jshargo/medical-interview-conversations2 huggingface dataset:
user: I just came in because I've been having this just just yesterday it started this sudden just pain over the front of my kind of like a shoulder an also elbow and it was right after doing I was just doing some workout and this pain just started and it's just like a stabbing sharp pain that hasn't really gone away since then. 

assistant: OK, and so what activity were you doing specifically? 

user: So I was doing so I was just doing weight training and I was kind of flexing my elbows and I was working on my biceps. I was on that machine where you so know I wasn't using weights or doing curls, but I was working on my biceps and I think I did hear, I don't think I heard like any pop or anything, but right after that I just had this sudden sharp pain in my shoulder as well as my elbow. 

assistant: OK, so you you you think you heard a pop at that time?
user: Um I'm not sure if I heard a pop. Actually, I think I might have though. 

assistant: OK, and did the pain start immediately or or a bit later on? 

user: The pain I think it started pretty soon after, like probably within like half an hour of that happening. 

assistant: OK. And where is the pain located now?
user: The pain right now is a. Yeah, just kind of right at the front of my right elbow as well as near my shoulder as well.  D" OK. And. Um I think you mentioned the pain as as being sharp is that how you would describe the character of the pain?  Yeah, it's sharp. Yeah, I just feel like something stabbing in there. 

assistant: OK, and does the pain radiate anywhere else?
user: No, it's kind of in the same area as they described. 

assistant: OK, has there been anything you've tried to make the pain better?
user: No nothings I tried like Advil nothings really worked. 

assistant: OK. And, uh, sorry. How long is how many days is the pain been on going on for just just started yesterday? 

user: Yesterday. 

assistant: OK, and since then has the pain getting any better or any worse?
user: I think it's the same, probably a bit worse than so it just happened last evening and I I didn't end up coming last night, but I wanted to make sure. I'm just coming this morning since it's just been a really painful night. 

assistant: OK, have you done anything that's made the pain worse since last night? 

user: No I just tried to just rest and I tried to use some ice, but nothing. Nothing's been working and I kind of also have like this. It it's weird, it's just like this mass right where my biceps is. It kind of just makes my biceps look really big. 

assistant: OK, alright, well I skip look at that during the physical exam component thank you and so like are you seeing swell is there like swelling there is as well or is is that part painful?
user: Yeah, it's painful there swelling there as well. 

assistant: OK. And well, how severe is the pain on a scale of 10 to 1, 10 being the worst pain that you've ever experienced and one being the least. 

user: Probably at least an 8, maybe a 9. 

assistant: OK, so the pain is pretty severe then it sounds like. Uh, OK. Have you had any fevers or chills?
user: No. 

assistant: Have you had any unexpected weight loss? 

user: No. 

assistant: OK, and have you had any appetite loss?
user: Uhm no. 

assistant: OK, and have you had any headaches?
user: Uhm no. 

assistant: How about any sensory changes like changes to vision or hearing? 

user: No, nothing like that. 

assistant: Any changes to your sense of smell or sense of taste?
user: Nope. 

assistant: Have you had a runny nose or a sore throat?
user: Uhm no nothing like that. 

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

assistant: Any shortness of breath?
user: No. 

assistant: OK, any wheezing?
user: No. 

assistant: Um have you had any chest pain? 

user: No. 

assistant: Have you had any heart palpitations or feeling like your heart's racing?
user: No. 

assistant: Any lightheadedness or dizziness?
user: Nope. 

assistant: OK, uh, and have you had any abdominal pain?
user: No. 

assistant: Any changes to your bowel movements such as diarrhea or constipation or even blood in the stool.
user: No nothing like that. 

assistant: OK, any urination problems such as pain or frequency? 

user: Nope. 

assistant: OK and have you noticed any changes to your skin like rashes or changes to your nails or hair?
user: No. 

assistant: Alright, and have you had any neurological symptoms such as numbness or tingling?
user: No, I don't think so. 

assistant: OK, and have you had any muscle weakness? 

user: Just just in the in that area, I can't really like. I can't really flex an really move my upper upper arm in my elbow. 

assistant: OK. Do you have any pains in any other joints?
user: Um no that's it's only my right upper arm. 

assistant: OK. Um. And. Have you had any confusion or memory loss? 

user: No. OK. And in the past, have you been diagnosed with any other medical conditions?  Uhm no I've been pretty healthy, um I they think I do have like pre diabetes but I'm not on any medication. 

assistant: OK, and have you had any issues with your shoulder before like like a subacromial like impingement syndrome or like a rotator cuff pains or problems in the past?
user: A few years ago I did have some pain um with like some, they they told me not to do like overhead work like just things that require like with Physio I need to do some strengthening as well and it was it wasn't the same same shoulder. 

assistant: OK. And do you take any medications regularly? 

user: Uh, no. 

