jshargo/medical-interview-conversations2 huggingface dataset:
user: So I've been having a lot of trouble in the last two weeks of especially this past week of just a lot of shortness of breath. I'm getting a lot of coughing as well and producing a lot of material. And also I think I might have been having a fever this week as well. 

assistant: OK, uh, the shortness of breath is it happening at rest or exertion and how much exertion? 

user: Uhm, I think it's happening mostly on exertion. Usually I'm able to walk around the house, no issues, go up and down stairs, but right now I'm pretty limited. I can't really go up and down stairs without getting really short of breath. I can't even walk from the bedroom to the kitchen without becoming shortness of, like short of breath. 

assistant: OK, um OK, and when did that change happen?
user: So I would say one week ago is when this all kind of started. 

assistant: OK, and has it been getting any better, worse, or staying the same? 

user: I would say it's kind of getting worse. I'm coughing a lot more sputum up. I'm getting more and more short of breath. Now, I do have a call for like a very long time now I've I was diagnosed with COPD in my 60s. Probably like 10 years ago and but this seems to be just a much worse than my COPD. 

assistant: OK, sure it's been a lot worse in the last week it sounds like. OK. Uhm have you, are you able to lie flat? Like on your back without experiencing shorter breath, shortness of breath?
user: Yeah, and when I'm resting or lying down or trying to sleep I don't get short of breath. 

assistant: OK, and have you ever had instances where you woke up in the middle of the night really short of breath and you had to sit up to catch your breath? 

user: Uh no, I don't think so. 

assistant: OK, have you noticed any leg swelling?
user: No. 

assistant: OK, and you said that to you, so you've had a cough for awhile now, but it's gotten worse. This past week in your, are you bringing up sputum?
user: Yeah, I'm bringing up a lot of materials. I think every time I cough I'm bringing some sputum up and right now the like usually the color is like clear to whitish but right now it's a bit more yellow. 

assistant: OK, so a change in the sputum color and also sounds like you're bringing up more sputum as well. 

user: Yeah. 

assistant: OK and have you brought up or coughed up any blood? So have you had any hemoptysis?
user: No, nothing like that. 

assistant: OK, and have you had any wheezing?
user: Uhm, I do but when I get short of breath I have some wheezing, but usually I don't. 

assistant: OK, but but you've had wheezing this past week though.
user: Yeah. 

assistant: Yeah OK. And have you had any chest pain?
user: Just when I'm coughing and getting short of breath, I do have some discomfort in my chest. 

assistant: OK, uh, do you feel that, or could you describe he the pains character? Like is it sharp, dull, or achy? 

user: It's more just an ache and it's kind of more of a discomfort than a pain, and it kind of goes away once my episode of coughing and shortness of breath is relieved with some rest. 

assistant: OK. Uh, and uh, have you been experiencing any fevers or chills?
user: Yeah, I've been noticing that I'm getting a lot more chills this past week. They kind of come and go, but even at night I get like these chills that after wrap myself up in at least three blankets. 

assistant: OK, and have you had a fever?
user: Uh, I didn't get a chance to measure any of them, but I might have had a fever just from the chills that I'm expecting that I had a fever. 

assistant: OK, and have you had any night sweats? 

user: No. 

assistant: OK and have you had any unexpected weight loss over the last several months?
user: No, I think my weights been pretty steady. 

assistant: OK. Have you had any headaches?
user: No. 

assistant: Have you had any like eye redness or eye discharge?
user: No, not that I know of. 

assistant: OK, have you had a runny nose or a sore throat?
user: No. 

assistant: OK, have you had a loss of taste or loss of smell?
user: No, nothing like that. 

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

assistant: Have you had any abdominal pain? 

user: No abdominal pain. 

assistant: Have you had any diarrhea?
user: No. 

assistant: Have you had any constipation? 

user: No. 

assistant: Have you had any skin rashes?
user: No. 

assistant: Any muscle aches or joint pains?
user: No, nothing like that. 

assistant: OK, and have you had any any fatigue?
user: Maybe a little bit more tired just with the shortness of breath and chills and everything like that, but yeah, so a little bit more fatigue. 

assistant: OK, and have you had any fainting or dizziness? 

user: Uh, no. 

assistant: Or, OK and have you had any heart palpitations?
user: Nope. 

assistant: Alright. And have you been diagnosed with any medical conditions in the past?
user: No. Oh sorry, medical conditions in the past? COPD I have. I also do have some high blood pressure and I take some medications for cholesterol as well. 

assistant: OK, so you take medications for cholesterol and high blood pressure and you use any inhalers? 

user: No. Sorry, inhalers I, use, uh, two different kinds of inhalers. So one of them is just when I like need it, uh, like I've been using a lot more recently, like the Ventolin. And then I also have another inhaler called Spiriva that I've been using as well. 

assistant: OK, and do you have any allergies?
user: Uhm I do have an allergy to sulfa drugs. 

assistant: And what reaction?
user: I usually break out into hives. 

assistant: OK, and any prior surgeries or hospitalizations? 

user: So I've had a surgery to remove my appendix when I was really young. Then I've had another surgery for my hips as well, but yeah, other than that, no other issues. 

assistant: OK. And are your immunizations up to date?
user: Yeah, all of my immunizations should be up to date. 

assistant: OK, excellent and could you tell me a little bit about where you're living currently and who you're living with?
user: Yeah, so I, I currently live alone in, in an apartment just in the city. And yeah, I've been living alone for probably the last five years. 

