jshargo/medical-interview-conversations2 huggingface dataset:
user: Uhm they say I have like some high cholesterol. I'm taking this medication like a statin and but other than that umm no. 

assistant: OK, so do you take any other medications or is it just the statin?
user: It's just a statin. 

assistant: OK, and have you had any prior surgeries or hospitalizations?
user: Uhm I did a have a ACL repair just when I was probably 18. 

assistant: OK, do you have any allergies? 

user: No, not that I know. 

assistant: Alright, and are your immunizations up to date?
user: Yep. 

assistant: Could you tell me a little bit about where you're living and who you're living with?
user: Yeah, so I just lived with my wife, we live in small apartment. 

assistant: OK, and are you working right now? 

user: Yeah, just as a construction worker. Been doing that for the last probably 10 years. 

assistant: OK, uh and have you been around anybody who's been sick?
user: No. 

assistant: OK, and sorry as a construction worker I have you had any like any puncture wounds to your hands or anything that like any like slivers or things that have gone into the skin? 

user: Not any puncture wounds. Like uh yeah, I sometimes get splinters here and there, but nothing like nothing recently that I can think of that has been anything worrying or significant. 

assistant: Alright, OK and have you ever traveled anywhere recently?
user: Nope. 

assistant: Been around anybody who's been sick. 

user: Nope. 

assistant: Do you smoke cigarettes?
user: Yeah, I smoke probably a pack a day for the last. I don't know like 10 years. 

assistant: OK, and you smoke marijuana?
user: Not that much, probably just a couple times a month. 

assistant: OK, uh. And do you drink alcohol?
user: Yeah, probably. A couple of years a day. 

assistant: OK. Like one or two a day? 

user: Yeah. Probably one or two, sometimes 3. 

assistant: OK. And you use any rec other recreational drugs at and or any IV drugs and have you in the past?
user: No, I haven't tried anything beyond weed. I don't wanna try any other stuff. 

assistant: OK, I I see and that's good then uhm anybody in the family have any musculoskeletal or neurological conditions that run in the family?
user: Uhm not that I know. 

assistant: OK, and how about any autoimmune conditions like rheumatoid arthritis or hypothyroidism? 

user: Nope. 

assistant: OK, and as anybody in the family had a Dupuytren's contracture before?
user: Uhm no, I haven't I haven't heard it now. 

assistant: OK, and so uh next, I just wanted to go on to the physical exam portion, so just a couple more questions. So when you're looking at your hand, are you seeing any swelling redness? 

user: Not swelling, I just yeah just those nodules and I get like a little bit of whiteness around those nodules when I extend my fingers. 

assistant: OK yeah, but no redness?
user: No. 

assistant: OK, and are you are you seeing any, uh like muscle atrophy or any deformities of any of your joints in the fingers or the wrist? 

user: Nope. 

assistant: OK, and uh are there any areas that that you can palpate over your hand that causes pain.
user: Yeah, there's just some discomfort, like when I at the bases of those two fingers, like if I press on the nodules like it's sometimes a little bit like uncomfortable but it's not too bad. Like I, I don't, but I don't know I have a pretty high pain threshold too, so it's hard to say. 

assistant: OK, I see an when you're extending your fingers with like passive extension to do with your other hand do you get a lot of pain like along the tendons or the passive extension?
user: Yeah definitely. I would say more painful than if I try to extend it myself. Like just forcing it back but yeah, but not not anything too like I like it's not sharp or anything like that. 

assistant: OK, and with the on the nodules and stuff, do you feel any like crepitations or like crackling or rubbing over those, those areas or your palm? 

user: Uhm crackling oh no not that I have noticed. 

assistant: OK, and any issues with your like wrist or or elbow?
user: No, not that I know of. 

assistant: OK. Uhm so I think that's everything that I wanted to ask about today. Did you have anything that you wanted to add or or did you have any questions?
user: No, I think that's all. 

assistant: OK, I'm so right now it's sounding like it's most likely something called Dupuytren's contracture, but also we can't rule out like flexor tenosynovitis just yet or or trigger finger. Based on the the symptoms, but the fact that you're not having a fever, you don't have pain kind of along the the tendon, you're not seeing any swelling or redness that's all pointing away from the tenosynovitis. 

user: Mmmm 

assistant: But it'll be important to get some blood work and things to make sure that we're not missing that. But for Dupuytren's contracture. It'll be a uh, do doing what we can with therapy to try it like physiotherapy and activity modification to try and loosen those structures on the on the palm of your hand.
user: Yeah, so I'm bringing my um daughter because uh over these last uh several months she's had this uh this cough that that comes on, um it'll be at night time or sometimes uh after, in gym class. Um and I know during these episodes she'll have a really hard time, kind of catching her breath and and sometimes will have a wheeze as well and and it's just gone away quickly in the past but been noticing it happening more often recently. 

assistant: OK, so it's been going on for the last few months, but it's kind of getting worse? 

user: Yeah, exactly yeah. 

assistant: And how about the the coughing and the wheezing and the, does she have any kind of shortness of breath?
user: Um yeah she will like when it comes on, uh yeah she she has some shortness of breath. 

assistant: OK, and um does this happen at all, like when she's exposed to dust or kind of after exerting herself?
user: Yeah it does. Yeah I think the like the first time that um that I was made aware of it was yeah in in gym class so it would've been after some exercise. Um and, dust, uh, I'm I'm not sure. 