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

assistant: Have you had any hospitalizations or prior surgeries? 

user: I had my tonsils removed when I was probably like 10 or something, but that's about it. 

assistant: OK, and for the shoulder in the past did you have any imaging done like an ultrasound or or MRI maybe to look at the structures?
user: No, it was just a it kind of went away. I just did some physio they didn't really do any imaging. 

assistant: I see OK. And can you tell me a little about your living situation right now, like you're living with and where? 

user: Yeah so I'm living with my wife and um daughter and I'm living just in a condominium in the city. 

assistant: OK, and are you working right now?
user: Yeah, so I'm an accountant. I'm working from home, so it's not that bad, but I I might just take a few days off depending on what I have to do with this injury. 

assistant: OK, and um do you and hobby wise you mentioned like weight lifting, are you an active person like bodybuilding and that sort of thing regularly? 

user: I I just actually probably started this past year. I used to. I used to workout a lot. In University and in my early 30s but then I stopped and this year I've kind of gone back into it. 

assistant: OK, well it's good that you're staying active. And um do you smoke cigarettes?
user: No, I uh, probably tried a couple times and. High School and University, but just it was never my thing. 

assistant: OK, and how about cannabis, like smoking marijuana or using any of those types of products? 

user: No, I I try to stay away from any drugs. 

assistant: OK, uh, including recreational drugs?
user: Yeah. 

assistant: OK and. Uh, are there any musculoskeletal or neurological problems that that run in the family? 

user: Not that I know of, no. 

assistant: OK, now how about any autoimmune diseases?
user: Uh, no, I don't think so. 

assistant: OK, so next I just wanted to ask you to have a look at the at the arm. Compared to the other side, are you noticing any swelling, redness, or? 

user: Yeah, any swelling or redness, I do see some just like kind of like in the middle of this area, some redness kind of looks like some bruising in in that in that region. Uhm, I also feel like when I like try to flex my biceps kind of have moved upwards. 

assistant: OK, is this the mass or lump that I you were mentioning earlier that you kinda can notice in the in your right arm?
user: Yeah yeah. 

assistant: OK, is there any temperature change, like does it feel warm on that side?
user: Uhm I can't really tell if it's warm or not. 

assistant: OK, and you so you mentioned are you able to bend your elbow all the way up so to flex it all the way up, or is a range of motion limited?
user: It's pretty limited. It's pretty tough to flex. It's really painful and that I also can't like. I can't turn my arm, I can't supinate. 

assistant: OK so yeah, so is that so you have reduced supination as well?
user: Yeah. 

assistant: And how are your shoulder movement, are you able to like if you're lifting your arms straight out in front of you, are you able to to lift them all the way up above your head? 

user: Out like at the sides or in front of me? 

assistant: In front of you.
user: Yeah, the shoulder seems to be OK. I am able to lift up, but it's just if I try to move my upper arms at all it hurts a lot. 

assistant: OK, alright so. You'll get some pain at the at the shoulder with the movement. 

user: There there is discomfort in the affected side, but I can I can move it much more than I can move my elbows or anything like that. 

assistant: OK, I see. So I think that was everything that I wanted to ask about and and I look for on on the physical today. Was there anything I may be missed or anything like that?
user: Yeah, sure I had, I've been having diarrhea for the past three to four days, and it's been pretty bad. I couldn't go, uh I couldn't go to my classes, had to skip because it was just it was just embarrassing. 

assistant: OK, I'm sorry to hear that. Uh, have you ever experienced something like this before? 

user: Um, have I experienced something like this before? Uhm no, I don't think so. 

assistant: OK. And over the three or four days, have your stools all been loose? Or have you had some solid ones in between?
user: I think they've mostly been loose. I think they've all been loose actually, if I think about it. 

assistant: OK, and how many times a day have you been having episodes of diarrhea? 

user: Oh my god, I have I've lost count. I'm going every every hour. 

assistant: OK, every hour. OK, and then you notice any changes in the color of your stool?
user: No, it's brown. 

assistant: OK. Any blood in your stool that you've noticed? 

user: Um not really. I don't think so. I don't look that much to be honest. 

assistant: OK, um have you noticed any any pain associated with it?
user: Well, I didn't start off with pain, but I I I do have a bit of a cramp now since yesterday. It's just it hurts. Yeah, it hurts sometimes, it comes and goes. 

assistant: OK, and do you feel that when it, do you feel that you still have control over like releasing it to like does it come on and you don't even notice that it has happened or you still are able to kind of have a warning before you get to the toilet? 

user: Uh no I do get a warning, but it's just I I do need to get to the toilet really fast, yeah. 

assistant: OK, and before this happened, have you noticed, have you, is there anything that you've done differently that you've been eating differently, or any other changes that have happened in your life recently?
user: Um, I I did go to um, I did go to a new restaurant 5 days ago. 

assistant: OK, what did you have there?
user: Um  I I just got some rice with chicken Manchurian, it was a nice little Chinese restaurant, and yeah. 

assistant: Did anyone else have the same thing that you did that you were with?
user: Um, no not really, I went with my friend and I haven't really, haven't talked to her about this. I never really thought that these were related, that this was related to that. 

assistant: And then it's, you know, absolutely, potentially not like, maybe not. It could possibly be so not to not to worry you about that. We just like to get an idea of kind of the whole picture of what you're coming in with. So in terms of the last three to four days, have you experienced any nausea or vomiting?
user: Yeah yeah, I have actually, but it's not been as bad as the diarrhea. I didn't even yeah, I didn't, I wasn't even thinking about that. Yeah, I I did vomit, I think twice yesterday. 

assistant: OK, have you noticed any blood in the vomit?
user: No, it's just watery. 

assistant: And are you nauseated all the time, or is it kind of on and off? 

user: It's on and off. 

assistant: OK, have you taken any any over the counter medicine or anything to help?
user: Uh, not really. I was just trying to drink a lot of water, 'cause I I know that I can get dehydrated so just drinking lots of water. 

