jshargo/medical-interview-conversations2 huggingface dataset:
user: Nope 

assistant: OK. Um. And so so the next part, just for the physical exam. So do you have pain with shoulder AB duction. 

user: Uhm yes. So just to yeah, I do have some pain. Especially from. Yeah yeah pain throughout AB duction. 

assistant: OK, is there any like pain that's like parts of that that range of motion that are more painful for you?
user: yeah, so probably from 60 degrees to 120 degrees is more painful. 

assistant: OK. And. If your arm is outstretched and your thumb pointing down so your arm is internally rotated does that give you pain?
user: Yeah, if yeah, not not just like that, but if you were to like press down on it it the internal rotation does cause a little bit of pain. 

assistant: OK. OK, so it sounds like a positive jobes test and a positive Neer's test as well as a painful arc for your shoulder. And is there pain to palpation?
user: Uh. Just to, yeah, definitely just at the front of the shoulder there is some some pain over with palpation. 

assistant: OK, that sensation is normal, reflexes are normal and strength is slightly reduced as well. OK, so that was everything that I wanted to ask on history and check on the physical exam as well. Was there anything else that you wanted to mention today that I maybe forgot? 

user: No, I think that's it. 

assistant: OK, um so based onI know that the symptoms today along with your age and prior history of an overuse injury of the left shoulder, it certainly raises concern of having a rotator cuff tear or um a rotator cuff impingement syndrome and where there is inflammation there not necessarily actually a full tear of the muscle that's causing the pain. So, uh, those would be the two most likely things. Yeah, their rotator cuff tear or subacromial impingement syndrome. And so we were going to get an ultrasound of the left shoulder to evaluate the structures and possibly some other imaging such as an X Ray or MRI to determine the extent of the injury in the left shoulder.
user: Uhm, so I've had this runny nose, well first it was a stuffy nose, but now I've had this runny nose for the past week and a half and it doesn't seem to be getting any better. So I was just wondering if you could give me something for that? 

assistant: Yeah, so yeah, let's just try to first see what's going on. So you've been having this, so when did it start getting stuffy?
user: Uhm, it started getting stuffy about two weeks ago. 

assistant: Two weeks ago, and when did it start getting, like just a runny nose?
user: Yeah, that started a week and a half ago. 

assistant: OK, and have your symptoms, have these symptoms gotten worse at all?
user: No, it stayed about the same. 

assistant: OK and do you have any coughing?
user: No, no coughing. 

assistant: No coughing, uhm, any fevers or chills? 

user: No. 

assistant: No, uhm, and the, from the runny nose, are you having any yellow or green discharge?
user: No, it's clear. 

assistant: It's clear, OK. Have you at all coughed up any blood at all? 

user: No, nothing like that. 

assistant: OK, and do these symptoms come and go, or are they pretty constant?
user: Uhm, they are pretty constant. 

assistant: OK, and is there anything that you have tried that has helped you with these symptoms? Any over the counter medications? 

user: No, I haven't tried anything. I've been thinking about using some nasal decongestion but I don't want to make my runny nose any worse. 

assistant: Yeah, no, that's a, that's a fair point. And yeah, there's multiple things that you can try over the counter, but we can get into that more later. Are you having any other symptoms at all, like any, shortness of breath, chest pain, any kind of dizziness, anything like that?
user: No dizziness, I feel like sometimes I have a headache though, because I feel like there's a lot of fluid or something backed up into my sinuses. 

assistant: OK, so do you, are you feeling, that pressure in your face at all? 

user: Mhm, a little bit, yeah. 

assistant: OK. Have you at all in the past couple weeks to a month had contact with anyone that was sick?
user: No, nothing like that, that I can think of. 

assistant: OK and any travel?
user: Uhm, no. 

assistant: OK, and any symptoms of a loss of taste of, sorry, loss of sense of taste or smell? 

user: No. 

assistant: No, any nausea or vomiting?
user: Uh, nope. 

assistant: Any night sweats? 

user: No. 

assistant: How about fatigue, or do you feel tired?
user: A little bit, yeah. 

assistant: OK, are you, do you work at all? 

user: I work from home right now. 

assistant: OK, and has this affected your work in any way?
user: No. 

assistant: OK, uhm, where, where do you live? Do you live in an apartment, a house?
user: I live in an apartment. 

assistant: And do you live with anyone? 

user: No, just by myself. 

assistant: OK, and any mold or dust or fumes, anything in your household?
user: I have some old carpets, but that's about it. 

assistant: OK. Have you felt any changes in your sleep or appetite?
user: No, nothing like that. 

assistant: OK. Any changes in your bowel movement, like diarrhea or Constipation? 

user: No. 

assistant: Any urinary trouble?
user: No. 

assistant: OK. Do you have any past medical conditions that you've been diagnosed with, like asthma or anything else? 

user: Uhm, no, I'm healthy otherwise. 

assistant: OK, any allergies that you know of?
user: Uh, nope, no allergies either. 

assistant: OK. Do you take any regular medications? 

user: Uh no, I don't even take vitamins. 

assistant: OK. Any hospitalizations or surgeries in the past?
user: I had an arm fracture when I was younger, but that's it. 

assistant: OK, but other than that, nothing else?
user: No. 

assistant: OK. And currently right now, do you smoke cigarettes at all?
user: No. 