assistant: OK. Um does she have a dry cough or wet cough when she gets these spells? 

user: Uh dry. 

assistant: Dry, OK. Um did she bring up any sputum or blood at all?
user: No. 

assistant: OK and are her symptoms at all constant, or do they come and go based on how much she's exerting herself?
user: They come and go. Yeah, like most of the time she's been OK, but uh, and sometimes she'll get a cough at night time too. 

assistant: OK. Um so, and then has, does anything make, help you with your symptoms at all, or her symptoms? 

user: Uh, um not really no. 

assistant: OK.
user: Just resting I guess, sorry yeah, just just trying to relax. 

assistant: OK, and any other symptoms like fevers or chills or sore throat, chest pain, anything like that?
user: No, nothing like that, um yeah, just the wheeze. 

assistant: OK, any loss of her sense of taste or smell? 

user: No. 

assistant: OK, um any recent travel?
user: Uh no. 

assistant: Um any contact with anyone who's been sick recently?
user: Uh she has a, uh, a younger brother that goes to daycare. Uh and I know um those kids can be sick all the time, but um her brother's been OK. 

assistant: OK. Um does she complain of any kind of headaches or uh nausea or vomiting?
user: No, she doesn't. 

assistant: OK. Um any, have you noticed any fevers or chills? 

user: No. 

assistant: OK, um any night sweats?
user: No. 

assistant: OK. Um any changes in her bowel movements like constipation or diarrhea?
user: Nope, she hasn't had any change, changes like that. 

assistant: OK, and any kind of uh changes in her sleep or appetite?
user: No, she's been eating well and and gaining weight. 

assistant: OK, um any, uh so she's been gaining weight um, any exposure to any mold, dust, um new rugs or animals at home?
user: Yeah, we do have um 2 cats at home. 

assistant: OK. 

user: Yeah, there are animals at home. 

assistant: OK, how long have you had them?
user: Um for for about um yeah, just under a year. So yeah, just under a year. 

assistant: OK um, has she been diagnosed at all with any medical conditions in the past? 

user: Um, no, no, and when she was born she had to uh go in the, just be observed for a few um a couple of days for jaundice. She didn't need to have any therapy for it, it went away on its own, but that's about it. 

assistant: OK, and any um complications during the pregnancy with her?
user: No, everything was was normal and it was a vaginal delivery at at term. 

assistant: OK, um any issues with the development, uh is she meeting her milestones in her growth, um meeting her milestones on her growth chart as well?
user: Yeah, all of that has been has been normal. 

assistant: OK, um any allergies to medications or environmental factors that you know of? 

user: Not to um any medications that I'm aware of, but um she hasn't been tested, but she does get symptoms that uh kind of change with um seasons, like she'll get a runny nose and some itchy eyes um at different times throughout the year. 

assistant: OK. Um any medications that she has been on at all?
user: So when that happens we just use um like she'll just take a uh like Reactine or like I don't know something like that, but just an allergy pill, um but it's yeah, that's it. 

assistant: OK, um and any hospitalizations or past surgeries? 

user: No, luckily she's been healthy that way. 

assistant: OK, um any family history of any lung or heart conditions?
user: I think uh yeah, yeah her grandfather has diabetes, but um that's it. 

assistant: OK, uh, and currently what's her home situation like? Who does she live with? 

user: Yeah, so she lives with um myself and uh her father and then younger younger brother. That's it, yeah, that's four. 

assistant: OK. Um OK, and does anyone smoke in the household?
user: Um no, they don't. 

assistant: OK. Um OK, so those were all the questions I had. Um do you have any questions? 

user: Uh, no, I just uh yeah just wanted to figure out what's going on with this cough. 

assistant: OK, yeah, so it seems like the symptoms have been going on for a few months now. It seems that she gets them on exertion and um they're worsened by exertion. Um at this age, one thing that definitely we want to check is if she has asthma. Um she does have some other symptoms that um are associated with asthma, like it seems that she gets um, some irritation through environmental factors as well. So what we'll do uh for her is get something called a pulmonary function test for her to see, that'll test if she in fact has asthma or not, and then based on that we will uh see if she needs any puffers. Um that can help relieve some of her symptoms. Uh and lastly, since she's having a cough, we'll also do a like a Covid test just in case as well.
user: Um yeah, so I'm here because I've had this fever, this cough, and now my head hurts. That's been going on for about the past four days and I just want to make sure um it's nothing too serious. 

assistant: Yeah, yeah, that's great. So can you tell me, have you, did you measure your temperature?
user: Uh no, I haven't actually measured it, I just feel hot and feel chills. 

assistant: OK, but we can take your vitals here um and uh you you said that you've had a cough for the past four days, dry cough or wet cough? 

user: Um it's been pretty dry. 

assistant: Um, any uh no blood or any um sputum um coming up right?
user: No, no. 

assistant: OK and has the the cough gotten worse or better or the same, has it been the same since the past four days? 

user: Um it's it's actually getting worse. 

assistant: OK, is there anything that makes it better or worse?
user: Uh no, I don't think so. 

assistant: OK. Uh have you tried anything for your cough? 

user: I've tried like decongest like cough suppressants but it doesn't seem to have helped. 

assistant: OK. OK, and then tell me about your headache. That started four days ago as well?
user: Yeah. 

assistant: And uh where exactly is it? 

user: So it's like just on the front part of my head. 

