[doctor] morning christine , nice to see you .
[patient] nice to see you too .
[doctor] so i know my nurse told you a little bit of- ... um , about dax and i'm gon na tell dax a little bit about you , if that's okay ?
[patient] go for it .
[doctor] okay , great . um , uh , this is christine . she's a 63-year-old female patient . you're here for your routine , um , yearly exam . um , i know you have a history of high blood pressure and you've had some depression in the past . and i also know you did have a carpal tunnel release done about two years ago . um , how have you been doing ?
[patient] i've been doing well . um , the depression standpoint is doing great . i've been using , um , the medication you prescribed me last time and going to therapy every week . and that's really helped me manage .
[doctor] okay . and you're sleeping well at night ? and everything's been going well from that standpoint ?
[patient] yeah , i've been getting a full eight hours .
[doctor] okay . and no thoughts of hurting yourself or anything like that ?
[patient] no .
[doctor] okay , good . um , and , um , i- i know you've had some high blood pressure in the past . have you been checking your blood pressure ?
[patient] i have . it's been a little bit up and down-
[doctor] okay .
[patient] lately , i have n't had a normal , um , normal reading- reading in a couple of weeks . um , it's either been high or low . um , has n't really stayed put .
[doctor] has n't really stayed put ?
[patient] yeah .
[doctor] okay . and , um , you've been talking your medication though , right ?
[patient] yes , i have .
[doctor] okay .
[patient] my diet's been a little all over the place . i have been really stressed with work and putting in more hours, so you know, it has been hard. i have not had time to go to the grocery store, let alone prepare and cook meals. so, i have been eating a lot of frozen meals.
[doctor] okay .
[patient] that type of thing .
[doctor] and have you had any headaches or swelling or anything like that that's been abnormal ?
[patient] i have some headaches but i just thought that was looking at a computer screen all day .
[doctor] okay , well , that's fair .
[patient] yeah , exactly .
[doctor] okay good . and , um ... i know my nurse did a review of systems . other than what we've just talked about , has there been anything else that you wanted to add to that ?
[patient] um , my carpal tunnel release has been doing well . on , uh , we did that , i think it was two years ago now .
[doctor] okay .
[patient] uh , on my right , um , wrist , and that's been great .
[doctor] great , great . no numbness or tingling in your hands ?
[patient] no .
[doctor] fingers ? okay , good . all right , well , um , lem me do a quick exam if that's okay ?
[patient] okay .
[doctor] deep breath . squeeze my fingers for me . feel me touch you here ?
[patient] yup .
[doctor] can you touch down here ?
[patient] mm-hmm .
[doctor] can you push your leg out ? push this one up . pull it back . yeah , good . okay . so on my exam , um ... your exam's essentially normal , your lungs are clear , are- ... you do n't have any adenopathy in your neck , you do n't have any , um , uh , hyperthyroidism . um , your heart is regular without any murmurs . um , your grips are equal , neurologically intact , strength is good , pulses are good . so overall , um , your exam is fine . let's take a- a look at some of your labs and vital signs .
[patient] okay .
[doctor] hey dragon , show me the blood pressure . okay , so here in the office today it is a little bit elevated , okay ? so your blood pressure is a little bit high . so the results , um , do show that . um , hey dragon , show me the labs . okay , so good news is is your- your labs are all essentially normal , so the results of your labs are essentially normal , okay ? so ... um , my assessment is that your- ... you do have hypertension still . um , and i think we need to increase your blood pressure medicine a little bit , okay ? so i'm gon na increase your lisinopril to 10 milligrams a day , just once a day , um , but i'm gon na increase that a little bit , okay ? and then want you to check it and i'm gon na have you come back in a month and we'll see how you're doing with regards to that , okay ?
[patient] okay .
[doctor] um , your second problem is your dep- depression , you're doing great , i do n't wan na change anything at this point . let's just stay- ... we'll change one thing with your high blood pressure-
[patient] mm-hmm .
[doctor] so i do n't wan na change any other medications at this point in time , so let's just leave that as it is .
[patient] okay .
[doctor] and then your third problem was your carpal tunnel . that seems to be doing well . if you notice any tingling or any changes or you get some of those symptoms back , just let me know . okay ?
[patient] okay .
[doctor] all right . anything else i can do for you today ?
[patient] no , that's it .
[doctor] okay . great . uh , lem me get you checked out .
[patient] okay .
[doctor] hey dragon , finalize the report .


Medical orders:
description: lisinopril 10 milligrams once a day
order_type: medication
reason: hypertension
description: come back in a month
order_type: followup