jshargo/medical-interview-conversations2 huggingface dataset:
user: No, my appetite's been normal and my weight's been stable. 

assistant: Ok, and have you noticed any difficulties or changes with your vision or any eye problems? 

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

assistant: Ok, have you noticed any kind of numbness or tingling sensation in your limbs specifically like your back and your legs?
user: No, no tingling or numbness. 

assistant: Ok, any muscle weakness at all?
user: Nope, I haven't noticed any muscle weakness. 

assistant: Ok, and have you been sick at all recently with any viral or bacterial infections? 

user: Um I had a uh, and then I was diarrhea like several months ago and I had some antibiotics, but that was a yeah, so a few months ago. 

assistant: Ok, and other than that, currently are you sexually active?
user: Yes I am uh I I have a girlfriend then we've, uh, we started dating about about, uh, six months ago. 

assistant: Ok and do either of you have any history of any STI's at all?
user: Uh, no history of STIs. 

assistant: Ok, alright and is your partner fine or is she having any symptoms at all? 

user: No, she she hasn't been having any symptoms then we we've been using a condom mostly. 

assistant: Ok, alright and otherwise are you generally healthy or do you have any medical conditions?
user: Uhm, yeah, I'm I'm generally alright. I do have asthma actually and just, I had diarrhea a few months ago after eating at a buffet. So I think maybe it yeah, it was food poisoning or maybe something like that. 

assistant: Ok. 

user: But yeah, so asthma and that's it. 

assistant: Ok, and do you use any medications for your asthma?
user: Yeah, use that blue inhaler sometimes. I guess that just when I when I need it, but that hasn't been very often. 

assistant: Ok and do you have any allergies to any medications or any environmental factors? 

user: I do have environmental allergies, I I'm not sure if it's like ragweed or or pollen, but something like that. 

assistant: Ok, and have you had any hospitalizations or previous surgeries?
user: Uhm, never. 

assistant: Ok any family history of any medical conditions, any autoimmune conditions or any musculoskeletal conditions?
user: Yeah my mother has a uh psoriasis. 

assistant: Ok. 

user: Yeah, and so she's had to, I know use like like creams and stuff like that for her skin. 

assistant: Ok, and currently right now, do you work?
user: I do, yeah I work uh, at a bank. 

assistant: Ok, and your mother, so she had psoriasis. Did she ever have any joint pains alongside the psoriasis?
user: I don't believe so. I think she had just more issues with her with her skin. 

assistant: Ok, and so you work and then what's your living situation like?
user: Yeah, so I live with my girlfriend in a condo in the city here. 

assistant: Ok, and do you use any recreational drugs like marijuana? 

user: Yes, sometimes yeah, I'll smoke like once or twice per week, with that with a friend or something like that. 

assistant: Ok, and do you smoke?
user: No cigarettes, no never. 

assistant: Ok and you drink alcohol? 

user: Sometimes, yeah, I'll have a beer or two on weekends or or a cocktail with friends. 

assistant: Ok, alright, so those were just some of the questions I had. Now I'm just going to quickly uh, ask some specific questions. So have you noticed any kind of swelling in the areas that you are having pain or redness or anything like that?
user: Uhm no, I haven't noticed really any any uh redness or or swelling 

assistant: OK and no so, are you able to bend down and stand up straight or extend backwards so without pain or are you in any pain? 

user: Uhm, I do get it. It's a bit stiff. Uhm I, uh, yeah, I'm not really too sure it's like, not really, it's more more more stiff. 

assistant: Ok, and yeah, other than that, do you have any questions or concerns?
user: Uhm, yeah, I was just wondering, yeah, like like what what this could be possibly? 

assistant: Yeah, so definitely what so this this seems like it started off like 3 months or six months ago, and it's been going on and it's happening in the morning. And how old did you say you were?
user: Uhm I'm 26. 

assistant: OK, yeah, so uh, it seems progressive and you're getting some pain in your other joints as well and it's mainly from your middle to lower back. It can be multiple things that we would have to rule out. So you first you have a family history of psoriasis so it can be psoriatic arthritis. You don't have any other skins, changes or any other symptoms. It can also be since you have had a you were sick for months ago with a what might be gastroenteritis. It can be sometimes a few months afterwards you can get something called reactive arthritis - where you get this progressive pain in your joints and stiffness. And otherwise it can also be something called ankylosing spondylitis, which can present in men your age and it's kind of like a progressive, dull back pain and that has some morning stiffness as well. So yeah, there's definitely multiple things that it can be. So first we would need to do a full physical examination and book an appointment or for that in person. And we will get some lab work done as well, as well as a X Ray of the of the spine and your sacroiliac joints. And we'll also get some blood work with CBC, CRP and ESR. So those are just inflammatory markers as well as the rheumatoid factor antinuclear antibodies. Those are just some things that will test for different kind of rheumatological issues and to see if you have any arthritis. So yeah those are and then will also get an X Ray of your hands and knees since you're having pain there as well. So yeah, those are some steps that we'll take. Do you have any questions or concerns? 

user: No, that that sounds, that sounds great, thank you. 

assistant: Alright, yeah, so I will get in touch with you shortly.
user: Sounds great, thank you. 

assistant: Alright, take care. 

user: Bye. 

assistant: Bye.
user: Yeah. 

assistant: I know that you've been having experiencing a cough. Can you tell me a little bit about that?
user: Yeah, I um I've had this cough for the past two weeks and it just doesn't go. 

