jshargo/medical-interview-conversations2 huggingface dataset:
user: No cancer, but my mother died of a heart attack when she was 43. And my grandma also had a heart attack when she when she was younger. I wanna say in her 50s but I don't exactly remember how old. 

assistant: And currently right now, where do you live? Do you live in like a house, apartment? 

user: Yeah, I live in an apartment by myself. 

assistant: OK, and do you currently work?
user: Yeah, I'm in charge of um a retail store as a manager there. 

assistant: OK and do drink?
user: Sometimes on weekends or if I'm socializing with friends, but not very often. 

assistant: OK, and do you use any recreational drugs like marijuana?
user: Never. 

assistant: OK, and do you smoke? 

user: Yes, I smoke about 2 packs of cigarettes per day. And I've been smoking since I was 12. 

assistant: OK. Alright and in terms of your daily routine like do you get any exercise?
user: Uh, not really. Life's a bit too busy and hectic right now right now, unfortunately. 

assistant: OK. And how about your diet like what is your regular diet look like?
user: I'm just bringing my son today because he's been how many episodes where I'm eat hell gets all this coughing fit and become wheezy and become shorter breath and I mean after a period of time it goes away, but it's been happening every so often. 

assistant: Does he still have these symptoms? 

user: Like right now he's OK. When the symptoms come on, they last for I don't know, maybe 30 minutes, 60 minutes or or even less. But yeah it happens maybe once or twice a week where and it's been going on for a, a couple of months now. Yeah, he actually had a viral infection like a few months ago and I thought it was just that. It leared up and then he's just had a few more of these episodes, but without those kind of symptoms so. 

assistant: Hm? So all this started a couple months ago.
user: Yeah. 

assistant: Do you find that there and you mentioned that it happens about one to two times a week? Is there anything specific happening at that time? Any triggers that result in these symptoms?
user: Well I will say I think I like exercise. I find yeah like soccer practice. Yeah, after maybe, or even during a game, like when things are really intense. Yeah, I think during soccer I've I've kind of noticed it. And then at night time as well. It kind of randomly, he'll have this cough. 

assistant: OK. So I guess it's do you feel like it's affected by cold weather as well or no? 

user: Um, maybe yeah, like if he yeah completely in the winter time. Like I know when he goes outside if he yeah he takes like a deep breath or something like that. He'll talk about having shortness of breath or difficulty breathing in the cold weather. 

assistant: OK, other than the and I guess the cough. Is he coughing up anything, or is it kind of a dry cough?
user: It's dry. 

assistant: OK. Does he have any like chest pain during these episodes.
user: No, he hasn't said anything like that. 

assistant: Alright, any fevers?
user: No, he had a little bit of a fever at the that one time a few months ago, but he hasn't. So that's right. I think he had a some sort of illness then, but he hasn't had any fevers. 

assistant: I see. OK, any headaches?
user: No, he hasn't said anything like that. 

assistant: OK. And how has he had any other symptoms so anything like racing heart or belly pain or muscle aches or any changes in his bowel movements or urinary symptoms? 

user: Uh no, I haven't heard him, uh, I complain about anything like that. I think I'll everything like that's been normal. 

assistant: OK. So when he has these episodes, how like how severe are they? So how difficult is it for him to breathe?
user: Ah, well, you certainly when it first starts, I mean for the first minute or two. Yeah, he that when I think particularly at soccer practice school have a really hard time catching his breath, but like he would, he stops playing and rests and really tries to make sure that he is I don't know, just trying to to breathe and it kind of goes away. He's been able to manage it OK. 

assistant: OK, alright and I have these symptoms that have interfered with his daily activities? Does he for instance, try to avoid soccer practice. Or does he have difficulties falling asleep at night?
user: Yeah, definitely wakes him up a few and every once in awhile at night and he does have to take it a little easier at soccer for sure. So yeah, I am thinking it is affecting him. 

assistant: OK. And otherwise has he been, has he had any medical conditions that he's been diagnosed with? 

user: Uh, no, well he had some rashes when he was younger that he would get some some creams for, but that's mostly resolved now. 

assistant: OK, any hospitalizations or surgeries?
user: No, he hasn't had anything like that. 

assistant: OK, uhm. And just going back to his birth and your pregnancy, were there any complications at the time of pregnancy? 

user: Um, there was a prolonged labor, I think, but he was delivered vaginally and at term 

assistant: OK. OK, that's great.
user: And he, oh sorry, I was just going to say normal weight as well. 

assistant: OK good has, was he kept in the in ICU for a couple of days after, was he sent home?
user: I think they, like he was kept for not an ICU he was kept for one day I think so just monitor for infection because it was like prolonged labor but he was OK. OK, so yeah we were able to go home. 

assistant: OK, and I, what was I going to say. Forgot what I was going to say. How yeah, how has this growth and development been? Has he been seeing his doctor regularly? Any concerns there? 

user: Yeah he's been good with with growth. No concerns for that and his developments been normal as well. He's reached all of his milestones. 

assistant: OK, and is he going to school?
user: Yeah, yeah, he's been going to school. He hasn't really been, he hasn't missed well he's missed one or two days actually, because of the cough, like on nights that he just didn't sleep well, so in the morning he's just well, not not feeling good for school so he has missed a couple of days over the last few months. 

assistant: Okay. And does he, is there any other any conditions that run in the family? Including things like asthma or eczema, or allergic rhinitis or allergies. 

