jshargo/medical-interview-conversations2 huggingface dataset:
user: See I never come in besides like because I you know need my insulin. I never even go to the, I didn't even want to come in and just like it wasn't going away. 

assistant: Yeah yeah. And then other things like COPD, pulmonary fibrosis, and like like cancer stuff is super low on the differential right now, so. Yeah, so um. So yeah, so for right now we'll start. We can start by doing some blood work. First I do a physical exam, of course. And then from there we would kind of do some blood work to see if your white blood cell count is high. And then we can do a chest X-ray to see if there is like a consolidation if there's pneumonia, or you know or, or anything viral? Um, do you have any questions?Anything that you wanted to add that I missed? 

user: I don't think I don't think so, um yeah, I just hope I can get feeling better. Hope it's not anything serious like I I think yeah, I just hope it's like I hope like you said it's like I got like an infection or something and it will just be gone soon. 

assistant: Yeah yeah it does sound like it from the timeline like you started coughing two days ago, and then the difficulty breathing or shortness of breath also two days ago and then the chest pain just seems like it's from you coughing a lot.
user: It can do that? 

assistant: Yeah.
user: Yeah yeah stomach hurt, started hurting more last couple of days, maybe 3 days ago I think. 

assistant: OK, so for three days ago, for the last three days you said it's been hurting more. Did you have pain before that? 

user: It felt weird, like crampy. I just, I just thought I was constipated, 'cause I've been haven't been able to be able to go to the bathroom as well. I just thought I was kind of bloated a bit, but yeah, about about that time, started to feel a little bit more painful. 

assistant: Can you tell me kind of where you're feeling the pain the most?
user: Yeah, kinda like near my right hip like lower where my stomach is that kind of right and below my belly button. Sometimes a little bit on the top just below my belly button, but mainly just in that right lower side yeah. 

assistant: OK, have you ever had pain like this in the past? 

user: No, never. 

assistant: OK. And for the last three days, has it been pretty constant? Has it been on and off?
user: I feel it's been getting worse to be honest. 

assistant: Is there anything that you can think of this made it feel better? 

user: Honestly, just resting flat makes it feel a little bit better, but nothing much, no. 

assistant: OK, is there anything that makes it worse?
user: Touching it. Also I puked the the other day and that made it definitely feel worse, just that whole contraction in my body was nasty. 

assistant: OK, was it just the one time? 

user: Yeah. 

assistant: OK, you had the nausea associated with the pain?
user: Mhm, mhm. 

assistant: Um, did the pain stay in that same spot or does it move anywhere else? 

user: It has pretty much stayed in that one spot, yeah. 

assistant: Have you noticed any fevers lately?
user: Felt a bit hot the other day, didn't take a temperature though. 

assistant: OK, OK, and what specifically prompted you to come in today to the emergency department?
user: I thought it was just going to get better when it first started. Maybe just a bit of gas, but here we are kind of Thursday now and it's still pretty bad. 

assistant: OK, have you been in contact with anyone that's been sick lately? 

user: Not off the top of my head, no. 

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

assistant: And I forgot to ask, did you notice any changes to your bowel habits? 

user: Yeah, yeah. Before it was fairly regular, about once a day. Five days ago, I started getting constipated, it backed up and pretty much the picture I think last time I went to the bathroom was two days ago I think, yeah. 

assistant: OK, I'm just gonna ask you some questions about your overall health. You have any chronic conditions that you see your family doctor for, or any other doctor?
user: I got diabetes, type 2. 

assistant: And has that generally has that been well controlled for you lately? 

user: Most part, doctor checks my sugars. I'm not too regular on them myself, but last time he changed medications was a couple years back and I've just been on the same ones ever since. 

assistant: What medication are you currently taking?
user: Metformin? Metformin. 

assistant: And have you ever had any surgeries in the past?
user: No, I had my teeth pulled as a kid, but no. 

assistant: OK, still have your appendix?
user: Yeah, yeah, I never had that problem as a kid. 

assistant: And do you have any allergies? 

user: No, sometimes get a little bit congested during the fall, but that's it. 

assistant: Do you have any family history of gastrointestinal problems?
user: Gas, like no. I think my grandma died of breast cancer fairly early, but no, not not that not that I can think of. 

assistant: OK, and just in terms of your lifestyle, do you live here in town? 

user: Yeah yeah, I live here. 

assistant: Living alone or with family?
user: No, no, I got family. Me, the wife, got two kids, one of them is college bound now but yeah. 

assistant: Nice, and what do you do for work? Or are you retired? 

user: I'm still working, I am a production overseer, production manager over at Fairbanks. 

assistant: OK, you're a big boss.
user: It took awhile to get here. 

assistant: I'm sure it was very hard work. In general, do you drink alcohol?
user: Oh yeah, like, well, plan on drinking on the two four but not regular, special occasions mainly. Hot days, sometimes I'll have a beer or two. 

assistant: Sure, and do you smoke cigarettes? 

user: No. 

assistant: Have you ever smoked in the past?
user: No. 

assistant: Do you cannabis?
user: No. 

assistant: Any other substances? 

user: No. 

assistant: OK, is there anything else you wanted to bring up today that I didn't ask you about or any other questions that you have?
user: No, just hoping to get an answer to whatever is going on. 