assistant: OK. have never had anything like this before?
user: I’m I usually get a cold once a year or so. But the cough doesn't last this long, like it's usually over in a week or week and a half or so. 

assistant: Mm. And it's it's not letting up. 

user: Mm. 

assistant: OK um. I'm gonna ask you a few questions about the cough itself. Is this a dry cough that you're experiencing? Or are you producing like any any mucus or coughing up anything?
user: There was some mucus um earlier on, but now it's it's all, it’s a dry cough. 

assistant: Now, it's dry OK how long, what was the timeline for that? I guess how long? 

user: Yeah, so maybe for the first four or five days there was this like whitish clear kind of mucus that was coming up and then after that was a a dry cough. 

assistant: OK, OK. And do you feel like the intensity of the cough got worse over the last two weeks, or has it gotten any better?
user: Kind of the same, I would say. 

assistant: And has the cough gotten more frequent over this time as well? 

user: No. 

assistant: How often would you say that you're coughing?
user: Uhm? It's hard for me to quantify, maybe a couple of times an hour, maybe three or four times an hour or so. 

assistant: Is there anything you can think of that triggers the cough, or is it spontaneous?
user: It’s kinda, spontaneous um. Can't really think of anything. 

assistant: OK. And along with the cough, are you experiencing any difficulty breathing?
user: No. 

assistant: OK, have you noticed any fevers?
user: Uhm, no. 

assistant: OK um. Have you had any sore throat? 

user: Um I did initially um for the first two or three days and then that got better. 

assistant: OK um. Have you had any runny nose?
user: I did initially yeah, I have like had all those flu symptoms for the first couple of days, but the cough just kinda stayed. Everything else resolved in the first uhm three or four days I would say. 

assistant: OK. Thank you for sharing that have you had, did you have any chest pain at any point?
user: No, but I guess like sometimes when I'm coughing too much my chest hurts a little bit. 

assistant: OK, so it feels kind of sore after all that?
user: Yeah. 

assistant: OK. OK, have you been in contact, I guess it's hard to say because it started a while ago, but before it started bringing contact with anyone that's been sick?
user: I I work at the hospital, but. Um I'm wearing PPE all the time, and I'm very careful so. 

assistant: OK. Have you traveled anywhere outside of the province? 

user: No. 

assistant: OK, have you had any nausea or vomiting?
user: Uhm, no. 

assistant: OK, um so I'm just gonna ask you some questions about your overall health. Have you had any respiratory problems in the past? 

user: No. 

assistant: OK. Or do you have any chronic conditions that you see your family doctor for regular thing?
user: I’ve got acid reflux and uh, I also have anxiety. 

assistant: Are you currently taking any medications? 

user: Um. I I used to, not anymore. 

assistant: Uh, was there any particular medication that you stopped recently?
user: No, no. I used to take. I used to take something for anxiety two three years ago. 

assistant: OK. And what do you do for your reflux? 

user: I just avoid right now, I'm just trying to avoid the foods that make things worse for me and I feel like that's helped me quite a bit, uhm so yeah. I quite like acidic foods and chocolates and things like that. 

assistant: Sure. That's no fun.
user: Yeah. 

assistant: Do you have any allergies? 

user: Just hay fever. 

assistant: And do you have any family history of respiratory problems or heart problems?
user: No. 

assistant: OK, and this is in terms of your lifestyle. Do you live with family, alone? 

user: I I live with my partner. 

assistant: OK, and do you have any kids or pets living with you?
user: No. 

assistant: Do you smoke?
user: Uh I don’t, no. 

assistant: Drink alcohol? 

user: Um occasionally. On Christmas. 

assistant: Oh OK, I see. And do you use any other substances?
user: No. 

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

user: I’m a clerk at the hospital. 

assistant: OK. Right, you just say you working at the hospital. And, uh. I can't think I thought I had another question for you, but I can't remember it. Anything else that you wanted to tell me about that I didn't ask you.
user: Um. No, I guess I was just wondering why I still have a cough. It's been such a long time. Um yeah, and I was wondering if I could get any medications just to help with that. It's not really. Yeah, it's everyone's like scared at work when I cough. I have. I have had the covid test and I don't have it, um so yeah. 

assistant: When we got the last test done? 

user: Um I had the test done when I first started having symptoms about two weeks ago? Since then I've been at home and I'm just waiting for my symptoms to get better, but I you know, I kind of like get back, and I don't want to be coughing when I get back. Um yeah. 

assistant: OK. Well, I'm gonna have a quick listen to your heart and lungs I'll do a quick physical exam and then I will go get the doctor that I'm working with all kind of go over everything you talked about, and then we'll come back and talk to you about where to go from here.
user: Hey Doc, I'm a 45 year old man coming in, I'm worried there's a little old rash on my leg that I'm getting nervous about. 

assistant: Hi, so you I understand you have a rash on your leg.
user: I don't really know what I would call it. That's what I told the nurse when I came in, but it more hurts than anything. 

assistant: OK, uh, how long is this been going on for? 

user: Ah, it's been it's been looking weird for about a week, but only yes, it started hurting yesterday and started looking strange and I just wanted to come in to get it checked out. 

assistant: OK when you say it's looking strange, can you tell me what you mean by that?
user: Swollen, it looks bigger than it did before, and meaner, if that makes sense. 