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

assistant: Any recreational drugs like marijuana? 

user: No. 

assistant: OK. And do you drink alcohol?
user: Once in a while I'll have like a glass of wine every week. 

assistant: OK. And yeah, those are pretty much all the questions I have right now. Do you have any questions? 

user: Uh, no, what can I do about this runny nose? 

assistant: Yeah, so it seems like it's been going on for more than one and a half week. What, what is reassuring is that you're not having any other symptoms that are concerning, like you're not having any cough, you're not having any green or yellow sputum, you're not having any fevers, so it seems that you might just be having a cold, which can be caused by just a viral, uh, infection, but it should go away on its own. Just make sure that you're getting some rest, you're hydrating well, uhm, you can get some over the counter medications like Tylenol cold for example, but for now I would say we should just wait and watch. But just in case, also, since it is one of the symptoms that's for covid as well, in this time period we will just get a covid swab just in case, but most likely it's nothing to be worried about. Until you get your test, I would recommend staying isolated. And then we can go on from there, is that, does that sound good to you?
user: Yeah, that sounds great. Thank you so much. 

assistant: You're welcome, take care.
user: So I came to the emergency Department because I've been having pain in my chest. 

assistant: OK, where is the pain located?
user: I would say it's like the whole pretty much the left side of my chest. 

assistant: OK, and when did this pain start? 

user: So I think it started just around 2 hours ago. I actually was riding my bicycle and just fell off on, kind of just slipped and I think I fell on that side like when I the impact was right on my chest and since then it's been really painful. 

assistant: OK I am how would you describe the pain, sometimes people will use words like burning dull, achy.
user: I think it's more like someone is just stabbing me and then whole left side area. 

assistant: OK, and um. Anything that you've been doing that's that's made the pain worse?
user: If I. Think I have to take really really slow and shallow breaths. If I try to take a deep breath it just really hurts like taking those small, smaller breaths helps. 

assistant: OK, and do you feel the pain anywhere else, or is it just on the left side of your chest? 

user: No, I would say just on the left side. 

assistant: OK, and has the pain been getting worse, staying the same or getting better?
user: I'd say over the last two hours it's been getting worse. 

assistant: OK, and do you have any other associated symptoms? 

user: Uh, like I think I I'm having. Also maybe it's just because I'm trying to breathe slowly, but I feel like I can't catch my breath. 

assistant: OK, um has anything like this ever happened to you before?
user: No, no. I mean, I've never had any pain in my chest before. 

assistant: OK are you, did you have a loss of consciousness when you fell off your bike? 

user: No, I got right back up. I just just had the pain. 

assistant: OK, so any injuries to the head?
user: No. 

assistant: OK. 

user: That's fine. I was wearing a helmet. 

assistant: OK, excellent and any headache right now?
user: No. 

assistant: OK, how about any fever chills?
user: No, I feel I'm fine. 

assistant: Any nausea or vomiting? 

user: Nope. 

assistant: Do you feel as though your heart's racing?
user: I would say like in the last hour a little bit more so than usual. 

assistant: OK. Any skin changes or or rashes you've noticed?
user: Besides, just I got some scrapes here and there on my hands, but nothing else. 

assistant: OK, and do you have a cough?
user: Nope. 

assistant: OK, and any recent infections?
user: No, I've been pretty pretty healthy recently. No, no cough or no infections. 

assistant: OK, and uh, any dizziness? 

user: Um no. 

assistant: Alright, and I know you mentioned the few scratches on your hands, but any other injuries?
user: Oh no, I I think I got a pretty lucky. 

assistant: Oh, OK. And any alcohol or drug intake prior to falling off your bike? 

user: Oh no, no, I was completely sober. No no drugs or alcohol. 

assistant: OK, and any weakness or numbness or tingling that you noticed?
user: Um no nothing like that. 

assistant: Alright, and, when was the last time you had anything to eat or drink?
user: I just had some cereal and, um, just some chocolate milk around breakfast time but nothing else. 

assistant: OK, and how many hours ago was that? 

user: I would say around 3 hours ago. 

assistant: OK. Um, and have you been diagnosed with any medical conditions in the past?
user: Uh, not other than just a hay fever, but nothing nothing else. I have like a lot of allergies. 

assistant: Any allergies to medications?
user: Oh, just sometimes when I take like a nasal spray I think I might have an allergy to the steroids that they give me and sometimes also some of the antihistamines I think I get some allergies from them. 

assistant: OK. Uh, and any hospitalizations?
user: No, never. 

assistant: Any surgeries?
user: Nope. 

assistant: OK. Anybody in the family who have any illnesses? 

user: Just my father. He has type 2 diabetes but nothing else. 

assistant: OK, and how do you support yourself currently financially?
user: Oh so I work just as like a mechanic just in the city and currently I just have myself to support. I live alone in an apartment, so I'm doing fairly well. 

assistant: OK, and do you smoke? 

user: I smoke around like I'd say 2 and a half to 3 packs per day. I know it's. Yeah, I have tried quitting before, but I would say I've been smoking since I was 18. 

assistant: OK, and do you smoke marijuana?
user: No, no, no marijuana, no other drugs. 

assistant: OK, and do you drink alcohol? 

user: Yeah, it's just like sometimes on the weekend. I'll just have a beer or two while watching the game, but not nothing regular. 

assistant: OK, thank you.
user: I just started having, um, difficulty with breathing um, starting yesterday. And I also developed this cough um, yesterday morning. 