assistant: OK, well at this point I will do a quick physical exam. We may want to have blood work done, maybe some other tests based on what we find out from there and then we can kind of let you know after that, what the next steps will be. So I'm just going to take this and go over it with the physician that I'm working with and will get back to you shortly. Thanks for chatting with me.
user: Hi, I've had um I've had a cough for the past um three days and uh I also developed a fever, um I think, so I checked it yesterday night, it was um 38. And uh I just decided to uh come into the walk in clinic just to um just to get myself checked out. 

assistant: Yeah certainly, it it sounds like you um have had a fever as well, so uh with the cough, you said that started three days ago, has it been getting uh any better or any worse? 

user: It's gotten a little bit better, I'd say. 

assistant: OK, that's good. Um and and prior to three days ago, um did you have a cough before or was it a new new cough?
user: It's a new cough. 

assistant: Alright, and uh are you bringing up any sputum? 

user: No. 

assistant: Um are you bringing up any blood?
user: No. 

assistant: And have you had any shortness of breath? 

user: Uhm no, I haven't. 

assistant: OK, um how about any wheezing?
user: Yeah, I guess a little bit. 

assistant: A bit, OK. Um is it uh, are you having any chest pain?
user: Uhm, no. 

assistant: OK, um and so you mentioned um, with a fever have have you had any chills? 

user: Yeah I did. Um I had the chills yesterday. 

assistant: OK. And have you had any night sweats?
user: Uhm, no. 

assistant: Alright, and um have you had any eye redness, runny nose, or even a sore throat? 

user: No, I haven't. 

assistant: Alright, have you had any uh nausea or vomiting?
user: Uh no. 

assistant: Uh a loss of taste or loss of smell? 

user: No. 

assistant: OK and any um abdominal pains?
user: Uhm, no. 

assistant: Any uh diarrhea? 

user: No. 

assistant: You got any urinary problems?
user: No. 

assistant: OK, and have you had any skin changes or uh rashes? 

user: No. 

assistant: And how has your energy been? Have you had fatigue?
user: Um a little bit. 

assistant: Alright, and have you had any muscle aches or or body pains? 

user: Uhm, not much. No, but yeah, it's just I've been feeling, yeah, I guess a little bit. I have been feeling achy, uhm but I just thought it was my fibromyalgia acting acting up, but yeah, it's it's been worse over the past three days. 

assistant: OK. Uh so you've had um this cough, a dry cough, a fever, chills, and uh been more tired and and been a little bit more achy these past uh three days. Have you had any other symptoms?
user: I don't think so. 

assistant: OK, and have you tried anything to make it better?
user: Uh I just took a day or two off of work and I just rested and um had a lot of uh hot water. It helped me, uh It helped with the cough. 

assistant: OK great, and um have you had any uh like symptoms like this before? 

user: Yeah, um, yeah I mean, when I I guess I get sick I do get similar symptoms like when I get the cold or the flu, but I usually have like a runny nose um or like a stuffy nose, but that's kind of different this time, a little bit. 

assistant: OK, and in the past have you been uh diagnosed with any medical conditions?
user: I have fibromyalgia and uh I um also have schizophrenia. 

assistant: OK, and are you taking medications currently?
user: Uh yeah. Uhm, I take um quetiapine and uh I just I take Advil um when my uh joint pains are really bad. 

assistant: OK, and do you have a um somebody that follows you along for either uh fibromyalgia or or schizophrenia? 

user: Um my family doc. And then um yeah, it's pretty much just him. Um he, yeah. 

assistant: OK. And uh do you have any allergies to medications?
user: No. 

assistant: Alright and um are you aware if your immunizations are up to date? 

user: Um yeah. 

assistant: Alright, and could you tell me, alright then sorry actually, uh have you had any hospitalizations or uh previous surgeries?
user: Uhm well, I uh I've been hospitalized. I I was kept in the psych unit for a couple of days, um two years ago. But nothing other than that. 

assistant: OK. Um and it's been stable since then?
user: Yeah. 

assistant: OK, great. And I um I just wanted to ask a little bit about um your personal history. I was just wondering if you could talk a little bit about uh where you're living and and who you're living with.
user: Uh sure, so I'm living with my um I'm living with my husband and uh we live in an apartment. 

assistant: OK, and has he been sick or has anybody you've been around been sick?
user: Uhm, he was sick last week but he got better on his own. 

assistant: OK, and were were his symptoms similar to yours or or uh or were they different? 

user: Um they were kind of different, I would say. He just had a um he had a sore throat and uh that kind of lasted for three or four days, and then he just got better. 

assistant: OK, and um are you currently working or um?
user: Um I uh no, I'm a I'm a stay at home, I just stay at home, I don't work. 

assistant: OK, and so and have you traveled anywhere or any other uh potential exposures? 

user: Uh no. 

assistant: OK, um and do you smoke cigarettes?
user: I do. 

assistant: OK yeah, how much? 

user: Uh two or three a day. 

assistant: And and for how long or for, when did you start smoking? Sorry.
user: Uh so I've been uh smoking since I was uh 20 years old, so about 30 years ago was when I started. 

assistant: OK and and have you could, have you thought of, have you tried to quit before?
user: Uhm I did, but then I just didn't. Uh I just went back to it. Um but I'm trying to cut down. 

assistant: OK, uh it's good that you've been able to cut down, so congratulations on that. Um and do you drink alcohol? 

user: Uhm I I do. Uh, I'll drink um sometimes with my friends maybe uh once a month or once in two three months. Um but I haven't been going out with them since the pandemic started, so I haven't had much to drink. I haven't had anything to drink um since the past year. 