assistant: OK, well that's good to hear. Have you have you been eating normally or have you not been eating as much as you regularly do?
user: I have been eating less specially since yesterday when I had my these abdominal cramps started. I just don't feel like eating. 

assistant: OK. Is there anything that has been making it worse?
user: Making what worse? 

assistant: Just in general, like is there anything that you're finding makes your nausea or your diarrhea come on?
user: Not really, I don't think so. 

assistant: Do you notice any changes to your urine or any discomfort when going to the bathroom?
user: No. 

assistant: Have you traveled anywhere recently? 

user: No. 

assistant: OK, and have you noticed any fever or chills in the last few days?
user: Um, I've just been feeling really tired and and, I don't know, maybe I haven't checked my checked my temperature. 

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

assistant: OK. Have you noticed any major changes to your weight, I know that you might not weigh yourself everyday, but anything that jumps out to you?
user: I actually haven't weighed myself in the past five days, so I don't, I don't know. 

assistant: OK. OK, I'm I'm just gonna jump to you and your general history. Do you have any history of problems with your digestive system?
user: No. 

assistant: OK. Do you have any chronic conditions that you see a family doctor for regularly?
user: I have asthma. 

assistant: OK. Do you take any medication?
user: Yeah, I've got some puffers that my family doc gave me. 

assistant: OK. Nothing else? 

user: No, that's it. 

assistant: Do you have any allergies?
user: Um, no I don't. 

assistant: Have you (unclear speech due to connection issues)? 

user: I'm sorry, can you say that again? 

assistant: Have you ever been hospitalized in the past?
user: Um? I had my wisdom teeth removed. But no, I like I wasn't hospitalized, no. 

assistant: Have you been in contact with anyone recently that's been sick?
user: Nope, I don't think so. 

assistant: OK. What is your living situation right now? You said you're a student? 

user: I am. 

assistant: OK, and do you live, do you live on your own, with family, with roommates?
user: I live with two roommates. 

assistant: Do you drink alcohol?
user: Um, sometimes. 

assistant: OK, how how many drinks per week would you say?
user: I might have like a glass or two on the weekends. 

assistant: OK, do you smoke?
user: No. 

assistant: OK, do you use any other substances? 

user: No. 

assistant: OK, and what would you eat on a regular day typically, what would your typical diet be?
user: Hi, I've just been been so like weak and so tired, I just I can't I can't seem to like get off the couch, like I'll get up from my bed and go lay on the couch and then you know I might be able to get something to eat but I just I get so tired so fast and I don't know I don't know what's wrong. 

assistant: OK, when did these symptoms start? 

user: Um, like I've been feeling pretty tired for like a week, but like this bad for like maybe four days. 

assistant: OK, um and so it sounds like you haven't been going to work or like anything like that because you have been so kind of tired and weak.
user: Yeah, I mean at first I was already kind of working. I'm I'm a truck driver so you know, once you start the job, you kind of have to finish that. I was supposed to go on another another trip like 4 days ago and I just couldn't. I had to call my boss and say that I can't. 

assistant: OK, um have you had any like specific muscle weakness like in your legs or or in your arms? Or would you say it's overall like a general weakness? 

user: It's just everywhere. It's it's not like I can't move. I'm just really, really tired. 

assistant: OK, and how, how have you been sleeping?
user: I mean, I've just been sleeping like all the time. I have been sleeping all night and then like I said, I get up and I go to the couch and like just fall back asleep. 

assistant: OK, uh, have you been having any other symptoms?
user: I mean my my throat is maybe a little sore, but nothing nothing else. 

assistant: OK, uh, when when did the sore throat first start? 

user: Probably probably about a week ago. It's not really bad, it's just kinda there. 

assistant: OK, so it's it started just before uh, the weakness and fatigue?
user: Yeah, around the same time. 

assistant: OK, um, and have you been having any pain with swallowing? 

user: Uh, I mean maybe a little bit. 

assistant: OK, like with uh, like solid foods or liquids or both?
user: It it's just like it's just like it's a little a little tender. It's not like, really it's not like hard to swallow or anything, it just feels like it's like my throat's kinda tired. 

assistant: OK, have you had any changes to your voice? 

user: Uh, no, I don't think so. I mean, I live. I live alone so I can't really ask someone else if I have. 

assistant: OK, but your voice sounds the same to you?
user: Yeah, I think so. 

assistant: Alright, um, and so have you been having any fevers or chills? 

user: Um, I've been, I've been feeling really cold. 

assistant: OK, have you had any, uh, like shakes or or rigors?
user: I've been like kind of kind of shivering. 

assistant: OK, how about any night sweats?
user: Um, yeah, come to think of it, like I was I was, when I was last traveling with, when I was last on it because I'm a truck driver, I I was in the States, I I had to bring something to Ohio, and I had to change my clothes in the night. They were just like so drenched in sweat. 

assistant: OK, has that happened more than that that one time?
user: Maybe a couple times that it wasn't as bad, that one time was really bad, but here and there like I I've been feeling pretty sweaty at night in general. 

assistant: OK, and have you had any, uh, like difficulties breathing or shortness of breath? 

user: Not really, just like kind of tired, but it's not like hard to breathe. 

assistant: OK, um have you had a cough?
user: Uh, no. 