assistant: And does it feel like uh, what does it feel like? Is it like a throbbing sensation? A band like sensation? Um is it sharp, is it dull?
user: Uh it feels pretty throbbing right now. 

assistant: Is it both sides or on the uh left or right?
user: Uh it's it seems like it's both sides. 

assistant: If you had to give it a number from 1 to 10 with 10 being the most severe pain ever, what number would you give it? 

user: Uh I would give it about like a seven. 

assistant: Oh wow, OK. And how's it changed over the past four days?
user: Uh, it's just gotten a little bit worse. 

assistant: Um is it uh is it, what was I gonna say, is it constant or does it come and go? 

user: Um It seems pretty it seems pretty constant. 

assistant: Have you taken anything for it?
user: I tried like some Tylenol for it and it seems to help a little bit. 

assistant: Does it, is there a certain time of the day when it's worse? Before going to bed, at the end of the day, waking up, anything like that?
user: No, nothing like that. 

assistant: Have you had a similar headache in the past? 

user: Uh yeah, I guess I have, a little bit in the past, but that was also when I was like sick. 

assistant: Sure, um does it wake you up in the middle of the night?
user: Uh no, it hasn't woken me up. 

assistant: OK, um I guess other than the headache, I'll ask you about, and the cough and fever, I'll ask you if you've had any other symptoms. So have you had any confusion?
user: Uh no, no confusion. 

assistant: Any changes in your vision or your hearing?
user: No. 

assistant: Um any um redness in your eyes? 

user: No. 

assistant: Any loss of taste or loss of smell?
user: No 

assistant: Um any runny nose or stuffy nose? 

user: Uh nope. 

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

assistant: OK. Any chest pain or difficulties breathing? 

user: No. 

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

assistant: OK, any belly pain? 

user: No belly pain. 

assistant: Diarrhea?
user: No. 

assistant: OK, any aches or pains in your body?
user: No. 

assistant: Uh any rashes that you've noticed?
user: No, no rashes. 

assistant: Any discolouration of your fingers or toes? 

user: Uh I don't think so. 

assistant: OK, alright um and do you have any medical conditions?
user: No, I think I'm healthy otherwise. 

assistant: OK, alright and have you had any hospitalizations or surgeries?
user: Uh, no. 

assistant: OK, um what about medications? Are you taking any? Over the counter or otherwise? 

user: Uh I take some multivitamins, that's it though. 

assistant: OK, any family history of lung or heart problems uh or anything else, or cancers?
user: No. 

assistant: And do you currently live alone or do you live with someone else or with other people? 

user: I live with um my husband and our our daughter. 

assistant: OK, have you had any, have you traveled anywhere?
user: No, not recently. 

assistant: Have you uh, what do you mean by recently? 

user: Uh like I have traveled in the past two years. 

assistant: OK, that's fine, that's fine. Have you had any contact with anyone who might be sick? Either you or your husband or your daughter?
user: Uh no, I don't think so. 

assistant: Have you gone out of the home at all?
user: Uh just to do like essential things like groceries and the bank and things like that. 

assistant: Do you wear a mask and maintain social distancing? 

user: Yes. 

assistant: OK um alright, uh do you drink alcohol?
user: I drink like once once in a while, have a glass of wine. 

assistant: OK, how, I guess how often would you say?
user: Uh once a week. 

assistant: OK. And do you smoke? 

user: Um no, not anymore. 

assistant: Uh how much did you smoke in the past?
user: I I'd have like half a pack, um but I only smoked between like the age of 20 to like 25. 

assistant: OK. Do you smoke marijuana or have any edibles with marijuana in it?
user: No. 

assistant: Any recreational drugs? 

user: No. 

assistant: OK um alright well uh, and you said that you don't have a family history of any problem?
user: No. 

assistant: Yeah OK, alright, I think that's all the questions I had for you. So uh looks like you've had a fever, cough, and a um and a headache that's gotten worse in the past four days and your headache's pretty bad, a seven out of ten. Um and uh it could be that you have uh some sort of an infection, uh including um, with Covid being one of the possibilities, and so um continue to take Tylenol and and um monitor your uh fever. If it continues to get worse, or you um notice that your symptoms are just not getting better, um you should come back, you should uh, we'll also do a Covid, we'll also send in a request for a Covid swab. Um and uh we'll ask you to quarantine for the for the next 14 days and try to stay away from your husband and daughter as well, if you can at home. Um and uh I guess a couple of other questions that I wanted to ask and I should have asked earlier, do you have any um any stiffness in your neck or any difficulties moving your neck?
user: Hey, uh I just had this cough that's been like really bothering me. 

assistant: OK, how long have you had that for?
user: Uh like in the past few days, it's been really like gross and I've been coughing up this like gunk, but I've had it for, I've honestly had a cough for like three months, it's just like sometimes it's like there, and sometimes it kind of goes away. It feels like it keeps coming back. 

assistant: OK, have you had any chest pain? 

user: Um no, like it kinda hurts when I cough now but not not like on its own. 

assistant: OK, have you noticed any fevers at home? Or fevers at all in the last couple days?
user: Uh I've been feeling like hot at night in the past couple days, uh but like I didn't actually take my temp. 

assistant: OK, have you had any night sweats? You wake up, the sheets are soaked?
user: Uh no, not that. 

assistant: Nothing like that, OK, have you noticed any unexplained weight loss over the last little while? 

user: Um, no. 

