you had a cough before? 

user: Um, like before the three days you mean? 

assistant: Yeah.
user: Um, no, I was pretty healthy before then. 

assistant: I see and uh, with the cough, are you producing any phlegm or sputum? 

user: No, it's pretty dry. 

assistant: Okay, have you noticed any blood?
user: No. 

assistant: Alright, and have you had a wheeze? 

user: No, uh, no, nothing like that. 

assistant: Alright, and have you had any uh, chest pain with the cough?
user: No. 

assistant: Alright uh, and you noticed that your voice is, voice changed, and that was about 3 days ago as well?
user: Yeah, that, so, well no, actually that started about yesterday. Yeah, yesterday in the afternoon. 

assistant: Okay, and uh, any triggers for this? Like were you at any events that you had to be uh, kind of speaking loudly or talking a lot or anything where you're straining your voice?
user: Um no, no, I wasn't. I was like, I had school, I came home, I didn't do anything like that. 

assistant: Okay. Yeah, so it sounds, yeah, just sort of came on on its own. Alright, and have you had any like, eye redness, or discharge, or a runny nose? 

user: I have had uh, I've had a runny nose before, but no eye discharge. 

assistant: Okay. With the runny nose, what, what, what could you describe the uh, mucus that was coming out?
user: Uh, it was, it was clear. 

assistant: And has that gone away now and then when was the runny nose?
user: Yeah, that's gone, yeah that's gone. That went away but like, um, yeah, two days ago maybe. 

assistant: I see, and have you had a sore throat or do you have a sore throat? 

user: Um I have, so, it hurts because I'm coughing, but it doesn't seem like it's my actual throat. 

assistant: Alright, is there any pain with swallowing food or liquids?
user: No. 

assistant: Okay. Um, and have you had any fevers or chills? 

user: No. 

assistant: Or any, any night sweats?
user: No. 

assistant: And any changes to your weight recently?
user: Um, I've had some weight gain over the past like six months. 

assistant: Okay, well that's great. And about how much?
user: Uh just, maybe like 5, 10 pounds. 5 to 10 pounds, somewhere around there. 

assistant: Okay, well that's good. And um, have you had any nausea or vomiting? 

user: No. 

assistant: How about any abdominal pain?
user: Uh no. 

assistant: Any uh, diarrhea?
user: No. 

assistant: Or any urinary problems? 

user: No. 

assistant: Have you had any muscle aches or, or joint pains?
user: Uh, no. 

assistant: Okay, and have you had any loss of your taste or sense of smell? 

user: No. 

assistant: Okay, um, and any skin changes or rashes?
user: Nope, nothing like that. 

assistant: Okay, uh, and um, so you've been experiencing, so you had a runny nose that's gone away um, and now you've been having this cough for the past, dry cough, past three days and lost your voice yesterday. Have you been experiencing any other symptoms?
user: Um no, no other symptoms. 

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

user: Uh no, I've been pretty healthy. 

assistant: That's great, and u, have you been, um, have you had any allergies before?
user: No. 

assistant: Okay, and uh, do you take any medications regularly?
user: Uh, I just take some multivitamins. 

assistant: Okay, and uh are you aware if your immunizations are up to date? 

user: Uh, so I have everything except for that HPV vaccine. 

assistant: Okay, um, is it, do you have a plan to get that one or?
user: I think so. I'm just uh, waiting to follow up with my family doctor about that. 

assistant: Okay, well that, that's a good idea for sure. So it's great that you have a plan for that, um, for that. Yeah, it can be really helpful for preventing cervical cancer, as, as I'm sure you'll talk to the, with the family doctor about. Yeah, and have you had any hospitalizations or any surgeries? 

user: Uh no. 

assistant: Okay, um, where about are you living right now, and who are living with?
user: I live uh, with my parents um, and my two younger siblings. We live in a house. 

assistant: Has anybody else been sick or have similar symptoms? 

user: Uh no, no one at home's been sick. 

assistant: Okay, and uh, how about anybody at school or, or work, or anything like that that you've been around who's been sick?
user: So one of my friends actually had like a runny nose and a cough as well a couple of days ago, but uh, she seems to be better now and her voice is okay. 

assistant: Okay, and um, have you traveled anywhere outside of the city or province?
user: No, no, not recently. 

assistant: Alright, and, um, in the home, is there any uh like, are you exposed to any violence of any sort, like physical or emotional, either yourself or, or witnessing?
user: No. 

assistant: Okay, and what grade are you in? 