assistant: Okay, so did, did the cough come first or the breathing, difficulty breathing? 

user: Kind of around the same time when I woke up in the morning. 

assistant: And did it wake you up from sleep at all? Like did you wake up trying to catch a breath or anything?
user: No. 

assistant: Okay, so it happened after you had woken up and gotten out of bed. And um, so, can you describe your cough a little bit? Is it wet or is it dry?
user: Um, it's just um, it's just a dry cough. 

assistant: Okay, you're not bringing up any sputum or any other material?
user: No. 

assistant: And uh, are you coughing up any blood by any chance?
user: No. 

assistant: For the shortness of breath, can you describe it a little bit? Is it, are you having trouble taking deep breaths, or are you breathing faster? Can you describe it? 

user: Yeah, I just feel like um, I'm getting out of breath really easily, just like um, walking even, walking to the kitchen from my bedroom, I'm getting short of breath and it, it just started yesterday morning, it's so odd. 

assistant: Okay, and have you had anything like this happen before to you?
user: No. 

assistant: No. Were you doing anything before it started? Like were you doing any, any activities or any, are were you doing any exertions at all?
user: No, I was just uh, I, I slept in, I slept in a bit more than usual, um, and I was feeling quite um, drowsy. My, my doc increased my pain meds and I took the first dose um, yesterday night, um, I actually took an extra pill um, um, of the morphine um, and yeah, I don't know, maybe it, it's an allergic reaction to the morphine. 

assistant: Have you had any allergic reactions before?
user: No. 

assistant: And so you took an extra morphine last night and then went to sleep. Um, did you wake up coughing or catching your breath or anything like that? 

user: No, I actually, I ended up waking up at 1:00 PM or 2:00 PM, I was just very drowsy and uh, I think I, I think I might have taken a bit too much, I don't know. The, the arthritis pain was just killing me last night and I thought taking an extra pill would help. 

assistant: And is this, are your symptoms constant? Or do they come and go?
user: They're constant for the past two days. I've also noticed that I have, my breath just smells really bad. I don't know why. 

assistant: Is that something you noticed recently or in the last two days? 

user: Yeah, since yesterday. Actually, not even yesterday, this morning I would say. 

assistant: This morning, okay. Um, and is there anything that makes your symptoms worse? Like does lying down make your symptoms worse?
user: Not really. 

assistant: No. How about exerting yourself, does it make your symptoms worse? 

user: Yeah. 

assistant: Okay. Um, do you have any other symptoms like any fevers or chills?
user: I checked my fever last night, it was um, 37.2. 

assistant: Okay, so you didn't have a fever last night, okay. Um, do you have any other symptoms like dizziness uh, any fainting spells?
user: No. 

assistant: Okay. How about sore throat, headaches, muscle pain, anything like that?
user: No. 

assistant: Okay, any chest pain?
user: No, I don't. 

assistant: And um, have you been traveling at all recently? 

user: No. 

assistant: Any contact with anyone who has been sick recently?
user: No. 

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

assistant: Okay. Any night sweats?
user: No. 

assistant: Okay, any swelling in your legs or arms, hands?
user: No. No, I haven't noticed any of that. 

assistant: Any fatigue? Just feeling more tired today? 

user: Maybe a little bit. 

assistant: Okay. Have you been having any cold-like symptoms before the two days, like in the last week, like runny nose, sore throat?
user: No. I was, like, I was absolutely fine. 

assistant: Okay. Um, how about, do you have any changes in your bowel movements like constipation, diarrhea?
user: No. 

assistant: No. Any trouble with urinating?
user: No. 

assistant: Okay, any sleep or appetite issues?
user: No. 

assistant: Okay. Have you lost uh, significant weight in the last few months? 

user: No. 

assistant: Okay. Um, have you been exposed to anyone who may have had tuberculosis?
user: I don't think so. 

assistant: No, and uh, do you have any pets or animals at home? 

user: Um, I have a dog. 

assistant: Have you ever had any allergies to any pets or animals?
user: No. 

assistant: Any exposure to fumes or dust uh, with where you live?
user: No. 

assistant: Okay, and do you have any past medical history? Any diagnoses?
user: I um, I just have the osteoarthritis. 

assistant: Osteoarthritis, okay. Is that why you're taking the?
user: Yeah, yeah. 

assistant: And are you taking any other medications? 

user: I take uh, Advil. 

assistant: Advil, okay. Any allergies that you know of?
user: Um, no. 

assistant: Okay, any previous hospitalizations? 

user: Um, I had my wisdom teeth removed. But no, I wasn't, I wasn't hospitalized. 

assistant: Okay, is that the only surgery that you've had, or have you had anything else?
user: Yeah. No, that's it. 

assistant: Any family history of any lung or heart conditions?
user: Uh no. 

assistant: Any cancers?
user: Um, breast cancer, my grandma had it. 

assistant: Um, any uh, and currently, what's your living situation like, do you live with someone?
user: Um, I live with my husband. 

assistant: Okay.
user: And my dog. 

assistant: And your dog, okay. And did your husband tell you anything, like that has changed in your behaviour at all uh, recently?
user: He just said that I was, I was just extremely drowsy yesterday and I was very hard to wake up. 

assistant: Okay. Okay, um, do you smoke currently?
user: No. 

assistant: Have you smoked in the past? 

user: No. 

assistant: Okay, and do you work currently?
user: Uh I, I do. 