assistant: Swollen OK, is it red?
user: Yeah, it's red, it's turning more red, kind of in the area around it. I've got these I got these scabs. I've got diabetes and I'm not exactly the best with it and scratching at it, and normally it's not that bad, but this is just strange looking and there's no other word for it. 

assistant: OK, have you ever had anything like this before? I guess you kinda just said that you didn't, but I'll just double check. 

user: No no. Well I've had,  I have occasional ulcers and sometimes I have banged my toe when I'm not exactly the best taking care of my feet, but this is the first time I've gotten something that I don't know, I've just never seen it before. 

assistant: Do you have any ulcers right now?
user: Let me see. I think so, when's the last time I saw the family doc? I think I've got an ulcer on my left heel, but I think it's doing alright. 

assistant: OK, and what leg are you having this problem with? 

user: Right now it's on my right, so my ankle. 

assistant: OK, how have your sugars been controlled recently?
user: I stopped measuring them. Yeah, last time I measured it was pretty bad. I think my A1C last time was like 9 something. I'm trying, I'm trying better to be with it. It's hard with work you know? 

assistant: For sure, I can imagine so, in general, even if you don't know your numbers for your sugars, have you felt worse than usual lately? Have you felt rundown at all?
user: Yeah, actually I have gained more, feel hungry, sometimes just tired, but it's hard to tell. There's an awful lot going on in my life right now with the kids, but, It's hard to tell I think. Yeah, I need to see my family doc. 

assistant: OK. Definitely you know a good a good idea moving forward just to make sure you get on top of these things, but I'm glad you came in today so we can, you know, have a better look at you and make sure that there's nothing super concerning going on. So in addition to this, have you had any other new symptoms? 

user: Symptoms? Um, I feel a little hot actually. When the swelling started it's it also started leaking this like white stuff from one of the one of what used to be a scab so now like kind of an open wound now. 

assistant: OK, OK so when did you start feeling hot?
user: Honestly, last 12 hours. 

assistant: OK, you take your temperature at all? 

user: No, I don't have a thermometer at home. 

assistant: Have you had any difficulty breathing?
user: No no. 

assistant: Any chest pain? 

user: No. 

assistant: Have you noticed that your left, sorry, your right leg feels any hotter than the left?
user: Yeah, yeah it does. Actually changing socks the other day, yeah. 

assistant: Right. Say, have you alone have you felt ill recently? Have you been sick at all?
user: Aside from just feeling overall crummy last couple weeks, no don't really, less energy today, but I was up last night thinking about this and yeah wanted to come in and talk. 

assistant: OK yeah, you did the right thing. I'm glad that you're in today. Is the pain on your legs worse when you touch it? 

user: Yeah, maybe not so much when I touch it. When I walk with it and I start flexing it it, it doesn't like that. 

assistant: OK, uhm.
user: Just resting it right now, it feels fine. 

assistant: It's OK, OK. OK, well I'm going to if I think of any more questions specifically about your leg I will, I'll go back to it, but I'm going to just move on and ask you questions about your overall health. You've already shared with me that you you are diabetic. Do you have any other chronic conditions that you live with?
user: Chronic condition? I see the family doc about cholesterol. I'm on a pill for that. Uhm, I had asthma as a kid, not too much of an issue now. And my back, I've had back pain for the last 10 years, but all I really take for it is Tylenol Advil for that. 

assistant: OK, oh my other question about your leg was, have you lost any feeling in it?
user: It kind of is like a dull ache sometimes when I touch it. But, no like,  in the area, the ankle no, but definitely on my feet, like over the years I've noticed I feel less on it compared to what I did previously, yeah. 

assistant: OK, so sorry I kind of sidetracked there so we talked about your diabetes. You said you have high cholesterol. So what medications are you currently taking?
user: I'm taking 4 pills right now. One of them is for the cholesterol. I think it's called. rosuvastatin. The other three, they're all diabetes medications, but I don't remember. Metformin is one of them. Sidas...something I have a list somewhere. I'll give it to you later. 

assistant: OK, are you on insulin right now? 

user: No. 

assistant: Are you on any or any of these medications new to you, recently?
user: No no, but had them for about a year now. 

assistant: Do you have any allergies?
user: Um, yeah, I do actually. Penicillin, can't take that. 

assistant: And what happens when you take penicillin?
user: It's been a while, as a kid apparently like my face got bloated and I was having a hard time breathing so... 

assistant: Well, we will make sure that we don't give you that. Can you tell me if you've had any previous surgery?
user: Oh yeah, uh, what was it? I had my sinuses, had some pretty bad sinusitis when I was in my teens and they went in and kind of carved a little space out. 

assistant: OK, OK. Is that the only surgery that you had?
user: Yeah. 

assistant: And can you tell me, do you have any family history of diabetes, skin problems, anything else that stands out to you?
user: Yep, mom's side of the family, very much everyone has diabetes, high blood pressure, cholesterol. Dad's side of the the family is pretty healthy. I think maybe one of my aunts had lung cancer, but she's a pretty big smoker too. 

assistant: And then just ask you a few questions about your lifestyle. So you said that you have children.
user: Yeah, I do. 

assistant: Do you live in town? Do you live with your kids?
user: I live in town. I see my kids every two weeks. 

assistant: And, uh. What do you do for work? Did I already ask you this? 

user: No, I'm currently unemployed and looking for work, partially employed, I suppose we should say I have my own business. 

assistant: I see and, what do you, what do you do when when you are working, ideally?
user: When I am working, I'm an accountant. 