user: Yeah, sister does have some bad allergies. Her nose runs all the time and she also has that asthma. His sister uses and a daily inhaler and then also W1. 

assistant: I see. OK, and uh. How are things at home is he, is he doing well otherwise? Like at school and things like that, any stressors in his life?
user: No, he's been doing, uh, he's been doing well at school. He likes math and that that's been going, well. 

assistant: OK, great. Has he ever tried any puffers?
user: No, he hasn't actually. 

assistant: Has he been on any medications? 

user: Um, he he has not. 

assistant: Any allergies that he has?
user: Not that I'm aware of, but I I think he might. I mean so like environmental or I don't know, something. He does get symptoms like a runny nose and itchy eyes sometimes, but usually go away pretty pretty quickly and he doesn't fuss about it too much so, yeah so. 

assistant: From the symptoms that you've described so far, it sounds like he might also have asthma, but we will obviously have to do some testing and confirm that. Uhm, and also, it's given sort of the results, or even just like giving his symptoms, prescribe some buffers to help with those symptoms. Clearly it's affecting his life. He can't go to school or can't participate in soccer, or sometimes wakes up in the middle of the night, and that's not good. So, we'll we can be prescribed some puffers and see if those help and also get some testing done. Do you have any other questions for me?
user: Uhm, No, yeah I was just wondering about, so like the wheezing and all of that could be with from asthma too? 

assistant: Uhm, yeah, I would think so, but again, we'll get the testing done and see if there are any other, any other causes. 

user: Ok. 

assistant: You said the wheezing sort of lasts only 30 to 30 minutes to an hour and then gets better?
user: Yeah, I don't notice that any other times. 

assistant: Yes, it's possibly, I mean, I would think it's asthma, but then we'll get the testing done and see.
user: Hi um, I'm bringing my one year old daughter in because she's had this fever um, this runny nose and this cough, for the past three, four days. Um, and now, she sounds pretty wheezy. 

assistant: Okay, and um, as she had a fever the entire time over the past three or four days.
user: Yeah, I would say so like it's come and gone, but every time I checked her temperature, I tried to check her twice a day, it would be pretty high, like 38 or uh, 39. 

assistant: Okay, so it was between 38 and 39 each time you checked it. 

user: Yeah, and now I should mention like um, I checked today and she didn't have a fever today, but she sounds really wheezy now. 

assistant: Okay, is the wheeze new today?
user: Uh yeah. 

assistant: Okay, um, and the cough, that started about three or four days ago as well?
user: Yeah, that's right. 

assistant: And how, how does the cough sound? Does it sound like, barky or like a, seal-like cough? 

user: Um, it sounds pretty harsh. I don't know if it sounds barky. 

assistant: Okay, and is the cough worse at any particular time of the day, like morning or night?
user: Uh no it's, it's just always there. 

assistant: Okay, uh, is she bringing up any, any phlegm or sputum?
user: Um, she's bringing up some, um, she's, she actually, she used to bring up some phlegm, but now it's, it's pretty dry. 

assistant: Okay, um, so she was bringing up phlegm initially and is no longer. What colour was it? 

user: It was clear. 

assistant: Okay, any blood that you noticed there?
user: Uh, no, no blood. 

assistant: Okay, um, and yeah, she's, she's had a wheeze as well. Um, have you noticed, uh, any chest pain, if she's like pointing to her chest or anything? 

user: No, nothing like that. 

assistant: Okay, and has she had any, any like fainting spells?
user: No. 

assistant: Okay. Um, and, yeah so she's had a fever, has she had any like, chills or night sweats, like where she's shaking?
user: Oh no, no. 

assistant: And how has her mood been? 

user: She's been pretty fussy, um, yeah, she's been pretty fussy over the past few days, but I just thought it was because of how she was feeling um, like her symptoms. 

assistant: Yeah, certainly. Has she been eating and drinking okay?
user: Yeah, we've managed to get her to drink and eat okay. Um, so, in that sense, no changes there. 

assistant: Okay, how many diapers is she, how many wet diapers per day? 

user: Uh, about five. 

assistant: Okay, so yeah, still been to maintain hydration, it sounds like. Um, yeah, okay, and has she had any like, eye redness or eye discharge?
user: Uh no, nothing like that. 

assistant: Any suggestion that she might have um, like any ear pain or, or any ear discharge? 

user: No. 

assistant: Okay, and has she had a runny nose?
user: Um yeah, now that you mention it, yeah, she did have a runny nose. Um, it seems to be less now, but she did have a lot a few days ago. 

assistant: Okay, and did that start around the same time as the cough and, and fever?
user: Yeah. 

assistant: Okay, um, it's still going on, but, but just less.
user: That's right, yeah. 

assistant: Okay. On feeds or anything like that, did you notice like any redness in her, in the back of her throat?
user: Um, I noticed some, um, yeah, I noticed some redness, but I just thought it was because of her coughing a lot. 

assistant: Okay, um, and um, have you noticed any skin changes or, or rashes?
user: No. 

assistant: Alright, and any changes to bowel habits like diarrhea? 

user: Uh no, no changes there. 

assistant: Okay. Then any changes to um, like urinary habits as well?
user: Uh no, no changes there. 

assistant: Okay, and have you noticed any like bulging on her, on her forehead or on the anterior fontanelle?
user: No. 

assistant: Okay. Um, and uh, has she had any nausea or vomiting? 

user: No, not that I've noticed. 

