jshargo/medical-interview-conversations2 huggingface dataset:
user: Um, I would say it's getting worse. 

assistant: OK, and right now what would you say is the most troubling symptom for you? Is it that pressure in your face or is it the congestion?
user: It's the...it's the pressure in my face. It hurts. 

assistant: Yeah, have you tried any medications, over the counter medications at all? 

user: I tried some nasal sprays. And like decongestions but it's not really helping. 

assistant: OK. And so you've tried nasal sprays? Have you tried any of those, like nasal rinses, or anything like that?
user: Yeah, and they don't seem to be helping. 

assistant: I see, OK. Any recent contact with anyone who's been ill or any recent travel?
user: Uh, no. 

assistant: OK, any nausea or vomiting?
user: Uh, no. 

assistant: Any fevers or chills?
user: No. 

assistant: Any fatigue?
user: : Yeah, I've been feeling tired. 

assistant: OK, and how many days would you say you've been feeling tired for? 

user: Uh, I would say for the past three days? 

assistant: OK, and do you feel that, you know you're having some discharge, but do you feel that there is mucous building up and dripping down your throat or anything like that?
user: Yeah, now that you mention it, it does feel like that. 

assistant: OK, and have you noticed at all or has someone told you that your breath might smell bad? Or have you noticed it yourself?
user: Oh gosh, I hope not, no. No one said that. 

assistant: OK yeah, sometimes with like mucous buildup it can affect like your breath as well. So yeah, just wondering. Any chest pain at all? 

user: No, no chest pain. 

assistant: Constipation or diarrhea?
user: No. 

assistant: Any issues with urinating? 

user: No, no issues there. 

assistant: Any changes in your sleep or appetite?
user: Well, I guess sleeping is a little bit harder now because of the pressure in my face, but other than that, no. 

assistant: OK, is there anything that helps you at all that you've tried?
user: Like just the positions of how I'm sleeping sometimes helps, yeah. 

assistant: OK, so this has been going on for, just remind me again, like the last four day? 

user: Yeah, the last three days, last three days. 

assistant: OK. Do you have any other medical conditions at all that you've been diagnosed with in the past?
user: No, not that I can think of. 

assistant: OK. Alright, so have you noticed at all any weight changes? 

user: No. 

assistant: OK, and have you been exposed to like fumes or dust? Or how do you have any animals or pets at home?
user: No, nothing like that. 

assistant: OK, and do you take any medications or anything regularly? 

user: Um no, I just take some multivitamins. 

assistant: OK, and do you know if you have any allergies?
user: I just have some, I just have some seasonal allergies. 

assistant: OK, any previous hospitalizations or surgeries? 

user: Uh, no, actually I had my appendix taken out when I was 12. 

assistant: OK. Right, and do you have any family history of any conditions, like any lung conditions, heart conditions, any cancers?
user: Um, I know that there's some asthma that runs in the family. 

assistant: OK, and have you ever been diagnosed with asthma?
user: No.  D OK. Where currently where do you live?  I live in a house with my husband and my 3 year old daughter. 

assistant: OK. And do you currently smoke cigarettes?
user: No. 

assistant: Do you drink alcohol?
user: I don't. 

assistant: Any recreational drugs like marijuana? 

user: Um, I'll smoke a joint or two once a week. 

assistant: Ok, a joint or two, OK. And is that, is that just recreationally or has it been helping at all with your symptoms?
user: Uh, that's just recreationally. 

assistant: OK. Alright, yeah, so those are all the questions I had for you today. Do you have any questions at all for me? 

user: Uh, no, what was like, what do you think I have? 

assistant: Yeah, so from the symptoms that you're describing, it does seem more like sinus issues. There's a sinus behind your face and what can happen is if you get an infection, like all the the mucous and everything can build up and increase the pressure. That's the pressure you're feeling underneath your face.  It's because of a sinus infection most likely. And usually like, it's usually like a viral infection that can go away on its own. We usually ask patients to try the nasal rinses, and then some oral decongestents. Or have you tried any anti histamines?
user: No, I haven't. 

assistant: OK, so no antihistamines. It seems most likely that you have a sinus infection. It can be bacterial with the yellow discharge that you're having as well. So we can give you some antibiotics, so will give you some. Amoxicillin.
user: Sure. 

assistant: So it's only been three day since you're having these symptoms, right?  And you haven't had any high fever or anything like that? Have you measured your temperature? 

user: I haven't, I haven't, no. 

assistant: OK.
user: I don't feel hot though. 

assistant: OK, since it's been three days, what I'm going to do is still give you some antibiotics so Amoxicillin and then we'll see like after you finish that dose how you feel. And will set up another appointment for when we can do like a phone appointment and or clinic appointment when your doses are done. Does that sound good? 

user: Yeah that sounds great. Thank you. 

assistant: OK, you're welcome and hopefully you feel better.
user: I just came in here today, I usually don't come to the doctor that much unless I absolutely need it. Five days ago I started having this pain and swelling in my right knee. So and at first I thought it was just like my arthritis acting up but it's been getting more swollen and painful than usual, so I just wanted to come in and check it out. 

assistant: OK, so when did you first notice that this pain, like when did it get more swollen and painful than usual? 

user: So like I would say around 5 days ago it started getting more and usually I do get pain in some of my joints but I I don't really get swelling so that was a bit different. 

assistant: OK, and is the joint hot as well, or is there a temperature change?
user: It is, it does feel like if I touch the joint it does feel a bit warmer than the surrounding areas. 

assistant: OK, does it look red? 

user: It It definitely it definitely looks more red than my other knee. 

assistant: OK, and so what knee is it that, that's bothering you right now?
user: It's the right knee. 

assistant: OK. And so this pain has been going on for the last five days. Has it been getting better, worse, or staying the same?
user: I think it's getting a. It's getting it was getting worse, but it's like a bit better right now. 

assistant: OK.
user: Yeah it comes and goes in severity though. 

assistant: OK, and how would you describe the the pain. The character of it, is it sharp, dull, or achy?
user: It's it's like someone is stabbing me in the knee and it hurts the most when I'm moving the knee. 

assistant: OK, and does the pain radiate anywhere? 

