jshargo/medical-interview-conversations2 huggingface dataset:
user: Yeah, I sometimes I I do have coughing fits at night that wake me up. I do have disrupted sleep over the last few months. 

assistant: OK. Um and, you mentioned some joint pains as well and then when did that those start?
user: I would say over the last year is when I started noticing it a lot more than before. 

assistant: OK, have you been having joint stiffness or or muscle stiffness early in the morning?
user: It does get a little bit more stiff in the morning, but it's kind of just there throughout the day. 

assistant: OK, have you noticed any red hot or or kind of swollen joints?
user: No, nothing like that. 

assistant: OK, any injuries to any of your limbs or or joints that could explain some of the pains there? 

user: No, not that I know of, nope. 

assistant: OK, um, and how has your energy been? Have you been experiencing a lot of fatigue?
user: Yeah, I definitely have been more tired. I can't really even go outside for a walk sometimes or I get really tired working in the garden. So it's been tough. 

assistant: OK, and when did that when did you notice that change and and how were you different before?
user: Like before, like before six months ago, I remember I used to be able to go for long walks around the block, then when I was gardening I can go on for hours, but now I'm pretty it's pretty limited to like maybe 15-20 minutes and then I have to go back into the house. 

assistant: I see OK, so pretty big difference over the last six months to a year for you. 

user: Yeah. 

assistant: Have you been experiencing any fevers or chills?
user: Not really. Not that I know of. 

assistant: OK, how about, uh, excessive sweating at night? 

user: Nope. 

assistant: Alright and, how has your appetite been?
user: My appetite has been around the same, no changes there. 

assistant: OK, have you experienced any weight loss?
user: I've actually, I think, lost a couple pounds but not not too much. 

assistant: OK, would that be over the last six months or so? 

user: Yeah, around the last I would say three to four months. 

assistant: OK, uh, have you noticed any swollen glands anywhere like in your neck or anything like that you might feel like a lump?
user: No, not really. 

assistant: OK, have you had a sore throat or or runny nose? 

user: No, I haven't had a cold for more than two or three years I think. 

assistant: OK, about a loss of smell?
user: No. 

assistant: Loss of taste? 

user: No. 

assistant: Alright, have you been experiencing any chest pains?
user: When the coughing gets pretty bad like I get some strain in my chest but nothing other than that. 

assistant: Alright, and any heart racing?
user: Nope. 

assistant: Alright, and how about wheezing?
user: No, not really. 

assistant: OK, and have you noticed any swelling in your limbs, like in your hands and your feet or ankles?
user: No, not really. 

assistant: Alright at night, have you had any periods where you woke up extremely short of breath and you had to sit on the edge of the bed with your feet over? 

user: No, not that I remember. 

assistant: OK, and how many pillows do you sleep with?
user: Just one, same as before. 

assistant: OK, um and any abdominal pain? 

user: No, no pain is just in my joints and sometimes in my muscles, but other than that, no. 

assistant: OK, any urinary problems like pain or or going really often?
user: Nope. 

assistant: Alright and then any changes to bowel habits like diarrhea or constipation? 

user: No, not that I know of. 

assistant: OK, and have you noticed any skin rashes?
user: Uh, nope. 

assistant: OK, and, uh, are there any joints in particular that are most affected? 

user: I would say like my legs and arms. It's it's pretty much  lot of the joints, not really affecting my hip, but like everything else seems a bit sore. 

assistant: OK, and, have you been diagnosed with any medical conditions in the past?
user: No, never. I've been pretty fortunate. 

assistant: OK, so do you take any medications either prescription or over the counter?
user: No, just vitamins but nothing else. 

assistant: Alright, do you have any allergies? 

user: No, not that I know of. 

assistant: Have you been so you said you've been pretty healthy, but have you been in the hospital for any reason recently?
user: No. 

assistant: OK. Um and are your immunizations up to date?
user: Yeah, I I got a shingles vaccine, the one for pneumonia as well. 

assistant: OK, and have you traveled anywhere recently? 

user: No I've been at home. 

assistant: OK um and in the family, have you heard of anything like this happening in the family sort of way, onset of this kind of shortness of breath and cough that you've been experiencing?
user: Not really, I I don't really have shortness of breath like it's it's like a dry cough. Sometimes I do find myself breathing more shallow. Yeah, mostly it's just a dry cough that's been going on. 

assistant: OK, and more of the fatigue. 

user: Yeah. 

assistant: OK. And anybody in the family have like autoimmune diseases like rheumatoid arthritis or or lupus?
user: Uh I don't really, I can't really think of nothing my mom and dad were completely healthy. So I know and I don't have any siblings, so yeah, not nothing that I know of. 

assistant: OK, uh, any cancers in the family like colon cancer or anything like that?
user: No, no cancers. 

assistant: OK. Um, and could you tell me a little bit about your living situation?
user: Yeah, so right now I live alone in a small townhouse and yeah, that's I have a pet dog, but that's that's about it. 

assistant: OK, um, and how do you support yourself financially?
user: So, I'm retired, but getting a pretty good pension as well as for my a husband's pension as well, but he unfortunately passed away a couple years ago. 

assistant: I'm sorry to hear that. What did you say you retired, what did you do for work previously? Did you have any exposures to chemicals or asbestos products while while at work? 

user: Not that I remember, no it was it was a pretty, pretty much like a desk job I would say. 