assistant: OK, how about a runny nose?
user: Maybe maybe a little bit, but not like too noticeable. 

assistant: OK, and when did the runny nose start? 

user: Oh, it's all like around the same time. 

assistant: OK and have you been having any headaches?
user: A little. 

assistant: OK, and then how about any chest pain? 

user: No no. No chest pain. 

assistant: Alright, and how about any wheezing?
user: No, no, I don't think so. 

assistant: Alright, then any heart palpitations? 

user: No. 

assistant: OK, have you felt lightheaded or or like you were going to pass out or faint?
user: Uh not like I've been feeling really tired, but it's not been like I don't think it's been like fainting. 

assistant: OK, so kind of like you are fatigued that you've been experiencing. Um, have you had any abdominal pain?
user: I mean, I'm not really eating a lot, so it's kind of like gurgling. 

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

user: Uh, no. 

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

assistant: Any bowel problems?
user: No, I mean, you know I haven't been eating that much, so I haven't been going as much as normal, but it's I don't think there's problems. 

assistant: OK, so you haven't had any diarrhea?
user: No. 

assistant: OK. Um, and have you had any skin rashes? 

user: No, not that I've noticed. 

assistant: OK, and um have you had any like muscle aches or or joint aches?
user: I mean, I feel kind of achy all over but not in like one particular spot. 

assistant: OK. And in terms of your past health, have you been, is there any reason you you see a doctor regularly?
user: Oh Oh yeah, like I have I have high blood pressure and diabetes. Yeah, that's that's pretty well it, but yeah, those two things. Oh and I take a medication for my prostate. 

assistant: Oh OK, um, and do you take medications for the blood pressure and diabetes?
user: I yeah yeah, I um, oh geez, what's it called? I take ramipril, and I take Metformin. I was on insulin but I pretty well I just have been able to eat well so I'm not taking it now. And then, uh, I can't remember the, uh, the prostate one. Like tam, tam something. 

assistant: OK, maybe tamsulosin? 

user: That sounds right, yeah. 

assistant: OK, I can check on the chart as well to confirm. Um, do you have any allergies to medications?
user: No. 

assistant: Alright, and any recent hospitalizations?
user: No, no, I've been pretty good. 

assistant: OK, and any surgeries?
user: Uh, not for a really long time, I I had my gallbladder out like 20 years ago. Yeah, that's it. 

assistant: OK, um, and has anything like this happened to you or any of your family members before, suddenly they start started to feel fatigue like this? 

user: I don't think so. I mean, we've all like you know, caught colds and you know stuff like bugs and stuff but, not not quite like this, like I can barely get up. 

assistant: OK, anybody in the family have a history of heart disease or cardiovascular disease?
user: My dad had high blood pressure, that's it. 

assistant: OK, anybody in the family have cancer?
user: My mom, my mom had breast cancer. 

assistant: OK, and you told me that that you work as a trucker, so you were over in the states, it sounds like. How recently were you in the United States?
user: That was like about a week ago. I probably got back five or six days ago. 

assistant: OK, do you travel there often?
user: Oh yeah, yeah. I mean that's you know the route that I usually take. 

assistant: OK, uh any anybody you interacted with that was sick, do you believe?
user: I don't. I don't really interact with with many people. I kind of just go there and um, and then you know I stayed in a hotel. But you know, I didn't really see anyone besides like the lady that works there. And maybe you know, the people at the McDonald's like counter. I didn't I didn't like see anyone that I know that I sat with for a long time or anything. 

assistant: OK, but you got home about five or six days ago. Um, yeah, and who are you living with currently? 

user: Just me. 

assistant: OK, and do you drink alcohol?
user: Oh no. No, I used to a little bit, but not not anymore. 

assistant: OK, and how about cigarettes? Do you smoke cigarettes?
user: I quit um 10 years ago. 

assistant: OK. 

user: I smoked I smoked probably like 1/2 a pack a day for for a while, maybe 20 years. 

assistant: OK, but you quit over 10 years ago?
user: Uh, about 10 years ago, yeah. 

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

assistant: Alright, and how about any other recreational drug use, including the use of IV drugs? 

user: No, nothing like that. 

assistant: OK, and are you currently sexually active?
user: No no. 

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

assistant: OK uh, and are you currently in a in a relationship?
user: Uh, no, uh, like I have I have a friend that I see and we both, um, we both lost our spouses, um, several years ago, and I mean, we, we see each other and like we live in the same apartment building and often have meals together. But we're just like friends. 

assistant: OK.
user: But that's the person that would check on me if I needed it. 

assistant: OK, that's great. It sounds like you have some good support nearby. I'm sorry to hear about your wife. But I think that was all of the questions that I wanted to ask on the the history today. So next I we're gonna order some some lab work for sure to start with then and maybe we'll go from there. So we'll give you some fluids, and maybe some Tylenol and we will see what the lab work shows.
user: Hi, so I feel like I might have a bladder infection. I see a urologist because I've had some issues with like an overactive bladder for awhile. I've had a few bladder infections in the past and this is usually how how they feel. I feel like a little bit of burning when I go to the bathroom and I have to go like a lot right now. But then also sometimes it means that like it gets like this when I have my period and I don't have my period right now, but I you know I I could be getting it, but I also just don't wanna let it go keep going if I do have an infection. I just like rather get it like treated if I do. 