assistant: OK, and have you been around anybody who's been sick?
user: Uhm, not recently. I think I just I just go out to get groceries and stuff. I haven't really been going out too much. 

assistant: Alright, So have you traveled anywhere?
user: No. 

assistant: OK uhm, do you drink alcohol?
user: Maybe a couple of years a week. 

assistant: OK, and do you smoke cigarettes?
user: Yeah, I still smoke cigarettes. Even though I have COPD, I just yeah, I can't really quit. I smoke probably half a pack a day. 

assistant: OK, how long have you smoked for approximately? 

user: Uh, probably at least 45 years. 

assistant: OK and uhm, if you wanted to talk about quitting, we can discuss that further at a later time if you'd like. Uhm, and so do you use any recreational drugs?
user: No, no no no drugs at all. 

assistant: OK. Uhm, and have you had a family history of heart disease or any lung conditions?
user: Uhm, not, I mean like no lung conditions, but I have a family history like my both my grandather and father both had heart attacks in their 60s. 

assistant: OK, and any lung cancer in the family? 

user: No, not that I know of. 

assistant: OK. So I think that was all the questions that I I wanted to ask today. Was there anything else that I maybe forgot about that you wanted to mention?
user: Hi I just want to talk about these, these times when I feel like I'm just I'm suffocating and I just can't breathe. It's pretty scary and I don't know what's going on. 

assistant: Yeah, certainly, um, feeling short of breath like that can be quite scary for sure. When, when do these episodes kind of happen? Are they spontaneous? Or can you think of things that you're doing when they when they come on.
user: Uhm? I, I don't know, it's just like. Uhm? Sometimes, like before interviews, sometimes just kind of random. Uhm, yeah. I can kind of tell when they're about to come on. Uhm? Yeah, I think. It's mostly like job interviews. 

assistant: OK, have you had many of those recently?
user: Job interviews? 

assistant: Yeah.
user: I got I got laid off because of the pandemic and now I've been looking for jobs and it's just like it's kind of nerve wracking. But also like I don't know, I'm just worried it could be something else like it's just, yeah, it's like I really just can't breathe, it's so weird. 

assistant: OK, yeah, it's certainly. It sounds like there's been a lot of stress recently. Certainly plenty for with the pandemic as well. And so when you get short of breath, you you said you have this, you could feel that it's coming on and how long does it last for? 

user: Like 15 minutes 15, 20 minutes. 

assistant: Is there anything you do to help it go away?
user: I'll just say go and lie down and close my eyes. 

assistant: OK. And do you get shorter breath if you walk far distances or exert yourself? 

user: Oh no, no. I go out for a run every single day. Nothing happens at that time. 

assistant: OK. And. Have you had a cough?
user: No. 

assistant: Any wheezing? 

user: No. 

assistant: OK. And have you had any any chest pain?
user: Yeah, I kind of feel like this pressure at that time is just like yeah, someone's like pressing my chest inwards, kind of. It's hard to explain. 

assistant: I see do you it is it um like, do you feel it in any one particular spot or? 

user: No. 

assistant: OK.
user: I just feel like my chest is really tight and it's just it's like I can't like expand my lungs. 

assistant: I see and does this last around 15 minutes as well?
user: Yeah. 

assistant: OK. And similarly you like going for runs and stuff like that you on't ever get any chest pain? 

user: No, no, no. 

assistant: OK. And and I know you mentioned you didn't have a cough, but have you brought up any phlegm or brought up any any blood?
user: No, no, I have not had a cough. 

assistant: Oh no, OK, I'm sorry.
user: That's OK. 

assistant: And have you otherwise been well? Or if you had any infectious symptoms, like a runny or red eyes, runny nose or sore throat? 

user: No. None of those. 

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

assistant: How about any fevers or chills?
user: No. 

assistant: Have you had any night sweats? 

user: No, but I get really sweaty when these episodes happen. Just like yeah, my face is like sweating, and my neck. 

assistant: OK. Yeah, Um, OK, and How is your weight been recently? Any weight gain or loss?
user: Yeah, I've gained quite a bit of weight since the pandemic started. Yeah, gained about 10 pounds. 

assistant: OK, any changes to your diet or appetite?
user: Oh yeah, I've been eating quite a bit, been baking a lot at home. 

assistant: OK. And, and have you had any abdominal pains?
user: No. 

assistant: Any diarrhea?
user: Uhm? No. 

assistant: OK. Any nausea or vomiting? 

user: No. 

assistant: Alright, and any urinary problems like pain or frequency?
user: No. 

assistant: Any rashes or skin changes? 

user: No. 

assistant: And, any muscle aches, body pains or joint pains or swelling?
user: Nothing like that, no. 

assistant: OK and how's your energy been? 

user: Um. Well, I've been feeling a little low. Since I've been laid off just like worried about my finances and I kind of sleep all day. I'm not feeling very energetic. 

assistant: OK. How is your interest in activities been?
user: I don't know, I just feel like staying at home and just being in bed all the time. 

assistant: OK, so you're um, have you had a low mood?
user: Yeah. 

assistant: Alright and are you sleeping more than usual?
user: Yeah. 

assistant: OK, is there anything that you're feeling particularly guilty about right now? 

user: No. 

assistant: OK. How is your concentration been?
user: Uhm, not great. 

assistant: OK. You haven't been able to focus and have you felt like things are moving in slow motion?
user: No. 