assistant: Alright. Um just yeah, she's been a little bit more, um, irritable as well. Um, okay, and has she had any symptoms like this before?
user: I mean, when she was a few months old she had similar symptoms, um, and she was like hospitalized for maybe a day or two, but she became better. 

assistant: Okay, did she need like antibiotics or inhalers or anything like that? 

user: I think they just gave her some oxygen and then um, some fluids. 

assistant: Okay. Um, has she been diagnosed with any medical conditions before?
user: No. 

assistant: Okay, and besides that one time going, like going to the hospital, has she been hospitalized or had any surgeries? 

user: Uh no, before that she was fine. 

assistant: Alright, uh, are the immunizations up to date?
user: Yeah, everything's up to date. 

assistant: Excellent. Um, and in terms of the pregnancy itself, were there any complications throughout um, with mom? 

user: Uh, no, no, no complications. 

assistant: Okay. And was it a full term delivery, and vaginal or c-section?
user: It was uh, full time and it was vaginal. 

assistant: Okay, any concerns at birth, like jaundice or, or any types of distress?
user: Uh no, nothing like that. 

assistant: And how is her growth and development been thus far? Any concerns? 

user: No. 

assistant: Okay, um, that's great, and in terms of um, the home environment, who's living with her and um, who's primarily looking after her?
user: Um, so it's her dad and I, as well as her um, her grandma. 

assistant: Okay, and has anybody in the home been sick recently?
user: No, everyone's been healthy. 

assistant: Okay, um, and has there been any travel?
user: Um no, we haven't gone anywhere recently. 

assistant: Okay, um, and does anybody uh, in the house smoke? 

user: Uh, nope. 

assistant: Okay, and are there, are there any pets or are there any like carpets or um, linens that can hold, hold a lot of dust or dander?
user: No. 

assistant: Okay, any other exposures, to like triggers, or potentially things that, that could be exposed or stuff like, that could be inhaled? 

user: No, I don't have anything like that at home. It's a fairly new home and uh, it's hardwood floors, yeah. 

assistant: Okay. Um, and uh, any family history of lung problems or heart problems?
user: No, no. 

assistant: Okay, how about a family history of any congenital diseases or um, any genetic diseases?
user: No, nothing like that. 

assistant: Okay, um, and family history of any cancer? 

user: No. 

assistant: Okay. Um, so were there any other um, so that was everything that I wanted to ask today before I went on to the physical exam. Um, was there anything else that you, that you wanted to add or were wondering about that I maybe forgot to ask?
user: Yeah um, what, what can we do for her um, to make her better? And are you concerned about her breathing? 

assistant: Um, so the, the physical exam and the, the vital signs will really, will help with um, to assess her breathing and to see oxygen levels.
user: OK, I'm so I have been coughing a lot over the past week or so. And it's been pretty dry, but I've been coughing like almost nonstop throughout the day, and I'm feeling very short of breath, and my bronchodilator helps, but I found I'm using it a lot now. 

assistant: OK, how long have you know that you have asthma for? 

user: I was diagnosed when I was eight. 

assistant: You're 10 now.
user: That's right. 

assistant: So you're using your bronchodilator more. This is the one that you use, kind of as needed?
user: Yeah. 

assistant: OK and then do you have one that you take every day no matter what? 

user: Uhm? No, I don't have that one. 

assistant: OK. You just have the one that you take is needed. Do you take any other medications?
user: Uh no I don't take anything else. 

assistant: Just the one is it a it's a puffer? 

user: Yes. 

assistant: OK, and you're using it more than normal, so how often were you normally using it?
user: Um I was only using it like I don't know. Maybe once every two weeks or so. Not very often. But now I'm using it like almost everyday like five six times a week. 

assistant: OK, any are you? Does it usually turned out that you need it like during certain times like say when you're exercising or when it's cold? 

user: Um I find I use it more, both like when it when it's right after I like, run around after gym during recess. Um and yeah, the cold also makes it worse. 

assistant: OK, any other triggers that you can think of?
user: No, no other triggers. 

assistant: Normally get more in certain seasons? 

user: I. I guess no, no big changes there. I find the cold air makes it worse like winter makes it worse or like. Yeah, maybe also the spring spring with like pollen and stuff like that. 

assistant: OK, so you have allergies too?
user: I think, so I haven't ever been like formally diagnosed. 

assistant: OK, I see I see. Yeah, that would make sense. No. OK, uh, so you say you've had more coughing lately, is that right? You said the last two weeks. Or the last week 

user: Last two weeks. 

assistant: Last two weeks. Is your cough and a dry cough?
user: Yeah. 

assistant: Have you been bringing up gunk OK. Dry cough? Have you noticed any wheezing?
user: Oh yeah, I've been wheezing a lot, actually. 

assistant: OK, uh and that's uh. Do you use your bronchodilator every time that you're wheezing?
user: When it gets really bad, like when I get so easy that I find it hard to breathe. 

assistant: OK, so you're getting Wheezy even more times than then you're having to use your bronchodilator.
user: Yes, that's right. 

assistant: OK. Are you having any symptoms at night time?
user: Yeah, how they don't happen as much as my daytime symptoms, but I been having it maybe like every other day or like you know, every two days or so. 

assistant: OK. And when you have these so when you have these episodes, you're copping your wheezy. Do you feel like you're having a hard time breathing? 

user: Yep, that's right. 

assistant: Do you feel it gets tight in your chest?
user: Yes. 