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

assistant: OK, so you're feeling it just in the knee and you said moving the knees is painful. Is there anything else that makes the pain worse?
user: Uhm, not really like resting it definitely helps, yeah, but I just have to keep it a bit immobilized. 

assistant: OK, and is there anything that that makes the pain better that you've tried like maybe medications or any ice packs or anything like that? 

user: Uh, not really. I do take some painkillers, so just some Advil, which seems to help a little bit. 

assistant: OK. And. And um. OK, is the pain worse at any particular time of the day, like do you have morning stiffness?
user: Yeah, usually with my normal this arthritis I do get some morning stiffness but this is completely different, it's throughout the day pretty much. 

assistant: OK, and did you have any trauma or any injury to the knee? 

user: No, I didn't. 

assistant: OK, uh.
user: I I did have like a steroid injection to the same knee just a week ago, but no, I I haven't fallen on it. I haven't had any operations. 

assistant: OK. Anne. And. Have you had any fevers or chills? 

user: No. 

assistant: OK, have you had any changes to any of your senses like vision, hearing or your sense of smell or taste?
user: No, nothing like that. 

assistant: Have you had a runny nose or sore throat? 

user: No. 

assistant: Have you had any cough or shortness of breath?
user: No. 

assistant: How about any wheezing? 

user: Nope. 

assistant: Have you had any chest pain or yeah, have you had any chest pain?
user: No. 

assistant: How about any lightheadedness or dizziness? 

user: No, 

assistant: OK and have you had any nausea or vomiting?
user: Um nope. 

assistant: Alright, have you had any loss of appetite? 

user: No. 

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

assistant: Have you had any changes to your bowel movements such as diarrhea or constipation, incontinence?
user: No. 

assistant: Any urinary problems like painful urination or frequency. 

user: No, not really. 

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

assistant: OK, and any other painful joints or muscle aches or body pains? 

user: Yeah, I just got my general like I havee osteoarthritis, so I like It's been a pretty long time though but I get some pain in my hips sometimes my knees, so it's it's that's been going on for awhile, but this is something I've never experienced though like this significant pain and swelling and redness. 

assistant: OK. And have you had any changes to your memory or any confusion?
user: Nope. 

assistant: OK, and have you had any unexpected weight loss?
user: No. 

assistant: And how about any night sweats?
user: No. 

assistant: OK, Um in the past have you been diagnosed with any medical conditions?
user: I do have. So I have a couple conditions. I have osteoarthritis in both my knees and hips. I have high blood pressure. I did have a heart attack four years ago and I also have had heart failure. And also I'm just a bit on the overweight side. 

assistant: OK, are you currently taking any medications?
user: Yeah, so I am taking just um Furosemide then Ramipril for my blood pressure. But yeah, that's that's about it right now and like just painkillers over the counter.  DL OK, uh. And any allergies to medications?  Um, just to have a penicillin allergy. 

assistant: OK, and what's the rash, or sorry what's the reaction?
user: I don't really remember I was a child at that time. I don't remember what reaction I really got. 

assistant: I see OK and have you had any prior hospitalizations or surgeries? 

user: Surgeries I did have my appendix removed when I was young and also I was hospitalized after my heart attack a couple years ago. 

assistant: OK, did you have any surgeries on your on your heart like a cabbage or?
user: I had a couple a couple of stents put in. 

assistant: OK, and you take aspirin for that?
user: Um yeah. 

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

user: Yeah, I live with my wife and daughter. And kind of live in a small little townhouse just, in the city. 

assistant: OK, uh, are you currently working or uh, are you retired?
user: I I kind of had to retire after just my past medical history like the heart attack and then. There was just too much stress at work. It was too much for me. But yeah, I'm just at home right now. My wife still works. Yeah, I'm taking it more easy now. 

assistant: OK. And with being at home, are you able to manage the majority of activities of daily living on your own, or are you receiving help? 

user: Oh you're not receiving any outside help. I can do most things myself. My wife does most of our shopping and cooking though. 

assistant: OK. And do you drink alcohol?
user: Yeah, I I do. I do drink probably drink like three or four beers a night. 

assistant: OK, Ann, and at the smoke cigarettes?
user: I used to I I forced myself to quit after my heart attack. 

assistant: OK, well that's good. I'm glad that you quit and how long did you spoke for and how much were you smoking during that time?
user: Probably smoked for more than 30 years and I was smoking only one to two packs a day at most. 

assistant: OK. And. OK, and then I about your um family history. Is there anybody in the family that has any heart or lung conditions?
user: Yeah, so heart disease runs in my family. My brother, my dad, they both both have had heart attacks. But yeah, my on my mom side everyones pretty healthy though. 

assistant: Oh OK, that's good, and Alright, so I just wanted to the I guess physical exam piece you've already mentioned that it's red, it's swollen and is warm to touch compared to the other knee and um painful to move. Are you having any limping with your gait?
user: Yeah, I barely like I can't really put too much away or move that knee around. So yeah, if I stood up I would have a limp. 

assistant: OK, uh, and is there any instability to either varus or valgus stress? 