assistant: OK. Um I see. And uh have you had any um history of heart or lung conditions in the family?
user: Hi, yesterday I was grocery shopping and, yeah, just in the parking lot somebody bumped into my car and this morning I woke up and my neck is just really painful. It hurt yesterday a little bit, but I mean it was so mild I didn't think much of it. But today it's it's quite a bit worse. 

assistant: OK, so can you tell me how this accident happened? Were you sitting in the passenger seat and the driver? And was the impact from like behind at the back of your car or at the front?
user: It was at the back so I was the driver and was just going over a speed bump in the parking lot so slowed down quite a bit and the person behind me must not have, and they bumped into me. There's just some scratches on the bumper. They didn't hit too hard, but I, I guess maybe hard enough. 

assistant: OK, and did the neck pain start immediately after?
user: Uh no it's I, like not immediately, yeah, I think it started a bit later on and then worse a bit, a bit today. 

assistant: OK. Alright, and is there pain anywhere else on your body?
user: Uh really like my. No, just just really, my neck. 

assistant: OK. OK, and does anything feel broken? Do, are there bruises anywhere? Any obvious signs of trauma? 

user: No, I can’t, I didn't notice anything like that and I can move my neck around so I don't think any I don’t, I don't think anything is broken. Just hurts a lot. 

assistant: Alright, and is a pain constantly there or does it come and go?
user: It kind of comes and goes, it just it's worse with movement. If I just kinda sit still, I don't notice much pain, but if I'm betting my head forward or. Mostly backwards, so I'll get, I'll get pain. 

assistant: OK, and you said this happened yesterday, right?
user: Yeah yeah, this happened yesterday afternoon. 

assistant: OK. Um and does anything make this better? Like have you tried ice, say any topicals any positions that that helps with the pain? 

user: I did try some like Advil last night, but like when I when the pain was coming on and it must've helped me sleep I guess, but I haven't tried any ice or anything like that, just mostly I guess resting. 

assistant: OK so you said the pain is at the back of the neck does it radiate anywhere up into your head or down into your shoulders or lower or upper back?
user: Uhm. Maybe a little bit to the upper back, like when I like trap, trapezius, muscle area, or the traps like it if I push on those muscles around that area, I do get a little bit of tenderness. 

assistant: OK, OK, and if you were to describe the quality of this pain, would you say it's sharp, dull, achy, throbbing? Uhm, how would you describe it? 

user: I would say it's sharp. Yeah, especially if I do any movements like it'll be feels like I mean, it stabbed in the neck. 

assistant: OK, alright, and have you ever had it had pain like this in the past?
user: No, this is the first time. 

assistant: OK. And do you feel like it's getting worse, the pain since it started yesterday?
user: Yeah, it could be that at first I didn't even have any pain at all. Maybe it was just the adrenaline pumping or whatever, but now I can notice the pain. 

assistant: OK. OK, and 1 to 10, 10 being the worst pain you've ever felt how bad is this pain?
user: It would be. I would say probably a 6 or a 7. 

assistant: OK, OK and. Have you had any tingling or numbness? 

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

assistant: OK, any dizziness or fainting spells?
user: No. 

assistant: Any headaches?
user: Um I. No. 

assistant: No OK. And. Is this affecting your sleep at all? 

user: Oh no, I guess like last night it was a little bit more difficult because I was just I slept I just on my back so that I wasn't moving around as much, so that was a little bit awkward, but I was able to sleep though. 

assistant: OK, I know you said you have some pain with certain movements, but do you find it's hard to move your neck at all?
user: Oh, it feels a bit stiff, but like I'm able to move it. But yeah, I feel stiff. 

assistant: OK. Any issues with vision like is it blurry? 

user: No. 

assistant: No, how about ringing in your ears?
user: No. 

assistant: No, any sorry yes that, any issues concentrating on on tasks?
user: Um. Yeah, this morning I I guess it's been a little bit more difficult to focus on things, but maybe I was just worried like focusing on the pain in my neck. 

assistant: Yeah, for sure. Any fevers or chills?
user: No. 

assistant: Any changes in your weight? 

user: No, my weight it's been been the same. 

assistant: Any changes to your hearing?
user: No, that's been been normal. 

assistant: Smell or taste?
user: That's been normal. 

assistant: Um chest pain or heart palpitations?
user: No, nothing like that. 

assistant: OK. No cough, shortness or breath, shortness of breath or wheezing?
user: No, none of that. 

assistant: How about Issues with their bowel movements? 

user: No, I haven't had any diarrhea or any any any constipation nothing like that. 

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

assistant: Changes in your appetite?
user: Uh, no that my appetite's been good. 

assistant: OK how about changes in urine? 

user: No, I haven't had any any changes to or any urinary symptoms at all. 

assistant: OK, OK, that's good. And are you otherwise healthy? Do you have any longstanding medical conditions?
user: Uhm. No, I am otherwise healthy, I just I'd take birth control, and I am a multi vitamin but that's it. So no medical conditions. 

assistant: OK, alright that's good um. And have you had any hospitalizations or surgeries in the past?
user: Uhm, no, I haven’t. 

assistant: No OK. How about medications? Are you on any?
user: Just the the the birth control that I'm I'm taking. I've been taking that for about five years now. 

assistant: Five years OK, any side effects or any issues with that? 

user: No, it's been good day I, I've been really happy with it overall too. They help regulate my cycles. 

