Split (2)

train · 244 rows

audio stringlengths 34 34	text stringlengths 4.37k 12.6k
dataset\resampled_file\RES0121.wav	D: What brings you here today? P: Yeah hi, I've had this cough, um, for the past four days and it just can't, it won't go away. So, I was just wondering if, you know, I can get something for it. D: Okay, so uh, so you've been having the cough for four days. Can you describe the cough a little bit? Is it like a dry cough or wet cough? P: Uh, it's dry. D: It's dry, okay. Um, are you coughing up blood at all? P: No, no blood. D: Okay, are you bringing up any, although you're not coughing, are you bringing up any kind of sputum? P: No, no, it's, it's pretty, it's pretty dry. D: Okay. Um, and any other symptoms at all, besides the cough? P: No, nothing else. D: Okay, and have you been sick at all recently with fever, chills, runny nose, um any cold like symptoms? P: Um, you know, a week back I had a runny nose. Um, and sometimes like a stuffy nose, but that went away. D: Okay. Um, and after that, did you have any fevers at all? P: No. D: Okay, and has this happened to you before at all? Like a cough lasting more than four days? P: Yeah, it's happened to me in the past. Um, yeah it, yeah it has. Um, but it's just more bothersome this time cause I'm coughing a lot more. D: Okay, and is there anything that you've tried that has helped you relieve the cough at all? P: I tried some over-the-counter cough suppressants. Uh, they don't seem to be working too well. D: I see, and anything that's making your cough worse at all? No? P: No. D: Do you have any other symptoms, like a sore throat, runny nose, headache, anything like that? P: No, nothing like that. D: Okay. Have you been around anyone that's sick recently? P: No. D: No. Um, have you had any, um have you traveled at all outside of the province or country at all recently? P: Nope, not outside the province. D: Okay, and other than that, are you having any symptoms of, kind of, muscle aches uh, or anything like that? P: Uh no, no muscle aches. Um, nothing else that I can think of. D: Okay, any shortness of breath? P: No, no shortness of breath. D: Is the cough like constant, goes on throughout the day, or is there a time that it's worse? P: Uh, it's pretty, it's pretty constant. D: Okay. And do you have any kind of um increased tired, like getting more tired or fatigued? P: Um, no. D: Um, any kind of chest pain or feeling that your heart is racing? P: Um no, nothing like that. D: Okay, any changes in your bowel movements? Any constipation or diarrhea? P: No. D: Okay, any um nausea or vomiting? P: Um nope, nothing like that. D: Okay, um, any kind of uh, changes in your sleep or appetite? P: Uh, no. D: And um, have you lost any significant weight recently? P: No. D: No, okay. Um, otherwise, are you healthy? Do you have any medical conditions at all? P: Uh, no I don't, I'm otherwise healthy. D: Otherwise healthy, okay. Any allergies to any medications? P: No. D: Any allergies to any environmental, or any environmental factors? P: No. D: Okay. Um, any family history of any medical conditions related to the heart, lungs, any cancers at all? P: Uh no, nothing like that. D: Okay, alright. Um, are you, so, what, what is your living situation like right now? P: I live in um, an apartment by myself, I'm a student. D: Okay. Um, and are you working at all or are you a student seeming? P: Um, I work part time. I work as a barista. D: Okay, and anyone, anyone in your work environment, or uh in your home environment, or at school that has been sick around you? P: Not that I've heard of, no. D: Okay. Um, and other than that, do you smoke at all? P: Um, no I, well, I used to smoke before. I stopped last year. D: Last year, okay. And how long did you smoke for? P: I smoked just a couple, like two years. D: Okay, yeah. So congratulations, that's a really great thing to do, especially like right now, with the pandemic going on and everything it's, earlier you stop, it's really good. P: Thank you. D: Besides uh, like smoking, um do you use any recreational drugs like marijuana? P: No. D: No, okay. And how about alcohol? P: Nope, I don't drink too much alcohol. I drink like over the Holidays. D: Okay. And I forgot to ask you this earlier, but any hospitalization or surgeries in the past? P: No, nothing like that. D: Nothing like that, okay. Those are all the questions, um, I have for you. Do you have any questions or concerns? P: Um, yeah, what should I do about this cough? D: Yeah, so this cough, um, it's been going on for the last four days. Since you do have a cough, um and right now that, like, is considered a symptom, like, like a potential symptom for COVID, we definitely want to do a COVID swab test for you, which will come back in 24 hours to 48 hours. You should still try and isolate as much as you can away from any roommates, or family members for the next, so, 14 days since you first experienced the, the cough. P: Okay. D: Based on, like, public health will call you as well so you can follow their instructions. And if, it can be anything else too, like, with a cough, there can be multiple things going on. You can have um, like an upper respiratory, viral, or bacterial infection. But since you're not having too many other symptoms right now, it can just be bronchitis. Um, this is something that we'll try and keep an eye on and make sure it's nothing else like, uh pneumonia, for example. But right now, yeah, we'll get that testing done and then just, kind of wait and watch. P: Sure, yeah. Thank you. D: You're welcome, take care. P: You too.
dataset\resampled_file\RES0124.wav	D: Um, what brings you in today? P: Uh yeah, hi, I just came in here today cause uh, lately, for the last couple of months, I've been getting these coughing fits. They don't really seem to be going away and I was a bit concerned. D: So you've had this, when did this start? P: Uh, I would say probably during the winter uh it, it kind of started, where I started having um, just coughing fits when I'm walking to school and then also during like gym class I started having these coughing fits and sometimes I also felt like I couldn't breathe. D: Um, okay. Okay, what did you, is there anything, so it's basically worse when you're um, doing some sort of an exercise such as walking um, or being in the gym class, and it's also worse in the cold? P: Yeah. Yeah, and then also like, I remember when I was walking down the street and someone was smoking and then I just completely just started having that episode right after I walked past them. D: Okay um, alright. Uh um okay, sorry, one moment. Okay um, so is there anything that makes your cough better? What do you do to make it go away? P: Uh, I just basically have to, if I, if I'm doing any kind of activities, just take a moment, sit down for like 10 to 15 minutes and then it seems like it goes away on its own. D: And you said that sometimes you also have difficulties breathing with it? P: Yeah, like a couple of times it got really bad where I had to um like, it was difficult get, it was, it was like I was trying to take deep breaths for air, but uh it was, it just felt like I couldn't. D: I see. So this started a couple of months ago, has this ever happened to you before that? P: No, before that I've been fine. D: Okay, and so I'm going to ask you about a couple other symptoms. Let me know if you've experienced any of these in the past couple of months. Um, so have you had a headache that accompanies the cough? P: Uh no. D: Um, any changes in your vision or your hearing? P: No. D: Any confusion? P: No. D: Um any, um, runny nose or stuffy nose or sinus congestion? P: Uh no, not really. D: Okay, any sore throat? P: Uh no. D: Any um, chest pain? P: Um, sometimes when I get like really bad coughing fits, like it sometimes starts hurting in my chest as well. D: Yeah. Um, does it go away when you stop coughing? P: Yeah, it goes away after, I just take some rest. D: Um, have you had any belly pain? P: Uh no, not at all. D: Do you feel like your heart's racing? P: Uh, no. D: Any changes in your, any nausea or vomiting? P: No. D: Any changes in your bowel movements? P: No. D: Any acid reflux? P: Uh, no. D: Okay, um, and any certain muscle aches or joint pains? P: Um no, nothing like that. D: Any numbness or tingling in your arms or legs? P: No. D: Okay, let's get back. Okay, great, it sounds like that the, the cough is sort of the main symptom here that you have. Um, is the cough dry or wet? P: It's usually uh, it's usually dry. D: Uh sorry, can you say that again? P: It's usually dry. D: Okay um, have you ever brought up any sputum or any blood? P: Uh never any blood, I have like on occasion, like sometimes brought up some sputum. D: Okay, alright. Um okay, and, uh, have you been vaccinated? P: Uh, yeah, all my immunizations are up to date. D: Okay, good good good. Um, does the cough sound like a barky cough or a muffled cough, or um, does it have a specific characteristic? Does it sound different than when you're sort of coughing to clear your throat, for instance? P: Uh yeah, it's like pretty, it can get pretty harsh. I also noticed like uh, there's like this weird noise I started making like right after when I'm trying to take deep breaths in. D: Okay, okay. Okay, so you're wheezing. Okay, so you ever um, cough so much that you end up vomiting? P: No, no that hasn't happen yet. D: Um, and do you, so you mentioned that it's worse when you're in the cold or exercising, and smoking makes it worse? What about things like dust or pollen? Um, say when you're cleaning the house and there's also dust, does that make things worse, or is it worse in a specific time of the year when you're outdoors? P: Uh, now that you mention it, yeah, like if we're ever in the basement or anything like that, I, I do start getting like kind of irritation um, in my throat, and that kind of, sometimes I have also coughed at those times. D: Alright. Uh, can you tell me, okay so, can you tell me if you have any medical conditions that you've been diagnosed with? P: No, nothing else, I've been pretty healthy. D: Okay. Had, did, when you were a child, did you have any sort of rash? Did you have eczema? P: Oh I, yeah, so I did I, at one point I was using like this cream um, probably when I was ten. Just for some eczema on my hands. D: Okay. And um, have you ever had allergic rhinitis, which is basically sort of having um, red or teary eyes, itchiness on the face, a runny nose at certain times of the year, or in um, areas with mold or dust, or termites and things like that? Have you had anything like that as a child or right now? P: Uh, not that I know of, no. D: Okay. Alright, uh do you have any, um, I guess going back, were you a healthy child, growing up? P: Yeah, as far as I know, I, I didn't really have any concerns from like the school or home at all. D: Okay, that's great. Do you uh, did you ever have any hospitalizations? P: No. D: Any surgeries? P: No. D: Are you taking any medications? P: Uh, no medications. D: Are you still using the eczema cream? P: No, no. That kind of just went away on its own, or like right after I used the cream. Like it's good now. D: Okay, good. Are you allergic to anything? P: No, I don't think so. Maybe just like environmental allergies sometimes, in the springtime. D: What happens then? P: Um, just sometimes like uh, I don't know if it's like a pollen allergy like I, I do get some, I guess I do get like some nasal congestion and things like that. D: Um, have you ever seen an allergist? P: No, I haven't. D: No. Uh, who prescribed the cream for the eczema? P: Um, just a, it was like at a walk-in clinic. D: Okay, okay. Um alright, and do you have any family history of any um, lung-related problems? Or any other problems? P: Um, my older sister has asthma, and uh, I don't know if anyone else in the family has asthma. Um, I think my father has high blood pressure. D: Alright, and you mentioned that things are going well at school. Um, who do you live with at home? P: Yeah so I live with my older sister, and my mom and dad. D: Okay, okay. And things are good at home? Do you feel safe? P: Yeah, yeah, I feel completely safe. D: Any concerns about bullying at school? P: No, no, not at all. D: Okay are you uh, are you taking any marijuana or any street drugs? P: No, no, my parents would kill me. D: What about alcohol? P: Uh, I'll come, I've, I haven't tried it um, yet, at all. D: Okay, okay. Just wanted to mention that the conversation that we're having right now is confidential between you and me. Um, unless you mentioned anything that harms you or harms anyone else so, so feel free to discuss whatever or talk openly about um, any issues that you have. Um, okay, and um, are you sexually active? P: No, no. D: Alright, okay. So um, that's all the information I needed. Uh given that you've had these coughing fits for the past couple of months that are, that have certain triggers, uh, and also given that you've had a history of eczema, and your sister has asthma, so kind of, sort of runs in your family in a way. You might also have a diagnosis of asthma potentially. Um, and so, what I would recommend is that you get um, testing done and um, uh I guess before I sort of talk a little more about this, I just want to get a sense of how severe your asthma, if it's asthma at all, um if, does it, does it affect your ability to, you said school was going okay, does it affect your ability to do well at school at all? P: Um definitely in, in gym class, but other than that it hasn't really affected me. D: Does it wake you up at night? P: No, so far no. I, I like, I get pretty good sleep. D: Okay, okay. Um, and how often, I guess is, do these episodes occur? How many times a week, or how many times a month? P: Uh, so they just started like two months ago, and I've had like maybe four or five of them in total. D: Okay, okay. Uh, and they kind of get better on their own. Okay, so we can sort of talk about these, sorry, puffers that you might need to, to use as needed. Um, your sister might have some of those, so you might be familiar with what I'm talking about. P: Yeah. D: Um, so we can talk about that. Um, given that your symptoms are, yes, they've been occurring for the past couple of months, but because you have had a cough, it might be a good idea just to have a COVID test done once. Um, I don't think that's what you have, seeing that this, these symptoms have been lasting for, have been occurring for the past two months, so we'll just kind of do that test to rule it out. Um, in the meantime, I would recommend that you um, try this inhaled corticosteroid puffer that you can use, that you should use on a daily basis, and try to avoid uh, the triggers. So the things that you, that cause these symptoms. Um, we can go over how to use uh, a puffer properly and I will also give you a spacer, which will help deliver most of that medication in the, uh, to your lungs. Do you have any questions? P: Uh no, I don't have any questions at all. Thank you so much.
dataset\resampled_file\RES0006.wav	D: What brings you in to see us? P: So I've just been having this cough that I feel has just been getting worse, and I've also been feeling a bit short of breath for the last few months. D: OK, could you tell me when the cough started? P: So I would say it started around two months ago. D: OK, and has the cough been dry or have you been bringing up sputum? P: Uh, it's usually always, uh, produces like the sputum, and it's usually white or yellowish in colour. D: OK, and how much sputum are you producing each day? Some, sometimes it's useful to think about like teaspoons or tablespoons. P: I would say every time I cough like a teaspoon I probably have like. I don't know. Maybe 5 to 10 teaspoons a day. D: Uh OK, and is there any particular time of day that the cough is worse? P: Um, not really. It's pretty, pretty much the same. Sometimes it is worse in the morning. Yeah, and sometimes it gets better when I go out for a smoke. D: OK um. And have you noticed any blood? P: No, um I haven't noticed any blood. D: OK, and have you had, so you had shortness of breath, when did that start? P: It's around two months ago, around the same time. D: OK, And. Is this? Do you have shortness of breath at rest or is it when you exert yourself? P: Uh, it's it can happen like at anytime, but worse when I am exerting myself. D: OK and then have you had a cough before? P: Uh. Not as frequently. I would say not really, it just started in the last two to three months. D: OK, and have you had shortness of breath like this before? P: Just throughout my life I've had asthma so when I am exercising too much or get exposed to like dust, sometimes get shortness of breath. D: OK. Has there been anything, um besides exerting yourself, that's made that either the cough or or shortness of breath worse? P: Uh, over the last year like I've had a couple of chest infections. After going to the ER, they gave me some antibiotics. But yeah, when that happens it usually gets worse. The shortness of breath and the cough. D: OK, and uh, do your symptoms feel like any of those times right now? P: No, I I don't feel like I have a fever and no other symptoms, just the shortness of breath and cough. D: OK, and have you been doing anything that's made it better? P: I've been taking some Tylenol Cold, hasn't really helped too much. I've tried my inhalers, they sometimes help, but I've never had have this frequent of coughing and shortness of breath before. D: OK, um, and how has your energy been? Have you been experiencing fatigue? P: Um, when it gets really bad then I can't really step out of the house, but other than that I feel like my energy's still there. D: OK and you have it, have you had any fevers or chills? P: No. D: OK, how about at a loss of smell? P: No. D: Um a loss of taste? P: Nope. D: OK, and have you had any chest pain? P: No, just sometimes when I'm like coughing a lot it gets a little bit uncomfortable. But other than that, no. D: OK, um have you had any instances where you felt like your heart was racing? P: No. D: OK, how about being lightheaded or or like you were going to pass out? P: No. D: OK, have you had a runny nose or or a sore throat? P: Nope. D: OK, and how about headaches? P: No headaches. D: Alright, and have you had any wheezing? P: Um, sometimes I've noticed it, but I had it before. Like with asthma as well, but not not that much. D: OK, and how about abdominal pain? P: No abdominal pain. D: Alright, then any urinary problems? P: Nope. D: Any bowel problems? P: No. D: Any rashes? P: Nope. D: OK, and then how about any muscle aches or or joint aches or or body aches? P: No, nothing like that. D: Alright. And you mentioned asthma, but have you been diagnosed with any other medical conditions? P: No, just asthma. D: OK, and do you use inhalers? Are there any other medications you're currently using? P: Oh no, just the salbutamol and like the steroid inhaler. D: OK, yeah, and how often are you using both of those? P: So the steroid one I am using pretty much every day but the salbutamol I found I've been using a lot more recently. I would say probably at least six to 10 times in a week. D: OK, um that reminded me I I forgot to ask. Have you notice any changes to your voice? P: Um no, not really. D: OK um. And I was wondering if you had any allergies to medications? P: No, not that I know of. D: Alright, and have you been in the hospital recently? P: No. D: Alright, so when was the last time that you had antibiotics? P: I would say like six months ago. D: OK and any surgeries? P: Nope. D: OK, and did you get the flu shot this year? P: Yep. D: OK, great um and I was wondering if you could tell me a little bit about your living situation. P: So I live in London um in a small apartment with my wife. D: OK, do you have any pets around? P: No, no pets. D: Alright, and um, any exposures at work too, like dust or any types of like chemicals like that. P: No, not really. My work is pretty much a desk job, so nothing like that. D: OK, and do you smoke cigarettes? P: Yeah yeah, I smoke a lot of cigarettes just like I would say 30 cigarettes a day. D: OK, and how long have you smoked for? P: I'd say, probably at least 25 years. D: OK and sorry, could you remind me of your your age again? P: So I am 60 years old now. D: OK, so you started smoking um around 35. P: Yeah yeah. D: OK. Have you tried to quit? P: Yeah, tried to quit. I've even quite a couple times but then just got back onto it. Yeah, not not really ready to quit. D: OK. That's fair enough. If there's something that you wanted to talk about quitting smoking at another appointment, we can arrange follow up for that. P: Alright D: Do you drink alcohol? P: Not much, just out say one or two beers on the weekend. D: Alright, and you use any recreational drugs like cocaine, crystal meth, or IV drugs. P: No, nothing like that. D: Alright, and has anything similar like this happened in your family before? P: Uh, I think my um sister has a COPD, like she smokes a lot too. But that's that's about, I don't know if that's genetic. D: Oh OK, um I. So I mean anybody in the family have cancers? P: Um no, not that I know of. D: Alright um so, that that was all the questions that I wanted to ask on history. Was there any, uh, any other questions that you had? P: No, not really. Just wanted to get to the bottom of this. D: OK for sure so um we will run some investigations and likely get a chest X Ray because it's been a couple of months that these symptoms have been going on for. But I think it could be related to your smoking and most likely um Bronc, chronic bronchitis, but we can definitely will be looking into this, and then also with possibly some pulmonary function tests as well. P: OK, sounds good.
dataset\resampled_file\RES0065.wav	D: So what brings you into the family clinic today? P: Yeah, I've had this sore throat for the past three days and it doesn't seem to be getting any better at all. I feel sort of feverish so. I just thought I should come in and get this checked out. D: OK, and when did you start having this sore throat? P: Three days ago. D: OK, and how about the fever? P: The fever I noticed maybe a day back. D: OK, and did you get any temperature measurements? P: I didn't take any myself. But I felt hot, and I felt chills. D: OK, and have your sore throat or fever gone worse at all? P: I think it's getting worse, yeah. D: And does it usually happen during the day, throughout the night or does it have any sort of pattern? P: I would say that it doesn't really have a pattern. The sore throat is always there and the fever started a day back and it seems to break sometimes, but right now there is no real pattern to it. D: OK. And besides that, do you have any cough? P: No, no cough. D: OK, and have you tried anything that has helped you at all? P: I tried just like those Lozenges and seems to be helping just soothe my throat, but it's a temporary relief. D: OK. And have you had anything like this happen to you before? P: No, nothing like this. D: And is the sore throat constant? Or does it come and go? P: I would say it's pretty constant now. D: OK. And have you been around anyone that has been sick recently? P: Not that I know of. D: Anything that makes your sore throat worse? P: I guess swallowing foods makes it worse, or at least it's painful. D: OK. And have you at all noticed any like swelling around your neck region, like swelling of your lymph nodes? P: So yeah, not swelling of my entire neck, but I have felt some lumps in my neck. D: OK, and how about any swelling anywhere else on your body? P: Nowhere else. D: OK, have you noticed any kind of skin changes like rashes or anything like that? P: No. D: OK. And have you traveled at all recently? P: No, nowhere. D: OK, do you have any headaches or nausea or vomiting? P: No, nothing like that. D: OK, and any night sweats. P: No. D: And do you feel fatigued like increased tiredness at all? P: Umm, yeah, I've been feeling really tired. D: OK, any chest pain or feeling that your heart is racing? P: No, nothing like that. D: OK. Any issues with bowel movements, like any diarrhea or constipation? P No, no, that's been normal. D: OK, any changes in your urination? P: No, no changes. D: Have you been getting sleep at night or do you have to keep waking up? P: Um, I've been getting OK, I sleep like, I've been sleeping about 7 to 8 hours. D: OK. And how about your appetite? P: I would say that's been OK as well, it's just hard to eat a lot of food because of this sore throat. D: And is it just with solids or do you get the soreness with liquids too? P: I would say mostly with solids, sometimes with liquid. If it's like really cold or something. D: OK. Do you have any kind of allergies to anything in your house like carpets, pets or anything like that? P: No. D: OK, have you had any recent infections like a cold? P: No. D: No, OK. And do you have any past medical conditions? P: Um, I have Crohn's disease. D: And when did you get diagnosed with Crohn's? P: That would have been last year. D: Last year, OK. And are you taking any medications for your Crohn's disease? P: I am on something for it, I think it's Sulfasalazine or something like that. D: OK. And any other medications besides that? P: Uhm, no, I don't think so. D: Any previous hospitalizations or surgeries? P: Um, I had a colonoscopy done. I just needed hospitalization for just the day I guess. D: OK, and when was that? P: That was also last year. D: Last year, OK. And do you have any family history of any conditions that run in the family? Like do you have any Crohn's disease or Ulcerative Colitis that run in the family? P: Yeah, both do. D: Both do, OK. Any anything else that runs in the family? P: Uhm, I know there's some asthma and eczema that run in the family too. D: OK. And you mentioned you haven't been around anyone that was sick or recently got sick? P: No. D: OK. And where do you currently live? P: I live in an apartment by myself. Sorry, not by myself, with my parents and my younger brother. D: And do you at all drink alcohol? P: No, I drank once or twice in the past, but I didn't like it. It makes my Crohn's worse so I stay away from it. D: OK, and do you smoke cigarettes? P: No. D: And how about any other drugs like marijuana? P: No. D: OK. Alright, so do you partake in any like sports or activities or anything like that? P: Um, I swim. D: OK, any contact sports? P: No. D: OK. Alright, so yeah, overall it seems that you had this sore throat which is constant, getting worse and a bit of a fever in th last one or two days and you've also had swelling in your neck and so yeah, do you have any other questions or concerns? P: No, like what do you think I have? Do you think it's COVID? D: Yeah, so definitely at this time, you know whenever people have any respiratory symptoms we always want to rule out COVID. So will definitely get a swab for COVID testing done for you today which should come back within 24 to 48 hours and in the meantime you should self isolate. And other than that, it can also be, due to this swelling in your lymph nodes and also just the other symptoms, it can be other viral infections. It can be mono so we definitely have to do a couple of tests, and there's one test that will do for mono as well which is called EBV antibody testing. So we'll do a couple of these tests today and then see what what comes back. And in the meantime you should definitely self isolate if you haven't been doing so already. P: OK, sure I can do that. D: Yeah, do you have any questions? P: No, that sounds good. Thank you so much. D: You're welcome. Take care. P: You too.
dataset\resampled_file\RES0044.wav	D: What brings you in? P: Um I just uh I have, I have a cough that I've had for a couple of days and like normally if I had a cough or cold, I would just like stay home and rest, but just because you know there's like Covid I I wanted to make sure, like I wanted to get checked out. D: Yeah, of course that that was a great idea. Thanks for coming in. Um how long have you had this cough for? P: Uh it's like 2 days. Like maybe three days ago, I started to feel like my throat was dry and I was like, oh, maybe I need to drink more water or something and then the next day I started like actually coughing. D: OK, is it a dry cough or a wet cough? P: Yeah it's really dry. D: Really dry, OK. So no sputum, no blood that you're bringing up? P: No, nothing like that. It's just kind of annoying. D: Yeah, um do you have any wheeziness associated with your coughing? P: I don't think so. D: No, OK. No shortness of breath? P: No, no, I've been, I feel like I've been tired, but I don't think it's been actually hard to breathe. I just feel overall like really tired. D: OK, OK, and have you tried anything for the cough, like um over the counter cough syrup or anything like that? P: Uh like I have, I've just been drinking tea and just like tea with honey just to like make it feel better. I I didn't like take any medicine. D: OK, and do you, have you noticed that there are any triggers for your cough, like the cold, or dust, or any like environmental triggers? P: I mean, I've been, just because of Covid and stuff, I've been staying home ever since I had it. Uh so, I don't, I can't think of anything, but I don't think so. D: OK, and do you find that it's constantly there or um is it worse during a particular time of day, like morning, afternoon, or evening? P: It's kind of just been there all the time right now. D: OK, and um is it getting worse, do you think? P: I think so. I think like today is worse than yesterday, and the day before that, it just felt like dry and then and then like the next day I started coughing, so yeah. D: OK, and have you ever experienced anything like this in the past? P: I mean, I've had coughs before, um this one feels like particularly dry, but uh like it, it's not too different than like when I'm just like, like had a cough in other years. D: OK, OK. Um and you mentioned that your throat was also dry. Do you have a sore throat? P: Maybe a little bit this morning, yeah, like at first it just felt dry like I was thinking like, oh it's like you know I need to take a sip of water or something and now it just feels, now it's starting to think, I feel a little bit sore, I think. D: OK, um is it hard for you to swallow foods or fluids? P: Oh sorry, could you repeat that? I just missed the last part. D: Oh no worries. Is it hard for you to swallow food or fluids? P: Uh no, it's not hard. It's not hard to swallow things. D: OK um, and then have you had a runny nose or a stuffy nose? P: No, not particularly. D: No, OK. How about any changes to your hearing or vision? P: No. D: No, how about changes in smell or taste? P: Uh, no, that's like a Covid thing, right? Like I was hoping because I could still, I could still like taste my coffee this morning, I was hoping that that means I don't have Covid, but yeah, I don't really know. D: I mean yeah, some people have it, some people don't. Um I guess people with Covid present in different ways, yeah yeah, do you have a fever at all? P: Um like when I came in here, when the nurse took my temperature, she said I had um, like she said I had a fever. Uh I don't have a thermometer at home, um but like I've been feeling really hot so would probably, I've probably been having it for a couple of days. D: OK, OK, we can take, yeah we can take your temperature. Sorry, did you say you already took your temperature today and? P: The nurse took it, yeah, I don't know what it was, but the nurse kept coming in and she said it was a little high like I don't know if it was like a fever but I've been feeling hot, so. D: OK OK yeah so yeah we'll double check to make sure that um you either do or don't have a fever. Um have you experienced any chills or night sweats over the past few days? P: Uh, no. D: No, OK. OK, how about um any weight loss? P: No, like I don't weigh myself regularly, but I don't think so. D: OK, um any changes to your hair or uh nails or skin, like rashes? P: Uh no. D: No, OK. How about um chest pain? P: Uh, no. D: No chest pain, OK. Um swelling in your limbs? P: Uh, no. D: No, do you ever feel like your heart's racing? P: Uh, no. D: No, OK. Um how about um, how about any dizziness or or fainting spells? P: Um, no, like I've been just tired. D: Just tired, OK. P: Yeah I don't, I don't, I haven't fainted or anything. D: OK, any headaches? P: No. D: No, OK. Uh how about confusion or memory loss? P: Um, no, I don't think so. D: OK, um any changes to your bowel habits? P: Um, no. D: No, OK. So no constipation or diarrhea or blood in your stool? P: Yeah, exactly. D: OK, any changes to your urine? P: No. D: OK. Any nausea or vomiting? P: No. D: No, OK. And um no abdominal aches? P: No. D: No, OK. Um are you otherwise healthy? P: Um like I have um, I have uh Like some um Like digestive problems generally, like I haven't had any changes to that, but they think it might be like Crohn's or something. Um but other than that, no. D: Um you said you had digestive problems. Did you say it might be Crohn's? P: Yeah, like I, I've been seeing my family doctor and they they said they thought it might be, um but we don't really know, just like in general, I guess they've been calling it IBS. D: Oh, I see, OK. Um, OK. P: I wish I knew exactly, but they just said, yeah, they don't really know. D: OK. P: But there haven't been any changes right now. D: Oh yeah, I see, OK. Um have you ever had any hospitalizations or surgeries? P: No. D: No, OK. Um are you on any medications? P: No. D: OK, and how about um any allergies? P: Um, just uh pineapple, like not any medications or anything. D: Pineapple, OK. Um are you up to date with all your immunizations? P: Uh yeah yeah. D: OK. Um any family history of lung conditions or heart conditions? P: Um, like my my uncle had a heart attack. D: OK. P: I don't, like, not my parents. D: OK, I see. Um any cancers in the family? P: Uh, no. D: OK. Um and do you smoke? P: No. D: No, OK. How about marijuana? P: No. D: No, OK, um any other recreational drugs? P: Um no, no D: OK, how about alcohol? P: Uh, like I drink, I don't know maybe I'll drink like a bottle of wine on like a weekend, like over a whole weekend or something so like, I don't know maybe like 3 or 4 drinks over the weekend. D: Three or four drinks a weekend, OK. P: Yeah, something like that. D: Sure, OK. P: I'm not at all like. D: OK, so occasionally? P: Yeah. D: OK. And where do you live? P: Uh I live in town here. D: OK, do you live in a house, in an apartment? P: Um my fiancé and I live in a townhouse. D: In a townhouse, OK, um, any um concerns for like old carpets or mold or asbestos, anything like that? P: Uh no, it's like a new a new building. D: OK, OK, and do you think you may have been in contact with anyone who's been sick recently? P: Well, so um, I work uh in like, I work in an office that's attached to a factory um and I, so like I have to actually be there, I haven't been able to work from home. Um and there was someone else in my office that I think was coughing in that, like last week and I I don't know, I questioned it but I I didn't actually get to talk to them and ask them, or like I don't know if they were actually sick or something. So, I might have been, and we wear masks and everything, like we're really good, but I don't know, I feel like the offices aren't like super, like the air flow's not that great. D: Yeah. P: So yeah, I think that's another reason I was concerned, that I I feel like some people might have been sick and I didn't really know the whole story. D: Right, OK, so potentially, from from the workplace then, OK. P: Yeah. D: And, OK, um have you traveled anywhere recently? P: No. D: No, OK. Well those were all the questions that I had for you today, was there um anything that I missed that you wanted to discuss today? P: Uh not that I can think of. D: No, OK. So right now it seems like, if I'm going through my differential diagnosis list for you, at the top is, the thing that we have to rule out is Covid, so we'll take a swab and send it off for those PCR results and you'll hear back either tomorrow or the day after, about the results. But in the mean time, and I guess even if the test is negative, um and you're still having symptoms, please do isolate for 14 days. Um and if your symptoms get worse, um like you know, you're having trouble breathing, uh your fever, your temperature is off the charts, um or you're having any sort of neurological symptom, please do um go to the ER and seek out help. Um if it's not Covid, it could be another viral illness that's going around at, during this time of year, um, and usually the treatment for that kind of stuff is supportive, so make sure you're staying well hydrated, you're eating nutritious foods, uh you're getting good sleep. Um and if not, and your symptoms, you know you're having a productive cough, um you're really short of breath, uh we can test you to see if you have some sort of bacterial pneumonia, and those are usually treated with antibiotics, so that's kind of the plan right now. Um so we'll just start with that Covid swab for now. How does that sound? P: Yeah, that that sounds great. That's really what it, like, I I don't feel super sick, I just really wanna know if I have Covid or not. D: Yeah for sure and I, and I think it's good that you came in. P: Awesome. D: Alright, thank you. P: OK thanks.
dataset\resampled_file\RES0205.wav	D: I'm going to be having a chat with you today get an idea of how things are going and then I'll go over it with the opposition that I'm working with and we can come back together and talk to you about the next steps, that sound good to you? P: Yeah. D: I know that you've been having experiencing a cough. Can you tell me a little bit about that? P: Yeah, I um I've had this cough for the past two weeks and it just doesn't go. D: OK. have never had anything like this before? P: I’m I usually get a cold once a year or so. But the cough doesn't last this long, like it's usually over in a week or week and a half or so. D: Mm. And it's it's not letting up. P: Mm. D: OK um. I'm gonna ask you a few questions about the cough itself. Is this a dry cough that you're experiencing? Or are you producing like any any mucus or coughing up anything? P: There was some mucus um earlier on, but now it's it's all, it’s a dry cough. D: Now, it's dry OK how long, what was the timeline for that? I guess how long? P: Yeah, so maybe for the first four or five days there was this like whitish clear kind of mucus that was coming up and then after that was a a dry cough. D: OK, OK. And do you feel like the intensity of the cough got worse over the last two weeks, or has it gotten any better? P: Kind of the same, I would say. D: And has the cough gotten more frequent over this time as well? P: No. D: How often would you say that you're coughing? P: Uhm? It's hard for me to quantify, maybe a couple of times an hour, maybe three or four times an hour or so. D: Is there anything you can think of that triggers the cough, or is it spontaneous? P: It’s kinda, spontaneous um. Can't really think of anything. D: OK. And along with the cough, are you experiencing any difficulty breathing? P: No. D: OK, have you noticed any fevers? P: Uhm, no. D: OK um. Have you had any sore throat? P: Um I did initially um for the first two or three days and then that got better. D: OK um. Have you had any runny nose? P: I did initially yeah, I have like had all those flu symptoms for the first couple of days, but the cough just kinda stayed. Everything else resolved in the first uhm three or four days I would say. D: OK. Thank you for sharing that have you had, did you have any chest pain at any point? P: No, but I guess like sometimes when I'm coughing too much my chest hurts a little bit. D: OK, so it feels kind of sore after all that? P: Yeah. D: OK. OK, have you been in contact, I guess it's hard to say because it started a while ago, but before it started bringing contact with anyone that's been sick? P: I I work at the hospital, but. Um I'm wearing PPE all the time, and I'm very careful so. D: OK. Have you traveled anywhere outside of the province? P: No. D: OK, have you had any nausea or vomiting? P: No. D: OK, any belly pain? P: Uhm, no. D: OK, um so I'm just gonna ask you some questions about your overall health. Have you had any respiratory problems in the past? P: No. D: OK. Or do you have any chronic conditions that you see your family doctor for regular thing? P: I’ve got acid reflux and uh, I also have anxiety. D: Are you currently taking any medications? P: Um. I I used to, not anymore. D: Uh, was there any particular medication that you stopped recently? P: No, no. I used to take. I used to take something for anxiety two three years ago. D: OK. And what do you do for your reflux? P: I just avoid right now, I'm just trying to avoid the foods that make things worse for me and I feel like that's helped me quite a bit, uhm so yeah. I quite like acidic foods and chocolates and things like that. D: Sure. That's no fun. P: Yeah. D: Do you have any allergies? P: Just hay fever. D: And do you have any family history of respiratory problems or heart problems? P: No. D: OK, and this is in terms of your lifestyle. Do you live with family, alone? P: I I live with my partner. D: OK, and do you have any kids or pets living with you? P: No. D: Do you smoke? P: Uh I don’t, no. D: Drink alcohol? P: Um occasionally. On Christmas. D: Oh OK, I see. And do you use any other substances? P: No. D: OK. Uhm, and what do you do for work? P: I’m a clerk at the hospital. D: OK. Right, you just say you working at the hospital. And, uh. I can't think I thought I had another question for you, but I can't remember it. Anything else that you wanted to tell me about that I didn't ask you. P: Um. No, I guess I was just wondering why I still have a cough. It's been such a long time. Um yeah, and I was wondering if I could get any medications just to help with that. It's not really. Yeah, it's everyone's like scared at work when I cough. I have. I have had the covid test and I don't have it, um so yeah. D: When we got the last test done? P: Um I had the test done when I first started having symptoms about two weeks ago? Since then I've been at home and I'm just waiting for my symptoms to get better, but I you know, I kind of like get back, and I don't want to be coughing when I get back. Um yeah. D: OK. Well, I'm gonna have a quick listen to your heart and lungs I'll do a quick physical exam and then I will go get the doctor that I'm working with all kind of go over everything you talked about, and then we'll come back and talk to you about where to go from here. P: Sounds great. D: OK well thanks for chatting with me. P: Your welcome.
dataset\resampled_file\MSK0045.wav	D: What brings you here today? P: Um so I'm here because my shoulder has been really painful for the past week um and any movement of that shoulder, of my right shoulder, causes a lot of pain. D: OK, and how long have you been having uh this pain for? P: For the past week, D: Past week, OK. Um and did you injure your shoulder at all recently? Any trauma to the area or anything like that? P: Um so about like, a couple of months ago, I um was do, I I work in construction so um I was moving around some heavy objects and um I guess like the repetitive motions caused some sort of rotator cuff injury. But I had that um, like I got that treated and everything was fine for a couple of months. But this pain just started a week ago. D: OK, and where is this pain located exactly? P: Um it's it's just like in my shoulder, like at the joint between my upper arm and um shoulder. D: OK, and uh is it an aching pain or is it a sharp stabbing pain? P: So at rest it seems to be like achy and stiff, but um but when I move my shoulder, when I try to move it, it it causes more of a sharp pain. D: Sharp pain, OK and what kind of movements cause the sharp pain? Or is it just any movement? P: Uh any movement. D: OK. Are there any uh movements that are worse in particular? P: Um I think um, like no, anything hurts. D: OK. OK, and how much would you rate this pain out, on a scale of zero to 10, 10 being the worst pain you felt in your life? P: I'd give it about a 7. D: Seven, OK. P: Yeah. D: And are you having uh, is this pain moving to any other uh joints or any other part of your body? P: No. D: OK, so just just in the area that you described? P: Yes. D: OK, and do you notice any kind of um, just looking at your shoulder outside, from the outside, any swelling, redness, any masses or deformities? P: No, I don't see anything like that. D: OK, alright and um is there anything that you've tried that has helped with your pain? P: Um I've tried some ibuprofen, some ice. It seems to help temporarily. D: OK, and earlier when you had the rotator cuff injury, did you get physiotherapy? P: Um I did. But not, but I didn't finish the full course. I just went for a week or so and then um I had to go back to work, um so I stopped doing that. D: I see, um yeah, so that's something definitely uh it's very important and we'll need to consider going forward as well. Other than that, are you having any symptoms of any fevers or chills? P: Uh no, nothing like that. D: OK, and have you been sick recently at all or met with someone who was sick? P: No. D: OK, any any weight loss um or loss of appetite? Anything like that? P: Uh no, nothing like that. D: OK, any numbness or tingling? P: No. D: Any weakness in your extremities? P: No. D: Any um any just symptoms or anything else like diarrhea, constipation, urinary changes? Anything else is going on? P: No. D: No, OK. So it's mainly just the shoulder pain? P: Yes. D: OK, um alright, and does rest help at all, like when you're lying down, just not moving your shoulder. Does that help with your pain? P: Uh, yeah I would say so. D: OK. And is is this stiffness there just throughout the day, or is it there in the morning and then gets better during the day? P: It's pretty much there all day. D: OK. Alright um and have you been diagnosed with any medical conditions in the past? P: Uh, I have um, I have diabetes, but that's about it. D: OK, and do you take any medications? P: I'm on metformin. D: OK. Um and do you have any allergies to any medications? P: No, no allergies to medications. D: Have you been hospitalized or had any surgeries in the past? P: No. D: No, OK. Um any family history of any musculoskeletal or rheumatological conditions? P: No. D: OK, and currently right now, so you said you work as a construction worker, right? P: Yes. D: And are you off of work right now, or have you been off work um due to your previous injury and pain, or are you still working? P: I'm still working, but modified, um so I am not uh lifting any heavy objects or anything like that. I'm just doing some like groundwork. D: OK, that's good. Yeah, I mean, um we might also need to, if you're doing any kind of overhead like work where you're raising your arms above your shoulders, that might uh, cause further problems as well, so we'll look into some of those modified duties as well. P: OK. D: Um yeah, and what is your living situation like right now? Who do you live with? P: Um I live by myself right now. D: Do you live in a house or apartment? P: Um I live in an apartment. D: And, uh, uh, in terms of your daily life, do you smoke at all? P: Um I don't smoke. I used to smoke before, but that was like 20 years ago. D: OK, that's good, and do you use any recreational drugs like marijuana or any other drugs? P: Uh no, no. D: How about smoking, you smoke cigarettes? Sorry, you said you you quit. Um do you drink alcohol? P: I'll drink like a glass of wine here and there. D: OK. Alright, um yeah, and those were some of the questions I had for you. In terms of just a physical examination, uh when you press on the area that you describe, um when you press around the area, does it hurt? P: I have to press pretty hard for it to hurt. D: OK, but otherwise it's not tender? P: No. D: OK, and again, no swelling, redness, or anything like that, just it's mainly just on the inside? P: Yeah. D: OK, and um and any kind of movement hurts, right? There's no particular movement that, like if you were instead of um trying to raise that shoulder by itself, if you were to just move it with the other arm. Does it hurt? P: The other arm? The other arm doesn't hurt at all. D: Or like if you were to use your left arm to to passively move your right arm and shoulder. Does that hurt or is it when you just try to move the right arm by itself? P: It's, oh, it still hurts, any any moving of the shoulder hurts. D: OK, alright, so yeah, so based on what um you've told me so far in your recent shoulder cuff injury, what can sometimes happen is uh with those injuries, you might get some um inflammation and what might happen is something called uh adhesive capsulitis, or just commonly knows as known as a frozen shoulder. And there's different stages, so that might happen, so in the initial stages like freezing um and then there's stiffening in stage two, and then usually after 6 to 12 months it starts uh getting better. P: OK. D: Um and it might also affect your other shoulder as well. So what we'll um end up doing today is see if um we can get some um imaging done so we can do an X-Ray of your shoulder. I'm sure you've had X Rays before, so we'll kind of compare them to your shoulder X Rays from before. We, if we need to, we can also get an ultrasound if um we don't, uh we can't really tell from the X Rays. And then from there, um we can get some blood work as well. Um just your normal blood work as well as inflammation markers, and then um from there we'll need to uh, really um discuss some management strategies. So you've already tried some physiotherapy, but now we need to make sure that's uh, it's it's consistent because this is something that has a high recurrence rate and we will definitely need to finish the full course of physiotherapy, whatever it may be, um because if physiotherapy doesn't work, we may have to consider like other options like um corticosteroid injections right into your shoulder. P: OK. D: For some relief. But yeah, so first we'll just try some conservative methods like physiotherapy, pain management, uh and then go from there. How does that sound? P: That sounds pretty good. Thank you. D: Welcome, alright, so we'll call you for the X-Rays and then we'll go from there. P: OK, sounds good.