assistant: OK well, and do you smoke?
user: Yeah once in a while, yeah, when I'm stressed. 

assistant: How much do you smoke on average?
user: Last couple of weeks, I've been smoking more, maybe like 2 packs a week. 

assistant: OK. Do you drink alcohol? 

user: Yeah yeah. 

assistant: How much do you typically drink?
user: Average week, maybe a 2 4. 

assistant: So maybe like 3 per day or something like that if you were to average it out? 

user: Yeah, if you average out I mainly go through the two four in a weekend to be honest. 

assistant: Oh, I see. OK, more so on the weekend, so maybe a little bit more than three per day on those days?
user: Mhm. 

assistant: OK so that that that's everything that I need to ask you for now. I'd like to get a closer look at this leg. Did you have any other questions or concerns before we move forward to the physical exam?
user: No I just want to get this figured out. 

assistant: OK, yeah, we will definitely do that for you. So yeah, I'm going to have a look at it and then after that I will go talk to the doctor that I'm working with and we'll see what we can do for you. That sounds good?
user: So I've had this, uh, this cough that it started two days ago and it's been getting worse. I've been bringing up this rust colored sputum. 

assistant: OK, and so that's been going on for a few days?
user: Yeah, yeah about two days. 

assistant: OK, and how often are you coughing? 

user: It's it's happening all day. Really, throughout the day and really any type of exertion or or movement, I'm getting short of breath and it's triggering a cough. 

assistant: OK, and the shortness of breath, is it just with the exertion or it can, is it happening at rest? How are you feeling right now?
user: Yeah, even right now it feels like I'm not able to get, I don't know, a full breath, it just feels like it's more difficult to to breathe. 

assistant: OK, have you felt any kind of dizziness or fainting episodes?
user: No, I haven't. 

assistant: OK. Have you been feeling any chest pain at all?
user: Uh, no, I, I I haven't had any chest pain. 

assistant: OK, and so with your coughing you're producing the rust colored sputum, but how much would you say you're producing? 

user: Uh I would say, yeah, maybe three or four teaspoons every every couple hours. 

assistant: OK, are you producing any blood like in your cough or sputum at all?
user: No, it wasn't really red, it's kinda orange. 

assistant: Orange, OK. Any greenish or yellow material? 

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

assistant: OK. Any fevers or chills?
user: Yeah, I have had, I've had both of those. I've had a I I checked my temperature this morning and it was 38.2 and I was pretty chilly last night. 

assistant: OK. Uhm, and before these symptoms started, were you having any similar symptoms at all before?
user: Ah, no, I mean a few weeks ago, probably like a yeah a couple of weeks ago I had a runny nose. And and sore throat for a couple of days. It went away on its own though. 

assistant: OK. Uhm, any anything that makes your symptoms better or worse that you've tried?
user: I did try some over the counter cold medicine. It, I think it might have helped me sleep last night, but didn't really do a whole lot. 

assistant: OK, does your shortness of breath improve with any positions or does it improve when you're not exerting yourself?
user: Uh, not really. It's kind of always there, 

assistant: It's ok. Do you have to wake up at night to take a deep breath? Or do you feel any kind of shortness of breath with laying down at all?
user: No, I haven't had any issues like that. 

assistant: OK and do you notice any kind of swelling in your feet, ankles, arms, legs, anything like that?
user: No, I haven't. 

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

user: Uh, I don't I, I mean I see my granddaughter and I might have got a cold from her a few weeks ago, but recently I haven't seen anybody. 

assistant: OK, are you having any night sweats?
user: No, just a chills last night. 

assistant: OK. Are you breathing faster?
user: Yeah, I have felt like I've been been breathing a bit faster. 

assistant: You have any muscle aches or anything like that?
user: Ah no, not really. 

assistant: OK, and give any other symptoms like chest pain, runny nose, sore throat, anything like that?
user: Uh, no. Just been really tired these last couple of days and I've just felt like sleeping all day. Haven't felt like eating either, my appetite has been really poor. 

assistant: OK, uhm. And other than that, have you experienced any kind of headaches, nausea or vomiting?
user: No, I haven't. 

assistant: OK, any fevers or, you said you have had some chills, right? 

user: I have yeah. 

assistant: OK. And then a fever too. Kind of a sensation of your heart racing at all?
user: Ah, yeah, right. It doesn't feel like it's well, it does feel like it's beating a bit faster than usual, just not feeling too well. 

assistant: Yeah, so yeah, we'll do a physical examination and get all your vital signs as well right after. Any, so you said you haven't been able to eat, ave you noticed any significant weight changes recently? 

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

assistant: OK, any exposure to any dusts or animals, fumes, anything that might have triggered some of these symptoms?
user: No, I don't think so. My husband and I, we moved into a new kind of apartment here and it, it's brand new. 

assistant: OK, any kind of loss of sense of taste or smell?
user: No, that's been normal. 

assistant: OK, any exposure or any travel outside of the country at all.
user: No, nothing like that. 

assistant: OK, so just mainly the coughing with the rusty material as well as just the shortness of breath. Umm, and do you get any pain at all in your chest when you breathe in or out? 

