jshargo/medical-interview-conversations2 huggingface dataset:
user: The smell isn't totally gone I can still smell something if it smells really really bad and and then and then I can taste really, really salty foods, but I can taste normal things like I can't taste of banana. 

assistant: OK, is that been pretty consistent throughout the last couple of days or is it on and off? 

user: It's been pretty consistent, yeah. 

assistant: OK. And did this dry cough that start at the same time?
user: Yes. 

assistant: And when you say sorry, you said mild cough, and I my next question was do you feel like it's a dry cough or you producing any sputum? Any blood? Or is it to not, not bringing up anything? 

user: It's dry. 

assistant: OK, has that gotten worse over the last couple of days?
user: The dry cough? Um it's been pretty consistent as well. 

assistant: OK is there, have you done anything to try to make it better? Have you taken any over the counter medications or? 

user: No, I haven't tried anything. 

assistant: OK, OK. Have you had, in addition to these symptoms, have you had any fevers?
user: Fevers, no fevers. 

assistant: OK, any difficulty breathing?
user: Um no, no headaches. 

assistant: OK, any sore throat?
user: No. 

assistant: OK, any chills or night sweats? 

user: No. 

assistant: OK, any muscle ache or general weakness?
user: Uh no. 

assistant: OK, so generally it seems like you're pretty well other than this loss of taste slash smell and the dry cough that correct, 

user: Yes. 

assistant: OK and then recently have you been in contact with anyone that's been sick?
user: Um no not that I can remember or yeah, not that I can remember. 

assistant: OK, have you traveled anywhere? 

user: Um I went hiking with my partner two weeks ago. I guess there were some people who kind of brushed by us, but other than that I don't see where else I could have gotten this from. 

assistant: OK, was that hiking somewhere close by?
user: Yeah, it was like half an hour from where we are. 

assistant: OK. Are your immunizations up to date? 

user: Yes. 

assistant: OK, and can you think of any for this dry cough, just a circle back to that. Can you think of anything that triggers it? It's called the cold or being around certain things like cats or dogs or any other environmental things?
user: No. 

assistant: OK. Have you had any chest pain? Thats the other thing . I'm not sure if I asked you . 

user: No no chest pain. 

assistant: OK. And in terms of your general health, do you? Do you have any chronic conditions that you live with?
user: Um no no. 

assistant: Do you take any medications?
user: No. 

assistant: OK, have you ever had any surgery or been hospitalized for another reason?
user: Um no. 

assistant: Do you have any allergies?
user: No allergies. 

assistant: Do you have any family history of respiratory problems, cancers or heart problems?
user: No, nothing like that. 

assistant: OK. And just in terms of free lifestyle, so do you live with family?
user: Um no. 

assistant: OK, do you read along with a partner or roommate? 

user: I live with my parents and my younger sibling. 

assistant: OK. And is that in town here?
user: Yes, yeah. 

assistant: OK. And in general, do you eat a healthy diet? Do you exercise?
user: Yeah, I think so. 

assistant: Do you smoke?
user: Uh no. 

assistant: OK, do you drink alcohol?
user: Uh I I have drank alcohol before but not not regularly. 

assistant: OK um. And I do use marijuana? 

user: Um I have taken edibles before but also not very regularly. 

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

assistant: OK, and are you currently in high school? 

user: Uh yes, I am in my last year of high school. 

assistant: OK, and how is that going?
user: Pretty good, yeah, we're doing things online now. 

assistant: So you haven't really been out of the house?
user: No. 

assistant: OK. OK. Uhm I think that's all my questions for now. Uh I definitely like to get you a covid test just because your symptoms are consistent with some common covid symptoms. So basically that means that we would do a swab. It might not come back for a day or two. You definitely have to self isolate between now and when you get the results back, potentially even if it's negative, longer, if you're still having symptoms. 

user: Yeah. 

assistant: Otherwise, there probably. There might be a couple other tests we want to do. We might have more questions when we come back, we'll go over this with the doctor that I'm working with today, but just wanted to give you a heads up of what to expect next. Did you have anything else you wanted to tell me that I didn't ask you about or any questions?
user: No, uh thank you so much. 

assistant: OK, well thanks for coming in today. Will definitely get you taken care of shortly. 

user: Thank you. 

assistant: K thanks.
user: I I've had this cough that's been ongoing and and getting worse, and and now I've been having this like sharp pain in my in my chest. 

assistant: OK, and when did the cough first start?
user: So yeah, like the cough started, uh, started maybe a couple of weeks ago. 

assistant: A couple weeks ago, OK, and has it gotten worse since then, or has it stayed about the same? 

user: Uh it, it got worse initially, but it's been about the, uh, well, actually yeah, it's been getting worse 'cause now I've I've started to notice blood in the sputum that wasn't there at first. 

assistant: OK, and when did you first notice that?
user: So I, I first saw some blood, uhm, two days ago. It was a really small amount so I didn't worry too much, but I I brought up blood yesterday and again this morning. It's been just about enough to cover a tissue, so it's not a lot of blood each time, but it's pretty red. 

assistant: OK, and before that were you getting any production throughout your coughs for the last few weeks, like were you producing any sputum? 

user: Uh, no. 

assistant: No, OK. Can you just describe your cough currently? Is it more of a wet cough or dry cough?
user: Uh it, yeah, it's it's dry mostly with the exception of bringing up some of the blood. 