assistant: Alright, so have you had any thoughts of hurting or harming yourself?
user: No. 

assistant: OK. And have you had depression or anxiety in the past?
user: Um I've been diagnosed with depression. 

assistant: OK. And have you had panic attacks before?
user: No, but do you think that's what's going on? 

assistant: Potentially, it certainly can't rule out. Inorganic cause meaning something going on, otherwise just yet we might need to do some physical exam and some investigations first, but it certainly could be related to that. With all of the stressors that are going on. And so you had a low mood. Have you had any periods in your life where you felt really energetic, like you didn't need any sleep, you're really talkative, you had all the energy in the world.
user: I wish, no, I've never really felt that way, 

assistant: OK. And have you had any concerns with eating disorders in the past? 

user: No. 

assistant: Alright. And then you mentioned, even diagnosed with depression, if you had, are you have you been diagnosed with any other medical conditions?
user: No. 

assistant: OK, are you on any medications right now? 

user: No, I was doing pretty well. I used to have these episodes of depression when I was younger as a teenager and they kind of went away. I was on meds at that time, but I think I think it's coming back now. 

assistant: OK, so you haven't been on medication now for for quite awhile for years.
user: For like 12 years 13 years. 

assistant: OK, what did you use that, if you can remember?
user: Prozac? 

assistant: OK, and did you find it helped? 

user: Yeah, yeah it was very helpful, was very good. 

assistant: OK. That's good. Any allergies to medications?
user: No. 

assistant: Alright and any hospitalizations or surgeries? 

user: No. 

assistant: OK, and can you tell me a little bit about where you're living and who you're living with?
user: I I live, I live with my girlfriend. 

assistant: OK. And. Has there been anybody around that that has been sick that they have been around?
user: No. 

assistant: OK, have you traveled anywhere?
user: No no. 

assistant: And do you smoke cigarettes?
user: Oh no, I don't. 

assistant: OK, do you drink alcohol?
user: I don't. 

assistant: OK. And. Are you currently sexually active? 

user: Yeah. 

assistant: OK, and any chance that you could be pregnant currently?
user: No. 

assistant: And have you been pregnant in the past? 

user: No. 

assistant: OK. And do you smoke cigarettes?
user: I don't. 

assistant: Do you drink alcohol?
user: No. 

assistant: And do you use any recreational drugs? 

user: No. 

assistant: OK, and any family history of heart or lung problems?
user: My grandfather had lung cancer. But that's about it. 

assistant: Did he smoke for a long time?
user: Oh yeah, he was a big smoker. 

assistant: OK, and anybody in the family have problems with mental illness? 

user: My mom has uh depression too. 

assistant: OK. Anybody in in the family have problems with substance, substance use?
user: no. 

assistant: OK. Um, and  I think that's everything that I I wanted to ask on history today. So you been having these episodes where you get really short of breath and you get chest pain, you'll get sweaty and have what sounds like what sounds like an impending sense of doom where you kind of feel like it's coming on and it lasts for 15 minutes and not related to exercise. Were there any other symptoms or things that you've been experiencing recently?
user: Yeah, it's also,  I also feel like my heart's like breathing really fast. 

assistant: Oh, OK. And I does that, how long does it last for? 

user: Same time. Like everything is just sort of comes on at the same time. Just kind of goes away together. 

assistant: OK, would you say that it comes on like kind of like at the snap of your fingers sort of thing like really quickly and then?
user: I can kind of tell it's gonna come on like I have a sense of it and then it just like starts. It suddenly just happens. 

assistant: OK. So you you have the heart racing, are there any other symptoms as well?
user: I don't think so. 

assistant: OK, so, uh, we will get an ECG and  I will look at that, but I've been concerned now thinking that this might be related to anxiety or panic attacks and so, I guess that would be something that we could discuss more about in regards to like I guess previous traumas and things that and the stresses that you might be dealing with currently to help manage manage stress better.
user: Hi there, I, I've had this cough that started um, three days ago, and over these past couple of days, I've just been really achy all over and so, I've had a headache as well. 

assistant: Okay, well I'm sorry to hear that you're not feeling well. Um, the cough, when did that start? 

user: Yeah, so that, about three or four days ago um, it started to come on, yeah. 

assistant: Okay, and then how about the headache?
user: That's been more in the last two days. 

assistant: Two days, okay, and then the uh, muscle ache?
user: Yeah, it's been there for about two, yeah about two or three days. I wake up in the morning and I've been feeling like really fatigued and achy. 

assistant: Um, the cough, is it dry or you're bringing up phlegm?
user: It's, it's dry, but it's gotten a little bit worse since it started. It's just been happening more often. 

assistant: Okay, and does it sound harsh?
user: Uh, maybe a little bit, yeah. 

assistant: Okay. Is it getting worse do you think?
user: Yeah, I think so. 

assistant: Okay, are you experiencing any shortness of breath along with the cough? 

user: Uh, a little bit after, um, if I have like a coughing fit that's bad enough, but um, for the most part, I've been okay. 

assistant: Okay, any wheeziness?
user: Um, no. 

assistant: No. Chest pain?
user: No. 

assistant: Okay. Do you ever feel like your heart's racing? 

user: No, I haven't felt like that. 