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

assistant: OK, any past medical conditions that I should know of?
user: Yeah, I, umm, I had a stroke like that like six years ago. And I have type 2 diabetes. As well as GERD. 

assistant: OK, and uh, yeah, I'm sorry you had you had a stroke six years ago or how are you after that? Were there any kind of, like did, after rehabilitation, do you have any symptoms still going on at all?
user: Yeah my, my left hand, still, still it gives me some some problems. I get uh, uh, Botulinum toxin injections for, for the tightness in my hand. 

assistant: OK, OK, and are you taking any other medications at all? 

user: Yeah, I use metformin. Empagliflozin or an SGLT2, insulin and uh, and aspirin, I think. 

assistant: OK, and any over the counter medications?
user: Yeah, I take a multivitamin and in vitamin D. 

assistant: OK. Any allergies to any medications at all? 

user: No. 

assistant: OK, any environmental allergies?
user: No. 

assistant: OK, any ill contacts at all?
user: No, no. 

assistant: Any recent or prior hospitalizations? 

user: No, the last time I was in the hospital was I was for rehab after my stroke. 

assistant: OK and so, but after that, no other hospitalizations or surgeries?
user: No. 

assistant: OK, any surgeries in the past?
user: Yeah, well I did have a C-section for my son but that was many years ago now and everything for that was, was OK. Yeah. 

assistant: OK. Any family history of any lung or heart conditions? Any cancers? 

user: Uhm, yeah, my dad had had a heart attack actually, but he was in his 80s when that, when that happened. 

assistant: OK, uhm and currently right now, are you working at all?
user: No, I'm retired. I used to be a teacher for Grade 3, uhm, but yeah, but since retired and my husband and I just moved into a smaller apartment to make it a bit easier on us. It was a lot trying to look after the house. 

assistant: OK, well congratulations on your new home. Are you at all, you or your husband requiring any kind of supports outside of the home at all? 

user: No, between us two we managed to get the shopping done, the cooking and and all the cleaning, and that sort of thing. I use a walker to get around when we're going longer distances. 

assistant: OK. And currently right now, do you smoke at all?
user: Uh, yes I, I spoke about half a pack per day or maybe even less. 

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

user: Since I was 15 maybe? 

assistant: OK.
user: So yeah for like 45 years. 

assistant: And have you, at all been diagnosed with COPD or anything like that? 

user: No, I was tested actually, uh, a couple of years ago and that the results were normal. 

assistant: OK. Alright, and have you thought of quitting at all? I know you've been smoking like for a very long time, but have you at all tried to quit before?
user: Like I've considered it, but I I just don't think it, it'll be possible at this time. 

assistant: OK, well if you at all are wanting any information or want to talk about quitting at all, um, we can provide more resources. Do you besides smoking, do you use any recreational drugs like marijuana?
user: No. 

assistant: No. Any alcohol at all?
user: No. 

assistant: OK. Yeah, so those are some of the questions I had a, I will be doing a physical examination with your shortness of breath. I just want to get a good listen to your lungs and take all your vitals as well. However, yeah so after that since you're having some symptoms of what might be a pneumonia, it can be a bacterial infection, a viral infection, we will have to get some blood work done as well as a chest x-ray. And right now, with the pandemic going on, we will also do Covid swab test for you as well, just in case. Does that sound good?
user: Yeah, that makes sense, thank you. 

assistant: Alright and, if if you're while you're here, if your shortness of breath gets any worse at all, just let us know and we'll help you out.
user: Hi, so I just came in today because I've been just been feeling um, like my head's just been hurting for the past three or four days and I also felt really cold throughout the day for the last few days as well, so, um, I did end up checking my temperature just yesterday afternoon and it was um, 38.7 degrees celsius. 

assistant: Okay, um. Tell me about the headache, where exactly is it?
user: Yeah so it's kind of just throughout like the front of my forehead and it kind of goes to the side into my temple. 

assistant: And what does it feel like? 

user: It feels like a constant aching. I've had uh, migraines before, but they like, it's not like the pulsating sensation that I usually get with them. 

assistant: I see. Uh, okay, and how severe is the pain, if you had to rate it from 1 to 10?
user: Um, more than like severe. It's definitely less severe than my migraines, but it, it's just constant. It's, it's just been there for the last four days and I would say probably a 6 out of 10. 

assistant: Did you do anything for the pain? Did you take any medications? Anything that makes it better? 

user: Yeah, I took a Tylenol, I took um, Advil. It helps for like a few hours and then it just comes back. 

assistant: And anything that makes the pain worse?
user: Um, I definitely think just, if I rest, it's better if, but if I'm like, like I can't, I can't concentrate on work or like anything. 

assistant: Okay. Um, and other than the, um, the fever and headaches, have you um, had any um, cough? 

user: No, no cough. 

assistant: Runny nose or congestion?
user: No. 

assistant: Sore throat?
user: No, not really. 

assistant: Changes in your sense of smell? 

user: Uh, I do actually feel like I, like I am losing my smell today. 

assistant: And sense of taste?
user: I just had breakfast today so um, breakfast was okay. I didn't, uh, but yeah, definitely sense of smell. 

assistant: Okay, and any difficulties breathing? 

user: No. 

assistant: Okay, any chest pain?
user: No. 

assistant: Um, do you feel like your heart is racing? 

user: No. 

assistant: Any diarrhea or constipation?
user: No. 

assistant: Nausea or vomiting? 

user: No. 

assistant: Pain in your belly?
user: Uh, no, nothing like that. 

assistant: Okay, um, do you feel like your neck is stiff?
user: No. 

assistant: Any numbness or tingling in your arms or fingers, or toes?
user: No. 

assistant: Any um, night sweats or weight loss, unintentional?
user: No, I've only been gaining weight. 

assistant: Okay. Any fluid in your, any sort of, swelling in your legs?
user: No, nothing like that really. 