assistant: OK um, so no reasons that you were visiting farms and like being around birds or anything like that?
user: Um, not really, but I I do think like the old building that we lived in might have had asbestos. Does that does that like count at all? 

assistant: Like a it could be important, uh, because, uh, well how long, how long did you live there for? 

user: I would say almost 20 years. 

assistant: OK, so um, yes, that definitely would be is is important for the history today because, unfortunately, long term exposure to asbestos when breathing it in can cause some of the symptoms that you've been describing along with cough and uh, respiratory symptoms. So it'll be something that we'll be sure to investigate today, OK? But I just had a couple more questions. First, do you smoke cigarettes?
user: I quit long time ago, more than like 10 years ago, but I used to smoke like 5 to 10 cigarettes for around 20 years. 

assistant: OK, and do you smoke cannabis? 

user: No. 

assistant: Alright, do you drink alcohol?
user: No, not anymore. 

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

assistant: Alright, and are you currently sexually active?
user: No. 

assistant: Alright, and have you had a sexually transmitted infection before?
user: No. 

assistant: OK, so those are the questions that I wanted to go over to make sure I asked on history. Was there anything that else you wanted to tell me? 

user: No, I think that's all. 

assistant: OK, so next we'll do your physical exam and order some investigations. But currently thinking that it could be related to asbestos exposure as well as um, something called, well, it could cause pulmonary fibrosis and then also the joint pains that you've been experiencing might be another symptom that is suggestive of a connective tissue disease, and it doesn't sound like you have a family history of those, but we will do some lab work and investigations for for those including a chest X-Ray and a chest CT.
user: Sure, my 5 year old daughter, I noticed that she's been coughing a lot over the past two days. She sounds like she has a stuffy nose and now she's got this pink eye so I just wanted to get it checked out by you. 

assistant: Yeah, for sure. So the cough started 5 days ago?
user: Two days ago. 

assistant: OK and is the cough barky or harsh sounding?
user: Yes, it sounds harsh. 

assistant: OK, alright was there anything that changed two days ago that might have triggered the cough? 

user: I don't think so, although she does go to daycare. 

assistant: OK, uh and so has she been bringing up any sputum with the cough?
user: No, no sputum that I've noticed. 

assistant: OK, notice any blood? 

user: No. 

assistant: Alright, and is the cough worse at any particular time of day?
user: No. 

assistant: OK, and has there been any wheezing?
user: No, not that I noticed. 

assistant: OK. And you mentioned the red eyes. When did you notice that? 

user: That was just yesterday. 

assistant: OK, any discharge from the eyes?
user: No. 

assistant: OK, nothing like that? No tearing or anything like that?
user: No. 

assistant: OK. Umm and has she complained about any like changes to vision?  P No, not really, just the pain.  No. OK, uh, and how about any itchiness in the eyes? 

user: She's been rubbing it and so it's possibly itchy. 

assistant: OK. And have you noticed any mucus coming out?
user: Umm, no, it's actually stuffy. 

assistant: OK 

user: Yeah, not so much mucous. 

assistant: OK, has she mentioned anything about losing smell?
user: No. 

assistant: OK, umm and has she mentioned anything about being congested? 

user: She just sounds like she's congested. 

assistant: OK. Umm any sore throat?
user: Umm, possibly. 

assistant: OK, how has she been eating?
user: Um, she's been eating OK. I guess she's been eating alittle less than usual. 

assistant: OK umm, would you say that she's been going to the bathroom as often as normal?
user: Yep, I would say so. 

assistant: No changes there, OK. Um and has she had any loss of taste?
user: Umm, possibly since she's not eating as much. 

assistant: OK. Any fevers or chills? 

user: Um, she did feel a little bit hot, but I didn't take her temperature. 

assistant: OK, so hot. We will definitely check for fever today. Any night sweats?
user: Umm, no. 

assistant: OK. And has she been gaining weight OK?
user: Yep, Yep, no change, nothing abnormal there. 

assistant: OK, and has she been complaining about having any stomach pains?
user: Umm, no. 

assistant: OK, has she had any nausea or vomiting? 

user: Um no no. 

assistant: OK, and how about any painful urination?
user: No. 

assistant: OK, and any diarrhea?\ 

user: Umm, no. 

assistant: OK, and has she mentioned anything about headaches?
user: No. 

assistant: OK. And how about any aches or pains anywhere?
user: Uh, no, I don't think so. 

assistant: Have you noticed any rashes? 

user: No. 

assistant: OK, and has she been diagnosed with any conditions before?
user: No. 

assistant: OK. And any reason for her to be hospitalized?
user: Uh, no. 

assistant: OK, um does she take any medications regularly? 

user: Um, no. 

assistant: OK, does she have any allergies to medications?
user: Umm, no. 

assistant: Alright, any surgeries before? 

user: Umm, no. 

assistant: Any concerns with her growth or development?
user: Umm, no, everything's been pretty normal. 

assistant: OK, and any concerns about her vision or hearing? 

user: No. 

assistant: OK. And can tell you tell me a little bit about the living situation currently? Are you the primary caregiver?
user: I am. 

assistant: OK, and who else is in the home? 

user: Her father. 

assistant: OK, are there any pets around?
user: No. 

assistant: Alright. And does anybody in the house smoke?
user: No, no one smokes. 

assistant: OK, any exposures in the house to like carpets or dust or inhalants that might bring on a cough? 

user: No. 