user: I'm in grade 7 or, yeah grade 7 now. 

assistant: Oh awesome, and uh, I don't, is there any smoking in the home?
user: Uh no, no one smokes at home. 

assistant: Okay um, and then, um, anybody in the family uh, have any heart or lung conditions? 

user: Heart or lung? I know, um, like, heart disease, runs on my father's side of the family. I'm not really sure like exactly what, what kind of diseases though. 

assistant: Okay, um, and I, sometimes people that, kind of in this age group, might experience with either drugs or alcohol. Have any of your friends done that or, or yourself?
user: I know like some of my friends have uh, tried alcohol and try marijuana, but I haven't experimented yet. 

assistant: Okay, that's good and um, I, that's all I wanted to ask today on history. Was there anything else that you wanted to add?
user: Oh, nothing that I want to add. I just, what do you, how do you think I can make this, make my voice better? And how long will I have, have this horse voice? 

assistant: Yeah, so uh, right now it's sounding like um, a viral type illness where there's inflammation of the vocal cords, uh, with having the cough and the runny nose a couple of days ago. Actually, this reminds me that. Have you, I'm not sure if I asked about fevers or chills, if you have any?
user: Uh no, I haven't. 

assistant: Okay, um, and so for, if it is a viral infection then, um, it's just supportive kind of management. So that will mean trying to stay as hydrated as you possibly can over these next um, next few days and then also you can use things like, if they help, like lozenges or something along those lines. Um, but it will, it will just take some time for it to come back on its own, a few days to a couple of weeks sometimes. And the cough could possibly last for um, two to four weeks after um, after having a viral type illness.
user: Hi, yeah, so I've had this uh back pain that's been going on now for the last uh two weeks, it's just kind of right in the lower back and it just hasn't gone away. 

assistant: OK, um last two weeks you said, is it getting worse? 

user: Uh no, it's not really getting any worse, uh it's just been uh limiting my abilities at work. 

assistant: Right, OK, and what do you do for work?
user: So I work um at a butcher shop. 

assistant: OK.
user: Yeah, and we're like always like carrying heavy things and yeah, it's a lot a lot of like lifting and standing. 

assistant: OK. Did anything trigger this back pain two weeks ago? Did you have some sort of injury or trauma to the area? 

user: No, I can't think of anything uh like specific that happened, but there was one night where um like after work, I was sitting down after dinner and um I got pretty stiff that night. It was pretty sore and kind of ever since then, it's been been sore. 

assistant: OK, OK, um and is this a persistent kind of back pain or does it come and go?
user: It's um, I can kind of always feel it, but it certainly gets worse if I am moving. So if I'm just kind of sitting at rest, I don't really, yeah, I don't really feel it that much. 

assistant: OK, OK, and if you were to describe the quality of this pain, um would you say it's sharp, throbbing, achy, crampy?
user: I'd say I get kind of uh, it's a sharp pain. 

assistant: Sharp pain, OK. Um does anything make it better or worse?
user: Um better would just be uh resting. 

assistant: OK.
user: Um kind of just lying down, or um yeah, just just trying to uh rest. But um making it worse, yeah, if I'm uh like really any movement um if I'm like bending forward or um kind of like leaning to the side, I start to get um get some pain in the lower back. 

assistant: OK, OK. And then 1 to 10, 10 being the worst pain you've ever felt, how bad or uh how severe would you rate it? 

user: I would say 7. 

assistant: A 7, OK. And have you ever had pain like this in the past?
user: Uh yeah, I've I've hurt my lower back before like many years ago. Um but it's been OK since then. 

assistant: OK. Uh did you get any sort of treatment or management for that pain um back in the day?
user: At that time it was just rest and like did some stretching and I took some um anti inflammatories and it went away after a couple of months. 

assistant: OK, OK. Um and are you having any sort of like numbness or tingling, anywhere on your body? 

user: No, nothing like that. 

assistant: Alright, how about any muscle weakness?
user: Uh no muscle weakness. 

assistant: No, OK. Are you still able to walk and do things that you normally would do in a day?
user: Uh yeah, I'm able to walk still. 

assistant: OK. Um any dizziness or fainting spells?
user: Nope, nothing like that. 

assistant: OK. Any pain elsewhere on your body? 

user: No, just just the lower back, yeah. 

assistant: OK. Headaches?
user: Uh nope. 

assistant: OK, weight loss?
user: No, I haven't had any weight loss. 