dataset\resampled_file\RES0171.wav	D: What brings you in today? P: Yeah, I've had a shortness of breath, and even at at rest. Really, feeling like it's difficult to breathe, and when I take a deep breath I get a chest pain. D: When did this start? P: This started yesterday. D: How bad is your shortness of breath? P: Like, I don't know. I feel like I'm OK, like n terms of being able to breathe, but I mean if I exert myself at all, there's no way I would be able to. It's, I just feel like even at rest it's hard to breathe. D: OK, has it gotten worse since yesterday or better, or kind of been the same? P: It's mostly been that been the same or actually sorry it's got, got a little bit worse at first. It was more more with exertion, and now it's, at rest as well. So yeah, it's got worse. D: I see, OK. Are you able to talk in full sentences or do you need to take a deep like stop to take a breath? P: I could talk in full sentences. D: And the chest pain, does it only occur when you take a deep breath, or are there other times as well? P: I pretty much yeah only when I'm taking a deep breath and say, I mean, maybe that's why part of the I can't take a deep breath so it's making me feel it's making the breathing more difficult making me feel more short of breath. D: OK. Any other symptoms that you've had? A fever or headache? P: No, nothing like that. D: Any cough? P: Yeah, I, I've had a cough as well over that the same same time period. D: Is it a dry cough? Are you bringing something up? P: It's dry, yeah, I haven't brought up any sputum or any any any blood. D: OK any other flu like symptoms, runny nose, stuffy nose, sore throat? Anything like that? P: No, I just had um, yeah, the shortness of breath and chest pain. D: OK, uhm. And have you, I guess I just invited more general questions about others potential symptoms. Do you feel like your heart is racing or do you feel like you have, uhm, do you have any belly pain or any changes in your bowel movements? P: No belly pain or changes to bowel movements, but I do feel like my heart is beating really fast really fast though. D: Yeah, OK. Uhm, you said this started yesterday. Were you like completely fine the day before? P: Uh I was yeah. D: Anything that's happened recently that's different or new? P: I'm well it like uh, about two weeks ago I had a hysterectomy 'cause I, for abnormal bleeding. Yeah I had surgery 2 weeks ago. D: What have you been doing these past two weeks in terms of sort of physical activity? Have you been moving around or no? P: It's it's certainly been less I I've been moving a little bit, but I've had a lot of pain so I just haven't been doing as much activity, that's for sure. D: I I see and have you had any, I guess any pain in your legs. Or swelling in your leg? One or the other? P: Yeah, I have had actually, yeah my right my right calf is pretty sore. D: Definitely have a look at that. Have you noticed that it's been bigger or more red or warm? P: Um, no, I don't notice anything like that, just I, just really hurts. D: Uh, OK. Any medical conditions that you've been diagnosed with? P: Um, yeah, yeah and I have a high BMI. Type 2 diabetes and anxiety. D: Do you have any bleeding disorders? P: Um other yeah, no. I think you're right. It said fibroids. D: OK, OK. And do you take any medication? P: Yeah, so uh insulin, well metformin. And then that's it. D: OK. P: I'm sorry and then an SSRI. Like I said, low pram for anxiety. D: Alright. And do you have any allergies? P: No, I don't. D: And, who do you.. do you currently live alone? P: Uh no, I live with my husband and and our two sons. D: OK and, do you, have anyone sort of come in to help you out over these past two weeks? Are you getting any outside help from nurses etc. Or are your are your family members being supportive and helpful? P: Yeah, it's been mostly the the family members. My husband's been working from home and the kids have been helpful as well. They are 10 and 12 so they are able to do some things on their own so yeah they've been supportive. D: That's great. That's great. OK, and you smoke at all? P: I do yes I I smoke about a half a pack per day. D: For how long? P: Um, yeah, but I I started in my, yeah, after the kids were born actually, uh so like 10 years ago. D: OK, have you tried cutting it down at all? P: Yeah, I have. I've kind of gone through spurts of quitting and restarting, quitting and restarting. So yeah, I've tried before. D: OK, and what about marijuana or recreational drugs? P: No, don't use anything like that. D: And alcohol? P: Yeah I'll have some wine on the on the weekends, but maybe that's like a glass or two. D: OK, OK uhm, and do you have any medical conditions that long run in the family? P: Just, uh, yeah, my father actually had a stroke when he was 68, and that's it. D: OK OK uhm. You haven't ever had one, have you? P: No, I I haven't had anything like that. D: OK, alright. So. I guess come to in terms of smoking, you said that you've tried to quit a couple of times in the past. Do you intend on trying again? I know it can be very hard to, to quit smoking. P: Yeah, it's only something that is always kind of in the back of my mind. D: OK, if there's I'm happy to assist you and share resources and problems like medications and things like that that could help you if you're interested so we can talk more about that. talking about your I guess you mentioned that your weight is a little higher than or, its outside the normal range, is that something that you would like to cut down? P: Yeah, I really try to eat more vegetables and have been trying to do that sort of thing. I've lost a few pounds, but not enough, definitely want to keep going. D: OK, good good, as long as you feel that you what you're currently doing is helping you and is helping you reduce weight. That's great. But also I'm here for you if you need more education or guidance on that. So, given what you've told me so far, it sounds like you might have developed a clot in your leg somewhere, simply because you had a surgery and you were not moving around very much. Sometimes that causes the blood to kind of, not move around your body is as as much as it usually does, and kind of stays in one place and get turned into a clot and that clot can sometimes get dislodged and settle into your lungs, and that can make it difficult for you to breathe. So, we'll do some tests that that's what my understanding is. Given what you've told me so far, but we do have to confirm it using a test. Also, the fact that you smoke and your weight, and your BMI is high, increases your risk of developing a clot, so I would definitely strongly recommend that you continue to try to reduce both and try to quit smoking. And so we'll do an ultrasound of your leg and we'll do a scan of your chest and see what's going on and then decide if we need to give you any medications, like any blood thinning medications. P: OK, yeah, that sounds really good. Thank you. D: Welcome.
dataset\resampled_file\RES0198.wav	D: What brings you here today? P: Um hi, yeah I've had the stuffy nose um that's been on and off, as well as a runny nose for the past week and it doesn't seem to be getting any better, so I thought I should come in and get it checked out in case I have covid. D: OK, yeah I know for sure that's a good idea. So how long have you had this for? P: A week now. D: A week. And did. So what started first? Was it the runny nose? Or like the stuffiness? P: It felt pretty stuffy at first, but now it's mostly running. D: OK, and are you coughing at all? P: No. D: No OK, and the runny nose what kind of content are you producing or draining? Is it mainly like clear or is there any color to it? P: It's mostly clear. D: OK. And, is it mainly just congestion and drainage from your nose or are you feeling and go at the back of your throat as well? P: Uh no it's just mostly for my nose. D: OK, any other symptoms like sore throat, shortness of breath, fevers or chills? P: No. D: No OK. And is this like something that's constant or does it come and go? P: Ah, it's it's. Ah It's been pretty constant for the past week. D: OK, has this happened to you before at all? P: No, well, actually I've had I've had a cold before but not recently. Maybe like five years ago. D: OK, have you tried any over the counter medications at all? P: Um I've tried like decongestants and. That's not. Well, I guess my nose is runny now so that worked a little bit. D: OK. OK, and have you been in contact with anyone who's been sick recently? P: Uhm? No, I don't think so. My I have um a nephew who I live with who goes to daycare. D: OK, and has he been sick at all? P: No, he's been fine. D: OK, any recent travel at all? P: No. D: No, OK. Any headaches or nausea or vomiting? P: Nope, nothing like that. D: OK, any fatigue? P: A little bit. D: OK, any loss of sense of taste or smell. P: Um. No, um not that I've noticed. D: OK, any sort of like chest pain or racing sensation of racing of yourbheart or anything like that? P: No. D: No OK? Any changes in your bowel movements? P: No. D: How about your any difficulties in urinating? P: Um no. D: OK, have you been sleeping and eating well? P: Yes. D: OK, any weight changes like any significant weight loss recently? P: No, no, no, nothing like that. D: OK. At home or at work home any exposure to like fumes, dust or animals? P: No. D: OK, and have you been diagnosed with any medical conditions in the past? P: Um I have type one diabetes. D: OK, and when were you diagnosed with that? P: When I was like 7. D: OK. And so you have your insulin medication and your are you all up to date with that? P: Yes. D: OK, and do you see an endocrinologist? P: I do. D: OK, alright. Any medications that you are on besides insulin? P: Uh no . D: No, OK. Any allergies at all? P: No. D: OK, have you been hospitalized or had any surgeries before? P: No. D: No, OK. Any family history of any medical conditions, in particular with the lungs or the heart. P: No. D: No, any autoimmune diseases? P: No. D: OK. And currently right now do you work or do you go to school? P: I’m in school right now. D: OK, and so are you living, where are you living right now? P: I live in an apartment by myself. D: OK. And currently, do you use any recreational drugs like marijuana or anything? P: Uh no, not OK so not frequently, but maybe like once a month I'll have an edible. D: OK, any other recreational drugs like cocaine and heroin? Anything like that? P: Oh no. D: No. And you drink alcohol? P: Uh no. D: And do you smoke tobacco? P: No. D: Yeah, those were all the questions that I had for you today. Do you have any questions for me? P: I yeah, how do I get rid of this? And it's really been bugging me. D: Yeah, it kind of so just a stuffy nose in the runny nose it seems like it's most likely a viral infection like the common cold. It takes a few weeks for the symptoms to get relieved, but there's not much that we can do besides supportive care, so make sure you get you stay well hydrated. You can use over the counter medications uh like Tylenol cold. now, if you to relieve some of your symptoms, but since right now we're in a pandemic, some of these symptoms can also be seen in covid patients, so we will also get a swab done for you today, and you should have the results back by 48 hours. Um until then, we recommend that you stay isolated in your own home and not see anyone else. And then once the results come back, you'll get further instructions from public health. P: OK, that sounds great. Thank you. D: Your welcome. Take care P: You too bye.
dataset\resampled_file\MSK0018.wav	D: What brings you in? P: I just came in because of I just got into like this uh, incident while I was playing rugby. I kind of got tackled and then fell onto my right shoulder. Um, and after I got up, I haven't, I've just been, this just happened a couple hours ago actually and uh, I've just been in intense pain in my right shoulder and I can't seem to move it at all. D: Okay, um, and sorry, when was this exactly? P: Uh, probably 2 hours ago. D: 2 hours ago, okay. Um, and is this pain persistent or is it like on and off? P: It's, it's constant. It hasn't gone away at all. D: Okay. 1 to 10, 10 being the worst. How bad is this pain? P: I don't know, like probably like 8 or, 8 or 9. D: 8 or 9, okay. Um, and is it a sharp kind of pain or is it dull and aching? P: It's, it's sharp. Like if I try to move it at all, it's like a sharp pain. D: Okay, um, and have you ever had anything like this in the past? P: Uh, no, never. D: Never, okay. And are you able to move your arm at all or you can't move it? P: I could move my fingers and hand and elbow, but um, elbow a little bit, but like uh, yeah, I can't move my shoulder whatsoever. D: Okay, um, and do you, are you experiencing any tingling or numbness? P: Um, no, I don't think so. D: No, okay. Uh, how about any muscle weakness? P: Um, in that area, I don't know if it's weakness or pain, but I just can't move it up and I, I, I do feel some like numbness just above my shoulder. No tingling though. D: Okay, any pain elsewhere in your body? P: No. D: No, okay. Any headaches? P: Um, no. D: Confusion or memory loss? P: Uh, no. D: Uh, weight loss? P: Uh, no. D: Fevers or chills? P: No. D: Rashes? P: Um, no. D: Uh, changes in your vision, hearing, smell or taste? P: Uh, no. D: Um, coughing, shortness of breath or wheezing? P: Um, no. D: Chest pain or heart palpitations? P: No. D: Changes in your bowel movements? P: No. D: Changes in voiding? P: No. D: Um, okay. And then with regards to this pain, does anything make it better or worse? P: Um, um not anything that I've tried that's made it better. Worse is probably just if I try to move it at all. D: Okay, and the pains in your shoulder, does it radiate down or up elsewhere? P: Uh, mostly towards my shoulder, um, kind of down towards my upper arm as well. D: Okay, I see. Um, alright, and um, are you otherwise healthy? Do you have any other medical conditions? P: No. Yeah, otherwise I'm healthy. I've never been to the doctor much. D: Okay, alright. Um, and are you on any medications? P: No. D: No, okay. And um, are you up-to-date with your immunizations? P: Yes. D: Okay, and do you have any allergies? P: Uh, no. D: Any family history of musculoskeletal diseases? P: No, not that I know of. D: Okay. Uh, and any family history of autoimmune conditions? P: Um, no. D: Okay. Um, do you smoke at all? P; No. D: No. Um, do you consume marijuana? P: Uh, no. D: Uh, do you drink alcohol? P: Uh no, just, just with friends sometimes on the weekends, but not really. D: Okay. Um, and then, where do you live right now and who do you live with? P: Uh, I live just outside of town with my parents in a house. D: Okay. And um, have you traveled anywhere recently? P: Um, no, I've been at home. D: Okay, any sick contacts? P: No. D: No, okay. So now we're just going to move on to um, the physical exam part of this. So can you take a look at both your shoulders and let me know if you see any redness or swelling? P: Um, I don't think I see any redness or swelling, but um, my right shoulder and my arm just seems a little bit lower than my left one. D: Okay, okay, any um, warmth on, on that shoulder? P: Uh, no, not that I can feel. D: Okay, any atrophy, deformities, or skin changes? P: Um, deformity, I, I do feel like kind of uh, like my shoulder's dropped and like there's just kind of this uh, little, like divots, where like the shoulder should be. D: Okay, okay. And can you palpate that area for me? Just um, the bones in that area, so like right where your arm would connect to your shoulder and then kind of on your shoulder blade. Does that hurt when you press down? P: Yeah, it hurts a lot. D: Okay, so some tenderness and pain in the acromion process and scapula. Um, and if you press down on your biceps, triceps, does that hurt? P: Not as much, no. D: No, okay. And then can I get you to um, can you lift your shoulder up at all? Like to where, to the point where your fingers are touch, like reaching the ceiling? P: No, I, I can't. I can't move it at all. D: Alright, so um, it sounds like you have a shoulder dislocation. Um, so we are going to do an x-ray of your shoulder joint first to make sure that it's, it's just a dislocation and there aren't any broken bones or fractures. And then um, we can resolve this by doing something called a closed reduction, um, to try to put the joint back in its place. P: Okay. D: Um, and if that closed reduction doesn't work, then uh, you may need surgery for like a, um, a weak shoulder joint, or if like ligaments um, aren't like, strong enough and it's it continues to happen. P: Okay. D: Um, otherwise, we can keep it immobilized for a few days to a few weeks, um, depending on how bad the dislocation is. Um, and then once that's removed, you can do some rehab as well to restore some range of motion. Does that sound like a good plan? Do you have any questions or concerns in the meantime? P: Uh, no, I think that's, uh, that's great. D: Okay.
dataset\resampled_file\RES0215.wav	D: How can I help you today? P: Um yeah hi, I brought I brought my 8 year old daughter here um because I've noticed that she's been quite wheezy um for the past four five days and now she has a slight cough, um sounds like she's a little short of breath, so I just wanted to get things checked out. D: OK, so for the, when it first presented, about four to five days ago, what did you notice, notice first? P: Um I noticed that she was wheezy um and it's it seemed like she was having some difficulty taking in deep breaths. D: OK, now was this with any type of activity or just at rest? P: Yeah, she was playing tag with one of her cousins and she she was quite out of breath after. D: OK, has she ever had anything like this before? P: No. D: Nothing like that, OK, and has it been fairly steady since then? Or has it been fluctuating? P: It's been fluctuating. D: OK, but it hasn't really gone away in the sense that you're still concerned coming now four days later? P: Yeah, it's just it would, she would have these these uh episodes, but it would resolve on its own and then she would, you know go back to doing some sort of activity and then she would have all these symptoms all over again, but when she rests um then it goes away, so I wasn't really sure, too sure what to think of it. But now I think it's important to get it checked out, so here we are. D: Has she had any fevers at home? P: No. D: Has she had a runny nose at all at home? P: No. D: Has she seemed well otherwise, does she look sick? P: Yeah, she looks fine otherwise. D: OK. And has she had any sick contacts recently? Anyone around her or her friends been sick? P: No, not that I've noticed. D: OK. Any recent travel anywhere? P: Uhm, no, no, we didn't go anywhere because of covid. D: OK, but she's still been going to school I suppose, playing with her friends? P: Yes. D: OK. Have you noticed any rashes? Any skin changes anywhere on her body? P: Uh not that I've noticed, no. D: OK, nothing like that, has she complained of any pain anywhere? P: No. D: OK, and has she had any recent infections? P: Uh she had, actually she had a couple of infections over the past two years. Uh they would come and go uh and we took her to the doctor each time and it just ended up being some sort of viral infection. D: OK, so nothing really needing antibiotics in the last couple of years? P: No. D: And in terms of how she's been doing, has she been keeping up with her peers in terms of education, and how she moves, how she acts? P: Uh yeah, she's been yeah, she's been on par with her peers. D: OK, so does she have a family physician? P: Um yes. D: OK, so they haven't brought up any concerns about how she's growing, how she's developing? P: No. D: So her weight, her height, they've been good for her age? P: Yeah, yeah. D: Excellent. And has she gotten, has she been keeping up to date for immunizations? P: Yes, she's fully up to date. D: Excellent. In regards to how she's doing, otherwise health, in terms of her health, has, did she see a family physician for any other medical issues that she might be having? P: Uh no, she's otherwise pretty healthy. D: OK. How was the birth? Was there any complications when she was born? P: No, she was a vaginal delivery, full term, no complications. D: OK, so nothing when you were pregnant with her, no toxic congestions? By that I mean um did you drink any alcohol, smoke at all when you were pregnant with her? P: No. D: No, OK. And you just had antenatal care, so you saw doctor for ultrasounds and just for checkups? P: Yep, everything was fine. D: OK. And when she was born, she didn't have to stay in the hospital at all? P: No, no. D: And was she born, uh what weight was she when she was born? P: Uh, she was, how much was she? I think she was about 8 kilos. D: 8 kilos? P: Sorry 8 pounds, 8 pounds. D: Yeah, no worries. And then otherwise she is, so she's been healthy otherwise, been doing well, uh just in terms of how she's been doing uh with other systems of her body, have you noticed any concerns for her bowel movements? P: Uh no, she's been pretty regular. D: OK, any concerns for peeing? P: Uh no, she's been going pretty frequently and she's, yeah no changes there. D: And we already talked, she hasn't had any fevers, when she coughs does she ever bring anything up? P: Uh no, I haven't noticed any phlegm, no. D: OK, and when she's having these wheezy episodes, do you ever notice that she looks like she's really straining to breathe, really struggling? P: Uh yeah, so she, it's not like she turns blue or anything like that, um she just slightly slightly has a hard time catching her breath. D: OK, so these usually recover on their own? P: Yeah. D: You don't give her anything for it? P: No. D: OK, uh does she have any allergies? P: Um no, well she has some seasonal allergies, but nothing that she's been tested for. D: OK, do you give her anything for seasonal allergies? P: Sometimes she takes like Reactine or like over the counter stuff, but um no, no prescribed medications. D: OK, so she doesn't have any allergies where her face swells up or she has trouble breathing? P: No. D: OK, and this, these episodes mainly happen when she's playing with friends, so do they happen in a certain environment? Like for example, is this in a friends house or is this outdoors or has it been across different settings? P: It's been across different settings but I will say it's worse when um when when there's colder weather. D: OK. P: Yeah. D: And do these episodes ever happen in your home? P: Yeah. D: And what's the context from them happening in your home? P: Um usually when she is out and about running around in the backyard with her friends um is when I've mostly noticed it, yeah. D: OK, so she doesn't have any symptoms at rest? P: Oh, no. D: And she doesn't have any symptoms at night? P: Uh at night, so there was one one one night when she had some issues um with like wheeziness but it did resolve on its own. D: OK. And did she wake up at night with that or just? P: Just trouble falling asleep, I think yeah. D: OK. Alright, so we already talked about, so she doesn't really have any past medical issues that she's seen a doctor for, uh any surgeries? P: No surgeries. D: OK. Is she taking medications right now? P: Um no, no medications. D: Aside from the occasional Reactine? P: Uh yeah, aside from that, nothing, no regular medications. D: And she's in school? P: Um yeah, she's uh she's in Grade 3 now. D: OK, and does she live with you? P: Uh yeah she lives with me and my husband. D: OK, do you two live in a house in town? P: Um yep, in a townhouse D: OK, and what do you two do for work? P: Um so my husband is an ultrasound technician and I am a uh kindergarten teacher. D: OK, excellent, and this is a question we just ask everyone, has there ever been any CC CAS involvement in the family? P: No. D: And does anyone smoke in the household? P: Uh, no no. D: OK, uh do you keep any carpets or pets in the household? P: We have carpets, but they're new carpets. We just got them, uh maybe six months ago, and nothing else. D: So no pets, no dogs? P: No. D: OK. Any wood burning fireplaces, stoves in the household? P: No. D: And changed your air filters? P: Yeah. D: Alright, excellent, so I think I have all the information I need, we're just going to do a physical exam and then I'm going to go talk to the physician and I'll come in and see your daughter and we'll talk about next steps from there. Do you have any questions that you'd like me to direct to him before that happens? P: No, thank you so much. D: Alright, have a good one P: You too, bye bye.
dataset\resampled_file\RES0208.wav	D: What brings you in today? P: Hey, so I just for the last couple days I've just been feeling really short of breath really rundown. Just like super tired and you know, normally really active and I'm just, I'm just having a rough go. D: Is there is the shortness of breath knew for you? P: Yeah yeah, it's just like just like I can't. I don't know like I can't catch up. I kind of just feel I feel a bit weak like I've just been feeling really tired and then because of that I haven't really been eating a lot so. Yeah, I don't know. D: So. You've just been feeling very tired, can you I guess, like tell me a little bit more about your difficulty with breathing. When does it happen? P: I think just like overall, I'm finding it like it's hard to hard to get like super deep breaths it's not like I I can't. I don't get the feeling that I can't breathe. It's just that everything's a little bit more like laborious. D: OK. And you said that it started a few days ago. Have you had any other symptoms other than the difficulty breathing and the fatigue? P: I mean. I felt I think I felt really hot yesterday. I don't know the thermometer, but I had my wife put her put her hand on my forehead and she got a I felt pretty warm. And come to think of it, I this morning I, I really I didn't eat much because I just haven't been that hungry, but I don't really feel like I couldn't really taste my breakfast. D: Has that ever happened to you before? P: No never I like, I like my food. D: Me too, um OK, what about your sense of smell? Do you feel like you're not you are not able to smell well either? P: I haven't thought about it too hard, but yeah, kind of. D: OK. And have you had a cough? P: Uh I don't know I. I feel like I maybe could be starting starting one. D: Sure. P: Like it's when it feels dry like it's on its way. Haven't really been coughing much. D: I see, what about a sore throat? P: I’m starting to feel a little bit like that. Like I don't know if I'm imagining it, but yeah, I I think so. D: I see OK. Have you had a runny nose or any congestion? P: No. D: Any headaches? P: Uh. Good question, I I kind of I get I get headaches fairly often I don't think I'm getting any more than usual, but I have had a little bit. D: OK. Is the headache that you've had different in quality from the headaches that you usually get? P: I mean, I don't know, I don't know. I usually get kind of difficult stress headache, you know? D: Yeah yeah. P: Pretty well. I am stressed, just that I you know, might be sick. D: And have you had any changes in your vision or hearing? P: No. D: In the past three four days, no OK. Any nausea or vomiting? P: No, no, I haven't. D: Have you had any chest pain? P: Uh, like it's. No, yeah no. No chest pain. D: Any do you feel like your heart's beating really fast? P: No, I wouldn't say so. D: OK, have you had any pain in your belly? P: No. Cause I I meant I haven’t really been eating but yeah. D: OK, any urinary symptoms? P: No, I don't think so. D: OK. And you mentioned you have muscle aches, is it, so all over your body or is it a specific part, specific area? P: I would just say I feel kind of overall achy. D: OK, P: Um not any one spot. D: Any numbness or tingling in your arms or legs? P: Uh, no. D: OK. All right, have you had any exposure to anyone who could potentially be sick? P: Well. My grandkids, uh, visited last weekend and my grandson has a cold. He goes to daycare. Yeah, so I'm not really. I'm not really sure like he's been staying home and they didn't. They didn't really know that when they came to visit. D: OK, that's yeah, uhm OK. And have you traveled anywhere outside the province? P: No no. D: OK alright. Do you have any medical conditions that you've been diagnosed with? P: Uhm? I'm pretty, I'm pretty healthy. I have some um like reflux that I see my doctor for. And I've had I've had some difficulties like with like urinating a little bit. Yeah, my my prostate's a little big like it's not cancer but. So just those two things that aren't that aren't there that really big deal they don't affect my life too much. D: Are you taking any medications for either problem? P: I take avodart. D: OK. P: And for the the reflux I take a tums here and there I used to be on a medication, but it seemed like I kind of figured out the foods that were going to help, so I stopped. D: Great, that's great. Any allergies to medications, foods, or environmental allergies? P: Uh no, no D: No, and any medical conditions that run in the family? Specifically, anything related to the lungs? P: No, not that I can think of. D: And do you you mentioned that your grandkids have came to visit. Do you live alone? P: Uh no. I live with my wife. D: And are you currently working or are you staying at home? P: Uh, I'm working from home. I I, I've gone out a few times to see clients. I work as a financial advisor. I've gone to see a couple clients that are really old and have a hard time doing stuff over the phone or over the computer, but I'm like 95% from home. D: Have you gone to see any clients in the past three or four days or in the past week? P: No, no, it's probably been a couple weeks since I saw anyone . D: Sure OK. And do you smoke? Or did you ever smoke at the past? P: No, I I maybe did for maybe like three years in my 20s. It wasn’t heavily yes. D: Any marijuana or recreational drugs? P: No. D: Any alcohol? P: I usually have a whiskey or two on the weekends. D: OK alright. Uh so it sounds like you have some sort of an infection with the fevers and fatigue and muscle aches, and then the difficulty breathing, of course, and then your sensation, that sensation that you are having a very cool sort of a sore throat and cough that you might be getting. We can't necessarily rule out covid just yet. P: Thats what I was worried about. D: Yeah, and given that you're having difficulties breathing, we're also going to have a look at your chest and do it physical exam, but also do a chest X Ray just to make sure, or just to see if there's anything a infection that is settling in your chest, and a covid swab and then uh go from there. We’ll decide whether you need to stay in the, you need to stay in the hospital and if you can go home based on those results, but if you are to go home, we would request that you stay away from from everyone, so including your wife. Try to self isolate as much as possible and your results should come out in 24 to 48 hours and then the public health nurse should tell you what to do if your results are positive. P: OK, OK no, that sounds fair, D: All right. Well, let's do a physical exam and then go from there. P: OK. Thank you. D: You're welcome.
dataset\resampled_file\MSK0031.wav	D: How can I help you? P: Hi, I just was brought in here today. I had a fall just waking up coming down the stairs. I fell off the last few stairs and just fell onto the right side and on, right onto my head and now, uh I couldn't even I could barely stand up and put any weight on my hip. It's the right hip. D: OK, Uhm, so what caused you to fall in the 1st place? Did you just lose balance, were you dizzy? P: I think I just I missed, I wasn't dizzy or anything. I just missed one of the steps and just slipped, slipped down the stairs. D: OK. P: But it was just the last few stairs I didn't have like I didn't hit my head or anything like that. D: OK, and when was this? P: This was a so I guess now two hours ago. D: Two hours ago, OK. Has a pain been constant since? P: Yeah, it's, it's really excruciating. D: OK, does anything make it better or worse? P: No, it's I'm just in extreme pain. Like I I I can't even put any weight on it. D: OK, so you can't, OK so you can't weight bear, and you can't walk on on that leg I guess. P: Mhmm. D: OK. Is it a sharp kind of pain or is it dull and achy? P: It's uh, it's pretty sharp, like if I'm not putting any weight on it right now, it's like really achy. But if I put any weight on, it's really sharp. D: OK. And where is this pain exactly? Is it just in your right hip or is it radiating up into your upper anterior lower back or down to your leg? P: It's in the right hip, mostly just on the side, but the pain is kind of like, all over the right side of my groin and I feel like there's some swelling there as well. D: OK. And one to 10, 10 being the worst pain ever. How bad is your pain? P: I would say 10, like I've never experienced pain like this. D: 10, OK. And do you, have you ever had pain like this before? Like have you ever had a fall in the past? P: No, this isn't this is the first time I've had a fall. D: OK, any numbness or tingling? P: Uhm, no, not that I can tell, no. D: Dizziness or fainting spells? P: Uhm, after the fall out like this, I I don't know if it's due to the pain, but even in the ambulance, coming out of the ambulance I was feeling a little bit dizzy, but I don't know if that's just 'cause of the pain. D: OK, any headaches? P: No. D: Confusion or memory loss? P: No D: Uh, joint pains or muscle aches elsewhere? P: No D: Weight loss recently? P: No. D: Fevers or chills? P: Nope. D: Uhm, and rashes? P: Uh no. D: Any changes to your vision, hearing, smell or taste? P: No. D: Any, uh, you experiencing any cough, uhm, shortness of breath or wheezing? P: No. D: OK, how about chest pain or heart palpitations? P: No, not that I have experienced. D: OK, and how about changes your bowel movements? P: Nope. D: OK, how about changes to urine? P: No, nothing. D: OK. And. Are you otherwise healthy? Do you have any longstanding medical conditions? P: Yeah, so I just have a, uhm I do have some osteoarthritis and then I have, I take this medication for blood pressure. It's called uh, Ramipril. D: OK. OK, and is that the only medication that you're on? P: Uh, yeah. And then I'm just on vitamins like vitamin D, calcium and just multivitamins. D: OK. And are you up to date with your immunizations? P: Yes. D: Yeah, OK. Any allergies? P: Uh, no, not that I know of. D: OK. Any family history of lung or heart conditions? P: Uhm, I think, uh my father, he died of a heart attack in his 60s. D: OK, OK, any musculoskeletal issues? P: Uhm, no, I don't think so. D: No. Uhm, how about autoimmune conditions? P: No, not that I know of. D: Any cancers? P: Uh, I think, my, my mother had some skin cancer, but the ones that, she didn't need any surgery, they just zapped them off. D: OK. Uhm and do you smoke? P: No, I've never smoked? D: OK, uhm, do you drink alcohol? P: Just maybe like a wine, what every other day, a glass of of wine. D: OK, and then do you consume marijuana in any form? P: No. D: OK. And how about in terms of where you live? Who do you live with and where do you live? P: I live with uhm, just my husband and and we just live in a small apartment. D: OK. And have you been in touch with any, anyone sick recently? P: Uh. No, I've I've been like at home with my husband. We haven't really left. D: OK. And have you done any travel recently? P: Uhm, no, I've just stayed at home. D: OK. Alright, so let's move on to the physical exam part of this interview. So if you can, I'm going to get you to take a look at both your hips as well as your legs. Do you notice any redness or swelling in the area? P: I do notice some swelling. It's a little bit red. I can't really see too much red. D: OK. OK. Any muscle atrophy? Any deformities or skin changes like bruises? P: Uh, maybe some bruising, but I, I don't notice anything else. D: OK. Alright. And then when you place the back of your hand on both hips, do you notice any temperature changes? Is one side warmer than the other? P: It's a little bit warmer, the right side than the left. D: OK, and does one like appear to be shorter? Or does does it appear to be misaligned? Or in any sort of like strange positions like outward turning of your leg, one compared to the other? P: I think it's a bit, but look at it a bit, like outward turning. And then yeah, I would say it's more outward turns. D: OK, and if are you sitting down right now? P: Uh, yeah. D: OK, are you able to stand up from a sitting position? P: I can try, but it's very painful. D: OK. P: Yes, should I go ahead and try? D: Yes please. P: Yeah. So I yeah I can barely stand up. I can't, it's kind of just, I'm just supporting myself with my left like. D: OK and so I, I guess you can't do any of the like hip flexion or hip extension, hip abduction or addduction, correct? P: No, I can barely move it. D: OK alright those are all the questions that I had. Did you have any questions of your own? P: No, I think I I just don't know if I need surgery or something. D: Yeah, so it sounds like you have a hip fracture from your fall. Uhm, so, the way to treat this is a combination of surgeries and rehab and medication. So we will definitely look into the surgical option first, which is done using some internal repair with screws. Or, you can do a total hip replacement or a partial hip replacement. The orthopaedic surgeon will uh, decide like which option is best for you after we refer you for a consult with them, and then after that surgery they'll likely refer you to some rehab, so physiotherapy will focus on improving your range of motion and strengthening the muscles in that area. Uhm, and for management of pain, you can take ibuprofen or any over the counter pain medications for now. Does that sound OK? P: Yeah, that sounds good. Thank you so much. D: OK, great, no problem.
dataset\resampled_file\RES0154.wav	D: Uh how may I help you? P: Hi, so yeah I just came to the hospital because I've just been feeling over the last um few days uh just I can't really take like a deep breath. And then I've also been coughing up uh this greenish yellowish material. D: Oh OK, and when did this uh cough start? Sorry. P: So I think the cough started like 4 days ago and then the shortness of breath started uh just yesterday. D: OK, um and it's been yellowish green, were you coughing up sputum prior to this and um or did you have a cough before this? P: No, not really. D: OK. Um and have you noticed any blood? P: No, no blood. D: Alright, um and the shortness of breath, are you experiencing this at rest or um or with exertion? P: No, like at rest, even right now I'm like having trouble taking deep breaths. D: OK are you feeling any uh any chest pain? P: Um not pain, but there's definitely some straining and discomfort when I take a deep breath. D: OK is it, is the discomfort worse when you take a deep breath? P: Uh yeah, it's just like I just have to strain a lot to like take that deep breath. D: OK, um and uh have you noticed any wheezing? P: No wheezing. D: OK, um and have you had any shortness of breath or do you have any shortness of breath if you lie flat? P: Uh, no, not really. Not that I've noticed. D: OK, or have you had any uh times where you've uh woken up um from sleep because you were short of breath and you had to sit up? P: Uh no. D: Alright. Um and have you had any uh fevers or chills? P: I have had a fever like today, I had a fever I measured it was like 38.5. Yesterday, I felt like I had chills and a fever as well. D: OK, yeah, certainly sounds like a fever and have you had any night sweats? P: Last night, I would say I had night sweats. My sheets were a bit drenched. D: OK. And have you had a sore throat? P: No. D: Changes to uh, loss of smell, loss of taste? P: No, nothing like that. D: OK, have you had a runny nose or felt congested? P: No. D: OK, um and how about any eye symptoms like redness or itchiness, pain? P: Uh, no, nothing like that. D: OK. Uhm and um have you had any uh instances of fainting or feeling dizzy? P: Nope. D: Any abdominal pain? P: No. D: Any nausea or vomiting? P: No. D: Any diarrhea? P: No. D: OK, any rashes? P: No rashes. D: Um and then any muscle aches or body pains? P: No, not that I know of. D: OK, and how has your energy been? Have you had any fatigue or malaise the last several days? P: Yeah, I would say so. I just feel like I don't know if it's to do with the short, of being short of breath, but yeah, I just feel like I've just been needing more rest. D: OK, OK and have you had any headaches? P: No. D: No, alright, um so you've had this uh cough and you've been bringing up more sputum and shortness of breath and um and you've had a fever as well, um have you been experiencing any other symptoms? P: Um no, I think those are pretty much all the symptoms. D: OK. Um and in the past, have you been diagnosed with any medical conditions before? P: I do have, uh I take medications for high blood pressure. Um then I take medications for high cholesterol as well. D: OK. Um and do you take any other medications? P: Um just uh vitamin D calcium multi vitamins. D: Alright, any allergies to medications? P: Not that I know of. D: Alright, any prior surgeries or hospitalizations? P: Uh yeah, I've had a few. Uh so I had a C-section in my twenties. Um then I had just uh five years ago, I had a um my gallbladder removed. D: OK. Um and uh could you tell me a little bit about your living situation? Like who you're living with and and whereabouts? P: Yeah, so I'm living alone right now. Um, just in an apartment. D: OK, have you been around anybody who's been sick? P: Uhm no I, not anyone that I know of. I do, I I did see my just randkids just last week, though. D: OK, did they have a runny nose? Any symptoms like that? P: Not that I noticed, no. D: OK. Um have you traveled anywhere recently? P: No, I've been at home. D: No, OK. Um and and do you smoke cigarettes? P: No, I probably smoked for a very short time for like probably five years of my life in my 20s. D: OK, uh, do you smoke um marijuana? P: No. D: OK, and do you use any recreational drugs? P: No. D: OK. Um and um any family history of heart or lung conditions? P: Uh, I do have uh, my father passed away from a heart attack in his 50s. My brother has um high blood pressure, diabetes. Um and on my mom's side, she had like osteoarthritis. D: OK, and any cancer that is in the family? P: Um skin cancer, on my um father's side. D: OK, um and have you had antibiotics recently or within the last six months for any reason? P: No, no antibiotics. D: OK, so, so that was everything that I wanted to ask today on uh on history. Um was there anything that you also wanted to mention I I maybe forgot? P: No, I think that's all. D: Um OK, so uh yeah, with the the symptoms um it could be um pneumonia which could be bacterial or viral, um as well as the possibility of um something like uh like Covid, which is of course a concern for today. So we will go ahead and start those investigations and get a swab. Um and um you may need antibiotics for um for this, if there there is uh pneumonia so we'll also get a chest X-ray as well. P: OK, alright sounds good.
dataset\resampled_file\RES0122.wav	D: What brings you in today? P: Uh, yeah, so I, I just came in because I've been having, for the last, I would say 2 weeks, just a lot of congestion in my nose and then I've also been feeling a lot of pressure in my head as well as just, around my jaws and my face overall. D: Okay, and um, you said it started two weeks ago. Has it gotten better or worse, or been the same since then? P: Um, I'd say it's pretty much been the same, except like the pressure's getting worse. D: Okay, and do you find that the pressure is worse when you're bending down, or um, yeah, when you're like squatting or sitting down? P: Um, when I'm sitting down, I don't think so, but like sometimes I do feel like, for example, when I'm lying on one side, it gets really bad on that one side and I have to kind of switch over to the other side. D: Okay, alright. And uh, when did your headaches start? P: Um it's, I guess it's not so much as a headache as just kind of um, just pain in and around the cheeks and just going up to my head. And it started about, I would say around 2 weeks ago. D: Um, and do you have a stuffy nose? P: Yeah, I definitely have a stuffy nose and it started, um, it sometimes gets like, like a runny nose as well. D: Yeah, okay and what's the discharge like? P: Uh it's usually clear. D: Okay, and do you have a cough? P: No, no coughs. D: Sore throat? P: No. D: Um, and do you have any difficulties breathing? P: Um, no, not that I've noticed. Sometimes when it gets really stuffy, I, uh, have to breathe through my mouth. D: Yeah, I see. Do you have any difficulty swallowing? P: Uh, no. D: Any chest pain or any heart, um, palpitations? P: Nope. D: Um, any pain in your belly? P: Uh nope. D: Nausea or vomiting? P: No. D: Changes in your bowel movement? P: Nope? D: Any urinary symptoms? P: No. D: Any muscle aches? P: Nope. D: Um, any fevers or chills? P: No, not that I've noticed. D: Any weight, changes in your weight recently? P: No, no changes. D: Any uh, night sweats? P: Uh, no. D: Okay. Um, alright so, have you had any contact with anyone who could have been sick in the past two weeks or before that? P: No, no, I'm very like careful. Um, I barely go out. D: Good, that's very good. Um are you, have you traveled anywhere outside the province? P: No. D: Okay and um, do you currently work? P: I work from home right now, um, I'm an accountant. D: Okay and do you live with anyone else, or do you live alone? P: Uh, so I live with my family. I live with my husband and um two daughters. D: Have any of them been sick recently? P: No, they've been fine. D: Okay, good. Um, and do you smoke? P: No, not at all. D: Do you smoke marijuana or consume any recreational drugs? P: Probably the last time was in college, um for marijuana. D: I see. Um, what about alcohol? P: Alcohol, I'll probably have a glass of red wine a day. D: Alright, okay. And um, have you, do you have any, um I guess carpets or, or um curtains or any sort of animals around, anything that might cause any kind of environmental allergies? P: Uh no, nothing like that. D: Okay, um alright. And do you have any medical conditions that you've been diagnosed with? P: No, I've been completely healthy. D: Any hospitalizations or surgeries? P: I did have a, um, c-section with both my, both my children. D: I see. Any complications after? P: No complications after. They were both healthy, I, I didn't have to stay in the hospital. D: Great, great. Um and any allergies uh to medications, foods or environmental allergies? P: Nope, not that I know of. D: Any medications, including over the counter herbal medications? P: I have uh, I do take uh, Tylenol cold in bed sometimes, to relieve some of the pain and pressure. D: That's good, that's good. Is there anything else that makes the the pressure and the pain better? P: Um, I have done those like, kind of those steam um, therapies. That sometimes helps. D: Okay good, good, good. Um, any uh, anything that makes the, that makes it worse? I know that lying on one side, you said, makes things worse for you. Anything else that's made the pressure worse? P: Um, no, I would say that's, that's about it. D: Okay, any changes in your sense of smell? P: Yeah, definitely. Uh when I get really stuff, stuffy, like I don't really smell anything. D: What about sense of taste? P: Um taste, I guess, like with the smell gone sometimes like the taste feels weird too, but like not, not really. D: I see, okay. Um, and any family history of any medical conditions? P: Um my, my father did have a heart attack in his uh, I think it was late 50s, but he's well and alive right now, so he's fine. D: Good. Alright, well that's all the questions I had for you given the symptoms that you've shared with me, it sounds like you might have something called um, rhinosinusitis, uh which is basically inflammation of the sinuses and of the uh, of the nasal cavity or the area inside your nose, and uh, often it's just treated with conservative management, so just continue to take um, Tylenol if that seems to help you, and do the steam therapy. It will take time to get better, um, but if you feel that it's um, it's not getting better in the next week or so, give us a call again and we can maybe see if it's a bacterial infection and see if um, if antibiotics might be needed but oftentimes it's usually a viral infection, and antibiotics are not needed, and sort of just resting and taking care of yourself, um, and trying to manage the symptoms that way can help. Um, but also check your temperature here to see if you have any fevers and uh, go from there. We'll also, I guess, we'll also do a COVID swab because your symptoms do overlap with some of those symptoms. Um, and we'd recommend that you quarantine until at least uh swabs, swab results are out and then public health will let you know what to do. P: Okay. D: Do you have any questions for me? P: Uh no, that's all. Thank you so much. D: You're welcome.