assistant: OK. Ummm and uhh anybody in the family been sick?
user: No. 

assistant: OK, and how about anybody you mentioned at the daycare? Was anybody been sick there?
user: No, I don't think so. I contacted them and checked, but it seems like no one's been sick. 

assistant: OK, and you say you haven't traveled anywhere?
user: Oh no, no, not recently. 

assistant: OK. And any lung conditions or heart conditions that run in the family?
user: No. 

assistant: OK, and how about any genetic conditions or congenital conditions in the family?
user: No, none, none that I know of. 

assistant: OK, so the main symptoms are the cough that started two days ago and also you've noticed she's been congested. And sorry, what was the last symptom? 

user: She has this pink eye and she has a cough. 

assistant: Yeah, right, that could be conjunctivitis. OK, so at this point we will certainly run some investigations to look into what this could be. It sounds like a viral infectious type of process, especially if it's involving the eyes, nose, and and with a cough. And so we will test with a swab for covid for sure. But it could be something more common, like the common cold. We just need to make sure that we're comprehensive in that with the testing.
user: Yeah, so nice to meet you. I've been having this pain right in my abdomen. It's kind of like in the upper right area. 

assistant: OK, and so uh, when, where is this painting located exactly?
user: So it's just in the upper right corner of my abdomen, right below where the lungs are, and it, yeah, it's just I have this severe pain that's going on. 

assistant: OK, and how long is it been going on for?
user: So it's been going on for the last few days and it got worse today. 

assistant: OK, and how long is it been since it's like got got worse, has this been a few hours or or how long is that been? 

user: So I would say it got worse, just three or four hours ago before I came to the Emergency Department. 

assistant: OK, and does the pain radiate anywhere?
user: Uh no, it stays right in the in the spot that I told you right in the right upper corner. 

assistant: OK, and when did the pain start? Or if you could tell me what were you doing right prior to the pain starting?
user: So I think it started after just three days ago after I had a meal like I I think it was after lunch around half an hour or an hour after lunch. 

assistant: I see OK, has the pain gotten worse, stayed the same, or gotten better since since yesterday? 

user: I think it's gotten, it was, it's the worst today, like especially like a few hours ago like 3 hours ago, it was much worse than the other two days. 

assistant: OK, and how would you describe the character or the quality of the pain?
user: So it's like a sharp, I would describe it as like a sharp pain. 

assistant: OK, and on a scale of 1 to 10, 10 being the most severe pain, what would you rate it as?
user: I would rate it as, right now I would rate it as an 8. 

assistant: OK, and has anything like this happened to you before?
user: I think it happened to me a few years back, where I had this pain and then it just kind of went away on its own. I didn't go to the Emergency Department then though. 

assistant: OK, and has there been anything that you've tried to make this pain any better? 

user: I tried taking just like Advil and Tylenol, but it didn't really seem to help the pain too much. 

assistant: OK, and have you had any other associated symptoms such as nausea or or vomiting?
user: I've I've had some nausea over the past few days, but I haven't vomited anything. 

assistant: OK, so no blood in your emesis uh or no vomiting at all? 

user: Uh, yeah. 

assistant: OK, and have you traveled anywhere recently?
user: Uh no like we haven't traveled anywhere recently. 

assistant: OK, and, how has your energy levels been? 

user: Uh, energy uh when it's hurting a lot like today I've been it's been difficult to move around, I've been pretty drained from the pain but uh otherwise over the last few days it hasn't affected me too much, but today I would say my energy levels are down. 

assistant: OK, and have you noticed any skin changes or any rashes?
user: I don't think so. I mean, I don't think I've noticed any kind of skin changes. 

assistant: OK, and how about any changes to urinary habits like painful urination or the color of your urine? 

user: No no, no changes. 

assistant: OK, and have you had any changes to bowel patterns such as diarrhea or changes in color of your stool?
user: No, I don't think so. No changes that I've noticed. 

assistant: OK, so  notice any blood in the stool? 

user: No, no blood. 

assistant: OK, and how has your appetite been?
user: It's it was around the same before the pain actually started getting worse, so today I didn't really feel like eating. I did have nausea over the past few days, but my appetite I would say is the worst today. 

assistant: OK, and have you noticed any changes to your weight recently?
user: No, no, I don't think so. 

assistant: OK, and have you had any recent infections?
user: No, not not that I know of. 

assistant: OK, so next just to ask some questions about your past medical history, have you been diagnosed with any medical conditions in the past?
user: Uh so, I think the only thing is my doctor told me that I should lose some weight, but other than that no medical history. 

assistant: OK, and any allergies to medications? 

user: Uh no, no allergies. 

assistant: And are there any medications that you take on a regular basis, either prescribed or over the counter?
user: Uh not prescribed, sometimes I take like some antacids when I get heartburn. But this is just like a couple times a month after dinner, sometimes at night, but that's about it. 

assistant: OK, and, uh, any, um, hospitalizations? 

user: Just for just when I had my children, at the time of their birth, but that's it. 