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

assistant: OK, and any instability when testing the ACL or PCL with the anterior and posterior kind of translation test. Pulling and pushing it?
user: Uhm, no. 

assistant: OK. And any I don't think I asked this any muscle weakness? 

user: No. 

assistant: And any numbness, tingling?
user: No. 

assistant: Or burning sensations? 

user: No. 

assistant: OK. Alright, so that was everything that I wanted to check. Was there any anything that I may be missed or any final questions?
user: I've had, uh, worsening, uhm, shortness of breath, uhm, for the past couple of days. 

assistant: OK, and, this has just been getting worse over the last couple of days?
user: Yeah. 

assistant: OK, how far are you able to walk before getting shorter breath?
user: A couple of stairs, two to three stairs. 

assistant: OK, and how far were you able, to, to walk before that? 

user: Hmm, I'd say about ten or eleven stairs. 

assistant: OK, and have you had shortness of breath like this before?
user: Yeah, uhm, six months ago. 

assistant: OK, could you tell me about what happened six months ago? 

user: Yeah, yeah, I was feeling all, I was feeling, just like this was feeling awful. I went to the hospital. They started me on a water pill, kept me for a couple of days and then sent me back home. Uhm, they changed some of my meds, I think, increased the dose of something and yeah that's what happened. 

assistant: OK, I see and have you been having, uhm, any swelling?
user: Yeah, Oh my goodness, it's so bad I couldn't wear my shoes this morning. It's gotten worse over the past, one month. 

assistant: Have you, have you had any changes to your weight?
user: Yep, gained five pounds in the past two months. 

assistant: And have you had any changes to your appetite or, or diet or exercise? 

user: I can barely exercise. I feel so short of breath. My dad's the same. 

assistant: OK, uhm, and have you had any, uh, instances where you've woke up in the middle of the night extremely short of breath?
user: Yeah, that happened last night, couldn't fall asleep. 

assistant: Did it help, uh, sitting up? 

user: Yeah, I just went and sat on my chair and slept on the chair. 

assistant: OK, and do you, uh, typically have problems with shortness of breath if you lie flat?
user: I do, I have to, uh, started using two pillows. 

assistant: Is this a nightly thing? 

user: It's, it's fine with the two pillows now. 

assistant: OK. Yeah, and have you been experiencing any cough?
user: No. 

assistant: Alright, and, uhm, how about any, any chest pain? 

user: No. 

assistant: Have you been having any, uh, instances feeling as though your heart's racing or beating out of your chest?
user: No. 

assistant: Alright, have you had any fainting or dizziness? 

user: Uh, no. 

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

assistant: OK, have you had any infectious symptoms such as uh, eye redness, eye discharge, nasal discharge or, or sore throat?
user: Not recently, I had that about two months ago, but that got better. 

assistant: OK, did you need antibiotics two months ago? 

user: No, no, just lasted a couple days and got better on its own. 

assistant: I see OK and, uhm, have you been having any abdominal pain?
user: No. 

assistant: How about any changes to bowel habits such as diarrhea or Constipation? 

user: Uhm, no. 

assistant: Any urinary problems?
user: I do, I, I uhm, I leak urine sometimes, actually quite often. 

assistant: OK, and do you use any medications? 

user: No I, I, well I do, I use a lot of medications, uhm, but I  don't remember their names. Uh, I have this blister pack and I just take everything in it. Uhm, I also I brought the list of prescriptions, I can give that to you. 

assistant: For sure, yeah I could go through, go through that, uhm here, uhm so, but first, have you been diagnosed with any medical conditions in the past?
user: Yeah, I have uh, heart, heart failure and uh, had two heart attacks and have high cholesterol, high blood pressure and, uh, I'm also overweight. 

assistant: OK, do you know what your BMI is currently?
user: What's that? 

assistant: So this is a measure of body mass index and, uhm, can help give an indication about weight ranges, uhm, whether, uhm, being in a healthy weight range or, uhm, a weight range that's associated with, uhm, risk of certain diseases such as high blood pressure. 

user: No, I, I, I don't know. I, I've never heard of that. I, I know my weight, I could tell you that. 

assistant: Sure yeah.
user: I'm 250 pounds. 

assistant: OK, and yeah we can check that, uh, with your height today. 

user: My height is 5'2". 

assistant: OK, thank you. And, uhm, so just looking at the medications here now, I see a variety for uhm, cardiovascular protection, so things like aspirin, beta blocker, ACE inhibitor, statin, uhm and, uhm, do you have any allergies to medications?
user: No. 

assistant: Uhm, and have you had any, uh, so you mentioned surgeries to your, to your heart? Do you have a stent placed?
user: Yeah, I had to stent put in after the first heart attack about five years ago and then another one, uh, three years ago. 

assistant: OK, and have you, have you been stable in regards to your, uh, like chest pain? Have you had any? 

user: No, I haven't had chest pain. I have a, uhm, a heart doctor who, uhm, I went to see after the last hospitalization six months ago. Things were looking OK at the time. He ordered a bunch of tests. I Haven't done all of them yet. 