assistant: And uh, how would you, sorry, dis you say you don't work or do you work?
user: I'm a banker, but I'm working virtually, uh, remotely right now. 

assistant: Okay. And um, do you use any recreational drugs like marijuana?
user: I um, no. Well sometimes I'll use marijuana for the pain, but I haven't been doing that recently, for the past two months. 

assistant: Okay. Um, how, how often would you say you use it? 

user: Only when the pain gets uh, too bad, so maybe um, three or four times a month. 

assistant: Okay, and do you use any alcohol?
user: Um, yeah, I'll, uh, I'll drink once a week, two glasses, two or three glasses of wine. 

assistant: Um, any, alright, so I think that those are all the questions I have for you today. Do you have any questions or concerns for me?
user: Um, no. 

assistant: Okay, so yeah, definitely with the coughing and shortness of breath we will definitely get a COVID swab test done. Um, that should come back in the next 24 to 48 hours and then public health will contact you. Um, yeah, based on what you're telling me so far, we will definitely do a physical examination, get your vitals, and get your oxygenation and everything done. But I also think, since you were very drowsy and were, had fallen asleep and were really difficult to wake up, sometimes you can get what's called aspiration pneumonia. Um, and that's, that can also be a possibility and what we will do is get a chest x-ray, get some blood work done as well today. Um, now we may require antibiotics, and if your vitals unstable we might actually admit you as well. Um, does that sound good?
user: Yeah. 

assistant: Alright, so yeah, we'll get those tests done and we'll be there with you shortly. We'll also get like an EKG done as well.
user: I'm I'm here because I, I've oddly been feeling really short of breath and have a fever or and a cough. 

assistant: OK, when did the shortness of breath start and are you short of breath now?
user: It started about uh, I guess I could start yesterday. And a little bit, but it's getting better. 

assistant: Started yesterday, OK, well I'm glad, it's getting better. When did the cough start? 

user: It started around the same time. 

assistant: OK, it is it. A dry cough or or wet cough?
user: It's a dry cough. 

assistant: OK, is it? Is this cough new or if you had a cough before?
user: No, it's it's kind of new. 

assistant: Alright, have you brought up any, I know you said its been but have you brought up any blood? 

user: No. 

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

assistant: OK. And you mentioned a fever as well. Have you checked your your temperature today or yesterday? 

user: Yeah, it was at 38 last night. 

assistant: Are you feeling feverish today as well?
user: Yeah, a little bit. 

assistant: OK, and uh. So have you had any any infectious symptoms, like runny or red eyes? 

user: No. 

assistant: How about a runny nose or feeling congested?
user: No, no, it's just a cough. 

assistant: Cough? OK. And what what, were you around any triggers yesterday or like around any anything that was out of the normal for you?
user: I got a notice that this happens to me every time I go to my boyfriend's place, so I started dating, I started dating someone new about six months ago and every time I go to his place, a couple hours later I just like develop these symptoms, just kind of odd. I thought that I was just getting a cold. But now that it's happened like three times, I'm thinking maybe you have some sort of an allergy like maybe,  I don't know. Maybe it's like yeah, I'm just allergic to something. Maybe his plants or something. I don't know. 

assistant: OK, and it does this happen each time that you go go to his house?
user: Um, yeah, yeah. Kind of almost yeah, that's like you haven't like. I haven't been to his place very often because of the pandemic. But yeah, every time I go kinda feel really crappy after. 

assistant: I see OK and, uh, are there any other environments you can think of where this happens or have these symptoms happen at any other point?
user: No, I don't think so. 

assistant: OK. And have you had a sore throat? 

user: No. 

assistant: How about any losses of smell or or taste?
user: No. 

assistant: OK, and have you had any chest pain? 

user: No, no. I haven't. 

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

assistant: Alright, and any abdominal pain or diarrhea?
user: No. 

assistant: Any urinary problems like painful urination or frequency?
user: No. 

assistant: Have you had any muscle aches or body pains?
user: Yeah, yeah. Just act different feeling achy and kinda tired these past well like 12 to 14 hours. 

assistant: I see OK, so it has been kind of like all over or there are particular muscles sore or our body part?
user: No, it's it's like all over. 

assistant: OK, and you've been fatigued as well? 

user: Oh yeah. 

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

assistant: Any skin changes or rashes? 

user: Uh, no. 

assistant: Alright. And then how about any night sweats or chills? I know you mentioned fevers.
user: No, I've just been feeling hot. 

assistant: OK, I mean, how was your weight been over the last several months? Is it like have you lost weight or gaining weight or is up in the same?
user: Kind of in the same. 

assistant: OK. And uh, in the past, have you been diagnosed with any medical conditions?
user: No, I'm pretty healthy. 

assistant: OK, you see. Yeah, you haven't had asthma in the past or or anything like that?
user: No. 

assistant: OK, any allergies to medications you're aware of or or environmental things like or dust or pollen?
user: No no. Which is why I was kind of surprised. I'm usually fine and I spend a lot of time outdoors so, I don't know. Yeah, I was surprised when this happened when I went to his place. 

assistant: OK, did you ever get these kind of symptoms if you are like yeah or around smoke or or anything like that, you could maybe be inhaling or or even if you are outside in the cold?
user: No. 

assistant: OK, and you get seasonal symptoms like throughout the year you get like itchy runny eyes or like. Like a runny nose? 

user: No, no. That hasn't happened to me. 

assistant: OK, and do you take any medications?
user: I just take a birth control pill. 

assistant: And when, how long have you been on that for?
user: About three years. 

assistant: OK. And any prior surgeries or hospitalizations? 

user: Oh no. 

assistant: Alright, and can you tell me a little bit about where you're living currently and two you're living with?
user: I live alone, uh? I have an apartment next to the University. 

assistant: OK, and any potential for being around anybody who's been sick like your boyfriend or his family or or anywhere else?
user: No, I've just been visiting him and I just go grocery shopping. I've just I've been doing schooling online. Yeah, I don't think so. I'm usually very careful, I'm not. Yeah, I'm not maintaining social distancing with my boyfriend. He's in my social circle, but yeah, other than that no one I think yeah. 