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

assistant: OK, and have you had any prior surgeries?
user: Nope, no prior surgeries. 

assistant: OK, and any family history of gallbladder disease or cardiovascular disease in the family? 

user: Um, so my father died of a stroke when he was in his 60s, my mother does have gallstones. 

assistant: OK, and what do you do for work?
user: So I work in at the bank as a consultant. 

assistant: OK, and do you drink alcohol? 

user: Uh, yeah sometimes, maybe one or two glasses of wine every night. 

assistant: OK, and do you feel the need to cut down on your drinking?
user: No, not really. 

assistant: OK, have you ever felt annoyed by people criticizing your drinking? 

user: Uh No. 

assistant: OK, have you felt guilty about your drinking?
user: Uh no, so should I be? 

assistant: Uhm no, at the at this time, just wanting to gauge a sense of how you feel about your drinking levels at this time and the follow up question to that would be, have you ever felt the need to have a drink early in the morning? 

user: Uh no, no I've never drank, I don't drink in the morning. 

assistant: OK, and do you use recreational drugs?
user: Uh, no never. 

assistant: OK and do you smoke cigarettes?
user: Nope. 

assistant: And um, do, oh, and then, um, who are you living with currently at home?
user: Hi, I'm here because I've had this numbness and tingling in my feet for awhile now and I started to notice these open wounds on my feet as well and I'm not feeling it, but it's there. 

assistant: OK, and when did you first notice the numbness and tingling?
user: It's been on going for the past like 2 years, but recently I've seen the past like 3 months it's gotten worse. 

assistant: OK, and do you feel it in in both feet? 

user: Yes. 

assistant: OK and, where about do you feel the numbness and tingling tingling. Do you feel like all the way up your up your leg, or is it only part way?
user: It it goes right up until my ankles. 

assistant: OK. And do you have wounds on your feet that like you, you don't notice them because you can't feel it? 

user: Yeah, I don't notice it because I can't feel it, but then I'll see them and they look bad. 

assistant: OK, do you recall hitting your foot or off of anything or stepping on any objects that could have caused trauma to your feet?
user: Um I mean it's possible um, but I didn't feel anything, so I'm not too sure about that. It is the summer, so I've been like going to the beach and when I'm at the park like I'll take off my flip flops. 

assistant: OK, have you had any like muscle weakness, to your legs or feet? 

user: Hum, maybe a little bit of muscle weakness in my legs. 

assistant: OK, have you had any problems with balance or have it you had any falls?
user: No. 

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

user: No. 

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

assistant: And have you had any unexpected weight loss?
user: No. 

assistant: OK, have you had any headaches?
user: No. 

assistant: Alright, have you had any sensory changes like changes to your vision, hearing or sense of smell or taste? 

user: No. 

assistant: Have you had any any sore throat or cough?
user: Nope. 

assistant: How about um any shortness of breath?
user: No. 

assistant: OK, have you had any wheezing? 

user: No. 

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

assistant: Any have you had any dizziness or lightheadedness?
user: Nope. 

assistant: Have you had any heart palpitations or feeling like your heart's racing? 

user: No. 

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

assistant: How about any abdominal pain?
user: No. 

assistant: Have you had any changes to bowel movements like diarrhea or constipation?
user: Nope. 

assistant: OK. And have you had any urinary problems like frequency or painful urination?
user: No. 

assistant: OK, and have you had any rashes on your skin? 

user: No. 

assistant: OK, and any muscle aches or joint pains?
user: No, nothing like that. 

assistant: OK, and do you have any numbness or tingling to any other parts of your body?
user: Maybe a little bit in my fingertips as well. 

assistant: OK, and when did you first start noticing that?
user: Um in the past year. 

assistant: OK, and have you had any like like clumsiness or like dropping objects? 

user: Um yeah, definitely some of that like I'll find it hard to like open cans and bottles. 

assistant: OK, any weakness in the hands?
user: Um only when, only sometimes when I'm trying to grip things pretty hard. 

assistant: OK, uh. And. Have you had any memory changes or any confusion?
user: No. 

assistant: OK, and have you had any any back pain?
user: No. 

assistant: OK, in the past have you been diagnosed with any? Or sorry before that and have you had any neck pain?
user: No, no neck pain. 

assistant: OK. And in the past, have you been diagnosed with any medical conditions?
user: Um yeah, so I've been diagnosed with diabetes. Hypertension. Hypercholesterolemia. Obesity. And and I think, yeah, I think that's that's about it. 

assistant: OK, and are you currently on any medications? Like do you have? Do you use insulin?
user: I do so. I'm on insulin, short acting and long acting, I'm on Ramipril, I'm on Atorvastatin, yeah. 

assistant: OK. an, and do you recall any like what your A1C has been in the past or, an have you had your eyes checked and kidneys checked?
user: A1c has been pretty high. Especially recently I think it was eight point 8.1 or something. The last time I got it checked. I haven't had my eyes checked in awhile, and in terms of my kidneys, I think I did a urinalysis recently and everything came back normal. 

assistant: OK. And do you have any allergies to medications? 

user: No. 

assistant: Alright, and have you had any prior surgeries or hospitalizations?
user: No, I don't believe so. 

assistant: OK, and are your immunizations up to date?
user: Yes. 

assistant: OK, and. and. Can you tell me a little bit about where you're living currently and who you're living with? 

user: I live in a house downtown with my wife. 

assistant: OK, and are you working currently?
user: I am, I work from home though. 

assistant: OK. So and, have you been around anybody who's been sick?
user: Oh no, I don't think so. 

assistant: OK, and have you traveled anywhere recently? 

user: No, not outside the province. 

assistant: Alright, and do you drink alcohol?
user: Um yeah, I'll have some alcohol every day. 

assistant: OK, OK how many drinks per day would you have for and how many drinks per week?
user: I'll have about 5 beers a day. 