assistant: OK understood. When was your last period?
user: Um, like 2 weeks ago. 

assistant: About two weeks ago, are you fairly regular?
user: Like yes and no, it's. I'm I'm not super irregular, but I I sometimes have like basically it's like I alternate sometimes. I my cycles like 4 weeks and sometimes it's more like 5. 

assistant: Sorry, just clarify again, you're 30 years old?
user: Yeah I'm 30. 

assistant: Ok are you on any contraception right now?
user: Uh, no, I'm not. 

assistant: Ok. Are you sexually active at all? 

user: No. 

assistant: No? Ok. So just in terms of your urinary tract infections, when was your last one?
user: I had one like 3 months ago maybe. 

assistant: 3 months ago ok, and they prescribed you antibiotics and it went away fairly quickly?
user: Yeah yeah it went away like I always I always have an overactive bladder and I always have to go pretty frequently, like every hour, sometimes half hour. But so that's still there, but like it hasn't ever since then, I haven't had any like pain with it. 

assistant: Ok, so you still have quite a, you have a, quite a bit of urgency to go? 

user: Yeah. 

assistant: Kind of going more frequently, but I suppose the new thing you're a little bit concerned about is that it, it burns a little bit, it stings a little bit when you do urinate. Am I understanding correctly?
user: Exactly like for the past couple days, it's felt like that. 

assistant: Ok, has it been getting progressively worse at all?
user: Um, maybe a little bit I I feel like now I can recognize it pretty early when it's not too bad to kind of get ahead of it. 

assistant: OK understood. And do you have any pain kind of behind your ribs at all? On your back? 

user: Sorry, can you repeat that? 

assistant: You haven't had any pain on your back, middle back kind of close to your ribs, have you?
user: Not that I can think of. 

assistant: Ok, and have you noticed any changes to the quality of the urine? For example has it looked frothy or smelled bad?
user: It maybe looked like a little cloudy. But nothing, nothing else out of the ordinary like I've never had blood in it or anything. 

assistant: Understood. Have you noticed any visual changes in the area near the vagina?
user: No, not that I can think of. 

assistant: Like any lesions, anything like that? Anything concerned for an STI that you're worried about?
user: No, and like I haven't had like had a sexual partner in a few years. 

assistant: Understood, understood. These are kind of questions that we ask when someone's having a little bit of maybe an issue holding in their urine. Have you ever felt any numbness or inability to feel kind of around your buttocks region? For example, when you wipe with tissue paper, can you feel that well?
user: Oh yeah, I can feel everything. 

assistant: Ok and no changes to your poops, to your bowel movements? 

user: No, nothing, pretty normal. 

assistant: Ok, and how do you feel otherwise?
user: I, I mean, I feel I feel a little tired, felt like a little hot yesterday. I don't have a thermometer so like I didn't take my temperature but, you know, sometimes I feel a little hot like when I've had the infections before. 

assistant: OK, you don't have any swelling on your anywhere in your body on your ankles, do you?
user: No. 

assistant: No? Ok, and then, so no puffiness around your eyes that you've noticed?
user: No, nothing like that. 

assistant: Any rashes or any changes on your face? 

user: Like my mom said, I, I I saw my mom earlier and she said I looked like a little flushed but it's not not like a rash or anything. 

assistant: No? No markings across the bridge of your nose and your cheeks?
user: No. 

assistant: Ok, and then in regards otherwise you feel a little flushed, a little tired? Any other medical issues that you have? 

user: No, just this like overactive bladder thing. 

assistant: OK, and have they given you any medications for it?
user: We tried a few different ones before, now I get I get Botox injections into the bladder like maybe twice a year. 

assistant: Anything else they've used recently? Like any medications you're on right now, I suppose? 

user: No, nothing no nothing else. Yeah, I guess I have like I have an inhaler but I don't use it all the time like I haven't had to. 

assistant: Oh, so you have asthma?
user: Yeah, like I honestly don't feel like I have it very much now, but I still have like I still have the inhaler. 

assistant: Understood, understood. Anything else, you've taken medications for in the past? 

user: Oh, I used to take birth control, like the the pill but like I just I don't have a boyfriend right now and I just didn't really feel like I needed it otherwise. 

assistant: Understood, understood. And have you had any past surgeries?
user: Um, I had my appendix out when I was 24. That's it though. 

assistant: Ok got it. And then just in terms of you yourself, do you live in London?
user: Yeah yeah I do. 

assistant: Ok. What do you do for work?
user: I work at a bank. 

assistant: Ok, do you have any children? 

user: No. 

assistant: Ok, and in regards to anything so any sick contacts?
user: Uh no. 

assistant: Any recent travel?
user: No. 

assistant: Any allergies? 

user: Like sometimes in the spring I'll get like a little stuffy but... 

assistant: Ok, sounds great.
user: No like, yeah... 

assistant: Nothing to concerning? No drug allergies?
user: No, nothing like that. 

assistant: Got it, got it. OK, I think what now do next, I'll move to a physical exam. I think we might just do some investigations just in order to get some more information. And then the physician will come in to see you, ok?
user: Hi I um I just developed uh or I guess I just started having difficulties with uh breathing starting this morning. It was just very odd, I was fine yesterday night and then just this morning, I've had a really hard time breathing um and yeah, I thought I should come in and get it checked out. I don't know what's going on. 