assistant: And is the blood just in like sputum that you're bringing up? Or are you coughing up blood into the tissue, for example?
user: Blood is, I'm coughing that up into the tissue. 

assistant: OK, and do you remember 2 weeks ago prior to that, were there any factors that might have caused this, like for example, did you travel anywhere or see or was in contact with anyone that was sick? 

user: No I haven't uh, traveled anywhere. I have been doing volunteering and and things at the homeless shelter here in in town. It's been really cold out. 

assistant: OK, uh, and how long have you been volunteering there?
user: Uh, I started this winter, so the last three, three or four months. 

assistant: OK, and were you in contact with anyone there that was sick or was having similar symptoms at all?
user: There are certainly some people around that that had some that would have a cough, or were not feeling very well but, uh, and sometimes I would see people who would even have a hospital gown on, that that that uh came from the hospital. So yeah, there were definitely some people who weren't feeling well. 

assistant: OK, and do you know if anyone at the homeless shelter or anywhere else around your surrounding has had tuberculosis?
user: No, not that I'm aware of. I haven't heard of that. 

assistant: OK, are you having any other symptoms at all besides the the coughing and the blood, like coughing up blood as well? 

user: Yeah, I've been uh, starting to get like this sharp chest pain as well. I kind of feel it on the left sides and in center I guess kinda more so. 

assistant: OK and your chest pain, when did that start?
user: So, uh, this started, yeah, 'bout a few days ago as well. It's been within the last week. 

assistant: OK, and uh, would you describe it as, so you said it's kind of a sharp pain, does it move around anywhere?
user: No, the pain I feel it about in the same spot each time. 

assistant: OK, and are you feeling the pain when you're coughing or is it when you're exerting yourself, like when do you feel the pain, and how long does it last?
user: I, yeah, I will feel it when I cough. I also feel it uh, if I'm maybe moving around as well. Like changing positions or things like that. It hurts for a few minutes and then it it will kind of settle down. If if I'm, if I stay stationary and sort of lean forward a little bit it will it will start to feel better. 

assistant: Sort of feels better? OK, and besides, besides like leaning forward, has anything helped reduce that pain at all?
user: Yeah, well if I lie flat, uhm it, it's uh, or sorry. No actually, the pain gets worse if I I lie flat or if I'm if I'm taking a deep breath in. But really, the only thing that helps the pain is if I try to lean forward when I'm sitting down. 

assistant: OK, I see, and do you have any pain when breathing in or out? 

user: I do, yeah it it gets worse if I if I'm taking a deep breath in, and even more so after I after I cough, if I'm trying to catch my breath, I'll feel it then too. 

assistant: OK, and uhm, other than these symptoms, do you have any kind of shortness of breath? Do you have any dizziness or increased sweating, any of those symptoms?
user: I have been sweating at night, but, uh, yeah that's it. 

assistant: And how about any fevers or chills? 

user: I I have felt a bit hot. That's more so yeah, maybe when I've been having night sweats, but I feel OK now. 

assistant: OK, and when you say night sweats, are your sheets and blankets like soaked your pillows?
user: Yeah, there there have been a few few nights for sure, but it doesn't happen every night. But over these last several months, it's been weird, I've woken up soaked. 

assistant: OK, uh, do you have any other symptoms like a headache or nausea, vomiting? 

user: No. 

assistant: Have you measured a temperature at all?
user: Uhm no I haven't. 

assistant: OK, we can do that today. Do you have any other symptoms like feeling like pounding your chest, racing heart, anything like that?
user: No, nothing like that. 

assistant: Have you noticed any swelling in your extremities, like your legs and hands? 

user: No. 

assistant: OK, and do you have any issues with your bowel movements? Any Constipation or diarrhea?
user: No. 

assistant: Any urinary issues? 

user: No. 

assistant: OK, any issues with your sleep and appetite?
user: Uh, no. Sleep's been OK, and I've been eating well, but I have uhm, lost some weight and and I've been more fatigued over the last couple months. 

assistant: OK. Before the two weeks or a couple of weeks that you had this, were you sick at all recently? Like with a cold or any flu like symptoms?
user: No, I I uh, I guess I've been fatigued over the last couple of months, but I haven't had any flu like symptoms. 

assistant: OK, and do you have any exposure to dust, fumes, animals anywhere in your surrounding?
user: I do have uh, two cats at home, but I've had them for seven years now and I've been tested for allergies and and I'm clear there. 

assistant: OK? Do you live with anyone right now? 

user: Yeah, I live with my husband and we have three daughters as well. 

assistant: OK, and are any of them sick at all or have any similar symptoms.
user: Yeah, my my husband's had a cough uh, as well, he hasn't brought up any blood or anything though. But my my daughters have felt OK. 

assistant: OK, and do you have any past medical diagnosis like high blood pressure, diabetes, asthma, anything like that?
user: Yeah I do have uh, type 2 diabetes, as well as high blood pressure. I've been diagnosed with depression before as well. I do take a few medications for diabetes and blood pressure. I'm not on insulin though. 

assistant: OK, and do you know what medications you take?
user: I think an ACE inhibitor and, and I think Ramipril and uh, metformin. 

assistant: OK, and do you take anything for depression? 

user: I used to take a a citalopram, but I stopped and and things have been been stable. 

assistant: That's good. Any hospitalizations or surgeries in the past?
user: I had two C sections for my second daughter and and 3rd. 

assistant: OK, any complications at all with those C sections? 