assistant: OK. OK, have you had any any colds lately? Or any infections? . 

user: Um no, no, nothing like that. 

assistant: K, does anyone that lives with you or anyone that you're around often, has anyone been sick?
user: No. 

assistant: OK. Could you have been in contact with anyone that sick even outside of your house?
user: No. 

assistant: OK, have you traveled anywhere? 

user: Uh no. 

assistant: Have you lost any of your sense of taste or smell?
user: No. 

assistant: Have you had any fevers? 

user: Uh no. 

assistant: OK. Any any? Nausea or vomiting?
user: No. 

assistant: Any belly pain? 

user: No. 

assistant: We just ask those questions because sometimes these things can happen with an infection or after an infection and we just want to make sure that that's not, you know what's happening right now. We probably will do a covid swab just because of the times that we're living in right now, but I just want to ask you a few more questions before I go talk to the doctor. So do you have besides your asthma, do you have any health problems?
user: Oh no, no no. 

assistant: OK. And you said, besides the bronchodilator, you're not taking any medications. 

user: No. 

assistant: And you think you might have allergies in the spring? Do you have allergies to anything else that you know?
user: Uh no, not that I know of. 

assistant: OK, does anyone else in your family have asthma?
user: I think my sister has asthma too. 

assistant: Anyone in your family have any other breathing problems? 

user: No. 

assistant: Anyone else in the family have any allergies?
user: Uh no, I don't think so. 

assistant: OK. OK, sounds good and you live at home did you say live with your parents and your sister? 

user: Yep, that's right. 

assistant: Cool. Are you currently going to school online or in person?
user: Uh both We do half days. 

assistant: OK. How are you finding that?
user: Yeah, it's been OK. It's it's different, but it's been working out OK so far. 

assistant: Cool not to have to get out of your PJS some days. 

user: Yes, that's true. 

assistant: OK, did do you guys have any pets in the home?
user: No pets, we have just like well I guess we have goldfish. 

assistant: Oh, OK. Those are cool pets. Does anyone in the house smoke?
user: No. 

assistant: OK. OK, I think that's all my questions that I had for you today. What do you like to do for fun?
user: Oh I'm I like playing games online with my friends and and before covid we used to get together and have movie nights and play sports together. 

assistant: It sounds really cool. Hopefully we can get this figured out for you so you don't have any, you don't have to use your your medications every time you play sports 'cause that's no fun. And 

user: No. 

assistant: You should be able to enjoy that. So, so we're going to try to get this sorted out for you. I'm gonna go talk to the doctor and tell him everything or her everything that you said and yeah we’ll come back and see you shortly, hopefully maybe all you need is a little change to your medications and maybe it will be better be able to better control your asthma.
user: Hi. Uh, I've just had this cough for the past week and I was worried I might have Covid so I just wanted to um I just wanted to be checked. 

assistant: Sure, so you mentioned you, it started a week ago.
user: Yeah. 

assistant: Has it been persistent or does it come and go?
user: Um it's just been there. 

assistant: Been there. OK.
user: Yeah, I just get this itchy sort of uh like scratchy sensation in my throat. And then I just cough and um that makes it better. 

assistant: OK. OK, uhm what, how would you describe your cough like is it barky? Is it harsh? Is it muffled?
user: Uhm no, I don't I don't think it's barky or harsh. 

assistant: OK, and does anything make it better or worse like you know, like the cold air, laying down, at particular time of day? 

user: Not really, I haven't uh, nothing's really helped. Um I also tried a cough syrup, um it didn't, it helped for a couple hours, but then it was back again. The cough was back again. 

assistant: OK, and have you ever experienced anything like this in the past?
user: Uh well, I I said yeah when I get a cold. 

assistant: Mhmm, OK. 

user: Once a year maybe. 

assistant: Once a year? OK. Um do you experience any shortness of breath with this cough?
user: No. 

assistant: No, OK. Is it a dry cough or do you bring up any phlegm? 

user: No, it's a dry cough. 

assistant: OK, uh any blood that you've seen?
user: No, no. 

assistant: No, OK. And do you feel wheezy?
user: No. 

assistant: No, chest pain? 

user: No. 

assistant: No, um feeling like your heart's racing?
user: No. 

assistant: Any swelling in your limbs? 

user: Uh no. 

assistant: No, any fainting spells?
user: Uhm, no. 

assistant: No, OK. Do you ever feel like your nose is stuffy or runny?
user: No. 

assistant: No, any changes in your vision or hearing? 

user: Uh no. 

assistant: A sore throat?
user: No. 

assistant: Um loss of smell or taste?
user: No. 

assistant: Any weight loss?
user: Uh no. 

assistant: Fevers?
user: I checked no, no, I don't have a fever. 

assistant: No, any rashes? 

user: No. 

assistant: Issues uh, any changes in your bowel movements?
user: Um uh no, I've just been constipated from time to time, but that's nothing, that's not new. 

assistant: OK, constipation. And I'm sorry when did your constipation start? 

user: Oh it's a problem for years. I don't eat enough fibre. 

assistant: Oh, OK. Any changes in your urine?
user: No. 

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

assistant: No, OK. Any joint pain? 

user: No. 