assistant: OK, do you know, uh, by any chance, what the, uh, last ejection fraction was on your echocardiogram?
user: I don't know, I, I don't know all of that. I don't know, you have to ask my daughter, she knows much more about me. 

assistant: Yeah, no problem, well, we could look into, uh, some of those old, uh, older tests that you've done. OK, and, uhm, so can you tell me a little bit about your living situation currently? You mentioned your, your daughter, are you living with your daughter?
user: Yeah, I live with my daughter. My husband passed away, uh, three years ago, and so I've just been staying with my daughter. It's just the two of us now. 

assistant: I see, I'm sorry to hear that about your husband. Uhm, are you currently, uh, like functioning independently around the home, or does your daughter help with a lot of the tasks? 

user: Oh, she, she, she has to help me out, uhm she has to help me out. I uhm, I sometimes need help with the showering, simply because I get really short of breath and then, so I have to stop and it's just, she's just worried that it's unsafe, so she helps me out with that. Uhm, she gets most of the things done at home. She does the groceries and everything. 

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

assistant: And, do you drink alcohol?
user: Not anymore. 

assistant: OK, do you smoke marijuana or use any cannabis products?
user: No, no, no, no, nothing like that. 

assistant: Alright, then, uh, do you, uhm, use any other recreational drugs? 

user: No, no I don't. 

assistant: Alright, uhm, have you been around anybody who you think might have been sick?
user: No, I've just been staying at home. My daughter's been working from home too. 

assistant: OK, so uh, you haven't had much contact with, uhm. 

user: No. 

assistant: With others recently? OK, have you, so you haven't traveled anywhere?
user: No. 

assistant: Alright, uh, and uh, and in terms of family history, has anybody had any heart or lung conditions? 

user: Oh yeah, everyone in my family has high blood pressure. My mom had a heart attack. My brother had a heart attack. My sister had a heart attack. Everyone, everyone has heart problems. 

assistant: OK, certainly sounds like something, uh, common in the family. Has there been any other, uh, conditions that run in the family?
user: No. 

assistant: Alright, uhm, I, I don't, I don't think I asked. Have you had any fevers or chills?
user: No. 

assistant: OK and or, or any night sweats?
user: No 

assistant: OK, and, uh, I might have asked, but just to, to be complete, did you have any nausea or vomiting? 

user: No. 

assistant: OK, uhm, so were there any other symptoms or anything else that, that I may have forgot to ask about?
user: Hi, I was just really worried. My son just yesterday night I noticed that he was making these grunting noises and I did notice that he was a bit warm yesterday as well, and today I, he just hasn't been himself, just very, very irritable, crying a lot. Yeah, I just got bit worried. 

assistant: Yeah, for sure. What started first? 

user: I would say the there was a little bit of coughing earlier, like yesterday. But then later on during the night, it kind of turned into this grunting noise, and he's kind of like his chest is moving a lot more when he's taking a breath in and all that. 

assistant: OK. Uhm did you measure his temperature at home?
user: Yeah, so I think it was 38.5 degrees Celsius. 

assistant: OK, and did you do that orally or rectal or under armpit?
user: I did it under the armpit. 

assistant: OK. OK, uhm so you mentioned that he's had a fever, he's been grunting and he just seems a little bit more fussy. Is that right? 

user: Yeah. 

assistant: OK is he coughing at all?
user: He was yesterday but not really now. 

assistant: OK and was it a dry cough?
user: I think so. I mean, not-nothing really came out. 

assistant: OK, that's good. So no blood, no sputum?
user: No. 

assistant: OK, and did he seem wheezy?
user: Uh, no. 

assistant: No, OK. So there's no wheezing with the grunting? 

user: Maybe a little bit like that, just a little bit of a noise, but it's mostly the grunting. 

assistant: OK. Has he had any weight loss?
user: No, not that I really, we haven't really weighed him now since his last appointment. 

assistant: OK. Does he seem excessively tired or fatigued?
user: Uhm, moreso today I would say he's like earlier, he was very fussy, but now he seems a bit more tired. 

assistant: OK. Any rashes that you've noticed? 

user: No. 

assistant: No, OK. Uhm any changes in his vision or hearing?
user: Uh, no, not that I can tell. 

assistant: No, OK. So he's responding to like sounds and he's still looking at you and things like that?
user: Yeah. 

assistant: OK. Have you noticed a runny nose or stuffy nose?
user: Uhm, no, nothing like that. 

assistant: No, OK. And he said he hasn't had any like fainting spells?
user: Uh, no, I don't think so. 

assistant: No, OK. And how many wet diapers is he producing in a day now? 

user: Probably 5 or 6. 

assistant: 5 or 6 OK. Has that changed from before?
user: No, it's pretty much the same. 

assistant: OK, and uhm any changes to his bowel movements?
user: No. 

assistant: No. How about his urine? 

user: No. 

assistant: No, OK. OK. And then you said he was fussy, is he still eating and drinking OK?
user: Uh no, today he's not really taking anything in, like very fussy, very hard to feed him today. 

assistant: OK, is he crying a lot?
user: Earlier today was crying a lot, but now has calm down and just I guess tired himself out. 

assistant: Yeah, OK. Alright, and is he an otherwise healthy child? 

user: Yeah he was, he was premature by three weeks so, Other than that like I remember when he was born they did have earlier some issues with his oxygen not being high enough and they had to like keeping, keep us in the hospital for a bit longer. 