dataset\resampled_file\RES0188.wav	D: What brings you in? P: Hi, I was just really worried. My son just yesterday night I noticed that he was making these grunting noises and I did notice that he was a bit warm yesterday as well, and today I, he just hasn't been himself, just very, very irritable, crying a lot. Yeah, I just got bit worried. D: Yeah, for sure. What started first? P: I would say the there was a little bit of coughing earlier, like yesterday. But then later on during the night, it kind of turned into this grunting noise, and he's kind of like his chest is moving a lot more when he's taking a breath in and all that. D: OK. Uhm did you measure his temperature at home? P: Yeah, so I think it was 38.5 degrees Celsius. D: OK, and did you do that orally or rectal or under armpit? P: I did it under the armpit. D: OK. OK, uhm so you mentioned that he's had a fever, he's been grunting and he just seems a little bit more fussy. Is that right? P: Yeah. D: OK is he coughing at all? P: He was yesterday but not really now. D: OK and was it a dry cough? P: I think so. I mean, not-nothing really came out. D: OK, that's good. So no blood, no sputum? P: No. D: OK, and did he seem wheezy? P: Uh, no. D: No, OK. So there's no wheezing with the grunting? P: Maybe a little bit like that, just a little bit of a noise, but it's mostly the grunting. D: OK. Has he had any weight loss? P: No, not that I really, we haven't really weighed him now since his last appointment. D: OK. Does he seem excessively tired or fatigued? P: Uhm, moreso today I would say he's like earlier, he was very fussy, but now he seems a bit more tired. D: OK. Any rashes that you've noticed? P: No. D: No, OK. Uhm any changes in his vision or hearing? P: Uh, no, not that I can tell. D: No, OK. So he's responding to like sounds and he's still looking at you and things like that? P: Yeah. D: OK. Have you noticed a runny nose or stuffy nose? P: Uhm, no, nothing like that. D: No, OK. And he said he hasn't had any like fainting spells? P: Uh, no, I don't think so. D: No, OK. And how many wet diapers is he producing in a day now? P: Probably 5 or 6. D: 5 or 6 OK. Has that changed from before? P: No, it's pretty much the same. D: OK, and uhm any changes to his bowel movements? P: No. D: No. How about his urine? P: No. D: No, OK. OK. And then you said he was fussy, is he still eating and drinking OK? P: Uh no, today he's not really taking anything in, like very fussy, very hard to feed him today. D: OK, is he crying a lot? P: Earlier today was crying a lot, but now has calm down and just I guess tired himself out. D: Yeah, OK. Alright, and is he an otherwise healthy child? P: Yeah he was, he was premature by three weeks so, Other than that like I remember when he was born they did have earlier some issues with his oxygen not being high enough and they had to like keeping, keep us in the hospital for a bit longer. D: OK. P: But yeah, after that, like there haven't really been too many concerns. D: OK, so he's hitting all the developmental milestones like in terms of motor movements, ah speech, behaviour, all of that? P: Yeah, no issues there so far. D: OK, and how about medications? Is he on any? P: No. D: No medications, OK. And is up to date with all his immunizations? P: Yeah, oh he had all his immunizations so far. D: OK. How about allergies? Does he have any? P: Not that I know of. D: No, OK. Any family history of lung or heart conditions? P: No. D: OK, and does anyone at home smoke? P: No, no one smokes. D: OK. Has he been in contact with anyone sick recently? P: Uh, no, not that I know of. Uhm his older sister does go to school though, but I don't know if she might have carried something home. D: OK, how old is she? P: She's six years old. D: Six, OK. And is she healthy or is she having similar symptoms? P: No, she's healthy. No, no symptoms. D: OK. Any travel recently? P: No. D: No, OK. And who does he live with at home? P: Uh, so his older sister, me and his mother. D: OK, any reasons to believe like you have old carpets, dust, mold, asbestos, pets, anything like that that could worsen his symptoms? P: Uh, no nothing like that. D: OK, so I think those are all the questions that I had for you. Did you have any questions or any concerns? Anything that I missed that you wanted to add? P: No, I think that was all. D: OK, uhm so for him we'll do a Covid swab just to rule that out because some of his symptoms do overlap with that. But it it's really sounding like a picture of like community acquired pneumonia, so we'll do a couple of things for him. Uhm, we can get his temperature, get his oxygen oxygen saturation right away we'll get a chest x-ray. We'll do some blood work as well and uhm, he might need to be admitted depending on uhm, the oxygen, oxygen saturation and the fact that he's grunting. So if he's admitted will give him some extra oxygen and keep monitoring him and keep him hydrated. Uhm we'll also give him some antibiotics if, if it turns out he has pneumonia. Yeah, does that sound OK? P: That sounds good. Thank you. D: OK yeah, no worries.
dataset\resampled_file\RES0212.wav	D: So what brings you in the clinic today? P: Hey, uh I just had this cough that's been like really bothering me. D: OK, how long have you had that for? P: Uh like in the past few days, it's been really like gross and I've been coughing up this like gunk, but I've had it for, I've honestly had a cough for like three months, it's just like sometimes it's like there, and sometimes it kind of goes away. It feels like it keeps coming back. D: OK, have you had any chest pain? P: Um no, like it kinda hurts when I cough now but not not like on its own. D: OK, have you noticed any fevers at home? Or fevers at all in the last couple days? P: Uh I've been feeling like hot at night in the past couple days, uh but like I didn't actually take my temp. D: OK, have you had any night sweats? You wake up, the sheets are soaked? P: Uh no, not that. D: Nothing like that, OK, have you noticed any unexplained weight loss over the last little while? P: Um, no. D: So so you go on the scale, you lost a few pounds, but you haven't been trying to basically. P: No, like I, I don't really weigh myself, but I don't think so. D: So you haven't been noticing clothes have been fitting loose or anything like that? P: No, no, like I wish but no. D: Got it, got it. Now let's talk about what you're bringing up with your cough. What colour is it? P: It's really gross. It's kind of like greenish. D: Greenish, OK, and also any red or any blood with it? P: No. D: OK. And doesn't smell at all, smell funky? P: I haven't noticed. D: OK, so you've just been bringing this stuff up for the last couple of days, when specifically? Two days ago, three days ago? P: Like maybe maybe three days. D: Three days ago, and you said before that you kind of had this dry cough before. Uh when did you first notice that? Three months ago, you said? P: Yeah, I was uh, I I do like um, it like sounds silly but I do like a pole dancing class just for exercise and I was like at my class and I kind of just started to like feel like I was like a little coughy and like I don't think there's anything special, that was just like when I noticed it. D: OK, anyone at the class sick at that time? P: I don't think so, like it's a really long time ago, I don't really remember. D: Got it, got it. Anyone sick near you or around you in the last couple of weeks? P: No, no, not that I can think of. D: OK, and regarding other, any, we already talked about chest pain, uh you've been able to eat food alright? P: Uh yeah, like uh yeah it's like pretty normal. D: So no nausea, no vomiting? P: Uh no, none of that. D: You don't have a stiff neck at all, do you? P: No, no I don't. D: OK, but how about other parts of your body? Any pain? Tenderness anywhere? P: I don't think so, no. Like I'm I'm a little tired now, um like the cough is like maybe for like a month, it's been kind of waking me up a little bit so my my sleep hasn't been great, but I don't think it's like I have like pain. I'm just like tired. D: OK so the cough does wake you up at night? P: Yeah. D: Does it wake you up every night? P: Yeah, like pretty well, for like the last, not like all three months, but probably the last month. D: OK. Alright. I'm just gonna move on, talk a little bit about you and the past. Uh so any issues that you've seen a doctor for before? P: Uh just like eczema. D: OK, and do you take anything for that? P: Just like moisturizing creams, um like my family doctor back home said like, a couple times when it was really bad she would give me one like to go get at like shoppers, but right now it's not bad so I just have just like a regular cream. D: Got it, ever been hospitalized before? P: Uh, no. D: OK, any surgeries? P: No. D: OK so aside from the eczema, it sounds like you're pretty healthy eh? P: Yeah. D: OK. Do you have any allergies? P: Uh I think maybe um maybe cats because, I I don't have one, but sometimes I've noticed stuff, but I've never like, it's never really been too big of an issue. D: OK, so you've never taken any medications or got stung by a bee and had any trouble breathing or even a certain food? P: No. D: Nothing like that, OK, are you taking any medications right now? P: Uh no. D: OK, and you just go to Western? P: Mhmm. D: Do you live uh near campus with anyone? P: Uh I have like a roommate, yeah we, I live in an apartment with a roommate. D: OK, have they been sick at all in the last little while? P: No. D: OK, and last little while, have you done any traveling? P: No. D: So you haven't been outside the country or any exotic locales in the last little while? P: No, like I'm planning to on March break, but I haven't gone anywhere. D: Got it, got it, so you live in town uh with your roommate and you're currently a full time student? P: Mhmm. D: OK, and just regards to anything, do you smoke? P: No, like I don't um I don't smoke cigarettes like I sometimes sometimes smoke marijuana, but usually um usually it's like the vape. D: OK, how often we say you do that a week? P: Oh, like, maybe like once every like 2 weeks or something. D: Got it, any other substances slash drugs? P: No, like alcohol sometimes, like. D: OK so no cocaine, no heroin? P: No. D: And have you ever um injected drugs into your body? P: No. D: Got it, got it. Just coming back to alcohol, uh how often would you say you drink? P: Maybe like one one night like on the weekend. D: OK and what do you drink, how much do you drink? P: I don't know, maybe like 5 or 6 beers. I guess it just depends on the night. D: Got it, got it, and other questions, when was your last menstrual period? P: Maybe like 2 weeks ago? D: Two weeks ago, OK. Are you sexually active? P: Uh yeah, just with my boyfriend. D: OK, so do you two use contraception, birth control? P: Yeah, we use uh like condoms. D: OK, any chance you could be pregnant right now? That was a strange question to ask if you're sexually active, but any unprotected sex in the last two weeks? P: No. D: Got it, alright, and we're just kind of going over things,so it sounds like you've had this cough or a cough for a little while but it's only become bad in the last three days. You're waking up at night and you're kind of bringing up this foul or not this foul but this kind of greenish sputum, but it's, no blood in it, and otherwise you don't have any constitutional symptoms so I will go review your story with the doctors. Anything else you'd like to bring up with them before I go? P: I don't think so, I just like I like I hope I just can feel better 'cause I've been missing like my exercise stuff 'cause I feel like it's just like coughing and it makes it hard to like do well. D: Got it, got it. We'll see what we can do. OK, thank you very much. P: OK, thanks.
dataset\resampled_file\MSK0022.wav	D: What brings you here today? P: I have been having this, pains in my in my joints that's been ongoing now for the last several months and it's been getting worse over this period of time. D: OK, so several months, is the pain, so where, where exactly is the pain? P: So I get it in some of the joints in my hands. And then also my feet as well. So yeah my. Yeah, really in my feet and my hands. D: OK, and what kind of pain is it, is it like an aching pain, is it sharp pain? P: It'll be a bit at achey when it's there, but I if I move the joints at all when it's really sore, I can get a sharp pain as well. D: OK, and is this pain worse at all at any particular time of the day? P: Yeah, I would say in the morning time or if there's any period of time where I I'm like sitting and resting for awhile and I get up to move. I have a lot of stiffness and it takes me over an hour, sometimes to just get moving. D: OK, um so so if I understand it clearly it's. You get, do you get like morning you get morning stiffness and then when you're not very active or not doing things but then it gets better with movement? P: Yeah, exactly, yeah there's morning stiffness and it does get a little bit better with with movement. D: OK, do you have any of this pain or stiffness in the bigger joints in your body, like the hips or the knees or your shoulders? P: Uh, no nothing, no. Just really the small joints. D: OK in the morning stiffness lasts more than 30 minutes you said? P: It does, yeah. D: Yes, OK. Is is it symmetrical like is the pain symmetrical as in is it happening in both hands in the same areas and both feet in the same areas? P: Yeah it is actually now that you mentioned that, it is symmetrical. I'm noticing that it's the same. It's the same joints on both sides of my body that I'm seeing that are affected. D: OK now yeah, I I just have. Yeah, this one particular question. It's pretty specific, so when you look at your hands in which joints are painful. In your fingers is, do you, do you have any pain or swelling in the last joints like so just um, just, below the tip of your fingers? P: No, actually like the those joints are all, have been fine. I can move the tips of my fingers no problem, and I haven't had any joint swelling or pain in the tips of my fingers. D: OK, and how about, have you had any pain at all in the, I guess the first joints of the finger. So when you make a fist like the first joint that bends? P: Oh yeah, like my knuckles, you mean? D: Yeah that your knuckles. P: Yeah, yeah those actually. Those are the worst I can notice, those kind of on the like on my index finger, middle finger and and ring finger on both sides they they all look like they're swollen and and those hurt hurt really bad. D: OK, and in your feet, which joints would you say are hurting the most? P: I, I would say the like the big toe joint. On both of my feet, those bother me. Yeah, but my big my big toe on on both feet, but my right foot's worse than the other. D: OK, I see OK. And are you getting any pain in any other joints? P: Um actually yeah my my right ankle bugs me a little bit. I'm sorry if that's considered a large joint. But yeah, my ankle hurts and then also my in my hands I have. Like the middle one. Not proximal interphalangeal joint, yeah those ones hurt too. D: OK. P: I think I have like more than 10 joints that are swollen and painful. D: OK, I see and has this pain been pretty constant or have there been days that you don't have the pain? P: Yeah, there are days that are better than others for sure. It just. I'm not really too sure what the reason it is like. Maybe I'm just more rested or something like that, but. There are days that that are better, but over the last several months it's been getting getting worse. D: OK, and how much would you rate the pain from zero to 10, 10 being the worst pain you felt in your life? P: I would say it's probably a 6. D: OK, have you tried any medications at all to help with your, help relieve your symptoms? P: Yeah, I've been trying. Um acetaminophen and different types of anti-inflammatories like ibuprofen or Advil and I've tried creams and stuff too but it it doesn't seem to, help. D: OK. Are you feeling any other symptoms at all, like fevers or chills? P: Um I do. I have felt a bit warm. D: A bit warm, OK and how long has that been going on for? P: So it that varies as well, like some days I'll get. I'll feel like feverish for a little bit and it will kind of go away. I haven't checked my temperature, but, it I have felt warm at times. D: OK, and have you lost any movement in any of these joints at all? P: Uh it is harder to to make a fist. Yeah I can't fully close my my fingers all the way down to make a fist. D: I see. OK. Any kind of a um night sweats at all? P: No. D: Any weight loss? P: Um, well I think a few pounds, I just haven't really been as as hungry now. Yeah, my appetite hasn't been been as good recently. D: OK, any skin changes or rashes? P: I over a couple of the joints, I do notice some some redness, but just over the the joints on my hand I can have some redness. D: OK, but you don't notice any changes anywhere else? P: No nowhere else. D: OK, any changes in your vision or hearing? P: No changes to vision or hearing. D: OK. Any shortness of breath, chest pain? P: No. D: Any changes in your bowel movements? P: No, that's been normal. D: OK, any changes in your urinary patterns? P: Nope, I haven't had any pain or anything like that. D: OK, any numbness or tingling sensation anywhere, anywhere in your body? P: Nope, I haven't had anything like that. D: OK, have you been sick at all recently, either with like cold symptoms of any viral symptoms? P: No, I felt OK. D: OK and any muscle weakness? P: I. I don't think so. I've just I I have had trouble like opening jars and various things, but I think that's part of the, um like pain that I'm having in my in my hands it makes it hard to grip. D: OK, uhm. And in terms of your medical history, have you been diagnosed with any conditions? P: Uh, yeah I have a low thyroid and or or hypothyroidism. I think it's called I and I also have. Uh, high blood pressure, so I take my medication for high blood pressure and and something for the thyroid as well. D: OK, and when were you diagnosed with the hypothyroidism? P: Um this was about I like four years ago. D: OK, today tell you what it was caused by it at all. P: Oh, I think I was, I think they said Hashimoto's. D: OK, OK, OK, and since then you've been on the thyroid medication? P: Yeah, I think it's like Synthroid or or something like that. Yeah I think Synthroid. D: Alright. Any other medications at all that you take regularly? P: Yeah, I think it, I'm taking an ACE inhibitor for the blood pressure. D: OK, any allergies to any medications that you know? P: Uh, no. D: OK, any hospitalizations or surgeries in the past? P: No. D: OK. Any family history of any autoimmune conditions? P: My mom had hypothyroidism as well, and uh, and that's it. D: OK, so anything else like rheumatoid arthritis, ulcertaive colitis, Crohn's disease, type one, diabetes, anything like that? P: I I think my cousin actually has type one diabetes. He's a, like he's much younger than me, but yeah, I think he I have a cousin with type one diabetes as well. D: OK. Alright, and um currently do you work? P: Yeah, I've been working as a administrator so it's been tough on the computer with with how my hands have been causing me pain. D: Oh so from the typing also gives you some pain? P: Yeah I can. It can give me a little bit of pain, but once my hands start moving it's it's OK. It's just I'm a bit slower at my job with with how it is, especially starting in the morning. D: OK, I see. OK, and currently what's your living situation like? P: So I live with my husband as well as our, uh, our daughter. She's 4. D: OK, and are you currently right now, do you smoke at all? P: I I don't. I quit smoking four years ago when my daughter was born and before that I didn't smoke much to me anyway it was I was only smoking like you like maybe four or five cigarettes a day so I just stopped then. D: OK, that's really good. Uh, uh, congratulations. P: Thank you. D: Yeah, and other than that, do you use any recreational drugs like marijuana? D: Uh, no, I don't. OK, how about alcohol? P: I'll have a glass of wine sometimes, but very rarely. D: OK. Um yeah, so those are just some of the questions I had for you now. I just wanted to ask a few questions regarding just physically examining the joints that hurt. So when you look at those joints, do you notice any kind of swelling, redness, or when you feel any warmth to them? P: Yes I yeah I do. I feel swelling, warmth and redness. D: OK, and do you notice any kind of deformities, for example like you're not able to bend your finger or any kind of deformities that you didn't see before? Or, like, for example, your wrist is turned uh, outwards a little bit. Anything like that? P: Uh, no, nothing like that, no deformity. D: No deformities. OK, when you go over your joints, do you notice any kind of like nodules or harder materials that don't seem to be your bones? P: Not really, no. No, I don't notice anything like that. They just share a bit larger from the swelling it feels like. D: OK, I see. Are you able to make a fist with both both hands? P: Not completely, I can close my hands part of the way, but I can't make a full fist. D: I see. OK and are you able to completely extend your fingers and show your palms? P: Yeah I can do. I can do that. D: OK. And are you able to walk without a limp or anything like that? P: Um, yes I can. D: OK. Alright, so those are just all the questions I had for you today. Do you have any questions or concerns? P: Um no, I'm just wondering what what this could be. D: Yeah, so from what you're describing to me you do fit into. The age range and all the symptoms are kind of point towards arthritis, and in this case it sounds more like rheumatoid arthritis. Ddefinitely it can be different types of arthritis that we will investigate just in case as well. But given that it's symmetrical, you have the morning stiffness that doesn't go away for more than 30 minutes and just the pattern of where those where the stiffness and pain is occurring itt sounds more likely to be rheumatoid arthritis, especially since you've also, you also have another autoimmune condition with hypothyroidism, it's more likely to be another autoimmune condition. So what we will do is get a few tests done. This will involve some blood work as well. And we will also get some imaging done, so we will get like the CRP and ESR for inflammatory markers we will get like your full CBC blood count we will get rheumatoid factor test done as well as antinuclear antibody and a lot of other different just markers to rule out anything else besides rheumatoid arthritis and then we will also get just X-Rays of your hands and feet as well. So does that sound good? P: It does, yeah, thank you. D: You're welcome. And then if it does come out to be rheumatoid arthritis arthritis, which seems likely, you will need a referral to a rheumatologist to manage and treat your, uh, treat you with medications. D: OK, thank you alright, you're welcome. Take care.
dataset\resampled_file\RES0140.wav	D: Um, what brings you in today? P: Hi, I just came in uh, I just had this sudden, just this morning after I woke up, this sudden shortness of breath and like each time I take a deep breath I'm getting this chest pain. D: Okay, and this just started this morning, you said? P: Yeah. D: Were you absolutely fine last night? P: Yeah, I didn't have any trouble last night. D: I see, I see, okay. Um, any other, does the chest pain only occur when you're taking a deep breath in? P: Yeah, mainly it's during that time. D: Okay, um, have you had any other symptoms such as a headache or cough, or runny nose, congestion, sore throat? P: Um, no. No, nothing like that. D: And changes in your bowel movement? Any pain in your belly? P: No. D: Any urinary symptoms? P: No. D: Any um, any pain in your legs? P: Um, I did notice last, last night and for the last few days that my right calf like, just feels um, painful and it seems a bit more swollen. D: Um, was there anything that you were doing a couple of days ago? Any, say, any flights or periods um, where you might be sitting still or lying still for awhile? Any surgeries, anything like that? P: I was, I was just discharged from the hospital um, last week after a hip surgery. D: Um, okay. Were you moving around at home after the hip surgery? P: Um not, not really. Like I was, I was told I should move around a bit, but it's been quite hard. D: Um, alright, and do you have any medical conditions that you've been diagnosed with? P: Yes, I have uh, high blood pressure, and um, I also have this thing like, like varicose veins. D: Um, do you take any medications? P: I, I take this medication called um, lisinopril. D: And any new medications that were started after your hospital stay? P: Um, no, they gave me like some pain medications I seem to, uh, um I got hydromorphone medication. I've been trying to stay away from it though, just taking Tylenol instead. D: Is your pain controlled well with Tylenol? P: Yeah, I tried to suck it up. I just don't wanna go on those other medications. I've heard like, you can get addicted to them. D: Yeah, that's fair, that's a fair point. But it's also, I guess it's important that you move around at home. Um, so maybe try to, maybe we can increase your Tylenol dose, or maybe um, see if there's another pain med that you can be started on if you're not interested in opioids, just to make sure that you're moving around 'cause that's very important. At the hospital, did you receive an injection in your, in your tummy. P: An injection in my tummy, um. D: Every day, once a day? P: I think so, yeah I did. D: Okay, okay. Um, alright. And do you have any allergies? P: Uh, no allergies. D: Okay, um, and who do you live with? P: I live alone. Yeah, right now I live alone in an apartment. D: Were you discharged with any support? P: Yeah, I do have a nurse coming in, like every, everyday, but I don't, they, they didn't come like yesterday. D: Okay, okay. Um, and do you smoke, or did you ever smoke in the past? P: I used to smoke in, probably in my 20s and 30s, but then I stopped when I had kids and stuff. D: Do you drink alcohol? P: Um, yeah, probably uh, a glass, once or twice um, every couple days. D: Um, and sorry. just going back, how much did you smoke in your 20s and 30s and for how many years? P: Probably smoked for, probably, 15, 15 years, probably like, like half a pack a day. D: Alright um, and do you consume any marijuana or any recreational drugs? P: No. D: Okay, alright. Well given your symptoms, um, with the, with the swelling and the pain in the right calf and the difficulties breathing, it's very likely that you have um, and your recent hospitalization and hip injury, um it sounds like you might have something called, or pulmonary embolism, basically, which is a blood clot inside your lungs, and so we'll do a scan of your lungs to see what's going on. We'll also do an ultrasound of your leg, and then um, we might have to treat, uh, this with blood thinners. And we definitely have to hospitalize you, and we'll be measuring your vitals and seeing if you need any oxygen to help you out. P: Okay, I'll be, I'll be here for a while then? D: Well, we'll keep you for a bit, at least the next couple of days until your, your breathing gets better. And you've, you've been started on anti, on blood thinners. P: Okay. D: And we can be sure that you're, you're doing okay, we'll also continuously monitor your vital signs um, to make sure that you're doing well, and then we'll make sure that you're discharged. We will also get you some physiotherapy here while in the hospital to help you um, mobilize better when you get home. Um, and we'll also do a COVID swab just in case. Did you have any exposures to anyone in the past couple of days before you came, at home, after you came home? P: No, I've been just at home, just the nurse. D: I see, I see. Okay, well, we'll do a COVID swab just in case and go from there. Do you have any questions? P: No um, yeah, that, that sounds good. D: Okay, great.
dataset\resampled_file\RES0116.wav	D: What brings you in? P: Yeah, so uh I'm just bringing my son uh here to the clinic. He's been having um just I think he's been complaining of uh ear ache in his uh I think it's mainly in his left ear for the last, I'd say at least a week. Um he's been kind of just having discomfort um and over the last few days uh he also started crying because of how much pain he is having, and then um we also noticed that he had like was just feeling warm, so we took his temperature and he actually had a fever just yesterday of like 39 degrees Celsius. D: OK, uhm, alright. So let's back up just a little bit. The ear pain, when did that start? You said a couple of days ago, so was that two, three, four days? P: Uh I think the discomfort like uh, we saw him scratching his ear for the whole last week, but uh the crying actually started just I would say four days ago, um. D: OK. P: So I think the last few days have been really tough for him. D: Yeah, so three, four days. OK, have you taken a look into his ear? Like does does it seem red? Is there discharge? P: Uh I think we did see some uh, just like it wasn't red or anything, but I think we did uh see some um just kind of clear to almost uh clear to yellowish fluid from his affected ear. D: OK, clear to, you said white-ish? P: Uh like it was a bit of a yellow tinge to to it as well. D: Yellow, OK, OK. And which ear was it, sorry, the right or left? P: Left ear. D: Left ear, OK. And the right ear looks normal? P: Yeah, right ear, he hasn't been complaining uh at all. I haven't even looked at the right ear yet. D: OK, is he itching his ears at all? P: Uh he was he was itching like pretty much this whole week, but I think right now he's hesitant to even touch his ears. D: OK, and does it look like it's angry on the outside or on the inside of his ears? P: I can't really see anything on the outside. D: OK, OK, and have you noticed that his hearing has changed at all? P: Um he still like answers to us and like I don't think his ear, hearing is affected. D: OK. Has he had any past issues with his ears, like ear infections or like hearing issues in the past? P: Uh no hearing issues, but he did have uh like he used to, probably when he was uh like 2 years old, he did have a couple ear infections. D: OK, OK. Were they were they treated with antibiotics? P: Uh I think one time they were, but I I'm pretty sure that was on, in his right ear. D: OK, OK. He's never had to get like tubes inserted or anything like that? P: No, no, nothing like that. D: No, OK. Um, alright. Um has he had a stuffy nose or runny nose? P: Uh not this week, but he he was a bit like stuffy like last week I would say. D: OK, he was a bit stuffy, you said? P: Yeah, maybe even, maybe two weeks ago. D: OK. And that stopped. Did he have anything else along with his stuffy nose at that point? P: No, nothing else. D: Um right now, have you noticed any changes in his vision, in his smell or taste? P: Uh mo, not that I know of. D: OK, how about weight loss? P: No, he's been um growing pretty well. D: OK, and you said um you had taken his temperature. When did you take his temperature? P: I just took it yesterday but uh he was feeling a bit warm yesterday so we just took it and it was like um 39 degrees Celsius. D: OK, OK sweet. Um so 39 degrees, so he does have a fever uh for sure. We'll take his temperature again today just to make sure. Have you been giving him anything for his high temperature, like Tylenol? P: No, we haven't given him anything. D: OK. Have you noticed any rashes on him? P: No. D: No, um how about coughing? P: Uh no, he hasn't been really coughing. D: No coughing, how about wheezing or shortness of breath? P: No. D: Like anything that would indicate he has chest pain or palpitations of his heart? P: No, I don't think so. D: No, OK. Any dizziness or fainting spells? P: No. D: Confusion? P: No, I don't think so. D: Headaches? P: Uh not that I know of. D: OK, and how how have his bowel movements been? P: His bowel movements have been pretty much the same, um he's uh, yeah, there's been no real changes. D: No, OK. Um alright, and how about uh nausea or vomiting? P: Uh no, no, no nausea or vomiting. D: Any appetite change? P: Uh no, uh, maybe a little bit more fussy just, but I don't know if that's probably due to the pain. D: OK. Um and how about his urine? P: Uh his urine has been the same, like no changes. D: No changes, OK good. Is he an otherwise healthy kid or does he have any longstanding conditions? P: Yeah, he's pretty healthy. There have been no concerns at all that we've had for the doctor. Uh he's been growing well, um meeting all of his milestones. Um yeah, no, nothing that's concerning. D: OK, um do you know if his mother's pregnancy with him was normal? Did she have any complications? P: Um she didn't have any like complications during the pregnancy. Uh they did have to, um I forgot what it's called, but uh he was like a difficult baby coming out. Um and he was at term though, he wasn't premature, but they had to use just um some tools to get him out. D: OK, OK. Um so it was a vaginal delivery, but they used some tools like forceps maybe or vacuum? P: Yeah, yeah it was forceps, yeah. D: OK, OK. Um and he's, you mentioned he was full term? P: Yeah, he was born at uh 40 weeks. D: OK, perfect. Did he need to be hospitalized for any reason after that? P: No, he wasn't hospitalized. Uh we stayed there maybe one day extra just because um there was some just kind of misshaping of his head. D: OK. P: That kind of went away. D: OK, OK, good. And is he on any medications? P: Uh no, no medications. D: No medications, up to date with his immunizations? P: Yeah, he's all up to date. D: OK, any allergies? P: Um not that we know of. D: OK, how about family history of lung conditions, heart conditions? P: Um no, we've been pretty healthy as parents. Um and I think my my father has like high blood pressure, diabetes, and all those types of things. D: OK, OK, any um ear issues like congenital ear, sorry um, genetic hearing issues or ear issues? P: No, nothing like that. D: OK, um does anyone at home smoke? P: No, no one smokes. D: OK. Um and who does he live with? P: So he lives with um me, his father, and his mother as well. D: OK. Uhm, any siblings? P: No siblings, he's an only child. D: OK, and how are things at home, um is like, are things financially stable? Any relationship issues? P: No, we've been pretty uh fortunate like it it's, no financial issues uh and we have a lot of support from our parents as well. Uh the relationship is great, so no, no issues. D: OK, good good. Um has he had any sick contacts recently? P: Um I don't think so. He's, we've been at home so I don't know. We we did have like, with our with my brother's uh kids like uh they came to see us once um but that was like, that was, I think at like three weeks ago. D: OK, OK, three weeks ago. Alright, um travel to anywhere recently? P: No. D: No, OK. Alright, those were all the questions I had for you today. Do you have any questions that you wanted to ask me today before we end the interview? P: Uh no, not really. Just wanted to know if, like I remember he did need antibiotics before so I was just wondering if he needs them now. D: Yeah, um so, well first, because some of his symptoms overlap with Covid, like the fever especially, we'll do a swab on him anyways um and you should hear those results in about 24 to 48 hours. Um and then it, this picture sounds like acute otitis media, so like an ear infection. And um it's especially likely because he's had them in the past, so I'm gonna have to take a look into his ears first before like um coming up with a management plan. But I'll kind of walk you through what we look at. So if I take a look and I see like a perforated tympanic membrane with like pus, we'd prescribe like 10 days of um antibiotics. If he has some like middle ear effusion, so like some fluids with like a bulging tympanic membrane and he appears to be really ill, uh which from the sounds of it, he sounds ill, he's had this fever for more than two days, we'll also prescribe antibiotics for 10 days. And then, if it's just some middle ear effusion, so just that clear fluid um or just the bulging tympanic membrane, we can just um reassess him in 24 to 48 hours to see how he's doing. And if he's worse, again, we'll prescribing prescribe him some antibiotics. Um the antibiotics that we usually prescribe are amoxicillin, and because he doesn't have a penicillin allergy, that should work. P: OK. D: Yeah, how does that sound? P: That sounds good. Thank you so much. D: OK, great, thank you.
dataset\resampled_file\RES0142.wav	D: Uh, what can I do for you? P: Hi um, yeah so I, I just came here today um, because I've just been feeling um, like I have this really sore throat for the last uh, week, and I've also been getting some chills over the last few nights as well. Um, so yeah, I just came to check it out. D: Um, okay, and um, when did uh, so your sore throat started um, a week ago. What about um, the chills? P: Um, chills, I've been feeling them over the last few nights um, and I've also just been feeling very tired and um, over the last whole week as well. D: Okay, um, have you had any difficulties swallowing? P: Um, yeah, I definitely feel like uh, I do get some pain ones following, but it may be just with the sore throat. D: And um, have you had, uh, have you had any headaches? P: Uh, no headaches. D: Any uh, stuffy nose or runny nose? P: Uh no, nothing like that. D: No um, sinus congestion? P: Uh no. D: Okay, what about uh, cough? P: Um, no, not, not, no cough really. I've also noticed, also like the back of my throat, when I look in the mirror, is like just very red and like angry looking. D: And um, any difficulties breathing? P: No. D: Any um, pain in your chest? P: No. D: Um, do you feel like your heart is racing? P: No, nothing like that. D: Any changes in your bowel movements, or your urinary, or any urinary concerns? P: Uh, no. D: No belly pain or muscle aches? P: Uh no, nothing like that. D: Alright, um, so uh, are you um, do you have any medical conditions that you've been diagnosed with? P: No, I've been pretty healthy all my life. D: Any medications that you've been on? P: Uh no. D: Any allergies? P: No allergies. D: Okay, and um, any medical conditions that run in the family? P: Um, I think um, my mom has diabetes, but that's about it. D: Okay. And um, who do you currently live with? Or do you live alone? P: I live with uh, my mom. D: Anyone else at the house? P: No, it's just us two. D: Alright, um, and any um, recent exposures to anyone who might be sick. P: Um my, my boyfriend, he kind of had similar symptoms, I would say a few weeks ago. D: Um, and um, did he, did he get um, did he see a doctor? P: No, he didn't want to go to the doctor, and it kind of just resolved, like he, it went away on its own. D: Okay, alright. Um, and do you um, do you drink? P: Just on the weekends maybe, uh, some wine. D: And what about um, marijuana? P: Um just socially, like right now there's no parties, but like when I'm at parties. D: Um, what about alcohol? P: Uh, yeah, so just uh, socially again. D: Oh, yeah. P: Right now, with my mom drinking every now and then. D: I see, okay. Um, alright, well that's all the questions I had, and uh, sorry one more. Have you been up to date with your immunizations so far? P: Yeah, I've been having all my immunizations. Uh, I also feel like, so with a sore throat, I also have some um, pain on the sides, like on my, on my neck. Like I almost feel like some lumps on both sides. D: Oh, I see, I see. Okay, okay. Um, so I guess I, at this point I would like to maybe have it, examine you, just have a look inside your throat, maybe feel your neck for those lumps, and uh, then decide what to do from there. Um, given your symptoms, um, this could be a viral infection, or um, it could be a bacterial infection caused by um, bacteria called, or I guess, strep, strep throat. It could also be uh, mono. Um, but I'll uh, I'll have a look, we'll do the rapid strep test and uh, based on those results, we'll decide what to do. If it is strep, you might require antibiotics. If not, if it's mono and if we can do maybe a blood test for that, you might have to um, not engage in, in physical activity um, or exercise, vigorous activity, or like sports for the next couple of weeks or months as, as that can be, uh, as that can cause problems if you get hit in the, in your belly. It could cause your spleen to rupture and sometimes your spleen become very big if you do have mono, but we'll discuss all of that a little bit more after we do uh, the strep test. We'll also check your temperature, um, and see um, how you're doing. Have you been taking anything to help yourself, to help soothe your sore throat? P: Um, just some lozenges. D: Yeah, so just continue uh, just drinking water and taking lozenges just to um, provide some comfort for yourself, and we'll do the test, then we can chat a bit more after. P: Okay, sounds good, thank you so much.
dataset\resampled_file\RES0195.wav	D: What brings you in here today? P: Yeah hi, I'm so over the past few months I've noticed that I get short of breath sometimes. And my eyes are so irritated. And they feel itchy and red. And I've also noticed this rash below my knees, so I just wanted to get everything checked out. D: OK and when did this all kind of start? P: Ah it started a couple months ago like 2, 3 months ago. D: OK and when did the shortness of breath start? P: That's been on and off for the past two months as well. D: OK, and how about the rashes? P: The rashes started like a month back, but it looks worse now. It started off small. D: OK, um so for the cough, is it like a dry cough or a wet cough? P: It's a pretty dry cough. D: Dry cough OK, are you bringing up any green or yellow material or any blood at all? P: No. D: OK, and this also started like a few months ago? P: Yes. D: And is it constant or does it come and go? P: Um it's it's getting worse now so it feels more constant now, but at first it it just came in. Yeah, it came in went. D: OK, and has this happened to you before at all of these symptoms? P: No. D: OK. Alright um. So it started a few months ago and how about the rashes? Are they have they been there like the ones below your knee since the two months? Or do they come and go? P: Um that's been there for the past month. D: OK. And can you describe the rash a little bit? What does it look like? P: Sure, so it's now pretty diffuse. It's just below my knees like on my shins. It's on both sides. The one on my right side is a little bit bigger. It's about I'd say maybe like 10 centimeters and diameter. It's it's red or like a dark pink um. There's nothing coming out of it. D: OK. Is it painful or itchy at all? P: It's um painful, yeah. D: OK. What kind of paint do you feel that when you press on it? P: It's it's not that OK, so it's not painful painful, it's tender. So if I touch it, it will feel tug tender. D: OK. Uh. Have you tried anything that has helped you relieve these symptoms? P: Um I took some ibuprofen that helped a little bit. D: OK. OK, um and. So you've had the cough, but have you been having any kind of shortness of breath? P: No. Well, actually sorry, sorry I have had a shortness of breath. I haven't had a cough. D: OK, so no cough, but you've been having shortness of breath. P: Yeah D: And. When your shortness of breath is it more so that you're not able to take deep breaths, or you taking shallow breaths, how would you describe it? P: It just feels like, yeah, I can take in a full deep breath. D: I see. And are you having any other symptoms like fevers or chills? P: No. D: OK, and how about the eye irritation? When did that start? P: That started a month ago as well. D: OK, and you do you have any red eyes? Or can you see any changes in your vision at all? P: Yeah, my eyes do look a little bit red and. I don't know if my vision changed a lot, but sometimes things will look a little bit blurry when they're far away. D: OK. And with the shortness of breath, is it brought on by exertion, or can it be at rest as well? P: It can be at rest as well. D: OK. And then, do you have any other symptoms? Like any joint pains? P: No no join pains. D: OK. Any nausea or vomiting? P: Um no. D: OK, any headaches? P: No. D: Any muscle pain? P: Uh no. D: OK. And any recent travel or contact with someone who's been sick? P: Um no. D: Do you see any or do you notice any like fluid coming out from your eyes or anything like that? P: Uh no, I didn't notice that. D: OK, do you get any night sweats? P: No. D: And any chest pain? P: Sometimes the shortness of breath. D: OK, is it just like a discomfort or is it a pressure or stabbing pain? P: Ah it just feels like a discomfort. D: Do you feel your heart is racing? P: Uh. No. D: OK, and any changes in your bowel movements at all? P: No, nothing like that. D: OK. Any changes in your urinary pattern? P: No. D: OK. Any sore throat, runny nose, any cold like symptoms? P: Uh no, but I haven been feeling um a little bit hot, so I wonder if I have a fever. I haven't checked it. D: OK, we can check. Have you had any recent weight changes? P: Now that you mention it, I have had some weight loss over the past um six months. I've lost about 15 pounds. D: 15 pounds OK. How about your appetite? Have you been eating well? P: Yeah, I've been eating the same. D: OK, OK, and have you had any exposure to any fumes, dust, animals or pets in your environment? P: No. D: Have you been diagnosed with any medical conditions in the past? P: Uh no. D: Do you take any medications? P: Um nope. D: OK, any allergies? P: No allergies . D: OK. Hospitalizations or previous surgeries? P: Uh I had a C-section for my second child. D: OK, any complications with that? P: No, it was it was a pretty standard. I didn't have any excessive blood loss or anything like that. D: OK, any family history of any medical conditions like any lung or heart conditions? P: Um no lung or heart conditions. There are some autoimmune conditions in my family though. D: OK, and what what kind of autoimmune conditions are there? P: Uh, there is rheumatoid arthritis um . There is um uh lupus. Like type one diabetes. D: OK. OK and then. Are they for any like direct relatives like your parents or or children? P: Yes, my parents. D: OK. And currently right now do you work? P: I work from home. Yeah, I teach I teach online. D: OK and how's your living situation like right now? P: Pretty good. We live in a house. I live with my husband and two children. D: OK, um. And do you currently smoke? P: No. D: OK. And any recreational drug use like marijuana? P: No. D: OK and any um alcohol? P: I drink once in awhile like I'll have a glass of wine on Fridays. D: OK. Alright, yeah, so those are all the questions I had. Do you have any questions for me? P: Um no, like what what do you think I have and how should I treat it? D: Yeah, so definitely one thing we need to rule out with the shortness of breath is any viral or viral infection like coronavirus so we will get a test done for you today. However, since this seems to be kind of a chronic issue, been going on for a few months and you're having with the shortness of breath, some other symptoms, the rash below knees, or is what we called erythema nodosum and irritation in your eyes and you have a family history of auto immune conditions as well. So sometimes you can get an auto immune disease that affects the lungs, so we need to rule out something like sarcoidosis which can cause fibrosis in your lungs and cause shortness of breath. So just to work that up will get a chest X Ray and also do some inflammatory marker tests like CRP, ESR and some other rheumatological tests as well, and based on what comes back we may have to refer you to a rheumatologist for further management and treatment. Yeah, so let's just do some of those tests 1st, and then we'll go from there. You have any questions? P: No, that sounds great. Thank you so much. D: You're welcome, and you may need depending on what we find, steroid treatment today or until you see the rheumatologist. P: OK. D: Alright, take care. P: You too.