user: No, everything was was good. 

assistant: OK, any other surgeries or hospitalizations?
user: No. 

assistant: OK, do you have any family history of any lung conditions, heart conditions, any cancers? 

user: My dad had a stroke when he was in his late 60s, but that's the only thing I can think of. 

assistant: OK, and I know you said you volunteer at the homeless shelter, but do you do anything else for work at all?
user: Yeah, I've been doing some administrative work from from home because of covid, so with the extra time I've been trying to to do some extra volunteering. 

assistant: That's really good. And so besides, so you live with your husband and three kids, does anyone in smoke in the house or do you smoke at all? 

user: No, I don't. No one smokes in the house. 

assistant: OK, does, uh, do you take any recreational drugs like marijuana?
user: No. 

assistant: And how about alcohol? 

user: Sometimes I'll have some like red wine with dinner, but that's only on like Christmas or an occasion. 

assistant: OK. Yeah, alright so uh other than that, sorry, I think I might have forgotten to ask you a couple questions. So no fainting spells, no shortness of breath, nothing like that?
user: No, I haven't had anything like that, just a stern cough. 

assistant: OK, and no chest pain on exertion? 

user: No, it's the chest pain, well, I guess if I'm like moving around a lot, but it's not, it doesn't come on uh, like because of like physical activity. I just feel it like anytime I'm, like when I'm breathing in or even just moving my body around in the chair. 

assistant: And any like fatigue or increased tiredness.
user: Yeah, I've had some fatigue for sure. 

assistant: OK, and have you lost any weight recently?
user: Yeah, I I have actually. I'm I'm down 20 pounds. I thought that was great. I I was 200 pounds just two months ago. 

assistant: And have you been trying to lose weight or that 20 pounds just went away spontaneously? 

user: Uh, I mean I I guess I've tried to make changes to my diet here and there because of the diabetes, but I don't really think that it would be enough to lose 20 pounds. 

assistant: OK, I see. Yeah so, do you have any questions? Those are all the questions I have. Do you have any questions or concerns?
user: No, I was just, I guess just concerned about the the blood in the, in the cough. 

assistant: Yeah, so definitely that's something concerning. We want to make sure there was no, so you work at a homeless shelter, where there may be a tuberculosis case, and your symptoms of coughing up blood as well as losing a significant weight recently, and some of the other symptoms that you described as well, point towards uh TB as one of the causes. No lung cancer history right, in your family? 

user: No. 

assistant: OK, uhm so we definitely want to do testing for TB. Will do us a smear today of your sputum and we will, since you have been in contact with your family, we will have to contact a public health if the tests come back positive, and it seems that, we'll also do some other testing. Sometimes with tuberculosis you can get something called pericarditis, and some of the symptoms you are having may point to pericarditis as well, so we might have to do an EKG. We might have to further do an ultrasound, an x-ray, for example. So first we'll just get the TB test done and then if it comes back positive, you will need to isolate, be admitted to the hospital as well, and be on a course of antibiotics. So I know this is a lot to take in. Do you have any questions or concerns at all?
user: Not right now. Guess will wait until some of the results come back and yeah, get started. 

assistant: Yeah, so we'll just do the TB test first, alright? 

user: Alright, thank you. 

assistant: Welcome, take care.
user: I've just had this cough that it that has gotten a lot worse and really short of breath. 

assistant: Uhm, can you tell me more about your shortness of breath?
user: Yeah, just over the past, like 12 hours or so, I've just been finding it more and more difficult to to breathe. 

assistant: OK. What are you able, I guess when do you feel short of breath? 

user: Yeah, it's just like right now at rest I can like I'm OK, but it still is feeling increasingly difficult. So like throughout the day, it's just been getting getting worse and the cough has been getting worse also. 

assistant: And before these 12 hours where, did you have any difficulties with breathing?
user: Uh no, I I I had a cough but not, not really any shortness of breath. 

assistant: And can you tell me about your cough? Is it a dry cough or wet cough?
user: I've been bringing up some some sputum. 

assistant: OK, what does it look like?
user: It's like greenish and yellow. 

assistant: Mhmm, OK. And you said that you had a cough prior to the past 12 hours. And that your cough is now worse. How is it worse? 

user: Ah, it's been just happening more often and like just like throughout the day usually, my cough is only in the morning. I'll bring up some some sputum in it and I'm ok, but it's carried on throughout the day. 

assistant: OK, uhm, and, was your sputum and greenish yellow before as well? Or was it just starting yesterday or, or couple days ago?
user: Yeah, that's new. That's just starting new. It was more like, I don't know, whitish? Or yeah, white I guess, before? 

assistant: OK, alright and I guess has this ever happened to you before? 

user: Uh, no, this is the first time that that this has happened before. 

assistant: OK, and you have any other, I guess symptoms are until I ask you about a couple. Do you have any, do you feel confused or fuzzy?
user: No, that that feels OK. 

assistant: Any headaches?
user: No. 

assistant: Any stuffy, stuffy nose or runny nose?
user: No. 

assistant: Sore throat? 

user: No. 

assistant: Any chest pain?
user: Ah, yeah I did. I do have a, uh, uh some, well, I guess I guess it's not really pain, it's more like like just chest tightness. I'm really having a hard time with that, with breathing. 

assistant: Uhm, I see, OK. Do you feel like your heart's beating very fast?
user: No. 

assistant: OK. Do you have any belly pain or any nausea or vomiting?
user: No. 