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

assistant: Uh, numbness or tingling?
user: No. 

assistant: Uh confusion or memory loss?
user: No. 

assistant: This headache, is it always there? 

user: These past couple of days, yeah, it's kind of, it, it's been there. It's been a little bit more mild after using some Tylenol or Advil to help settle it down, but I just have this, yeah, achiness in the front, front of my forehead and kind of sides of my head. 

assistant: Yeah um, sides of your head, okay. And 1 to 10, 10 being the worst pain you've ever felt, how, how would you rate it?
user: A 4. 

assistant: A 4 okay, so it's not the worst headache you've ever had in your life?
user: No, it's not that bad, it's just been pretty annoying. 

assistant: Yeah um, okay. And have you like, do you usually get headaches?
user: Not really it, yeah I don't get them that often. I guess they come when I, I, well, get sick. 

assistant: Okay yeah, that makes sense. Um, have you had any fevers recently? 

user: Um, I have felt a bit hot um, and, but I, I didn't check my temperature and um, yeah. 

assistant: Okay. How about weight loss, have you experienced any weight loss recently?
user: No, I've been, my weight's been pretty stable. 

assistant: Okay. Um, any rashes?
user: No, I haven't noticed any rashes. 

assistant: Okay, um, and any changes in your hearing or vision? 

user: No. 

assistant: Runny nose or stuffy nose?
user: No. 

assistant: Sore throat? 

user: Um, yeah, now that you mention it, I have had a little bit of a sore throat as well. Hasn't been too painful with um, like swallowing uh, foods or anything like that. It's kind of worse in the morning and it's not so bad later on. 

assistant: Okay um, alright. How about changes in your smell or taste?
user: No, nothing like that. 

assistant: Um, changes in your bowel movements?
user: No, I've been uh, regular. 

assistant: Okay um, and then nausea or vomiting? 

user: Nope, I haven't had anything like that. 

assistant: Okay um, changes in your urine?
user: No, I've had UTIs, like one or two in the past, um, so I know what that's like. So yeah, everything's been normal. 

assistant: Okay, good. And are you otherwise healthy or do you have any longstanding medical conditions?
user: Uh, I have asthma, which I will like, asthma and allergies, and I'll use um, just Ventolin for that every like once in awhile, but it hasn't bugged me too frequently. 

assistant: Okay. Um, do you also take anything else for that asthma or is it just the Ventolin that use?
user: Yeah just Ventolin. 

assistant: Okay. Have you had any hospitalizations or surgeries in the past?
user: No, well I, I've had my, my wisdom teeth taken out and, actually yeah I had my tonsils out as well when I was 12. 

assistant: Okay. Um, are you on any medications besides Ventolin? 

user: Yeah I, I currently, I think a birth control. 

assistant: Okay, how long have you been on that for?
user: Uh, since high school, so I, yeah since I was 18 so eight years. 

assistant: Okay, and um, are you up to date with all your immunizations?
user: I am, yeah. I get the flu shot every year. 

assistant: Okay, okay, good. Any allergies?
user: Uh yeah, to cats and um, like, I think environmental triggers. No medicines. 

assistant: No medicines, okay. Any family history of lung or heart diseases? 

user: Um, my grandfather had, had a stroke when he was in his 70s and um, but he was like, a smoker and a drinker, and didn't really look after himself very well unfortunately, and uh, but that's about it. 

assistant: Okay, um and do you smoke?
user: No, I don't 

assistant: No, okay. Any other recreational drugs like marijuana, cocaine, heroin or anything like that?
user: No, I don't use anything like that. 

assistant: Okay. How about um, alcohol, do you drink? 

user: Yeah, sometimes, I'll have a or maybe a cocktail on the weekend, or um, a glass of wine with dinners. 

assistant: Okay. Are you currently sexually active?
user: I am, yeah with uh, with my boyfriend. Um, we use uh, condoms as well. 

assistant: Okay, so you use both condoms and you're on birth control so, okay good, that's a lot of protection. Um, how long have you two been together? 

user: Um, uh six months. 

assistant: Okay, okay, good. And um, any sick contacts recently?
user: Um, not that I'm aware of. 

assistant: No, okay. Any travel recently?
user: Nope, just been um, going to, or just been doing online uh, classes. I'm finishing up my masters right now. 

assistant: Okay, okay wow, congrats.
user: Thank you. 

assistant: Um, and where do you live and who do you live with? 

user: Yeah, so I live in an apartment downtown here um, just with uh one of, one of my friends who's a roommate. 

assistant: Okay, and is everyone at home healthy?
user: Yeah, she hasn't had any any symptoms, any symptoms either. 

assistant: Okay. Okay, well those were all the questions that I had for you. Did you have any questions um, or anything that you wanted to bring up that I haven't covered?
user: Yeah, absolutely. Uhm, I don't know, I've just been feeling a little feverish, uhm, and I also have a, a bit of a sore throat. 

assistant: OK, when...
user: I just came in, I just came in to see what's going on, cause I was worried, you know, with covid going on, uhm, going everywhere. 

assistant: Certainly, when did the, the sore throat start? 

user: Last night actually. 

assistant: OK.
user: Yeah. 

assistant: And uhm, have you had any, uhm, problems with swallowing, like food or liquids?
user: No, I don't think so. I just had breakfast this morning and no problems there. 

assistant: OK, uh, any like, changes that, uhm, other symptoms that you've been having with the sore throat?
user: Yeah, I'm just feeling a little feverish. 

assistant: OK, and when did that start? 

user: This morning. 

assistant: OK, did you take your temperature?
user: No, I don't have a thermometer at home. 