assistant: So so you go on the scale, you lost a few pounds, but you haven't been trying to basically.
user: No, like I, I don't really weigh myself, but I don't think so. 

assistant: So you haven't been noticing clothes have been fitting loose or anything like that?
user: No, no, like I wish but no. 

assistant: Got it, got it. Now let's talk about what you're bringing up with your cough. What colour is it?
user: It's really gross. It's kind of like greenish. 

assistant: Greenish, OK, and also any red or any blood with it?
user: No. 

assistant: OK. And doesn't smell at all, smell funky? 

user: I haven't noticed. 

assistant: OK, so you've just been bringing this stuff up for the last couple of days, when specifically? Two days ago, three days ago?
user: Like maybe maybe three days. 

assistant: Three days ago, and you said before that you kind of had this dry cough before. Uh when did you first notice that? Three months ago, you said? 

user: Yeah, I was uh, I I do like um, it like sounds silly but I do like a pole dancing class just for exercise and I was like at my class and I kind of just started to like feel like I was like a little coughy and like I don't think there's anything special, that was just like when I noticed it. 

assistant: OK, anyone at the class sick at that time?
user: I don't think so, like it's a really long time ago, I don't really remember. 

assistant: Got it, got it. Anyone sick near you or around you in the last couple of weeks?
user: No, no, not that I can think of. 

assistant: OK, and regarding other, any, we already talked about chest pain, uh you've been able to eat food alright?
user: Uh yeah, like uh yeah it's like pretty normal. 

assistant: So no nausea, no vomiting? 

user: Uh no, none of that. 

assistant: You don't have a stiff neck at all, do you?
user: No, no I don't. 

assistant: OK, but how about other parts of your body? Any pain? Tenderness anywhere? 

user: I don't think so, no. Like I'm I'm a little tired now, um like the cough is like maybe for like a month, it's been kind of waking me up a little bit so my my sleep hasn't been great, but I don't think it's like I have like pain. I'm just like tired. 

assistant: OK so the cough does wake you up at night?
user: Yeah. 

assistant: Does it wake you up every night?
user: Yeah, like pretty well, for like the last, not like all three months, but probably the last month. 

assistant: OK. Alright. I'm just gonna move on, talk a little bit about you and the past. Uh so any issues that you've seen a doctor for before?
user: Uh just like eczema. 

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

user: Just like moisturizing creams, um like my family doctor back home said like, a couple times when it was really bad she would give me one like to go get at like shoppers, but right now it's not bad so I just have just like a regular cream. 

assistant: Got it, ever been hospitalized before?
user: Uh, no. 

assistant: OK, any surgeries? 

user: No. 

assistant: OK so aside from the eczema, it sounds like you're pretty healthy eh?
user: Yeah. 

assistant: OK. Do you have any allergies?
user: Uh I think maybe um maybe cats because, I I don't have one, but sometimes I've noticed stuff, but I've never like, it's never really been too big of an issue. 

assistant: OK, so you've never taken any medications or got stung by a bee and had any trouble breathing or even a certain food?
user: No. 

assistant: Nothing like that, OK, are you taking any medications right now? 

user: Uh no. 

assistant: OK, and you just go to Western?
user: Mhmm. 

assistant: Do you live uh near campus with anyone? 

user: Uh I have like a roommate, yeah we, I live in an apartment with a roommate. 

assistant: OK, have they been sick at all in the last little while?
user: No. 

assistant: OK, and last little while, have you done any traveling? 

user: No. 

assistant: So you haven't been outside the country or any exotic locales in the last little while?
user: No, like I'm planning to on March break, but I haven't gone anywhere. 

assistant: Got it, got it, so you live in town uh with your roommate and you're currently a full time student? 

user: Mhmm. 

assistant: OK, and just regards to anything, do you smoke?
user: No, like I don't um I don't smoke cigarettes like I sometimes sometimes smoke marijuana, but usually um usually it's like the vape. 

assistant: OK, how often we say you do that a week? 

user: Oh, like, maybe like once every like 2 weeks or something. 

assistant: Got it, any other substances slash drugs?
user: No, like alcohol sometimes, like. 

assistant: OK so no cocaine, no heroin? 

user: No. 

assistant: And have you ever um injected drugs into your body?
user: No. 

assistant: Got it, got it. Just coming back to alcohol, uh how often would you say you drink?
user: Maybe like one one night like on the weekend. 

assistant: OK and what do you drink, how much do you drink? 

user: I don't know, maybe like 5 or 6 beers. I guess it just depends on the night. 

assistant: Got it, got it, and other questions, when was your last menstrual period?
user: Maybe like 2 weeks ago? 

assistant: Two weeks ago, OK. Are you sexually active?
user: Uh yeah, just with my boyfriend. 

assistant: OK, so do you two use contraception, birth control? 

user: Yeah, we use uh like condoms. 

assistant: OK, any chance you could be pregnant right now? That was a strange question to ask if you're sexually active, but any unprotected sex in the last two weeks?
user: No. 

assistant: Got it, alright, and we're just kind of going over things,so it sounds like you've had this cough or a cough for a little while but it's only become bad in the last three days. You're waking up at night and you're kind of bringing up this foul or not this foul but this kind of greenish sputum, but it's, no blood in it, and otherwise you don't have any constitutional symptoms so I will go review your story with the doctors. Anything else you'd like to bring up with them before I go?
user: Yes, I brought in my daughter. She's 8 years old. So recently she's been telling me she's having a lot of ear pain. And she's had a fever for the past two days as well. We checked her temperature at home. It was 38.8. And so we're just here to see if we can get some antibiotics for it. 