dataset\resampled_file\RES0127.wav	D: What brings you in here today? P: Hi, I've I've just been. I've been sneezing a lot and I have this runny nose. It's just been very irritating. I kind of want to do something about it. I've had it for awhile, but it's just. You know, I decided to like, come in to find out what's. What's wrong with me? Why do I like? Why does this happen to me? All my friends are OK. D: Oh yeah, I know it must be very, very irritating. How long has it been going on for? P: It's been years, I don't even remember. D: Oh years, OK and years like just sneezing and the runny nose has been going on for the last few years. P: Yeah, it kind of kind of comes on like around the spring time. It just gets really bad at that time. D: yeah? OK, and are there any besides during the spring time, any kind of allergens or any anything in the house or around you that triggers it, like dust or anything like that? P: Yeah, dust makes it a lot worse. Like when I have to vacuum the house, I just feel awful for the next two days. D: I see, do you get any other symptoms besides the, uh, sneezing and runny nose? P: Yeah, let my nose so stuffy and sometimes it's just like my eyes and my nose are just itchy and my eyes get like red and teary sometimes. It's so embarrassing when I'm going to school. I also wake up in the morning with this like sore throat and have just cough and clear out my, you know clear my throat. D: OK, and does that happen like every morning? P: It's usually worse around springtime. D: OK. and are you coughing at all? P: Well, I have to like cough to clear my throat but then not otherwise. D: OK, and are you bringing up any sputum? P: Yeah, that yeah I do. D: Like, uh, how much would you say? Do you just bring it up in the morning, or like throughout the day, P: just in the morning, D: just in the morning? P: Yeah D: Do you have a sensation of like anything kind of dripping down your throat like after you wake up like just a build up? P: Yeah yeah I do. D: Ok. And besides that, have you been having any symptoms of fevers, chills, sore throat? P: I get a bit of a sore throat, I guess in the morning, but it just goes away after. D: OK, P: But no fevers. D: OK, and is there anything that you've tried at all, like medications or anything that has helped you with these symptoms? P: Uhm yeah, I tried like umm Reactin and that really helped. D: That helped OK that's good and are you taking Reactin right now? P: I didn't take it today. I tried it a couple days ago. D: OK. And have you traveled at all recently? P: No. D: No, OK, and any sick contacts, anyone around you that has been sick? P: I don't think so. D: OK, any headaches? P: No. D: Any nausea or vomiting? P: no. D: Any fevers or chills? P: no. D: Any kind of fatigue or tiredness throughout the day? P: I do feel more fatigued when I have these symptoms. D: OK, any night sweats, fevers, or chills? P: no. D: Any changes in your bowel movements at all? P: No. D: Any trouble urinating? P: no. D: Any changes to your appetite or weight? P: I've been losing weight, but I've been dieting and working out more. D: OK, and how much weight would you say you've lost over the last few months? P: I've lost about four pounds in the past four, five months. It's been hard to lose weight. D: And so no, no sudden like loss of weight or anything like that right now? P: No, no, no D: Well, it's really great that you're, you know, trying to lose weight and dieting and and having like a healthier lifestyle. It is definitely harder with the pandemic going on right now to to get in the activities. And it's hard like being at home, and sometimes it's really difficult to like not eat right P: Yeah yeah true. D: So besides besides that any kind of recent exposures to any fumes, dust, animals, pets like anything like that? P: Yeah, it was kind of like vacuuming a couple of days ago when it got really bad, but nothing. Not not. I don't think there's not been any other exposures. D: OK. And do you have any past medical conditions that you have been diagnosed with like asthma, eczema, anything like that? P: I haven't been diagnosed with anything. No. I did have like I know that I would sometimes get kind of short of breath as a child. But my mom doesn't really trust doctors, so she wouldn't take me to one. D: OK, have you had shortness of breath after that, like when like as a child, how old were you? P: I must have been like 8 years old or 9 years old that I remember, but I think I've had it before that as well as my mom tells me. D: Oh OK, do you have that at all now? P: No, no, I don't. D: OK, OK Have you ever seen an allergist before? P: No, no. D: No OK. Do you have any known allergies to any medications? Yeah any medication? P: no D: no. Do you take any medications at all on a regular basis? P: No. D: No, OK. Have you been hospitalized or had any surgeries in the past? P: No. D: Any family history of any asthma, eczema, allergic rhinitis. Anything like that? P: Yeah, I think it kind of runs in my family like everyone in my family is just kind of always having this runny nose and sneezing. My mom has it. My younger brother has it. But like we haven't really been diagnosed with anything like we, we rarely go to the doctor. D: OK, OK, and currently right now, do you work at all? Or sorry, do you go to school? P: I do I do. I've been doing it virtually. D: Virtually OK, so have you noticed anyone sick around you? P: No. D: No OK. And what at home? What's your living situation like? Who do you live with? P: I live with my mom, dad and my younger brother. D: And, yeah, I just want to let you know that any questions I ask you today and anything we talked about it's completely confidential and unless like there is any potential harm to yourself or anyone anyone else. So yeah, I'm just gonna ask you a few questions. Do you feel safe at home? P: Oh yeah. D: OK, and do you drink alcohol at all? Or have you tried alcohol? P: No, not at all. D: Have you tried any recreational drugs like marijuana? P: No. No. D: How about smoking? P: Umm no D: no OK, and are you sexually active? P: No. D: No OK. And so overall, do you feel safe in your home and as well as outside of your home environment? Any kind of bullying or anything like that going on? P: No, not at all. D: OK, alright. Yeah, so those are kind of all the questions that I had for you. Sorry just one more question, any loss of sense of taste or smell? P: Yeah, it's hard to smell and my nose is stuffy, but no loss of taste. D: Yeah, OK. OK, so do you have any questions at all for me? P: No, I just I I just wanna get some medications to help with this. I'm just sick and tired of my runny nose. D: Yeah, it must be very frustrating. So you've tried Reactin before, right? P: yeah D: Yeah, so one method is to definitely like stay away from some of those allergens that are potentially causing your symptoms. But I I do really think so you might have something called like allergic rhinitis. And I think it might be beneficial to for you to see like an allergist P: sure. D: And so I can refer you to someone as well. Just have a sense of what kind of things allergic to you and like what medications you would require. In the meantime, definitely like any antihistamine medications would help with your symptoms. But since you're also having congestion and sneezing, just just in case, we will just do a COVID swab test for you today. And it takes around 24 to 48 hours to come back. And in the meantime, you should just isolate as much as you can in your own home. And then based on the result they would give you more instruction. P: Sure D: Alright. Thank you, take care.
dataset\resampled_file\RES0004.wav	D: It's nice to meet you. What's your name? P: It my name is Scott. It's nice to meet you too. D: Alright, um so Scott. How old are you? P: 15. D: OK, What brings you in today? P: Um, I've had a sore throat now for a couple of weeks and it's just not going away. D: Couple of weeks. OK, so about two weeks, three weeks? P: Yeah, about two to three weeks. D: OK, um what does it feel like is it, is it kind of like a burning feeling? Is it more like an itchy feeling? What does it feel like? P: Uh I would say it's kinda yeah like burnin' or burning or scratchy. D: OK, and does it hurt when you swallow? P: It does, yeah, uh, If my throat hurts when I'm eating or Um uh or swallowing like liquid's as well, but cold stuff seems to make it feel a little bit better. D: OK, good, and does your neck hurt too? P: Um. A little tender, I've noticed the um some lumps at the front of front of my neck that have been a bit sore. D: OK, and is it mostly sore, kind of like midline? Or is it more sorta one side versus the other? P: Um I'd say, maybe the, uh, the right side is a little bit more sore, but I think I can feel it on both sides of my neck. D: OK, and how bad would you say your discomfort is 1 to 10, 10 being the worst. P: Um. I would say maybe a two or three if I move my neck I I can feel it more, but otherwise I can just barely notice that it's there. D: OK, so it's not preventing you from sleeping, going to school, playing, things like that? P: No, it's more so the sore throat when swallowing. D: OK. OK. Um, have you noticed a fever at all? P: Um, I have. Yeah I felt hot and Um I checked my temperature this morning and it was 38.7 I think it was. Is that a fever? D: Yeah, I'd say that's a fever. We can also do another temperature check today. P: OK D: Um yeah, but that definitely sounds like a fever. Um, have you noticed rashes anywhere? P: Um Yeah, I've had this, uh this, like red I guess pink rash that I have noticed it's come over my chest and and belly area. D: OK, how big is it? Is it more than a centimeter? P: Uh huh. Yeah, it's pretty well, I mean, it's kind of, um spread out over over an area like it's not all continuous I guess. You can kind of see patches or blotches. D: OK and, is it raised? P: No, it's it's not raised. D: OK. OK, is it itchy? P: Uh, no, it's not itchy. D: Painful? P: No, not painful. D: OK and is it bleeding or oozing anything like pus? P: Um no it's not, nothing like that, it's just pink and red and it's just kind of shown up over the last little while. I've noticed it on my um like hands a little bit too. D: OK, and you said this started when like was this before the sore throat or after? P: Oh I can't like remember the onset. I I think that the sore throat started first and maybe a rash came a little bit later. D: OK, OK and have you noticed that your that your glands are swollen? P: I think so, um maybe that's what's swollen in my neck. D: OK, OK. Um how about coughing? P: No, I haven't had a cough no. D: And how about a stuffy nose or or a runny nose? P: Nothing like that. D: OK, body aches? P: Yeah, I felt so some muscle aches for sure. D: OK, upper limbs or lower limbs? P: I say I got a whole body, I just feel like my muscles and joints are sore. D: OK, yeah, and or do you have any headaches? P: Uh. No, I haven't really had any headaches. D: No OK. And how's your appetite? Are you still eating well? P: Um. It might be a little ah might have been a little bit down. I just kind of haven't been feeling so great, so I'm I've probably eating less the last few weeks, yeah. D: Have you been around anyone who may have been sick recently? P: Yeah, actually I think a few of my friends or there was somebody in my gym class knew that I sounded like they had similar symptoms. D: OK, OK, and when was this? P: Um, Uh, now that I think about it, probably about three or four weeks ago. D: OK, and were they ever treated for that? Did they see a doctor? P: Um I'm not sure. D: No, OK. No worries. P: I just remember them being off for school 'cause they were they were sick. D: OK yeah, any issues with your eyes? P: No. D: No, nothing like crusting or pus coming out of your eyes? Red eye, anything like that? P: Um. No, that well, did they might have looked maybe a little bit more more red, red then usual but I haven't noticed any anything in terms of itchiness or um discharge. D: OK. Any nausea or vomiting? P: Um, no nausea or vomiting. D: OK, how how about your stools? Have they been normal? Have you had diarrhea, constipation, anything like that? P: No changes to bowel habits. D: OK how about urine? P: Um, that's been OK. D: OK, OK. Um, have you ever had these symptoms before? P: Um, I mean I've had sore throats in the past, but not while feeling like this though. D: Yeah. OK, when was the last time you had a sore throat? P: Um, I don't know maybe when I was a kid. D: OK. P: It's been awhile. D: Yeah, like a strep throat kind of thing, or or more viral? P: Yeah, I do remember getting antibiotics when I was younger. D: OK, OK, and are you otherwise healthy? Do you have any medical conditions? P: I was diagnosed with uh with asthma. D: OK, and are you on any medications for that? P: Um yeah, so I, I just use ah Ventolin as needed, but otherwise oh and then I take Flovent daily so um. D: OK. P: I think that's the one, there's there's a couple inhalers that that I take. D: OK, OK, and any other medications? P: Uh, sometimes I'll take um like Reactine or some other type of allergy pill, but that's it. D: OK, What are you allergic too? P: Um mostly seasonal allergies, bug me like um yeah, like seasonal allergies and dust, maybe. D: OK. And are you up to date with all your immunizations? P: Yeah, my mom makes me get the flu shot every year. D: OK, good. And it's, OK, have you seen another doctor for the symptoms at all? Have you been worked up for that? Any blood work testing done for it already? P: No, I thought I would have felt better by now and so I haven't seen anybody but it's kind of just been going on now, not seeming to get better. So wanna come see somebody. D: Yeah for sure. Have you tried anything for your symptoms? Any medications, anything over the counter? P: Um yeah, I've tried some Tylenol and it's, I I think what is it Advil? And that definitely is helped with some of the kind of aches and pains, but they've come right back. D: OK, um any family history of Lung issues, heart issues? P: Um, No. nothing like that, um no. D: Yeah, OK. How about cancers? P: I, I think my Grandfather had a like pancreatic cancer. D: OK, OK. Um, alright, so do you live at home correct? P: Yeah, I live with my parents and my younger sister. She's 12. D: She's 12, Is she healthy? P: Yeah she is. D: OK, good and have you guys traveled recently? P: Um no we've been, we've been at home. D: OK, OK, Um, and do you smoke? P: No, I don't smoke. D: No, How about marijuana? P: I I've tried it once or twice but it was just those couple times, nothing that I do or used regularly. D: OK, And how about alcohol? P: No, no alcohol. D: No alcohol. OK, are you sexually active? P: No, I'm not. D: No, OK um. Is there a possibility that? Or actually sorry I should rephrase that. Have you kissed anyone recently? P: Um I. Well, I I guess I kinda have a girlfriend now. Um that we, that I started hanging out with about two months ago. D: OK, OK. P: And so I guess yes. D: OK, alright, well that's good. Um have, has she had any of these symptoms? P: Uh, well she she was, wasn't feeling well for awhile back, but, I don't think it was this bad for her. D: OK. Actually, and she's better now? P: Yeah, she's better now. D: OK. Alright, so you mentioned you're not sexually active. If you were to be, make sure you use protection. Um and OK. So everything at home is OK then? No ones, no ones sick at home you mentioned, right? P: Yeah, no ones, no ones sick at home. D: OK. And school is going OK? P: Um yeah, schools been been going OK for the most part it's been tough these last few weeks feeling like this though. D: Yeah for sure. And are you and your girlfriend in an exclusive relationship? P: Uh. I I think so yeah. D: OK, I ask because there's something called what you may be familiar with um it's called the kissing disease. In medical terminology, it's called mono, as caused by a virus called EBV, and so it could be that so we're covering all our bases. P: Oh, I've heard of mono before. D: Yeah, P: OK. D: It's it's likely it could be up there in terms of what you have, so I think those were all the questions I had for you. Did you have any questions for me? Anything you wanted to add? P: Um, no, I think that's you covered everything. D: OK alright so I will will go off a few, we'll try to cover our basis and get you tested for mono which I would have to do like a monospot test and we can do rapid strep test as well to see if he has something called strep throat. But yeah, we'll see what those results come back as. And we'll go from there. Does that sound good? P: Yeah, no, that sounds good. D: OK, thank you.
dataset\resampled_file\CAR0004.wav	D: What brings you here today? P: I'm just having this really sharp pain in my chest and I'm scared. I think I'm having a heart attack. D: Oh wow, yeah um that must be really scary. When did this, when did this pain start? P: So about 3 days ago. D: Three days ago, OK, and where exactly in your chest do you feel it? P: It's kind of right here, right over my heart I think, that's where it's the worst. D: OK, and is it, what kind of pain is it? Is it more like a dull pressure pain, or is it a sharp pain? How would you describe it? P: I would say it's a sharp pain. D: A sharp pain, OK. Um, so it started three days ago, has it been coming and going or has it been constant? P: It just lasts for a few seconds and then it goes away. D: OK, does the pain come on when you're doing any activities or When does the pain usually come on? P: Oh, it's usually worse when I'm coughing or laying down. Yeah, yeah. D: OK, and um, does it improve with any positional changes at all, or anything that you do that does it help? P: When I when I lean forward, it actually does get better. I think about it, yeah. D: OK, and has this ever happened to you before? P: No, no it hasn't. D: OK and on a scale of 1 to 10, one being the least amount of pain felt and 10 being the worst, how much would you rate it? P: I would say a 6 out of 10. D: OK, and does the pain move anywhere in your chest or does it stay in the same spot? P: Yeah, I think it kind of goes to my neck sometimes. D: OK, and do you have any other symptoms, like do you have any shortness of breath, dizziness, anything like that? P: No, I don't. D: OK any any palpitations? P: No. D: OK. Alright, and other than that, have you been having any other symptoms at all besides the pain? P: No, no, nothing else, that's it, just have these sharp episodes of pain that last a couple of seconds. D: OK, um have you have you tried like any medications that has helped the pain? P: Yeah, I took some um, I took some Tylenol and that did help. D: OK. P: I took it once yesterday. D: Alright, um, any recent injuries to the area like did you have any falls or anything like that? P: No, no I haven't. D: Any headaches, nausea or vomiting, fevers, or chills? Any of those symptoms? P: No. D: OK, any cough, runny nose, any viral symptoms? P: No, well not right now, but I did have a, I did have a flu last week. I had a fever, had a runny nose. I did have a bit of a cough and I was feeling super tired, but not anymore. I'm OK now. D: OK, and have you at all had any dizziness or have you fainted at all? P: No. D: OK. Have you been noticing any kind of weakness or numbness? P: No. D: No, OK, and in terms of your past medical history, do you have any medical conditions like diabetes, high blood pressure, any other diagnosis? P: No. I'm a pretty healthy 25 year old. D: OK. Um, do you take any medications? P: I sometimes take Tylenol. D: OK, and any allergies at all? P: No. D: OK, and any previous surgeries? P: No no, no surgeries. D: Do you have any family history of any heart conditions or any cancers or anything like that? P: Yeah, my father, he he had a heart attack two weeks ago and he and he passed away. And I'm worried I am having a heart attack too. D: It was just two weeks ago? P: Yeah. D: I'm so sorry to hear that. Yeah, it must be really difficult time for you right now. OK, so you're worried you might be having a heart attack as well? P: Yeah. D: OK, so we can definitely do some tests and see what was going on. I just have a few more questions and then I'll just get to some of the management and what we will be doing for you in the future. So currently right now do you work at all? P: No, I'm a student. I, well as a part time job, I do work as a post man. D: OK, and where are you a student? What do you do? P: I'm studying engineering at Western. D: Alright, and currently where do you live? Do you live in student housing, an apartment or a house? P: I live with my parents, well my mom now, in a house. D: Right, and you drink at all any alcohol? P: I drink occasionally, maybe one or two drinks on the weekends. D: OK, and any recreational drug use like marijuana or cocaine? P: No. D: And do you smoke? P: No. D: Alright, so those are all the questions we had for you today. And yeah, it must be really difficult and scary for you right now, but we'll make sure to get to the bottom of this to see what's going on. So what we can do is get you an ECG to see how your heart is functioning and then see getting the blood work if we need it for the future. But yeah, right now I would say try not to worry too much about it right now and see um what some of those tests come back. P: Thank you. D: So yeah, you're welcome.
dataset\resampled_file\RES0084.wav	D: What brings you in? P: Hi Faiha, I've been very concerned lately. This past week I, first just started having this really bad headache and then my body, just completely all started hurting after completely rest, and then three days ago I just started having a lot of chills and I had a pretty high fever, just two days ago of almost like I think it was like 38 or 39, yeah, I was just very concerned and I came here today. D: Yeah, it's good that you came in. Lets rewind a little bit and get a full history. So you said the, what started first, the fever or the headache? P: So, the headache started first, so that was around four days ago. D: OK P: And three days ago, like my body just started aching all over the place and then just two days ago I noticed that I had a fever and I've been getting a fever since then, as well, like even today, I was having chills. D: OK, OK, and you said your highest recorded temperature was 39? P: Like 38 to 39. D: OK, so headache started four days ago. Is it persistent or constant or does it come and go? P: It was pretty constant, the headache kind of got better yesterday but last few days it's just been constant headache Pretty much every day. D: OK, OK. Does anything make it better or worse? P: Just some rest and, uh, I tried to take some Tylenol to get rid of it, took some Advil as well. It did help a little bit, but it just kind of came back after the medication wore out. D: How long does the headache last when you get it? P: If I don't take medications, it can last honestly, the whole day. D: OK, yeah, um, and if you were to describe it, is it sharp, dull, achy? P: It's just achy and it's kind of all over the front of my forehead. D: OK. P: Sometimes it's just like a throbbing pain. D: OK, and, alright, and you said it's mostly at the front of your head. How about near the Crown of your head, temples? P: It can go to the temples sometimes, but mostly it's my forehead. D: OK, OK, and severity-wise 1 to 10, 10 being the worst headache you've ever, worst pain you've ever felt. How bad is it? P: Right now it's not that bad, probably like a two or three, but when it was, just a few days ago, it was like probably an 8 or 9. D: Yeah, and then have you ever experienced something like this before? P: No, I'm not usually one to get headaches. My wife, she gets migraines, but like I rarely ever have headaches. D: Yeah, OK, and then you mentioned the headache is getting a little bit better now? P: Yeah, the headache has improved a bit, the body aches are still there and the fever is still there but like the headaches I feel have gone down. D: OK, alright. Have you had any fainting spells or dizziness? P: No, nothing like that. D: Any confusion or memory loss? P: No. D: Any neck pain? P: Uhm, not neck pain but like just below my neck, like my back, upper back hurts as well. D: OK, and, any weight loss recently? P: Uhm, no, I don't, I don't think so. D: Any excessive fatigue? P: Yeah, I have been feeling pretty tired and just, uh, I haven't even gone to work this whole week, just kind of laying in bed honestly with all the pain and the fever and headaches, just yeah, it's exhausting. D: OK, any changes in your hair, nails or skin, like rashes? P: No, nothing that I've noticed. D: How about changes in your vision or hearing? P: No. D: No OK, how about a stuffy nose or runny nose? P: Uh, I do feel a bit more stuffy like today, but there's no like runny nose or anything like that, but I do feel a bit more pressure and stuffiness in my face today. D: OK, OK, how about changes in smell or taste? P: Yeah, I think, just last night dinner, it was just kind of a funky like, different taste. I couldn't really tell, uh, everything was kind of a bit bland. Yeah, I think my taste buds are acting all weird too. D: OK, um, any coughing or shortness of breath? P: Uh, no, no, I haven't been coughing or no shortness of breath at all. D: OK and how about wheezing? P: No, no wheezing? D: OK, any chest pain? P: No. D: How about feeling like your heart's racing? P: No, nothing like that. D: No, OK. Any swelling that you've noticed in your limbs? P: No. D: No, ok. Any issues with your bowel movements or urine? P: No, nothing. D: OK, how about nausea or vomiting? P: uh no, no nausea or vomiting. D: OK, and those were all the questions I had about your symptoms. Are you otherwise healthy or do you have any longstanding medical conditions? P: Yeah, I have a couple conditions that I see my family doctor for. I do have diabetes, then I have high cholesterol. I also have this thing called fatty liver but that's that's about it, and a high blood pressure. D: OK, when were you diagnosed with all of these things? P: Yeah, probably like, it all kind of went down in my 40s. I did gain a lot of weight at some point during my 40s and that's when all these things started happening. D: OK, so you said diabetes, high blood pressure, fatty liver, and sorry, what was the other one? P: High cholesterol. D: High cholesterol, OK, are you on medications for all of these things? P: Yeah so I am on a statin medication for the cholesterol, then I'm on metformin, and then I'm on a blood pressure medication as well. I can't recall the name. Uh, so yeah, those are the medications that I'm on. D: OK. And do you take your medications regularly as prescribed? P: Yeah, I don't miss any doses. D: OK, good. And, are you up to date with all your immunizations? P: Yeah, I think so. D: OK, good. Do you have any allergies? P: No, no allergies. D: How about family history of lung conditions or heart conditions? P: Yes, I have a pretty significant family history for heart conditions. My father passed away from a heart attack in his 50s. My mom has high blood pressure. Diabetes is also pretty big in my family as well. D: OK, well I'm sorry to hear that. Any cancers in the family? P: No, no cancers. D: OK, do you smoke? P: I used to when I was in my 30s. I quit a pretty long time ago. D: OK, how much did you smoke before that? P: I probably smoked up until I was 35, so for probably like 10 years from 25 to 35 and probably smoked a pack a day at that time. D: OK, yeah, and do you drink alcohol? P: I've been told like, not to for my liver, but I sometimes maybe have the rare red wine maybe once a month. D: Once a month, OK, any other recreational drugs? P: No, no recreational drugs. D: OK, no recreational drugs, and where do you live right now? P: I just live with my wife in an apartment in the city, and yeah. D: OK, any old carpet, dust, mold, anything that is concerning from that standpoint? P: Nope. D: No, and have you been in contact with anyone who's been sick recently? P: Not that I know of. D: Do you still go to work? P: I just have like a desk job. I have my own room. It's not like, I don't see too many people and like, when I do I'm wearing a mask so I don't think so. D: OK. P: I have stopped going to work though like, just in case. D: OK, good and have you traveled to anywhere recently? P: No, we've been pretty homebound. D: Pretty homebound, OK, alright, well that's good and those are all the questions that I had for you. Did you have any questions for myself? P: Yeah, I don't know, what do you think is causing all of this? D: Yeah, it sounds like you have some sort of infection, so the first thing we need to rule out is covid, of course. So we'll do a swab and those swabs should come back to you in about 24 to 48 hours and until then, it's important that you do isolate and you isolate for 14 days at least, and that includes from other people at home. And if those swabs come back negative, you could possibly have like, another infection. But if your symptoms worsen, like you start getting neurological deficits like weakness or seizures or anything like that, you should come back to the ER and we'll get that checked out. And, so that's where we'll start for now, because your presentation is acute, we think it's likely infection related. P: OK, that sounds good to me and should I be staying in my own room or anything like that at home? D: Yeah, if you can like, it's recommended that you try to isolate in your own room for the next 14 days because your symptoms do overlap with that of covid, yeah. P: OK, sounds good.Thank you. D: Yeah, no worries, take care. P: Thank you.
dataset\resampled_file\RES0036.wav	D: Can we just begin with what brings you in here today? P: Yeah, so I've been pretty breathless for the past six days and it's it's just worse. I have to stop from, I had to stop so many times walking here from my car. D: OK, and when did this first start? P: Six days ago. D: And did it start like gradually or was it all of a sudden? P: Bah, pretty sudden actually. D: OK, and were you doing anything before it first happened? P: No. Just work and spending some time at home. D: OK, and so you're having the shortness of breath, but are you having any like coughing at all? P: Oh yeah, a lot of coughing too, yeah. D: OK, and is it a dry cough or a wet cough? P: Um, so I've noticed this weird rusty colored sputum and I've noticed that like a couple times a day. D: And did your cough started around the same time as when your shortness of breath started? P: Uhm, yeah, I'd say so. D: OK, so around six days? P: Yeah around there. D: And has it been constant like I've been constantly having a shortness of breath every day with the coughing? Or does it come and go? P: Um? It's pretty constant now. D: OK, and do you find that it's been getting worse at all? P: Uhm, yeah, I'd say it's getting, I'd say it's getting worse. D: OK, and is that both the coughing and the shortness of breath or one or the other? P: It's, it's both. D: It's both OK. P: Yeah. D: And do you remember if you were doing something at the time when the shortness of breath first started? Have you recently had any infections or anything like that previously? P: I don't know bout an infection. Um, but I guess I have been feeling a little feverish. I haven't taken my temperature, but I've been feeling you know, kind of cold. D: OK. And when you feel the breathlessness, how long does it usually last for? P: Um, it's kind of hard to say, it's it's always their baseline, but it gets worse when I when I walk or when I exert myself. D: OK. And besides like the exertion, does it get worse with any when you're near pollen, when you're outside in the cold, anything like that? P: Um? It gets worse when when no no, I wouldn't say that no, no. D: OK. And is it worse in the morning or at night? P: It it doesn't matter. D: It is there all the time? P: Yeah. D: OK. And is there anything that makes it go away or I mean or anything you've tried that makes it better? P: Well, I guess I've tried some taking some Tylenol and that's helping my like regulating my temperature. D: OK. And have you ever noticed any blood in the cough? P: It's rusty colored, but I don't know if that's blood. D: OK, but you've never actually coughed up uhm red blood. P: No. D: OK. And. Is there anything that makes your symptoms worse besides exertion? P: Uh, no. D: OK. And do you notice, having any wheezing or any other breathing sounds? P: I notice some wheezing. Yeah, it's it's, it's not that much though. D: OK. Before this, before the six days, have you ever experienced anything similar? P: Uh, no. D: No, OK. Have you traveled outside of the country at all recently? P: Uh, no. D: Yeah, OK. Do you have any other symptoms, like a sore throat, runny nose, chest pain, anything like that? P: I do have this sharp chest pain that gets worse with coughing. D: OK and is is that always there or is it just when you're coughing a lot? P: I guess when I'm coughing a lot. D: And that starts six days ago too as well. Or is that? P: Yeah. D: OK. And do you ever feel any kind of is it so you said, mention it was sharp, but do you ever feel like increased pressure in your chest? Anything like that? P: Uh, no. D: And how would you rate this pain when it occurs from a scale of 1 being the least amount of pain you've felt in your life, and 10 being the worst? P: The sharp chest pain? I'd say maybe like a 7. D: OK, and does it go away on its own or does it spread to different areas of your body at all? P: It just starts gradually going away at when I stop coughing. D: OK. Have you experienced any kind of headaches with nausea or vomiting? P: Uhm, no. D: OK. So you mentioned you had some chills, but you don't know if you had a fever. P: Mhmm. D: OK. Have you experienced any kind of dizziness or fainting spells? P: Uh, no. D: OK. And have you been in contact with anyone who has been ill recently? P: Not that I know of, no. D: OK. Have you experienced any night sweats? P: I feel chilly at night, but I don't, maybe, yeah. D: OK, any significant weight loss recently? P: No. D: And have you noticed any kind of symptoms like your heart is racing? Or anything like that? P: No. D: OK. Have you experienced any changes in your bowel movements at all like in constipation or diarrhea? P: No. D: Any changes in your urinary patterns? P: Um, no. D: Any issues with your sleep or appetite at all? P: Uhm, no. D: OK. Have you had any recent infections like a cold or anything like that recently? P: Um, I guess I had a runny nose a few days before. D: OK. P: Yeah. D: Have you at all been exposed to anyone with tuberculosis in the past? P: No. D: Any exposure at your workplace or at home to any fumes or dust in pets or animals? P: Ah, well I have birds, but I've had them for awhile. D: OK. How long have you had the birds for? P: Ah about three years. D: OK, and no, they haven't caused you any issues before? P: No. D: OK. And do you have any allergies that you know of? P: No allergies. D: OK. Any past medical conditions, like high blood pressure, diabetes, asthma? P: No. D: Any previous surgeries? P: No, none. D: OK. Any hospitalizations for any reason? P: No. D: OK, are you on any medications currently? P: No. D" And do you have any family history of any medical conditions like cancers or heart attacks or any lung issues? P: No. D: OK. And currently, do you work? P: I do. The place I work is very crowded and it's not the best conditions to work in, and there's an air conditioner, which I think is broken. It's quite humid, it's never been checked. Yeah. D: And how long have you been working there? P: For the past year. D: OK. And where do you live currently? Do you live in a house or an apartment? P: Uhm, I have a small apartment, also not in the greatest location. D: OK, do you have any exposure to mold or excessive dust in your household? P: Um, maybe, ah it's a very badly kept apartment, so it's possible. D: OK, do you have any potential exposure to asbestos in your house or at work? P: I mean, yeah, probably. Both buildings are very, very old. I doubt they're being maintained. D: OK. And do you currently smoke at all? P: I smoke 10 cigarettes a day. D: OK, and how long have you been smoking for? P: Um, since I was 20. D: OK. And do you use any recreational drugs like marijuana? P: I smoke a little cannabis sometimes. D: And how often, would you say you smoke in an average week? P: Maybe about 5 milligrams. D: OK. And do you drink alcohol? P: I do, but not a lot. D: How much would you say you drink in a week? P: Ah, maybe 5 drinks? D: OK. And in terms of your daily routine, do you think you get enough exercise? P: Probably not. D: OK. Uhm, and how about your diet? Do you get 3 meals a day or is it well balanced? P: I eat a lot of fast food and junk food. D: OK. Alright, is there any other questions or concerns that you had for us today? P: No. D: OK. So yeah, based on what we discussed today, it seems that you may have an upper respiratory tract infection. The other things on differential would be a COPD exacerbation due to your significant smoking history. So we will do some investigations ti figure out what this is, and then perhaps can give you antibiotics or other medications to help you, unless it's a viral infection.
dataset\resampled_file\RES0098.wav	D: How may I help you? P: So, I just came in here because for the last day I've been just getting shortness of breath. I recently, yesterday actually, was just busy at home, cleaning out my basement. And, like that was yesterday afternoon, I did that for a couple hours and then at night I just started to get the shortness of breath. It's continued until today. I'm also getting some wheezing and tightness in my chest as well as some cough. So yeah, that's all just been happening over the last day. D: OK, and uh, is the shortness of breath here now? is it, is at rest? Or are you having that when you're exerting yourself? p: More so when I'm like exerting myself, if I'm sitting down it's better, but I still have, I would say, like my breathing is not normal right now, like it's, I still have to take deeper breaths. And I do have that chest tightness when I take those deep breaths. D: OK, do you have any chest pain? P: No, it's more so just the tightness. I wouldn't call it pain, but I do still have a little bit of wheezing. D: OK. P: So yeah, that's, that's that. D: And you mentioned a cough as well. With the cough is it, has it been dry, or have you been bringing up sputum? P: Uhm, it was, it was mainly dry yesterday, like, like the cough has kind of gone away, but yesterday night I was coughing a lot and it was mostly dry. D: OK, have you brought up any blood? P: No. D: OK, and have you had any infectious symptoms like, eye tearing or red eyes, maybe a runny nose or sore throat? P: Uhm, not a sore throat, but it does feel like it, it's kind of like just constricted in there like, uhm, I don't know if it's relevant, but I, I do have asthma. Uh, like I was diagnosed ten years ago, but it's been pretty stable, like it's, like just right now. I haven't had shortness of breath for a pretty long time. D: OK, uh, and, uh, we'll get back to the past medical history shortly, I just wanted to ask a few more symptoms, but certainly could be relevant today. Uhm, so uhm, so you mentioned that you have had some throat tightness. Have you had any loss of smell or, or loss of taste? P: No, nothing like that. D: OK, and have you had any fevers or chills? P: No. D: OK, have you had any nausea or vomiting? P: No, no nausea or vomitting. D: How about, any diarrhea or Constipation? P: No. D: And have you had any urinary problems like painful or frequency? P: No. D: OK and have you had any night sweats over the last several weeks to months? P: No, nothing like that. D: And, uhm, have you had any weight changes over the last little while? P: No. D: OK. And have you noticed any skin changes or rashes? P: Uh, no, I, I do have just like the general, like, eczema, that I use a cream for, but that's just normal for me. D: OK. And any muscle aches or, or joint pains? P: No. D: Have you had any fatigue? P: No. D: OK, alright you mentioned asthma as part of your past medical history. Have you been diagnosed with any other conditions? P: No, it's just asthma and it was diagnosed, I think when I was like, probably 11 or 12 years old. D: OK, and do you use inhalers for that? P: Yeah, I have two inhalers, uh, like one, one is like a blue one, one is like an, like an orange one, uh, it's, so I think it's one of them is just like, I take whenever I really need to and the other one I take every day. Uhm, and I haven't been taking the one, uh, I think it's called Ventolin. But I took it like, uh, had to take it like three or four times last night and like, throughout the day yesterday. And it, it did help, but it didn't really relieve some of my symptoms. D: OK, and prior to that, how often have you been using, uhm, the blue one. P: The blue one before yesterday, probably the last time I used it was probably like a month ago. D: OK, so you don't need it that that often then? P: No. D: Do you have any triggers for asthma that you're aware of, like exercising or going out into the cold or even like allergies like dust or, or, or pollen? P: Uhm, I do have allergies in the spring. I think it's to pollen and in the winter, it does, like my symptoms do get a bit worse and I have to use the ventil more. But recently for the last few months at least, it's been pretty stable. I haven't really had to use, use it too much. D: OK, and, and do you use any other medications? P: Uh, just when I have allergies. I, I just use over the counter allergy meds. D: OK, and you use a cream for, for your skin too like, yeah? P: Yeah, I use, like it's, it's, I think it's like a mixture of like a steroid cream. D: OK, and do you have any allergies to medications? P: Not that I know of. D: OK, and are your immunizations up to date? P: Yeah. D: Alright, and right now, who are you living with, and whereabouts are you living? P: Yeah, so I'm just living with a couple roommates. I just go to college and I'm living with three other roommates. D: OK, and has anybody been sick? p: No, everyone's been fine. D: And have you traveled anywhere? P: Uhm, I decided, like, I, yesterday I went home like, to my parents house and helped my dad, that's where I was cleaning the basement. But besides that, that was, that was uh, that was it? D: OK, and sorry, just had to backtrack a little bit. Have you had any hospitalizations, either due to asthma or for any other reason? P: Uhm, I think when I was 15, I, I had to go to the emergency department, but I, I wasn't hospitalized. D: OK, and was this, uh, did you have similar symptoms at that time? P: Yeah, it was, uh, it was for asthma and like, uh, that time it was definitely much much worse and I remember like I was breathing a lot, uh, the shortness of breath was really bad and the ventolin like puffers weren't even helping me at that time. D: OK yeah, OK, and have you had any surgeries before? P: No. D: Alright, so yeah, you mentioned that you're, you're cleaning up the basement yesterday? Was there a lot of dust down there or anything like that, that might have triggered it? P: Yeah, we were like just moving boxes. There were books here and there that definitely there would have been dust. I should have been more careful, like wore a mask, but I didn't think about it at that time. D: OK yeah for sure, uh, and do you smoke cigarettes? P: No, like I can't even stand cigarette smoke. D: OK, that's good. And do you smoke marijuana or use any cannabis products? P: Uh, no if I, if I really want marijuana, I would have to go with edibles, I, I can't take the smoke. D: OK, I see and, do you drink alcohol? P: Uh just, I would say probably on the weekends I might have four or five beers. D: OK, and, anybody else in the family have asthma or skin irritation like, like you have? P: Yeah so my, my older sister actually also was diagnosed with asthma. She also has the eczema that I have and my mom was also diagnosed with asthma when she was a child, but she's been completely fine since then. D: OK, well that's good that, that she's been OK. Does anybody in the family have any heart or, or lung conditions or any cancers that run in the family? P: My grandfather died of lung cancer, but he was just, just smoked all throughout his life. D: OK, uhm, alright, so that was all of the questions that I wanted to ask today. So the next part we'll go on to do a physical exam, but did you have any thing else that maybe I forgot to ask about today? P: Uh, no, I, I, I think I know what this was caused by, but yeah, let's, let's see. Thanks for your help. D: Oh you're welcome, so yeah, we'll, we'll, uhm,trial some more puffers and see what we could do, cause certainly it's sounding like an asthma exacerbation, and so definitely let somebody know if your, your breathing is getting more difficult. P: Yep, sounds good.