assistant: Any changes in your bowel movements or any urinary symptoms? 

user: No. 

assistant: Any muscle aches?
user: No. 

assistant: OK, uhm, alright. And uh, in terms of your past medical history, any medical problems that you've been diagnosed with? 

user: Yeah, I was diagnosed with COPD uh, two years ago. Umm yeah, this is at I went to my family doctor for this and I had some testing done when I was diagnosed at that time. 

assistant: OK. Any other diagnosis?
user: Yeah, I have high blood pressure. Aortic stenosis, uh, and uh, and high cholesterol. 

assistant: Are you taking any medications? 

user: Yeah, I I take a uh, a statin medication. I think some type of blood thinner, as well as something for the blood pressure as well, I can't remember the the names of them. 

assistant: Why were you on a blood thinner?
user: Oh I, I heard that it was, it was umm, oh good for me for a friend since I've I've had uh aortic stenosis. 

assistant: OK, sure. All right and have you had any surgeries? 

user: Uh, no I haven't. 

assistant: OK, and any hospitalizations?
user: No, I haven't. 

assistant: OK. Uhm, do you have any allergies to food, environmental allergies, or any allergies to medications? 

user: No. 

assistant: OK. Do you have a or what's your current living situation? Are you living in an apartment or house? Do you live alone? Do you live with other people?
user: Yeah, I live alone in a in house, here in town. 

assistant: OK. And are you currently working, are you retired? 

user: Yeah, I I do, I currently, well, I just do some volunteering at the golf course in the summer, but otherwise, retired. 

assistant: What did you do for work?
user: Uh, so before, I worked at the Beer Factory in in town, Labatt. 

assistant: OK, and have you ever had any exposures to any chemicals or any anything that you, any irritants that you think any smoke that might affect your lungs? Or your, yeah.
user: Uhm, no, I don't think so. I mean, working in the factory environment, I, I'm sure things years ago weren't as clean as they are now, but yeah, I'm not sure. 

assistant: OK, alright. And are you, you said you live alone, are you able to take your things like getting groceries or cooking or cleaning the house or do you need help with that? 

user: I I do uh, get some help from my son who lives, who lives nearby, and umm, I able to to get them to to help make some meals and and bring some food over and then I'll go visit them as well. You can take care of the house so and all that not OK on my own, but it certainly gets gets lonely there. 

assistant: I'm sure. What about what about things like walking? Do you use a cane or a walker?
user: Uhm, no, I don't. 

assistant: OK and do you are able to bathe on your own, dress on your own? Do you need help? 

user: Oh yeah, those things are OK. 

assistant: OK, have you ever have you been on oxygen at all?
user: No, I haven't, but I feel like I could be right now. It's like, really, I'm short of breath. 

assistant: Yeah, yeah, we can definitely do that here. Uhm, alright. So, given your symptoms, it sounds like maybe you're having a COPD exacerbation, potentially. Do you feel like you might have had contact with anyone who was sick?
user: Not that I can think of. 

assistant: OK, have you traveled at all, outside the country or outside the province?
user: No, I I've just been helping out at the golf course, but that's all. Kind of outside. 

assistant: Are you wearing a mask and maintaining social distancing?
user: Yeah, we are like, I'm like helping out with cleaning the carts and kind of helping out with the grounds. 

assistant: Mhmm, OK, alright. So we'll do a Covid swab here just in case. And seeing that you're not feeling very well, you might require oxygen, we're going to keep you here in the ER, and we might have to, you might have to be hospitalized. We'll measure your vitals, do a physical exam, do a chest x-ray and you might be having, as I mentioned earlier, in exacerbation, upper COPD or a worsening of your COPD, potentially because you might have an infection, either a viral infection or bacterial infection that can sometimes worsen your COPD symptoms. You might be started on an antibiotic we'll be putting you in oxygen and giving you some steroid some, are you actually about that, are you, are you using any puffers at home?
user: Ah, yeah, so yeah I have been using uh, sorry I I have been using ventolin and there was a daily inhaler, Spiriva, I believe. I've been using that each day. 

assistant: OK great great yeah so we'll be, we'll be giving you some puffers here as well, and yeah, we'll see how things go. Do you have any questions?
user: Uh, no, that that sounds good. Thank you. 

assistant: OK, alright.
user: I've been feeling really, just, bad these last couple of days. I've had these, uh, muscle aches and headache and cough that have been really bothering me. 

assistant: When did all this start? 

user: So yeah, about 3 days ago I woke up in the morning with, uh, and yeah, I started having these, like muscle aches and a cough started kind of that day. 

assistant: OK, can you tell me a little bit more about the cough? Is it a dry cough or wet cough?
user: It's a dry cough, I haven't brought up any any sputum and no blood. 

assistant: And the muscle aches, is it all over? is it specific part of your body?
user: Yeah, It's just kinda all over, just feels kind of icky. 

assistant: OK, and has the cough gotten better or worse over the past three days?
user: It's got a little worse. I think I would say it's a bit more frequent. But the cough isn't that bad, but it's gotten worse. 

assistant: OK, and you mentioned headaches. When did those start? 

user: So within the last couple of days, yeah, I've had a headache, want to say, most of the time. And I've been using Tylenol or Acetaminophen to help with those. Its taken the edge off of the headaches, for sure. 

assistant: Do you usually get headaches?
user: Every once in a while, maybe once or twice a month, maybe even less than that. 

assistant: Is your current headache similar to the headaches that you usually get? 

user: It is, yeah, it's yeah, It feels like my head is being squeezed and I kind of have a pressure, where yeah, that kind of squeezing sensation on my forehead. 

assistant: That front part, both sides, left and right?
user: Yeah, kind of both sides. 

assistant: Is it accompanied with, uh, so is the headache worse when you're in bright light? 

user: No. 

assistant: No, OK, is it worse when, are you trying to stay in a dark room with no sound? Is it worse when you're, when people are talking or there's loud noises around you?
user: No. 