assistant: OK, um and has this happened before at all? 

user: She's had some ear infections on and off since she was like uh 2. 

assistant: OK, then has she required antibiotics?
user: Yes. 

assistant: OK, when was their last ear infection? Do you remember? 

user: It was actually last year when she was seven? 

assistant: OK, and so is it just one ear that she's having the pain? Or is it both?
user: It's one ear. 

assistant: OK. In which which ear is it? 

user: It's the right ear, 

assistant: Right ear. And when did you notice that she started having this pain?
user: Um I noticed it like 3 days ago. 

assistant: Three days ago, OK. Was she irritable, like or was he kind of tugging her ears in pain? Or how? How would you describe it?
user: Yeah, she basically, while she told me she's been having some ear pain. And yeah, she's been pulling at it. And you know she's tried like mineral oil and things like that to see if she can unblock it but I I looked in there, it doesn't seem like there's a lot of wax in there. Um yeah. 

assistant: Um has it been so painful that she has been crying at all?
user: Yeah, she's cried a few times. 

assistant: OK, have you noticed any kind of drainage coming out of her ears? Any fluids? 

user: No, I didn't notice that. 

assistant: Um, any fevers or chills?
user: Yeah, she's had a fever for the past two days. 

assistant: Past 2 days. OK, did you get a chance to measure it at all? 

user: Uh 38.8. 

assistant: 38.8 OK. OK, and she had any other symptoms recently like a cough, runny nose, sore throat, any viral or cold like symptoms?
user: No, not that I've noticed. 

assistant: OK, um. And she had any headaches?. 

user: No headaches. 

assistant: OK. Any recent travel or contact with anyone who's been sick?
user: Um no. 

assistant: No, any nausea or vomiting? 

user: Uh No. 

assistant: Any changes in her bowel movements?
user: Uh nope. 

assistant: OK. And any fatigue or just feeling very tired? 

user: Uh she's been pretty tired. 

assistant: Has she had to miss any school or anything like that?
user: Yeah, she wasn't going to school for the past three days. 

assistant: OK. And any issues that are sleep or appetite?
user: No. 

assistant: OK. And any medical conditions that she's been diagnosed with in the past. 

user: No, she's been pretty healthy. Besides the recurrent ear infections. 

assistant: OK, has her hearing been affected at all?
user: Not that I've noticed. 

assistant: OK. And you mentioned it's recurring how she ever had to see an ear, nose and throat specialist? 

user: So when she was younger, when she was like 4 she saw one, but then she hadn't had an ear infection between the age of 4 to 7 so we didn't go back to them. 

assistant: OK yeah.
user: After. 

assistant: OK. And if she ever had tubes put into your ears or anything like that? 

user: Uh no they were. They were talking about it, but we never ended up doing that. 

assistant: OK, OK. Any medications that she takes everyday?
user: Uh no just multivitamins. 

assistant: OK. Any allergies? 

user: No. 

assistant: OK. Any? Contacts at all. Any hospitalizations or surgeries in the past?
user: No. 

assistant: How about her birth?  Was it a vaginal delivery or C-section?
user: It was vaginal. 

assistant: And was she premature or at term choose that term? 

user: She was at term. 

assistant: Any complications at all during your pregnancy with her?
user: No no. 

assistant: OK, after she was born, does she have to stay in an ICU or any complications afterwards?
user: No, she was healthy. 

assistant: OK. That's good, and in terms of her development throughout the years, any issues with her growth, learning or anything like that?
user: Uh no she's been pretty good with hitting all those milestones. 

assistant: OK, alright, and currently right now. So is she doing online school or she doing in person?
user: Ah she is going in person. 

assistant: OK, and how about her living situation currently? 

user: Ah should also at home with myself from her father and her younger sibling. 

assistant: OK. Uh, and uh? Any, anyone smoke in the house at all?
user: No. 

assistant: No. OK. Alright, so those are all the questions I had for her today, so definitely since there is a risk that she might be having another ear infection, we will need to do like a full physical examination. I'll have to look into her ear to see if I see any inflammation or perforation and then based on that we'll discuss some management. She may require some antibiotics like she has had before, but that will depend on what. I see on physical examination she has been having a fever so she might. And it's only been three days, right? So we may even do some conservative management and get her to take some maybe pain medications and then go from there. Or ear drops.
user: OK. 

assistant: Uh, but yeah, so we'll do the examination and then go from there. She said she has, besides the fever and that your pain she's not really having any other symptoms so? I don't think she needs to get tested for Covid right now, but that's something we can consider as well if she develops other symptoms. 

user: OK, that sounds great. Thank you. 

assistant: Your Welcome. Take care
user: I've been having issues with just a cough that's just been constantly like bothering me for the past few bit. 

assistant: OK, um, when did this, what can you tell me a little bit more about the cough itself? Any any sputum?
user: So yeah, it it does have some like dark yellow greenish mucus material every time I cough. That's not doesn't always happen, but it's been worse like that keeps happening over the last few days. 

assistant: OK, and any blood in the sputum? 

user: No. 

assistant: OK, and how much have you been bringing up would you say?
user: I would say every time I bring it up it's around like one teaspoon, usually one teaspoon in the day. 

assistant: OK, and when did this cough start?
user: Um, so I think it started around like I would say six months ago and it's kind of just coming it just keeps coming and going here and there, but it's recently just starting to get very irritating. 