dataset\resampled_file\MSK0036.wav	D: How may I help you? P: I've just been experiencing a, some pain and numbness and tingling in in just my wrist area and thumb, middle finger, and index finger. D: OK, and when did this pain start and is it the right hand or or left hand? P: Hum, it's the right. It's a the right hand, but I also find it so starting to happen in the left hand as well, but more so on the right hand. I feel this kind of sensation over my palms and fingers it started I would say probably 2 weeks ago. And it's been, I think it's gradually been getting worse. I'm having more difficulty at nighttime, especially. It's also waking me up from sleep, and it's yeah just affecting my daily routine, my work. So yeah, I just wanted to understand what was going on. D: OK, I see and did you have any trauma to the wrist or or any injury, or have you had an injury in the past? P: No, I haven't had any falls, no accidents, nothing like that. D: OK. And are you right or left handed? P: I'm right handed. D: OK yeah, and you mentioned it was the right hand that started to hurt first and then the left one has started since then? P: Yeah, yeah, and I don't know if it's just 'cause I use my right hand more that I feel more pain and the symptoms. But yeah, I definitely would say it's worse. D: OK, and where are you finding that the pain is specifically located? P: So the pain I feel like it's more like a discomfort. Just over the like palm, like near the wrist and the lower palm area is where the discomfort is and then the numbness and tingling is just like in thumb an the 1st 2 digits. D: OK, and how would you describe the character of this sensation, is it burning, is it sharp, achy or or stabby? P: Um I would say it's more of kind of like an aching, aching pain. Um it does sometimes turn into kind of like a burning sensation with the tingling, but yeah, more so on the palmer like on the palm side of things, it's more like an aching pain. D: OK. And you have some burning as well? P: Yeah. D: OK. And is the does it radiate anywhere, are you feeling this in in your neck, shoulder, or down your arm at all? P: It kind of goes from the palm, along, so it goes from the palm it goes upwards like to my fingers, but also backwards like into my lower arm as well. Like my forearm. D: OK, and do you have any pain in the neck? P: In my neck? D: Yeah. P: No. D: OK, an anything that you've done that makes the pain worse? P: Uh. I I just have to like I work as an accountant. There's a lot of work I do on the computer with a keyboard mouse, so I feel like it's hard to really do that all day right now. So I think if I do that, I'll make it worse. But if I take a rest and kind of just shake my hands a little bit, then it gets better. D: OK, um so kind of like flicking your wrist sort of thing, so kind of shake out the? P: Yeah. D: OK, um an anything that you do that makes it better besides those moves like have you taken any medications or tried any like wrist splints or anything like that? P: No, I haven't tried any medications or splints. D: OK, and what is the severity of the pain on a scale of 1 to 10, 10 being the worst you've ever felt and do you feel this pain at any particular time of day more than than others? P: The pain is probably like a, a 5, and I feel it more during the night as well as like when I'm working, I feel it's definitely more as I continue to do more work. D: I see OK. And. Have you had any like numbness and and that tingling in the hand or anywhere else? P: No, just in the areas that I described nowhere else. D: OK, and have you had any muscle weakness? P: Uhm no, I don't think so. D: OK, and how about any issues with like gripping objects, dropping objects or like opening jars? P: Yeah, I I do I do have like when I'm lifting things and opening jars opening lids like I do have the similar discomfort, pain as well as the numbness and tingling. D: OK, alright and have you had any fevers or chills? P: No. D: Have you had any night sweats? P: No. D: Have you had any unexpected weight loss? P: No. D: OK. Have you had any headaches? P: No. D: How about any like sensory changes such as changes to your vision or hearing? P: No, no, nothing like that. D: How about a loss of your sense of taste or sense of smell? P: No. D: Have you had any runny nose or feeling congested? P: No, nothing like that. D: How about a sore throat or a cough? P: No, OK. D: Have you had any shortness of breath or wheezing? P: Uhm no, nothing like that. D: Have you had any chest pain or feeling as though your heart's racing? P: No. D: OK, have you had any dizziness or or lightheadedness? P: No. D: Alright, and have you had any of nausea or vomiting? P: No. D: And any abdominal pain? P: No. D: OK. Have you had any diarrhea or constipation or blood in the stool? P: No. D: Alright, have you had any urinary problems like pain or frequency? P: No. D: Alright, have you noticed any skin changes or like rashes or anything like that? P: No. D: OK, and. Have you had any like muscle aches or or body pains? P: No. D: OK, and any confusion or memory loss? P: No. D: OK, uh, and have you been diagnosed with any medical conditions in the past? P: No, I've been fairly healthy. D: OK. And so do you take any medications regularly, either prescribed or over the counter? P: No, I I've been pretty healthy. Sometimes I take some Advil for headaches and stuff or Tylenol, but that's it. D: OK. Uhm and do you have any allergies? P: Uhm, nope. D: And have you had any prior hospitalizations or surgeries? P: No, I haven't. D: Alright, and can you tell me a little bit about where you're living and and who you're living with? P: I'm living with my husband and two kids in a small townhouse. D: I see and you mentioned you're an accountant. Are you working right now? P: Yeah, I. I am in, I'm an accounting, time off and just taking a little bit easy before I find out like what this is and how this will really impact my work. D: I see OK. And have you been around anybody who's been sick recently? P: No. D: Have you traveled anywhere? P: No. D: Do you smoke cigarettes. P: No. D: OK, and how about smoking marijuana? P: No no, no drugs. D: OK, so no recreational drugs? P: No. D: OK, and are you currently sexually active? P: Yes, just just with my husband. D: OK, uh, and any concern for sexually transmitted infection? P: No. D: OK, um and do you drink alcohol? P: Uh, just maybe some wine every other day. D: OK, um and in the family are there any musculoskeletal or like neurological conditions? P: No. D: OK, and how about autoimmune conditions like rheumatoid arthritis or like hypothyroidism or type one diabetes? P: In my family history? I think there is. D: Yeah. P: Some, there's definitely some diabetes on my father's side. But other than that, I think one of my aunts on my mother side had um a hysterectomy for cancer. D: OK, alright and was it endometrial cancer? P: Not sure actually, but she I just know that she had her uterus removed. D: I see alright and um so next I wanted to just move to the physical exam portion and so just first inspecting the hand and wrist do you see any swelling or redness? P: No. D: How about any changes to temperature, do any of the joints feel warm? P: No. D: And are you seeing any muscle atrophy or any deformities of any of the joints in the hand? P: Uhm, maybe like just a little bit like I feel like I've lost some of like the fat pad just right near my thumb. D: I see OK. And is there any areas of your hands over like any of the joints or over the rest that if you press you feel pain? P: Um no. D: OK and are you able to to move your wrist or the full range of motion? P: Yeah, I can move it. D: OK, uh. And is there any, uh, so that then the next test I'll just ask you to just tap on the the kind of base of your palm there with your index finger and middle finger of your left hand, and when you do that, do you feel any burning or tingling? P: Yeah yeah. I definitely do. D: OK, so that would be, yeah, positive Tinel sign and do you get any, so if you flex both of your wrists so that the back of your hands are pressing against each other. And if you hold that position, do you start to get symptoms of the burning and tingling? P: Um yeah, I do feel it as well there. D: OK, alright so that was everything I wanted to ask about and check today um did you have any questions? P: No, I just wanted to know how I can fix this. D: Yeah, certainly so it's sounding like a carpal tunnel syndrome which that the differential would be something like radiculopathy coming up up from the neck, which you're not having any neck symptoms and the positive Tenel sign and positive Phalen sign are highly suggestive of carpal tunnel syndrome, along with the nighttime symptoms and the burning and tingling sensation you're experiencing. And so to help with this one of the first things that that can be done is trying to use like wrist splints at night to try to keep your hand in a neutral position, but also, uh depending on like if there is inflammation there NSAIDs might help a little bit like ibuprofen or or things like that. But the majority of the therapy will be kind of an activity modification, and if symptoms don't improve over a period of time, then surgery could be a potential option as well. P: OK, sounds good. D: OK.
dataset\resampled_file\RES0067.wav	D: So what brings you here today? P: Yeah I have my 2 year old daughter here with me. I don't know what's happening with her, but she seems to be getting really sick. So I'll give you that kind of timeline. So two days ago she was feeling hot and her fever hasn't broken. We've been giving her Tylenol, but she still seems to have a fever. The last time I checked her temperature was 38.5 and she seems to have issues swallowing food. She's drooling and she seems short of breath. D: OK, and when did she start getting short of breath? P: That started yesterday. D: Has her fever been getting worse or has it stayed around the same? P: So I just checked the first day. It was like 38, 38.5. D: OK, and when did the trouble swallowing start? P: That started yesterday as well. D: OK, and has it been getting worse at all? P: I think so. Now she's barely even drinking fluids. D: OK, so it's both solids and fluids. OK, have you noticed any swelling in her neck area or redness or swelling in her throat? P: Yeah, I've noticed some of that. D: OK, you see a lot of redness in there? P: I see, yeah, I see quite a bit of redness in there. D: And has she been drooling at all? P: Yeah, a little bit today. D: OK. Alright, any coughing? P: Not hat I noticed. D: No coughing. OK, and do you notice that she's increasingly fatigued, or just not herself? Or is she irritable? P: Yeah, she's very irritable. D: OK, do you notice any kind of paleness or blueness in her skin? Anything like that? P: She's not blue. She's looking a little pale though. D: OK, and sorry, when did the shortness of breath start? Is it getting worse at all? P: Shortness of breath started yesterday as well, moreso today which is why I brought her in. D: OK, any other symptoms like nausea or vomiting or diarrhea or constipation? P: Um, no nothing like that. D: OK, and how's her appetite and sleep? P: It's been, it's been not great. She's not eating well, I guess because she's in a lo of pain and she didn't sleep well for the past two nights either. D: OK uhm, has she had any recent infections at all, like a cold or anything like that? P: She did have a cough 2 weeks ago, yeah. D: OK, and did it just go away on it's own or did she need any antibiotics or any other medications? P: I think no, she didn't need any antibiotics. It kind of went away on its own. D: OK, any sick contacts within the last week or two weeks? P: I mean, she goes to daycare so she might have picked something up from there. Yeah, last I checked, no one at daycare was sick like right now. But three weeks ago there was someone who was sick. D: OK, any past medical history? P: Um, no, she's been pretty healthy otherwis. D: Any issues during pregnancy or after birth at all? P: No. D: Are her immunizations are up to date? P: Um, yes, she didn't get the H. flu vaccine though. D: OK, OK, any hospitalizations or anything like that in the past? P: Um, no. D: OK, and any family history of any medical conditions? P: Um, no. D: And currently, who does she live with at home? P: I'm she lives with myself as well as her older brother. D: OK, alright, so yeah those are all the questions that I have. P: Do you think this is like an urgent matter? D: Because she has not been vaccinated with the H.flu vaccine and some of the symptoms that she's displaying like the drooling and trouble swallowing and now especially the shortness of breath are very concerning, I really think we should go to the Emergency Department. I'll give them a call to le them know that you're coming. Yeah, and what they will most likely do there is get a test done to see if she has H. flu and also they might do perhaps like a COVID swab as well. They might get an X Ray of her neck as well to see it. So what I think might be going on is with H. flu you can get swelling of your epiglottis and it can kind of obstruct your throat. It's very urgent matter, so that's why we will make sure you get to the ER and, uh, you know, we'll go from there. Does that sound? I know it may be very worrying right now. Do you have any questions at all? P: Yeah, do you know how long will she have to be in the hospital? D: So right now we just need to make sure that she's stable, like all her vitals. You know when she gets to the ER, they can give her the appropriate antibiotics as well. And based on that, we need to make sure her breathing get stabilized, so she might be in the ER for one day. If they think she needs to be on IV antibiotics in the hospital, she might be in the hospital for a few more days or even a week. So it's really hard to say right now, but our priority right now is to make sure she's stabilized in the ER. P: OK. OK yeah, that sounds good. D: So I'll give them a call right now, and, uh, you can head over to the ER. Or if you need a ride, we can arrange to do that for you too. P: OK, great, that sounds great. D: Thank you. P: You too.
dataset\resampled_file\RES0209.wav	D: So what brings you in? P: OK, I'm so I have been coughing a lot over the past week or so. And it's been pretty dry, but I've been coughing like almost nonstop throughout the day, and I'm feeling very short of breath, and my bronchodilator helps, but I found I'm using it a lot now. D: OK, how long have you know that you have asthma for? P: I was diagnosed when I was eight. D: You're 10 now. P: That's right. D: So you're using your bronchodilator more. This is the one that you use, kind of as needed? P: Yeah. D: OK and then do you have one that you take every day no matter what? P: Uhm? No, I don't have that one. D: OK. You just have the one that you take is needed. Do you take any other medications? P: Uh no I don't take anything else. D: Just the one is it a it's a puffer? P: Yes. D: OK, and you're using it more than normal, so how often were you normally using it? P: Um I was only using it like I don't know. Maybe once every two weeks or so. Not very often. But now I'm using it like almost everyday like five six times a week. D: OK, any are you? Does it usually turned out that you need it like during certain times like say when you're exercising or when it's cold? P: Um I find I use it more, both like when it when it's right after I like, run around after gym during recess. Um and yeah, the cold also makes it worse. D: OK, any other triggers that you can think of? P: No, no other triggers. D: Normally get more in certain seasons? P: I. I guess no, no big changes there. I find the cold air makes it worse like winter makes it worse or like. Yeah, maybe also the spring spring with like pollen and stuff like that. D: OK, so you have allergies too? P: I think, so I haven't ever been like formally diagnosed. D: OK, I see I see. Yeah, that would make sense. No. OK, uh, so you say you've had more coughing lately, is that right? You said the last two weeks. Or the last week P: Last two weeks. D: Last two weeks. Is your cough and a dry cough? P: Yeah. D: Have you been bringing up gunk OK. Dry cough? Have you noticed any wheezing? P: Oh yeah, I've been wheezing a lot, actually. D: OK, uh and that's uh. Do you use your bronchodilator every time that you're wheezing? P: When it gets really bad, like when I get so easy that I find it hard to breathe. D: OK, so you're getting Wheezy even more times than then you're having to use your bronchodilator. P: Yes, that's right. D: OK. Are you having any symptoms at night time? P: Yeah, how they don't happen as much as my daytime symptoms, but I been having it maybe like every other day or like you know, every two days or so. D: OK. And when you have these so when you have these episodes, you're copping your wheezy. Do you feel like you're having a hard time breathing? P: Yep, that's right. D: Do you feel it gets tight in your chest? P: Yes. D: OK. OK, have you had any any colds lately? Or any infections? . P: Um no, no, nothing like that. D: K, does anyone that lives with you or anyone that you're around often, has anyone been sick? P: No. D: OK. Could you have been in contact with anyone that sick even outside of your house? P: No. D: OK, have you traveled anywhere? P: Uh no. D: Have you lost any of your sense of taste or smell? P: No. D: Have you had any fevers? P: Uh no. D: OK. Any any? Nausea or vomiting? P: No. D: Any belly pain? P: No. D: We just ask those questions because sometimes these things can happen with an infection or after an infection and we just want to make sure that that's not, you know what's happening right now. We probably will do a covid swab just because of the times that we're living in right now, but I just want to ask you a few more questions before I go talk to the doctor. So do you have besides your asthma, do you have any health problems? P: Oh no, no no. D: OK. And you said, besides the bronchodilator, you're not taking any medications. P: No. D: And you think you might have allergies in the spring? Do you have allergies to anything else that you know? P: Uh no, not that I know of. D: OK, does anyone else in your family have asthma? P: I think my sister has asthma too. D: Anyone in your family have any other breathing problems? P: No. D: Anyone else in the family have any allergies? P: Uh no, I don't think so. D: OK. OK, sounds good and you live at home did you say live with your parents and your sister? P: Yep, that's right. D: Cool. Are you currently going to school online or in person? P: Uh both We do half days. D: OK. How are you finding that? P: Yeah, it's been OK. It's it's different, but it's been working out OK so far. D: Cool not to have to get out of your PJS some days. P: Yes, that's true. D: OK, did do you guys have any pets in the home? P: No pets, we have just like well I guess we have goldfish. D: Oh, OK. Those are cool pets. Does anyone in the house smoke? P: No. D: OK. OK, I think that's all my questions that I had for you today. What do you like to do for fun? P: Oh I'm I like playing games online with my friends and and before covid we used to get together and have movie nights and play sports together. D: It sounds really cool. Hopefully we can get this figured out for you so you don't have any, you don't have to use your your medications every time you play sports 'cause that's no fun. And P: No. D: You should be able to enjoy that. So, so we're going to try to get this sorted out for you. I'm gonna go talk to the doctor and tell him everything or her everything that you said and yeah we’ll come back and see you shortly, hopefully maybe all you need is a little change to your medications and maybe it will be better be able to better control your asthma. P: Yeah, that sounds great. Thank you. D: Thanks talking with me and we'll see you soon. P: OK, great thanks.
dataset\resampled_file\RES0197.wav	D: What brings you in here today? P: Yeah, hi, I'm so I have been very wheezy for the past week um and I'm also like consistently coughing all the time and it's not getting any better. Um I do have asthma and I think it's it's acting up. D: OK, and how long have you had asthma for? P: Since I was like 5. D: OK, and are you using any puffers? P: Yes, so I am on a short acting. As well as an inhaled cortico steroid. And I only take the short acting like when I have the symptoms D: OK. And so how how long have you been symptoms worsening for? P: For the past week I would say. D: OK, and how how often have you used the ventilin? P: The ventilin that I use is almost every day like a couple times a day. D: OK, so would you say more than 10 times? P: Yes. D: OK. And have you had to do you have y to miss any school or anything like that over the past week? P: I missed two days. D: Two days, OK. And are you just getting daytime symptoms or are you waking up from sleep or not being able to sleep because of your symptoms? P: I woke up twice last week. D: OK. OK, so yeah, definitely seems like your symptoms are really acting upon and so you're getting some wheezing and you say you're also getting a cough. P: Yes, that's right, D: OK. And what kind of things would you be doing that you get these symptoms? Is it mostly exertion or is it exposure to dust or any other environmental factors? P: Uh, but, it's mostly exertion, but things like cold air can trigger it too. D: OK, I see. OK, any have you been exposed to any new environments where there is, you know, dusty carpets, mold, new animals, anything like that? P: Uh no nothing like that. D: OK, OK, and how would you describe the cough? Is it wet or dry? P: It's dry. D: OK, and. And how about the wheezing? Are you getting it like frequently every time you have an episode, or just sometimes? P: I I'm getting an on and off, but basically every time I cough after that I'll be wheezy for a little bit. D: OK. OK, and are you having any other symptoms like sore throat, runny nose, shortness of breath, anything like that? P: No, nothing like that. D: OK, and any blood in your sputum at all? P: No, no blood. D: OK, OK and has the ventilin been helping at all? Or do you find that it's less effective? P: Ventilin um it's been helping temporarily, but it definitely doesn't help as much as it used to. D: OK, um. And have you traveled at all recently or been in touch with anyone who's been sick? P: Uhm, no, nothing like that. D: OK. And, and any headaches? Nausea or vomiting? P: He no, nothing like that. D: Nothing like that OK, any dizziness or fainting? P: No. D: No OK, any fevers or chills? P: No. D: No. Any fatigue? P: Um a little bit because I haven't been sleeping too well. D: OK, any? Sensation of chest pain or racing of your heart? P: No. D: No. OK. Any changes in your bowel movements? P: Uh no. D: Any changes in your appetite or weight? P: No. D: No, any changes in your sense of smell or taste? P: No D: OK, OK. An other than asthma since you were five an do you have any other medical conditions at all? D: OK, do you take so you take the ventilin and then do you take the inhaled cortico steroid puffer as well? P: I do. D: OK and you take that daily? P: Um yes. D: Any other medications that you take? P: No, just some multi vitamins. That's about it. D: OK, any allergies to any medications that you know? P: Not to medication I’m allergic to like strawberries and Kiwis. D: OK, and what kind of reaction do you get? P: I just break out in hives. D: OK, and have you been previously hospitalized for any reason? P: No. D: OK, any past surgeries? P: Ah nope. D: OK and currently like who do you live with? P: I love with both my parents and two of my siblings. D: OK, and are any of them sick at all? P: No everyones pretty healthy. D: OK. And. So currently right now you're 16. This is an age where sometimes your peers or yourself might experiment with alcohol, smoking or recreational drugs. Have you have you tried anything at all? P: No, I haven’t. D: OK. Do you have any friends or peers that have tried alcohol or recreational drugs? P: I don't think so. D: OK, and in terms of just your home environment school. Do you feel safe or do you find yourself feeling unsafe or having been bullied at all? P: Oh, I'm pretty, I feel pretty safe. D: OK, that's good. And any family history of any heart or lung conditions at all ? P: No. D: No. OK, so yeah, those are all the questions I had for you today. Do you have any questions? P: Yeah, So what can I do about These these symptoms? Should I continue taking my puffers? D: Yeah, So what we'll have to do is re assess. So right now we will need to alleviate some of your symptoms so we will get you get you some ventilin and you mate will do like a full physical examination and get your oxygen saturation and everything an you might need some cortico steroids as well and then we'll talk about changing your regiment for your puffers as well and whether or not we need to add something else into your therapy, so we'll do a full physical examination and then go on from there. Does that sound good? P: Yeah, that sounds great. Thank you. D: You're welcome.
dataset\resampled_file\RES0019.wav	D: I was wondering if you could tell me what brought you in? P: Sure, you know I've been feeling kinda hot for the past couple of days and I have this terrible, terrible headache. And just my brain feels foggy. So I thought I should come get it checked out. D: OK, I see when uh did these symptoms start exactly? P: So they started about 3 days ago. But it's getting worse. D: OK. Uh, and uh, in terms of the headache, uh, does your head hurt in any particular location? P: I would say mostly the sides of my head. D: OK, and how long has the headache been going on for? P: Uh the same amount of time, so like the past three days. D: OK, and um, how would you describe the headache? Is it like sharp, is it like a vice grip? Is it pulsating, pressure like sensation or none of those? P: It you know it feels crampy. D: OK. Um, and has there been anything that triggered the headache or or made it worse? P: I don't think so. Nothing is helping, sleeping is not helping, moving around is not helping. It's just always there. D: OK, does the headache get worse with lying flat? P: Uh, no, I wouldn't say so, no. D: OK, and are you feeling any pain down into your neck or into your shoulders or back? P: No, no. D: OK. And, would you say that this headache, which is was like worst headache of your life or thunder clap kind of sensation? P: Uh, no, no. D: OK, have you had headaches like this before in the past? P: No, never. D: OK. And, how would you rate it in terms of severity, with 10 being the most severe that you could possibly have and one being not painful at all? How would you rate it? P: I would say I would give it around a 6 or seven. D: OK. And have you had any nausea or vomiting? P: No. D: OK, and how about any sensitivity to light when you're you're seeing it or sensitivity to sound? P: No. D: OK, and have you had any eye symptoms such as discharge, tearing or or itchiness? P: No, nothing like that. D: OK, um, and so you you mentioned that you had you had a fever as well. Did you check your temperature? P: I didn't actually, no I didn't check my temperature, I just feel hot. D: OK, we'll be sure to check that today in clinic. And have you been experiencing any other symptoms? P: Um, just like the brain fog that I was speaking of, you know. I just don't remember, I remember things, but it's it's like I'm doing everything underwater. D: Oh OK. Have you been uh confused or concerns with your memory? P: Um, no, I haven't forgotten things. It just feels like I'm really slow at doing things. D: I see, OK, and how has your energy been? Have you had uh significant fatigue? P: Yes, I would say I am significantly more tired than I used to be. D: OK, um, how has your sleep been? P: My sleep has been pretty normal. I go to bed around the same time, wake up around the same time. Yeah, I'd say that there's no issue there. D: OK, with this fatigue, have you had any aches and pains? P: Some muscle aches, I would say mostly in my arms and just my legs, yeah. D: OK, and have you had a cough? P: No cough, no. D: Alright, how about shortness of breath? P: No shortness of breath either. D: OK, have you experienced any chest pain? P: No. D: OK, how about any period where you felt as though your heart was racing? P: No. D: OK, and have you have any wheezing? P: Um no no wheezing. D: OK, and have you had any loss of taste or smell? P: Um, no. D: OK, alright have you noticed any rashes? P: No rashes either. D: Alright. And have you had any abdominal pain? P: No no. D: OK, have you had any diarrhea? P: Um no, no diarrhea. D: OK, um and any constipation? P: No. D: Alright, and then how about any urinary problems such as painful urination or going frequently? P: No, no changes. D: OK. And are you currently sexually active? P: I am. D: OK. Could you tell me about your partners or partner? P: Sure, I I just my husband, um we we don't use protection. But I'm on the birth control pill. D: OK, and have you had a sexually transmitted infection before? P: No. D: OK, and any I guess like vaginal discharge or vaginal discomfort? P: No. D: OK. And, so next just wanted to ask a few questions about your past health. Have you been diagnosed with any medical conditions in the past? P: No. D: OK, so no diabetes, high blood pressure, anything like that? P: No. D: Alright, and do you take any medications regularly like prescription or over the counter? P: I don't. D: Alright, so it's just the birth control? P: Oh sorry, yes. Just the birth control pills. D: Yeah OK, no worries, and any allergies? P: Just seasonal allergies. D: OK, and so are immunizations up to date? P: Yep, they are. D: Alright, and in in the home, is there anybody who's sick right now? P: No, no one is sick. D: Ok, how about at work? P: I'm I'm a teacher. Um, so I work with a lot of children, but no one that I no one I know of has been sick. D: OK, um and so have you traveled anywhere recently? P: No. D: Alright. And do you smoke cigarettes? P: I don't. D: OK. Do you smoke marijuana? P: I don't. D: Alright. Did you use any recreational drugs? P: I sometimes take some marijuana edibles, but that's about it. D: OK, and, do you purchase those at a dispensary? P: I do. D: OK, so for one of the Ontario stores? P: Yes. D: OK great yeah 'cause you could never be sure where else, what the dosing is, so it's good to get it from the appropriate stores for sure. P: Right. D: Do you drink alcohol? P: I do, I'll have a glass of wine with dinner. D: OK is this daily? P: Um most days I would say, maybe like four or five days of the seven days of the week. D: OK, I see. And has anybody in your family had similar symptoms in the past to what you're having or had any lung conditions in the past? P: No, nothing like that. D: OK, how about any heart conditions? P: Um, my father passed away at 75 from a heart attack. D: OK, and uh, how about any cancers in the family? P: None that I know of. D: OK. So I think that was, uh, all of the questions that I wanted to ask on history today. Was there anything else that you thought I was missing or that you wanted to tell me about? P: No, I don't think so. But, uh, what do you think I have? D: So with the acuity of your symptoms, starting with the last few days and getting worse, especially with a fever which we now have documented of 38.8 and a kind of feeling, uh, tired with aches and pains and the headache, I am concerned that you have possibly a viral infection, and one of those possibilities could be COVID-19, but also it could be the influenza. It could be something like the common cold, such as adenovirus. So certainly we will do a PCR COVID swab as well as order some general lab work to look for signs of infection, such as a CBC and a white blood cell count. But um, for now we will get those tests ordered. Did you have any questions? P: OK yeah that sounds great. Do you think I could also have you know, meningitis or something? 'Cause I was reading online on Google and that's the first thing that came up. D: Oh yeah, you're you're absolutely right, so, um sorry, I we will go ahead and investigate that as well and we might need to do a lumbar puncture or some blood work to look for signs of infection that might be needed to be treated with antibiotics. P: OK, alright that sounds good, thank you.
dataset\resampled_file\RES0181.wav	D: How may I help you? P: Hi, umm, so I've had a sore throat for the past three days and it doesn't seem to be getting any better, and I've also had a fever. So, I thought I should get it checked out by you. D: Yeah, for sure. So you said that the sore throat started three days ago. Has it been getting any better or any worse? P: Neither, it's been the same. D: OK, is it painful to swallow food or liquids? P: It's painful to swallow solids, yeah. D: OK, uh, and how is your, umm, have you had any voice changes like a hot potato voice or sound like muffled or any voice changes at all? P: No, not really. No. D: OK. And have you noticed any like neck swelling? P: No. D: OK. And how about your appetite? Has that changed? P: Uhm, I'm still hungry, I just don't eat as much 'cause my throat is sore. D: Right, OK, that makes sense. And so you mentioned that you also had a fever. When did that start? P: That started two days ago. D: OK, OK and did, did you check it? P: It was 38.8. D: OK. Alright, so yeah, certainly a fever. OK, and have you had any, uh, like any runny nose? P: No, not that I've noticed. D: How about any red eyes or itchy eyes or eye discharge? P: No. D: OK, how about any loss or changes to your sense of smell or taste? P: No. D: OK. Have you had any any headaches? P: Um, no headaches, no. D: OK. How about any cough? P: No cough. D: No coughing, OK. And how about any shortness of breath? P: No. D: OK, have you had any wheezing? P: No. D: How about any chest pain? P: No chest pain. D: Any fainting or dizziness? P: No. D: OK, and have you had any heart palpitations? P: Uh, no. D: OK. And so you don't you haven't had any cough, but have you had any instances of bringing up any sputum or or any blood? P: No. D: OK. And have you had any nausea or vomiting? P: No. D: Have you had any abdominal pain? P: No. D: You had any diarrhea or, or constipation? P: Uh, no. D: OK. How about any urinary problems? P: Um, no, nothing like that. D: I see, OK. And any skin changes or rashes? P: No. D: Alright, any muscle aches or body pains? P: No. D: And any, and how's your energy been? Have you had fatigue? P: I have been, yeah, I've been tired. D: OK. And have you had any, have you been diagnosed with any medical conditions in the past? P: Um, I have type one diabetes. D: OK, and uh, insulin wise, do you use a pump or is it like, how do you manage diabetes? P: I use an insulin pump, yeah. D: OK, excellent, and do you see an endocrinologist for that? P: I do. D: OK. Well that's good and have you had any complications or have things been stable? P: Things have been pretty stable. I had, when I was younger, I had a few episodes of like hypoglycemia. But now things are pretty stable. D: OK, and you can recognize those signs like feeling jittery and sweaty might, maybe a little anxious when that comes on? P: Yes, I'm an expert now. D: OK, that's great that you can recognize that those signs. It's important. And have you had any allergies? P: Uhm, no allergies. D: Any, and all your immunizations up to date? P: Ah, yes. D: OK. Uhm, and any hospitalizations or surgeries before? P: No. D: OK, uh, and uh currently, are you in, in school or working? P: I'm in school. I'm in Grade 10 and we're doing half days now. D: OK. Err, half days like in person? P: Yeah half in person and half online. D: OK. Have you been around anybody who's been sick? P: No, no one at schools been sick actually. D: OK. Uhm and have you traveled anywhere? P: Ah, nope, not not since COVID. D: OK, I see an are you ah, who are you living with? P: I live with both my parents and three of my siblings. D: OK, and anybody at home have any sore throat or cough, or or anything like that? P: Uhm, so my younger sister had a sore throat like a week back, but that's all she had. She never had a fever and her sore throat went away in like 2 days. D: OK. Uh, OK and does she need any treatment? P: No. D: OK. Uh, and uh, and I I know people around your age might experiment with drugs or alcohol. Have you used anything like that or your friends? P: Oh no, no, nothing like that. D: OK. And do you smoke cigarettes or have you tried? P: Uhm, I tried once but I don't ever do it regularly. D: OK. And uh, and do you smoke cannabis or use cannabis products? P: Um, no, I never have tried. D: OK. And and is there a family history of any heart or or lung conditions? P: Uhm, I know my grandfather had lung cancer, but he used to smoke. D: OK, I see. How old was he? Roughly? P: Uhm, he was in his late 60s. D: OK, I'm sorry to hear that, and thank you and oh sorry, I forgot to ask her are you currently sexually active? P: No. D: OK. Have you been sexually active before? P: Uh, no. D: OK, so umm, OK. Uhm, so that was all the questions that, uhm that, that I wanted to ask, was there anything else that you wanted to umm, mention today? P: Uh no, I don't think so. Is it, when you asked me if my neck was swollen, my necks not swollen but I feel like inside the back of my throat, my tonsils feel a little bit swollen. D: OK. And have you looked? Does it look like you have like redness in the back of your, back of your mouth? P: Yeah, it looks pretty red and angry. D: OK, and it's sore? P: Yeah. D: OK, so it's just to kind of summarize, this happens like this sometimes you been having so the sore throat, like the redness and swelling of the tonsils in the back of your mouth, as well as a fever and being pretty tired over these last few days. P: Yes. D: OK, yeah. Um alright, so it's sounding like most likely this would be strep throat or, or Group A strep pharyngitis with, because you have no cough, and with a high fever and swelling that you've been redness that you notice in the back of your mouth. And so we'll do a rapid strep antigen test and it will require just a throat swab. To see, to to detect for that, however with a, uh, umm, yeah, I guess that's it. That's what I yeah, well, we'll start with with that now and it could potentially be something like uhm, a viral illness, but that's lower on the on the differential then the bacterial infection is right now. And because of COVID it will be, we'll do a swab as well because people can get fever and sore throat with with COVID as well. P: Ok. D: So just to make sure that we're being comprehensive. P: OK. That sounds good. Thank you so much. D: Thank you.
dataset\resampled_file\RES0043.wav	D: What brings you all in today? P: Essentially, when he, so today is Friday, when he got home from school on Wednesday, he seemed fine, but he, I don't know that night he started to have a bit of like a cough. It just seemed like a little dry cough, but obviously I just wanted to keep him home, keep him safe and not like spread anything if he was sick, so he stayed at home on Thursday and he was like having a bit of a cough. Um and then, yesterday it seemed to get a little bit worse and he was really tired, or sorry it's today, today is Friday, um, he was like his cough is like getting a bit worse and I've been taking his temp the whole time and it got like a little high today. What was it? My thermometer says it was high. I'm just like trying to remember. It was it was, it was like over 100 though. D: Oh OK. P: 101 or something or maybe 100.1. But anyways, it was, so I I just thought I should probably bring him in 'cause I was really worried about him and you know thought he could have maybe got COVID and get school or something. D: Yeah for sure. Um, OK, so just to clarify, he's had this cough and fever for the past five 5 days. P: Mhmm. D: OK. OK, so let's focus on the cough. P: Sorry, it's been more like 3 three days like Wednesday is when he came home and then, and then today's Friday, so yeah, sorry. D: Today is Friday, OK. Um, OK, yeah sure. So, is this cough a productive cough, or is it kind of a dry cough? P: Ah I think it's dry. I haven't noticed him like spitting up anything. Umm, yeah, he yeah, it's just been like little coughs. D: OK, and he, is he, he's not bringing up any sputum or blood? P: No. D: No OK good. OK, and does he sound wheezy at all to you? P: No, no, not that I've noticed. D: OK, how about short of breath? P: Um, I don't think so like he, usually he's a really active kid and he has, he hasn't been running a lot outside in the past couple days, so maybe he maybe he could have been having a harder time breathing but also I think he's just been tired in general. D: OK, yeah. OK, and is his coughing getting worse with certain times of the day? Like is it worse at night in the morning? P: I think it kinda just there the whole day. D: OK um. And does it, how does it sound? Does this sound like a barky cough? Does it sound? Um, like harsh, what is, what would you say the quality of it, of the sound of the cough is? P: Uh, I just sounds kind of dry. It's not like super loud. D: OK. OK, and has he ever experienced anything like this in the past? P: I don't like he's had colds before, but I haven't like, I haven't like you, this time he kind of had the fever, which is different than you know, having a regular cold. D: OK. And are his symptoms getting worse? P: I think so. Because yeah, he first day he just seemed like little dry and then yesterday is coughing and today he actually has a fever. D: OK, and um, is he complaining of anything like chest pain? Or feeling like his heart's racing? P: No, I don't think so. D: No OK. Does he have a sore throat? P: I don't think so. D: OK, and is he having any issues swallowing food or fluids? P: I don't know if he's having trouble swallowing, but he doesn't seem to have a big appetite right now. D: OK, um, and is he, does he have a blocked nose or runny nose? P: Maybe a bit of like a runny nose. D: OK, and does he have any issues with smell or taste? P: Ah, this morning he really seemed like he wasn't like into his breakfast and I wonder if he's losing his sense of taste a little bit. D: OK, how about vision or hearing? P: I think those are fine. D: OK, and is he complaining of any chills or night sweats? P: No. D: OK, any changes in his hair, nails or skin like rashes? P: No, I haven't noticed anything like that. D: OK, any changes in his bowel movements? P: Uh, no. D: Pardon? P: I'm sorry, no changes. D: OK, no diarrhea, no constipation, no blood in the stool. P: No. D: OK, any nausea or vomiting? P: No. D: OK, any changes in his urine? P: Really been looking, but I don't think so. D: Any dizziness or fainting spells? P: No, just like fatigue. D: OK, any confusion or memory loss? P: No. D: And is he an, is he an otherwise healthy child? P: Yeah, absolutely, he hasn't like decide to like vaccines, he hasn't had to go to the doctor like ever. I mean, he broke his arm once but that was it. D: OK, so no past illnesses and I guess no hospitalizations or surgeries except for the broken arm? P: Exactly, like nothing. D: OK and were things normal with your pregnancy with him? P: Yeah totally D: OK. Ah, and then how about as a newborn, any complications after birth? P: No, no, like everything was things really good. D: OK and then did he hit all his milestones? Up till now? P: Yeah totally D: OK. And does he have any allergies? P: Uhm, no, no, I don't think so. I mean like he hasn't really taken a lot of medicine, so it's hard to say, but like nothing, so far. D: Is he up to date with all his immunizations? P: Yep. D: Yeah, OK. And in terms of family history, are there any lung conditions or heart conditions? P: Uh, no, everyone is really healthy. D: OK, and um, are there, and who does he live with and where does he live? P: He lives with me and my husband, and he has a little sister like just in town here. D: OK, and is she healthy? P: Yeah I like she, yeah she's healthy. D: OK an any concerns for old carpets, mold, asbestos or any environmental issues like that in the home that you're in? P: No. D: No OK, um has he been around any sick contacts recently? P: Not not like outside of school. I like we know for sure, not outside of school but he goes to school right now so kind of hard to say. They haven't like contacted us about anything. D: OK, sure. And has he traveled anywhere recently? P: No. D: No, OK. OK, well those are all the questions I had for you today. Were, was there anything that I missed that you wanted to chat about today? P: I don't think so. Like I realized that I can often times like we don't really do much for kids when you know, when it's just like a virus or something. But we do, I guess, need to have a COVID test to go back to school, even if you know either way 'cause they want us to be able to say it's like the other kids have had uh an exposure. D: Mhmm. P: So yeah yeah, like. Sorry, go ahead. D: No go ahead. P: So I just wanted to basically see if it was that and I mean he does receive you're so scared. That's kind of what made me come in, like it's scaring me a little bit. D: Right, yeah, OK, so first thing is, first we need to do a COVID swab just to make sure that he either has it or it doesn't have it and those results will come back in 24 to 48 hours. Umm we do suggest because his symptoms overlap with symptoms of COVID that he isolate for 14 days and that includes from his his younger sister if possible. And then if the swap comes back negative, there is a chance for false negatives. But also it could be another viral illness that's going around nowadays. If his symptoms get worse, so if he has a really high temperature, if he has any neurological symptoms like seizures or if he's feeling weak, dizzy, if he has any fainting spells, please do take him to the ER and uhm, so for now I'll just wait for those COVID swabs to come back. How does that sound? P: Yeah, sounds good. D: OK great. P: Thank you. D: Yeah, no worries. Uhm and I should have mentioned if it was just the cough or if he was just short of breath or something like that and he didn't have the fever, we would add everything's like asthma to the list of things he could be worked up for, but right now it sounds like a, it sounds like an infection. P: OK yeah, that's good to know. D: Alright, sounds great. Have a good day. P: You too, thanks.
dataset\resampled_file\RES0169.wav	D: What brings you in today? P: I I've been having uh, this fever, the last couple of days and I've had a cough as well and my nose is, keeps running. D: OK. And when did the fevers start? P: I think the fever started two days ago. D: How, did you measure your magic temperature? P: Yeah, it was 38 point .5 when I when I checked it. D: And have you been checking it out past days? Has it gotten better or worse? P: It's been about the same both both days. D: And your cough, when did that start? P: Cough started four days ago. D: OK, is it a wet cough or dry cough? P: It's been dry. D: I've been bringing up any blood or any mucus or anything like that. P: No, and I haven't had a cough before either. This is new. D: OK, and the runny nose, what kind of discharge, or what like what's coming out of your nose? P: It's pretty pretty watery and clear. D: OK, alright, and when did that start? P: Yeah, yeah, sorry that started about four days ago as well, so about the same time as the cough. D: Have you had any other symptoms, such as having a stuffy nose that have congestion in your sinuses, sore throat? Umm, red eyes? Watery, teary eyes? Sneezing, any of those symptoms. P: Um, no nothing like that. D: Any difficulties breathing? P: No. D: Any pain in your chest? P: No. D: OK, any headaches? P: Uh yeah I have had a bit of a headache, actually. Well, just just this morning. D: How how bad is it? P: It's pretty mild. Something pretty simple like it, so I've had headaches like like this before. It's not, it's not a big deal. D: And do you have any fatigue or muscle aches? P: No muscle aches, but yeah, I have been fatigued last a couple of days. Two or three days. D: Any changes in your sense of smell? P: No. D: Changes in your sense of taste? P: No. D: Any pain in your belly or any diarrhea? P: Nothing like that. D: OK? Alright um, any medical conditions that you've been diagnosed with? P: Uh. No, I I've been, I've been healthy. D: OK, any surgeries or hospitalizations? P: No, I haven't had anything like that before. D: OK. And do you take any medications? P: No, I'm not. D: OK, and allergies to food or medications, or environmental allergies? P: I think I have an allergy to penicillin. I got it, I had a rash when I was I younger when I had that. D: OK, and do you currently? Would you currently let that? P: Yeah, so I I just live with my with my mom. D: OK, do you have any pets at home? P: No, it's just us two, uh, we live in a in a townhouse in in the city. D: Nice, OK. And do you do you or your mom go out for school or for work? P: Uh yeah, I've been going been going to school. I know with the some of the lockdowns and what not the schools been open so we've been going. They've been pretty cautious with the covid protocols. And but my mom's been working from home. D: OK, good. Do you feel like you or your mom may have had contact with anyone who could have potentially been sick? P: Uhm, I mean, maybe at the school or something like that, but I can't think of anybody who who's been sick. D: OK, alright, have you traveled anywhere outside the province? P: No. D: OK, uhm. And, uh, do you I guess a couple of other more general questions. Do you feel safe at home? P: I do, yeah. We have a good a good relationship. D: I'm glad, I'm glad, and an anything that we discuss will see confidential between you and me, unless there's something that you could be talk about that could harm you or harm anyone else. Do you feel safe at school? P: Yes, I do. I enjoy school. It's been fun. D: That's good, that's good. And have you can have been consuming the drug? Tried anything? P: No, I've heard of other people. I mean in high school doing stuff like that, but I haven't been around anything like that. D: OK, alright. Any alcohol? P: No. D: OK, are you sexually active? P: No. D: Alright. And uh, let's see so.. uh, you've had a fever, a cough, and a runny nose for the past few days. And have you been going to school? In the past couple of days or no? P: I know I've taken the last couple of days off, just been so tired and not feeling good so, yeah well. D: OK, OK. So yeah, it sounds like you might have some sort of viral infection which could potentially be covid, but could also be another sort of another viral illness, just like the common cold or the flu. Um, so I'll request that we get a covid swab done and the results should come back in 24 to 48 hours and um, just try to self isolate as much as possible. Don't go to school, don't meet other people. Try to stay away from your mom as well. And based on the results, you'll get more guidance from public health nurses, and you should just continue to sort of rest and drink lots of water. Maybe take Tylenol or Advil if that's making you feel better and hopefully your symptoms will get better. If not, if you feel like your symptoms are persisting for days or week or so, or you're having worsening symptoms, definitely come back or give us a call. P: OK, thank you.