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

assistant: Any stiffness in your neck? Any difficulties moving your neck?
user: No, that's OK, I mean a bit, like I don't know, like, kind of achy I guess with my upper back and shoulders feel a bit sore but, yeah I can move my head around ok. 

assistant: Alright, OK and, uhm, let's see. So have you had any fevers or chills?
user: I don't think so. 

assistant: OK, and any sore throat?
user: No. 

assistant: Runny nose, congestion? 

user: No. 

assistant: OK, uhm, any other, I guess, any difficulties breathing?
user: No, no, 

assistant: Any chest pain? 

user: No. 

assistant: Any palpitations? Do you feel like your heart's racing?
user: No. 

assistant: Any pain your belly?
user: No. 

assistant: Changes in your bowel movements or your urinary function? 

user: No, I haven't had any diarrhea, things have been normal. 

assistant: OK, good. OK, I suppose, OK, so you've had this cough and you've had muscle aches and this headache, how has, uh, so you've tried Tylenol, have you tried anything else?
user: No, I just use the Tylenol, and I took a Tylenol cold and sinus at night, which helped with the sleeping. 

assistant: OK, can you tell me if you have any medical problems, any medical conditions?
user: Yeah I have, uh, high cholesterol and yeah, I just have high cholesterol. 

assistant: Any medications that you're on? 

user: Yeah, I take a statin. 

assistant: And any allergies?
user: Uh, maybe penicillin, I think I got hives when I was a kid or some sort of rash. 

assistant: I see, OK, and any medical conditions that run in your family? 

user: I know my dad had a stroke when he was in his late 70s and my mom had high cholesterol as well. 

assistant: OK, OK, and do you currently smoke? Or have you ever smoked?
user: No, I quit smoking when I had my first kid, so that was about, yeah, that was 17 years ago. 

assistant: OK, and how much did you smoke before that?
user: I smoked about a half a pack per day. 

assistant: For how many years? 

user: For about 12 years I guess 

assistant: OK, and do you consume alcohol?
user: Yeah, I'll have three or four glasses of wine over the weekend. 

assistant: Alright, and what about any marijuana? 

user: Uh, no. 

assistant: Any recreational drugs?
user: No. 

assistant: OK, do you take any herbal medications or any vitamins or anything else over the counter?
user: Yeah, I do take magnesium and, like, vitamin D and, uh, a multi vitamin. 

assistant: And, do you, have you had any contact with anyone who is sick or you think might be sick? 

user: I don't think so, um, everybody in my family has been been OK. 

assistant: Have you had exposure to anyone or met anyone who you think might have had covid?
user: Uh well, I did go to a family party, just last weekend. It was outside and we were maintaining distancing, but, yeah. 

assistant: Are you vaccinated? 

user: No, not yet. 

assistant: No, OK, alright, OK, so you've had this dry cough and muscle aches and headache for the past three days or so and your symptoms are getting a little bit worse or your cough's getting worse for the past three days. We're gonna, it could be that you have some sort of a viral infection like an upper respiratory infection but you might also or you could possibly have covid, so we'll do a covid test, and I just recommend that you stay hydrated and continue to eat and drink well and and monitor your symptoms. Take Tylenol, it sounds like Tylenol has been helping a little bit, continue to take Tylenol, get lots of rest and if you have any shortness of breath, or if you feel like your symptoms are getting worse call 911 for help if your concerned about your health at all. And we'll get a covid test set up for you.
user: Hi I am having difficulties breathing and I've just had this cough and it's, It's been two months now. 

assistant: Two months, so did the two months of the difficulty breathing or the cough? 

user: Two months of difficulty breathing and the cough is gotten worse. I've had a cough for a couple years now. I'm a smoker. 

assistant: OK and is is this cough different at all?
user: It's just, it just doesn't go away. 

assistant: OK, and when did the shortness of breath start?
user: About two months ago. 

assistant: OK, and is it getting worse?
user: oh yeah 

assistant: OK. Are you bringing up any sputum at all with your cough?
user: Uhm? I sometimes uhm, yeah I do. 

assistant: OK and is is there any color to it or is it clear?
user: it's pink in color 

assistant: It's pink in color?
user: Hmm 

assistant: Ok. Have you coughed up any blood at all?
user: Sometimes 

assistant: sometimes?
user: Streaks of blood here and there. 

assistant: Little streaks of blood? OK, and have you ever coughed up any just without without it being in the sputum, just onto a tissue or anything like that? Just coughing up any blood? 

user: No. 

assistant: OK. So an are your symptoms just constant over the last two months or do they come and go?
user: Shortness of breath just kind of stays. 

assistant: OK, and is there anything that helps with your shortness of breath, like taking a rest or any positions in particular?
user: Yeah, sometimes resting does help. I find that it's worse when I'm moving around, I'm huffing and puffing more. 

assistant: OK, and is it worse at all when you lay down?
user: No. 