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

user: Yes, so I have uh, type 2 diabetes. I was just recently started on metformin medication. 

assistant: When were you started on metformin?
user: So I think around uh, it's been around two months. 

assistant: Okay, how is that going for you? Are you tolerating it okay?
user: Yeah I've, I've been tolerating it well. It's just they, they said like I'm kind of just on the edge of the diabetes, like my level, so they just want to act, um, proactively. 

assistant: Yeah, that's good. Um, any other medical conditions? 

user: No, that's, that's all. 

assistant: Any medications other than metformin that you take? Anything over the counter?
user: Um, so I do take, when my migraines get bad, like I do take, I have taken naproxen before. 

assistant: Okay. Surgeries? 

user: Uh, no surgeries. 

assistant: Hospitalizations?
user: Uh no. 

assistant: Okay, any allergies to medications, foods, or any environmental allergies?
user: Not to any medications, but I do have an allergy to peanuts. 

assistant: Okay, what happens? 

user: I do get like a, an anaphylactic reaction. 

assistant: Okay, okay. Um, and any um, family history of any medical conditions?
user: Uh, so on my dad's side, they like all, like all the men seem to have diabetes, so it's good that I'm starting on the medication. Um on my mom's side, they're pretty healthy. I don't think my mom has any medical conditions. 

assistant: Okay, good. Um, and do you currently live alone or do you live with other people?
user: Yeah, so I live with my wife, I live with my two kids, a son and daughter. 

assistant: And um, have you or any of them had any exposures to anyone who could possibly be sick?
user: Um just, uh, so my wife is a school teacher, um, and they did have in-person. Just uh, she's a high school teacher, and they had some they have in-person classes. So yeah, I don't know, but she's been feeling well. My kids are feeling well too. 

assistant: Okay, and have you traveled anywhere outside the province? 

user: No. 

assistant: Okay, and do you currently smoke or did you ever smoke in the past?
user: No, I've never smoked. I do smoke marijuana just, maybe once or twice a month with some friends. 

assistant: Okay, any recreational drugs?
user: Sorry, no. 

assistant: Um, any alcohol?
user: Yeah, I probably drink um, a couple of beers during the weekend. 

assistant: Okay, got it. Um, alright. Well, given your symptoms, um, we would like to do a COVID swab, just in, or request a COVID swab to be done through public health, um, just to, just to rule it out. Your symptoms do sound like, or overlap with some of the symptoms that are seen in patients who do have COVID. It could be that you have um, just um, just I guess like your headache and fever. Um, I'll also like do a physical exam to see there's nothing else going on. But in the meantime, I, I'd like you to self isolate and stay away from the rest of your family members as well, um, at least until the results are out. And then when the results are out, if it's positive, you'll receive more guidelines from public health as to what you need to do.
user: Okay, sounds good, um, and I work from home, so I don't need to. 

assistant: Oh that's good. Okay, so you work from home. 

user: Alright. 

assistant: Good.
user: Sure, you know I've been feeling kinda hot for the past couple of days and I have this terrible, terrible headache. And just my brain feels foggy. So I thought I should come get it checked out. 

assistant: OK, I see when uh did these symptoms start exactly? 

user: So they started about 3 days ago. But it's getting worse. 

assistant: OK. Uh, and uh, in terms of the headache, uh, does your head hurt in any particular location?
user: I would say mostly the sides of my head. 

assistant: OK, and how long has the headache been going on for? 

user: Uh the same amount of time, so like the past three days. 

assistant: OK, and um, how would you describe the headache? Is it like sharp, is it like a vice grip? Is it pulsating, pressure like sensation or none of those?
user: It you know it feels crampy. 

assistant: OK. Um, and has there been anything that triggered the headache or or made it worse? 

user: I don't think so. Nothing is helping, sleeping is not helping, moving around is not helping. It's just always there. 

assistant: OK, does the headache get worse with lying flat?
user: Uh, no, I wouldn't say so, no. 

assistant: OK, and are you feeling any pain down into your neck or into your shoulders or back?
user: No, no. 

assistant: OK. And, would you say that this headache, which is was like worst headache of your life or thunder clap kind of sensation? 

user: Uh, no, no. 

assistant: OK, have you had headaches like this before in the past?
user: No, never. 

assistant: OK. And, how would you rate it in terms of severity, with 10 being the most severe that you could possibly have and one being not painful at all? How would you rate it?
user: I would say I would give it around a 6 or seven. 

assistant: OK. And have you had any nausea or vomiting? 

user: No. 

assistant: OK, and how about any sensitivity to light when you're you're seeing it or sensitivity to sound?
user: No. 

assistant: OK, and have you had any eye symptoms such as discharge, tearing or or itchiness?
user: No, nothing like that. 

assistant: OK, um, and so you you mentioned that you had you had a fever as well. Did you check your temperature?
user: I didn't actually, no I didn't check my temperature, I just feel hot. 

assistant: OK, we'll be sure to check that today in clinic. And have you been experiencing any other symptoms? 

user: Um, just like the brain fog that I was speaking of, you know. I just don't remember, I remember things, but it's it's like I'm doing everything underwater. 

assistant: Oh OK. Have you been uh confused or concerns with your memory?
user: Um, no, I haven't forgotten things. It just feels like I'm really slow at doing things. 