dataset\resampled_file\RES0110.wav	D: How may I help you today? P: Hi, um so for the past week or so I've um I've had this cough um and some shortness of breath. I feel hot and I just feel kind of uh fuzzy like I just I can't concentrate on things very well. I get confused sometimes so I thought I'll come to you to get it checked out. D: Yeah, yeah it's it's that was a really good idea to come in to get checked out. Um so can you uh, I'll talk I'll ask about each symptom a little bit. So starting with the shortness of breath can you um tell me how uh bad the shortness of breath has been? P: Uh it's been sometimes it's not so bad, some other times it's really bad. Um at first it wasn't that bad, but now like I'm having a hard time taking a deep breath in. Um it hurts and I just feel like I can't walk like 2 blocks even before getting short of breath. D: And uh before this week how much did, did you ever feel short of breath before this? P: No, nothing like this before. D: No, OK. Um do you feel that the shortness of breath has gotten kind of worse over time? P: Yeah, I think so. D: And what about the cough? Did that start at the same time as the as the difficulty with breathing? P: Um it started before the difficulty with breathing. D: Can you, uh is it a dry cough or a wet cough? P: Um it was it was a dry cough at first, but now I'm seeing some phlegm um and it looks kind of yellow. D: Have you seen any blood in the phlegm? P: No. D: Uhm and, uh, are you hearing any wheezing sounds? P: Yeah, a little bit. D: OK. Um how uh, has the cough sort of improved or gotten worse over time? P: Um it's it's gotten worse. D: OK. And you mentioned you also you also have a fever. Did you check your temperature? P: Um I did I it was like 38.5 this morning. D: And have you been checking your fever this past week, or was that the first time you, um, checked it? P: It's the first time I checked it. I I've felt hot though in the past and I've felt like I had chills. D: Yeah. You're also feeling a little bit fuzzy. When did that start, and can you explain that a little bit? P: That started about um, I think like yesterday morning. Um I just feel fuzzy like I can't concentrate on things as much as I used to be able to. And the other day I uh was cooking something and then I forgot I was cooking it. Um yeah, just a little bit confused. D: Did you leave the stove on? P: No, no, I had turned it off. I just forgot I left like the pot on the stove and made dinner. D: OK, OK and you feel like this is very new, that this has not been going on for weeks or months where you forget things or having difficulties with concentration? P: No this has never happened before. D: Uh OK. I'm gonna ask you about a couple of other uh symptoms just to make sure that you don't have any other um, just to get a full picture. So do you have a headache at all? P: Um no, no headache. D: OK, any changes in your vision or your uh hearing that has that has uh been very sudden or that has happened over the past week? P: No. D: Nothing like that, OK. Um any change in your taste, change uh, sense of smell? P: No. D: Sense of taste? P: No. D: OK uhm and uh any runny nose or congestion? P: Um a little bit of a runny nose, yeah. D: And what's that discharge like? What colour? P: It's also yellow. D: Um any uh sore throat? P: Uhm no, no sore throat. D: OK. And um any chest pain? P: Yeah, it hurt hurts when I try to take a deep breath in. D: When did that start? P: That started about the same time as my shortness of breath. D: OK, uhm and uh any uh do you feel like your heart is racing? P: Um no, not really no D: OK. Do you get any chest pain otherwise um in this week when you're not trying to take a deep breath? P: No, there's no chest pain at rest. D: Where is your chest pain? P: It kind of feels like central to my chest um uh yeah, just in the chest area, it doesn't radiate to anywhere else. D: OK OK. Does it get better right away after you um sort of stop taking that deep, stop doing deep breathing? P: Uh no otherwise it doesn't hurt. D: It doesn't hurt, OK good. Um alright, and any uh belly pain? P: Uh no. D: Any nausea or vomiting? P: No. D: Uh any changes in your bowel movements like diarrhea or constipation that is new in the past week or two weeks or so? P: No. D: OK. Um any um difficulties with uh peeing? Do you have uh any pain or any increase in how often you're going to the bathroom, or how um urgently you need to get to the bathroom? Anything like that? P: No. D: No, OK. Any pains in your joints or muscles? P: Uh no. D: Any fatigue uh in the past week? P: Yeah, I've been feeling tired. D: Um any um any weight loss recently? P: Uh no. D: OK, any um night sweats? Do you feel like you're drenched in sweat at night? P: Um no, no night sweats, but I do feel chills. D: Yeah, um and any swelling in your your belly or your um in your feet, in your legs? P: No. D: No, OK. OK uhm can you tell me about any uh medical conditions that you might have? P: Um sure I had a DVT uh two years ago. I have diabetes, for which I am on insulin. And I have hypothyroid. D: OK. I've got to say it's quite impressive that you know uh the word DVT, most patients don't know that. P: I've had a blood clot. D: Any um, so are you on any medications uh other than the insulin? P: Um yeah, so I'm on insulin and I'm on Synthroid. I'm on aspirin as well, like baby aspirin. D: Have you ever had any um COPD? P: No. D: Ever been diagnosed with asthma? P: No D: Heart attack or any heart related problems? P: No. D: OK, OK. Um has, have you had any hospitalizations in the past? P: Um no. Actually sorry, I have, for the DVT. D: Yeah, yeah, yeah, I see. Any surgeries? P: Uh no, no surgeries. D: OK. Um what what caused your DVT? Do you remember or do you know? P: Uh I was, I was flying somewhere. I was well, I was flying back from somewhere and I got off the plane and um I guess they found uh blood clots. D: I see, I see. OK. Any allergies to medications, environmental allergies, food allergies, anything? P: Uh no, I don't think so. D: OK. And I forgot to ask in terms of medications, are you taking anything over the counter? Any herbal pills, any vitamins, etc. P: Just some um calcium, vitamin D. D: Well, that's great. P: Yeah. D: That's great. Uh yeah, that's very important that you know for women um um above the age of 65, I think, 50. Um uh OK, so in terms of your living situation, are you living with someone? Are you living alone? P: Um I live with my husband. D: OK, and are you, um, is there anybody else in the house? Any pets, animals? P: Uh no, we don't have any pets or animals. D: And uh are you able to take care of things like uh dressing, uh changing, going to the bathroom on your own? Do you need help? P: Uh no, I am pretty independent. D: What about things like groceries or taking care of finances? P: Uh no, I'm pretty independent in in that aspect as well. D: OK, that's wonderful. Um have you had any recent travels? P: No, I've been trying to stay at home because of Covid. D: That's good. Um and any, do you think any exposures to anyone who could possibly be sick? For you or your husband? P: Um I mean we we do laundry at a laundromat. Um but other than that, no. D: OK. Um OK. Uh alright, well I think I have all the information I need today. Um let me go talk to my my preceptor and we'll come and do physical exams and listen to your chest and uh do a few uh lab tests to draw your blood and do a chest X Ray likely and then um uh go from there. You, it sounds like um sounds like with the with the fuzzy feeling, the fevers, the difficulties breathing, I think it would be a good idea for you to stay here for a couple of days maybe, but we'll um we'll let you know what happens and what the results show. I'm really glad that you decided to come in today. Do you have any questions for me? P: Um no, thank you so much. D: Welcome. Um so the likely diagnosis is um a pneumonia, either bacterial or viral, but given yeah, yeah could be either, OK. P: Do I still need to isolate in this case? D: Oh that's very true. Yep, Yep uh so. P: OK. D: Well, you will be in the hospital, so yes you do. We will be we will be doing a Covid test, but that's a really good point um uh because your symptoms do overlap with Covid symptoms um we will also uh have you in an isolated room away from other patients until your Covid swabs are back and we know whether um, yeah, we'll follow the guidelines um put forth by the public health. P: OK, sure.
dataset\resampled_file\RES0017.wav	P: I've been having this cough for around, I would say half a year now and I just can't seem to get rid of it. D: OK. And does this cough have any phlegm that you bring up? P: No, it's completely dry. I can't bring anything up. D: OK, and since the cough started, has it been getting getting worse, staying the same, getting any better? P: It was pretty much the same for I would say like three or four months, but then I've noticed it getting more frequent over the last couple of months. D: OK, and six months ago, can you think of anything that that changed? Including like, traveling anywhere or changing in in your work or or living environment? P: Uh, not really, uh, I'm like almost 75 years old now, so I just thought it was probably just due to my age. D: OK. Uh, have you been have you brought up any blood with the cough? P: No, I've never brought up any blood. D: OK, and have you have had any shortness of breath? P: Not that I've noticed, but I do find that I get a little bit more tired with exercise than I used to, but not really any shortness of breath. D: OK. Um, and have you been experiencing any other symptoms? P: I don't know if this is just due to old age, but like I've noticed some joint pain as well, like in my hands and feet. I just assumed that was 'cause I'm getting old. D: OK um, and has there been anything that's made the cough worse? P: Sometimes when, I'm exercising a lot more but not not too much, it's kind of just always been there, hasn't really changed too much, but it's gotten more frequent over the last couple of months. D: OK, and anything that's made the cough better that you've tried? P: No, nothing I've tried like everything. I've tried Tylenol cold, I've tried other home remedies but like like steaming and everything like that but nothing has really helped. D: OK, and is the cough worse in the morning, throughout the day or or at night? P: It's pretty much always there. It doesn't really change with any time of the day. D: OK, and is the cough interfering with sleep? P: Yeah, I sometimes I I do have coughing fits at night that wake me up. I do have disrupted sleep over the last few months. D: OK. Um and, you mentioned some joint pains as well and then when did that those start? P: I would say over the last year is when I started noticing it a lot more than before. D: OK, have you been having joint stiffness or or muscle stiffness early in the morning? P: It does get a little bit more stiff in the morning, but it's kind of just there throughout the day. D: OK, have you noticed any red hot or or kind of swollen joints? P: No, nothing like that. D: OK, any injuries to any of your limbs or or joints that could explain some of the pains there? P: No, not that I know of, nope. D: OK, um, and how has your energy been? Have you been experiencing a lot of fatigue? P: Yeah, I definitely have been more tired. I can't really even go outside for a walk sometimes or I get really tired working in the garden. So it's been tough. D: OK, and when did that when did you notice that change and and how were you different before? P: Like before, like before six months ago, I remember I used to be able to go for long walks around the block, then when I was gardening I can go on for hours, but now I'm pretty it's pretty limited to like maybe 15-20 minutes and then I have to go back into the house. D: I see OK, so pretty big difference over the last six months to a year for you. P: Yeah. D: Have you been experiencing any fevers or chills? P: Not really. Not that I know of. D: OK, how about, uh, excessive sweating at night? P: Nope. D: Alright and, how has your appetite been? P: My appetite has been around the same, no changes there. D: OK, have you experienced any weight loss? P: I've actually, I think, lost a couple pounds but not not too much. D: OK, would that be over the last six months or so? P: Yeah, around the last I would say three to four months. D: OK, uh, have you noticed any swollen glands anywhere like in your neck or anything like that you might feel like a lump? P: No, not really. D: OK, have you had a sore throat or or runny nose? P: No, I haven't had a cold for more than two or three years I think. D: OK, about a loss of smell? P: No. D: Loss of taste? P: No. D: Alright, have you been experiencing any chest pains? P: When the coughing gets pretty bad like I get some strain in my chest but nothing other than that. D: Alright, and any heart racing? P: Nope. D: Alright, and how about wheezing? P: No, not really. D: OK, and have you noticed any swelling in your limbs, like in your hands and your feet or ankles? P: No, not really. D: Alright at night, have you had any periods where you woke up extremely short of breath and you had to sit on the edge of the bed with your feet over? P: No, not that I remember. D: OK, and how many pillows do you sleep with? P: Just one, same as before. D: OK, um and any abdominal pain? P: No, no pain is just in my joints and sometimes in my muscles, but other than that, no. D: OK, any urinary problems like pain or or going really often? P: Nope. D: Alright and then any changes to bowel habits like diarrhea or constipation? P: No, not that I know of. D: OK, and have you noticed any skin rashes? P: Uh, nope. D: OK, and, uh, are there any joints in particular that are most affected? P: I would say like my legs and arms. It's it's pretty much lot of the joints, not really affecting my hip, but like everything else seems a bit sore. D: OK, and, have you been diagnosed with any medical conditions in the past? P: No, never. I've been pretty fortunate. D: OK, so do you take any medications either prescription or over the counter? P: No, just vitamins but nothing else. D: Alright, do you have any allergies? P: No, not that I know of. D: Have you been so you said you've been pretty healthy, but have you been in the hospital for any reason recently? P: No. D: OK. Um and are your immunizations up to date? P: Yeah, I I got a shingles vaccine, the one for pneumonia as well. D: OK, and have you traveled anywhere recently? P: No I've been at home. D: OK um and in the family, have you heard of anything like this happening in the family sort of way, onset of this kind of shortness of breath and cough that you've been experiencing? P: Not really, I I don't really have shortness of breath like it's it's like a dry cough. Sometimes I do find myself breathing more shallow. Yeah, mostly it's just a dry cough that's been going on. D: OK, and more of the fatigue. P: Yeah. D: OK. And anybody in the family have like autoimmune diseases like rheumatoid arthritis or or lupus? P: Uh I don't really, I can't really think of nothing my mom and dad were completely healthy. So I know and I don't have any siblings, so yeah, not nothing that I know of. D: OK, uh, any cancers in the family like colon cancer or anything like that? P: No, no cancers. D: OK. Um, and could you tell me a little bit about your living situation? P: Yeah, so right now I live alone in a small townhouse and yeah, that's I have a pet dog, but that's that's about it. D: OK, um, and how do you support yourself financially? P: So, I'm retired, but getting a pretty good pension as well as for my a husband's pension as well, but he unfortunately passed away a couple years ago. D: I'm sorry to hear that. What did you say you retired, what did you do for work previously? Did you have any exposures to chemicals or asbestos products while while at work? P: Not that I remember, no it was it was a pretty, pretty much like a desk job I would say. D: OK um, so no reasons that you were visiting farms and like being around birds or anything like that? P: Um, not really, but I I do think like the old building that we lived in might have had asbestos. Does that does that like count at all? D: Like a it could be important, uh, because, uh, well how long, how long did you live there for? P: I would say almost 20 years. D: OK, so um, yes, that definitely would be is is important for the history today because, unfortunately, long term exposure to asbestos when breathing it in can cause some of the symptoms that you've been describing along with cough and uh, respiratory symptoms. So it'll be something that we'll be sure to investigate today, OK? But I just had a couple more questions. First, do you smoke cigarettes? P: I quit long time ago, more than like 10 years ago, but I used to smoke like 5 to 10 cigarettes for around 20 years. D: OK, and do you smoke cannabis? P: No. D: Alright, do you drink alcohol? P: No, not anymore. D: OK, and do you use any other recreational drugs? P: No. D: Alright, and are you currently sexually active? P: No. D: Alright, and have you had a sexually transmitted infection before? P: No. D: OK, so those are the questions that I wanted to go over to make sure I asked on history. Was there anything that else you wanted to tell me? P: No, I think that's all. D: OK, so next we'll do your physical exam and order some investigations. But currently thinking that it could be related to asbestos exposure as well as um, something called, well, it could cause pulmonary fibrosis and then also the joint pains that you've been experiencing might be another symptom that is suggestive of a connective tissue disease, and it doesn't sound like you have a family history of those, but we will do some lab work and investigations for for those including a chest X-Ray and a chest CT. P: Sounds good.
dataset\resampled_file\RES0015.wav	D: What brings you in today? P: So I've been having just a worsening breathlessness. I've been also having a cough, and I think I might have also had a fever in the last couple weeks. D: OK, um so the breathlessness started six weeks ago, correct? P: Yeah. D: OK and then when did the cough start? P: I'd say around the same time the breathlessness started, so around six weeks. D: OK. And then the fever? P: The fever I've kind of had on and off in the last couple weeks. I would say two to three weeks. D: OK, OK um and do you, how often are you having this breathlessness? P: Um I would say it's pretty much there most of the time. It sometimes gets worse when I'm exerting myself, but I think just baseline, I feel like I've been able to breathe less heavily than before. D: OK, so alright, and how long does it last when you do get it? Or is it just always there? P: Uh, it's kind of just there, but then when it's getting worse like it lasts a couple minutes to, I would say like 10 to 15 minutes and then it goes back to like just the normal breathlessness. D: OK, and if you were to describe the quality of your breathlessness, would you say that it feels like a kind of like a burning feeling, like you're having a hard time catching your breath or does it feel like you're breathing too fast? P: I think it's more I just can't seem to take like deep breaths. And then when I get breathless, I I really try to take a deep breath but I just can't find myself catching my breath at that time. So it's just more not being able to catch my breath. D: OK, sure. And are there things that make make it better or worse? P: Uh, not really, I think it's sometimes moving around too much, but like nothing, nothing really causes it. D: OK, um, and was there any sort of trigger six weeks ago that you think may have like caused all of your symptoms? P: Oh I'm not sure I I don't think there was any triggers. D: OK, has anyone around you been sick? P: So there there are some people living in my house that have a bad cough over the last few weeks. D: OK. P: So yeah. D: So they have similar symptoms to you as well then? P: Yeah, some of them like don't really have the shortness of breath and it's just like a cough. D: OK. P: But yeah, there are some of them also have some shortness of breath. D: OK, OK. And have you traveled anywhere recently? P: So I actually came to Canada one year ago. I'm originally from India and I I'm I came here to study. D: OK. OK, um alright. If you were to rate your breathlessness from one to 10, 10 being the worst, how bad is your breathlessness? P: It can get pretty bad. Like I I would say up to an 8 sometimes, maybe a couple times a week. D: OK, and have you ever experienced this before? P: No, this is like the first time I'm having this issue. D: OK, and do you feel like it's getting worse, better, has it changed since you started having these symptoms? P: I think it's getting worse and that's why I was getting a bit scared and I came here. D: OK. Yeah, that was a good call and have you had any changes to your smell recently? P: No, no changes to smell. D: Any anything like a runny nose or stuffy nose? P: Uh, no, not really, no. D: No? OK, how about a sore throat? P: No, no sore throat. D: No sore throat, any changes to your taste? P: Nope. D: Any changes in hearing? P: Nope. D: Ear pain or discharge from your ears? P: No, nothing like that. D: OK, any eye pain? P: No. D: Changes in your vision? P: Nope. D: Any discharge from your eyes? P: Nope. D: OK, and you mentioned fever and some night sweats. How often are you getting these night sweats and do they feel like chills? P: I think in the last two weeks I've been getting it more frequently, like I would say every other night I I feel, I would feel chilly at one point and then I'll break out into night sweats or have to take off my blanket. I think I measured it once or twice over the week and it did show like a fever of 102. D: OK, OK. OK, and any changes to your skin like rashes? P: No, nothing like that. D: Any weight loss? P: I would say I think I'm losing a little bit of weight over the last couple weeks. I haven't really weighed myself, but I feel that I have lost some weight. D: OK yeah, and the coughing, are you coughing up any blood? P: Uh, I don't think so. Sometimes, like when I cough up like sputum, there is like a little bit of pink, pink tinged sputum as well. Sometimes it's like brownish in color and sometimes it's green, but I haven't actually coughed up any blood. D: OK, um and you said there's some sputum like pink tinged sputum. How much sputum would you say you cough up every time you cough? P: Maybe like a like a spoonful I would say. D: OK. And do you ever feel like you're wheezing? P: Uh, no, I I don't think so. I I don't really notice any noises when I'm breathing. D: OK. And, alright, so any chest pain? P: No, no chest pain at all. D: OK. How about swelling in your legs or in your limbs? P: No, no swell leg swelling. D: No leg swelling? OK, um how about do you feeling like your heart's racing? P: No. D: No OK. OK, and any nausea or vomiting? P: No, no nausea or vomitting. D: How about changes in your bowel movements? P: No. D: OK, how about changes in urinating? P: No, it's been fine. D: Alright any headaches? P: No headaches. D: Any dizziness or fainting spells? P: No, nothing like that. D: OK, no confusion or memory loss? P: No. D: OK, and are you otherwise healthy? Do you have any medical conditions? P: Um I think when I was back in India a couple years ago, they did give me some antibiotics for like a chest infection, but I couldn't really afford the medications and didn't take them. I didn't finish the course, but other than that, nothing else. D: OK, did they mention what type of chest infection it could've been? P: No, I don't really remember. I think it was some kind of pneumonia. D: OK, OK. Are you on any medications? P: Just uh I take Tylenol sometimes, like it hasn't really been helping. D: OK. And, are you allergic to anything? P: No, not that I know. D: OK, are you up to date with all your immunizations? P: Yeah, as far as I know. D: OK. And and is there any family history of lung conditions or heart conditions? P: Nope. D: No OK, how about cancers? P: No cancers that run in the family, no. D: OK OK, so you mentioned you moved to Canada from India about a year back. Where do you live now? P: So I live in it's, we have like a student house with some of the students who came from India as well, and there's six of us living together in in a house. D: OK, OK, and are they sick as well or no? P: Yeah, so three of them actually have like, two of them have a cough and one of them has some shortness of breath as well. D: OK. And have they been to a doctor? Have they been investigated? Were they ever given a diagnosis? P: No, not that I know of. I think I might be the first one who actually went to a doctor. D: OK, OK. Um, do you smoke? P: I smoke like I would say like 5 cigarettes a day. D: OK, how long have you been smoking for? P: Around 10 years. D: OK, that's, it's been a while then. Um, and do you do you drink alcohol? P: No, I I don't drink and I don't do any drugs either. D: OK, OK. Are you sexually active? P: Not currently, no. D: No, OK. Have you ever had unprotected sex? P: No. D: No?, OK. OK, um, did you have any questions or concerns? Anything you wanted to discuss that I hadn't asked you about? P: Um, so yeah, this is just like my first time visiting a doctor in this country and like I was just very scared that it might be something serious, so just wanted to know what it can be. D: Yeah, for sure. So the first thing we want to rule out is TB. Because you have recently moved to Canada from a country where it is, I believe it is endemic, so and some of your most of your symptoms fit with TB and how it presents so we just want to make sure it's not that because it is highly infectious and and we don't want it to spread. So, we can do like a AFB smear or I think they have other diagnostic work up for that too. So we'll do that first. If not, we can check to see if it's like another, another typical pneumonia, we can do a chest X Ray for that as well. If both of those turn out to be negatives, then we'll have to work you up further for other things, like COPD, or lung cancer. How does that sound? P: That sounds good. Thank you.
dataset\resampled_file\RES0078.wav	D: How may I help you? P: I've been having difficulties breathing over these last few days. D: When did it start? P: It started about, like, three or four days ago. D: OK, and since then, has it gotten any better or worse? P: It has, maybe gotten a little bit worse, but not, maybe, a little worse. D: And are there certain times when you feel that you're more short of breath than other times? Anything in particular that you're doing that makes it worse? P: Uhm, not really, it's kind of, I just feel like, it's just more difficult to breathe, uh, most of the time. D: And, has this happened to you before? P: Uhm, not like, no, nothing like this has happened before. D: OK, do you have a history of any lung problems? P: No, I don't, I've been healthy. D: So no COPD, no asthma, nothing like that, right? P: No, nothing like that. D: OK, so you're just having difficulties breathing for the past three-four days. Do you have any, uh, do you have a cough? P: I did have a, uh, yeah, I've had a cough as well, over these last few days. D: And has it been a dry cough or wet cough? P: I've been bringing up, some, like, uh, whitish sputum. It's like, yeah, whitish or clear. D: And you haven't seen blood anytime right? In your sputum? P: No. D: OK, and has the cough gotten any worse overtime? P: Uh, it's been about the same. D: And have you had fevers or chills? P: I have felt hot but no chills. D: OK. What about, any redness in your eyes or any congestion in your nose? P: Uh, I haven't noticed anything like that. D: OK, have you had a sore throat? P: Uh, it's felt a little itchy I guess but no pain with swallowing. D: And do you have any chest pain or chest pressure? P: Yeah, when I like, uh, take a deep breath or after after I cough I've been having some chest pain. D: To give it a number from one to ten, what would you say in terms of how severe it is with ten being the worst pain ever. P: I would say, maybe six. It feels pretty sharp when it happens and it goes away after a few minutes. D: OK, and where exactly is it, is the pain? P: Uh yeah, I kind of feel it, Yeah, just over on the right side of the sternum. D: OK. Alright, and does it radiate anywhere? Does it go anywhere other than that one location? P: No, I feel it just in the one spot. D: OK, uhm, and has that pain gotten worse overtime? P: No, that pain started, I guess like two days ago. More recent than the cough or shortness of breath. D: I see, I see, OK. And so you said that coughing makes it worse and sometimes breathing in. So is it just normal breathing or when you're doing like, deep breathing? P: Deep breathing. D: Deep breathing hurts? OK. Alright, and you've never experienced this before, right? P: No, I haven't had a pain like this before. D: OK, when you sort of touch that area over your chest, does touching it make it worse? P: Uhm, no, I haven't noticed that, touching it doesn't make it worse. D: OK. Uhm, alright, have you had a headache? P: Uh, no. D: No, OK. What about fatigue or muscle aches? P: I've been fatigued. No muscle aches. D: OK, any pain in your belly? P: No. D: Any diarrhea? P: No. D: Constipation? P: No. D: Any changes in your, uh, any changes when you pee? P: Uh, nothing there. D: No. OK. Any rash that you've noticed on your skin? P: No. D: OK. Any changes in your sense of taste? P: No. D: Changes in your sense of smell? P: No. D: OK, alright. So sounds like for the past three-four days you've had difficulties breathing and a cough with this whitish sputum, whitish or clear sputum. You've also been feeling a little bit feverish. Have you checked your temperature? P: No, I haven't. I don't have a thermometer at home. D: Yeah, no problem and your throat's been a little bit itchy and then two days ago you also started having this pain in your chest. Is there any other symptom that I have not mentioned that you have been experiencing over the past couple of days? P: No, that's everything. D: Yeah, OK. And you mentioned that you don't have a history of asthma or COPD. Do you have any other medical conditions? P: I have high blood pressure. And I take Amlodipine, for that. D: OK any other over the counter medications or any other medication that you're on? P: No. D: Any allergies? P: No allergies. D: OK, and where do you currently live? P: In a townhouse just outside of the city here. D: I see, do you live alone? P: No, I live with my wife and daughter. D: And have your wife and daughter been sick recently or have either of you had contact with someone who's been sick? P: I've been working from home, uhm, but my daughter has recently started going back to high school and she's had a runny nose recently and a sore throat, but that's about it. D: And what about your wife? P: She's been fine. Yeah, she's been healthy. D: OK, good. Other than your daughter, have you been in contact with anyone else who might have, who might be sick or might have symptoms similar to what your daughter has? P: I don't think so. D: OK, alright, and do you, have you traveled anywhere recently? P: No, I've been just, uh, working from home. D: OK, and do you smoke? P: No. D: Ever smoked in the past? P: No, I've never smoked before. D: Marijuana? P: I mean, I'll have a joint sometimes with friends at a party or something, but that's maybe once a month? D: Sure, and any street drugs? P: Nope, nothing like that. D: OK, and do you drink alcohol? P: I have a beer a couple of times per week. D: Alright, and you told me about your medical history, but do you have, have you ever had any surgeries or any hospitalizations in the past? P: Uh, I've had a hernia repair, about seven years ago. I haven't had any issues since. D: Alright, OK, uhm, and are there any medical conditions that run in your family? P: Uhm, my grand-father had a heart attack, in his seventies. And, I think my dad has high blood pressure as well, but, I think that's it. D: Alright, well, so, I think that's all that I wanted to know. I can see that you haven't been feeling well over the past couple of days and I'll go back to my attending and we will come back and chat with you little bit more and do a physical exam and go from there. P: Sounds good, thank you. D: You're welcome.
dataset\resampled_file\GAS0005.wav	D: Would you mind by starting with what brought you in today? P: Yeah, so I'm just coming in with my son. He's six years old and yeah, just over the last few days he's not been himself and he's been having this stomach ache. Uh, so it started around like I would say 3 days ago and then he's also having vomiting for the last two days, he's vomited in total six times over the last two days and then yesterday he also developed a fever as well. I managed to measure it and it was 38.3 degrees Celsius. D: OK, I see. So I just so that I understand the timeline, so he started to have abdominal pain about 3 days ago, started with having vomiting and diarrhea two days ago and you checked his temperature, he had a fever as of yesterday? P: Yeah. D: OK, and uh, was there anything that that he ate that was different over over these last few days? P: No, we've been strictly home food during like a pandemic like no, no real changes. D: OK, and what's his kind of behavior been like over these last couple of days? P: Yeah, so at first with the stomach pain he was a bit just irritable and just not himself, but especially yesterday with the fever just been very quiet and just kind of sleeping pretty much the whole day. D: OK, I see and uh, could you describe the vomit? P: Yes, so vomit like, it started two days ago. The first day it was just like he puked up the things that he had eaten, but yesterday it was it was mainly just like uh just yellowish material, I couldn't really tell if it was food or not. D: OK, have you noticed any bile or blood in the vomit? P: Uh no I didn't notice any blood and I didn't notice any green material. It was mainly just like like normal vomit, like yellowish color. D: OK, I see and, has the what was the vomiting triggered by anything that you're aware of, like eating or drinking? P: Uhm? Yeah, two days ago it was it was after after lunch when he first vomited. But after that it's just been kind of random. D: I see OK, and, uh, and with regards to his diarrhea, has there been any any blood or or any color changes? P: No, no, I didn't notice any blood at all. It's definitely just very very watery and he's had to go probably even just in the last day, probably around like six or seven times. D: OK, um, and he's vomited how many times? P: So in total I can count 6 times. D: OK, and, has he been complaining of any headaches at all? P: No, not that I know. D: No. OK, and how about any ear pain or or eye pain? P: No, not that he's mentioned to me. D: OK, and any eye redness? P: Nope. D: OK, and as he had a runny nose? P: No, not really. D: OK and has he had a sore throat or any pain with swallowing? P: No. D: OK, have you had any loss of taste or loss of smell? P: Uh no, not that he has mentioned to me now. D: OK, and has he had a cough? P: Uh, no, not really. D: OK, and how about any shortness of breath or wheezing? P: No. D: OK, and has he had any any pain anywhere? Any chest pain? P: Um, he did, he did point to his stomach like it seems like he was having with all the vomiting like, he was having some stomach pain as well. D: OK, is there any specific location that that he's feeling the pain? P: Well, it's hard to say. He was just pointing at the center of his belly like, I don't know if it's like, I tried pressing on it and he didn't feel any pain then, but I think it's just kind of all over his stomach. D: OK, and has he had any urinary problems like painful voiding or been peeing more often? P: No, that's been OK. D: Have you noticed any rashes or skin changes? P: Uh, no, not not really, no. D: OK. And has he had any muscle aches or uh, or joint pains that that he's mentioned? P: No, no he hasn't mentioned anything like that. D: OK, and he's had a fever, has he had the chills? P: Yeah, so that's that's what I, that prompted me to take his temperature yesterday around the afternoon, like we had to wrap him up with like more than two blankets and he was still feeling cold so, yeah, definitely was having chills. D: OK, and and has there been any concerns with his growth, either weight or or height? P: So he's been going along the charts pretty well, like no concerns during his growth. Otherwise, he's a very healthy child. D: OK, so no medical diagnosis previously? P: No nothing like that. D: OK, and uh, yeah, is he meeting all developmental milestones OK? Like gross motor, fine motor, doing well at school? P: Yeah yeah, he didn't have any issues with walking, running, he's pretty social with all his peers. He's doing well at school, no complaints. D: OK, excellent and you know, no medical conditions, but has there been any reasons for being in the hospital before? P: No, not at all. We, yeah, we haven't really gone to the doctor with him after like all those vaccinations that he had to do, so he's been good. D: OK, great, so immunizations are up to date? P: Yeah, immunizations all up to date. D: Excellent and does he have any allergies? P: Uh, no, uh, not not anything that we know of yet. D: OK, and I just wanted to ask about his birth history. Were there any complications throughout throughout pregnancy, either mom being sick or having any any issues herself? P: No, so it was a normal vaginal delivery, uh no issues, uh he was born at 39 weeks, didn't need to stay in the hospital at all. Yeah, it was a pretty smooth pregnancy compared to some of the other ones. D: OK, oh, that's that's great. Do you remember the Apgar score or his birth weight? P: Uhm, I don't exactly remember his Apgar scores, I think they were like just just they they were normal like there was nothing concerning about them, and birth weight I think he was probably around 3 kilograms. D: OK, great so, yeah healthy birth weight at term it sounds like. And so, healthy, does he take any medications regularly? P: No, no medications. D: OK, and could you tell me about who is living with currently and then who's looking after him? P: Yeah, so he's living with myself, his mother and, and then my husband, and he has two older siblings. One is a boy, seven years old, and another one like a 10 year old girl. D: OK, and has anybody in the house been sick? P: Uh no, no one has been sick recently, however he does, they did let them go back into school at one point, so I don't know, I don't know, so that was just last week, so I don't know if he caught something from school. D: OK, but nobody that you know that's had similar symptoms? P: No. D: OK, and have you traveled anywhere? P: No, we've been, we've been at home. D: OK, uh, and then you know recent changes to anything in the diet you've mentioned? P: No, that's been fine. D: OK, and any concerns for safety in the home, whether physical or or verbal abuse? P: No, no concerns like that. D: OK, yeah a question that we have to ask everybody and is there any smoking in the home? P: No, no, we don't smoke. D: OK, great then, are there any pets? P: Nope, no pets. D: Alright, and uh and in the family, has there been anybody who's had any heart problems or any lung problems? P: Uh, we are getting the 10 year old tested for just uh, asthma. D: OK. P: But nothing diagnosed yet, no. D: OK, anybody in the family have any congenital diseases or any genetic diseases? P: No, not that I know of. D: OK, uh, anybody in the family have celiac disease or Crohn's disease? P: No, no, uh no history of any kind of bowel diseases. D: OK, so I think that's, uh, everything I want I wanted to ask about today. Uh, was there anything that maybe I I forgot to ask or or that I missed that you wanted to tell me? P: Uh, yeah, no it's, it's also just like I was just reading up like, can it be like I don't know if it can be COVID as well, if it can, it can do this as well? D: It is possible. Uh, it's uh, especially with nonspecific symptoms, COVID can cause a variety of different presentations, and there for some people it can be more gastrointestinal issues like like your son has with vomiting and diarrhea and belly pain. But it also could be well, uh, another type of gastrointestinal virus itself or or a viral illness like the common cold, which can also end up causing symptoms like this as well. So we will, I will go ahead and do a COVID test today, along with some other blood work. And maybe increase the hydration as well, because it sounds like he has lost a lot of fluid over these last couple of days. So we will check electrolytes and go from there on the test results. P: Alright, sounds good. Thank you so much.
dataset\resampled_file\RES0075.wav	D: What brought you in today? P: Yeah, so uh, just randomly like 2 days ago I just started having this chest pain when I'm breathing and it's just been getting worse and then because of that, I'm finding that I'm very short of breath as well, so I just got really concerned. D: OK, I see. When did the chest pain start? P: So, there was some discomfort like just 2 days ago, but then just yesterday it started getting very painful when I was breathing. So yeah, I would say 1 day ago. D: OK, and were you doing anything at the time when the chest pain started? Like did you get in a car accident maybe? Or any trauma to the chest or anything you can think of? P: No, not really. I was just at home and then I noticed that when, I like, take a deep breath in, it's just, like, a very sharp pain. It's kind of like in my right side of the chest and it feels like a stabbing pain. D: OK, and so the pain comes on when you breathe in, or yeah, when you take a deep breath. Does the pain come on at any other points or does it go away? P: Uh, it's mostly, yeah, I feel the sharp pain when I breathe in. D: OK, so the pain is intermittent then, it sounds like. And has there been anything you've tried that's made the pain better? P: Not really, just more shallow breathing, and it hurts less with that, but that's about it. D: OK, and are there any positions that help make the pain any better like leaning forward or laying down? P: Not really, it's uh, it's pretty much the same, I think. D: OK, and uh, you mentioned you had shortness of breath as well. When does this come on? P: Since yesterday it's been pretty constant and it's more like, Uh, just uh, I'm really having trouble getting any deep breaths in, so I feel like I'm having to just breathe faster and more shallow. D: I see, OK, and has anything like this happened to you before? P: No, never. D: OK, and have you been experiencing any headaches? P: No. D: How about any viral symptoms, like eye redness, nasal discharge, or nasal congestion or cough? P: I have been having a little bit of a cough, but that's it, like, it kind of started today, but it's nothing too significant. D: OK, alright, is the cough dry or have you brought up sputum? P: It is dry. D: OK, and have you had a sore throat? P: Uh, no. D: How about a loss of taste or a loss of smell? P: No. D: OK, how has your appetite been? P: My appetite's been pretty good. It's like, definitely with the pain, I don't really feel like eating today, but I don't think it's changed. D: OK, so has your weight been stable over the last several months. P: Yeah, weight has been stable. D: OK, and have you had any fevers, chills, or night sweats? P: Uhm, Nope. D: OK, and have you had any episodes where you feel like your heart is, like, racing or beating out of your chest? P: No, I don't think so. D: Any dizziness or Lightheadedness? P: No. D: OK, and have you had any wheezing? P: No, I don't think so. D: OK, and with the cough, have you brought up any blood? P: No. D: OK, and have you had any, Uh, like urinary problems? P: No. D: Any bowel problems like diarrhea or Constipation? P: No, nothing like that. D: And any abdominal pain? P: No. D: Have you had any nausea or vomiting? P: No. D: OK, and have you had any muscle aches, joint pains or skin changes? P: No. D: OK, and uhm, in the past have you been diagnosed with any medical conditions? P: No, I've been pretty healthy. D: OK, so do you take any medications regularly? P: No, nothing at all. D: And do you have any allergies? P: No, no allergies. D: Any hospitalizations in the past or any surgeries? P: No. D: OK, and currently, can you tell me just a little bit about your living situation? P: Yeah, so I just live with uh, a couple of my roommates. I'm going to University. D: OK. P: I live in like a student housing situation. D: OK, has anybody in the house been sick or anybody that you've been around been sick? P: No, we've been all pretty healthy. D: OK, and do you smoke cigarettes or use any like vape products or anything like that? P: No, I haven't ever smoked. I do smoke weed like, I would say, once or twice a week. D: OK, and how much would you say? Like 1 gram or less or? P: 1 gram probably lasts like 2 weeks. D: OK, and do you drink alcohol? P: Yeah, just a couple of beers maybe on the weekend. D: OK, and are you currently sexually active? P: Yeah, just one partner, my girlfriend. D: OK, and, do you use condoms? P: Yeah, we use condoms, we're pretty safe. D: OK, and have you had a sexually transmitted infection before? P: No, never. D: OK, any concerns right now or anything like that? P: No, uh, we've been pretty safe and we've both been tested before and everything, so I'm not really concerned. D: OK, great and has anybody in the family had like a similar presentation before, like any lung problems or heart problems? P: No, I think my sister, she has asthma, but that's about it. D: OK, and uh, any cancers that run in the family? P: Not that I know of. D: OK, so it sounds like you had this uncomfortable feeling in your chest about two days ago, but the pain really came on yesterday and it's really painful when you have a deep deep breath. So, in conjunction with your symptoms of not being able to take a deep breath and being short of breath, it sounds like you possibly have what's called a pneumothorax and so we'll do a physical exam and do a chest X-ray as well to examine this and check vitals as well to make sure that you're work of breathing is OK and we can do some blood work and go from there. P: OK, yeah, sounds good. Should be like, worried at all? D: I think right now, you're speaking in full sentences and you're not short of breath at rest, typically, when this this happens, if it's small enough, it'll usually resolve on its own and so we'll get some more information from the imaging and the lab results, but it's reassuring that you haven't been getting worse since it happened. P: OK, alright, sounds good. Thank you so much.