assistant: No? And do you find yourself ever having to wake up at night and gasp gasping for air?
user: No, it hasn't gotten that far but seeing how bad it's been over the past two months and how fast is progressing, I won't be surprised if I can't even sleep. It's been quite difficult I I don't even know why I waited so long. I should have come in earlier. 

assistant: Well, I'm glad you came in today. We can definitely try and help you with what's going on. Do you at all use any kind of medications to help you with your symptoms?
user: I've just been using my inhalers a bit more but they don't always help. 

assistant: OK, and what are you using the inhalers for?
user: Oh, I have COPD. 

assistant: COPD? OK, and when were you diagnosed?
user: It's been 15 years now. 

assistant: 15 years and do you know the how many puffers are you taking?
user: Uhm, I'm taking uhm, I'm taking two puffers. 

assistant: OK, and do you have one that that you take when you when you absolutely need it? 

user: Yeah, yeah I do. That's the one that I've been trying to use but 

assistant: Has it been less effective at all recently?
user: Yeah, it hasn't been helping. The blue one I tried to keep taking the blue one and it's just, you know it's not helping. 

assistant: Have you been sick at all recently with fever? Chills, like runny nose? Any cold like symptoms?
user: No. 

assistant: No, nothing like that? Have you been in contact with anyone that's been sick?
user: Oh no. I've been staying at home. I've been very careful these days. 

assistant: Yeah for sure. Any so this started two months ago? Are you having, so you have not traveled then I'm assuming? 

user: No. 

assistant: OK, are you having any kind of dizziness or fainting spells?
user: Oh no, no no. 

assistant: No? OK, any kind of swelling in your legs or hands that you've notice?
user: No 

assistant: OK. Any headaches at all? 

user: No. Well, sometimes I do. But it's not been severe. It's been there for the past uhm always when I'm stressed out I get these headaches. It's nothing new. 

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

assistant: No? Any diarrhea or Constipation? 

user: No. 

assistant: No OK, any fevers or chills recently?
user: I have a mild fever. It just, it's been there. 

assistant: When did you notice?
user: Uhm I was just checking my temperature about a month ago and noticed that I had a fever. 

assistant: OK. This was a month ago?
user: Yeah. 

assistant: Have you had it recently at all?
user: I haven't checked it recently, but I do feel a little hot. 

assistant: OK, are you getting night sweats at all?
user: Sometimes. 

assistant: Sometimes, OK. And are you getting any kind of significant weight loss? 

user: No. 

assistant: No, then your weight's been fine?
user: It's been the same. Although I have been eating quite a lot more now with the pandemic and being home, you know that might be still in the same. 

assistant: And so are you having, do you feel like tired throughout the day or increased fatigue?
user: Oh my God. So tired I can, you know, with the difficulty breathing I feel like all my energy spent just trying to, trying to get to the bathroom. 

assistant: OK, and how? Is there like? How much do you walk or move around that you get short of breath? Or are you short of breath at rest as well? 

user: Uhm? I'm short of breath all the time. Yeah, it's just, It's it's worse when I am moving. 

assistant: And so you've been diagnosed with COPD. Have you had to use oxygen at home at all?
user: No. 

assistant: No OK, how about have you had any hospitalizations in the past for your COPD? 

user: Yeah, I had a had a couple last year. 

assistant: A couple of hospitalizations?
user: Yeah, yeah. About four hospitalizations last year. 

assistant: Oh, I see. And and did you have to use any oxygen in the hospital? 

user: Yeah yeah I did. I did. 

assistant: They never sent you home with any like oxygen tank or anything like that? OK.
user: Although they told me my COPD was pretty bad. That I might need to get oxygen at some point. 

assistant: I see. And have you, when you in hospital, did they give you antibiotics or when you went home? 

user: Yeah. Yeah they did. they did. 

assistant: Did they tell you you had pneumonia at all at any point?
user: I don't think so. 

assistant: No. OK, OK any any changes or do you get any chest pain at all?
user: Uhm, sometimes when I breathe in very deep. 

assistant: I see. Any any kind of sensation that your heart is racing?
user: No. 

assistant: No. OK Any kind of issues with your sleep or appetite? 

user: Umm. Well, no, not really. It's just the difficulty breathing sometimes it's been hard to sleep. 

assistant: OK, any any exposure to any fumes or allergens in your household, any animals, pets?
user: No. 

assistant: OK. And other than COPD, have you been diagnosed with any medical conditions in the past?
user: No, I'm pretty healthy otherwise. 

assistant: OK, do you have any allergies at all to medications or environmental allergies? 

user: I'm allergic to cats. 

assistant: To cats, OK, do you have a cat?
user: No. 

assistant: No OK. Have you been around any cats recently?
user: Nope 

assistant: No OK, are you on any medications besides the puffers?
user: Nope 

assistant: OK, and so you use the ventolin and then what's the other puffer that you use? 

user: Uhm I don't remember the name. 

assistant: Do you know the color at all?
user: It's orange 

assistant: orange OK. So you've had four hospitalizations in the past year. Any surgeries in the past? 

user: I had a knee replacement on my right side. 

assistant: OK, and when was that?
user: 10 years ago 

assistant: OK. Do you have any family history of any lung conditions, heart conditions, any cancers? 

user: My dad had COPD as well. 

assistant: OK. And any lung cancers in the family?
user: no. 

assistant: No, so currently do you work at all? 