assistant: OK, OK, good. And then are you up to date with your immunizations?
user: I am yes, I'll get the flu shot every year. 

assistant: OK, that's good. Do you have any allergies? 

user: I do, yeah, but it's I think they're just all environmental, 'cause I'll typically get issues with seasonal changes and then then it goes away. 

assistant: Oh I see. OK, any family history of lung or heart conditions?
user: I think my dad has high blood pressure, and diabetes. Yeah, but no heart or or lung conditions. 

assistant: OK, how about a musculoskeletal issues? 

user: I think maybe osteoarthritis and my grandpa, grandparents, but. 

assistant: OK.
user: But yeah. 

assistant: How about an autoimmune conditions?
user: No, nothing like that. 

assistant: No? OK how about cancers.?
user: Uh, no cancers. 

assistant: OK. And then, do you smoke?
user: No, I don't. No I've never smoked before. 

assistant: OK, how about marijuana? Do you consume that in any form?
user: No, I don't. 

assistant: OK. And then do you drink alcohol? 

user: Every once in a while I'll have a glass of wine, but it's usually a social thing or or at Christmas. 

assistant: OK. Come have out in terms of sick Contacts. Have you had any recently?
user: I don't believe so. Um I've been going to work, I work as a bank teller, um but everybody at work hasn't been sick and we've been using masks and cleaning our hands and all of that sort of thing. 

assistant: OK, OK, that's good. And how about travel? Have you had any recently? 

user: No, I've been put at home, but looking forward to a vacation though. 

assistant: Yeah for sure. And then, where do you work and who do you live with and where do you live?
user: Yes, I I work at a bank. And I live with my husband and our time and our son, he’s, he's six. 

assistant: OK, OK. OK, um those are all the questions I have for history. We can move on to the physical exam part of this interview. Did you have any questions before we did that? 

user: Uh, no, no, that sounds good. 

assistant: OK so if you have someone there with you, or if you have a mirror, or if there's any way you can take a look at the back of your neck as well as the front of your neck um. Do you see any redness or swelling in that area?
user: No, I don’t. 

assistant: No, OK. Do you see any muscle atrophy? Any deformities or skin changes?
user: No, nothing like that. 

assistant: OK. And then when you kind of just with the back of your hand, place it on your neck in the front as well as the back, does it feel warm at all?
user: No. 

assistant: No OK. And then I'm gonna get you to palpate certain areas so we'll start with the chin. Does that hurt when you press down?
user: No. 

assistant: No OK, how about just where the thyroid would be?
user: No pain or yeah, no pain there. 

assistant: No pain there OK. How about to the sides, kind of where your. Sternocleidomastoid muscles are? 

user: Yeah, I think like a little bit of tenderness in the the front of the neck muscles there. 

assistant: OK and then how about when you move towards the back and then on your C spine, cervical spine just like at the very back of your neck?
user: Yeah, so there's there's no pain when I push on the like bones I can feel like so, actually on that that like C spine itself there's no pain, but like oh off to the side so on the muscles. To the sides or there's a bit of tenderness. 

assistant: OK, so kind of like where, so there's pain on their trapezius and deltoid muscles?
user: Uhm. Uh. Yeah, more trapezius not so not so much deltoid and then also, um, like the the perispinal muscles. 

assistant: OK, I see, alright. Uhm. OK, and then let's move on to some range of motion exam so I'm gonna get you to flex your neck. So look down at the ground all the way as much as you can. Does that hurt?
user: It does, yeah. 

assistant: It does but you're able to fully flex your neck. 

user: Yeah, I can touch my chin to my chest all almost uh but yeah, I'll get pain at the back of my neck when I do that and the front. 

assistant: And the front? OK. And then how about when you extend your head all the way back so that you're looking at the ceiling?
user: I’m able to do it still is a bit stiff and it's slow to get there, but again I I get pain at the back in the front of my neck when I'm doing this. 

assistant: OK, OK, how about when you flex your neck to the side so that your right ear is touching your right shoulder?
user: Um yeah, I get there's a little bit of a pain in the muscles on the left side when I'm doing that 

assistant: OK, and then how about when you do the opposite? Touch your left ear to your left shoulder so that you're laterally flexing your neck on the left side?
user: A little bit of pain there too, but I'm able to do it though. 

assistant: OK. So you're able to do all of these, it's just that you have some pain when you do that? 

user: Yeah, exactly, I could do all of the movements, but yeah, it's pain and stiffness. 

assistant: OK, OK. Those are all the questions that I had for you. Did you have any questions of your own?
user: Uh no, that I just was wondering if I if you think I I don’t, needed an X Ray or like you think that anything is broken. Kind of like concerned about today, because of this pain. 

assistant: Yeah. And for sure, um so right now it just to me it sounds like a whiplash injury and so kind of like low impact. But just to be certain, we can order an X Ray to rule out any fractures or dislocations. And in terms of like the management plan, for pain management you can rest, you can either apply heat or cold packs to your neck for 15 minutes every couple of hours or so. You can try some over the counter pain medications like Ibuprofen or Tylenol. And if it still doesn't get better, we can try like, we can try injections to the area to relieve some of that pain, but something else in conjunction we can try as physiotherapy and they'll basically help you with. Range of motion exercises and try to strengthen the muscles in that area and to improve your posture and normal movement. And that's kind of where we can start for now. And if it doesn't get any better, we can talk about alternative management plans, does that sound OK?
user: It does, yeah, that that makes sense. Thank you. 