assistant: Yeah, certainly, and so uh like did this shortness of breath wake you uh like did you wake up, um like just like uh to kind of sit up to catch your breath, um or when did the shortness of breath start? 

user: Um it was kind of after I woke up and I was sort of, um just walking around that I I noticed that I was feeling short of breath just walking around, which was so weird. You know that that doesn't really happen to me. 

assistant: OK. Um and with this, with the shortness of breath, have you had had a cough?
user: No. 

assistant: OK, and um have you had any wheeze? 

user: Um no. 

assistant: OK, and have you been having any uh any chest pain?
user: Yeah, I kind of, I guess it just hurts a little bit when I take a, when I breathe in. 

assistant: OK is is this pain when you take a deep breath in? 

user: Yeah, I guess so, yeah. 

assistant: And where do you feel the pain?
user: Um it's kind of on my um right side. 

assistant: OK, does the pain uh like radiate anywhere or do you feel it just in that one spot? 

user: It's just uh it's just in that one spot. It's just this sudden and like like this stabbing sensation um when I'm like taking a breath in. Uhm, actually now that I think about it, it's it's kind of there even when I'm like breathing normal, but it's not as bad. When I take a deep breath it's like really, really bad or when I um yeah, when I like cough or like I'm laughing or something, it just gets really bad. 

assistant: And when did you first notice this pain?
user: Kind of um late this morning. 

assistant: OK uh have you tried anything for a for the pain? 

user: Uh I don't know, it's just I just try not to take deep breaths, I'm just trying to just take a normal breath and try not to talk too much. And yeah, just like not doing anything that worsens the pain. 

assistant: OK, I see and um did you have any trauma to that to that area recently like a car accident or I don't know, getting hit in the ribs, or anything like that?
user: No, no I didn't. 

assistant: OK. Um and have you had any episodes where um or actually rather like, do you have any issues with lying flat and having shortness of breath? 

user: No. 

assistant: OK, and um have you had any headaches?
user: Uhm, no. 

assistant: Have you had any uh fevers or chills? 

user: No. I don't think so. 

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

assistant: Have you had any changes to your weight recently? I mean, like over the last several months.
user: Uh no. 

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

assistant: How about any changes to your sense of uh taste or your sense of smell? 

user: No, those are OK. 

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

assistant: Alright. Um and have you had any diarrhea? 

user: No. 

assistant: How about any urinary problems?
user: No. 

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

assistant: OK. Um and how about any uh muscle aches or body pains?
user: Um yeah, I kind of have uh, it's just my left leg hurts a little bit. I'm not quite sure why. But yeah, nothing else. 

assistant: OK, whereabouts, uh where does it hurt um on your left leg?
user: Um kind of in the calf area. 

assistant: OK is it is it swollen or have you noticed any redness of the skin there? 

user: Yeah it is. It is swollen actually, compared to my right leg. It's a little bit warm too. 

assistant: OK, um have you had any uh like periods of time where you were bedridden over the last several days or or last several weeks?
user: No. 

assistant: OK, any surgeries recently?
user: No. 

assistant: Alright, and have you traveled anywhere over any long distances recently?
user: Oh yeah, yeah, I came back um two days ago. Um I went to um I went to India to visit my family, there was a death so had to to go. I came back yeah, two days ago. 

assistant: OK, yeah, that's quite a long flight and I'm sorry to hear about um the loss of the family. Um OK, um oh and that reminds me, have you coughed up uh any blood at all?
user: Uh no. 

assistant: OK. Um and um I just wanted to switch gears a little bit and ask about your past health. Have you been diagnosed with any medical conditions?
user: Uhm I I've had um anxiety. And uh yeah, that's that's about it. I had asthma as a child, but nothing since then. 

assistant: I see, and do you uh take any medications for anxiety or have you?
user: Uh no, I'm just trying to um, just trying to reduce my stress and and trying other other ways to sort of handle my anxiety before I, I'm just trying to avoid builds actually. 

assistant: I see, OK. So do you take any medications like either prescribed or over the counter?
user: Uh no. 

assistant: Do you have any allergies to um to medications or or environmental? 

user: No. 

assistant: Alright, and um have you had any surgeries in the past or any hospitalizations?
user: Uh I had my appendix removed when I was uh 30 years old. 

assistant: OK, um and any complications with that?
user: No. 

assistant: Alright, and currently uh whereabouts are you living and uh who are you living with? 

user: Um I'm just living with my sister. And uh yeah, we we live in an apartment together. 

assistant: OK, and has she been sick or have you been any, around anybody who's been sick?
user: No. 

assistant: OK, um and uh any potential exposures to uh TB, uh either in your on your travels or or anybody that you that you know of? 

user: I don't think so, no. 

assistant: OK. Um and do you smoke cigarettes?
user: No. 

assistant: And do you drink alcohol? 

user: No. 

assistant: Uh how about the use of any uh recreational drugs?
user: No. 

assistant: OK, um and in the family is there a history of any bleeding disorders or any uh clotting disorders? 