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

assistant: OK, how about any, like red eyes or runny nose?
user: No, neither of those. 

assistant: OK, have you had a headache? 

user: No. 

assistant: OK, uh, and have you had any shortness of breath?
user: I don't think so. 

assistant: OK, and how about any loss of taste or loss of smell? 

user: Yeah, I don't, uh, yes, I said I was eating breakfast this morning, but it just tasted really bland. 

assistant: OK, so maybe loss of taste, so you feel like your nose is really or that you're really congested?
user: I guess yeah, now that I think about it. 

assistant: OK, uh, and how has your appetite been? 

user: It's alright. 

assistant: OK, and so you haven't had any cough or shortness of breath, but have you noticed any wheezing?
user: No. 

assistant: OK. And have you had any chest pain?
user: No. 

assistant: Have you felt as though your hearts's been racing at all or, or beating out of your chest?
user: No. 

assistant: OK, have you been dizzy or lightheaded?
user: No. 

assistant: OK. Have you had any nausea or vomiting? 

user: No. 

assistant: Any abdominal pain?
user: No. 

assistant: Have you had any diarrhea or constipation?
user: Uhm, I'm often constipated but nothing new there. 

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

assistant: Alright, and then how about any muscle aches or, or body aches? 

user: Sort of, like I just, I found it really hard to get out of bed this morning. 

assistant: OK. How has your energy been? Have you been, like really fatigued?
user: Yeah. 

assistant: OK, and when did, uh, you said the muscle ache started this morning, uhm, how, when did the fatigue start? 

user: I'd say this morning as well, yesterday was just like a little tickle in my throat and I thought it would just go away you know, and I woke up this morning and I just felt horrible. And the sore throat was just worse and I felt feverish and tired and I felt really crappy. 

assistant: OK, yeah, and have you had any symptoms like this before?
user: Well yeah, I usually get a cold once a year in the fall. It does feel similar to that. 

assistant: OK. 

user: But I still wanted to be careful and come in, just in case. 

assistant: yeah, certainly. Have you had, have you been diagnosed with any medical conditions before?
user: I have migraines. 

assistant: OK, and are you taking any medications regularly?
user: No, no, I'm not. It's not bad. I sometimes just take like, Advil whenever my headache's coming on. 

assistant: OK. Any allergies? 

user: Uh, nope. 

assistant: OK. And do you smoke cigarettes?
user: I smoke, uh, two or three a day. 

assistant: OK, and have you tried to quit? 

user: No. 

assistant: OK, if at any point this is something that you wanted to talk about, we, we certainly could later.
user: sure. 

assistant: Do you drink alcohol?
user: Uhm, a glass at night with dinner. 

assistant: OK, and do you use any other recreational drugs?
user: No, no, no, nothing like that. 

assistant: OK, have you in the past? 

user: No. 

assistant: OK, and have you been around anybody who's been sick recently?
user: Uhm, oh, my, like my little granddaughter had, uhm, you know, they're always having a runny nose, right, the little ones. 

assistant: Mhm. 

user: But no, nothing, nothing else. I've just been at home for the most part. 

assistant: OK, have you traveled traveled anywhere?
user: No. 

assistant: OK, and, uh, does your granddaughter go to daycare? Or is she in school?
user: She, she does go to daycare, yeah. 

assistant: OK, and has there been anybody else around that, that's been sick that you're living with, or you see often?
user: No, that's about it. 

assistant: OK, I, I think, I don't think I asked this, but have you had any surgeries before?
user: I had cataract surgery done. 

assistant: OK, and the left, right eye or right eye? 

user: Both actually, it runs in my family. We get it pretty early on. 

assistant: OK, and are there any other conditions that run in your family like heart conditions or cancer?
user: Diabetes. 

assistant: Diabetes, OK. And who had diabetes? 

user: Lets see, my mom, my sister, my brother, yeah, yeah. 

assistant: OK. And just to, get to know you a little bit better as well. I was wondering if you could tell me a little bit about your living situation?
user: Sure, yeah, I live with uh, I live with my son and daughter and my grandson. 

assistant: OK, uhm, and, uhm, OK, yeah, I think that's all I wanted to ask about today. Was there anything else that you wanted to tell me or maybe that I forgot to ask about? 

user: Uh no, I don't think so. Do you think I have covid? 

assistant: It's, it's certainly possible. It will be something we test for.
user: Sure. 

assistant: Although the symptoms that you're experiencing, with feeling or having a fever, sore throat, and not feeling well with the muscle aches and fatigue, uhm, its relatively non-specific, so as you mentioned, it could be something like the common cold, that you've experienced in the past, so we can't rule that out either at this time, but we will do some investigations including a nasal swab for covid and kind of go from there.
user: OK, sounds good. 

assistant: All right, we'll get that started.
user: Um I'm here because I've had some numbness in my right hand and uh doesn't seem to be going going away, so I thought I should get it checked out by you. 

assistant: Yeah, certainly so, so when did this exactly start? 

user: Um so it's been pretty gradual, I would say over the past month or two months um is when I first noticed it, but the numbness is definitely worse now than it was at the start. 

assistant: OK, and uh where is this um the pain and numbness, where are you feeling it exactly?
user: Um it's particular, it's the worst on my thumb and index finger. 

assistant: OK, do you feel it on your ring finger or uh, or sorry or your middle finger? 

user: Um there is a little bit on my middle and ring finger, but it's like it's very very mild. 