assistant: OK, yeah, no worries.
user: Yeah, so I'm just coming in with my son. He's six years old and yeah, just over the last few days he's not been himself and he's been having this stomach ache. Uh, so it started around like I would say 3 days ago and then he's also having vomiting for the last two days, he's vomited in total six times over the last two days and then yesterday he also developed a fever as well. I managed to measure it and it was 38.3 degrees Celsius. 

assistant: OK, I see. So I just so that I understand the timeline, so he started to have abdominal pain about 3 days ago, started with having vomiting and diarrhea two days ago and you checked his temperature, he had a fever as of yesterday? 

user: Yeah. 

assistant: OK, and uh, was there anything that that he ate that was different over over these last few days?
user: No, we've been strictly home food during like a pandemic like no, no real changes. 

assistant: OK, and what's his kind of behavior been like over these last couple of days? 

user: Yeah, so at first with the stomach pain he was a bit just irritable and just not himself, but especially yesterday with the fever just been very quiet and just kind of sleeping pretty much the whole day. 

assistant: OK, I see and uh, could you describe the vomit?
user: Yes, so vomit like, it started two days ago. The first day it was just like he puked up the things that he had eaten, but yesterday it was it was mainly just like uh just yellowish material, I couldn't really tell if it was food or not. 

assistant: OK, have you noticed any bile or blood in the vomit? 

user: Uh no I didn't notice any blood and I didn't notice any green material. It was mainly just like like normal vomit, like yellowish color. 

assistant: OK, I see and, has the what was the vomiting triggered by anything that you're aware of, like eating or drinking?
user: Uhm? Yeah, two days ago it was it was after after lunch when he first vomited. But after that it's just been kind of random. 

assistant: I see OK, and, uh, and with regards to his diarrhea, has there been any any blood or or any color changes? 

user: No, no, I didn't notice any blood at all. It's definitely just very very watery and he's had to go probably even just in the last day, probably around like six or seven times. 

assistant: OK, um, and he's vomited how many times?
user: So in total I can count 6 times. 

assistant: OK, and, has he been complaining of any headaches at all?
user: No, not that I know. 

assistant: No. OK, and how about any ear pain or or eye pain?
user: No, not that he's mentioned to me. 

assistant: OK, and any eye redness? 

user: Nope. 

assistant: OK, and as he had a runny nose?
user: No, not really. 

assistant: OK and has he had a sore throat or any pain with swallowing? 

user: No. 

assistant: OK, have you had any loss of taste or loss of smell?
user: Uh no, not that he has mentioned to me now. 

assistant: OK, and has he had a cough?
user: Uh, no, not really. 

assistant: OK, and how about any shortness of breath or wheezing? 

user: No. 

assistant: OK, and has he had any any pain anywhere? Any chest pain?
user: Um, he did, he did point to his stomach like it seems like he was having with all the vomiting like, he was having some stomach pain as well. 

assistant: OK, is there any specific location that that he's feeling the pain?
user: Well, it's hard to say. He was just pointing at the center of his belly like, I don't know if it's like, I tried pressing on it and he didn't feel any pain then, but I think it's just kind of all over his stomach. 

assistant: OK, and has he had any urinary problems like painful voiding or been peeing more often?
user: No, that's been OK. 

assistant: Have you noticed any rashes or skin changes? 

user: Uh, no, not not really, no. 

assistant: OK. And has he had any muscle aches or uh, or joint pains that that he's mentioned?
user: No, no he hasn't mentioned anything like that. 

assistant: OK, and he's had a fever, has he had the chills?
user: Yeah, so that's that's what I, that prompted me to take his temperature yesterday around the afternoon, like we had to wrap him up with like more than two blankets and he was still feeling cold so, yeah, definitely was having chills. 

assistant: OK, and and has there been any concerns with his growth, either weight or or height? 

user: So he's been going along the charts pretty well, like no concerns during his growth. Otherwise, he's a very healthy child. 

assistant: OK, so no medical diagnosis previously?
user: No nothing like that. 

assistant: OK, and uh, yeah, is he meeting all developmental milestones OK? Like gross motor, fine motor, doing well at school? 

user: Yeah yeah, he didn't have any issues with walking, running, he's pretty social with all his peers. He's doing well at school, no complaints. 

assistant: OK, excellent and you know, no medical conditions, but has there been any reasons for being in the hospital before?
user: No, not at all. We, yeah, we haven't really gone to the doctor with him after like all those vaccinations that he had to do, so he's been good. 

assistant: OK, great, so immunizations are up to date?
user: Yeah, immunizations all up to date. 

assistant: Excellent and does he have any allergies? 

user: Uh, no, uh, not not anything that we know of yet. 

assistant: OK, and I just wanted to ask about his birth history. Were there any complications throughout throughout pregnancy, either mom being sick or having any any issues herself?
user: No, so it was a normal vaginal delivery, uh no issues, uh he was born at 39 weeks, didn't need to stay in the hospital at all. Yeah, it was a pretty smooth pregnancy compared to some of the other ones. 

assistant: OK, oh, that's that's great. Do you remember the Apgar score or his birth weight? 

user: Uhm, I don't exactly remember his Apgar scores, I think they were like just just they they were normal like there was nothing concerning about them, and birth weight I think he was probably around 3 kilograms. 