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

assistant: Headaches?
user: No. 

assistant: No, OK. Are you otherwise healthy? Do you have any longstanding medical conditions?
user: I have diabetes. 

assistant: OK, how long have you had diabetes?
user: It's about, it's been uh seven years now. 

assistant: OK, any hospitalizations or surgeries in the past? 

user: No. 

assistant: OK and um how about medications? Are you on any?
user: Uh yeah, I've been taking uh metformin for the past uh, for the past five years, when, five or six years. 

assistant: OK. 

user: Um and uh my family Doc started me on uh ramipril about two weeks ago, he told me that uh now that I'm 50, I need to I need to be on this pill as well, so now I have to take 2 pills instead of one. 

assistant: OK.
user: Yeah because I think it's it's good for my heart or something. 

assistant: Yeah, for sure. So you started that two weeks ago, OK. Are you up to date with all your immunizations?
user: Uh yeah, I think so. 

assistant: OK, any allergies? 

user: Uhm penicillin, I just get uh I get a rash. I got a rash when I was a child, I haven't had it since then. 

assistant: OK, OK. Any family history of lung or heart conditions?
user: Uh no, nothing like that. 

assistant: No, OK. Do you smoke? 

user: Uh, no. 

assistant: No, how about, uh, marijuana or other recreational drugs?
user: No. 

assistant: No, OK, um alcohol?
user: Uh yeah, I drink on the weekends. 

assistant: OK, what do you drink and how much do you drink? 

user: I'll have maybe two or three uh bottles of beer. 

assistant: OK sure, and um have you been in contact with any sick people recently?
user: No, no, I've just been staying at home.I'm just scared of covid, but I'm I'm still worried I might have somehow gotten it. 

assistant: Yeah, for sure. Uhm, any travel recently? 

user: No. 

assistant: No, OK. And where do you live right now?
user: I live in a house with my wife and my two kids. 

assistant: OK, uh are they healthy?
user: Yeah, they're all healthy. 

assistant: OK. Any old carpet, dust, mold, or asbestos in your home?
user: Um not that I'm aware of. 

assistant: No, OK. OK, well it seems like um those are all the questions that I had for you today. Did you have any questions of your own? 

user: Uh no, I just want to get tested for Covid. 

assistant: Yeah, so we will definitely do a Covid swab on you because you have a cough, um and those results should come back to you in about 24 to 48 hours, and so you'll know more then. But because your symptoms do overlap with that of Covid, we still recommend isolating for 14 days. But the other thing I want to mention is that you don't have any other symptoms of infection besides your cough, and it seems like the cough started a week ago and you started this new medication ramipril two weeks ago, and so ramipril is a type of ACE inhibitor and one of its side effects is that in some people it can cause coughing. So, I am going to review your medications and if your family Doc also agrees, we may try uh another um blood pressure medication for you instead of ramipril.
user: Sure. 

assistant: Um so we'll try and change that medication and see if your coughing stops. How does that sound?
user: So I've been having just a worsening breathlessness. I've been also having a cough, and I think I might have also had a fever in the last couple weeks. 

assistant: OK, um so the breathlessness started six weeks ago, correct? 

user: Yeah. 

assistant: OK and then when did the cough start?
user: I'd say around the same time the breathlessness started, so around six weeks. 

assistant: OK. And then the fever?
user: The fever I've kind of had on and off in the last couple weeks. I would say two to three weeks. 

assistant: OK, OK um and do you, how often are you having this breathlessness?
user: Um I would say it's pretty much there most of the time. It sometimes gets worse when I'm exerting myself, but I think just baseline, I feel like I've been able to breathe less heavily than before. 

assistant: OK, so alright, and how long does it last when you do get it? Or is it just always there?
user: Uh, it's kind of just there, but then when it's getting worse like it lasts a couple minutes to, I would say like 10 to 15 minutes and then it goes back to like just the normal breathlessness. 

assistant: OK, and if you were to describe the quality of your breathlessness, would you say that it feels like a kind of like a burning feeling, like you're having a hard time catching your breath or does it feel like you're breathing too fast?
user: I think it's more I just can't seem to take like deep breaths. And then when I get breathless, I I really try to take a deep breath but I just can't find myself catching my breath at that time. So it's just more not being able to catch my breath. 

assistant: OK, sure. And are there things that make make it better or worse?
user: Uh, not really, I think it's sometimes moving around too much, but like nothing, nothing really causes it. 

assistant: OK, um, and was there any sort of trigger six weeks ago that you think may have like caused all of your symptoms?
user: Oh I'm not sure I I don't think there was any triggers. 

assistant: OK, has anyone around you been sick? 

user: So there there are some people living in my house that have a bad cough over the last few weeks. 

assistant: OK.
user: So yeah. 

assistant: So they have similar symptoms to you as well then? 

user: Yeah, some of them like don't really have the shortness of breath and it's just like a cough. 

assistant: OK.
user: But yeah, there are some of them also have some shortness of breath. 

assistant: OK, OK. And have you traveled anywhere recently?
user: So I actually came to Canada one year ago. I'm originally from India and I I'm I came here to study. 

assistant: OK. OK, um alright. If you were to rate your breathlessness from one to 10, 10 being the worst, how bad is your breathlessness?
user: It can get pretty bad. Like I I would say up to an 8 sometimes, maybe a couple times a week. 

assistant: OK, and have you ever experienced this before? 

user: No, this is like the first time I'm having this issue. 

assistant: OK, and do you feel like it's getting worse, better, has it changed since you started having these symptoms?
user: I think it's getting worse and that's why I was getting a bit scared and I came here. 

assistant: OK. Yeah, that was a good call and have you had any changes to your smell recently?
user: No, no changes to smell. 

