[doctor] hi , vincent . how are you ?
[patient] i'm good . how about you ?
[doctor] i'm good . so le- are you ready to get started ?
[patient] i am .
[doctor] okay . vincent is a 56-year-old male here with abnormal lab findings . so , i've heard you were in the er , vincent , and they found that you had a low hemoglobin .
[patient] yup .
[doctor] were you having some dizziness and some lightheadedness ?
[patient] i was very lightheaded . i- i do n't know . very lightheaded .
[doctor] okay . and have you noticed bleeding from anywhere ?
[patient] i have not . i have n't hurt myself in quite a while . maybe a slight nick from a knife while chopping some onions , but nothing more than that .
[doctor] but no blood in your stools or-
[patient] no .
[doctor] . anything like that ?
[patient] no .
[doctor] okay . and any type of weight loss or decreased appetite or night sweats ? coughs ?
[patient] uh , s- slightly decreased appetite , but i wish i had some weight loss .
[doctor] um , okay . and how about any abdominal pain ? fever , chills ?
[patient] uh , none of that .
[doctor] okay . all right . um , any nausea or vomiting ?
[patient] not really . yeah . maybe a bit of nausea .
[doctor] okay .
[patient] i- sitting at the back of a car , that makes me nauseous at times .
[doctor] okay . all right . um , well , how are you doing in terms of your knee replacement . i know you had that done last year . that's going okay ?
[patient] mm , it seems okay . yeah .
[doctor] okay . you're walking around without a problem ?
[patient] yup , yup . just not good enough to run yet , but everything else works just fine .
[doctor] all right .
um , and i know a few years ago , you had , had that scare with the possible lung cancer , but then they did the biopsy and , and you've been fine .
[patient] yup , yup . all good .
[doctor] turned out to be benign .
[patient] yup .
[doctor] okay . great . all right . well , let's go ahead and do a quick physical exam . so looking at you , you do n't appear in any distress . your heart is regular . your lungs sound nice and clear . you have some tenderness to the right lower quadrant to palpation of your abdomen . your lower extremities have no edema .
[doctor] um , all right . well , let's go ahead and look at your labs , okay ?
[patient] yup .
[doctor] hey , dragon , show me the hemoglobin . yeah , so your hemoglobin is 8.2 , which is quite low for somebody of your height and weight , so we'll have to look into that a , a little bit further . i know that they did the endoscopy in the emergency room . hey , dragon , show me the endoscope results .
[doctor] good . so it looks like you had some gastritis , which is just inflammation of your stomach and they also found a slight polyp , which i know that they biopsied and the results are pending at this time . um , so , you may have had some bleeding from the gastritis . it's not usual for people to have bleeding from that .
[doctor] um , okay , well , hey , dragon , show me the anemia panel . okay .
[doctor] anyway , okay . well , vincent , i think , you know , in terms of , my impression of you is that you've had this newfound anemia and for that , i think that we should go ahead and put you on protonix , 40 milligrams , once a day to help with the gastritis . does that sound okay to you ?
[patient] it does . you're the doctor . i do n't know what it is .
[doctor] so that's just , uh , what we call a proton pump inhibitor which , uh , helps decrease the amount of acid secreted within your stomach .
[patient] got it . makes sense .
[doctor] hey , hey , dragon , order protonix , 40 milligrams , once a day .
[doctor] and i'd like you to try to cut down on your caffeine 'cause that can also irritate your stomach . try not to take any ibuprofen and try to cut down on any alcohol intake , okay ?
[patient] yup , yup . the coffee's the hard part .
[doctor] yeah . it always is . how about one , one , one eight-ounce cup a day ? okay ?
[patient] sure .
[doctor] um , and we'll go ahead and we'll see you in a couple weeks , okay ?
[patient] sure thing .
[doctor] i'm going through , uh , i'll also order another , uh , cbc on you . hey , dragon , order a complete blood count .
[doctor] all right . the nurse will be in soon . it's , you know , settle all that . i'll see you soon .
[patient] see you .
[doctor] hey , dragon , finalize the note .


Medical orders:
description: protonix 40 milligrams once a day
order_type: medication
reason: gastritis
description: complete blood count blood
order_type: lab
reason: anemia