assistant: OK. Uh, and uh, like how long, is, are the symptoms constant or or are they intermittent?
user: Um I would say it's somewhat constant, but it's worse when um when I'm trying to like hold the steering wheel or using my phone, or you know, reading a book. 

assistant: OK, I see, and um is there anything that you do uh at those times, to try to help get the symptoms to go away? 

user: Um I guess I like shake out my hand um or yeah, try to put pressure on those numb, numb areas. 

assistant: OK, does flicking the the wrist or anything like that, does it help?
user: Uh maybe slightly. 

assistant: OK. And uh like how would you describe the the pains in your hand, like dull, achy, sharp? 

user: I would say the pain is more like a tingling sensation. Um so I guess the tingling is is like a sharp feeling, um I wouldn't call it so much pain as I would just like tingling and numbness. 

assistant: OK. OK, and uh is is there anything, so you mentioned sort of the driving and using your phone, are there any other activities that make it worse?
user: Recently I found it's hard for me to hold things um in my right hand, so like if I'm trying to open up a jar um like it's hard for me to hold it, and sometimes I find uh like it'll just fall out of my hand. 

assistant: OK, so you're like dropping items and stuff?
user: Mhmm, yes. 

assistant: OK, and do you feel any, uh, like the numbness or tingling, does it radiate anywhere? Like to your forearm or up into your like upper arm or shoulder?
user: Uh no, I don't think so. No. 

assistant: OK. And do you have any neck pain? 

user: No. 

assistant: OK, and have you had any trauma or injuries to your wrist or hand?
user: No, nothing that I can think of. 

assistant: Alright. Um and, have you had any weight loss recently?
user: No. 

assistant: Have you had any night sweats? 

user: No. 

assistant: OK, have you had any changes to vision or hearing?
user: No. 

assistant: How about other senses like any changes to your sense of smell or sense of taste?
user: No. 

assistant: Alright, have you had a runny nose or felt congested? 

user: Uh no. 

assistant: Alright, have you had a sore throat or a cough, perhaps?
user: No. 

assistant: Alright, have you had any shortness of breath? 

user: No. 

assistant: Have you had any chest pain or feeling like you're uh like feeling like you have heart palpitations?
user: No. 

assistant: OK. Have you had any lightheadedness or dizziness?
user: Uh no. 

assistant: Alright, and have you had any nausea or vomiting?
user: No. 

assistant: How about any abdominal pain? 

user: No. 

assistant: Alright, how about any urinary problems?
user: Uh no. 

assistant: Have you had any changes to your bowel movements like diarrhea, constipation?
user: No. 

assistant: OK, and have you had any changes to your hair or nails? 

user: No. 

assistant: And any skin rashes or um anything like that?
user: No. 

assistant: Alright, and uh have you had any other pains in your joints or any joint swelling?
user: No. 

assistant: OK. Uh, and have you been diagnosed with any medical conditions before?
user: No, not that I can think of, yeah no, when I was younger I had like childhood asthma but nothing since. 

assistant: OK, do you use any inhalers now? 

user: No, not for a long time. 

assistant: OK, do you take any other medications?
user: No. 

assistant: OK, um and how about, do you have any allergies? 

user: No. 

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

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

user: So um I live with my boyfriend and we live in a rented basement apartment downtown. 

assistant: OK. Um and are you working currently, or are you in school?
user: Um I am a grad student. 

assistant: OK, excellent, and um do you smoke cigarettes?
user: I don't. 

assistant: OK, and uh do you drink alcohol? 

user: Um I'll have a glass of wine once a week. 

assistant: Alright. Um and do you use any recreational drugs?
user: Uh no. 

assistant: OK. And in the family, uh, are there any, is there a history of like hypothyroidism or other autoimmune conditions?
user: Um there's rheumatoid arthritis in the family, but that's about it. 

assistant: OK, um but you don't have any other joint swelling or pains, right?
user: No. 

assistant: OK. Uh, and so next I would like to just um uh do a physical exam, and for the first part I'll ask you to just have a look at the hand and wrist and, are you seeing any swelling, erythema or redness or like any muscle wasting or or atrophy?
user: Um so, in my right hand, um I guess the you know the fleshy part of your thumb just above your wrist, um that seems to be um I guess atrophied compared to my left hand. 

assistant: OK so, OK, so the muscle bulk is um reduced there.
user: Mhmm. 

assistant: OK, and are you feeling any temperature changes, like does the, any areas of the hand or wrist feel warm or hot? 

user: Um no. 

assistant: Alright. Um and are there any areas if you uh palpate that cause pain, like over the wrist or any of the joints?
user: No pain. Um yeah, no pain. 

assistant: Alright, um and, are you able to uh flex and extend your wrist?
user: Uh yeah I can do that. 

assistant: Alright, and and how about making a fist and and then also extending your fingers back out?
user: That hurts, or like that causes the tingling. 

assistant: OK, um are there any any issues with like moving your elbow or your shoulder?
user: No. 

assistant: OK, and if you take your opposite hand, um with just your uh kind of pointer finger and middle finger and just really tap, um right near the wrist crease called the Tinel's test, you tap there. Do you feel any reproduction of symptoms? 

user: Yeah, that that causes the tingling. 

assistant: OK, so you're positive Tinel's test, and um if you kind of place your wrist so that um like the backs of your hands are facing each other so that your wrists are flexed downwards and your um, your wrists are flexed and your fingers are pointing towards the ground and you just hold that position for a period of time. Um do you feel any pain?
user: Uh I guess a little bit of tingling. 