assistant: OK.
user: But yeah, after that, like there haven't really been too many concerns. 

assistant: OK, so he's hitting all the developmental milestones like in terms of motor movements, ah speech, behaviour, all of that?
user: Yeah, no issues there so far. 

assistant: OK, and how about medications? Is he on any?
user: No. 

assistant: No medications, OK. And is up to date with all his immunizations?
user: Yeah, oh he had all his immunizations so far. 

assistant: OK. How about allergies? Does he have any?
user: Not that I know of. 

assistant: No, OK. Any family history of lung or heart conditions? 

user: No. 

assistant: OK, and does anyone at home smoke?
user: No, no one smokes. 

assistant: OK. Has he been in contact with anyone sick recently? 

user: Uh, no, not that I know of. Uhm his older sister does go to school though, but I don't know if she might have carried something home. 

assistant: OK, how old is she?
user: She's six years old. 

assistant: Six, OK. And is she healthy or is she having similar symptoms?
user: No, she's healthy. No, no symptoms. 

assistant: OK. Any travel recently? 

user: No. 

assistant: No, OK. And who does he live with at home?
user: Uh, so his older sister, me and his mother. 

assistant: OK, any reasons to believe like you have old carpets, dust, mold, asbestos, pets, anything like that that could worsen his symptoms? 

user: Uh, no nothing like that. 

assistant: OK, so I think those are all the questions that I had for you. Did you have any questions or any concerns? Anything that I missed that you wanted to add?
user: No, I think that was all. 

assistant: OK, uhm so for him we'll do a Covid swab just to rule that out because some of his symptoms do overlap with that. But it it's really sounding like a picture of like community acquired pneumonia, so we'll do a couple of things for him. Uhm, we can get his temperature, get his oxygen oxygen saturation right away we'll get a chest x-ray. We'll do some blood work as well and uhm, he might need to be admitted depending on uhm, the oxygen, oxygen saturation and the fact that he's grunting. So if he's admitted will give him some extra oxygen and keep monitoring him and keep him hydrated. Uhm we'll also give him some antibiotics if, if it turns out he has pneumonia. Yeah, does that sound OK?
user: Yeah, I've had uh, a cough that's been um, bugging me for the last several months now, and more recently I've noticed that I've started to bring up a bit more, or a little bit of blood as well. 

assistant: Okay, well that's not good. So you said the cough started several months ago, how many months ago do you think, like three, four, five? 

user: Uh, yeah I would say, yeah, maybe like, like five or six, and it kind of started um, it was really infrequent and so it didn't really, well I thought it was just the usual smoking, but it's been getting worse over these last, over these past six months. 

assistant: Okay and um, the blood in the cough, when did that start?
user: So that started about, uh, about two weeks ago. 

assistant: Two weeks ago, okay. Um, how much blood are you coughing up like, if uh, like is it the size of your palm, is it more than that, less than that?
user: Uh, I would say less than that, like each time there's maybe to about the size of I don't know, uh, like a looney. So like inside of the palm. 

assistant: Okay, sure. Um, and are you experiencing any shortness of breath along with your cough?
user: Yeah, now that you mention it, I have been. It's uh, you know, I thought that was just kind of me getting older and the smoking, but I've certainly been able, I haven't been able to walk as far and even uh, to the end of the driveway getting the mail now is, is pretty, I'll get short of breath. Before I used to be able to walk a lot further than that, just a couple of years ago. 

assistant: Yeah, for sure. Um, and sorry you said, you mentioned, you mentioned you had some wheezing as well, right?
user: Um, I haven't really had any, noticed any wheezing. 

assistant: No, okay. Um, and have you had a fever recently?
user: No. 

assistant: Weight loss? 

user: Um yeah, now that you mention it, maybe, maybe a little bit, like 5 to 10 pounds over the last, the last month. 

assistant: Last month, okay. Um, any chills, fever, sorry, chills, or night sweats?
user: No um, no, I haven't had anything like that. 

assistant: Okay, any rashes?
user: No. 

assistant: Changes in your vision or hearing?
user: No. 

assistant: Um, how about a stuffy or runny nose? 

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

assistant: Okay um, and then change in your smell or taste?
user: No, that's been normal. 

assistant: Okay, and how about chest pain? 

user: No, I haven't had any chest pain. 

assistant: Okay. Um, and do you ever feel like your heart's racing?
user: No, I haven't had anything like that. 

assistant: Okay, how about calf pain when you walk, like more than a block or two?
user: No, I haven't had any symptoms like that. 

assistant: Okay, any changes to your bowel movements? 

user: No things have been normal there. 

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

assistant: Uh, changes to your urine? 

user: No. 

assistant: No. Uh, headaches?
user: Every once in a while, I'll get a headache, but it's, they're pretty mild. Usually I'll take an Advil and they go away. 

assistant: Sure, um, how about dizziness or fainting spells? 