assistant: OK, do you feel as though that's a lot? 

user: Yeah, I. I'm hoping to cut down. 

assistant: OK, that's good, and if at any point you need help or I would like to discuss that, just please let me know. OK, and do you smoke cigarettes?
user: I do. 

assistant: OK, how much do you smoke?
user: Talk about half a pack a day. 

assistant: And for how long have you been smoking for?
user: For the past almost 20 years. 

assistant: OK, have you thought about cutting down? 

user: Ah yeah again, that's something that I'm hoping to quit doing in the future as well. 

assistant: Certainly OK. And are you currently sexually active?
user: I am. 

assistant: OK and. Could you tell me about your partners or partner?
user: Yeah, just my wife. We've been together for the past five years. 

assistant: OK, any concerns for a sexually transmitted infection at this time? 

user: No. 

assistant: OK. And any a musculoskeletal or neurological conditions that run in the family?
user: No. 

assistant: OK, and how about any cancers that run in the family? 

user: No cancers that I know of. 

assistant: OK, and how about heart conditions or or lung conditions?
user: No, nothing like that. 

assistant: OK, so next. Just wanted to move on to their physical exam piece of the appointment today, so just looking at your um, the, at your feet and at the joints of the ankle and toes are you seeing any swelling, redness, or yeah, any swelling or redness? 

user: Um no no swelling or redness. 

assistant: All right, are there is there a temperature change to your feet or any of the joints? Are they feeling hot or cold?
user: No. 

assistant: OK. And is there any deformities or misalignment of any of the joints? 

user: No. 

assistant: OK, and any scarring from any of the trauma?
user: Uhm, there are like. Yeah, there's some scarring from like ulcers. 

assistant: From previous ones that have that have healed?
user: Healed. Yeah, that's right. 

assistant: OK, and. And is there any pain to palpation over the um ankle joint, over the ankle joint? 

user: No. 

assistant: OK, then how about over any of the joints of your toes?
user: Um no not nothing like that. No pain, just um I can't feel it. 

assistant: OK. And how is the range of motion of your feet and toes?
user: Um pretty good. I can move them all. 

assistant: OK, and then how about your knees?
user: My knees are also the same. 

assistant: OK, uh, an any ankle like instability with any special tests? 

user: No 

assistant: OK, and and on walking is there any limp or does it appear, how does the walk appear?
user: I'm pretty normal. I'm not limping. 

assistant: OK. And. OK, so that was everything that I wanted to ask and and check today. Did you have any questions?
user: Just what do you think is going on with my feet and how do I get some sensation back? 

assistant: So it does sound like it could be related to diabetes where what happens is you get like a peripheral neuropathy overtime and you can lose sensation to your feet in a glove and stocking distribution, which sounds like the history history you're saying today with having sensation reduced on your feet and also your fingertips as well.
user: Yeah, so I've had this cough now, it's been going on for about two weeks, just, just hasn't gone away. 

assistant: Uhm, oK, can you tell me a little bit more about this cough? Is it dry or wet? 

user: Uh, yeah it's been, uhm, mix, it's been dry sometimes and I have had a little bit of sputum production recently, uh, it's been mostly clear though. 

assistant: Has the cough gotten worse over the past two weeks?
user: No, it's been about the same. 

assistant: Uhm, and have you had any blood that came up with the sputum?
user: No, I haven't noticed any blood. 

assistant: Alright, what about any other symptoms over the past two weeks? Have you had, have you had any fevers or chills?
user: Not, no. 

assistant: No. OK. And any uhm, I guess, any runny nose? 

user: Yeah, my nose was a bit runny last week, but it's, that's better now. 

assistant: OK. OK, uhm, it's just, OK last week, what else, what other symptoms did you have last week?
user: Yeah, I had a sore throat and a little bit of a headache as well, uhm, and, and some aches and fatigue. Those were uh, yeah, that was last week for about three days, and then I started to feel better. But I still have this cough, that, it's still going on. 

assistant: So those other symptoms that you had last week that lasted about three days, are they all gone? are you still feeling fatigued or having a headache?
user: Those are both, yeah, they're gone. 

assistant: Hmm, It's only the cough?
user: Yeah I just have the cough. 

assistant: Is there any time, any specific time of the day that it's worse or better? Anything that triggers it?
user: Uhm, maybe like, maybe when I went out into the cold or, uhm, like, when I went for a run where I really kind of exerted myself, it brought it on, but other than those things, nothing. 

assistant: OK, but you're otherwise feeling better?
user: Yeah, for the most part, yeah, feeling better, but I still have a cough. 

assistant: OK. Uhm, have you had any chest pain?
user: Uhm, no. Nothing like that. 

assistant: Any other symptoms such as belly pain or diarrhea or Constipation or changes in your urine, are having any urinary symptoms?
user: No, I haven't had anything like, like that. 

assistant: OK. OK, and can you tell me about your past medical history, any medical conditions you have?
user: Yeah, I, I'm healthy. I haven't, been diagnosed with, with anything. 

assistant: OK alright, any medications that you take including over the counter pills or any herbal pills or multi vitamins etc.
user: Yeah, I'm taking a birth control. 

assistant: I see. OK, any allergies? 

user: No allergies. 

assistant: OK. Do you have any, you don't have any lungs related diseases right? Like asthma or COPD or anything of that sort?
user: Uhm, no, nothing like that. 