assistant: OK, so that would be a positive Phalen's test as well. Um and range of motion of the neck, do you have any problems with that or any pain there? 

user: No. 

assistant: OK. Um I think that was everything I wanted to ask about and check on the exam. Did you have any questions for me?
user: Yeah, so I'm I'm George, the father, my daughter is 5 years old and I noticed just a few days ago that she was walking a little bit funny and kind of having a limp when she came back from school. And since since that then, she's been saying that it just hurts too much to put any weight on on that leg, on the right leg. And since then I've been like carrying her around. It's been very painful for her. So I just wanted to come in and check what might be going on. 

assistant: OK and so so. And this, when did this exactly start?
user: So just two days ago. 

assistant: OK, an um did she have any trauma to her right hip or or to hurt your right leg like a fall or any injuries?
user: Sorry um no. Not that I know of at least and she hasn't told me anything like that. She does do some activities, some sports, but I haven't seen her fall anywhere. 

assistant: OK. Um. Alright, and uh, has she has she not not been able to walk then?
user: Yeah, so I've I've been carrying around for at least like she's missed school too, but been carrying her around for the last 1 1/2 to two days. As soon as I had like ask her to walk she starts kind of a hopping and saying that there's a lot of pain near the top of her leg and by your hips whenever she puts her foot like a foot down. So yeah, she's in pain crying, so I kind of have to carry her. 

assistant: OK. And, uh, how has her behaviour been recently like her mood and things like that? 

user: She's definitely been more just, a bit anxious about the pain. Very scared about putting her foot down and just overall, I think also more irritable crying more because of the pain so but I I guess I understand if there's something going on it must be very painful. 

assistant: OK, and. Alright, has she had any fevers or chills?
user: Uhm I. Did notice a couple of days ago she felt a bit warm but we didn't really measure her temperature. Over the last few weeks, though, she has had a. Kind of a runny nose and a cough and I think she might have had a fever last week as well so she has been sick recently. 

assistant: OK, so it sounds like she might have had a cold last week and did like the runny nose and cough go away?
user: Yeah, the runny nose and cough are gone. Fever was gone too, but she did feel a little bit warm yesterday so I'm not sure about that. 

assistant: OK, so she's at a a bit warm now still OK.
user: Yup. 

assistant: Has she had any any headaches?
user: No, no headaches. 

assistant: Any sensory changes like things to her vision or hearing or taste or smell?
user: No. 

assistant: OK. Any um sore throat or cough? 

user: No. 

assistant: Alright, any shortness of breath?
user: No. 

assistant: Any chest pain? 

user: No. 

assistant: Has she had a loss of appetite?
user: No. 

assistant: OK, and has she had any unexpected weight loss? 

user: Oh no, nothing like that. 

assistant: Any night sweats?
user: No. 

assistant: Any nausea or vomiting?
user: No. 

assistant: Any abdominal pain? 

user: No abdominal pain. 

assistant: OK, any diarrhea or constipation or blood in the stool?
user: No, nothing like that. 

assistant: Alright, and any problems with urination like pain or frequency? 

user: No, not that she's mentioned, no. 

assistant: OK. And any skin rashes or changes?
user: No. 

assistant: OK, and any muscle aches or body pains or any other pains anywhere else?
user: No, it's mainly just her upper right leg and hip. 

assistant: OK, I have she had any numbness or tingling? 

user: No, not that she's mentioned no. 

assistant: OK and and, how about a muscle weakness?
user: No. 

assistant: No OK. And any confusion or or memory loss? 

user: Um no. 

assistant: OK, I'm and in the past has she been diagnosed with any medical conditions?
user: She did have this condition with her hips. Dysplasia, like developmental dysplasia of the hip. So when she was born she she was getting like this clicking noise and her, in her hips and so she was in this splint for probably almost two months at the start, like after she was born. 

assistant: OK, and did her hips, did like was she able to walk afterwards?
user: Yeah, yeah. And we were seeing a specialist, an orthopedic surgeon and they were managing her and after one year they stopped following her. She was well like she was walking, no issues. 

assistant: OK, so she's walking around one year.
user: Mmm 

assistant: Have you had any other concerns about her, either social or physical development?
user: No, she's been really great. She's good with people, she's has great social skills. She has grown well, met all her milestones, she's doing really well at school and gets along well with her peers as well. 

assistant: OK, excellent. And were there any concerns throughout pregnancy, such as gestational diabetes or hypertension or any exposures to infections?
user: No, her mom's pregnancy was perfectly normal. She was born, like she was delivered vaginally at 39 weeks. She was breech at that time, which the doctor said might have to do with her clicking hips. But yeah, but since then or during pregnancy, no other complications. 

assistant: OK, that's great. And. Uh, in regards to, you mentioned her hurt hip any other past medical history? 

user: Um no other than that she's been healthy. 

assistant: OK, and does she take any medications regularly over the counter or prescribed?
user: No no, no medications. 

assistant: OK, any allergies to medications? 

user: No, not that I know. 

assistant: And sorry has she taking anything for the, the pain?
user: No, I haven't really given her anything, I didn't know what to give. 

assistant: OK all right, we'll talk more about that. Has she had any prior surgeries or hospitalizations?
user: No. 

assistant: Can you tell me about who she's living with and whereabouts she's living?
user: Yeah, so she's currently living at home with me, my wife, and she has an older brother. We live in a small house just near near the city. 

