[doctor] hi ms. hernandez , dr. fisher , how are you ?
[patient] hi dr. fisher . i'm doing okay except for my elbow here .
[doctor] all right . so it's your right elbow ?
[patient] it's my right elbow , yes .
[doctor] okay . hey dragon , ms. hernandez is a 48-year-old female here for a right elbow . so , tell me what happened .
[patient] well , i was , um , moving to a new home-
[doctor] okay .
[patient] and i was , um , moving boxes from the truck into the house and i lifted a box up and then i felt like this popping-
[doctor] hmm .
[patient] and this strain as i was lifting it up onto the shelf .
[doctor] okay . and when- when did this happen ?
[patient] this was just yesterday .
[doctor] all right . and have you tried anything for it ? i mean ...
[patient] i put ice on it . and i've been taking ibuprofen , but it still hurts at lot .
[doctor] okay , what makes it better or worse ?
[patient] the ice , when i have it on , is better .
[doctor] okay .
[patient] but , um , as soon as , you know , i take it off then it starts throbbing and hurting again .
[doctor] all right . uh , let's review your past medical history . uh ... looks like you've got a history of anaphylaxis , is that correct ?
[patient] yes . yes , i do . yeah .
[doctor] do you take any medications for it ?
[patient] um , ep- ... just an epipen .
[doctor] just epipen for anaphylaxis when you need it . um , and what surgeries have you had before ?
[patient] yeah , so carotid . yeah-
[doctor] . yeah , no , uh , your , uh , neck surgery .
all right . well let's , uh , examine you here for a second .
so it's your , uh , this elbow right here ?
[patient] yeah .
[doctor] and is it hurt- ... tender right around that area ?
[patient] yes , it is .
[doctor] okay . can you flex it or can you bend it ?
[patient] it hurts when i do that , yeah .
[doctor] all right . and go ahead and straighten out as much as you can .
[patient] that's about it .
[doctor] all right .
[patient] yeah .
[doctor] so there's some swelling there . and how about , uh , can you move your fingers okay ? does that hurt ?
[patient] no , that's fine .
[doctor] how about right over here ?
[patient] uh , no that's fine . yeah .
[doctor] okay . so on exam you've got some tenderness over your lateral epicondyle . uh , you have some swelling there and some redness . uh , you have some pain with flexion , extension of your elbow as well . uh , and you have some pain on the dorsal aspect of your- of your forearm as well . okay ? so let's look at your x-rays . hey dragon , show me the x-rays . all right . your x-ray of your elbow-
it looks like , i mean , the bones are lined up properly . there's no fracture-
[doctor] . it , uh , there's a little bit of swelling there on the lateral elbow but i do n't see any fracture , so that's good . so , looking at the x-ray and looking at your exam , uh , my diagnosis here would be lateral epicondylitis , and this is basically inflammation of this area where this tendon in- inserts . and probably that happened when you were moving those boxes . so we'll try some motrin , uh , about 800 milligrams every six hours . uh , i'll give you a sling for comfort , just so you can use it if- if it's causing a lot of pain .
[patient] hmm .
[doctor] and it should get better , uh , in about , you know , in a couple of days it should be improved . and if it does n't get better , give us a call and we'll see you some time next week . okay ? so we'll give you a sling , we'll give you the motrin , i'll give you about , uh , 30 , uh , uh , 30 , uh , uh , medications for that . uh , do you have any questions ?
[patient] no , no . thank you .
[doctor] hey dragon , order the medications and the procedures . all right , why do n't you come with me and we'll get you signed out ?
[patient] okay , sounds good .
[doctor] hey dragon , finalize the report .

Medical orders:
description: motrin 800 milligrams every six hours 30
order_type: medication
reason: right lateral epicondylitis