assistant: Alright alright, that's good,  and who do you currently live with, and where do you live? 

user: Alright, so I live with a few roommates. I'm just finishing up my undergraduate degree. 

assistant: Yeah, that's great. Have you had any contact with anyone who was sick recently?
user: No, not that I could think of, I mean we went out one night last week and that's kind of when I had those other symptoms for a few days after that. 

assistant: OK, OK. Uhm and have you traveled outside the city or country? 

user: No, I haven't. 

assistant: No, ok. Do you drink alcohol?
user: Sometimes yeah, I, I will with friends, kind of socially. 

assistant: alright. 

user: Just a few drinks. 

assistant: What about smoking?
user: Uh, no. 

assistant: Marijuana? 

user: Uh, sometimes with, like socially with friends, but that might be once a month or probably even less. 

assistant: Any recreational drugs?
user: No. 

assistant: OK, alright and any lung conditions that run in the family?
user: So two days ago I started to have this cough. Came out of nowhere. I haven't had a cough before and I, just today I've noticed the fever as well and and I've had a headache the last few days. 

assistant: Can you tell me a little bit more about your cough? Has it gotten better or worse over the past two days? 

user: So it, it's a it's been about.. well, it got worse at first and then it's been about the same since then. 

assistant: Okay, and is it dry cough or wet cough?
user: It's dry. 

assistant: Okay. Uhm? And does it ever wake you up at night? 

user: No. Well, it kind of happens all throughout the day. Yeah, no, no, it hasn't woken me up at night. 

assistant: OK, is there any, are there any triggers? Anything that makes your cough worse?
user: I can't think of anything really. It just kinda comes on like throughout the day on it spontaneously. 

assistant: How do you take any medications to help with your symptoms? 

user: Yeah, some over the counter cold medicines. I tried some to take Tylenol cold and sinus or something like that anyway and it did help me sleep a little bit with that the headache and just haven't been feeling very good, to help with that. 

assistant: And tell me about your fever. Did you check it check it, check your temperature?
user: I did yeah today I checked it and it was, like just over 38 I think like 38.1 or two. 

assistant: OK, what about your headache? Where exactly is it? 

user: I kind of feel it all over. It's like a band night feels like it's just around my head and squeezing. 

assistant: And, how like if you had to give it a number from one to 10? What number would you give it? With 10 being the worst headache ever?
user: I would say maybe a 5. 

assistant: OK, and you mentioned that the Tylenol helped. 

user: It did, yeah, probably took it down to a two or three. The headache didn't go away entirely. It was sort of still there, but did help. 

assistant: Have you had any other symptoms?  Have you had a confusion or is it any fuzziness? Or any flu like symptoms?
user: Uh, I have felt just tired and, over these last couple of days. That and I have had a sore throat as well. 

assistant: Oh, you get OK. OK, what about a runny nose or stuffy nose?
user: Uh, no, nothing like that. 

assistant: Any difficulties breathing?
user: No. 

assistant: Any difficulty swallowing with a sore throat? 

user: Ah is a little bit painful, but I've been able to to eat and drink okay, just really takes a little longer. 

assistant: Any dizziness or fainting in the past couple of days?
user: No, nothing like that. 

assistant: OK, any rashes or changes in their nails? 

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

assistant: Any changes in your? I guess have had any chest pain?
user: No, haven't had any chest pain, haven't had anything like that before. 

assistant: Any belly pain? 

user: No. 

assistant: any changes in your bowel movement, any diarrhea?
user: No, no, I haven't had ah, any diarrhea. 

assistant: OK, uhm any changes in your urination, any difficulties or any pain or any increase in frequency?
user: No, I've had a urinary track infections before so I know what that's like. I haven't had any of those symptoms. 

assistant: OK, alright, good. And. Have you been diagnosed with any medical conditions in the past? 

user: Uhm? No, I haven't. I had surgery on my knee when I was a teenager. I uh tore my ACL but it's been good since then. 

assistant: Any hospitalizations?
user: No. 

assistant: OK, any medications that you're taking, including over the counter meds? 

user: Yeah, I just say I'm on birth control right now. I've been taking it for the last like five years. 

assistant: OK, any allergies?
user: Oh no, I don't think so. 

assistant: OK, good. And do you have any medical conditions that run in the family? Including any heart or lung conditions or cancers. 

user: Yeah, my, my aunt had had breast cancer. But ah, and my dad has high blood pressure. 

assistant: OK OK uhm. And do you currently smoke?
user: No, I don't. 

assistant: Do you ever smoke in the past?
user: No, I I I I I've stayed away from that. 

assistant: Good. Any marijuana or recreational drugs?
user: Yeah, sometimes, well, we'll smoke with like friends at a party I guess, but I haven't had any. I haven't done that in awhile. 

assistant: Alright. Any alcohol?
user: Similar like sometimes at a party, but I mean yeah, it's been awhile for something like that, so I haven't really had any alcohol on in months. 

assistant: And are you currently working, or? 

user: I am yeah. So it's uh, yeah I work for this tech company so I've been able to do a lot of my stuff at at home. 

assistant: OK, uhm. Have you had any exposures to anyone who could potentially be sick?
user: I will without, well, yeah I there a couple or last weekend. Actually there was a family party that we went to. It was outside, but uh, it, yeah, there's people around. There was nobody that was sick that I'm aware of. 

assistant: OK. And and have you traveled anywhere outside the province? 