assistant: OK. Fevers or chills?
user: Nope, no fevers or chills. 

assistant: Um rashes?
user: Uh no rashes. 

assistant: Changes in your vision, hearing, taste or smell? 

user: No changes like that. 

assistant: OK. Any coughing, shortness of breath or wheeziness?
user: Um nope, nothing like that. 

assistant: Um chest pain or heart palpitations?
user: Nope, nothing like that. 

assistant: OK. Issues or changes in your bowel movements? 

user: Uh no changes to bowel movements, no diarrhea and no incontinence or anything like that. 

assistant: OK, um and then uh nausea or vomiting?
user: Nope, nothing like that. 

assistant: OK, how about um changes to your appetite?
user: Um nope, I've been eating uh, I've been eating well. 

assistant: Changes in your voiding? 

user: Uh nope, I haven't had any changes to urination. 

assistant: OK. Um and then are you otherwise healthy or do you have any longstanding medical conditions?
user: Uh I I've had a few sports injuries when I was younger, uh like to my my knee, but that's it, I've been healthy otherwise. 

assistant: OK and um those injuries, are they all healed? 

user: Uh sometimes I'll get um like a little achiness in my knee from from doing like too much activity, but I know when those, when that happens. 

assistant: OK. Are you on any medications?
user: No, I I don't uh take any medications. 

assistant: OK. Are you up to date with all your immunizations?
user: I am, yep. 

assistant: OK. Um do you have any allergies?
user: Uh, no allergies. 

assistant: OK, any family history of um muscular or skeletal issues? 

user: Um no, nothing like that. 

assistant: OK, how about um heart or lung diseases?
user: Uh, no, no heart or lung diseases. 

assistant: OK, uhm how about autoimmune conditions? 

user: Um nope, nothing like that. 

assistant: OK. Cancers?
user: Uh no cancers. 

assistant: OK. Um and do you smoke? 

user: Um no, I don't smoke. 

assistant: OK and do you consume marijuana?
user: Uh sometimes, I'll have like uh edibles, little candy, sometimes at nighttime they they help me uh relax and sleep, but I don't use that very often. 

assistant: OK, how often do you use them?
user: I would say maybe uh once a week. 

assistant: Once a week, OK. Alright um and then, what else did I wanna ask you? Um do you, do you take any recreational drugs?
user: No, and I haven't used any before. 

assistant: OK, and how about alcohol, do you consume alcohol? 

user: Yeah I'll have a couple of beers on the weekend, so maybe like two or three. 

assistant: OK, uhm and who and where do you live right, who with and where do you live right now?
user: Yeah, I live with my wife and our um and our son who's in high school. We live in a in a house. 

assistant: OK, OK. Um alright, and any concerns for STI's at all? 

user: Oh no, I've been with my wife now for a long time and we've been monogamous so no concerns for uh sexually transmitted infection right now. 

assistant: OK, how about um sick contacts, have you been in contact with anyone sick recently?
user: No, I don't think so. 

assistant: OK, any travel recently? 

user: Uh no, I haven't traveled anywhere. 

assistant: OK um and well, let's move on to the physical exam part of this interview. Um so I'm going to get you to stand up from a sitting position. Does that hurt your back?
user: Um yeah it does. I I do feel a little bit of a a twinge there. 

assistant: OK, and where about specifically?
user: Kind of just, yeah, on the lower uh lower right side like more on the, more on the right side. 

assistant: More on the right side, OK. Now, if you have a mirror with you, or if you have someone there with you who can um speak to this, does your right side appear more red, swollen, or hot compared to your left side of the lower back? 

user: Uh no, nothing like that. 

assistant: No, OK, and does it seem like it's more atrophied or do you see any deformities or skin changes in that area?
user: Uh nope, no deformities or skin changes. 

assistant: OK, um alright and I'm gonna get you to um bend down all the way and touch your toes if you can.
user: Um yeah I I can get part part way down. 

assistant: You can get partway down, does it hurt? 

user: Um a little bit, I can feel it pulling and stretching, yeah. 

assistant: OK. Um alright, and then I'm gonna get you to uh like laterally flex to your right side. So kind of like you're doing an exercise um and you're just like bending towards that side.
user: Yeah, that hurts. 

assistant: That hurts, OK, how about the other side, the left side? 

user: Yeah that hurts too. 

assistant: OK. Um and now I wanna get you to uh bring your knees up towards the ceiling. Does that hurt? One at a time, like your right right knee and your left knee.
user: Uh, not really. 

