[doctor] Hi there. It's Doctor Smith from Babylon.
[doctor] Can you confirm your name, date of birth, and your home address, please?
[patient] Um, it's .
[doctor] . Um, I can't hear you at the moment actually. Could you turn it up, the, volume up?
[patient] Uh, can you hear me better now?
[doctor] . Yeah, that's better. Thank you.
[patient] Um, OK. Sorry about that.
[doctor] Are you in a private place you can have a consultation?
[patient] Uh, yes.
[doctor] What can I do for you today?
[patient] Um, I've been having this, blinding headache for a few days. Um, and it's like, really bothering me and , I find it very hard to focus or, like I can't even go to work.
[doctor] OK, and any headaches in the past before this?
[patient] Not really just they're, on and off. Um, I recently had a, a one for like two days, um, but it just went away with Ibuprofen, so nothing like, more, longer than two days before.
[doctor] So, how did this start?
[patient] Um, it just started all of a sudden. I woke up one morning with a headache, and that was three days ago, and I just keep having it.
[patient] Doesn't really go away with Ibuprofen either, I try that, but it just. It gets a little bit better but like, doesn't go away.
[doctor] OK, and whereabouts in your head is the pain?
[patient] Um, it's kind of all over but, I feel like over my right eye, it's um bit, stronger.
[doctor] OK. Any problems with your vision? Or, any problems tolerating the light?
[patient] Um, lights definitely make me more sensitive. Like, um, I don't really, like strong lights.
[patient] Um, and um, yeah, vision I think, I get this, shooting light sometimes.
[patient] Um, not sure how to explain it. Just a bit of um, weird kind of vision.
[doctor] OK, and um, any, any nausea or vomiting?
[patient] Uh, no, feeling a bit sick, but no vomiting.
[doctor] Any tingling? Or numbness? Or weakness anywhere?
[patient] Um, no.
[doctor] Any change in your smell or taste?
[patient] No, none at all.
[doctor] Um, and, in the past, when you've had headaches, what have they been like?
[patient] Um, I was sick but I had no more headache, it's just um, a bit of a pressure, in between my eyes, um.
[patient] But nothing major.
[doctor] OK, and, with, with this, has it been there all the time? Or is it coming and going?
[patient] Kinda all the time. Um, so when I take Ibuprofen it gets a bit better, so it's a bit, like less um, it, it bothered me less, but then I still have it, it's still there.
[doctor] Um, and what would you say, the severity is? If, if ten is the worst pain you've ever had, and zero is nothing, what would you say the pain is like?
[patient] I guess it's mostly, eight, and then it kinda comes down to maybe a five.
[doctor] OK, and what about at night-time, are you able to fall asleep?
[patient] Um, yeah, I'm, sleeping well.
[doctor] Is it waking you up in the night-time?
[patient] No, no, no. But I can wake up with it in the morning.
[doctor] OK. Any worse when you change position, or bend over, or cough, or anything like that?
[patient] Mmm.
[patient] Sometimes when I stand up, quickly I get a bit of a, stabbing pain. Um, or if I throw my head like, it I kind of feel like something is moving inside.
[doctor] OK. And have you had any, uh, eye checks recently?
[patient] Um, yeah, actually had one recently and, nothing changed my vision.
[doctor] OK. And have you had any cold symptoms, sore throat, sore ears, or pain over the sinuses? Any cough or flem?
[patient] No, no.
[doctor] No. Any, any nose bleeds, or coughing up any blood or anything?
[patient] No.
[doctor] And just recently, have you been well, or have you had any general problems? Any change in your weight? Or, tiredness, lack of energy, anything like that?
[patient] Um, no change of weight, maybe um, lack of energy but it might be because, I'm just having these headaches. so I'm find it quite difficult to go through my daily activities , you know when you have this constant headache.
[doctor] Have you been at work recently?
[patient] Um, I work from home but, couldn't really manage to, do it all the time. So sometimes I just took a day off.
[doctor] So, you've been, you've had a headache for three days. , how many days have you missed off work?
[patient] Um, so I worked from home all these three days and, um. First day I worked from home and then, um, the second I just took the whole day off. And, today I just tried to work from home the first half of the day but, I, I just stopped in the morning 'cause, I couldn't focus.
[doctor] OK. And, any other, medical problems in the past?
[patient] Um, I think I only had a, a pain, um, when I was younger but, no causes found and that went away, but that's, the only thing I know of.