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

assistant: Okay, um, any confusion or memory loss?
user: Uh, I guess I um, forget things a little more easily now, but, that's just part of getting older. 

assistant: Okay, sure. Um, and then other questions I have for you, are um, are you otherwise healthy? Do you have any major medical, medical conditions?
user: Uh, I have arthritis um, in my knees and uh, hands, um so I have a lot of pain from that sometimes, and I also have high blood pressure and um, GERD. 

assistant: Okay. 

user: Or acid reflux, yeah. 

assistant: Sure. Do you take any medications for these things?
user: Um, yeah, I'll take Tylenol um, for the arthritis, and sometimes use some like, topical creams for my knees. Um and uh I, I take amlodipine as well, I think, for the blood pressure. 

assistant: Okay. Okay, and um, are you up to date with all your immunizations?
user: Yeah, yeah, I remember getting one not too long ago, actually. Well, seven years ago I guess now, but I didn't realize, that we uh, had to get anymore. 

assistant: Um, so yeah, after you turn 65, they should've given you the Shingrix for shingles and pneumococcal vaccine, does that sound familiar?
user: Yeah it does. Yeah, I just didn't know about them until that time. 

assistant: Okay yeah, sure. Any allergies that you have?
user: Uh, I don't think so. 

assistant: No. How about family history of lung or heart conditions? 

user: My uh, grandfather had, had lung cancer. And he was in his uh, 70s when he, when he passed away, I remember. 

assistant: Okay, okay. And do you currently smoke?
user: I do, yes. Yeah, I, I smoke um, I don't know, maybe half a pack a day now, which is, it's a lot less than I used to. I was smoking two packs a day at one point. 

assistant: Okay, well congratulations on cutting down. Um, yeah, if you need help cutting that down even more, let us know, we have resources that you may be able to use.
user: Yeah, absolutely. Thank you. 

assistant: Yeah, no problem. Do you do any other recreational drugs like marijuana, cocaine, heroin, anything like that? 

user: Yeah since I, oh CBD drops, I, at night I find that helps with uh, sleep and, and the pain in my knees. 

assistant: Oh okay, are those prescribed drops?
user: Um. well I do buy, I get them from uh, like the uh, the OCS store, I think they're called. 

assistant: Okay yeah. Okay, that's good that you're getting them from, like an official store.
user: Yeah they're for, they were, uh, my friend said that they worked for her, and so I just gave them a try and I, I found that they've helped. 

assistant: Okay, good. Um, and where do you live right now? And who do you live with?
user: Yeah, so I live in uh, in an apartment with my, with my husband. 

assistant: Okay, And any like, old carpets, dust, mold, or asbestos in this apartment? 

user: No, I don't believe so. It's relatively new. We just moved out of our house, uh, just to make it a little easier on us. 

assistant: Okay yeah, for sure. Um, have you been in contact with anyone sick recently?
user: No, I don't think so. I've been spending a lot of time at at home uh, with my husband, and he's been okay. 

assistant: Okay, good. How about travel?
user: No, we've been pretty scared with uh, COVID and all that, so we've been staying, staying home for the most part. 

assistant: Okay, okay, good. Um, those were all the questions that I had for you today. Did you have any questions of your own for me? 

user: No, I was just really concerned when I started to see um, the blood coming up more recently, and so I was just hoping to get this figured out. 

assistant: Yeah, for sure. Um, so they're a couple of things we're gonna work you up for. Um, because some of your symptoms overlap with COVID, we'll start by getting a COVID swab and you should hear back in about 24 to 48 hours. Um, we will also do a chest x-ray um, to look for any signs of lung cancer. Um, and then if we see consolidation or anything that would indicate um, like a mass in your lungs, we will discuss options for like biopsies which is the gold standard for diagnosing lung cancers. Also, I know you haven't had any recent travel or anything like that and your symptoms have been going on for a long time, but uh, it may also be worthwhile to uh, also check for things like TB, which could also cause you to cough up blood. Um, so we'll start, we'll start from there, and then if those come back negative, then we'll work you up further for other things that you may have, but are like more rare. How does that sound?
user: Hey, I've just been feeling kind of ill over the past two days and uh, I thought I'd just come in to see what's going on. So I've had um, um, I was feeling very achy and I had a cough and then I think yesterday night I developed a fever. 

assistant: OK, and so um, last night you developed a fever. What, uh, did you check your temperature?
user: Um, I didn't, but I'm pretty sure I have a fever and like I can feel it. 

assistant: OK. Have you had any chills or night sweats?
user: I had chills last night. 

assistant: OK. Uh, so you mentioned you've had a cough as well, and when did that start?
user: Two days ago. 

assistant: And is the cough been, um producing any phlegm or sputum? 

user: No, it's kind of dry cough nothing 

assistant: alright. How about any any blood?
user: No. 

assistant: OK. And you've had muscle aches. Has this been like a whole body type of feeling, or is it any particular muscles that hurt?
user: No. 

assistant: Alright. And have you had a cough before or is this a new cough?
user: It's a new cough. 

assistant: Have you had any wheezing with the cough?
user: A little bit. 

assistant: Yeah, so you've had wheezing as well. Are you able to to hear it? 

user: Yeah, it's just like I can kind of like tell, when I'm breathing like it just, yeah. It sounds different. I don't know what a wheeze sounds like, but it just sounds different. 

assistant: OK, um, and have you had any chest pain?
user: Uh, uh, sorry, can you say that again? 

assistant: Sorry um, did you have any chest pain? 

user: Uh, no. 

assistant: OK. Um, have you had any, uh, um, symptoms such as red eyes or or itchy eyes or runny nose?
user: No. 

assistant: OK, have you had a sore throat? 

user: No. 

assistant: Any nausea or vomiting.
user: No. 