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

assistant: Alright then are you currently working or going to school?
user: I'm going to school. 

assistant: OK, cool and uh. And are you currently sexually active?
user: Yep. 

assistant: OK, and are you using birth control. Are you using condoms?
user: Yep. OK, any concern for any sexually transmitted infection at this time?  No. No, I'm very careful. 

assistant: OK? And do you smoke cigarettes? 

user: No. 

assistant: Do you drink alcohol?
user: Sometimes if, like during like parties and stuff, but I haven't really been drinking much 'cause there's nothing going on. 

assistant: OK yeah I see. And uh do use any recreational drugs?
user: No. 

assistant: Alright, then umm in the family is there a history of any lung problems or any any heart problems?
user: Um just high blood pressure. My mom and dad have it. 

assistant: OK. And so I wanted to ask about the boyfriend's house as well. Is there any pets in the home there? 

user: Oh yeah. Yeah, he has this cute little parrot. And he also has a cat. 

assistant: OK, and do you have any pets at your house?
user: No, no I don't. 

assistant: Oh, OK. So that I think that was everything that I wanted to ask on on history today, was there anything else I forgot to mention or you wanted to to bring up?
user: I've had this pain in my back thats kind of like in my lower back and my buttocks and it's now radiating down to my right leg. I've had this for awhile now, but it's getting worse and I just want to come get it checked out. 

assistant: OK, and how long have you had this pain for? 

user: About a month. 

assistant: OK, and has gone worse at all like did you have the it radiating through your leg before or is that something that happened after?
user: That's something that happened after that happens that that's been going on for the past week. 

assistant: OK, and is this pain constant or does it come and go? 

user: And it's pretty much always there, but certain things can make it worse. Like if I'm walking or doing certain activities it can it can make it worse. 

assistant: OK. And did you have any back pain before this month?
user: No, not, I mean no, not really. 

assistant: OK. An what kind of pain would you say it is. Is it like a sharp stabbing pain or is it more so a dull aching pain? 

user: Um usually or well before it was like a mild achy pain, but now it can be. It's sharp and it feels like a burning sensation. 

assistant: OK, a burning sensation, where would you say that burning sensation is?
user: It's like down my buttocks to the right leg. 

assistant: OK, and do you feel any kind of numbness or tingling with it?
user: Um a little, a little bit of tingling. Yeah, a little bit of tingling. 

assistant: OK, and how would you rate the pain from a scale of zero to 10, 10 being the worst pain you've had in your life?
user: So usually it's about like a 5 to 6 out of 10, but when it gets bad and um sharp, I'd give it an 8 out of 10. 

assistant: OK, and are there any kind of motions or positions that cause you more pain? 

user: Yeah, so I'd say like just any sort of physical activity, like if I'm on my feet a lot, it hurts. 

assistant: Mmm.
user: Yeah, that's pretty much the only thing that I can think of right now. 

assistant: OK, did anything happen one month ago or before this pain started. Like any injuries or falls that might have caused this pain?
user: Um no like a long time ago, like 6-7 years ago I injured my back at work but. I just did some conservative treatments for that and it went away. 

assistant: OK was it your lower back.
user: Yes. 

assistant: OK. And what do you do for work? 

user: I used to work on an assembly line, so I used to. Like carry heavy objects and things like that. Like car parts. 

assistant: OK, and do you still work there?
user: No, I don't. 

assistant: OK when did you stop working there?
user: About three years back. 

assistant: OK and is there any other work you do currently? 

user: Um I work from home now. I do daycare at home. 

assistant: OK. OK, and just getting back to the pain so it's kind of in your lower back, your buttocks and then it goes to your right upper leg?
user: Mmmm 

assistant: Does it move anywhere else besides that or those are the regions that it stays in?
user: No, those are kind of the only regions that I'm experiencing it right now. 

assistant: OK. And do you get more pain leaning bending forward or would you say extending your back?
user: I would say ext.. Extending my back hurts more. 

assistant: OK and you get pain with sitting down? 

user: Um sometimes. 

assistant: OK, how about lying down?
user: Um lying down I guess it depends on the position. If I am straight on my back it's it's not too bad, but if I like I'm hunched over or something like that, it hurts. 

assistant: OK, I see OK and have you tried any medications over the counter and painkillers that have helped?
user: I tried some ibuprofen and some like topical.. um like ointments but it helps temporarily and then the pain comes back. 

assistant: OK, let's see and. Other than that, so other than this pain that's been going on do you have any fevers or chills?
user: Uhm No, no fevers or chills. 

assistant: OK, no night sweats? 

user: No. 

assistant: Any increased fatigue?
user: No, no. 

assistant: Any rashes or skin changes? 