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

assistant: OK, um and any heart conditions, lung conditions?
user: Um just a heart attack. Uhm both my grandparents on my dad's side uh had a heart attack and uh diabetes as well. Um I think both my parents have diabetes. 

assistant: OK. Have you been tested for uh diabetes as well?
user: Uh yeah, yeah yeah I go to see my family doctor and my uh, he said my sugars were good. 

assistant: OK, great. Um alright, so um you've been experiencing uh so this this chest pain when you breathe in deeply since this morning um as well as some more difficulty breathing, and some left pain uh left leg pain with with some swelling. Uh have you been, after travels as well, have you had any other symptoms?
user: Sure, um, I've been experiencing some issues breathing, um and just a lot of coughing over the past year or so. 

assistant: OK. And is your cough, has it been a wet cough or a dry cough?
user: Uh, but it's been a wet cough. 

assistant: OK. You mentioned it started over a year? 

user: Well, about, about 8 months. 

assistant: 8 months. And has it been getting worse at all?
user: Yeah, I think it's been getting worse. 

assistant: OK. And so it's been a wet cough. Do you release any kind of like phlegm or sputum?
user: Um, yeah, it's usually clear, but sometimes it can look yellow or green. 

assistant: OK, and how, how much would you say you produce every day? 

user: Um, like um, in total per day? 

assistant: Or just maybe every time you cough.
user: Every time I cough maybe like the size of my thumbprint. 

assistant: OK, and have you notice at all coughing up any blood? 

user: No. 

assistant: Is the blood ever mixed into the phlegm?
user: No. 

assistant: OK. And uh, has it been constant coughing? Or does it come and go over the last eight months?
user: Um, it comes and goes, but there, there it's always like I have a tickle in my throat or something. 

assistant: OK, and when it first started, had anything changed in your life? Uh, had you move to a new place or started smoking or anything like that? 

user: No. 

assistant: No. OK. Is there anything you do that makes the coughing or shortness of breath worse?
user: Um, I guess walking. 

assistant: Walking? Is there anything that makes it better at all?
user: Just resting. 

assistant: Just resting, OK. How much can you walk or run until you feel the coughing or shortness of breath?
user: About like 200 meters. 

assistant: OK. And has this ever happened to you before the eight months?
user: No. Actually, I get wheezy because I have asthma, but it doesn't, it's not as bad as this. 

assistant: OK. And, um how often are you coughing, are you coughing throughout the day? Or is it more so during the day and then or more at night?
user: Uh, it's just kind of always there, um throughout the day. 

assistant: OK. And do you have any other symptoms besides the difficulty breathing and the cough? Do you have a sore throat, runny nose, dizziness, anything like that?
user: No. 

assistant: OK, so just the difficulty breathing and the cough?
user: Yeah. 

assistant: Do you get any chest pain at all?
user: No chest pain. 

assistant: Great, have you traveled anywhere outside of the country recently?
user: Uh, no, no. 

assistant: Any headaches, nausea or vomiting? 

user: No. 

assistant: Any fever, chills or night sweats?
user: No. 

assistant: Do you feel increasingly fatigued throughout the day?
user: Yeah, I guess coughing a lot makes me tired. 

assistant: OK, do you ever feel that your heart is racing or you have any kind of chest pain?
user: No. 

assistant: Have you noticed any issues urinating? 

user: No. 

assistant: Any changes in your bowel movements, any constipation or diarrhea?
user: No. 

assistant: Any issues with your sleep or appetite?
user: Uh, no. 

assistant: Any significant changes in your weight? 

user: No. 

assistant: Have you had any recent infections that you know of?
user: Not that I know of. 

assistant: Any antibiotics that you've had to use for any infections?
user: No. 

assistant: Um, do you think you have had any exposure to tuberculosis in the past?
user: No. 

assistant: And do you have exposure to fumes or dust or animals or pets in your work or home environment? 

user: I have a bird. 

assistant: A bird? And when did you get the bird?
user: Like five years ago. 

assistant: OK, but no issues before the eight months? 

user: No. 

assistant: OK. In terms of your overall health, do you have any past medical conditions? You mentioned asthma, but anything else like diabetes, high blood pressure?
user: I have type 2 diabetes and high blood pressure. 

assistant: OK. And or do you take any medications for those conditions? 

user: No, it's just being controlled by diet. 

assistant: OK, any medications for any other reasons?
user: I take some vitamin D tablets. 

assistant: OK, any allergies, environmental or to medications? 

user: No. 

assistant: OK, have you ever been hospitalized?
user: No. 

assistant: Any ill contacts near you at home or work? 

user: No. 

assistant: Any previous surgeries?
user: No previous surgeries. 

assistant: OK, do you have any family history of asthma or any other lung condition or any cancers? 

user: No lung conditions or cancers. 

assistant: OK. And currently, do you work?
user: I do. 

assistant: And where do you work?
user: I work as an accountant. 

assistant: OK. And do you currently live in an apartment or a house?
user: In an apartment. 

assistant: OK. And do you live by yourself or do you live with anyone else?
user: Just by myself. 

assistant: OK. Any new changes to your house uhm, any new carpets or anything like that? Or have you moved into a new new place recently? 

user: No. 

assistant: OK, do you use any recreational drugs like marijuana?
user: No, I smoked when I was younger, but not anymore. 

assistant: OK, and do you smoke cigarettes?
user: I do. 

assistant: OK, and how much would you say you smoke on an average day?
user: Uhm, about half a pack a day. 

assistant: OK, and how long have you been smoking for?
user: Since I was 18. 

assistant: OK. And you drink alcohol?
user: Uhm, sometimes. 

assistant: And how often would you say on an average week, how many drinks of alcohol would you say you have? 