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

user: Uh yeah, I kind of just foods have just been tasting little bland, since yesterday. 

assistant: OK, so yeah, I lost of taste today. Have you had a runny nose at all?
user: No 

assistant: OK. Any abdominal pain or diarrhea?
user: No. 

assistant: Any urinary problems like uh pain or frequency. 

user: Uhm? I uh, I I've had that for a while like it's just I think my prostate's kind of large so it's it's hard for me to, like I pee very frequently. 

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

assistant: Uh. And how is your energy been?
user: I've been feeling a little tired. 

assistant: Alright, so you've had this dry cough that started two days ago. Been feeling feverish, have had some muscle aches, been tired and also a loss of taste. Have you been experiencing any other symptoms? 

user: No, that's I think that covers it all. 

assistant: OK. Oh sorry, I asked about chest pain, but have you had any like dizziness or feeling like you're going to faint or even like your heart's racing really fast?
user: No. 

assistant: OK, have you been diagnosed with any medical conditions in the past?
user: Um, just a large prostate. It's not cancer or anything, it's just kind of large. 

assistant: OK so I have you heard of BPH before? 

user: Yeah, I think that's what the doctor said. 

assistant: OK, and do you take any medications for that or for any other reason?
user: Yeah, I do. I do take a I think a medication for that. Uhm? It's called tamsulosin. 

assistant: OK yeah call me what is like Flomax or or tamsulosin, but there are there are others for sure. 

user: Yeah I think I think it's called Flomax. 

assistant: OK yeah it's the brand name for it but lots of yeah lots of different namings can be hard for the medication sometimes. And have you had any surgeries or hospitalizations?
user: Nope. 

assistant: Do you have any allergies? 

user: Nope. 

assistant: OK um, and can you tell me a little bit about where you're living and who you're living with?
user: I just live with wife in an apartment. 

assistant: OK. And has she had any symptoms or been sick at all? 

user: Oh no, she's feeling good. 

assistant: Have you had any sick contacts?
user: I don't, no I haven't. I don't think so. I mean potentially. I was. I was actually out with my friends, but no one was sick. 

assistant: OK. Have you traveled anywhere?
user: Nope. 

assistant: OK. And do you smoke cigarettes?
user: I used to, I quit. I quit 10 years ago. I used to smoke about two or three cigarettes a day for 20 years. 

assistant: OK, well congratulations on quitting, that's great.
user: Thanks. 

assistant: Do you smoke cannabis or use cannabis products?
user: Nope. 

assistant: Do you use any recreational drugs?
user: No. 

assistant: And do you drink alcohol?
user: Yeah, maybe sometimes once or twice a month, maybe a glass or two at a time. 

assistant: OK, uh. And anybody in the family have any heart or lung conditions.
user: Uhm? Yeah, I think it's called Hypertrophic cardiomyopathy where people kind of die early. People get like people in my family got heart attacks very early on in their 30s. My brother died and when he was 15. 

assistant: Oh wow, sorry to hear that and uh, has that been looked into for yourself?
user: Oh yeah, I see a cardiologist. I get regular checkups done. 

assistant: OK. And. OK, and uh, so that was everything that I wanted to ask about on history today. Did you have any anything else that you wanted to mention or anything you were concerned about?
user: No. 

assistant: OK, um so with your your symptoms today, they do overlap potentially with covid, and So what we'll need to do or will well, it'll be important to do a swab to test for covid. It could be something else like the common cold. Like another type of viral illness, but because of the pandemic it will be important to self isolate, including from your wife, for the next 14 days and we'll get back to you with the results as soon as we can.
user: Really I just don't I I don't feel quite right like I've had this pain in my chest for five days now and I've been just feeling kind of out of breath. 

assistant: Oh OK, um where are you feeling this pain? 

user: Um, it's it's kind of um. On the left side of my chest and it's just like a tiny. It's like a lingering sharp pain. I don't really feel it anywhere else. It's just kind of there all the time right now. I I've never had anything like this before. 

assistant: OK, so you're not feeling the pain radiate any to any other locations. You're just feeling it sort of in the one spot on the left side?
user: Yeah, yeah, exactly. 

assistant: OK, and since this pain started 5 days ago, has it gotten any better, any worse, or stayed the same? 

user: Like when I when it started I was just I was just like sitting on my couch. Um and now it's harder if I'm, it's worse if I'm walking around, like if I walk just down the street to get the mail. But otherwise it's kind of kind of just there, like I took some Tylenol and Advil, and they maybe take the edge off a little bit, but it's always there. And it's worse when I, when I take a deep breath then I really feel it. 

assistant: OK, so it's worse. Is the pain worse when you're walking as well? Like out to get the mail?
user: It's I don't the the pain is, but I I'm not I can't catch my breath when I'm doing that. 

assistant: OK, and how far could you usually walk, or um? 

user: Oh yeah, usually walk before I go for long walks like every day, like probably like 5 kilometers or something. 

assistant: OK, so prior to this happening you were feeling well?
user: Yeah, totally. I've not ever had any problems with my heart or lungs or anything. I thought it was maybe just like a chest infection. But I I don't know anymore. 

assistant: OK, so you've had that, the difficulties breathing and the pain. And have you had any other symptoms?
user: Mmm I think it's just those those, the two things that I said. 

assistant: OK, so have you been experiencing any fevers or chills? 

user: No. Nothing like that. 