assistant: No, OK, how about when you um flex your knees backwards? 

user: Nope. 

assistant: And kind of point your knees towards the ground.
user: No, no pain there. 

assistant: OK, so no pain on knee extension or flexion. Um how about when you point your toes to the ceiling?
user: Uh no pain there. 

assistant: OK so no pain on plantar flexion, how about when you point your uh toes to the ground? 

user: No pain there. 

assistant: OK, so no pain on dorsiflexion, and then sorry I forgot to ask you earlier, do you have any sort of numbness in the groin area?
user: No, no numbness in the groin area. 

assistant: OK, so no numbness in the groin area, no weakness, no um changes in your bowel or bladder habits, including no incontinence, so uh no red flags? 

user: Yeah, nothing like that. 

assistant: OK, OK, good um and, OK so those are all the questions that I had for you. Did you have any questions for myself?
user: Uh, I have just been feeling very short of breath recently. 

assistant: OK.
user: And I thought I should come in. I've also had a, I've also had a cough. 

assistant: I see. OK, uhm, and when does this shortness of breath, uhm, come on? How, how much activity are you able to do? 

user: Uhm, I can walk a block. 

assistant: OK.
user: Without being short of breath. 

assistant: And prior to this change, how far were you able to walk and and how long ago did you, did you notice this change? 

user: Uhm, I, I guess I could walk, uh, I don't know, it's been very, I guess it's, it's been a gradual change. Uhm, maybe a month, a month ago I felt that I couldn't really walk as much as I used to, and then it's only gotten worse. Two or three months ago I could, I could walk a kilometre or two, or more. 

assistant: OK, so quite a significant change over the last little while. Have you had any episodes where you wake up in the middle of the night with, with shortness of breath, and you need to sit up?
user: No. 

assistant: OK, and how many pillows do you sleep with?
user: One. 

assistant: OK and have you noticed any like ankle swelling or or leg swelling?
user: No. 

assistant: OK. And you mentioned cough. When did that start?
user: I've had a cough for a while, the past five, ten years, but I feel that it's been a little bit more frequent now. It's just, I just get into this coughing fit and I think there was a time when I had a little bit of blood come out as well, once or twice. The coughing also makes it difficult for me to breathe, you know, I feel very short of breath after that. 

assistant: Yeah, certainly, uhm, how much blood have you coughed up? 

user: Oh, I don't know. I think it was it was a little bit. 

assistant: Did it happen each time, or has it only been a couple of times?
user: I think maybe, two or three times but then there have also been times when I cough up this, this stuff that I cough up is a little bit pink in color. It's not exactly blood, but it's, it's, you know, pinkish. 

assistant: OK, and are you producing sputum each time you're coughing up?
user: Most of the times, yes. 

assistant: OK, is this a change from previously? Did you have a dry cough before? 

user: A bit more of a dry cough before, but I mean, so sometimes it will be a dry cough sometimes, uh, it was more of a wet cough, but it was, it was usually just this white thing coming up. It wasn't like, there was never blood before. 

assistant: OK, and you're coughing more often as well over this last month?
user: Oh yeah, Oh yeah, 

assistant: OK. Have you been experiencing any, any headaches?
user: No. 

assistant: OK, how about any eye pain or ear pain?
user: No, no, no. 

assistant: How about any eye redness or, or discharge?
user: Nope. 

assistant: Any runny nose or sore throat? 

user: no. 

assistant: OK, have you had any fevers or chills?
user: Uhm, I, I checked my fevers, I checked my temperature uh, couple days ago. It's just been this little bit, 30, I think it was 38. 

assistant: OK, so, yeah, that would be a fever. 

user: That was I think two weeks ago. 

assistant: OK, do you feel hot now?
user: Not really, no. 

assistant: OK. Have you had any night sweats?
user: Uh, no. 

assistant: And have you had any weight loss over the last several months?
user: Oh, yeah. 

assistant: How much weight? 

user: About 20 pounds. 

assistant: OK, and so how, How long was that weight loss over?
user: I'd say about about, uh, three, three-four months? 

assistant: OK and sorry, what was your starting weight, roughly?
user: Yeah, yeah I was, uhm, 210 pounds. 

assistant: OK, uhm, so yeah, about a 10% reduction in your weight over the last couple of months, it sounds like. OK, How is your appetite been? 

user: Uh, it's OK. 

assistant: Alright, and have you been having any chest pain?
user: No. 

assistant: Any, any wheeze? 

user: No. 

assistant: Have you had any dizziness or lightheadedness?
user: Uhm no, no. 