user: Uhm, maybe 2 glasses of wine a week. 

assistant: OK. And in terms of your diet and exercise, would you say you get 3 meals a day? Well balance, well balanced diet?
user: Um, yeah, I'd say so. 

assistant: OK, and lastly, in terms of exercise, would you say you're fairly active throughout the week?
user: Yeah absolutely. I have had this awful, awful headache for the past, two days I wanna say, its horrible. 

assistant: OK, has the headache, uhm, stayed the same, gotten worse, gotten any better?
user: It's only gotten worse over the past two days. 

assistant: OK, and when the headache started, was it like a thunder clap, kind of worst headache of your life when it came on?
user: No, no. 

assistant: OK. Was there anything going on two days ago around the time of the headache, like did you hit your head or anything like that? 

user: No, I just, uhm, I just went out for dinner, the night before and I know that there are certain foods that can trigger my migraines, but this really feels different. It doesn't feel like my migraine. 

assistant: OK. Uhm, and have you had any other associated symptoms, with the headache.
user: I've been feeling really tired. I took the day off yesterday and today, I'm working from home, but I still decided not to get any work done today or yesterday. 

assistant: OK. Uhm, and the fatigue, when did that start? 

user: I think that started yesterday morning. 

assistant: OK. And sorry, back to the headache. Have you tried anything for it?
user: I took Tylenol and Advil, but, I guess it did get better for about an hour a little bit, but it was back on again. 

assistant: OK. And could you describe like where you feel the headache? 

user: Sure, yeah, so it's like right in the front. Just kind of feels like a band, just like this pressure in the front of my head. 

assistant: OK, and has there been anything that's made the headache worse, like lights or, or sounds?
user: No, no, like I said it's like nothing like my usual migraine headaches. 

assistant: OK. And, I mean, the Advil or Tylenol, It helps the symptoms for a brief period, but has there been anything else that's helped your headache?
user: No, not really. 

assistant: OK. And is there any particular time of the day that the headache's worse, like, is, in the morning time when you're first waking up or later in the day?
user: I don't think so. 

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

assistant: OK. And have you had any, like visual changes?
user: No. 

assistant: OK. Uhm, and have you had a runny nose or a sore throat? 

user: Uhm, I've had a bit of a sore throat. 

assistant: OK, have you, have you had a cough?
user: Yeah, but honestly the headache's been bothering me the most. 

assistant: OK, and when did the cough start?
user: About the same time. 

assistant: OK. 

user: Maybe two days ago. 

assistant: OK, and have you had any neck stiffness? Does it hurt if you, if you move your neck around?
user: No, nothing like that. 

assistant: OK, uh and with the, with the cough, have you had any difficulties breathing or shortness of breath?
user: Maybe a little bit. 

assistant: OK, how about any wheezing?
user: No. 

assistant: OK. Have you been bringing up any sputum with the cough? 

user: No. 

assistant: OK, how about, any, any blood?
user: No. 

assistant: OK. And have you had any changes to your sense of smell?
user: No. 

assistant: Any changes to your sense of taste?
user: No. 

assistant: OK. Uh, and have you had any changes to your weight recently over the last several months? 

user: I don't think so. 

assistant: Alright, and how is your appetite been?
user: Uhm, it's fine. 

assistant: Any chest pain?
user: No. 

assistant: OK. Uhm any lightheadedness or, or feeling dizzy? 

user: No, no. 

assistant: Alright. Any nausea or vomiting?
user: No. 

assistant: Any urinary problems? 

user: No 

assistant: How about , uh, have you had any muscle aches or joint pains?
user: A little bit. 

assistant: OK. And any rashes anywhere? 

user: No, no, no. 

assistant: OK. And have you been diagnosed with any medical conditions before?
user: Uhm, I have, uh, I have migraines and uh, I also have Polymyalgia rheumatica. 

assistant: OK. Are you taking any medications currently, for either of those? 

user: No. 

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

assistant: OK, any surgeries? 

user: No. 

assistant: OK, and, uh, do you smoke cigarettes?
user: no. 

assistant: Drink alcohol? 

user: No. 

assistant: OK and do you use any other, use any recreational drugs?
user: No. 

assistant: OK. And any family history of similar symptoms like, like, unusual headaches or anything like that? 

user: Well, migraines kinda run in the family. 

assistant: Migraines, OK.
user: Yeah. 

assistant: And any heart conditions or cancers or anything like that in the family? 

user: No no no. 

assistant: OK. And have you been around anybody who's been sick, recently? You went out for dinner a couple days ago.
user: Yeah, uhm, I don't think anyone was sick. 

assistant: OK. And you didn't feel that you had any triggers to your migraines at that time?
user: No, I didn't. I did yes, I, I did meet up with my friends and we went out for dinner. I know we're not supposed to, but it's been such a long time. 

assistant: Yeah. 

user: I don't think they were sick at the time, but I haven't really talked to them after. 

assistant: OK. Have you traveled anywhere?
user: No. 

assistant: Alright. And so I don't think I asked, did you have a fever or chills? 

user: No, not really. 

assistant: Oh OK. Uhm, so the symptoms you've been experiencing, you've had a headache that's been the most bothersome these, these last couple of days, which feels different than your migraines but you've also had a sore throat, a cough, shortness of breath as well as a little bit of muscle aches and fatigue over these last couple of days.