assistant: I see, OK, and how has your energy been? Have you had uh significant fatigue? 

user: Yes, I would say I am significantly more tired than I used to be. 

assistant: OK, um, how has your sleep been?
user: My sleep has been pretty normal. I go to bed around the same time, wake up around the same time. Yeah, I'd say that there's no issue there. 

assistant: OK, with this fatigue, have you had any aches and pains?
user: Some muscle aches, I would say mostly in my arms and just my legs, yeah. 

assistant: OK, and have you had a cough? 

user: No cough, no. 

assistant: Alright, how about shortness of breath?
user: No shortness of breath either. 

assistant: OK, have you experienced any chest pain?
user: No. 

assistant: OK, how about any period where you felt as though your heart was racing? 

user: No. 

assistant: OK, and have you have any wheezing?
user: Um no no wheezing. 

assistant: OK, and have you had any loss of taste or smell?
user: Um, no. 

assistant: OK, alright have you noticed any rashes?
user: No rashes either. 

assistant: Alright. And have you had any abdominal pain? 

user: No no. 

assistant: OK, have you had any diarrhea?
user: Um no, no diarrhea. 

assistant: OK, um and any constipation?
user: No. 

assistant: Alright, and then how about any urinary problems such as painful urination or going frequently? 

user: No, no changes. 

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

assistant: OK. Could you tell me about your partners or partner? 

user: Sure, I I just my husband, um we we don't use protection. But I'm on the birth control pill. 

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

assistant: OK, and any I guess like vaginal discharge or vaginal discomfort? 

user: No. 

assistant: OK. And, so next just wanted to ask a few questions about your past health. Have you been diagnosed with any medical conditions in the past?
user: No. 

assistant: OK, so no diabetes, high blood pressure, anything like that?
user: No. 

assistant: Alright, and do you take any medications regularly like prescription or over the counter?
user: I don't. 

assistant: Alright, so it's just the birth control? 

user: Oh sorry, yes. Just the birth control pills. 

assistant: Yeah OK, no worries, and any allergies?
user: Just seasonal allergies. 

assistant: OK, and so are immunizations up to date?
user: Yep, they are. 

assistant: Alright, and in in the home, is there anybody who's sick right now? 

user: No, no one is sick. 

assistant: Ok, how about at work?
user: I'm I'm a teacher. Um, so I work with a lot of children, but no one that I no one I know of has been sick. 

assistant: OK, um and so have you traveled anywhere recently?
user: No. 

assistant: Alright. And do you smoke cigarettes? 

user: I don't. 

assistant: OK. Do you smoke marijuana?
user: I don't. 

assistant: Alright. Did you use any recreational drugs? 

user: I sometimes take some marijuana edibles, but that's about it. 

assistant: OK, and, do you purchase those at a dispensary?
user: I do. 

assistant: OK, so for one of the Ontario stores?
user: Yes. 

assistant: OK great yeah 'cause you could never be sure where else, what the dosing is, so it's good to get it from the appropriate stores for sure.
user: Right. 

assistant: Do you drink alcohol? 

user: I do, I'll have a glass of wine with dinner. 

assistant: OK is this daily?
user: Um most days I would say, maybe like four or five days of the seven days of the week. 

assistant: OK, I see. And has anybody in your family had similar symptoms in the past to what you're having or had any lung conditions in the past?
user: No, nothing like that. 

assistant: OK, how about any heart conditions?
user: Um, my father passed away at 75 from a heart attack. 

assistant: OK, and uh, how about any cancers in the family?
user: None that I know of. 

assistant: OK. So I think that was, uh, all of the questions that I wanted to ask on history today. Was there anything else that you thought I was missing or that you wanted to tell me about?
user: No, I don't think so. But, uh, what do you think I have? 

assistant: So with the acuity of your symptoms, starting with the last few days and getting worse, especially with a fever which we now have documented of 38.8 and a kind of feeling, uh, tired with aches and pains and the headache, I am concerned that you have possibly a viral infection, and one of those possibilities could be COVID-19, but also it could be the influenza. It could be something like the common cold, such as adenovirus. So certainly we will do a PCR COVID swab as well as order some general lab work to look for signs of infection, such as a CBC and a white blood cell count. But um, for now we will get those tests ordered. Did you have any questions? 

user: OK yeah that sounds great. Do you think I could also have you know, meningitis or something? 'Cause I was reading online on Google and that's the first thing that came up. 

assistant: Oh yeah, you're you're absolutely right, so, um sorry, I we will go ahead and investigate that as well and we might need to do a lumbar puncture or some blood work to look for signs of infection that might be needed to be treated with antibiotics.
user: I've just come in today because I've been having some issues with my hips as well as my knees. Just over the last probably a month or two, I've been just getting, this stiffness and pain especially, uh, throughout the day as the day goes along, and I also experience some stiffness when I wake up in the morning, uh, in my hips and knees, so I just wanted to come and check out what that might be. 

assistant: OK, and you said it started in the past month?
user: Yeah, maybe up to two months actually. Yeah, I would say two months. 

assistant: OK, and is the pain and stiffness always there or does it come and go? 

user: It's, it comes and goes. It's worse in the, so it's stiff, more stiff in the morning first, but like as the day goes on, probably near the afternoon it gets worse. So I've had to stop some of my activities like gardening and being outdoors and things like that. 