assistant: OK, great so, yeah healthy birth weight at term it sounds like. And so, healthy, does he take any medications regularly?
user: No, no medications. 

assistant: OK, and could you tell me about who is living with currently and then who's looking after him?
user: Yeah, so he's living with myself, his mother and, and then my husband, and he has two older siblings. One is a boy, seven years old, and another one like a 10 year old girl. 

assistant: OK, and has anybody in the house been sick?
user: Uh no, no one has been sick recently, however he does, they did let them go back into school at one point, so I don't know, I don't know, so that was just last week, so I don't know if he caught something from school. 

assistant: OK, but nobody that you know that's had similar symptoms?
user: No. 

assistant: OK, and have you traveled anywhere?
user: No, we've been, we've been at home. 

assistant: OK, uh, and then you know recent changes to anything in the diet you've mentioned?
user: No, that's been fine. 

assistant: OK, and any concerns for safety in the home, whether physical or or verbal abuse? 

user: No, no concerns like that. 

assistant: OK, yeah a question that we have to ask everybody and is there any smoking in the home?
user: No, no, we don't smoke. 

assistant: OK, great then, are there any pets?
user: Nope, no pets. 

assistant: Alright, and uh and in the family, has there been anybody who's had any heart problems or any lung problems?
user: Uh, we are getting the 10 year old tested for just uh, asthma. 

assistant: OK. 

user: But nothing diagnosed yet, no. 

assistant: OK, anybody in the family have any congenital diseases or any genetic diseases?
user: No, not that I know of. 

assistant: OK, uh, anybody in the family have celiac disease or Crohn's disease? 

user: No, no, uh no history of any kind of bowel diseases. 

assistant: OK, so I think that's, uh, everything I want I wanted to ask about today. Uh, was there anything that maybe I I forgot to ask or or that I missed that you wanted to tell me?
user: Uh, yeah, no it's, it's also just like I was just reading up like, can it be like I don't know if it can be COVID as well, if it can, it can do this as well? 

assistant: It is possible. Uh, it's uh, especially with nonspecific symptoms, COVID can cause a variety of different presentations, and there for some people it can be more gastrointestinal issues like like your son has with vomiting and diarrhea and belly pain. But it also could be well, uh, another type of gastrointestinal virus itself or or a viral illness like the common cold, which can also end up causing symptoms like this as well. So we will, I will go ahead and do a COVID test today, along with some other blood work. And maybe increase the hydration as well, because it sounds like he has lost a lot of fluid over these last couple of days. So we will check electrolytes and go from there on the test results.
user: Hi, yes I just came in today because I've been a bit concerned about some breathing difficulties over the last few days. It all started out with like a cough over the last week, but now I'm having trouble breathing as well. 

assistant: Oh OK, well I'm sorry to hear that. So you said a cough as well, so the cough at least a week back and the shortness of breath or difficulty breathing, when did that start?
user: So yeah, the cough, I usually have a cough. I've had COPD for a long time, but this past week the coughing has been much worse with a lot of more sputum and. Other than that, it started I would say two to three days ago. The cough got worse and then every time I'm moving around I like have to sit down and catch my breath, which is pretty abnormal for me. 

assistant: OK yeah, so alright. So let's focus on the cough first. You said it's a wet cough?
user: Yes, I am producing a lot of sputum. 

assistant: OK, what color is your sputum? 

user: It's mainly like clear white. 

assistant: OK yeah so you don't see yellow pus or anything green or bloody in there?
user: No, I don't think so. But there's definitely like a lot more than what I usually produce. 

assistant: OK, umm this cough, does it sound harsh, barky or does it sound muffled? 

user: I would say it's a bit harsh at times. I wouldn't say it's barky or muffled. I do find myself wheezing a little over the last few days as well. 

assistant: OK. Do you find you have any chest pain associated with the shortness of breath?
user: Oh no, I don't really have any pains. 

assistant: OK, and have you ever experienced anything like this before? 

user: I did a couple of years ago, I had to be admitted because I had some shortness of breath. 

assistant: OK.
user: But that was, I think, two years ago. 

assistant: OK. And when you were admitted two years ago, did they tell you what you had?
user: Yeah, they said I had some kind of lung infection at that time, so they gave me some antibiotics while I was in the hospital. 

assistant: OK, did they ever say to you that you had anything else like asthma, COPD, any longstanding conditions? 

user: Yeah so I've had COPD for more than... I guess more than 10 years now so I think it just got a lot worse with the infection. 

assistant: OK yeah alright. So this time around, have you had any fevers?
user: I've been having a couple of chills but like they would come and go. I didn't really think it was a fever. 

assistant: OK, any weight loss? 

user: No. 

assistant: OK, how about changes in your hair or nails like or or skin like rashes?
user: Umm, no. 

assistant: Any changes in your vision or hearing?
user: Nope. 

assistant: And how about smell or taste?
user: Umm, no. I think they're the same. 

assistant: OK. Have a stuffy nose or runny nose?
user: I do feel a bit stuffy, but it's not too bad. 

assistant: OK. And any swelling in your in your legs or upper limbs?
user: No, not that I know. 

assistant: How about calf pain?
user: Nope. 

assistant: Dizziness or fainting spells? 

user: No. 

assistant: Headaches?
user: No headaches. 

assistant: Memory loss or confusion? 

user: Nope. 

assistant: Changes in your bowel movement or abdominal pain?
user: Nope. 

assistant: Changes to urinating?
user: No, that's all fine 

assistant: OK, so besides the COPD, do you have any other longstanding conditions? 

