jshargo/mts-medical-trainset huggingface dataset:
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Who lives with you, miss?

user: I live with my boyfriend.

assistant: Do you smoke cigarettes?

user: Yes, I do.

assistant: How about drugs?

user: Sometimes, but I don't want to talk about it.

assistant: Okay. Anything else you want to talk about?

user: Pardon?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I live with my boyfriend.

assistant: Do you smoke cigarettes?

user: Yes, I do.

assistant: How about drugs?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yes, I do.

assistant: How about drugs?

user: Sometimes, but I don't want to talk about it.

assistant: Okay. Anything else you want to talk about?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Sometimes, but I don't want to talk about it.

assistant: Okay. Anything else you want to talk about?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Who lives with you, miss?

user: I live with my boyfriend.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Who lives with you, miss?

user: I live with my boyfriend.

assistant: Do you smoke cigarettes?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: She lives with her boyfriend.  The patient has history of tobacco abuse as well as multiple illicit drug abuse.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Who lives with you, miss?

user: I live with my boyfriend.

assistant: Do you smoke cigarettes?

user: Yes, I do.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Good afternoon, doctor.

assistant: Refresh my memory, please, how old are you, sir?

user: I'm forty nine.

assistant: Also, I need you to remind me, when was your lower back surgery?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I'm forty nine.

assistant: Also, I need you to remind me, when was your lower back surgery?

user: It was in January of two thousand five. What was the name of the surgery, again?

assistant: It was a lumbar disc replacement. So, how are you feeling today?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: It was in January of two thousand five. What was the name of the surgery, again?

assistant: It was a lumbar disc replacement. So, how are you feeling today?

user: Truthfully doctor, the surgery did nothing. I'm still in a lot of pain.

assistant: Besides the surgery, what other interventions have you tried?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Truthfully doctor, the surgery did nothing. I'm still in a lot of pain.

assistant: Besides the surgery, what other interventions have you tried?

user: I have them written down, let me look. Um, I did acupuncture, T E N S unit at P T, and I've been to the chiropractor too.

assistant: Have you taken any medicines?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I have them written down, let me look. Um, I did acupuncture, T E N S unit at P T, and I've been to the chiropractor too.

assistant: Have you taken any medicines?

user: Yeah, I have those written down here. I've taken Elavil, Topamax, Cymbalta, Neurontin, and Lexapro.

assistant: Are you still taking any of these?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yeah, I have those written down here. I've taken Elavil, Topamax, Cymbalta, Neurontin, and Lexapro.

assistant: Are you still taking any of these?

user: No, I had bad side effects to some, and the others just didn't do anything.

assistant: Have you had any injections for this pain?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: No, I had bad side effects to some, and the others just didn't do anything.

assistant: Have you had any injections for this pain?

user: I've had a few into the, um, piriformis.

assistant: Did that do anything?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I've had a few into the, um, piriformis.

assistant: Did that do anything?

user: Um, it provided some brief relief, I guess. I had a Botox procedure done on March eighth two thousand six.

assistant: How did this work?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Um, it provided some brief relief, I guess. I had a Botox procedure done on March eighth two thousand six.

assistant: How did this work?

user: Honestly, it did nothing.

assistant: Where is your pain, exactly?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Honestly, it did nothing.

assistant: Where is your pain, exactly?

user: I'd say its seventy five percent in my butt and leg, and twenty five percent in my lower back.

assistant: Are you able to workout, or exercise, anything like that?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I'd say its seventy five percent in my butt and leg, and twenty five percent in my lower back.

assistant: Are you able to workout, or exercise, anything like that?

user: I've tried to increase how much I walk, but when I do I get spasms in my lower back.

assistant: I see, with ten being the worst pain of all time, how would you rate your pain today?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I've tried to increase how much I walk, but when I do I get spasms in my lower back.

assistant: I see, with ten being the worst pain of all time, how would you rate your pain today?

user: I'd say it's a six out of ten today.

assistant: What adjectives would you use to describe the pain?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I'd say it's a six out of ten today.

assistant: What adjectives would you use to describe the pain?

user: Um, I'd say its shooting, sharp, and, um, aching.

assistant: Specifically, what activities make the pain worse?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Um, I'd say its shooting, sharp, and, um, aching.

assistant: Specifically, what activities make the pain worse?

user: Well, lifting, standing for a long time, or, um, squatting. I can't do that anymore.