assistant: Any anything like a runny nose or stuffy nose? 

user: Uh, no, not really, no. 

assistant: No? OK, how about a sore throat?
user: No, no sore throat. 

assistant: No sore throat, any changes to your taste?
user: Nope. 

assistant: Any changes in hearing?
user: Nope. 

assistant: Ear pain or discharge from your ears?
user: No, nothing like that. 

assistant: OK, any eye pain?
user: No. 

assistant: Changes in your vision? 

user: Nope. 

assistant: Any discharge from your eyes?
user: Nope. 

assistant: OK, and you mentioned fever and some night sweats. How often are you getting these night sweats and do they feel like chills? 

user: I think in the last two weeks I've been getting it more frequently, like I would say every other night I I feel, I would feel chilly at one point and then I'll break out into night sweats or have to take off my blanket. I think I measured it once or twice over the week and it did show like a fever of 102. 

assistant: OK, OK. OK, and any changes to your skin like rashes?
user: No, nothing like that. 

assistant: Any weight loss? 

user: I would say I think I'm losing a little bit of weight over the last couple weeks. I haven't really weighed myself, but I feel that I have lost some weight. 

assistant: OK yeah, and the coughing, are you coughing up any blood?
user: Uh, I don't think so. Sometimes, like when I cough up like sputum, there is like a little bit of pink, pink tinged sputum as well. Sometimes it's like brownish in color and sometimes it's green, but I haven't actually coughed up any blood. 

assistant: OK, um and you said there's some sputum like pink tinged sputum. How much sputum would you say you cough up every time you cough?
user: Maybe like a like a spoonful I would say. 

assistant: OK. And do you ever feel like you're wheezing? 

user: Uh, no, I I don't think so. I I don't really notice any noises when I'm breathing. 

assistant: OK. And, alright, so any chest pain?
user: No, no chest pain at all. 

assistant: OK. How about swelling in your legs or in your limbs? 

user: No, no swell leg swelling. 

assistant: No leg swelling? OK, um how about do you feeling like your heart's racing?
user: No. 

assistant: No OK. OK, and any nausea or vomiting?
user: No, no nausea or vomitting. 

assistant: How about changes in your bowel movements? 

user: No. 

assistant: OK, how about changes in urinating?
user: No, it's been fine. 

assistant: Alright any headaches? 

user: No headaches. 

assistant: Any dizziness or fainting spells?
user: No, nothing like that. 

assistant: OK, no confusion or memory loss? 

user: No. 

assistant: OK, and are you otherwise healthy? Do you have any medical conditions?
user: Um I think when I was back in India a couple years ago, they did give me some antibiotics for like a chest infection, but I couldn't really afford the medications and didn't take them. I didn't finish the course, but other than that, nothing else. 

assistant: OK, did they mention what type of chest infection it could've been? 

user: No, I don't really remember. I think it was some kind of pneumonia. 

assistant: OK, OK. Are you on any medications?
user: Just uh I take Tylenol sometimes, like it hasn't really been helping. 

assistant: OK. And, are you allergic to anything?
user: No, not that I know. 

assistant: OK, are you up to date with all your immunizations? 

user: Yeah, as far as I know. 

assistant: OK. And and is there any family history of lung conditions or heart conditions?
user: Nope. 

assistant: No OK, how about cancers?
user: No cancers that run in the family, no. 

assistant: OK OK, so you mentioned you moved to Canada from India about a year back. Where do you live now?
user: So I live in it's, we have like a student house with some of the students who came from India as well, and there's six of us living together in in a house. 

assistant: OK, OK, and are they sick as well or no?
user: Yeah, so three of them actually have like, two of them have a cough and one of them has some shortness of breath as well. 

assistant: OK. And have they been to a doctor? Have they been investigated? Were they ever given a diagnosis? 

user: No, not that I know of. I think I might be the first one who actually went to a doctor. 

assistant: OK, OK. Um, do you smoke?
user: I smoke like I would say like 5 cigarettes a day. 

assistant: OK, how long have you been smoking for? 

user: Around 10 years. 

assistant: OK, that's, it's been a while then. Um, and do you do you drink alcohol?
user: No, I I don't drink and I don't do any drugs either. 

assistant: OK, OK. Are you sexually active? 

user: Not currently, no. 

assistant: No, OK. Have you ever had unprotected sex?
user: No. 

assistant: No?, OK. OK, um, did you have any questions or concerns? Anything you wanted to discuss that I hadn't asked you about? 

user: Um, so yeah, this is just like my first time visiting a doctor in this country and like I was just very scared that it might be something serious, so just wanted to know what it can be. 

assistant: Yeah, for sure. So the first thing we want to rule out is TB. Because you have recently moved to Canada from a country where it is, I believe it is endemic, so and some of your most of your symptoms fit with TB and how it presents so we just want to make sure it's not that because it is highly infectious and and we don't want it to spread. So, we can do like a AFB smear or I think they have other diagnostic work up for that too. So we'll do that first. If not, we can check to see if it's like another, another typical pneumonia, we can do a chest X Ray for that as well. If both of those turn out to be negatives, then we'll have to work you up further for other things, like COPD, or lung cancer. How does that sound?
user: Sure, um, I have been coughing a lot. I've been feeling short of breath and I just feel really wheezy, so I thought I should come check it out. 

assistant: OK, when did the cough start?
user: I've always had a cough. Well, I guess I've had a cough for the past five years, but over the past three days it's gotten a lot worse. 

assistant: OK, did anything happen 3 days ago that has brought the cough on?
user: Uhm, no, I was, I did groceries, I came home and then I started coughing a little bit more and I haven't been able to stop since. 

assistant: OK, is there any particular time of day that the cough is worse, like morning, night? 

user: Uhm, it seems to be worse in the morning. 

assistant: OK, and are you bringing up any sputum?
user: I am. Umm, and it looks yellow and sometimes even green. 

assistant: OK. With your cough prior to three days ago were you bringing up sputum with that?
user: I guess some, but it was clear. 

assistant: OK, and are you bringing up more sputum now, the same or less? 

user: Um, more sputum, and sputum just looks different. 