user: No 

assistant: Any uh. Any cough or cold symptoms recently?
user: Um no nothing like that. 

assistant: OK and apart from your back, any kind of joint or muscle pain anywhere else in your body? 

user: No. 

assistant: Any changes in your bowel movements?
user: No. 

assistant: OK, any urinary problems?
user: Nope. 

assistant: Any stool incontinence for your urinary incontinence?
user: No. 

assistant: OK, and any kind of numbness or paresthesia like around just your lower back and buttocks? 

user: No, no numbness just like that, tingling, burning feeling. 

assistant: OK, OK any recent weight changes like any significant weight loss?
user: No. 

assistant: OK. Any muscle weakness at all in that area?
user: I'm finding it hard to walk. 

assistant: Harder to walk? OK. Are you limping at all?
user: Yeah, I'm putting more weight on my left leg. 

assistant: OK. And do you feel, so you mention you feel tingling going down your right leg? Do you feel any kind of numbness at all? 

user: No. 

assistant: No, OK alright do you have any kind of urinary or fecal retention like at all?
user: No, I'm going. I'm using the washroom OK. 

assistant: OK, uh. Do you have any history of any cancers at all?
user: No. 

assistant: No OK. Are you on any. So do you have any past medical conditions you've been diagnosed with? 

user: No. 

assistant: No. Do you take any medications regularly?
user: No, I don't. I just take calcium and vitamin D and other but multi vitamins. 

assistant: OK, any allergies to any medications? 

user: No. 

assistant: Have you had any previous surgeries or have you been hospitalized for any reason?
user: No. 

assistant: No, OK, any family history of any autoimmune conditions, any heart or lung conditions? 

user: Um no not that I know of. 

assistant: OK, an and, currently you said you work from home. How would you describe your living situation like?
user: I would say I it's it's OK. I live in an apartment with my husband. 

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

assistant: OK, and do you drink alcohol? 

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

assistant: OK, and do you use any recreational drugs?
user: Um so I've I've been using cannabis oil for the past month just to see if it helps with the pain. 

assistant: OK, and has that been working for you at all?
user: A little bit I think. 

assistant: OK. OK, so those are some of the questions I had. And I'm just gonna ask a few questions about just examining the areas that are giving you trouble. So along your back, if you if you were to press down on from the middle to your lower back, any kind of pain when you press down. 

user: Um lower back, yes. 

assistant: OK, So what kind of pain is it like sharp or is it kind of a dull aching pain?
user: When I press down it feels sharp. 

assistant: OK, and do you have you notice any kind of swelling in your legs or, near the areas where you have pain swelling or redness, or  any warmth? 

user: Um it seems to. Actually, no, it's not. It's not warm. 

assistant: OK. And in terms of just movement, are you able to bend down?
user: I can bend down, it's just hard for me to get back up. 

assistant: OK See and how about like bend sideways.
user: I can do that. 

assistant: OK nd how about if you're laying flat are you able to raise your legs without bending your knees? 

user: I can do that, yeah, actually no. I can't. Sorry that that hurts. 

assistant: So your right leg hurts when you do that?
user: Yeah 

assistant: OK, great. And other than that, like when you when you do any of those movements, can you, do you get like that tingling again?
user: Yeah it does. Yeah. 

assistant: OK alright and when you stand up and walk how would you describe, are you having any kind of limping at all?
user: Um a little bit of limp yeah,  I'm putting more weight on the left leg. 

assistant: OK, alright, so yeah, those are just some of the questions I I had for you today. Do you have any questions at all?
user: Um no, what can I do about this back pain and how long do you think I'll have it for? 

assistant: Yeah, so it's been happening for one month right and you're getting some symptoms in in your lower leg, so normally we would wait before we do any kind of diagnostic imaging. But since you're also having these other symptoms we we were worrying about sometimes lower back pain can lead to something called sciatica. It's just when one of the nerves get pinched, and then that's why you're getting the tingling around your right upper leg. So what we can do is. We can do if you haven't had an X Ray, we can do an X Ray of your lower back. And then we can also do an MRI.
user: OK 

assistant: And. Based on what results come back at the same time we will, I will give you some information about some anti- inflammatory medications you could take to help relieve some of your pain, but other than that I will also refer you to some physiotherapy. That will help you do some exercises at home. Just ways to protect your back as well as strengthen some of your muscles to help deal with some of that pain. Yeah, so we'll get the results back. And then we'll go from there. 

user: OK, sounds good. Thank you. 

assistant: You're welcome. Take care.
user: Yeah, so I've had this cough that started within the last day and uhm, I've also been particularly short of breath as well. 

assistant: OK. Can you tell me about the, the cough, how, is it dry cough or wet cough?
user: It's wet, I've been bringing up, uh, sputum that's uh, It's just, it leaves a really bad taste in my mouth when bringing it up. 

assistant: What color is the sputum?
user: It's kind of, uh, like, yellowish green, type color. 

assistant: Havey you noticed any blood?
user: No, I haven't seen any blood. 

assistant: And it only started yesterday. What about the difficulties breathing, when did that start?
user: Yeah, that started really within the last twelve hours or so. 

assistant: And can you tell me if it's gotten better or worse since then? 

user: Yeah, it's been, it's been getting worse, uhm, and the phlegm, also smells really bad. 