user: I'm retired. 

assistant: OK, and what did you do before you retired?
user: I was I was a mechanic at Chrysler's. 

assistant: OK, and during your work, were you ever exposed to any chemicals or any kind of in your workplace or home exposed to any asbestos or anything like that? 

user: Not that I'm aware of. 

assistant: OK. And how long have you been smoking for?
user: Oh yeah, I was a teenager when I started. 

assistant: OK, and how much do you smoke on a on a daily basis? 

user: I smoke, I smoke a pack a day 

assistant: OK. Have you at all tried to quit before?
user: I can't quit. It's not gonna happen. A lot of people have told me try to quit but I I just can't live without it and I'm 75 now, you know. Like I'm not gonna live a lot longer anyway. 

assistant: Yeah yeah but also even if you try to cut down some of your symptoms might get better. Like even though you're 75, you can definitely have improvement in some of your symptoms that you're having, like the shortness of breath and coughing. So if at all that you you want to consider cutting down and gradually. we can talk about that more as well. 

user: Sure 

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

assistant: Do you drink?
user: No 

assistant: No, OK, so yeah, those are all the questions I have for you. Do you have any questions for me?
user: No, I just I guess I need to be admitted right? Just like those other COPD exacerbations? I'm thinking this is exactly that and I'll have to stay in the hospital, right? for a couple of days 

assistant: Yeah, so we definitely before deciding on whether or not you should be admitted, since you said the Ventolin is not working for you, we will definitely give you some some ventilation and perhaps steroid for just to get rid of some of your symptoms right now, and we want to also make sure since you're having like cough as well as shortness of breath to do a covid swab on you, just in case. I know you've been like isolating and everything, but just in case I will do that and we'll get like a chest x ray on you as well, just to see if there's any kind of pneumonia going on. And then from there we'll also get your blood work, and then from there we'll see whether or not you will require another admission. 

user: Sure. 

assistant: OK, and there you might, I'm not 100% sure, but you might require home oxygen if like we take your vitals and everything and your oxygenation is very low. Have you have you been talked about that at all in the past?
user: Yeah, they talked about it last time I've been trying to avoid it, but if it has to happen, it has to happen. 

assistant: Hmm yeah, and it might just sometimes just, you know you've had four admissions in the past and it might actually just help you stay at home if you are on oxygen. Anyways, yeah we can talk about that. We'll do like a full physical examination everything and go from there. 

user: Sure. 

assistant: Great, I'll be with you shortly.
user: Hey, I just, um, I just kind of came in to talk about my stuffy nose. It's yeah, it's been a problem for, I don't even know how many years it's always been there. And now that school is a little less busy and things are virtual and have more time, I decided I'll get something done, um, to get it fixed. 

assistant: OK, and how long has this been going on for?
user: Since I was young, um like maybe years, couple years. 

assistant: OK, and then do you like how often are you getting the stuffiness? Is it like every day? Is it during the day at night? When do you usually get it? 

user: It's kind of uhm, it's kind of all the time, to the point that I've somewhat gotten used to it. And it's just my, it's only on the left side and it's just always kind of stuffy. Initially I would have trouble falling asleep 'cause it would, I would just find it a little bit bothersome, but now I'm kind of just used to it. 

assistant: OK, and so it's just on the left side. It never moves to the right side.
user: Well, like sometimes when I get ill its on both sides, but usually it's on the left side. 

assistant: OK, and so you have stuffiness. But do you ever get any kind of discharge or drainage from your nose? 

user: Sometimes I get a little bit bleeding. 

assistant: Are you, OK. Um, bleeding? Is it blood mixed into the discharge or drainage? Or is it like you get nosebleeds?
user: I get nosebleeds like maybe yeah. Like maybe when I'm exercising or something I'm like at the gym. Uhm, fom doing the gym class. Yeah, yeah when playing with my friends. 

assistant: OK, and how often do you get these nose bleeds?
user: Uhm? Maybe once a month or once in two months. 

assistant: OK. And umm, and is there any, do you have any other symptoms? So like, do you have any pressure, sensation in your face around your jaw, cheeks, forehead?
user: No. 

assistant: No, so OK. And do you find yourself having more congestion when you wake up? 

user: Uhm? Not really, maybe a little bit. 

assistant: OK, so it's not worse when you're lying flat or anything like that?
user: No. 

assistant: OK, um, and do you find that you have to constantly clear your throat at all throughout the day?
user: Uhm, no. 

assistant: OK, and do you at all feel that some stuffiness drains back into your throat at all anytime during the day?
user: I don't think so, no. 

assistant: So it's just the congestion that's been going on for quite some time and does it change with the seasons at all?
user: No, it's just there all the time. Like I can't even tell. This is like my normal now, but my mom said I should get it checked out. 

assistant: OK, uhm. Have you tried anything for it like either medications or the neti pot or steaming and has anything helped you at all?
user: I tried steaming but it didn't do much. It kind of got better. Maybe for an hour maybe, but then yeah, it didn't do much. 

assistant: OK, and otherwise, are you having any other symptoms like fever, chills, cough, sore throat, anything like that?
user: No. 

assistant: Are you having any loss of sense of taste or smell?
user: Uhm, no. 

assistant: Any shortness of breath at all?
user: No. 

assistant: OK, uh. And otherwise, any recent travel or in contact with anyone who's been sick?
user: Uhm, no. 