assistant: OK. And you said it's, it gets worse with activity. Is there anything else that makes it better or worse?
user: Uhm, it probably, yeah, if I'm just exerting myself too much. Uh, in terms of better, I I think I've taken some Advil that does help with the pain. 

assistant: OK, OK. And then if you were to describe the quality of this pain, would you say it's achy, throbbing, dull, or sharp? 

user: It's kind of like this uh, achy pain, kind of deep within the joints themselves. 

assistant: OK.
user: Yeah, it just gets worse. I, as I walk more and do more activities. 

assistant: OK, and does the pain radiate also or does it, or is it pretty localized to your hips and knees? 

user: It's mainly in those areas. 

assistant: OK. And severity wise, one to 10, 10 being the worst pain you've ever felt, how bad is this pain?
user: Probably like a 7. 

assistant: Seven, OK. And have you ever experienced this type of pain before?
user: Uh, no, not really. 

assistant: And do you think your pain is getting worse?
user: Uhm, I think so. Like over the last two months, I feel like my pain, there's more stiffness, there's more pain throughout the day. 

assistant: OK, OK. And yeah, so do you, are you experiencing any sort of numbness or tingling in the areas? 

user: No, not really. 

assistant: No, OK. Any muscle weakness?
user: Nope. 

assistant: No. Are you still able to walk and do the things that you used to enjoy doing? I know you said gardening was hard for you. How about like other activities of like daily living like, uhm, cooking, using the washroom, things like that?
user: Yeah, those things I don't really have too much trouble with. 

assistant: OK, OK, that's good at least. And any dizziness or fainting spells? 

user: No. 

assistant: No, OK. How about memory loss or confusion?
user: No, nothing like that. 

assistant: Any headaches?
user: No. 

assistant: No, OK. How about joint pains or muscle aches elsewhere?
user: Uhm, no, I haven't really felt any other pain in any other joint so far. 

assistant: OK. And any weight loss recently?
user: No. 

assistant: No, OK. How about and fevers or chills?
user: Uh, no fevers or chills. 

assistant: No fevers or chills, OK. How about rashes?
user: No. 

assistant: And changes in your vision, hearing, smell or taste?
user: Nope. 

assistant: Uhm how about coughing, wheezing or shortness of breath?
user: Nope. 

assistant: Uhm, chest pain, heart palpitations or fainting? 

user: No. 

assistant: Changes in your bowel movements?
user: Nope. 

assistant: Uh, changes in your urinating?
user: Uh, no. 

assistant: OK. And then are you otherwise healthy or do you have any past medical conditions? 

user: Uhm, so I do have a prior history of hypertension as well as high cholesterol, diabetes, type 2 diabetes and also a bit more on the overweight side. 

assistant: OK, uhm, are you taking any medications for all of this?
user: Yeah, so blood pressure, I'm taking this medication called Telmisartan. And then for blood pressure, I'm taking uh, metformin. Sorry, not blood pressure, for diabetes I'm taking metformin. 

assistant: OK.
user: And then for the cholesterol I'm taking, and this medication, called Atorvastatin. 

assistant: OK. Alright, and do you have any allergies? 

user: No allergies. 

assistant: No allergies. And how about immunizations? Are you up to date with them?
user: Yeah, as far as I know. 

assistant: OK, that's good. How about family history of musculoskeletal issues?
user: Not that I know of, no. 

assistant: No, OK. Then how about uhm, lung or heart conditions?
user: No. I I think my father, maybe he had some heart issues. He did have a heart attack in his, let's see, like in the 70s. 

assistant: In his 70s, OK. OK, and then alright, and how about autoimmune conditions? 

user: Uhm, I don't think so. Uh, I can't, I can't recall any autoimmune condition. 

assistant: OK, an and do you smoke?
user: Yeah, I used to smoke a probably up until when I was like 65 or something. So, probably for 40 years of my life. 

assistant: OK, how much did you used to smoke?
user: Probably a pack a day pack a day. 

assistant: OK, uhm well, congrats for quitting. I'm sure that wasn't hard. I mean sorry, I'm sure that was hard. Uhm, yeah, so that's good. And have you, do you consume marijuana? 

user: No. 

assistant: Go to other recreational drugs?
user: No. No other recreational drugs. 

assistant: OK, that's good. Do you drink alcohol? 

user: Uh, nope, not anymore. I used to probably drink some wine here and there, but I've stopped drinking alcohol too. 

assistant: OK. And who do you live with right now? And where do you live?
user: Right now, I live with my wife and we live in a small condominium. 

assistant: OK. Uhm, alright, and then any recent sick contacts?
user: No. 

assistant: No, OK, how about uhm, uh travel anywhere? 

user: No. 

assistant: No, OK, that's good. And now I'm just going to get you to do the physical exam part of this interview with me, is that OK?
user: Yeah. 

assistant: OK, so we'll take a look at, if you can, if you have a mirror, we'll take a look at both hips first. Do you notice any redness or swelling on those hips? 

user: No, not really. 

assistant: No, OK. How about any atrophy, deformities, or skin changes?
user: No. 

assistant: No, OK. And then how about on your knees? Do you see any redness or swelling there?
user: Not really, no. 

assistant: No. Any atrophy, deformity, or skin changes there? 

user: Uh, no. 

assistant: No, OK. I'm gonna get you to palpate your hipbones. Does that hurt?
user: No, not really. 

assistant: OK, how about when you do that to your knees?