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

assistant: Any diarrhea or constipation? 

user: No. 

assistant: Any urinary problems?
user: No. 

assistant: Any skin rashes or muscle aches.
user: No. 

assistant: OK, and, uh, have you been diagnosed with any medical conditions before?
user: Yeah, I've been diagnosed with COPD, with, uh, high blood pressure and high cholesterol. 

assistant: I see, alright and do you take any medications for those?
user: Uh, I take Lipitor. 

assistant: OK.
user: They haven't done much. 

assistant: OK. And are you allergic to any medications or have any allergies?
user: Uhm, no. 

assistant: Alright, and have you been hospitalized for any reason, or like, including COPD exacerbation? 

user: Oh yeah, yeah. 

assistant: Or any similar symptoms?
user: It's been, uh, I was, uh, I was actually hospitalized about four or five times last year. 

assistant: And was this for COPD exacerbations? 

user: Yeah, yeah. 

assistant: OK, did those each require a stay in the hospital?
user: Two or three of them I did, yeah. 

assistant: OK. And have you had any surgeries? 

user: Uh, no. 

assistant: And are you currently smoking?
user: Yeah. 

assistant: OK, how much do you smoke per day?
user: I've got it down quite a bit. I only have two cigarettes a day. I used to have a pack and a half, Uh, but I've got it down a lot. I'm trying to, I'm trying to quit, but it's hard. 

assistant: Yeah, for sure it's great that you're working towards quitting. We can discuss that further and there are several options that might be available to help if it's something you're interested in, because yeah, it's definitely really hard. Are you, do you drink alcohol? 

user: Uh, once in a while, on Christmas. 

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

assistant: You smoke marijuana or use marijuana products? 

user: No. 

assistant: Alright, and who are you living with currently?
user: I live with my wife. 

assistant: OK, and are you, uhm, do you help looking after the home, and uh, like functionally independent right now? 

user: Uh, yeah. I use a cane. 

assistant: Mhm, ok.
user: And uh, yeah, my, my son comes over and helps out with groceries and my wife cooks but, I, I help her with cleaning sometimes. 

assistant: OK, great and, so are you retired?
user: yep. 

assistant: OK, uhm, and has anybody in the family had any heart or lung conditions? 

user: My dad died of lung cancer. He was a, he was a big smoker as well. And my mom had a heart attack. 

assistant: OK, and how old were your parents approximately?
user: Yeah, my dad was 65 and my mom was, was very young, she was 50. 

assistant: I see. Did your mom survive the heart attack? 

user: No, no she did not. 

assistant: Oh, I'm sorry to hear that. Uhm, and the lung cancer you mention, any other cancers that run in the family?
user: I've been having this cough for around, I would say half a year now and I just can't seem to get rid of it. 

assistant: OK. And does this cough have any phlegm that you bring up?
user: No, it's completely dry. I can't bring anything up. 

assistant: OK, and since the cough started, has it been getting getting worse, staying the same, getting any better?
user: It was pretty much the same for I would say like three or four months, but then I've noticed it getting more frequent over the last couple of months. 

assistant: OK, and six months ago, can you think of anything that that changed? Including like, traveling anywhere or changing in in your work or or living environment?
user: Uh, not really, uh, I'm like almost 75 years old now, so I just thought it was probably just due to my age. 

assistant: OK. Uh, have you been have you brought up any blood with the cough?
user: No, I've never brought up any blood. 

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

user: Not that I've noticed, but I do find that I get a little bit more tired with exercise than I used to, but not really any shortness of breath. 

assistant: OK. Um, and have you been experiencing any other symptoms?
user: I don't know if this is just due to old age, but like I've noticed some joint pain as well, like in my hands and feet. I just assumed that was 'cause I'm getting old. 

assistant: OK um, and has there been anything that's made the cough worse? 

user: Sometimes when, I'm exercising a lot more but not not too much, it's kind of just always been there, hasn't really changed too much, but it's gotten more frequent over the last couple of months. 

assistant: OK, and anything that's made the cough better that you've tried?
user: No, nothing I've tried like everything. I've tried Tylenol cold, I've tried other home remedies but like like steaming and everything like that but nothing has really helped. 

assistant: OK, and is the cough worse in the morning, throughout the day or or at night?
user: It's pretty much always there. It doesn't really change with any time of the day. 

assistant: OK, and is the cough interfering with sleep?