assistant: OK. When do you have difficult, like, is there anything that makes the, shortness of breath, worse?
user: Yeah, if I, uhm, when I was having a cigarette earlier today, it got a bit worse and when I went out to get the Mail today I, I just couldn't do it. I, I had to just sit down. 

assistant: And that what happened to you before, right?  p: No, I usually uhm, am able to go out and get the mail, no problem, yeah.  OK. Uh, and say two days ago, were you feeling perfectly fine? 

user: I was yeah, I wasn't sick at all. 

assistant: OK, so you've had this bad cough and you've had some difficulties breathing since yesterday. Have you had a headache at all?
user: No, no headache. 

assistant: Any, uh, runny nose?
user: No, it's really, no. 

assistant: Any congestion?
user: No. 

assistant: No, OK. Have you had any pain in your chest? 

user: Uh, no pain. 

assistant: When you're breathing in or breathing out any pain at that time? or deep breathing?
user: No, I haven't had any pain. 

assistant: OK, have you had any palpitations or you feel like your heart's racing? 

user: Uh, yeah, I do. I feel like my heart has been beating a little bit faster. 

assistant: OK. And any pain in your belly?
user: No. 

assistant: Nausea or vomiting?
user: Uh no, but, well I guess I have felt a little nauseous with the, uhm, bad taste in my mouth. 

assistant: OK, and any uh diarrhea or Constipation?
user: Uhm no, I haven't anything like that. 

assistant: OK, any sore throat? 

user: Uhm, no. 

assistant: OK alright uhm, any other symptoms that I haven't talked about, that you experienced over the past day?
user: No, it's really been, uhm, yeah, this cough and bringing up this, this sputum and being short of breath. 

assistant: OK, uhm, can you tell me about your past uh, medical history, do you have any medical conditions?
user: Uh yeah, I have uhm, high blood pressure. 

assistant: Mhm.
user: I also have acid reflux, so uh, gerd I think, think it's called? 

assistant: Yeah. 

user: And, uhm, high cholesterol as well. 

assistant: OK, ok.
user: And I've also been, had issues with anxiety in the past as well. 

assistant: In terms of medications, are you taking any?
user: Yeah, I take uhm, an ACE inhibitor, statin, uhm, and uh, medication for my stomach, I think, like Pantoprazole. 

assistant: OK, and uh, how well has your gerd been controlled? 

user: Uh, it kind of, it bugs me most days, its not so bad, I mean, sometimes I'll get a little bit of heartburn and acid in the, in my mouth, but it depends on what I eat so I really try to stay away from some, some foods. 

assistant: So the PPI hasn't completely curbed the, the acid reflux, you still get it?
user: Yeah, I still get it. It's definitely helped though it was a lot worse before, uh starting it. I've been on been on it now for a few years. 

assistant: OK, and as for your anxiety, do you ever get panic attacks?
user: No, I haven't had any, any panic attacks. 

assistant: OK, alright. Do you have any allergies?
user: No. 

assistant: OK, so you said that these symptoms started yesterday and they were quite sudden, uh, was there anything that you were doing yesterday or the day before that was different or unusual?
user: Well, yeah, I mean yesterday I, or, yeah, I had a bit more to drink than, uh, usual, more alcohol I mean. So, I mean, could that have something to do with it? I'm not sure. 

assistant: It could potentially. Did you, were you, were you drunk and did you pass out? 

user: Yeah, I think so. My, my friends, uh yeah, that's what my friends were, were saying anyway. 

assistant: OK, and uh, talking about alcohol, how much do you usually drink?
user: I usually, like, like four to six beers a day, but uh, yeah, yesterday was certainly more than that. 

assistant: Have you considered reducing the amount of alcohol you drink? Has it affected you in any way? 

user: I mean I, I'm retired now so, uhm, I don't know, I, I feel like it's been fine maybe, uh, I feel like it's been fine. 

assistant: OK, OK, I suppose we could talk a little bit more about that later if you want uhm, as four to six beers is quite a lot actually, and it can affect your health in certain ways, but we can, we can chat more about that later.
user: OK. 

assistant: And, uh, do you smoke?
user: Yeah, I smoke, uhm, a half a pack of cigarettes per day. It was well over a pack before, so I've cut down a little bit. 

assistant: No, that's great. OK, do you plan on cutting it down further or do you wanna stay right there?
user: Yeah I have been, have been trying, just too, too darn expensive these days, so, been trying to cut back. 

assistant: Yeah, yeah, that's fair, alright. What about marijuana? Do you consume marijuana?
user: No, I don't. 

assistant: Any recreational drugs?
user: Nope. 

assistant: Alright, do you have any family history of any medical problems?
user: Uh yeah, my, my father had, uh, he ended up having liver disease actually, he passed away from that I think. And he had heart problems too. He was a lifelong smoker and didn't really, didn't really take care of himself. 

assistant: Hmm, I see. Do you, do you have a family doctor? 

user: Uh, I do. I haven't seen my family doctor in a number of years now though. 

assistant: Yeah, well, you know it's, it's a good idea to see your family doctor on a regular basis, specially when you're getting older, because sometimes you might need changes in your medications, or there might be checkups or screenings that they might want to do. It's for your own benefit, you know, maybe even just seeing them once a year would be a good idea. I would definitely recommend that you book an appointment with them just for a checkup in the next couple of weeks. Is there a reason why you don't see your family doctor too often?
user: I just haven't been, uhm, sick and I've been able to, to refill my prescriptions, mostly from just calling in, so. 

assistant: OK, ok, I see, uhm, alright, and do you live alone or do you live with other people?
user: Yeah, I live with my wife. 

assistant: OK, alright, and are you able to take care of things like groceries or finances, or shoveling snow or cleaning the house, or do you need any assistance with those sort of household activities? 

user: Yeah, we moved, uhm, actually into an apartment last year. It's made it a lot easier in terms of the housework and that sort of thing. But I've been able to, uhm, I do the the grocery shopping and share the the chores around, around the house. I do, I'll use a cane sometimes. I, I injured my knee a number of years ago, but other than that, things are OK. 

assistant: OK, OK, good to hear. That reminds me, have you had any surgeries in the past?
user: Just on my, my left knee. I had a left knee replacement a few years ago. 