assistant: Does anything make the pain better?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Well, lifting, standing for a long time, or, um, squatting. I can't do that anymore.

assistant: Does anything make the pain better?

user: Um, sitting back, ice, and I guess there's some improvement with the pain medication.

assistant: Is the pain constant, or does it come and go?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Um, sitting back, ice, and I guess there's some improvement with the pain medication.

assistant: Is the pain constant, or does it come and go?

user: It's constant now, but, um, the intensity of it comes and goes.

assistant: Are you able to sleep at night?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: It's constant now, but, um, the intensity of it comes and goes.

assistant: Are you able to sleep at night?

user: Not really, it is affecting my sleep, which in turn affects my mood.

assistant: So, overall, I can summarize and say you're not happy with your pain relief so far?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Not really, it is affecting my sleep, which in turn affects my mood.

assistant: So, overall, I can summarize and say you're not happy with your pain relief so far?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Good afternoon, sir.

user: Good afternoon, doctor.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Good afternoon, sir.

user: Good afternoon, doctor.

assistant: Refresh my memory, please, how old are you, sir?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: This is a pleasant 49-year-old gentleman post lumbar disc replacement from January 2005.  Unfortunately, the surgery and interventional procedures have not been helpful in alleviating his pain.  He has also tried acupuncture, TENS unit, physical therapy, chiropractic treatment and multiple neuropathic medications including Elavil, Topamax, Cymbalta, Neurontin, and Lexapro, which he discontinued either due to side effects or lack of effectiveness in decreasing his pain.  Most recently, he has had piriformis injections, which did give him a brief period of relief; however, he reports that the Botox procedure that was done on March 8, 2006 has not given him any relief from his buttock pain.  He states that approximately 75% of his pain is in his buttock and leg and 25% in his back.  He has tried to increase in his activity with walking and does note increased spasm with greater activity in the low back.  He rated his pain today as 6/10, describing it is shooting, sharp and aching.  It is increased with lifting, prolonged standing or walking and squatting, decreased with ice, reclining and pain medication.  It is constant but variable in degree.  It continues to affect activities and sleep at night as well as mood at times.  He is currently not satisfied completely with his level of pain relief.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Good afternoon, sir.

user: Good afternoon, doctor.

assistant: Refresh my memory, please, how old are you, sir?

user: I'm forty nine.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: non-contributory.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Do you have a family history of neurological conditions that I should know about?

user: What exactly do you mean by that, doctor?

assistant: Well, it could be anything from A D H D, to epilepsy, to Alzheimer's.

user: Oh, no.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: non-contributory.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: What exactly do you mean by that, doctor?

assistant: Well, it could be anything from A D H D, to epilepsy, to Alzheimer's.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: non-contributory.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Do you have a family history of neurological conditions that I should know about?

user: What exactly do you mean by that, doctor?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: FAM/SOCHX
Patient Information: non-contributory.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Do you have a family history of neurological conditions that I should know about?

user: What exactly do you mean by that, doctor?

assistant: Well, it could be anything from A D H D, to epilepsy, to Alzheimer's.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: MEDICATIONS
Patient Information: Abilify.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Are you on any medications?

user: Yeah. I take Abilify to help with my mood.

assistant: Do you find that it's helping?

user: A little, yeah.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: MEDICATIONS
Patient Information: Abilify.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Are you on any medications?

user: Yeah. I take Abilify to help with my mood.

assistant: Do you find that it's helping?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: ASSESSMENT
Patient Information: Upper respiratory infection.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Your culture results came back positive for Streptococcus pneumoniae. This is a bacterial infection. I would like to take a course of antibiotics.  This should start to improve your symptoms with in three to four days.

user: Okay.

assistant: Please let me know if your symptoms have not improved or becomes worse.

user: I will. Thank you.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: ASSESSMENT
Patient Information: Upper respiratory infection.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Your culture results came back positive for Streptococcus pneumoniae. This is a bacterial infection. I would like to take a course of antibiotics.  This should start to improve your symptoms with in three to four days.

user: Okay.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: ASSESSMENT
Patient Information: Upper respiratory infection.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

assistant: Your culture results came back positive for Streptococcus pneumoniae. This is a bacterial infection. I would like to take a course of antibiotics.  This should start to improve your symptoms with in three to four days.

user: Okay.

assistant: Please let me know if your symptoms have not improved or becomes worse.