assistant: OK, and what do you guys do for work?
user: Yeah, so I'm a lawyer and my wife is a music teacher. 

assistant: OK, is there anybody who smokes in the home?
user: No, none of us smoke. 

assistant: OK um, OK, And any family history of heart or lung conditions? 

user: Uhm, no, no family history our family is pretty healthy. 

assistant: OK, how about any family history of any autoimmune conditions such as hypothyroidism?
user: No nothing like that. 

assistant: OK. And then any musculoskeletal or neurological conditions in the family? 

user: No. 

assistant: OK, so next on um just the exam. Um when you're looking at the right hip are you seeing any swelling, redness?
user: Uh, no, not that I see anything. 

assistant: No OK, and is there any like muscle atrophy around the hip? 

user: No, not that I see at all. 

assistant: OK and then is there any misalignment or deformity of the joints that you can see?
user: No, I can't. Yeah, I don't see anything in the hips or legs that really points out to me. 

assistant: OK um and is there any pain to palpation over the hip or or knee? 

user: Uh, if I if I press on it, I don't think she's in that much pain. It's mainly just when she's trying to walk or put put weight on it. 

assistant: OK, and is she able to move the hip in a full range of motion of like flexion, and extension, abduction, adduction?
user: Uhm, so she does. She is able to move it if she really tries. But it's mainly just the putting her weight on it and anytime she puts her weight on it is is when it really hurts. 

assistant: OK, so more about the weight on it, and is she able to move that her knee with a full range of motion? 

user: Yeah. 

assistant: OK, and any any muscle weakness when testing around the joint?
user: No. 

assistant: No, OK. So I think that was everything that I wanted to ask on history and check was there anything I maybe forgot about you thought would be more important today,
user: I've, uh, had a runny nose over the last few days and I've started to have a sore throat as well. 

assistant: Hmm, Uhm, when did this start? 

user: I would, so the runny nose started, uh, about five days ago and, and the sore throat, uhm, about the same. 

assistant: OK. Have you, uh, with the, the runny nose, do you have any, what's the discharge like?
user: Uh, it's been kind of watery, it's clear. 

assistant: OK. Alright and has your sore throat gotten better or worse over the past five days?
user: Uh, it did get a little bit worse initially and since then it's been kind of stable. 

assistant: Have you, uhm, had any difficulties swallowing? 

user: No, it, it is a bit sore, uhm, to swallow so it takes me a little bit longer to eat, but I've been able to still, still eat. 

assistant: Have you changed, noticed any changes in your voice? Any hoarseness in your voice?
user: No. 

assistant: No, OK. And do you have any nasal congestion? Does your nose feel stuffy? 

user: Yeah it does, yes. 

assistant: OK, uhm, any fevers or chills?
user: No, I don't think so. 

assistant: OK. Any difficulties breathing?
user: No. 

assistant: Any cough?
user: No. 

assistant: OK, uhm any, uh, pain in your chest?
user: No. 

assistant: Any other symptoms, anything related to your belly,  say, diarrhea or Constipation or any changes in your urinary, any urinary symptoms? 

user: No, nothing like that. 

assistant: OK, OK, are you feeling fatigued, tired? Have any muscle aches?
user: I, I have felt a little bit more drowsy these last few days and, uhm, yeah my, uhm, I have had some muscle aches as well. 

assistant: Have you taken anything to help yourself, anything over the counter or any pills? 

user: I did use, uh, some uhm, like cold medication to help because I was having a headache as well and a lot of I guess just like pressure from the nose stuffiness. 

assistant: Did the cold meds help?
user: Yeah, it did help a little bit, it did help my nose clear up but it came right back after a few hours. 

assistant: And how's your headache now? 

user: It's not too bad. It's pretty mild, but it's there. 

assistant: Uhm, do you usually get headaches of this sort, or is this very different from what you generally experience, if you usually have headaches.
user: I don't usually get headaches, but I have felt uhm, a headache like this before though. 

assistant: Oh OK, when was that?
user: Maybe the last time I was, I was sick. 

assistant: Sure.
user: Or if I don't get a good night's sleep. School's pretty early in the morning, so sometimes if I'm not sleeping well. 

assistant: I see. OK alright, any other symptoms that you've experienced over the past five days that I didn't ask you about?
user: No, it's been, yeah mostly the runny nose and sore throat and headache. 

assistant: I see. OK, alright, and do you have any medical conditions?
user: No, I've been healthy. 

assistant: All right, good, any medications that you take on a regular basis? 

user: Uh, I'll use like Reactine or Claritin sometimes for allergies, but that's it. 

assistant: What allergies do you have?
user: I have allergies to dust and some environmental things, like pollen or ragweed I think maybe. 

assistant: I see. Alright, and, uhm, do you have any family history of any medical conditions?
user: Uh, I think my dad has high blood pressure. He takes a medication for that, uhm nothing serious though that I know of. 

assistant: OK, alright, and who do you currently live with? 

user: So I live with both my parents and I have an older sister as well. 

assistant: Good, OK, and do you smoke?
user: I did try a vape once or twice, but, didn't really like it so, no. 

assistant: Alright, what about marijuana? 

user: Uh, no, I haven't tried that. 

assistant: Any recreational drugs?
user: No. 

assistant: Do you drink alcohol? 

user: No. 

assistant: And have you recently traveled anywhere?
user: No, we've been doing classes virtually. 

assistant: And any contact with anyone who you think might be sick.