assistant: OK, and um any triggers or uh precipitating events for for the cough? 

user: So like six months ago I remember I was in just in Phys.Ed and we were just doing some laps and that's when I just really started coughing. And yeah, nothing else was really going on. I just feel like when I started running sometimes I start to cough. 

assistant: OK, um, and has the cough been getting worse or staying the same, getting better?
user: I think it was pretty it was pretty much the same over the last few months, but then over the last week I would say just got really bad and over the last few days it's just been getting worse and worse. 

assistant: OK, um so it's been the cough has been happening on and off up until four days ago, it sounds like. Uh, is the cough happening daily now? 

user: Oh yeah, I would say like I'm coughing especially the last few days coughing several times a day. Um, it's pretty random, but like I would say throughout the day, I'm coughing. 

assistant: OK, anything you've tried to make the offer better?
user: Um, I mean, really, I, I didn't really know what to try, um, so no, I haven't tried anything. 

assistant: OK and anything you've noticed that that so I guess, yeah, anything you notice that makes it worse? 

user: So yeah, just like when I'm doing more activities, especially running, I find, uh I just get like these coughing fits and it just gets worse when I'm running. Yeah, it's pretty annoying because even sometimes when I'm just in class I just start coughing randomly, but I would say it's the worst when I'm doing activities. 

assistant: OK, so exercising brings out the cough? Any other symptoms you've been experiencing besides the cough?
user: Uh the only thing that sometimes, uh, like I panic sometimes when uh when I have like a really bad coughing fit especially in gym class. It almost feels like I can't breathe and that's when I get really scared. 

assistant: OK um, have you been having any nausea or vomiting? 

user: Oh no, no nausea or vomiting. 

assistant: OK. How about any headaches?
user: No, no headaches. 

assistant: OK and have you had a fever? 

user: Uh I think I felt like a little bit warmer in the past few days, but I didn't I didn't really check. 

assistant: OK, and have you had any chills?
user: I don't think so, no. 

assistant: OK, and have you traveled anywhere recently? 

user: Uh no, I've been I'm I've been home. 

assistant: OK, uh any night sweats?
user: No. 

assistant: Have you had any racing of your heart? 

user: No, nothing like that. 

assistant: OK, and have you had any symptoms of fatigue?
user: Uh no I, I think my energy levels are fine. 

assistant: OK um, do you have any chest pain? 

user: Um, sometimes when I cough, like when it's really bad, I sometimes feel like I get some pain in my chest when I'm coughing, but that's only been the case for the last few few days, I would say. 

assistant: OK, um any urinary problems?
user: No, I've been peeing alright, no issues there. 

assistant: OK, any bowel problems?
user: Uh, no. 

assistant: OK, any issues with your appetite?
user: No, I think I've been eating the same amount. 

assistant: OK, any changes to your weight? 

user: Uh no, still the same. 

assistant: OK and any problems with, uh, sorry, uh, any recent infections?
user: Like I feel like I might have a cold but I think I maybe a week ago I had like a little bit of a runny nose, so I don't know, I might have a cold. 

assistant: OK. Um, and these symptoms, cold symptoms, you've been feeling for the last few days? 

user: Yeah, it's almost up to a week now. 

assistant: OK, and any problems with sleep?
user: I feel like sometimes just in the past few weeks, like I started coughing at night and woke myself up, so sleep has been a little bit disturbed over the past few weeks. 

assistant: OK, uh, any exposures to tuberculosis? 

user: Oh no, no, not that I know. 

assistant: Any exposures to inhalants like smoke or or dust or fumes?
user: Uh no I don't have any pets like there's no like moss or anything in my home. No fumes, dust, yeah, nothing like that. 

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

user: Just just like with the skin I I I have eczema but nothing else. 

assistant: OK. Are you allergic to any medications?
user: Uh, so, I for my eczema like I do have like a hydrocortisone cream that I apply. But yeah, I don't think I'm allergic to any medications. 

assistant: OK, um do you have allergies?
user: I I do have allergies like sometimes around like animals. Like if I go to the farm or if I'm like at a zoo and just petting animals, I get my eczema gets really bad. 

assistant: OK, and any hospitalizations?
user: No, no, no, never been hospitalized. 

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

user: No, I've been I've been pretty much been at home, so no one. 

assistant: Alright, and any surgeries?
user: No surgeries. 

assistant: OK, any family history of asthma or or eczema? 

user: I don't know bout asthma. My mom does also have like similar like eczema to me. But yeah, nothing, nothing else that I know of. 

assistant: OK, uh, and what are you doing right now for work?
user: So currently like I'm not working. I'm a student just doing some online studying. I'm actually going to college to learn about how to make video games, but yeah, it's all just been at home right now. 

assistant: OK, and um, where are you from? Like are you living at home right now or are you away for school? 

user: Yeah, so I mean right now it's all online so I'm living at home with my mom. 

assistant: OK, uh, and do you drink alcohol?
user: Uh not often like just when I'm at like parties and like when I was at school, just maybe sometimes on the weekends, but nothing regularly. 

assistant: OK um, and have you tried any other drugs besides marijuana?
user: Um, just just marijuana I I try sometimes at parties but nothing like regular. Uh other than that, like just sometimes I've been offered like some pills at parties, but other than that, nothing else. 

assistant: So it sounds occasional. 