user: No been besides that, the family party last weekend, but I mean that was just here in town so. It was close by. 

assistant: OK, I guess I forgot to ask about a symptom. Have you felt that you've lost your sense of smell or sense of taste? Has it just been different?
user: I am here with uh, with my daughter, who has just been having a cough for the past um, two weeks. 

assistant: Okay, um, and can you describe the cough a little bit? Is it a dry cough or is she bringing anything up? 

user: Um, it is a, it is a dry cough, um, but she just keeps coughing and coughing and, and then she just, you know, once she'll start coughing she just doesn't stop. And then um, there's been times when she just turns blue, she's coughing so much. Um, and then it just gets, gets better um, on its own. But yeah, it's a dry cough. 

assistant: Okay, and um, what does the cough sound like? Is it like a harsh cough, a barky cough?
user: Um, it's just, she just makes this noise when she's like breathe, trying to take a breath in. It's, it's yeah. 

assistant: Okay, is it kind of a wheeze?
user: Yeah, sure. 

assistant: Okay. Um, and so there's episodes where she also turns blue? 

user: When she's coughing a lot, yeah, she does. 

assistant: Okay.
user: She's also vomited once or twice. 

assistant: Oh, I see, okay. Um, any blood in the vomit? Or is she coughing up any blood?
user: No. 

assistant: No, okay. Um, any, so this started two weeks ago, any kind of symptoms of runny nose or um, cold-like symptoms before then? 

user: Yeah, yeah she did have a bit of a runny nose. It was just uh, watery, uh, since discharge. And at that time her cough, she had a cough as well. Um, but I thought it was, you know, it's nothing. It was just like another flu and it would get better, but then she just, the runny nose got better without, in a couple of days, but the cough stayed. And it got, got pretty worse, uh, it got worse. 

assistant: Okay, um, other than the cough uh, any, any fevers or chills?
user: No, I don't think she's had fevers. I haven't checked, though. 

assistant: Okay. And the cough is pretty constant, or is it, does it come and go?
user: Yeah, she just has these episodes where she just coughs and coughs and coughs, and then she'll either vomit or just turn blue, or just um, get better in a couple, couple minutes. This kind of comes and goes like that. 

assistant: Okay. And is there anything that has helped her at all? Like any over the counter medications or anything like that? 

user: I haven't tried anything, I'm just worried about, you know she's my first child and I don't know what to give her and what not to give her at this age. So I just decided to come in and not try anything over the counter. 

assistant: Okay. Um, and so, has this happened before at all?
user: No. 

assistant: No, this is the first time, okay. Um, any so, she, she is vomiting. Um, is the vomit like green in colour? Or is she just vomiting up what she has eaten? What's the content of the moment?
user: It's usually just what she's eaten. 

assistant: Okay, um, any sick contacts recently or any travel?
user: No, I don't think so. Not, nothing really. 

assistant: Um, and how about her behaviour? Does she seem like uh, very tired or fatigued, or more irritable? 

user: She does get tired, especially after, and then she's irritable and crying after, you know, she has these fits of coughs. 

assistant: Okay.
user: Yeah. 

assistant: Okay. Um, any symptoms of diarrhea or constipation? 

user: No. 

assistant: Okay. Any um, any trouble with urinating at all?
user: No. 

assistant: No. How's her sleeping like? 

user: Uh, not great. It's just the cough keeps uh, waking her up and she just doesn't, can't fall asleep. 

assistant: Okay, any uh, exposure to dust or fumes, or animals or pets at home?
user: We, we did get a cat um, about a month ago. 

assistant: Okay. Um, and any, has she been diagnosed with any medical conditions in the past? 

user: No. 

assistant: Um, and any allergies that you know of?
user: Um, no. 

assistant: And um, any previous hospitalizations or surgeries? 

user: No. 

assistant: And how was your pregnancy, your pregnancy with her, like any complications at all?
user: No, no complications. It was uh, it was very, yeah, it went well. 

assistant: And was she at term or premature?
user: She was at term, she was born at term. 

assistant: Was it a vaginal delivery or uh, a c-section?
user: Uh, vaginal. 

assistant: And did she have to stay in the NICU at all, at the hospital afterwards?
user: No. 

assistant: Okay. And is she feeding well, like what does she usually eat? 

user: She's feeding well. She's doing uh, she eats everything, yeah. 

assistant: Um, and any family history of any medical conditions?
user: No. 

assistant: Um, and does anyone smoke in the house?
user: Um, her dad, but he, he doesn't smoke in front of her. 

assistant: And what's her living situation like? Who does she live with? And do you live in a house, apartment? 

user: Oh yeah, we live in an apartment. It's uh, me, my partner, her and the cat. 

assistant: Okay. And any difficulties or complications with her growth? Like in terms of her weight or her height?
user: No, no complications. She's doing okay. 

assistant: Okay. And in terms of her milestones, has she been meeting all of them on time? 

user: Yes. 

assistant: Okay. Alright, so I think those are all the questions I have for you today. Do you have any questions or concerns?
user: Uh, no. 

assistant: Yeah, so based on the symptoms, oh yeah, sorry I forgot to ask one other question. Has she, are her immunizations all up to date?
user: Oh no, no. I don't, I don't get those. My friend's, my friend's daughter developed autism and I'm just, I don't want that, you know, so no. I don't vaccinate my kids. Or I don't vaccinate my daughter and I haven't been. Yeah, uh no, I won't be doing that. 