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

assistant: OK, and you mentioned you've been you've had a wheeze, when you do you notice that? 

user: Uhm, I also, I guess I notice that mostly last night, yeah. 

assistant: OK, um and what types of activities have you had shortness of breath?
user: Uhm, I guess walking, doing day to day things has made me feel a little bit more short of breath than I used to feel. 

assistant: OK. And have you been experiencing any other symptoms besides the cough, wheeze and shortness of breath? 

user: Um, I feel a little bit more tired, but other than that, no. 

assistant: OK. So a bit more tired. How has your sleep been?
user: My sleep has been, um, pretty normal. It's been, yeah, it's been the same. I guess it's the coughing that's making me tired. 

assistant: OK, have you had any ear pain or eye pain? 

user: Ear pain, or eye pain? No. 

assistant: Any discharge from either, either your ears or eyes?
user: No. 

assistant: OK. Have you had a runny nose?
user: No. 

assistant: Or felt congested? 

user: No. 

assistant: OK, have you had a sore throat?
user: Uh, no. 

assistant: Or any difficulty swallowing? 

user: Uhm, no. 

assistant: Changes to your sense of smell or taste?
user: No. 

assistant: OK, have you had any changes in appetite?
user: Uh, no, I don't think so. 

assistant: Alright, and have you had any weight loss over the last several months? 

user: Weight loss, no. 

assistant: OK. How about have you had any fevers or chills?
user: Fevers or chills ah, no. No, nothing like that. 

assistant: Nights, how about night sweats?
user: No. 

assistant: Have you had any chest pain? 

user: Ah no, no chest. Well my chest feels, I guess sometimes I, it feels painful because I'm coughing so much, but nothing more than that. 

assistant: OK, do you get chest pain when you exert yourself physically?
user: Uhm, no. 

assistant: OK, so it's just after the coughing?
user: Yeah. 

assistant: OK and how would you describe the character of the chest pain? Some people will say sharp, dull, achy.
user: Um, I would say dull. 

assistant: OK, and have you had any like heart palpitations, feeling like your heart's racing?
user: No. 

assistant: And how about any episodes where you felt like you were going to faint or, yeah, pass out? 

user: No. 

assistant: OK. Uhm and have you had any swelling in your feet, ankles, hands?
user: No, nothing like that. 

assistant: OK. And then have you had any urinary problems?
user: Um, no. 

assistant: Any bowel problems?
user: No. 

assistant: OK, and then any joint pains or muscle aches? 

user: No, nothing like that. 

assistant: And how about any rashes anywhere?
user: No. 

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

user: Uh, no. 

assistant: OK. In terms of your past medical history, have you been diagnosed with any conditions before?
user: Uhm, I have high blood pressure and diabetes. 

assistant: I see. Are you on any medications for those? 

user: Um, for the blood pressure, the high blood pressure, I'm on a beta blocker and then for my diabetes I'm on metformin. 

assistant: OK, uh, do you, are you taking any other medications?
user: Um, just some calcium and vitamin D. 

assistant: Any surgeries in the past? 

user: Nope. 

assistant: Any allergies to medications?
user: No. 

assistant: OK. Are your immunizations up to date?
user: I believe so, but I recently learned that I should get something called the pneumococcal vaccine. I haven't gotten that yet. 

assistant: Yeah, you're you're right. So for um, in Canada or anybody or in Ontario, at least, anybody who's older than 65, it's recommended to get this vaccine to protect against certain types of bacterial infections type which can cause pneumonia. So it would be good something that you can set up with your family doctor.
user: OK. 

assistant: Yeah, and so are you, so do you smoke cigarettes?
user: I used to. 

assistant: OK, and how much do you smoke or how much did you use to smoke? 

user: Um, I smoked a pack a day and I smoked for 45 years, but I stopped two years ago. 

assistant: OK, that's great that you were able to stop. Do you drink alcohol?
user: Uhm, occasionally like once every two weeks. 

assistant: OK, and any triggers that you can think of you were exposed to either at work or home like chemicals or things that you were exposed to that you had to breathe, that you breathe in? 

user: No, nothing like that. 