user: OK, nothing like it, I'm not addicted or anything to any drugs. 

assistant: OK, do you smoke cigarettes?
user: I don't smoke cigarettes, but I do have marijuana once or twice in a week. 

assistant: OK and and uh, can you tell me a little bit about your diet and exercise?
user: Uh, I've had this cough ongoing for a couple of months now, uhm, and recently I've started to notice some blood. 

assistant: OK, so this cough has been going on for how many months?
user: I would say maybe six months. 

assistant: Six months, and have you had this cough before, then?
user: Yeah, I've had a cough before and kind of for a long time, 'cause I've smoked for a while. 

assistant: OK, I see, Uhm, what kind of cough do you have, is it productive? Like, is it a wet cough or is it a dry cough?
user: It's usually a dry cough, but recently I've been bringing up a little bit of blood. 

assistant: OK, and is the blood mixed in with like sputum that you're bringing out or is it that you're just coughing up blood?
user: It's mostly red, yeah, mostly blood. 

assistant: OK, I see, and is your coughing constant or does it come and go?
user: It's kind of like, constant throughout the day. 

assistant: OK, and have you noticed any kind of greenish or yellowish color of your sputum? 

user: Not really, no. 

assistant: How much blood would you say you're coughing up now in an average day?
user: I would say, maybe two or three teaspoons. 

assistant: OK, I see. Has your coughing gotten worse or has it stayed about the same? 

user: It's been about the same. 

assistant: OK, is there anything that makes your symptoms better or worse?
user: Not really, it's just kind of been there most days. 

assistant: And do you have any other symptoms like shortness of breath or chest pain, runny nose, anything like that?
user: Uhm No, no I haven't really had anything like that. 

assistant: OK, so with your coughing, you don't feel like you have any difficulty breathing?
user: No, I mean, I haven't had any shortness of breath, I've just had uh, well yeah, actually sorry, I have had difficulties breathing as well. 

assistant: OK, and when did that start? 

user: Uh, well that's been an ongoing problem for the last several years now, I thought it was related to smoking, but it's gotten worse. 

assistant: I see, OK, and do you have any chest pain with inspiration or expiration?
user: No, no chest pain. 

assistant: OK, any dizziness? Any fainting episodes? 

user: Nothing like that. 

assistant: OK, any recent travel outside of the country?
user: No, I've been at home. 

assistant: OK, any headaches, fevers or chills? 

user: No, no fevers or chills, and I haven't had any headaches either. 

assistant: OK, any losses in sense of taste or smell?
user: No. 

assistant: Any nausea or vomiting? 

user: Uhm, yeah, I have been a bit more nauseous recently, but I haven't had any vomiting. 

assistant: OK, and when did you start feeling nauseous?
user: It kinda comes and goes, I've had that problem for the last two months or so. 

assistant: OK, and do you feel nauseous at anytime particularly in the day, like after eating, Or does it just come on randomly?
user: Randomly. 

assistant: OK, and have you been having any kind of diarrhea or Constipation, changes in your bowel movement?
user: No. 

assistant: OK, any blood in your stools at all? 

user: No. 

assistant: OK, have you been feeling fatigued at all?
user: Yeah, a little bit more tired recently, yeah. 

assistant: And how recently would you say? 

user: I thought it was related to like, just being short of breath, Yeah, so maybe in the last couple of months as well. 

assistant: OK, and when do you get short of breath? Is it when you do any activities? Is it when you're laying down? Is there anything related to it?
user: If I exert myself or if I'm  doing more activity, it it does get harder to to keep up with it, but yeah. 

assistant: And do you notice you have to like get up at night to take a breath? Or when you're laying down,do you have any trouble breathing?
user: No. 

assistant: OK, and have you noticed any kind of swelling in your extremities or anything like that?
user: No swelling. 

assistant: OK, have you had any night sweats?
user: No 

assistant: OK, and how about your sleep and appetite, have they changed it all? 

user: Oh yeah, my appetite's been less. I've lost some weight over the last few months. 

assistant: OK, and how much weight would you say you've lost?
user: Maybe ten to fifteen pounds. 

assistant: OK, and how much do you weigh? 

user: I think now I weigh about one hundred and sixty pounds. 

assistant: OK, so yeah, ten to fifteen pounds in the last, how many months would you say?
user: Maybe two months. 

assistant: Two months, OK. Have you recently had any infections, like viral symptoms, like runny nose, fever, or any cold like symptoms? 

user: No. 

assistant: OK, and any exposure to anyone that you know of that might have tuberculosis?
user: No, I've been been mostly at home. I Haven't really been seeing many people lately. 

assistant: OK, and do you have any past medical history or any diagnosis like COPD, asthma, high blood pressure, diabetes, anything like that? 

user: Uhm, I had a cataract surgery, but that's about it. 

assistant: OK, and are there any medications that you take on a daily basis?
user: Multi-vitamins. 

assistant: Multi vitamins, OK, any allergies that you know of to medications or any environmental allergies?
user: I think sulfa, but that's it. 

assistant: OK, and what kind of reaction do you get?
user: Uh, I get a rash. 

assistant: Rash, OK, any surgeries or hospitalizations in the past?
user: I just had cataract removed from my right eye, and uh, that's about it. 

assistant: OK, any Contacts of yours that have been sick recently?
user: No. 

assistant: No, OK, and in terms of your family history, are there any cancers like lung cancer in your family or any heart conditions, anything like that?
user: I think my great uncle had lung cancer, my mom had type 2 diabetes, but that's it. 