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

assistant: OK, alright, uhm, so sounds like you've had a day of this wet cough with the, this, a bad smelling sort of sputum that's, that's yellowish green in color, and you've also had difficulties breathing for the past twelve hours, uh, so much so that you can't even go out to get mail and your hearts been racing. It's possible that while you were drunk that you might have, and given that you have acid reflux, that you might have accidentally have something go inside your breathing tube from, from your mouth or something that came up from your stomach and sometimes when that happens, food items can or other things can get lodged in your lungs and can become, uhm, can attract bacteria to, uh, to replicate and cause a bacterial infection, so it's possible that, that's what happened But it could also be a viral pneumonia or a viral infection in your chest. we'll get a chest x-ray done, we'll have some labs done as well, and we'll likely start some antibiotics. Have you recently been on any antibiotics?
user: No, I haven't. 

assistant: And you don't have any allergies to any, correct? 

user: Correct. 

assistant: Alright, OK, we'll also do a physical exam just to give a listen to your, to your lungs and see how they're doing and then go from there. Do you have any questions for me?
user: I was just bringing my son and he's just had cough for the last couple of days. I thought about a day and a half ago, it doesn't feel like a cold. He hasn't been too sick, but I was a little bit worried and I wanted to get him seen to see if there's anything we could do. 

assistant: Yeah, for sure. It's a good thing that you brought him in. So the cough, is it consistent? Or does it come and go? 

user: It seems to be a little bit worse at night. He'll have this cough during the day. Sometimes I'll notice when he's playing. He's had these coughing fits that last for up to a minute but usually recovers from. He hasn't been too active to be honest. He's been a little bit slowed down these last couple of days, but in regards to consistency, I'd say it's a little bit worse at night. 

assistant: OK, any other triggers like dust or the cold air? Anything like that?
user: I haven't really noticed anything. We've been mainly keeping inside due to covid, right? I think my wife left a window open the other night, and maybe the cough was a little bit better. I'm not sure. It's kind of hard to tell when we sleep. 

assistant: Yeah, have you tried anything for it, like have you given him any over the counter cough medications? 

user: No, we're a little scared to give him anything. He's so young. He's 2 1/2. We haven't been really giving him any medications to be honest. 

assistant: OK, good. And if you were to describe the quality of this cough, would you say it's barky? Is it harsh?
user: Barky might be a good word to describe it, like he's had colds before his coughs were quiet but this sounds harsh. It sounds like he's really trying to cough hard there. Very violent sometimes. 

assistant: OK OK. And has he ever had a cough like this in the past?
user: No, never. 

assistant: OK, and then in terms of the timeline, is it getting worse? His cough?
user: I think it has been to be honest. He was a little ill like he had a runny nose a couple of days ago, maybe two days ago and then the cough started but it only really started getting noticeably different about the night of the first day, about two days ago so. Now it's been more present I suppose,than it was when he just first had it. 

assistant: OK, and is it a dry cough or does he bring up sputum? 

user: Sputum like phlegm,no he doesn't bring anything up really, so dry. 

assistant: OK so no blood as well right?
user: No blood. 

assistant: OK,  does he have any shortness of breath with his cough?
user: I feel like when he has the coughing fits, he's winded. He's weak after them. Sometimes he cries after them or before the middle can be a trigger for it, but just resting normally, he doesn't seem that out of breath, no. 

assistant: OK any wheeziness? 

user: No, not really. He's able to breathe. I can't really hear him breathing that much. Sometimes at night after a bad cough he'll be really winded. And yeah, it does sound like a little different when he's breathing, but just right now he sounds normal. 

assistant: OK, and any reason for you to think he has chest pain?
user: He hasn't any sort of chest pain. He says his throat hurts, but I don't think it's his chest. 

assistant: Has he had any fevers?
user: No, no rashes. 

assistant: How about weight loss? 

user: No weight loss, he's a fairly healthy kid. 

assistant: And his vision and hearing are normal?
user: You know, I haven't gotten him formally assessed yet, but seems to be able to read pretty well from a distance. He's not in school yet, but I haven't noticed anything, and he can hear fine. I think he responds when I call. 

assistant: OK, has he had a stuffy or runny nose?
user: Yeah yeah, that's kind of how it first started three days ago. Maybe had a runny nose. OK, yeah. 

assistant: Does he still have a runny nose?
user: Umm, a little bit less now. No, not as much now. 

assistant: OK. And his taste, any reason to believe there are any changes there?
user: Well, we've been kind of spoiling him a bit, just giving him ice cream. His throat hurts a little bit and he seems to still like it, so it's hard to tell. 

assistant: OK, so he has a little bit of a sore throat as well?