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

assistant: Alright, and have you been near anybody who's been sick or has similar symptoms? 

user: Uhm, no. 

assistant: Alright, and anybody in the family have a heart or lung condition?
user: Um, no. 

assistant: Any cancers in the family? 

user: Um, there was a liver cancer. 

assistant: OK, and, I think that.. OK, and that was all I wanted to ask on history. Was there anything else that you wanted to tell me today?
user: Hi, I bring you my son today because I've noticed he's had been having this cough sometimes he’ll have it at night and and, he'll have some wheezing and difficulties breathing as well. 

assistant: OK, and when did this all start? 

user: So I I've been noticing it over the last several months. It's been happening um a couple of times per week where he'll get this cough and that at night time and yeah so over the last several months. 

assistant: OK, and what did it start with coughing or like the shortness of breath? What would it kind of start with?
user: Are more the, uh, the coughing, yeah, he just get it at night time and then sometimes he would get it um like it at at school as well. Or even if you went over to one of us, his friends houses, sometimes he would come home and or afterwards he would have a cough and wheeze and and be short of breath. 

assistant: OK, and so is it. Usually after he's worked himself up and like exercise or like just been really active?
user: Yeah, that definitely. I noticed that after those times for for sure. 

assistant: OK, and are these like the coughing? Is it wet or dry?
user: It's it's a dry cough. 

assistant: Dry cough OK, so no yellow green material or blood coughed up/ 

user: No, nothing like that. Uh coughed up. 

assistant: OK, and you're saying you also hear wheezing, right?
user: Yeah, I'll hear a wheeze. He has this like high pitched whistling sound when he exhales. 

assistant: OK, and has he at all had this happen before? Or is this the first time this is happening?
user: Um like when he was really younG I think like two he had like bronchiolitis or something like that. I think it was called you had a cough and um like a wheeze at that time, but I think it was because of a like an infection or viral a viral illness. 

assistant: I see. Um has he had any uh sore throat, runny nose, cold like symptoms at all recently?
user: No, he hasn't had anything like that. 

assistant: OK, OK, so his symptoms mainly occur when he's very active um, so they kind of come and go, and have you tried it at all anything that has helped with the symptoms?
user: No, I haven't tried anything. 

assistant: OK, any kind of dizziness, changes in his behavior at all from being very irritable to very fatigued? Anything like that? 

user: No, nothing like that. 

assistant: OK, um any fevers or chills?
user: No. 

assistant: OK, any recent travel or contact with someone who's been sick.
user: No. 

assistant: OK, any nausea or vomiting 

user: No. 

assistant: OK, any changes in his bowel movements?
user: No, he hasn't had any diarrhea, so no diarrhea, no constipation. 

assistant: OK, and um any changes in his appetite at all? 

user: Um no he's been eating and growing well. 

assistant: OK any changes in his weight?
user: Yeah yeah, he's been gaining weight uh over the last over the last little while. I think he's been gaining weight appropriately. 

assistant: OK, um do you find that his symptoms get worse in any particular season like the winter or anything like that? 

user: Um. I yeah. I mean sometimes I guess like in the in the fall or when the seasons change she does get like itchy eyes and like a runny nose. I think he does have maybe some environmental allergies. 

assistant: OK, OK, and at home or at school any exposure to like fumes, dust or animals?
user: Um no animals at at home, but the friends house he goes over to sometimes they have um a cat there. 

assistant: OK and does does he get those symptoms at his friends house?
user: Yeah, sometimes he'll come, he'll um he'll have a bit of a cough and you can hear a wheeze sometimes that after, it goes away uhh relatively quickly we like within 30 to 60 minutes and, but um yeah. 

assistant: OK. Any past medical conditions that he's been diagnosed with?
user: No, he just had that yeah the episode of I think bronchiolitis when he was young, but that was it. 

assistant: OK, any um medications that he has to take regularly? 

user: No. 

assistant: No, any allergies, training medications?
user: Uhm, no. 

assistant: No, or any allergies to any environmental or food factors. 

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

assistant: OK, have you had any rashes at all previously?
user: Uhm. No, yeah he hasn't had any rashes. 

assistant: OK. And um. Any hospitalizations or surgeries?
user: Uh nope. 

assistant: OK. And any family history of any heart lung conditions? Any history of asthma at all? 

user: Um yeah, his mom has a has asthma um and she uses a an inhaler like daily for it. 

assistant: OK has, when did um the mom get diagnosed with asthma? Was it during childhood?
user: Yeah, she was younger. Um ever since I've known her, she said she's had she's had asthma. It hasn't had any like real I guess exacerbations that that I've noticed or been able to control her symptoms with with um inhalers. 

assistant: And um for him, how many times would you say he's having these episodes in an average week now?
user: Uh I would say 2. 

assistant: 2 and is he getting Any of these symptoms at night time, like him waking up? 

user: He is yeah it's it. It is happening at night. 

assistant: OK, and then as he missed any days of school due to this?
user: Yeah um. He's missed a couple of days in the past month because uh he just didn't sleep well and then not feeling good the next day. So um yeah, he has. 

assistant: OK. Yeah, so and any issues with the mother's pregnancy with him at all? 

user: No, she's healthy and the delivery was at term with a normal body weight or birth weight rather and he he was healthy when he was born. 

assistant: So no prolonged stay in the ICU or hospital after that?
user: No, he was able to go home, luckily. 

assistant: OK, and afterwards has he been meeting all his milestones like his motor gross motor, fine motor, social skills and growth and all of those have been meeting them well.
user: He has, yeah yeah. He's been meeting all of his milestones and growing well. 

assistant: OK, and um any at all issues from the school in terms of learning difficulties or anything like that? 

user: No, he's been doing well uh in school. 

assistant: OK, that's good. Um does he have any siblings?
user: Um no, he's a it it's just him. He's our only child 

assistant: And what's the home situation like? Who does he live with? 

user: So it's myself and my wife, which his mom, and so it's just us three and we live in a um in a house. 

assistant: OK. Uh, and anyone in the household uh? Does anyone smoke at all?