assistant: OK, and currently right now, do you work? 

user: Yeah, I'm retiring soon. I work as a bus driver. 

assistant: OK, and in the past have you worked in any environment where you were exposed to any metals, toxins, any asbestos or anything like that?
user: Uhm, I don't think so. 

assistant: OK.
user: I worked as a bus driver for quite a number of years now. 

assistant: And where do you live right now? In an apartment? In a home? And who do you live with?
user: I live in a home with my wife and it's just us two. 

assistant: And do you know if there's any like asbestos exposure in your home at all?
user: I don't think so, no. 

assistant: OK and currently do you smoke? 

user: I've been cutting down, but I do smoke, yes. I smoke about a half a pack per day now. There was a time I was smoking two packs per day for a number of years and I started smoking when I was probably fifteen. 

assistant: Mhm.
user: Yeah, so it's been about forty, Yeah, forty-ish years at least. 

assistant: And have you thought of quitting at all?
user: Yeah, I've been trying. I was thinking of maybe talking about a prescription for helping quit or something like that today. I was feeling like this is causing some of my symptoms like my cough, shortness of breath. 

assistant: Yeah, well, it's really great that you're thinking about quitting. We can definitely help you with some resources, and some medications. Have you tried anything before that I should know of, to help you quit?
user: I've tried nicotine patches and gum, but that's it. 

assistant: OK, so yeah, there's uh, like other options as well that you can take. Have you heard of Champix?
user: Uh, I did hear of it actually. Yeah, so one of my friends tried it and it worked well for them so, Yeah. 

assistant: OK, yeah, so we can, if you're wondering about that, I can give you some information on that medication, like a whole package for you and then we can discuss if that could work for you.
user: That sounds great. 

assistant: OK, sweet. And other than smoking, do you use any recreational drugs like marijuana? 

user: No, I don't. 

assistant: OK, and do you drink alcohol?
user: Well I'll have one or two beers on the weekend. 

assistant: OK. Alright, so yeah, that's pretty much all the questions I had right now. It seems that your symptoms, You do have that cough and the shortness of breath and it's been chronic, but now you're coughing up some blood as well, so that is definitely something that's concerning and we want to make sure there is nothing going on so we will get a chest X-ray for you and see if we can find anything there. Are still producing the bloody sputum? 

user: Yeah, that's been coming up a daily still. 

assistant: OK, so if you think you can produce that, we can even take a sample of that as well and see if there is any presence. The one thing that we are concerned about with some of your symptoms and a long history of smoking as well is lung cancer. So yeah, we will do a chest X-ray, get some cytology done as well and then once we have that in the future we may need to maybe do a biopsy but right now we'll do a few of the first things that I mentioned and then go from there.
user: That sounds good. Thank you. 

assistant: You're welcome. Take care.
user: I I've been having uh, this fever, the last couple of days and I've had a cough as well and my nose is, keeps running. 

assistant: OK. And when did the fevers start? 

user: I think the fever started two days ago. 

assistant: How, did you measure your magic temperature?
user: Yeah, it was 38 point .5 when I when I checked it. 

assistant: And have you been checking it out past days? Has it gotten better or worse? 

user: It's been about the same both both days. 

assistant: And your cough, when did that start?
user: Cough started four days ago. 

assistant: OK, is it a wet cough or dry cough?
user: It's been dry. 

assistant: I've been bringing up any blood or any mucus or anything like that. 

user: No, and I haven't had a cough before either. This is new. 

assistant: OK, and the runny nose, what kind of discharge, or what like what's coming out of your nose?
user: It's pretty pretty watery and clear. 

assistant: OK, alright, and when did that start?
user: Yeah, yeah, sorry that started about four days ago as well, so about the same time as the cough. 

assistant: Have you had any other symptoms, such as having a stuffy nose that have congestion in your sinuses, sore throat? Umm, red eyes? Watery, teary eyes? Sneezing, any of those symptoms.
user: Um, no nothing like that. 

assistant: Any difficulties breathing?
user: No. 

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

assistant: OK, any headaches?
user: Uh yeah I have had a bit of a headache, actually. Well, just just this morning. 

assistant: How how bad is it? 

user: It's pretty mild. Something pretty simple like it, so I've had headaches like like this before. It's not, it's not a big deal. 

assistant: And do you have any fatigue or muscle aches?
user: No muscle aches, but yeah, I have been fatigued last a couple of days. Two or three days. 

assistant: Any changes in your sense of smell?
user: No. 

assistant: Changes in your sense of taste? 

user: No. 

assistant: Any pain in your belly or any diarrhea?
user: Nothing like that. 

assistant: OK? Alright um, any medical conditions that you've been diagnosed with? 

user: Uh. No, I I've been, I've been healthy. 

assistant: OK, any surgeries or hospitalizations?
user: No, I haven't had anything like that before. 

assistant: OK. And do you take any medications? 

user: No, I'm not. 

assistant: OK, and allergies to food or medications, or environmental allergies?
user: I think I have an allergy to penicillin. I got it, I had a rash when I was I younger when I had that. 

assistant: OK, and do you currently? Would you currently let that? 

user: Yeah, so I I just live with my with my mom. 

assistant: OK, do you have any pets at home?
user: No, it's just us two, uh, we live in a in a townhouse in in the city. 

assistant: Nice, OK. And do you do you or your mom go out for school or for work?