user: I do have some high blood pressure which I take, I think I take one of these medications called metoprolol. 

assistant: OK, and when was the last time you had your blood pressure checked?
user: Umm, probably like a month ago and it was pretty good. I've been checking by myself at home too and it hasn't been changing too much. I think the last one I took was probably like 135 / 80. 

assistant: Oh, I see. OK, any hospitalizations besides the one that you had for COPD a year back?
user: Umm, back when I was a kid I had my tonsils removed. 

assistant: OK, are you on any medications besides the metoprolol? 

user: I do take multivitamins.I think that's yeah, that's about it. 

assistant: Do you take any puffers for your COPD?
user: Yeah, so I do have three like different puffers I take. I can't remember the name. I do have some puffers I don't take. I've been using them right now. It has been helping with some of my shortness of breath, but I've definitely been having to use them way more than I used to. 

assistant: OK. Do you know which puffer you're on?
user: Yeah, so I think one of them is called ventolin. OK, and then I think the second one is called the Spiriva. 

assistant: OK, sure, Yep. 

user: So one of them should be a short acting beta agonist. 

assistant: Just wanna make sure that you have one with a long acting and then the other one is a long acting beta agonist. OK, good. Alright, are you up to date with all your immunizations?
user: Yeah, I think so. 

assistant: And are you allergic to anything? 

user: No, not that I know. 

assistant: Any family history of lung conditions?
user: Umm, no I don't think so. Yeah, no, I don't think so. 

assistant: OK. How about heart conditions? 

user: Yeah, my father died of a heart attack in his 60s. 

assistant: OK. Alright, any cancers?
user: My uncle had skin cancer. 

assistant: OK. Do you know what type of skin cancer like melanoma, basal cell, squamous cell?
user: No, I think it wasn't the bad one. It was like the one they can remove right away. 

assistant: Oh I see. OK, OK, that's good.Do you smoke?
user: Yeah, I've been smoking for around, I would say the last 20 years. 

assistant: OK, how much do you smoke?
user: Probably I would say pack a day for the last 20 years. 

assistant: Umm, have you ever thought about quitting? 

user: Yeah I did. I did once and then went back onto it. I definitely do smoke less than before though. OK, but yeah, I don't think I'm ready to quit yet. 

assistant: OK, yeah no problem. Do you drink alcohol?
user: Umm, yeah, maybe once a week I would have a small Cup of whiskey. 

assistant: OK, sure, that's fine. And any other drugs?
user: No, no marijuana, no other drugs. 

assistant: OK, and where do you live right now? 

user: Right now I live in a small bungalow in London. 

assistant: OK, any reasons to believe there are carpets, dust, mold, asbestos, anything that could be triggering your COPD?
user: Umm, I don't think so. Everything is pretty up to date. 

assistant: OK, have you had any contact with anyone that's been sick recently? 

user: No, I've been mostly trying to isolate and like just be in my own home. 

assistant: OK, how about travel to anywhere?
user: Nope, I've been in Ontario since the beginning of the pandemic. 

assistant: Yeah OK, that makes sense. Well, those were all the questions that I had for you today. Did you have any questions of your own?
user: Yeah, I was just worried if it can be COVID or if it's just like another infection that I had like before. 

assistant: Yeah, so we're definitely going to do a COVID swab on you and those results should take about 24 to 48 hours to come back to you. And in the meantime, because your symptoms do overlap with COVID, you should isolate for 14 days. Public health will be in touch with you if it's positive to do some contact tracing. If it's not COVID, it could be another viral infection that's been going around during this time of year which is likely because you have COPD, since you're already coughing more than you usually are and seeing more sputum. We will reassess to see whether your puffers are working. If we need to add any additional things like inhaled corticosteroids as well as antibiotics and so just keep an eye on your symptoms for now and will also want to do probably a chest X Ray and possibly a pulmonary function test. How does that sound?
user: Yeah, so I have like a really sore throat, started last night. 

assistant: Oh I'm sorry, uh. Can you, can you tell me a little bit more about that? So you, um, you've only had this sore throat for one night?
user: Yeah, I just I think it's getting worse. It's at the back of my throat and it's kind of burning. 

assistant: Mmm, OK. Do you have um, do you have any other symptoms? 

user: Um, like I think my voice is kind of like raspy. I feel like I might be losing my voice. 

assistant: OK, do you, do you have a runny nose?
user: No, not that I've noticed. I said it hurts when I swallow, right. I don't have a runny nose. 

assistant: No, OK. And do you have any pain in your ears?
user: Uh. I haven't noticed no. 

assistant: Any any sinus headaches, any sort of pain in and around your cheeks or pain in your forehead as you're trying to bend over?
user: Uh, no. No headache. 

assistant: Nothing like that, OK. Have you had any pain in your chest?
user: No. 

assistant: Any difficulties breathing? 

user: No. 

assistant: OK um. Any cough?
user: No. 

assistant: Alright, so all you've experienced so far is since yesterday evening you've had a sore throat with difficulty swallowing, and hoarse voice. Have you experienced any malaise, or do you feel feverish? Or do you have any chills? 

user: I definitely feel like really tired. I think I had. I think I had chills like yesterday. And I think when I first got here, they took my temperature and said it was like it was like pretty high. The nurse when I first got here. 