[doctor] OK. Have you been abroad recently at all?
[patient] No.
[doctor] Do you take any medications?
[patient] Um, just the pill.
[doctor] Which one?
[patient] Um, .
[doctor] And when did you start that?
[patient] Um, about a year ago.
[doctor] Any side effects with that?
[patient] Uh, no I don't think so.
[doctor] Have you noticed any, any um, increased frequency of headaches since you started that?
[patient] Um, no, , these headaches just very recently, but nothing um, but nothing really changes.
[doctor] OK. And when you'd , when you've had, when you described your headaches in the past, you said they were just general. Did you have any visual symptoms? Flashing lights? Nausea, vomiting with them?
[patient] No.
[patient] No, no.
[patient] No nothing, none of those.
[doctor] Have you had your blood pressure checked recently with your pill?
[patient] Um, yeah, I had it checked in the pharmacy when I got the pill, and they say it was normal.
[doctor] And when was that?
[patient] Uh, a year ago.
[doctor] OK. Um, and any allergies to anything?
[patient] No.
[doctor] And who do you live with at home?
[patient] Sorry?
[doctor] Who do you live with at home?
[patient] Uh, just by myself.
[doctor] OK. And do you smoke?
[patient] Uh, no.
[doctor] Do you drink any alcohol regularly?
[patient] Yeah.
[doctor] How much in a normal week do you think?
[patient] Um, probably like, three , once a week.
[doctor] . OK. And do you take any other drugs at all?
[patient] Um, no apart from the Ibuprofen that I take, sometimes when, the headache gets really bad, nothing else.
[doctor] OK.
[doctor] Um. So, uh, I mean it's obviously the first time you've had such a bad headache. And you said you'd had some altered light in front of your eyes as well?
[patient] Yeah.
[doctor] But you haven't had a high temperature. Have you checked your temperature?
[patient] Uh, no I didn't, I don't really feel, feverish or anything.
[doctor] OK. Um, I mean it, it, it could possibly be a migraine type headache.
[doctor] But, the fact it's still ongoing for three days, we probably should, book you into an appointment to get an examination.
[doctor] Um, obviously , if it settles, in the meantime then, we can cancel that. But we should do a neurological examination, look at the back of your eyes as well.
[patient] OK.
[doctor] Um, in terms of medication, I can prescribe you something, similar to Ibuprofen, but a bit stronger which you can take instead of Ibuprofen. And you can also take Paracetamol at the same time.
[patient] OK.
[doctor] So if you're happy to book a, , appointment with us, with the support line, for us to do a full examination.
[doctor] And start, the medication which I prescribe to you, take it with food.
[doctor] If, if you're, you said that when you go to bed your headache's, OK, and not waking you up in the night-time.
[patient] Yeah it's not, um but, you mentioned migraine and that um, reminded that, my mum, suffers from, like she has migraines, um.
[doctor] OK. Any other family history of medical problems?
[patient] Um, no I think that's it, but I know that my mum like, she has quite bad migraines, she's like, has the vomiting and everything, .
[doctor] OK that's fine. Um, I mean if, if in the meantime before your appointment your, headache is getting unbearable, getting worse or changing. Then , um, if it's that bad, then you should go to A and E and have an examination.
[doctor] Um, , you can call us for further advice on that.
[patient] OK.
[patient] Mm-hmm, OK.
[doctor] And when, when you have a, an examination with us, we'll check your blood pressure as well.
[doctor] Just to, make sure your pill's still appropriate for you, because sometimes if we, if we do think it's a migraine, then you would have to change your pill. If you've had these flashing lights, and things like that.
[patient] OK, .
[patient] Is there anything in the pill that can cause it? Or is it?
[doctor] Well , some , so that pill if you were having , regular migraines with um, flashing lights, or , other symptoms. It wouldn't be suitable to stay on that pill, particularly, we'd have to change it to something else.
[patient] All right.
[doctor] But you can carry on with that for the moment.
[patient] OK.
[doctor] Have you got any other questions?
[patient] Um, so will you like, um, send me a referral to a specialist, or do I have to to confirm?
[doctor] Uh.
[doctor] Yeah, if you book an appointment with the support team, then we can do a full examination then.
[patient] OK. Perfect.
[doctor] All right then. Take care.
[patient] Thank you very much.
[doctor] Bye.

Medical orders:
description: Paracetamol take it with food.
order_type: medication
reason: could possibly be a migraine type headache.