assistant: And have you been vaccinated throughout your life? 

user: Um, maybe when I was young, but I, yeah I don't, I just don't believe in vaccinations. I, yeah, no, I don't, I don't get those. 

assistant: Yeah, so there is definitely uh, there's a lot of research done beside, behind vaccinations and a lot of prevention goes into them, but definitely there is some anecdotal evidence of very loose associations to autism that have been found to be invalid and like they have been invalidated by the research. So definitely, it's very important to get your child vaccinated. In fact, the sum of the symptoms that your child may be having right now can be caused by something called pertussis, and um, there's usually a vaccination for that. Like after pregnancy as well, so that's something that is definitely on the differential, and at this time we definitely need to make sure she's okay and get her vitals done, see her oxygenation saturation, and just do supportive care while she's in the hospital, and we may need to admit her, but we'll do the full physical examination today, get a COVID swab done as well. And usually it, she's currently in the, it seems to be the second phase, where she's vomiting and coughing a lot, and then it usually, after that phase, two or three more weeks of just coughing. And so, we're going to do some supportive care for her right now, but yeah, definitely, you should consider vaccinating your child. We recommend that to every parent as there's a lot of diseases out there that can be completely prevented if you vaccinate your child.
user: Yeah I just came in here today I've been experiencing some difficulties with my right hand, especially at the bases of the 4th and 5th digits. I notice this happening over the last I'd say probably last few months it's been getting worse. I've been having trouble just kind of extending those two fingers and I kind of see like this little bump at the base of those two fingers. So yeah overall it's just been difficult working, I'm a construction worker and I don't know if this just keeps getting worse. 

assistant: OK. And you noticed um, and sorry, when exactly did it start?
user: Probably two months ago months ago. 

assistant: About two months ago, and it's the 4th and 5th digits or any other fingers involved or any parts other parts of your hand? 

user: No, it's just those two. 

assistant: OK. Uhm and how would you describe the the pain that you're feeling, is it a sharp pain and an achy pain or a burning pain?
user: Uhm, it's more a kind of like a aching, aching pain which gets worse with if I try to extend those fingers. And yeah, like that I do feel like the little nodules, but like pressing on them doesn't hurt or anything like that. 

assistant: OK, uh, and do you feel any radiation of pain like in into your hand or forearm? 

user: Uhm, no, not really. 

assistant: OK, and alright, is there anything that is aggravating or making the pain worse?
user: Uhm I think just a extending, it's it's I would say more than the pain it's just like discomfort and just not being able to extend that is is frustrating, uh, like the pain isn't that bad like there's like minimal pain. 

assistant: OK, and is there any like like clicking or. Yeah any any clicking or catching when you're trying to like extend the finger? 

user: Uhm I would say there is a. Yeah there's some like catching I would say if when I'm trying to extend. 

assistant: OK. And has there been anything that that you've tried recently that's improved the discomfort or or helped with the range of motion?
user: No, nothing that I've tried that has really helped and. Yeah, I'm just afraid if I stop kind of exercising and it'll just keep getting worse. 

assistant: OK, yeah, certainly. OK, and what, have you had any problems with your hand before like any trauma there or anything like that? 

user: Uh, my my construction worker so there's always like a lot of. I haven't had any falls or injuries on my hands luckily, but there is always just constant lifting. There's I used to drill a lot too, so there's like always constant and I'm right handed as well. So there's always like the vibration yeah so but no no direct like traumas or falls. 

assistant: Have you been having any neurological symptoms, such as like numbness or tingling or loss of sensation to any parts of your hand or upper extremity?
user: No numbness or tingling. And no weakness or anything like that. 

assistant: OK, so no muscle weakness?
user: No. 

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

user: No. 

assistant: OK, and how about any night sweats?
user: No. 

assistant: And have you been having any unexpected, have you had any unexpected weight loss? 

user: No. 

assistant: OK, and have you had any headaches?
user: Nope. 

assistant: Any sensory changes such as changes to your vision, hearing, loss of taste or sense of smell? 

user: No, nothing like that. 

assistant: Have you had a runny nose or felt congested?
user: Nope. 

assistant: Have you had any I redness or or itchy eyes?
user: Nope. 

assistant: Alright and have you had a sore throat or cough. 

user: No, nothing like that. 

assistant: How about any shortness of breath or wheezing?
user: Nope. 

assistant: Have you had any chest pain? 

user: Nope. 

assistant: Any lightheadedness, dizziness, or feeling as though you might faint?
user: No. 

assistant: You got any feelings of though your heart is racing?
user: Nope. 

assistant: OK, have you had any nausea or vomiting? 

user: No. 

assistant: Any abdominal pain?
user: Nope. 

assistant: Have you had any diarrhea or constipation? 

user: Nope. 

assistant: Alright, and have you had like any blood in the stool?
user: No. 

assistant: Any urinary problems like pain or frequency? 

user: No. 

assistant: An any skin changes like rashes?
user: No, nothing like that. 

assistant: OK, or any changes to your nails or hair like you'll notice like plaques on the nails or or hair loss? 

user: No. 

assistant: OK, and have you been having any muscle aches or joint pains or body pains anywhere else?
user: No, not really. 

assistant: Alright, and uh. Have you had any memory loss or confusion? 

user: No, nothing like that. 

assistant: OK, and have you had any appetite loss or fatigue?
user: Uhm no. 

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