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

assistant: OK, and um, how is your energy been? Have you experienced any like significant fatigue?
user: Um. Not. Well, I mean, I've been doing less stuff because it's harder to breathe like I'm getting kind of like I can't catch my breath. So I guess maybe maybe a little bit like fatigue. 

assistant: I see OK, but feeling fine energy-wise prior to the two 5 days ago? 

user: Yeah, totally. 

assistant: OK, uh and, have you been having any night sweats?
user: Uh, no, no I haven't. 

assistant: OK, how about any unusual headaches? 

user: No. 

assistant: Alright, and have you felt as though your heart is racing or beating out of your chest at all?
user: No, no, it's just that like sharp that sharp pain. 

assistant: OK, have you had any episodes of lightheadedness or feeling like you, you might might faint? 

user: No, no, just the difficulty breathing that scares to me, but it hasn't been like that. 

assistant: OK, have you had a cough?
user: No, no, that's the thing, that it seems weird, right? 

assistant: OK, um sometimes things can be associated with a cough so we'll absolutely look into what the causes of your symptoms are today. But you haven't brought up any any blood or any sputum?
user: No no. 

assistant: OK, and have you had any wheezing with your with your breath? 

user: I don't know. I don't think so. 

assistant: Alright, and how about any abdominal pain?
user: No, I mean the pain is like, yeah, it's in my chest. Yeah, that's not in my it's not in my belly at all. 

assistant: OK, and have you had any urinary problems? 

user: No, I mean so I had. I had a I had a hysterectomy. Weeks ago, maybe like maybe like a month ago now, um? So after that it was, you know, feeling a little. Like I was kind of not drinking as much and that so I wasn't peeing as much then, but I think it's normal now. 

assistant: OK um. And how have you recovered since the hysterectomy? Were you like bedbound for quite awhile afterwards or were you up an active?
user: Really, it was not really long that I may be a few days, I wasn't. I wasn't walking as much, but I thought it was like back to my normal self. 

assistant: OK, well that's good. I'm glad that you recovered from that surgery quickly. And what was the surgery for? 

user: Uh, I uh. I mean I, I'm done having kids and I, uh, I had. I was just having really heavy periods still so, uh, and you know a lot of pain there, so hat's why I had hysterectomy. 

assistant: OK, um, and have you had any bowel problems?
user: No no. 

assistant: OK, how about any skin changes or or rashes? 

user: No. 

assistant: OK, how about any joint pains or or leg pains or muscle pains?
user: Uh, no, I don't think so. 

assistant: OK. Um, so in regards to past health, any previous medical diagnosis? 

user: Uh, no. Just like I had the hysterectomy but I I don't like take any medications I don't have like high blood pressure or anything. 

assistant: OK so no prescription medications or over the counter medications you take regularly like supplements or?
user: No, just just to those like the Advil and the Tylenol I was taking for the pain. 

assistant: OK. And any other surgeries besides the hysterectomy?
user: Uh, like I have my wisdom teeth out when I was like a teenager. That's it though. 

assistant: OK, then, how about any allergies?
user: None. 

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

user: I think so, um. Yeah, yeah I don't. Yeah, I don't think, I didn't get anything that was supposed to. 

assistant: OK, well, that's good. And, uh, has anybody in your family experienced anything like this before?
user: My mom had a heart attack when she was like in her 70s. Uh. Other than that, I don't. I don't know. I don't think so. 

assistant: OK, any, um, cancers in the family or or bleeding disorders or coagulations disorders?
user: Um, no, I don't think so. 

assistant: OK, so I haven't heard of anybody in the family having like a blood clot, or or a thrombosis anywhere? 

user: I think my mom's like cousin, but not no one like not like my parents or anything. 

assistant: OK, um, so the next few questions I just wanted to ask about your personal and kind of lifestyle habits a little bit. But first, could you tell me about your living situation?
user: Uh, yeah I live. Um, like I said like I'm done having kids but I have 2 two kids. They're teenagers. I live um, with them and my husband and, uh. We live not far from here. 

assistant: OK, and what do you do for work? 

user: Um, Im an accountant. 

assistant: OK, and do you drink alcohol?
user: Um maybe a glass of wine on like the weekends but? Not other than no. 

assistant: OK and do you smoke cigarettes? 

user: I do, I'm trying to stop. I smoke maybe like. I don't know like 5 per day or something at this point. 

assistant: OK, but it sounds like you've been working on cutting down which is great. Um and have you used any other recreational drugs?
user: Um, no, no. I mean, when I was like younger I sometimes like would use marijuana, but I haven't really recently. 

assistant: OK, and have you been any been on any like long trips recently?
user: No I wish. 

assistant: Fair enough, vacation would be great. Um, OK so. But that was all the questions that I wanted to ask on on history, were going to run some investigations. I am concerned that you might have a pulmonary embolism, and so we're going to do some lab work and imaging to investigate that. 

user: OK I yeah. Is that scary? Is that bad? 

assistant: It can vary from being mild to severe, and so that's what we want to get. Some of the imaging and lab work to see well to first confirm if that's what you actually have, and if so, offer the right treatment.
user: Yeah, so um I just came in because uh so I I have this cough that's been going on for the last five years, but over the last month it's really been getting worse. Um and like last week I I've just been constantly coughing. So yeah, I was just a bit concerned. 

assistant: Yeah, OK, so you said the past couple of years you've been coughing. So how many years exactly would that be? Two, three, four? 

user: Probably five I would say, and I was diagnosed with uh COPD around that time. 

assistant: OK, OK, um the cough that you currently have, um is it a dry cough or are you bringing up any phlegm?