assistant: Have you previously been diagnosed with any medical conditions?
user: No, I'm pretty healthy. 

assistant: And do you know if you have any allergies to any medication? 

user: Uhm, no, no allergies to medications. 

assistant: OK, and any allergies to any environmental issues like factors that cause more stuffiness, sneezing, itching, red eyes, runny nose anything like.
user: I'm allergic to cats. 

assistant: Cats? OK.
user: But I haven't been around one for awhile. 

assistant: OK, uh, anything else like in your house or environment like carpets, dust, like anything that might irritate, give me more irritation?
user: No, not really. 

assistant: OK. So it's just a cat that you know, but you haven't been around. Do you have any other animals at home?
user: Uh no, I don't. 

assistant: No OK. Do you have any headaches at all?
user: No. 

assistant: Any changes in your bowel movements? 

user: No. 

assistant: Any urinary problems?
user: Nope. 

assistant: Has this affected your sleep or appetite? 

user: I snore at night sometimes, but that's, that's about it. 

assistant: OK, and do you snore, would you say most nights or is that something like has someone told you that?
user: My mom told me and sometimes I, I sleep with my mouth open. 

assistant: I see, OK. And do you know how long you've been doing this for?
user: Uhm, again, it's been like months or years. 

assistant: OK. And do you ever get, do you ever wake up at night trying to take a breath like just gasping for air?
user: No. 

assistant: OK. Have you ever had any surgeries or hospitalizations before?
user: No. 

assistant: Yeah, OK. On any family history of any heart or lung conditions.
user: Uhm, just heart disease. 

assistant: OK, then who has it? Or who had it? 

user: My my dad. My dad has, had a heart attack and my mom has high blood pressure. 

assistant: OK. And how old was your dad when he had a heart attack?
user: He was 50 years old. 

assistant: 50 years old? Ok.  And I'm currently right now, uh, are you a student? Do you work? 

user: I'm a student. 

assistant: And what's your living situation like?
user: I live with my parents. 

assistant: Ok. And do you smoke at all?
user: No. 

assistant: OK, have you ever smoked? 

user: No no no. 

assistant: Uh, any, any recreational drugs like marijuana?
user: Oh God no, never. 

assistant: No? Ok. And do you drink alcohol?
user: No. 

assistant: OK, and how, how's your home environment? Do you generally feel safe in your home environment as well as outside of your home? 

user: Oh yeah, it's great. 

assistant: Ok. So yeah, so mainly yeah. So there's all the questions I had for you. Do you have any questions or concern?
user: Nope. 

assistant: Ok so there can be many different reasons for this chronic congestion and we'll do a full physical examination for you today. Uh and some of the possible things that can be happening is you might be having a sinus issue like a chronic sinusitis. You can be having an allergic rhinitis or with the snoring and just the chronic congestion. You may be also having something called obstruct, obstructive sleep apnea. And there can be structures in your mouth, throats that can cause you to kind of obstruct and snore at night as well, and that even the congestion might cause that as well. So yeah, we'll do a couple test first and then if required, we might need to do some imaging and even perhaps send you to an EMT specialist if we think it's obstructive sleep apnea there. For now, we'll just do the physical examination to go from there.
user: Great, thank you. 

assistant: Welcome, take care.
user: Yeah, I have this pain in my chest. 

assistant: OK, and where is the pain exactly?
user: It's just right  over on the on the left side. 

assistant: OK, and when did this pain start?
user: It started just 30 minutes ago. 

assistant: OK, and did it just come on randomly or were you doing something strenuous?
user: I was just shovelling the driveway and it came on. 

assistant: OK, and has that pain been getting worse at all over the last half an hour?
user: No, it just came on suddenly and it's uh, uh, I'm sorry. Yeah the pain has been there this whole time and it's gotten worse ever since it started. 

assistant: OK, and how would you describe the pain? Is it kind of like an aching pain or is it a sharp or tight tightness kind of pain? How would you describe it?
user: It feels dull. I feel like there's a lot of pressure on my chest. 

assistant: And how do you rate the pain right now on a scale of zero to 10, zero being the least amount of pain you felt in your life, 10 being the worst?
user: Uh, seven. 

assistant: Seven, OK. Have you had ny similar episodes before?
user: No, I've never had any chest pain before. 

assistant: OK, and is the pain just staying in the region of the left chest area that you mentioned or is it traveling to any other part of your body?
user: No, I'm kind of just feeling it right here. On the left side. 

assistant: OK, uh, is there anything that you do that makes the pain either get worse or go away or like get better? 

user: Uh. I think it's a bit bit worse if I'm moving around or when I was walking in here. I think it it made it a bit worse, but nothing has seemed to make it any better since it starting. 

assistant: OK, and does it change at all from you changing positions like if you're standing up versus sitting down or laying down?
user: I think it's a little bit worse when I when I'm laying down. 

assistant: OK, and other than the pain that you've been having, have you been having any other symptoms like a cough or difficulty breathing or any pain when you're breathing in or out?
user: Uh, I've felt a little bit uh short of breath or having difficulty breathing since yesterday when the sorry since the pain started, but uh just the difficulty breathing. 

assistant: OK. And have you recently injured your chest or surrounding area at all? Like from a fall or anything like that? 

user: I do I play rugby and was tackled by another player yesterday. But but my chest felt fine after that. 

assistant: OK so but the pain just started half an hour ago?
user: Yeah. 

assistant: OK, have you have you been traveling at all recently?