dataset\resampled_file\GAS0001.wav	D: What brings you in today? P: I've just been feeling like very nauseated for, it feels like all the time right now. D: When did this start? P: It's been over a week. Maybe not quite two weeks, but like around then. Yeah, maybe like 9 days. D: And um, is it, do you always have the sensation of nausea or is it related, or does it come and go? P: Oh, I think it's like worse when I am smelling something really bad, and it's worse in the morning. But I feel like it's always kind of there. D: I see OK. Um, have you had any vomiting? P: Uh, yeah, like um, yeah, like a lot of days I'll throw up like once or twice. D: And this has all been over the past week, week two weeks or so? P: Yeah. D: OK, um, any other symptoms that you have? P: Oh no, just, well, like I feel like I've I've had to pee a lot more. Um, but I don't, I don't think that's like related. I think maybe I have just been drinking a lot of water, so yeah. D: How often do you have to pee? P: Oh, like, I feel like every couple hours right now. D: OK, so say every two hours, every hour, every five hours? P: Probably every probably every like 2, maybe, maybe every hour I get certain times in a day. D: Do you wake up at night to pee? P: Oh, like it doesn't wake me up but it's like I wake up because I hear something. Then I'll be like, oh I think I should probably go to the bathroom. D: Yeah, do you feel like you have control over when you are going to bathroom or is it difficult for you to hold it in? P: Oh I I I can control it. It's just like uncomfortable right? D: I see I see so, um, you have urinary frequency, but do you do you feel like, uh so you said that you can control it, you don't you don't feel like you need to run to the bathroom or you'll pee in your pants? P: No, I don't feel like that. D: OK. Do you have any pain when you're peeing? P: No. D: No, OK alright um, do you feel like you've been more thirsty recently? Why do you feel you've been drinking more more water? P: I think, I think just 'cause like I was getting I was like throwing up like so like I feel like I was a little dehydrated. D: Um, I see OK, um, have you, other than the nausea and vomiting, have you had any other stomach related issues? Any belly pain or changes in your bowel movements? P: Ah no, I don't think so, well my stomach has been like it feels like a little crampy. I thought that maybe it could be my period but like I'm not on my period. D: When did you last have your period? P: Oh well, let me think. Um, like six weeks ago. I guess that would be, I don't know. I don't really like keep track. D: OK, OK. Do you know if you get your periods regularly or are your periods irregular? P: I think they're I think they're usually pretty regular, but I don't I don't like I don't calculate it like to the day. D: True yeah, is it is it normal for you to go six weeks without a period? P: Oh, come to think of it, I don't, I don't think so. D: Alright. Um, OK. Uh, have you, I'll just ask you a couple more questions about your symptoms. So I know that you've been nauseous and have vomited a couple of times in the past two weeks. And, you have had some cramps in your belly. Have you had any flu like symptoms? P: No. D: Nothing like that? P: I don't think so. D: Any headaches? P: Uh no. D: Any fevers? P: No. D: Muscle aches? P: Uh no. D: OK, um, have you, have you had a cough at all? P: Oh no. D: OK, and have you noticed any blood in your stools? P: No. D: Have you, you haven't had any palpitations or chest pain or anything of that sort? P: No. D: Alright um can you tell me about your past medical history, any medical issues medical conditions that you have? P: Uh, nothing, nothing really. D: OK. Have you, um, been taking any medications? P: No, I mean, I've been taking like like I've been chewing like those ginger things that are supposed to help with nausea, but they weren't really helpful. D: I see. Any allergies? P: So just like nickel, like in jewelry, if I wear not real jewellery, it'll give me a rash, but it's not food or like or medications or anything. D: Um, and, uh, a couple of questions about your social history. Who do you currently live with? P: Um, like I I just I live with one roommate. D: Um and, do you currently smoke? P: No. D: Alright, you don't smoke, OK. Have you, do you consume alcohol? P: Uh, no, very rarely because I always get a headache. D: OK, when was the last drink that you had? P: Oh gosh, like like a month ago probably. D: OK, um, and you consume any illicit drugs? P: No, no. D: Alright, are you currently sexually active? P: Yeah just like with my boyfriend. D: And do you use protection while having sex? P: Yeah, we we just use condoms. I used to be on birth control but it always made me feel like like kind of sick so I don't use that anymore. D: Mhm, I see, OK. Uh and um, let's see. Family history. Do you do you have any medical conditions that run in your family? P: Uh, like I don't, I don't think so. I guess my dad my dad has like high blood pressure, yeah, I don't think there's anything else. D: Alright, alright, well, thank you so much for spending time with me today. I think I have gathered all the information that I would have liked. I will go talk to my attending, we'll come back and maybe ask a couple more questions and then share the plan with you. P: OK, thank you. D: You're welcome.
dataset\resampled_file\RES0109.wav	D: What brings you in? P: Hi, I've just had a runny nose and a cough for the past uh week. D: OK, um so for the past week you said, did the cough start first, or the runny nose? P: Uh it started with the cough. I usually don't come in when I have symptoms like this uh, but I've just been, uhm, I just heard of someone who passed away due to Covid and I'm just like very scared and I just decided to come in. D: Yeah, for sure that's understandable. Um With the cough, is it a dry cough or are you bringing up some phlegm? P: Um it's mostly a dry cough D: Dry cough. OK, um and is it persistent or does it come and go? P: It comes and goes. It does get better when I um take um like over the counter medications for for um like the antitussive pills. D: OK yeah yeah. Um and does anything make it worse like the cold air or certain times of the day or like when you're laying down? P: Um the cold air does make it a little bit uh worse. D: OK. And have you experienced something like this in the past? P: Uh yeah, I usually I do get a cold um couple times a year. D: OK yeah, that makes sense. Um and any shortness of breath? P: Um no, no I don't think so. D: No, any wheeziness? P: Um no. D: Chest pain? P: No. D: Um, how about a stuffy nose? P: Yeah, I do have a stuffy nose. D: OK, when your nose does run, do you notice that it's like uh yellow in colour or red? P: No, no. D: No, OK, so it's clear? P: It's clear, yeah. D: OK, any changes in your vision or hearing? P: No. D: Smell or taste? P: Um I I can't smell as as much, but I think maybe it's just because my nose is so stuffy, but also that made me a little bit concerned about Covid, but no problems with taste. D: OK, good any weight loss recently? P: Um I've been trying to lose weight, but nothing unintentional I guess. D: OK yeah, and then any fevers? P: Uh no. D: No fevers huh, OK. Any like excessive fatigue? P: I am tired but not, I guess it's not too bad. D: Yeah OK, and how about like rashes? P: No, I haven't noticed any. D: No rashes, OK. Um any uh, sorry, I asked you if you had chest pain, uh do you ever feel like your heart's racing? P: No. D: No, OK. Any changes to your bowel movements? P: No. D: No, um nausea or vomiting? P: Uhm, no. D: No, OK. Uhm how about headaches? P: Uhm, no. D: Fainting spells or dizziness? P: No. D: Joint pain? P: Um no. D: No, OK. P: Just my body feels a little achy, but. D: Yeah. P: No like specific joint pains. D: OK, and then any uh major illnesses that are longstanding? P: Um I don't know does depression count? I do have depression. D: OK, yeah, for sure. How, when were you diagnosed with depression? P: Uh when I was 15 years old. D: 15, OK. Um are you on any medications? P: I'm I'm on Prozac. D: Prozac, OK. And when were you diagnosed uh, prescribed that? P: Um I've just been on different medications uh over the past few years. Um this one seems to be working well. I started this about a year ago. D: OK good good, any allergies? P: Uhm, no. D: Are you up to date with all your immunizations? P: Mhmm. D: Um any family history of lung or heart disease? P: Uh, just um high cholesterol. D: OK. Um how about smoking, do you smoke? P: No. D: Um any other recreational drugs like marijuana? P: Um yeah, sometimes. I'll just have a joint um maybe um two or three times a week. D: OK, OK. And is that for like medical purposes or just like recreationally? P: Uh just you know just to relax. D: OK, sure. Um alcohol? P: Uh no. D: No, OK. And have you been around any sick people recently? P: Um I went to I went grocery shopping and and someone near me was coughing. I was still like six, you know, I was away from them but, I don't like, yeah, I don't know. D: Yeah, for sure. I think that you're, it's fair that you're concerned about that. And how about travel to anywhere? P: No, I haven't traveled anywhere. D: No, OK. OK, well those are all the questions I had for you. Did you have any questions of your own? P: No. D: No, OK. So we'll do a covid swab anyways today because your, some of your symptoms do overlap with that of Covid and you should hear back in about 24 to 48 hours. But in the meantime you should self isolate for 14 days. P: Sure. D: Um but it I think it does really sound like you have a common cold um so just like another viral illness, um so just treat it supportively you know um keep yourself hydrated, if you feel like you're getting a fever, take like Tylenol. Um if you have like pain like a headache or like sinus pressure or something you can take again an Advil or Tylenol. Um And if your symptoms worsen, or if you have any neurological symptoms, then you should see the ER um right away. P: Sure. D: Yeah, OK sounds good. P: Great.
dataset\resampled_file\RES0081.wav	D: How can I help you? P: Hi, my son Dave who's 5 years old, who comes to the clinic quite often, has uh, his asthma has been really bad over the past few days. I've tried his puffers, but they're not really helping much, and I'm just worried about him. D: So what symptom is he experiencing now? P: Uhm so, he's just having this wheezing that just doesn't go away, like, I can actually hear it, it's frightening, he's having like he's having difficulties falling asleep, he's just been very irritable, uhm, he didn't go to school yesterday. It's just, yeah, it's just, it seems like, it's just, he's not eating well either. D: OK, so yeah, it's been affecting, uh, sleep, appetite, his mood, has he been short of breath? P: If he was like, he said that he was having some difficulty breathing, yeah. D: OK, has he, uh, able to talk like in full sentences, like, how is he right now? P: Yeah, he's able to talk in full sentences but he just gets a little bit breathless when he's eating, which I think is probably why he's not eating much. But yeah, he's able to talk, he's not talking much either, just been like, just been in a mood, you know, he gets a little bit breathless when he's crying. D: OK, I see, and, has he had a cough? P: Yeah he does, he does have a cough, yeah. D: OK, and when did the cough start? P: I want to say about two days ago. D: OK, and has he been bringing up any sputum? P: No. D: Or any blood? P: No no no. D: OK, and has the cough been getting any better or any worse? P: It's been the same. D: OK, uhm, and has he complained of having a sore throat or painful ears? P: No, he hasn't complained of those. D: OK, and have you noticed any eye redness or or any discharge from his eyes or nose? P: No. D: OK, and has he been having any chest pain? P: Uh, no. D: OK, and you mentioned, uh, a wheeze, have you been able to hear a wheeze like this before? P: It's usually not this bad. D: OK, has he been having any abdominal pain? P: No. D: Any nausea or vomiting? P: No. D: Has he had any urinary problems like, painful when he's going to the bathroom? P: No, he hasn't complained of anything like that. D: I see, OK, and has he had any diarrhea or Constipation? P: No. D: OK, has he had any skin changes or rashes? P: No, no, I checked for those very carefully. He used to get rashes when he was a child, but no, he doesn't, he doesn't have anything right now. D: Alright, and has he had any muscle aches or joint pains? P: Uh, he's just been, he's just been not, he's not been as active as he usually is, so I don't, he hasn't said that any anything in particular about muscle pains, but I don't know if he knows how to, you know? He's just been, yeah. D: OK, and two days ago, can you think of any triggers like, was there any exposure to dust or smoke or maybe even pets that could have brought this on? P: Yeah, you know, if I think about it, he did go outside to play with his brother and, I don't know he might have got something out there maybe. D: Yeah, uh, certainly possible and was it like a particularly cold day? P: Yeah, it was a very windy, little bit chilly too. D: And when, like, during the winter time, does cold air trigger attacks for Dave? P: Oh yeah. D: OK, and how about exercise? P: No, I don't think, well, they went outside to play, so I mean he was, uhm, exercise does make it worse sometimes, so it could be that too. D: OK, and so, has dave been experiencing any other symptoms besides the the wheezing and the irritability and what you've described so far? P: No, I don't think so, that's, I think that's it. D: OK, you tried some inhalers, how often have you been using them? P: Yeah, we used his blue inhaler about five times yesterday, and another two or three times earlier today. D: OK, and do you use a spacer? P: Uhm, no we don't. I have to go get that and learn how to use it. D: OK, for sure we can go through, Uh, the proper technique, throughout this visit as well, just to review that again. P: I would love that. D: That's great, and has he been using any other medications to help over these last couple of days besides the inhalers? P: No, just the inhalers, we've also kept it the usual one, the one that he takes, the other inhaler. D: OK, does he have one that he uses, once, like, he uses daily? P: Yeah, yeah the one that he uses, I think the orange one. D: OK, so he does use a steroid inhaler? P: Yeah. D: OK, and does he have any allergies? P: Uhm, no he doesn't. D: OK, and does he have any medical conditions that have diagnosed previously? P: Just the dermatitis and asthma? D: OK, and when was his last asthma exacerbation? P: Last year. D: OK, has he ever needed to be hospitalized for one? P: Oh no, no, nothing like that, he's a healthy kid. D: OK, that's good, has he had any surgeries before? P: No. D: OK, and in regards to birth history, were there any complications throughout pregnancy or with delivery? P: Oh no, everything was normal. He was born via vaginal delivery and no complications. He was a healthy baby. D: OK, and have you had any concerns with growth or developmental milestones? P: No, no, the doc was pretty happy when he did the regular, the checkup and yeah things are good with him, he's a good kid. D: Awesome, OK, and could you tell me a little bit about the living situation, like who's the main caregiver and who he's living with? P: Yeah, so he lives with me, his dad and his brother who is 2 years older and he's not going to school right now. We're just keeping him at home due to Covid and trying to do some home schooling. I'm a homemaker, so I do have enough time to spend time with him and his older brother and, yeah. D: OK, has anybody in the home been sick, either his brother, yourself, or father? P: Uh, no. D: OK, and anybody, at work or any other places that you maybe traveled to, that, uh, been around anybody who's been sick? P: Uhm, no, I don't think so. I don't think there was anyone that was sick. D: OK, and have you traveled anywhere recently? P: No, no. We're just staying at home. D: OK, and are there any pets in the home? P: No. D: Alright, any carpets or like, uh, curtains or anything like that, covering the windows? P: No, we got all those removed when he had his big exacerbation last year. D: I see, OK, and does anybody smoke in the home, either cigarettes or marijuana? P: Uhm, my husband smokes, but he smokes outside, he never smokes in front of the kids. D: OK, I see, and uh, does anybody in the family, have any heart or lung conditions? P: No, uhh, I have some, I have high blood pressure but that's it D: OK, any, like, congenital diseases that run in the family? P: No. D: Or how about any genetic diseases? P: No D: Cystic fibrosis or anything like that? P: No no, no. D: OK, uhm, so was there any other, anything else that maybe I forgot to ask about or I'm missing that you'd like to add today? P: No, I'm just worried that he's going to have a big asthma attack like last year, I just also want to make sure nothing else is going on and if he can be taken care of and he's just, he's feeling awful. D: For sure, yeah, we'll, uh, check his his vital signs and do a physical exam. And it does sound like it could be an asthma exacerbation, and so we can trial some inhaler medications, a little bit different than what you use at home. But also using Ventolin as well and we'll assess the need for potential, uh, antibiotics and also steroid if necessary and if his breathing gets worse or you're starting to hear that the wheezing is getting worse or his work of breathing is becoming more intense then certainly we'll need to add on some oxygen and possibly, some other therapies. P: Thank you so much doc. D: Alright, thank you.
dataset\resampled_file\RES0206.wav	D: What brings you in today? P: So I so I have COPD and it's usually like pretty manageable with my puffers and that. But just in the last like 3 days I feel like it's gotten a lot worse. You know, I, I feel like I'm coughing more often and I'm now, uh, kind of producing more sputum. Kind of like a green yellowy sputum uhm. I even notice that there is like a little bit of blood a couple times when I was like, really coughing hard. I’ve been finding it like harder to breathe than usual. I don’t have home oxygen or anything, and I'm not. I didn't think I was quite there yet, but this these last few days it's been. It's been really hard to breathe. D: I see OK, so this is happened in the past three days. Have your symptoms gotten better or worse over this time? P: I feel like they've been get maybe maybe getting a little worse. They definitely haven't gotten better, D: OK, and has this ever happened to you before? P: I’ve had I had some troubles like when I've been sick before where the cough is gotten pretty bad. This is probably this is probably the worst that I've had, but I have like I have had in my COPD been made worse by being sick. D: I see OK. Well, I guess the first thing we're going. So how's tbad, how bad is your shortness of breath? P: Like I I walked here fine, but I normally like can walk around the block and I go for a walk, usually a couple times a day to walk my dog and it's been just it's been a little bit trickier to do that. D: I see OK. And uh have you ever had any hospitalizations in the past specifically for COPD exacerbations? P: Um I haven't. Uhm, like stayed over in the hospital. I like come to emerge a couple times. D: Alright um. How many times? P: I think twice maybe over the last like three years. D: Uhm when were you diagnosed with COPD? P: Uhm 4, 5 years ago? D: Was it formally diagnosed using the proper testing? P: Yeah, they referred me to a lung, a lung doctor. D: I see OK. And have you had any fevers or chills? P: I feel like I may have had a fever last night. I felt really hot. D: Did you check your temperature? P: I I don't have a thermometer at home. D: No problem. We can now check your temperature. P: Here by the bed. I would say had a fever. D: Sure. And. Have you had any other symptoms? So have you had like a runny nose or stuffy nose? Any pain in your sinus? P: I think I think I have a I've had a bit of a like this pressure in the sinus area, but it's been the cough has been the thing that's been the most bothersome. D: I see and have you had a sore throat at all? P: Oh no. D: OK. A headache? P: Uhm? Maybe a little bit, yeah. D: OK and any nausea or vomiting? P: No. D: Diarrhea or Constipation? P: No. D: Abdominal pain. P: No. D: OK. In have you recently lost weight unintentionally? P: No no, I wish but no. D: OK. Have you had any night sweats where you feel like you're drenched in sweat at night? P: Uh, no, nothing like that. D: Alright. And have you had any exposures to anyone who could potentially be sick? P: Um. Let me think I I meet my I meet a couple of friends to walk our dogs together outside and one of them was a bit sick for a bit. We try not to get too close, but maybe I don't know. Maybe sometimes we walk a little too close. We feel too safe 'cause we're like outside. D: OK, OK um. And did your friend get a covid test done? P: Uhm? I don’t know. D: That's OK. OK, and you mentioned that you had COPD that was diagnosed four or five years ago. Any other medical conditions that you've been diagnosed with? P: Um. Yeah I have a high blood pressure. D: OK, and are you taking any medications? P: I’m not, I'm not I we talked about it, but I decided to try to change my lifestyle as much as I could 1st and I've also done that for the COPD. It's generally pretty like I've been really trying to take care of it, but um I feel like I maybe got sick or something this time, yeah, so my blood pressure is like OK right now. D: OK, OK. P: My pressure and then I lost weight and started this walking more. D: That's great. That's really, really good that you're taking better care of yourself. Should definitely continue doing that. P: Right? D: And you've mentioned that you have some puffers. How often do you use those? P: Oh like I have the one that I use every day. That I'm supposed to just use no matter what, and then the one that I use when kind of just when I need it. I probably use it like once every two weeks. D: OK. OK. Uhm? And you mentioned that your COPD’s are getting better. Do you find that it's affecting your life in any way affecting the way that you're doing your daily activities at at home or at work, if you are working? P: I like pretty OK except for like if I get sick I so yeah, it's been. D: I see. P: So I think it's like pretty well managed like I stay on top of my lifestyle now. D: Thats good, thats good. Do you have any allergies? P: Uh, no, no. D: No, no allergies to medications ? P: No. D: OK, OK, good and. Do you, just a couple more to general questions. Have you traveled anywhere outside the province recently? P: No. D: You, I guess I should have asked you earlier, but have you noticed any change in your sense of smell? P: Uh no, I don't think so. D: Any change in your sense of taste? P: Uhm? No, I don't think so. D: Any confusion or fuzzy feeling? P: Nope. D: No OK, any muscle aches in your body? P: Uh no. D: OK, alright, and just kind of some questions about your living situation. Do you currently live alone? And I you mentioned that you have a dog? Are there any is there anybody, anyone else in the house? P: Uh my husband. D: OK and. Do you currently work? P: Yeah, I uh, like I've been working from home. I worked for the municipality. D: I see. Do you think you might have had any exposures to say dust or smoke or anything like that that could have worsened your symptoms? P: I don't think so. D: And do you drink alcohol? P: Oh, very rarely . D: OK do you smoke? P: I used to. I quit once they said I have COPD. I smoked 1/2 pack a day for probably 20 years. D: OK, OK, and do you consume marijuana or any recreational drugs? P: No. D: OK, uh, alright, well I guess one more question, are there any lung diseases or heart conditions or cancers that run in the family? P: No, nothing that I can think of. D: Alright, well that's those are all the questions I had for you. I will now do it physical exam and look at your vitals and listen to your chest. It's likely that what you have right now is COPD exacerbation, maybe just a like an infection that you got, which worsened some of your COPD symptoms. We would also have to rule out covid, so we'll be doing a covid swab and will decide based on the on your labs in your vital signs. It's instead of other things whether you need to stay in the ER and be admitted, or if you are good to go home, I will also talk to my attending and will make those decisions together and come back and talk to you. Does that sound good to you? P: Yeah, that sounds great. Thank you. D: Your welcome.
dataset\resampled_file\RES0022.wav	D: Would you mind by start starting to tell me about what brought you in today? P: Yeah, I I. It's just over the last week I can't like do anything without just feeling really like short of breath. I'm having a really hard time breathing. Like kind of do anyways because I have COPD. So I feel like over a few years it's been getting worse, but this week it just got really bad in particular. D: OK, I see so. How much activity were you doing that was bringing on, the shortness of breath? P: Like I, I usually I will walk my dog around the block and I haven't been able to do that like my husband's been doing it. And then I was just going to try to get the mail just like. I don't know. It's probably like 200 feet down the road and I could, I was so tired when I got back and I felt like I could barely breathe. D: OK, and did you have any chest pain with this? P: Uh. No, no, nothing like that. D: OK, and when did the shortness of breath symptoms start coming on? P: Mmm like it I've been. I feel like it's been sort of getting worse over the past few years. But just like a week ago, it just got really bad. Like very suddenly. D: OK, um, and has it been getting worse over this past week or has it stayed the same? P: Pfft maybe getting a bit worse, like it's been pretty bad the whole time. D: No, OK, I see, and have you had a cough? P: Yeah, like I again like I do normally because of my COPD but. It's just been really. It's been even worse this week, and usually when I get sick it's more like I'm like bringing up a lot of like yellowish gunk, but this time it's not been quite as like gunkie. It's been pretty dry. D: OK, so you're not bringing up any sputum with your cough? P: No, maybe maybe a tiny bit, but I kinda do that like anyways. D: OK. Uh, and have you coughed up any blood? P: No. D: OK, and um, have you had any other symptoms that have went along with this difficulty breathing, um and cough? P: Um I mean I've been, I don't have a thermometer at home, but I have felt like really hot. And. Just this morning, like my husband, you know he was trying to make sure I was still eating and drinking a lot and I don't really feel like I am tasting my food all that well. D: OK, so would you say that you have a loss of taste right now? P: Um pretty yeah yeah, I'm pretty sure I couldn't really taste my breakfast. D: OK. And how about your sense of smell? P: Actually, yeah come to think of it, I don't. I don't think I've really been smelling much. D: OK, so you're not able to smell either. Do you feel like your nose is congested or are really runny? P: It's not, it's not particularly congested or anything. D: OK. But still have had these changes in taste and smell. P: Mmmm D: Um OK and we will check your temperature as well to see if we can, if there is a documented fever. Have you had any night sweats? P: Whats that? D: So generally, patients would will say that their sheets are soaked and it will wake them up sometimes because it's uncomfortable. P: Oh no, I haven't had that. D: OK, how about any chills? So it could be like when you kind of shaking in your in your bed. P: No, not really. Just just like there really. I think, like fever, I think fevers. D: OK, and have over the last several months. Have you had any weight loss? P: No, I think I've been pretty well the same. D: OK, an with um the change in taste, how has your appetite been? P: Well, I mean that was just this morning that I noticed that. Um, before that, I think I was eating like pretty OK. D: OK, and have you felt as though your heart was racing at any point? P: No. D: OK. Uh, any dizziness or feeling lightheaded? P: Oh no, I don't think so. D: OK. And any abdominal pain? P: No. D: How about any nausea or vomiting? P: No. D: OK, have you had any diarrhea or constipation? P: Maybe maybe a little diarrhea. Oh but I didn't know if that was just something I ate or what. D: OK, so when did the diarrhea start P: Like yesterday. yesterday. D: OK, and and approximately how many times did you go to the bathroom, would you say? P: So probably like twice where it was really loose. D: OK, and did you notice any blood? P: No. D: OK um, has that happened again today? P: Oh no, I didn't go today. D: OK. And have you had any urinary problems like painful urination or needing to go really often? P: No. D: OK and then uh, have you had any headaches? P: Come to think of it a little bit, I just thought I was like it was maybe because I was tired. But yeah, I've had headaches. D: OK, have you had headaches like this in the past? P: Um, I mean only when there is like reasons for it, like being really overtired or. Uh. Yeah. D: OK, does this feel similar to any of those times? P: Let me know it's hard to say like I am tired so. Yeah, I think so. D: OK, would you say this was the worst headache of your life or a kind of like a Thunder clap sensation? P: No, nothing like that. D: OK. And have you got any photo sensitivity or kind of sensitivity of your light or sensitivity to sound? P: No. D: OK. And next question would be. Have you have any any joint aches or muscle aches or general body aches? P: I mean, I'm a little I feel like I haven't been moving as much. Feel a little sore. I thought it was maybe just 'cause I, you know, wasn't going for my long walks and my body was like getting tired and stiff. But yeah, I feel a bit achey when I come to think of it. D: OK, and have you noticed any rashes or changes in your skin? P: No. D: OK, uh, and then I'm not sure if I asked, but did you have a sore throat? P: Uh, no. D: OK. Um and next just wanted to ask about your past health. Um is there anything you see a physician for regularly? P: Just like the COPD. D: OK. P: My family doctor. D: OK, and do you use inhalers for that? P: Oh geez, I haven't seen my family doctor in awhile because of, the covid stuff. But I have an inhaler. Ah. That was probably like before covid that it was prescribed and then I ran out at some point and I haven't got it renewed. D: OK, so. When was the last time you used an inhaler, a a week ago, a month ago? P: I probably ran out like two months ago, but I wasn't using it every day. It was like one of those ones for like when you need it and, now, now this week I wish I would have had it. D: OK, I see. So before like two months ago, how often would you say you were using it? P: Oh, maybe once you're once a week. D: OK um. And when what types of situations where you finding yourself needing to use it more often? Or rather where there any kind of triggers to those events? P: Like if I if I say I took my dog for a walk and they kind of got away and I had to run a little like run a little bit. Usually I walk like pretty fast but if I have to run that would that would make it, would make me have to use it. D: OK, so a lot more exertion than what you're able to do now it sounds like. P: Yeah, like heavier exercise. D: I see, and any other medications like prescribed or over the counter that you take? P: No, that was it. D: Alright, and have you had any surgeries before? P: I had my appendix out when I was in my 20s. D: OK, and any allergies? P: No. D: OK, and um. Have you been anybody sorry, have you been around anybody who's been sick recently? P: Well, we haven't really seen anyone because of the covid stuff so. It's just my my husband has someone, like has, a friend that comes over for them to the they watch like the sports games together like our friend lives alone. So that's really the only person that's been coming into our house and I don't. I don't know that I don't think he's been sick. But he he might have been around people that were sick. D: OK, I see so he hasn't had any symptoms though? P: Not that I know of. We haven't heard from him in a few days though. D: OK, and how was your husband been? P: Oh, he's been well. He said he like he had a bit of a scratchy throat, but I don't think he's he hasn't really felt sick. I don't think. D: OK yeah, and do you live with anybody else or is it just you and your husband? P: Just the two of us and our dog. D: OK, and, uh, do you smoke cigarettes? P: Yeah, I've tried to stop but I I smoke like a pack a day. D: OK, we can talk maybe about quitting if you're interested later on in the appointment or at another time at a follow up. P: Sure, sure. D: OK, and do you drink alcohol? P: Like maybe like a glass of wine on a Friday. D: OK, so very it sounds occasionally, maybe a drink a week? P: Yeah, something like that. D: Alright, and um do you smoke marijuana? P: No. D: OK alright, how about that use like any like edibles or anything like that? P: No nothing like that. D: OK and then how about any recreational drugs? P: Um like what? D: Like things like cocaine, crystal meth, ecstasy. P: No, no. D: I See, OK, and Is anybody in your family had any heart conditions before? P: My dad had like high blood pressure. D: OK, anybody ever heard attack? P: No, not that I know of. D: OK, and anybody in the family have lung conditions in the past? P: Uh, no. D: OK, at any cancers that run in the family? P: No. D: Alright, so was there anything else that um you think I should know today that maybe I didn't ask about? P: I just feel tired. I just feel like really tired. D: OK, certainly that can be part of a kind of what how you're feeling and right now with the situation with the pandemic, COVID-19 is definitely pne thing that will be testing for today. P: Do you think I have COVID? D: It's very possible because of how general the symptoms are for covid, and so it's something that we want to test for. That being said, you could have another viral illness, such as the common cold like adenovirus. Or you could have a bacterial infection that's not Covid really related at all Or this could be an exacerbation of your COPD and maybe We need we need to just titrate your inhaler so we'll need to. Just run some lab work and do the PCR nasal swab as part of the work up an we will see what some of those investigations show. P: Oh geez, OK. D: OK, it's all in the meantime. You'll need to quarantine for 14 days. And if the results are positive, well after note notified public health so that the appropriate contact tracing can be made. But we'll get the investigation started now. P: OK, thanks doc. D: Alright, you're welcome.
dataset\resampled_file\RES0035.wav	D: May I just begin with asking you what brought you in here today? P: Sure, um, I've been experiencing some issues breathing, um and just a lot of coughing over the past year or so. D: OK. And is your cough, has it been a wet cough or a dry cough? P: Uh, but it's been a wet cough. D: OK. You mentioned it started over a year? P: Well, about, about 8 months. D: 8 months. And has it been getting worse at all? P: Yeah, I think it's been getting worse. D: OK. And so it's been a wet cough. Do you release any kind of like phlegm or sputum? P: Um, yeah, it's usually clear, but sometimes it can look yellow or green. D: OK, and how, how much would you say you produce every day? P: Um, like um, in total per day? D: Or just maybe every time you cough. P: Every time I cough maybe like the size of my thumbprint. D: OK, and have you notice at all coughing up any blood? P: No. D: Is the blood ever mixed into the phlegm? P: No. D: OK. And uh, has it been constant coughing? Or does it come and go over the last eight months? P: Um, it comes and goes, but there, there it's always like I have a tickle in my throat or something. D: OK, and when it first started, had anything changed in your life? Uh, had you move to a new place or started smoking or anything like that? P: No. D: No. OK. Is there anything you do that makes the coughing or shortness of breath worse? P: Um, I guess walking. D: Walking? Is there anything that makes it better at all? P: Just resting. D: Just resting, OK. How much can you walk or run until you feel the coughing or shortness of breath? P: About like 200 meters. D: OK. And has this ever happened to you before the eight months? P: No. Actually, I get wheezy because I have asthma, but it doesn't, it's not as bad as this. D: OK. And, um how often are you coughing, are you coughing throughout the day? Or is it more so during the day and then or more at night? P: Uh, it's just kind of always there, um throughout the day. D: OK. And do you have any other symptoms besides the difficulty breathing and the cough? Do you have a sore throat, runny nose, dizziness, anything like that? P: No. D: OK, so just the difficulty breathing and the cough? P: Yeah. D: Do you get any chest pain at all? P: No chest pain. D: Great, have you traveled anywhere outside of the country recently? P: Uh, no, no. D: Any headaches, nausea or vomiting? P: No. D: Any fever, chills or night sweats? P: No. D: Do you feel increasingly fatigued throughout the day? P: Yeah, I guess coughing a lot makes me tired. D: OK, do you ever feel that your heart is racing or you have any kind of chest pain? P: No. D: Have you noticed any issues urinating? P: No. D: Any changes in your bowel movements, any constipation or diarrhea? P: No. D: Any issues with your sleep or appetite? P: Uh, no. D: Any significant changes in your weight? P: No. D: Have you had any recent infections that you know of? P: Not that I know of. D: Any antibiotics that you've had to use for any infections? P: No. D: Um, do you think you have had any exposure to tuberculosis in the past? P: No. D: And do you have exposure to fumes or dust or animals or pets in your work or home environment? P: I have a bird. D: A bird? And when did you get the bird? P: Like five years ago. D: OK, but no issues before the eight months? P: No. D: OK. In terms of your overall health, do you have any past medical conditions? You mentioned asthma, but anything else like diabetes, high blood pressure? P: I have type 2 diabetes and high blood pressure. D: OK. And or do you take any medications for those conditions? P: No, it's just being controlled by diet. D: OK, any medications for any other reasons? P: I take some vitamin D tablets. D: OK, any allergies, environmental or to medications? P: No. D: OK, have you ever been hospitalized? P: No. D: Any ill contacts near you at home or work? P: No. D: Any previous surgeries? P: No previous surgeries. D: OK, do you have any family history of asthma or any other lung condition or any cancers? P: No lung conditions or cancers. D: OK. And currently, do you work? P: I do. D: And where do you work? P: I work as an accountant. D: OK. And do you currently live in an apartment or a house? P: In an apartment. D: OK. And do you live by yourself or do you live with anyone else? P: Just by myself. D: OK. Any new changes to your house uhm, any new carpets or anything like that? Or have you moved into a new new place recently? P: No. D: OK, do you use any recreational drugs like marijuana? P: No, I smoked when I was younger, but not anymore. D: OK, and do you smoke cigarettes? P: I do. D: OK, and how much would you say you smoke on an average day? P: Uhm, about half a pack a day. D: OK, and how long have you been smoking for? P: Since I was 18. D: OK. And you drink alcohol? P: Uhm, sometimes. D: And how often would you say on an average week, how many drinks of alcohol would you say you have? P: Uhm, maybe 2 glasses of wine a week. D: OK. And in terms of your diet and exercise, would you say you get 3 meals a day? Well balance, well balanced diet? P: Um, yeah, I'd say so. D: OK, and lastly, in terms of exercise, would you say you're fairly active throughout the week? P: Uhm, yep. D: And what kind of things do you do for activity? P: Um, I take walks when I can. Um, before this whole shortness of breath thing, I used to ride my bike. D: OK.
dataset\resampled_file\RES0165.wav	D: What brings you in here today? P: Um, I just I've had a cough and I've had a sore throat for the past two days and I was just worried that I might have COVID so I thought I'd come in. Just to make sure that everything's OK. D: OK, well that's a good idea that you came in, so it's been happening for the last two days. Did you start having the cough first or the sore throat or both around the same time? P: It started with a sore throat two nights ago and then it got worse in the morning when I woke up and then I developed the cough, like about a day ago, a day and a half. D: OK and can you describe your cough? Is it a wet cough or a dry cough? P: It's a dry cough. D: OK, are you having any kind of? Are you bringing up any blood or sputum at all? P: No. D: No OK. And, uh. So this started 2 days ago. Is it constant, are your symptoms constant? Or they come and go? P: No, they're not constant. They kind of come and go. D: OK, and do they occur when you're exerting yourself at all or it can happen it? Or do they happen at some point during the day in the morning or night, or just randomly? P: It's pretty random. D: Okay. Are you symptom getting any better or worse? P: Uhm? Maybe a little worse. I kind of feel like I'm also, um, I'm now having like a, a runny nose. D: A runny nose as well? OK, when did that start? P: Uhm, maybe like I don't know just now even, like an hour or two ago. D: OK, uhm have you had any recent exposure to anyone that's been sick recently at all? P: Uhm? Maybe. I, I work at a hospital. Um, but I'm always maintaining, social distancing and I try to be very careful. D: OK, and uh. Do you have you tried any medications over the counter to help with these symptoms? P: No. D: OK. Do you have any other symptoms like. Shortness of breath, chest pain, dizziness, or anything like that? P: No. D: No. Okay. And the sore throat are you having trouble or pain while swallowing any food? P: It's not that bad. D: Not that bad. P: It's just irritation in my throat. D: OK. Any hoarseness in your voice at all? P: No. D: Well, OK. Have you traveled at all recently utside of the province? P: No. D: Any headaches? P: No. D: Any nausea, vomiting? P: No. D: Any fevers or chills? P: Now I know. D: No OK. Any fatigue or malaise? P: Maybe a little bit. It's not too bad. D: OK, any muscle aches at all? P: Uhm? Yeah, little bit. D: Okay, and when did that start? P: Maybe two days ago? D: OK, and is it just all over your body or in certain locations? P: It's all over. D: Have you tried any pain medications? P: Uhm no, no I haven't. D: OK. Any changes in your bowel movement at all like Constipation or diarrhea? P: No. D: Um, any changes in your appetite? P: No. D: OK, have you lost any significant weight recently? P: Uh, no. D: OK. Do you have any past medical conditions that you've been diagnosed with? P: Um, no, I'm pretty healthy. D: OK. Any allergies to medication? P: No. D: Any environmental allergy? P: No. D: OK, any previous, so sorry? Are you taking any medications at all right now? P: Uhm? Um, I'm not, no. D: Any past hospitalizations or surgeries? P: Um, no. D: No. OK, and any family history of any lung or heart condition. P: Just high blood pressure. My mom has it. D: OK. Uhm, and currently, are you working? P: I was working before the symptoms started. D: OK, and what do you do for work? P: I work as a custodian at the hospital. D: OK, and so you've been isolating and have you gotten COVID swab test yet? P: Uhm no I haven't. D: OK, so yeah we can do that for you today after a physical, physical examination. P: Sure. D: Currently, right now, what's your living situation like? P: I live alone. D: OK, and do you live in like an apartment or house? P: Apartment. D: OK, and any new exposures at all in your house to dust, new, carpets, animals, anything like that? P: No. D: No, OK. And do you smoke? P: I used to, I don't anymore. I I smoked when I was in high school. Maybe a couple times. D: And do you smoke marijuana? P: No. D: Uh, any alcohol? P: Um, once once a day, maybe one class of wine at night. D: Yeah, so that's all the questions I had for you today. Do you have any questions or concerns? P: No. D: OK, so yeah, it seems like you've been having these symptoms for the last few days. They seem kind of like viral in nature with your dry cough and runny nose, sore throat. And sometimes with these viral illnesses, it may take some time for the symptoms to go away, especially the cough. So today we will do a COVID swab test for you today, as a lot of the symptoms overlap and you will receive the result in the next one to two days and be contacted by public health for further instructions. As for management, I think you can take over the counter medications like Tylenol cold, drink lots of fluids and stay hydrated. And if those if your symptoms worsen at all, you can contact us again. P: Sure, thank you. D: Welcome, take care.
dataset\resampled_file\RES0048.wav	D: What brings you in? P: Yeah, so I just came in because I've been having this cough that's getting worse over the last uh one and a half week and uh, I've also just recently in the last few days been getting some shortness of breath. Um and I also noticed uh my bowel movements have changed a little bit as well over the last week. D: OK, so yeah, let's break this down. The cough, when did that start? P: The cough, I think it started uh probably like around 10 days ago. D: 10 days ago, OK, and how about the shortness of breath? P: That just started in the last uh I think 3 days. D: OK, and then the the bowel bowel changes, when did that start? P: Yes, I think it also started in like, I would say, for the last three days I've been getting uh diarrhea. D: OK OK, so let's go back to the cough, is it constant or um is it triggered by certain things like the cold air, dust, um you know, um, certain times of the day, like morning, evening? P: Um, I would say it's pretty pretty constant since the last like 10 days, uh it's, there's no real pattern to it, and I've mostly just been inside my house. I don't think there are any triggers or I don't own any pets or anything like that, no new rugs, like uh, no no new changes really in my house. D: OK, OK and um have you tried anything to make it better? P: Um, no, not really. I I've done some uh home remedies like trying to do one of those steam steam masks and see if that helps, but it didn't really do anything. D: OK. Um and how about um the quality of that cough? Is it, does it sound harsh? P: Um, yeah I would say it's getting a little bit harsh. It's more just like, I'm not bringing anything up, it's more like a dry cough um, but yeah, I would say it's getting worse, definitely. D: OK. Um, is it a dry cough then, or are you producing a little bit of sputum or blood or anything like that? P: No, no, I haven't seen any blood at all and rarely do I bring like up some sputum, but like most of the time it's just a dry cough. D: OK, it's a dry cough. Um and would you say the cough's getting worse? P: Yeah, I'd definitely say in the last um three to four days I've been just coughing nonstop, it's very irritating. D: Yeah, have you experienced anything like this before? P: Um, probably a few years ago, I think I caught the flu or something and got really sick with a fever and just a lot of coughing. But since then, nothing else. D: OK. Um the shortness of breath, 1 to 10, 10 being the worst, how bad is it? P: Uh probably like a five. It kind of just started out with uh, three days ago, was kind of like I just couldn't take deep breaths like I noticed that my breathing was getting a little bit more more shallow and now it's, especially when I'm coughing, it's like I really have to sit down and catch my breath. D: Yeah, um does anything make the shortness of breath worse? Like I guess um you know exertion, uh laying down, anything like that? P: Um, not really. Maybe like sitting down helps sometimes, but even when I'm sitting down I'm still coughing. D: OK. OK and um do you have any wheeziness? P: No, I don't think so. D: OK, any chest pain? P: Um, maybe from all the coughing, sometimes I feel like there's some pain there, but it's not not anything that's too painful. D: OK, um do you feel like your heart's racing at all? P: Uh no, not really. D: OK. Um have you noticed any swelling in your limbs? P: No, I didn't notice anything like that. D: OK, how about um pain in your calves when you walk a few blocks? P: No, I've been fine that way. D: OK. Dizziness or fainting spells? P: Uh no, not really, I I thought maybe with the shortness of breath that would happen, but like so far that hasn't happened to me. P: OK, any fevers or chills? D: Uh no I, maybe like a few chills, like I'm not sure actually, it was hard to tell, but I haven't had any fevers. P: OK, we'll take your temperature today just to make sure. Um any weight loss over the past few weeks? D: Uh no, probably weight gain. P: OK, any changes in your hair, nails, or skin, like rashes? P: Uh, no, I haven't noticed anything like that. D: OK, any changes in your vision or hearing? P: Uh no, no, that that's all been fine. D: How about um loss of smell or taste? P: No, I haven't had uh, I think my taste and smell are still pretty good. No, no issues there. D: OK, um have you had a runny nose or stuffy nose? P: No, no, no no congestion really. D: OK, and um have you had a sore throat at all? P: No, no sore throat. D: OK. Um any issues swallowing food? P: No. D: No, changes in your appetite? P: Maybe just a little bit, like I don't really feel like eating when I'm coughing all the time, but other than that, no, not really. D: OK. How about nausea or vomiting? P: No, nothing like that. D: OK um constipation? P: No, diarrhea. D: Diarrhea, right. Um how often are you having a bowel movement right now? P: I would say uh like I've been going, probably more than eight times a day, probably in the last few days like 10 times a day. D: Oh wow, OK, and each time are you producing a lot of stool, or is it just a little bit each time? P: Like a little bit, but it's mostly liquidy. D: OK. Any solids at all? Like is it semi solid at all? P: Um maybe a little bit, but mostly it's just liquid. D: OK, um any blood in the stool? P: No, I've been checking uh no, I didn't notice any blood or change in colour. It's mainly just um liquid diarrhea. D: OK, any changes in your urine? P: No. D: No, OK, um any confusion or memory loss? P: No, not that I know of. D: OK, um how about muscle aches or joint pains? P: No, nothing like that. D: OK, and are you otherwise healthy or do you have any long uh standing medical conditions? P: Uh, so I do have diabetes and high blood pressure. D: OK, do you take any medications for those conditions? P: Yeah, so for diabetes I'm taking this medication called uh like I think metformin and then for the blood pressure, uh I think it's, I forgot the name, I think it's something like um ramipril or something like that. D: Yep, OK, and you're taking that um as directed, right? P: Yeah, I've been taking that regularly and my blood pressure, I've been measuring, it's been pretty steady, no changes. D: OK, that's good. Have you had any hospitalizations or surgeries in the past? P: I did have my appendix removed, probably in my 20s, but uh that was the only thing. D: OK, um and do you have any allergies? P: No, not not really. D: OK. Are you up to date with all your immunizations? P: Yep. D: OK. Are you on any other medications besides the ramipril and metformin? P: Just uh like multi vitamins for men over 50. D: OK, OK. Um any family history of heart conditions or lung conditions that you know of? P: Um yeah, so my family, like diabetes is pretty big, it runs in the family and uh my father in his 60s uh like died from a heart attack. Um other than that, not anything else I can think of, no. D: OK, any cancers in their family? P: Uh no, I don't think so. D: OK, do you smoke? P: I used to, I I quit probably five years ago, but before that I used to smoke probably a pack a day for more than 20 years. D: Oh OK, well good job for cutting down and quitting, um. P: Yeah. D: Yeah, um do you do marijuana at all? P: No, no no no drugs. D: Any other recreational drugs? You said no, right? P: Yeah no, no, I don't do any drugs. D: OK, um do you drink alcohol? P: Yeah, I probably have maybe um some whiskey maybe a couple times a week. D: OK. Um and where do you live right now? P: Uh, so yeah, I just live in the city in London uh in an apartment with my, just wife, my wife. D: OK, um is she also sick or is she OK? P: No, she's been completely fine, and I've been kind of isolating myself from her over the last week. D: OK, well that's good and that's smart, um just because you don't know what you have, right? P: Mhmm. D: Yeah OK, do, can you think of any other sick contacts that you may have had over the past one or two weeks or even three weeks? P: Um I go to the grocery store, then I go to work, I haven't noticed anyone being sick at work, but you know, you never know like who comes in asymptomatic and like they might be carrying it, with this virus like mainly I'm worried about covid and you know just how fast that's spreading everywhere. D: Yeah, for sure. Um yeah, for sure, have you traveled to anywhere recently? P: No, uh we've been in Canada, Ontario, haven't left to go anywhere. D: OK. OK, well those are all the questions that I had for you. Did you have any questions or did you have any concerns, anything that you wanted to discuss today? P: Yeah no, I just uh was wondering if I can get the covid test, that would just, I wanted to make sure I don't give anyone covid if I do have it. D: Yeah, for sure, I think that's a good idea. Um so, and it's definitely something that we need to rule out, so we'll do a covid swab today um and you'll hear back within 24 to 48 hours, um but in the mean time, regardless of whether you actually have covid or not, because your symptoms overlap with covid, um it's good to isolate for 14 days and that includes trying to isolate from your wife as well if possible, and public health should be in touch if it's positive uh to do contact tracing. Um and if it's not covid, it's probably another viral illness that's going around at this time of year. Uh if your symptoms get worse, um you know you're having neurological symptoms or or if your fever gets really high, or you're having a lot of trouble breathing, then you should go see the ER. How does that sound? P: My, if my breathing gets worse uh I'll just go to the emergency Department? D: Yes, please do. P: OK, sounds good. D: Alright, take care. P: You too, thank you.