assistant: I see I see, um. Have you, um. I'm just going to ask you about a couple other symptoms. Just um. Just to rule out some causes. Um, have you had any difficulties breathing?
user: No, no, that's OK. 

assistant: OK, um, you have been, have you had any muscle aches or pains? 

user: No, not not that. 

assistant: OK, have you noticed that your eyes have been more runny, more red? Anything like that?
user: No. No, nothing in my eyes. 

assistant: OK, any pain in your belly? 

user: Uh, it's like my whole belly's been like a little like sore or but it's it's pretty much like mild. 

assistant: When did that start?
user: Yeah, just like this morning I don't know. I haven't been eating a lot 'cause it just hurts to eat. I don't know if I'm just hungry. Like I've just been eating like ice cream 'cause it feels nice. 

assistant: Yeah.
user: But I probably shouldn't just eat ice cream. 

assistant: Ahaha. Um have you have you had any changes in your bowel movements? Any diarrhea, any constipation? 

user: Uh, no. 

assistant: Alright alright, any nausea or vomiting?
user: Uh, no vomiting. I feel like my throat. It just feels so like swollen but when I'm trying to talk with makes me feel a little bit nauseated. 

assistant: Your throat feels swollen, have you have you noticed any changes in, have you found that it's difficult for you to talk? Is your speech slurred? 

user: Uh, no, it's not slurred. It's just like sore because it's kind of like when I'm swallowing. You know. 

assistant: Have you noticed any changes in your sense of smell? Do you feel like you can smell less?
user: I think that's pretty normal. 

assistant: OK, what about taste? I know that you're not eating much 'cause you can't swallow, but do you feel like you can taste, your sense of taste is decreased? 

user: Uh, uh, no. I think that's good. Yeah, yeah, I think, I mean mostly eating like really cold stuff, but I can taste it all. 

assistant: Alright alright, um has it ever happened to you before?
user: Uh, no. Like I I had a cold like 2 weeks ago, but it wasn't like this though. That was more like runny nose and stuff. 

assistant: I see. Um, have you done anything recently? Have you had contact with um with anyone who is sick? 

user: Uh, my my girlfriend said that she was kind of, that her throat was feeling a little sore. I don't think it was as bad as as this but yeah, she said that. 

assistant: Have you, um, have you been spending time with her recently?
user: I haven't. I haven't seen her in a few days, but yeah, like I saw her I saw her really a few days ago. 

assistant: OK, OK Um, have you traveled anywhere? 

user: No. 

assistant: OK.
user: No, I wish. 

assistant: Do you feel like you've had any contact with anyone with who might have COVID?
user: Oh, I don't. I don't think so. Mostly just to my girlfriend and my roommate right now. 

assistant: Yeah yea, And do do you, do you know if they've been recently tested or if they might have had contact with anyone? Um, who maybe... 

user: Um, I dont think so. 

assistant: OK.
user: They're. They're pretty like they're pretty they just have online classes and they only really like leaves to get groceries and like go exercise outside. 

assistant: I see, OK, alright, um. Alright, I'm just going to ask you a couple of questions about your past medical history. Do you have any medical conditions? 

user: Oh no, no, I'm like pretty healthy. Alright, alright 

assistant: Nothing like asthma or COPD or any respiratory problems?
user: No, no. 

assistant: No, and. Are you taking any medications, including any over the counter medications or herbal medications? 

user: Um no. 

assistant: Alright um, do you have any allergies, including environmental allergies?
user: Oh, again, a little bit of a runny nose, like in the spring, but that's it. 

assistant: OK um. Alright, and do you smoke?
user: Uh, no. 

assistant: No, Ok. Do you consume alcohol? 

user: I drink like a couple beers on the weekends, but. Like I I yeah I play sports a lot and I don't like a lot of time on the weekends so I don't go out. 

assistant: OK, alright do you consume any other drugs?
user: No, no. 

assistant: No, OK. And you mentioned that you live with your roommate and you haven't had contact with anybody other than your roommate and your girlfriend. OK um. Have you...
user: So I've had this stuffy nose for the past three days. I'm getting some yellow discharge from the nose. I can't seem to smell well. And I have had this terrible headache for the past two days as well. 

assistant: OK, so just to kind of get a timeline, what kind of started first? 

user: So first, my nose was kind of stuffy. And and then I started having this yellow discharge from the nose and then I kind of lost some of my smell. And then now my head hurts. It's not even like, it's not like a headache, it's like a facial pressure 

assistant: OK. And have you had any of these symptoms before?
user: No, never. 

assistant: OK. Alright, have you noticed...so you said like the discharge is yellow, how much of the discharge are you having like in a day?
user: Like probably enough to fill the inside of my palm. 

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

user: Uh, no,  nothing like that. I did have what they thought was a viral infection a week back. 

assistant: OK. And did you recover from it, like on your own?
user: Yeah, it went away on its own. 

assistant: OK, so it was just, you just had some cold-like symptoms? 

user: Yeah, that's right. 

assistant: OK, alright, have you been coughing at all?
user: Uh, no. 

assistant: OK, any sore throat? 

user: No. 

assistant: Any trouble breathing?
user: No. 

assistant: Any loss of sense of taste or smell? 

user: I guess loss of smell. 

assistant: OK, and did that come after the congestion or was it present before?
user: The loss of smell came after the congestion. 

assistant: OK, and would you say you're still pretty congested? 

user: I think so, yeah. 

assistant: OK. And has it been getting worse would you say? Or do you feel that it's getting better?