dataset\resampled_file\GAS0004.wav	D: I understand that you've been having some diarrhea. Can you tell me a little bit about that? P: Yeah, sure I had, I've been having diarrhea for the past three to four days, and it's been pretty bad. I couldn't go, uh I couldn't go to my classes, had to skip because it was just it was just embarrassing. D: OK, I'm sorry to hear that. Uh, have you ever experienced something like this before? P: Um, have I experienced something like this before? Uhm no, I don't think so. D: OK. And over the three or four days, have your stools all been loose? Or have you had some solid ones in between? P: I think they've mostly been loose. I think they've all been loose actually, if I think about it. D: OK, and how many times a day have you been having episodes of diarrhea? P: Oh my god, I have I've lost count. I'm going every every hour. D: OK, every hour. OK, and then you notice any changes in the color of your stool? P: No, it's brown. D: OK. Any blood in your stool that you've noticed? P: Um not really. I don't think so. I don't look that much to be honest. D: OK, um have you noticed any any pain associated with it? P: Well, I didn't start off with pain, but I I I do have a bit of a cramp now since yesterday. It's just it hurts. Yeah, it hurts sometimes, it comes and goes. D: OK, and do you feel that when it, do you feel that you still have control over like releasing it to like does it come on and you don't even notice that it has happened or you still are able to kind of have a warning before you get to the toilet? P: Uh no I do get a warning, but it's just I I do need to get to the toilet really fast, yeah. D: OK, and before this happened, have you noticed, have you, is there anything that you've done differently that you've been eating differently, or any other changes that have happened in your life recently? P: Um, I I did go to um, I did go to a new restaurant 5 days ago. D: OK, what did you have there? P: Um I I just got some rice with chicken Manchurian, it was a nice little Chinese restaurant, and yeah. D: Did anyone else have the same thing that you did that you were with? P: Um, no not really, I went with my friend and I haven't really, haven't talked to her about this. I never really thought that these were related, that this was related to that. D: And then it's, you know, absolutely, potentially not like, maybe not. It could possibly be so not to not to worry you about that. We just like to get an idea of kind of the whole picture of what you're coming in with. So in terms of the last three to four days, have you experienced any nausea or vomiting? P: Yeah yeah, I have actually, but it's not been as bad as the diarrhea. I didn't even yeah, I didn't, I wasn't even thinking about that. Yeah, I I did vomit, I think twice yesterday. D: OK, have you noticed any blood in the vomit? P: No, it's just watery. D: And are you nauseated all the time, or is it kind of on and off? P: It's on and off. D: OK, have you taken any any over the counter medicine or anything to help? P: Uh, not really. I was just trying to drink a lot of water, 'cause I I know that I can get dehydrated so just drinking lots of water. D: OK, well that's good to hear. Have you have you been eating normally or have you not been eating as much as you regularly do? P: I have been eating less specially since yesterday when I had my these abdominal cramps started. I just don't feel like eating. D: OK. Is there anything that has been making it worse? P: Making what worse? D: Just in general, like is there anything that you're finding makes your nausea or your diarrhea come on? P: Not really, I don't think so. D: Do you notice any changes to your urine or any discomfort when going to the bathroom? P: No. D: Have you traveled anywhere recently? P: No. D: OK, and have you noticed any fever or chills in the last few days? P: Um, I've just been feeling really tired and and, I don't know, maybe I haven't checked my checked my temperature. D: OK. Have you noticed any rashes or changes in your skin? P: No. D: OK. Have you noticed any major changes to your weight, I know that you might not weigh yourself everyday, but anything that jumps out to you? P: I actually haven't weighed myself in the past five days, so I don't, I don't know. D: OK. OK, I'm I'm just gonna jump to you and your general history. Do you have any history of problems with your digestive system? P: No. D: OK. Do you have any chronic conditions that you see a family doctor for regularly? P: I have asthma. D: OK. Do you take any medication? P: Yeah, I've got some puffers that my family doc gave me. D: OK. Nothing else? P: No, that's it. D: Do you have any allergies? P: Um, no I don't. D: Have you (unclear speech due to connection issues)? P: I'm sorry, can you say that again? D: Have you ever been hospitalized in the past? P: Um? I had my wisdom teeth removed. But no, I like I wasn't hospitalized, no. D: Have you been in contact with anyone recently that's been sick? P: Nope, I don't think so. D: OK. What is your living situation right now? You said you're a student? P: I am. D: OK, and do you live, do you live on your own, with family, with roommates? P: I live with two roommates. D: Do you drink alcohol? P: Um, sometimes. D: OK, how how many drinks per week would you say? P: I might have like a glass or two on the weekends. D: OK, do you smoke? P: No. D: OK, do you use any other substances? P: No. D: OK, and what would you eat on a regular day typically, what would your typical diet be? P: Oh gosh, um well, I like to have oatmeal for breakfast. I usually make something quick for lunch, maybe like a salad, and then I might have my, I'll probably just like eat out at night, maybe get like a burger or fries or something. D: OK. Well, and I just wanted to jump over to ask you about your family history. Does anyone in your family have any history of digestive problems, or um abdominal problems, abdominal surgery? P: My brother had appendicitis when he was young. Um, my mom has had a hysterectomy if that counts. Yeah, nothing else. D: OK. OK, thank you for sharing that with me. So I think that's everything that I wanted to ask you for today.
dataset\resampled_file\RES0039.wav	D: I just wanted to start with what brings you here today to the family clinic? P: Hi, this morning I read after I woke up by I coughed up some phlegm and there was some blood in it and it it totally scared me. D: OK, and was this the first time that happened? P: Uhm, yeah, I've never I never noticed blood in my sputum before. D: OK, but have you been coughing recently? P: Uh yeah, I have, uh, had a cough recently leading up to this. D: OK, and how long have you had the cough for? P: Uhm, I've had it for uhm, yeah, about about four weeks. D: Wow, four weeks. OK. Do you know if you did anything prior to that, any new exposures or being around someone ill like anything like that that might have caused your cough? P: Yeah, I was just down in a, I went to Haiti on a on a trip for a, for a volunteer program with my school and I don't know I definitely notice there is a lot of people down there coughing. D: OK, and were you at all living like close quarters or were you crammed into like like smaller spaces at all when you were there? P: Yeah, we were kind of like living with the locals while we while we were there. It was part of the experience for volunteering. I was there for almost two months as part of, part of my my summer break through University. D: OK, and did you notice, uh, at all any potential exposures to tuberculosis? Anyone there that had tuberculosis? Or found out later? P: Yeah, there were definitely some people around that I heard of who who mentioned tuberculosis, but I don't know if anybody specifically who had it. D: OK. And the cough that you've been having for the last four weeks at, is it like a wet cough? Are you producing any sputum or phlegm, or is it more of a dry cough? P: Uh, I have been producing some phlegm, um, but it's been just kind of white, yellowish. D: Up until this morning? P: Yeah or moreso clear actually, up until today where I saw some blood. D: OK. And how much blood was in the phlegm? Was it like a significant amount it filled the whole production or just little streaks? P: Um it was pretty red. It, ah, yeah it was bright red and it was covering the, the issue. D: OK and have you had any similar episodes before? P: I've never brought up blood before. D: And after this morning, was that the only time you had that or did you did it recur at all? P: Um, it was just that time just this morning on the tissue and then a little bit in the toilet and it looked like a lot in the in the water. D: OK, I see and how often are you coughing in like an average day? Are you coughing throughout the day or does it come and go? P: Uhm, it's been pretty severe through throughout the day. I've been just coughing or coughing a ton. D: OK, anything that makes your coughing go away or makes it worse at all? P: Not-nothing seems to help. I've tried various over the counter medications and and stuff for, for cough and nothing has seemed to help it. D: OK, and are you having any other symptoms at all, like shortness of breath, sore throat, runny nose, anything like that? P: Uhm, nothing like like that. I mean the back of my throat, might feel a little itchy from the coughing, but not really sure. D: OK. Are you having any headaches or nausea or vomiting? P: Nothing like, well, a little bit of nausea maybe, but no vomiting. D: OK. How often you getting nausea? P: Uh, it's coming after like if I'm having a really big cough, coughing fit I could feel a little nauseous after but it doesn't last very long. D: OK, are you having any fevers or chills? P: Yeah, I've been having ah, so fevers throughout the day, but feeling really hot, and and really sweaty at night. D: OK, how often are you getting night sweats? P: Uhm, also a few times this past week, I've what woke up soaked. D: OK. And have you at all measured when you felt, measured your temperature when you felt like these chills and night sweats? P: No, I haven't measured my temperature yet. D: OK. Have you noticed at all, uh, any increased fatigue throughout the day? P: Yeah, but I've definitely been more more tired. I haven't been able to concentrate on, umm, on my schoolwork. D: OK. And, um, have you been having any shortness of breath? P: Just after the, like coughing really, but otherwise, ah, no. D: Any chest pain? P: No chest pain. D: Any feeling that your heart is racing? P: No, nothing like that. D: OK, any swelling in your limbs at all? P: No. D: Ok. Any loss of sense of taste or smell? P: Uh, no, nothing like that. D: OK, any changes in your bowel movements? P: Um, no. D: OK, any changes in your urination? P: No. D: OK, any changes at all in your sleep? P: Uhm, just been, well, I haven't been sleeping as well, waking up all sweaty and the cough is kept me up a little bit too. D: OK, any changes in your appetite? P: Uh, no, I've been eating OK. D: Have you noticed at all any weight loss over the last few months? P: Yeah, I think I'm down like 15 pounds since the summer time, which is great. D: OK, have you tried to lose weight at all or is it just been completely unintentional? P: Uh, well I, I mean my, my appendix was taken out a few months ago and so I guess after that I, well, maybe wasn't eating and eating as much, but I mean I wasn't really trying to lose weight. D: OK, and have you had any recent exposure to any fumes or dust or animals? P: Uh, no, my my parents have a dog at home, but I've been away at school, so. D: OK. OK, uh, in terms of your overall health, have you been diagnosed with any medical conditions before? P: Uh, no, I'm uh, healthy. D: So like no asthma or anything like that? P: No, nothing like that. D: OK, are you on any medications currently? P: Uh. Yeah, I take an oral contraceptive pill. D: OK um, and when did you start that? P: Probably about five years ago. D: OK. Do you have any allergies, to any medications or any environmental allergies at all? P: Uh, yeah, I think Septra, gives me a rash. D: OK. Um, any previous hospitalizations? P: No, I've never been in the hospital before. D: OK, any previous surgery? So you said you had the appendix removed but anything else? P: Uh, no the appendix was the only thing. D: OK. Any family history of asthma or any lung conditions? Any cancers that run in the family? P: Um, yeah but well, my grandfather had lung cancer, but he smoked for his entire life. And my mom has had diabetes for quite some time, but no, no lung problems. D: OK, any heart attacks in the family or any autoimmune conditions? P: No. D: OK, and currently what is your living situation like? P: So I live with uh, four roommates here going to school. D: OK, and so do you work right now or you just a student right now? P: Just a student. D: OK. And currently do you smoke? P: Uhm, I'mm smoke maybe maybe socially so, maybe a pack of cigarettes a week at the at the most. D: OK. And any recreational drug use like marijuana? P: Uh, yeah I'll smoke one or two joints on on the weekend with friends socially. D: OK yeah, so yeah. This uh, the smoking marijuana or cigarettes make your symptoms worse at all? P: Uhm, it depends. Yeah, sometimes I can. It can bring on some more coughing. D: Yeah, so yeah, we always recommend cutting down or quitting smoking whenever, whenever we see patients who are smoking, especially like, you're fairly young. And you know your grandfather had history of lung cancer with smoking throughout the year. So as early as we can quit smoking, the better for the long term health of your lungs, but whenever you're thinking of quitting, or if you want any more resources about quitting, just let me know. We can set up a separate appointment for that. P: OK, that that sounds good. Yeah, maybe maybe next appointment we can talk about that. D: OK, sounds good. Um. Any, uh, so no recreational, so just besides marijuana. Any other recreational drugs like cocaine or crystal meth, anything of that sort? P: Ah, no. Well, sometimes I at parties maybe a few times a year with friends will use ecstasy or something like that, but that's only a few times a year. D: OK. Uh, and any alcohol? P: Yeah, I'll have a few drinks on the weekend with with friends usually. Like rum or beer. D: OK. Yeah, so this is all the questions I had for you today. Any, any questions or concerns or any ideas of what you think this might be? P: Uhm, I don't know. I'm really concerned about the the blood that I brought up like I mean is this cancer or, uh, uh tuberculosis like one of those tuberculosis infections that I heard about while I was away? D: Yeah, so definitely, a cancer is pretty unlikely because you're fairly young and you've just recently started smoking, but one of the things that we're concerned about is your recent travel history being in close quarters. So definitely we need to get a chest X-Ray and we can even do a sputum culture to test for tuberculosis. And then based on the results, we might have to start you on like a whole antibiotic regiment if it does come back as tuberculosis. Yeah, we'll, we'll, we'll get those investigations done first and then we'll go from there. P: OK, thank you. D: We'll also get some blood work done as well, so that'll be done before your next appointment. P: Alright, that sounds good. Thank you. D: You're welcome.
dataset\resampled_file\RES0199.wav	D: What brings you in? P: Hi I just came in today I have been having, just been feeling really sick over the last three or four days. It started with just like a headache and cough four days ago and then I started getting some nausea and vomiting few days back as well as diarrhea. D: OK, so the headache and cough started first you said right? P: Yeah. D: OK, let's talk about the headache first that came on four days ago. Has it been persistent or does it come and go? P: It's been pretty persistent. Besides, when I take some Tylenol. D: OK, and does anything make it better or worse? P: Just a Tylenol, nothing really, yeah, it's pretty constant, D: OK, and have a an and sorry where exactly is it is it on it's like at the top of your head, temples, forehead? P: It's kind of like my forehead in the top of my head on both sides. D: OK and does it radiate your neck or anywhere else? P: No, I think it’s, it doesn't go to my neck or anywhere else. D: OK, and do you have neck stiffness or neck pain with that? P: No, not really. D: And one to ten, ten being the worst pain you've ever had, how bad is it? P: Uh the headache, probably like 7. D: OK. Uhm and timeline wise, has it gotten worse over the past four days? P: It's kind of stayed around the same, actually. D: OK, OK, and have you ever had a headache like this in the past? P: Not really, I don't really get too many headaches D: OK so this isn't you. Alright And let's go on to the cough. The cough started around the same time you said, has that gotten better or worse over the past four days? P: It's the cough is around the same as well. D: OK, and is it a dry cough or are you breaking up any flem? P: It's mostly a dry cough. D: OK, so no sputum or blood? P: No, no. D: OK, good. Alright, and are you short of breath at all? P: Uhm, no, not really, D: No OK. And how about wheezing? P: Uhm no, no wheezing. D: OK. Only saying an. And any chest pain? P: No. D: No OK. And have you had any weight loss over the past few months? P: No, I haven't. D: Any fevers or chills? P: No. D: No OK, uhm how about fatigue? P: I guess just a little bit tired over the last few days, but I don't know that's just just from the diarrhea and just being sick. D: Um OK, and how about rashes? P: No. D: No, OK changes in your vision or hearing? P: No. D: Uh itchy eyes, discharge anything like that? P: No, nothing like that. D: About a stuffy or runny nose? P: No, nothing like that. D: OK, how about changes in your smell or taste? P: Uhm smell I feel like a little bit. I've been kind of losing my smell over the last I would say one day. D: OK, OK. Alright, and any dizziness or fainting spells? P: No, nothing like that. D: Confusion or memory loss? P: No. D: Uhm alright and joint pains or muscle aches? P: Uh no. D: Alright. You mentioned you also have had diarrhea. When did that start? P: So probably like 2 days ago I started getting some liquid stools and I just had to go like probably five or six times a day. . D: OK. Alright. And uhm are you noticing any blood in there? P: No, I haven't seen any blood. D: OK, do you feel dehydrated? P: No, I've been trying to keep hydrated. D: OK, good, any changes in your appetite? P: Uh no. D: No, any nausea or vomiting? P: Yeah, I was having some. I'm having some nausea today, but I had some vomiting yesterday. I vomited two times. D: OK. And are you throwing up any blood? P: No. D: What color is it? P: Uhm it's usually I feel like whatever I eat. Yeah, contents, food contents. D: OK, do you think anything triggered that episode of vomiting? P: No, I haven't really ate anything new, I'm just in my house, yeah I I don't know what triggered it. D: OK, alright any feelings of like, feeling like you're bloated or gassy? P: Uhm, no. Nothing like that. D: OK, any constipation? P: No. D: OK. Alright, and are you otherwise healthy or do you have any longstanding medical conditions? P: No, I'm I'm pretty healthy. I don't really. I don't really even take any medications. D: OK. And are you up to date with her immunizations? P: Yep. D: Uhm, do you have any allergies? P: No, not that I know. D: No, any family history of lung or heart conditions? P: Uh, no, not that I know of. D: OK, do you smoke? P: No. D: No, OK. How about marijuana or yeah, how about marijuana? Do you either take edibles or smoke it? P: I’ve tried a couple times but it was not really my thing. D: OK. And how about other recreational drugs like cocaine, heroin and opioids? P: No, nothing like that. D: OK. Uhm and where do you currently live? P: I live just in an apartment just in the city. So yeah, just by myself though. D: OK, any like old carpets, dust, mold, asbestos, pets, anything that could be triggering your symptoms? P: No, not really. D: OK and have you been in contact with anyone sick recently? P: No, I've been. And kind of. At home, the only places I maybe have been in contact with someone is maybe at work. In like the lunch room and things like that. D: OK. OK and sorry, where do you work? P: I work at a car dealership. D: OK, OK. An any travel recently? P: No. D: OK, has anyone at your work been sick as well? P: No, I haven't really noticed anyone being sick. D: OK, OK, well those were the questions that I had for you. Did you have any questions of your own for me? P: No, I I was just wondering what this can be. D: Um yeah, so the first thing we want to rule out as covid because a lot of your symptoms overlap with those of covid, so we'll take a swab and you should get those results in about 24 to 48 hours. In the meantime, you should isolate for 14 days. And if your results are positive, public health will be in touch with you to do some contact tracing. But if it's not covid, it could be another viral illness that's going around this time of year that could be causing similar symptoms as well, but either way the management kind of is supportive, so making sure you're well hydrated, eating nutritious food, sleeping well, taking antipyretics like Tylenol for fever's if you get any. And you can also take Tylenol or anseads for muscle ache, joint pains, anything like that. Does that sound OK? P: Yeah, that sounds good. Thank you. D: OK. Great, no problem.
dataset\resampled_file\RES0119.wav	D: So what brings you in here today? P: Um yeah, so I brought my 7 year old daughter here um because she's been coughing uh a lot over the past two weeks. Um she's she sounds wheezy and I'm not too sure what's going on with her so, she's been off school um 'cause they think it's Covid. Uh we got her swab, but because she still has symptoms she can't go back to school, so here she is. D: OK, um and when did the cough start? P: It started two weeks ago. D: OK, and when did the wheezing start? P: Um that started about the same time like I should I should mention she does have like episodes like this. Um she's had episodes like this for the past like 2 years uh but they usually go away in a couple of days. But this time it's it's taking a lot like a lot longer to go away. D: OK, so it's been uh has been more than a week, you said? P: Yeah, it's been close to two weeks now. D: Two weeks, OK. And uh were these symptoms brought on by, are they usually brought on by any kind of like activities or can they come up just by themselves? P: I find it's usually worse in the winter um and if she's like doing some sort of uh like extensive physical activity, so if she's like playing tag and she's running around a lot. Um or if she's like at her gym class and they're running. D: OK, and the cough that she's having is it like a wet cough or is it a is it a dry cough? P: It's a dry cough. D: OK, and at all, is she bringing up any yellowish or white uh or green material or any blood at all? P: Uhm, it's, no nothing like that. D: OK, and are her symptoms uh constant or do they come and go? P: Her symptoms I guess come and go, um yeah, they come and go. D: OK, and how many days of school has she had to miss? P: She's missed almost two weeks now. D: Wow, OK um and when she's at home, is she is she like very tired, is she um? P: Yeah, yeah, she's pretty tired out um, yeah, she's pretty tired out, she's been doing a lot of like resting and uh you know watching TV. She's not really very active right now. D: OK, uhm and have her symptom symptoms been getting worse over the last two weeks, or are they getting better at all? P: Uh I can't, you know, I can't tell, it comes and goes so in that sense, it's been pretty constant. Um there hasn't been a day when she hasn't had these symptoms. D: OK, and do they get worse at night at all or are they um the same throughout the day? P: Uh yeah, now that I think about it, when she's laying down she does have a hard time. D: OK. And is she having any other symptoms at all, like uh shortness of breath, um or sore throat?Anything like that? P: Uh, no sore throat. She sounds wheezy, so she might have like some difficulty breathing, but she doesn't sound short of breath. D: OK, and any kind of uh runny nose or any other symptoms at all? P: No. D: No, OK. Uh anything that helps her or makes her symptoms better? P: Um no, nothing that we've tried. D: Any recent uh travel at all? P: No. D: No, any fainting or dizziness spells? P: No. D: OK. Um, any uh fevers or chills? P: No. D: Any um changes in her bowel movements like any constipation, diarrhea? P: No. D: Any urinary problems? P: No. D: And any uh any kind of, do these symptoms wake her up at night at all? P: Um no, no it doesn't wake her up at night. It just makes it hard for her to fall asleep. D: I see. Is she getting enough sleep? Like how, how, how many hours would you say on average she's getting per day? P: I'd say she's getting about 6 to 7 hours. She used to sleep about 8 hours before. D: OK, um and is she having any changes in her appetite at all? P: Um I don't think so, no. D: No? P: No. D: Um any kind of changes in her weight at all over the past few months? P: I haven't checked over the past month, but before that no, no changes. D: No changes, OK. And um has she been, she had like a cold or anything like that recently? P: No, not that I can think of. D: OK, has she been around anyone that's been sick recently? P: No. D: OK. Um does she have any past history of any medical conditions at all? P: Uh no, no, nothing like that. D: OK and um does she have any uh allergies to any medications or any environmental allergies? P: I think she might have some environmental allergies. We haven't gotten her officially tested though. D: OK. And um has she had any previous hospitalizations or surgeries? P: When she was a baby, when she was first born, she was hospitalized um for something about having like uh not fully developed lungs. D: OK and uhm, was she premature at all? Or was she born after uh, at term? P: She was slightly premature, I believe she's 34 weeks. D: 34 weeks, OK. And um was it a vaginal delivery or was it a C-section? P: Uh it was vaginal. D: Vaginal, OK. Were there any uh complications during the pregnancy or after she was born? C P: Um no complications after besides the hospitalization for the small lungs. D: OK. And is there any family history of any lung conditions, heart conditions, or cancers? P: Uh nope, nothing like that. D: Has anyone in the family have, had any kind of asthma, eczema, anything like that? P: Um no. D: No, OK. Um so, and in terms of like at school, are there any kind of complaints uh and any um issues with her development over the last last few years? P: No, nothing like that. D: OK, so she's been growing well? P: Yeah, she's been growing well. She's been gaining weight like a normal amount um and she's doing well, she was doing well at school. D: OK. And um at home, uh what is the environment like? P: Um she lives at home with both of us like um her mom and her dad, and uh she has a younger sibling who is 4 years old. D: OK. And um does anyone smoke in the house at all? P: Um no, not anymore. D: OK, um how long ago uh did someone smoke? P: Um it was, um so her dad used to smoke um and he stopped when she was like 3. D: OK, that's good. Um any kind of uh dust or mold or animals, uh anything in the household? P: No, we don't have any pets and um the place is just renovated so nothing like that. D: OK. Alright, so yeah, those were just some of the questions that I had for her today. Do you have any questions or concerns? P: Um yeah, so what can we do for her right now to make these symptoms go away? D: Yeah, so what we should do for her right now is, she's seven years old, um what I'm thinking right now with her symptoms especially coming on after uh exertion, being worse in the winter, she may have asthma. P: OK. D: And although she doesn't have any family history of it, it can happen without family history as well. Um so we would like to uh try and do uh what's called a pulmonary function test. That will help us kind of understand uh if she has um asthma or not and then we can try her on um, it's called a short acting beta agonist, so it's a puffer. P: OK. D: And uh usually when she gets these types of symptoms, she can use the puffer to help her. Uh and if it um helps her then it's most likely that she does have asthma and she will need um that puffer and then she might also need another puffer, which is an inhaled corticosteroid, um for the future to decrease um the likelihood that this asthma gets worse in the future. P: OK, OK yeah thank you. D: Yeah, no worries. So yeah, so yeah we'll get those tests done and then go from there. P: OK, sounds great. D: Take care. P: You too.
dataset\resampled_file\MSK0003.wav	P: My back, it just really hurts. I feel really stiff in the morning and um yeah, it's just been going on for a few months now. D: Ok, so for a few months, stiffness in the morning. So your back hurts, where exactly would you say it hurts? P: It kinda hurts all over. I can't really pinpoint any specific locations that hurts most, kind of hurts like all down my my back. D: OK, all the way up to I guess your neck and all the way down to your lower back? P: So I wouldn't really say the neck, and I guess more of the the lower parts. Maybe like the middle of my back and... D: I see. P: And down. D: Ok and what kind of pain would you say it is, is it like a dull aching pain? Is it a sharp stabbing pain? How would you describe it? P: It's a dull pain. D: Dull pain, ok. Ok, and on a scale of 0 to 10 with 0 being the least amount of pain you felt in your life and 10 being the worst, how much would you rate it? P: It's about a four or five. I mean some days it can be better, but yeah, some days it can be worse. D: OK and when did this start? P: I think this started about like four or five months ago. It's been going on, yeah, for probably about half a year now. D: OK, and when it first started up, was there anything that caused the back pain? Like any kind of trauma or injury, anything that you can think of that might have led to this? P: No, nothing that it's I I can think of. It's sort of it's come on so slowly like when I first started noticing the back pain it it was maybe like a 0 to a one. I didn't really notice it too much, but over these last 5, 6 months it has gotten has gotten a bit worse. D: Ok, so it kind of came on progressively. Didn't just come on suddenly at some point? P: Right, yeah, it's been getting worse. D: Ok, and have you ever had any previous episodes that are similar to this? P: Uh, not not in my back pain. I do get pain in my right knee and in my hands sometimes. But those pains just kind of come and go. D: Ok, and when did those pains start? P: Uhm, those ones started, probably similar timeline around six months ago. D: Ok, ok. And in the back pain that you're having, does it radiate or move to any other part of your body? P: No, I don't feel it anywhere else. D: Ok, and have you tried anything that has helped relieve some of the pain? Any medications or anything? P: Yeah, I've tried some Tylenol and Advil, and that the Advil is actually helped taking the edge off a little bit, but the next morning I I have the stiffness and and pain again. D: Ok, and for your pain, are there any kind of factors that make the pain worse, like bending down or standing straight up or laying down anything that makes your pain worse? P: Uh no nothing that I can think of that really makes it any worse. D: Ok, and is your pain worse when you wake up in the morning or is it worse as the day progresses? P: It's worse in the morning. It gets a bit better as the day goes on. I asked about it, an hour into the day, I feel my best. It takes a little bit of time to to move around a little bit first. D: Ok, approximately how much time would you say after you wake up, the stiffness and pain goes away? P: I would say maybe 30 to 60 minutes. D: Ok, alright. And no, you haven't had any trauma injuries in recently, right? P: No trauma or injuries. D: Ok and no fevers or chills? P: No. D: Ok, any night sweats? P: No. D: Any fatigue or malaise? P: Yeah, I have been a bit more fatigued than usual, and yeah, I I've had some malaise as well. D: Ok, and for how long have you had this? P: It's been similarly getting a little bit more progressive. I mean some days I'm just feeling like I just want to lay around and rest 'cause I'm feeling just so burnt out and other days I'm ok but, I'm certainly more tired than usual. D: Ok, I see. Other than that, have you noticed any kind of rashes or skin changes or changes in your nails at all? P: Uhm, no, I haven't noticed any any rashes or any nail changes. D: Ok, any shortness of breath? P: No. D: Any changes in your bowel movements or urinary patterns? P: No, I haven't had any diarrhea or any any urinary problems. D: Ok, have you noticed any changes in your appetite or your weight? P: No, my appetite's been normal and my weight's been stable. D: Ok, and have you noticed any difficulties or changes with your vision or any eye problems? P: No, I haven't noticed anything like that. D: Ok, have you noticed any kind of numbness or tingling sensation in your limbs specifically like your back and your legs? P: No, no tingling or numbness. D: Ok, any muscle weakness at all? P: Nope, I haven't noticed any muscle weakness. D: Ok, and have you been sick at all recently with any viral or bacterial infections? P: Um I had a uh, and then I was diarrhea like several months ago and I had some antibiotics, but that was a yeah, so a few months ago. D: Ok, and other than that, currently are you sexually active? P: Yes I am uh I I have a girlfriend then we've, uh, we started dating about about, uh, six months ago. D: Ok and do either of you have any history of any STI's at all? P: Uh, no history of STIs. D: Ok, alright and is your partner fine or is she having any symptoms at all? P: No, she she hasn't been having any symptoms then we we've been using a condom mostly. D: Ok, alright and otherwise are you generally healthy or do you have any medical conditions? P: Uhm, yeah, I'm I'm generally alright. I do have asthma actually and just, I had diarrhea a few months ago after eating at a buffet. So I think maybe it yeah, it was food poisoning or maybe something like that. D: Ok. P: But yeah, so asthma and that's it. D: Ok, and do you use any medications for your asthma? P: Yeah, use that blue inhaler sometimes. I guess that just when I when I need it, but that hasn't been very often. D: Ok and do you have any allergies to any medications or any environmental factors? P: I do have environmental allergies, I I'm not sure if it's like ragweed or or pollen, but something like that. D: Ok, and have you had any hospitalizations or previous surgeries? P: Uhm, never. D: Ok any family history of any medical conditions, any autoimmune conditions or any musculoskeletal conditions? P: Yeah my mother has a uh psoriasis. D: Ok. P: Yeah, and so she's had to, I know use like like creams and stuff like that for her skin. D: Ok, and currently right now, do you work? P: I do, yeah I work uh, at a bank. D: Ok, and your mother, so she had psoriasis. Did she ever have any joint pains alongside the psoriasis? P: I don't believe so. I think she had just more issues with her with her skin. D: Ok, and so you work and then what's your living situation like? P: Yeah, so I live with my girlfriend in a condo in the city here. D: Ok, and do you use any recreational drugs like marijuana? P: Yes, sometimes yeah, I'll smoke like once or twice per week, with that with a friend or something like that. D: Ok, and do you smoke? P: No cigarettes, no never. D: Ok and you drink alcohol? P: Sometimes, yeah, I'll have a beer or two on weekends or or a cocktail with friends. D: Ok, alright, so those were just some of the questions I had. Now I'm just going to quickly uh, ask some specific questions. So have you noticed any kind of swelling in the areas that you are having pain or redness or anything like that? P: Uhm no, I haven't noticed really any any uh redness or or swelling D: OK and no so, are you able to bend down and stand up straight or extend backwards so without pain or are you in any pain? P: Uhm, I do get it. It's a bit stiff. Uhm I, uh, yeah, I'm not really too sure it's like, not really, it's more more more stiff. D: Ok, and yeah, other than that, do you have any questions or concerns? P: Uhm, yeah, I was just wondering, yeah, like like what what this could be possibly? D: Yeah, so definitely what so this this seems like it started off like 3 months or six months ago, and it's been going on and it's happening in the morning. And how old did you say you were? P: Uhm I'm 26. D: OK, yeah, so uh, it seems progressive and you're getting some pain in your other joints as well and it's mainly from your middle to lower back. It can be multiple things that we would have to rule out. So you first you have a family history of psoriasis so it can be psoriatic arthritis. You don't have any other skins, changes or any other symptoms. It can also be since you have had a you were sick for months ago with a what might be gastroenteritis. It can be sometimes a few months afterwards you can get something called reactive arthritis - where you get this progressive pain in your joints and stiffness. And otherwise it can also be something called ankylosing spondylitis, which can present in men your age and it's kind of like a progressive, dull back pain and that has some morning stiffness as well. So yeah, there's definitely multiple things that it can be. So first we would need to do a full physical examination and book an appointment or for that in person. And we will get some lab work done as well, as well as a X Ray of the of the spine and your sacroiliac joints. And we'll also get some blood work with CBC, CRP and ESR. So those are just inflammatory markers as well as the rheumatoid factor antinuclear antibodies. Those are just some things that will test for different kind of rheumatological issues and to see if you have any arthritis. So yeah those are and then will also get an X Ray of your hands and knees since you're having pain there as well. So yeah, those are some steps that we'll take. Do you have any questions or concerns? P: No, that that sounds, that sounds great, thank you. D: Alright, yeah, so I will get in touch with you shortly. P: Sounds great, thank you. D: Alright, take care. P: Bye. D: Bye.
dataset\resampled_file\RES0202.wav	D: What brings you all in today? P: Hi. So I just brought in my son he's 5. Essentially, when he, so today is Friday when he got home from school on Wednesday, he seemed fine, but he I don’t know that night he started to have a bit of like a cough. It just seemed like a little dry cough, but obviously I just wanted to keep him home, keep him safe and not like spread anything if he was sick. So he stayed at home on Thursday and he was like having a bit of a cough. Then yesterday it seemed to get a little bit worse and he was really tired, uh sorry. Today, today is Friday. He was like his cough is like getting a bit worse and I've been taking his temp the whole time and it got like a little high today, what was it? My thermometer says it was high. I'm just like trying to remember it was it was. It was like over 100 though. D: Oh OK. P: Uh, 101 or something or maybe 100.1 if. But anyways it was so I I just thought I should probably bring him in 'cause I was really worried about him and you know so he could have maybe got covid and like at school or something. D: Yeah for sure. Um OK, so just to clarify, he's had this cough and fever for the past five five days. P: Mhm. D: OK, OK so let's focus on the cough. P: It’s Friday. Its been more like like 3 days. Wednesday is when he came home, and then um he. And then today is Friday. So yeah, sorry. D: Today is Friday OK. And um. OK, yeah sure uh so. Is this cough a productive cough, or is it kind of a dry cough? P: Uh I think it's dry. I haven't noticed him like spitting up anything. Yeah he yeah, its just like little cough. D: OK, And. He is he. He's not bringing up any sputum or blood? P: No. D: No OK good. OK, and does he sound wheezy at all to you? P: No, no, not that I've noticed. D: OK, how about short of breath? P: Um I don't think so like he usually he's a really active kid and he has. He hasn't been running a lot outside in the past couple of days, so maybe he maybe he could have been having a harder time breathing. But also I think he's just been tired in general. D: OK, yeah. OK, Uhm. Is his coughing getting worse with certain times of the day? Like is it worse at night, in the morning? P: Mm I think it kinda just there the whole day. D: OK, and it does it, how does it sound? Does this sound like a barky cough? Does it sound? Uhm? Like harsh, what is what would you say the quality of it, of the sound of the cough is? P: Uh, I, just sounds kind of dry. It's not like super loud. D: OK. OK, and has he ever experienced anything like this in the past? P: Um like he's had colds before, but I haven't like. I haven't like you this time he kind of had the fever, which is different than you know, having a regular cold. D: OK. And are his symptoms getting worse? P: I think so 'cause yeah, the first day he just seemed like a little dry and then yesterday is coughing and today he actually has a fever. D: OK, and is he complaining of anything like chest pain? Or feeling like his heart's racing? P: No, I don't think so. D: No, OK. Does he have a sore throat? P: Mm I don't think so. D: OK, and is he having any issues swallowing food or fluids? P: I don't know if he's having trouble swallowing, but he doesn't seem to have a big appetite right now. D: OK, and is he, does he have a blocked nose or runny nose? P: Maybe a bit of like a look at runny nose. D: OK, and does he have any issues with smell or taste? P: He, this morning he really seemed like he wasn't like into his breakfast and I wonder if he's losing his sense of taste a little bit. D: OK, how about vision or hearing? P: I think those are fine. D: OK, and is he complaining of any chills or night sweats? P: No. D: OK, any changes in his hair, nails or skin like rashes? P: No, I haven't noticed anything like that. D: Any changes in his bowel movements. Pardon? P: Um sorry no changes. D: OK, no diarrhea, no constipation, no blood in the stool? P: No D: OK, any nausea or vomiting? P: No. D: OK, any changes in his urine? P: I haven’t really been looking, but I don't think so. D: Any dizziness or fainting spells? P: No, just like fatigue. D: OK, any confusion or memory loss? P: No. D: And is he and is he an otherwise healthy child? P: Yeah, actually he hasn't decided to like a vaccine that he hasn't had to go to the doctor like ever like. I mean, he broke his arm once, but that was it. D: OK, um so no past illnesses and I guess no hospitalizations or surgeries except for the broken arm. P: Exactly, like nothing. D: OK, and were things normal with your pregnancy with him? P: Yeah totally. D: OK um. And then how about as a newborn, any complications after birth? P: No, no, like everything is things really good. D: OK, and then did he hit all his milestones up till now? P: Yeah totally. D: OK. Any, does he have any allergies? P: Um. No, no, I don't think so. I mean like he hasn't really taken a lot of medicine, so it's hard to say, but like nothing. D: Is he up to date with all his immunizations? P: Yeah. D: Yeah OK. And. In terms of family history, are there any lung conditions or heart conditions? P: Uh no everyone is really healthy. D: OK, and. And are there and who does he live with and where does he live? P: Um he lives with just me and my husband, and he has a little sister, like this in town here. D: OK and, is she healthy? P: Yeah, I think she, yeah she's healthy. D: OK um? Any concerns for old carpets, mold, asbestos or any environmental issues like that in the home that you're in? P: No. D: No, OK. Has he been around any sick contacts recently? P: Not, not like outside of school. I like we know for sure, not outside of school, um but he goes to school right now so. Kinda hard to say. D: OK. P: But they haven't. They haven't like contacted us about anything. D: OK, sure. And has he traveled anywhere recently? P: No. D: No OK. OK, well those are all the questions I had for you today. Were, was there anything that I missed that you wanted to chat about today? P: I don't think so. Um, like I, I realized that I can often times like you don't really do much for kids when you know when it's just like a virus or something. But we do, I guess need to have a covid test to go back to the school, even if you know either way 'cause they want us to be able to say. It's like the other kids have had an exposure. D: Yeah for P: yeah, like. Sorry, go ahead, D: No go ahead. P: I’m just basically wanted to see if it was bad. I mean he doesn't receive your so scared. That's kind of what makes him in like it's gonna be a little bit. D: Right, yeah, OK, so first thing is, first we need to do a covid swab just to make sure that he either has it or it doesn't have it and those results will come back in 24 to 48 hours. Um we do suggest because his symptoms are allowed with symptoms of covid that he isolate for 14 days and that includes from his his younger sister possible. And then if the swab comes back negative, there is a chance for false negatives. But also it could be another viral illness that's going around nowadays, and if his symptoms get worse, so if he has a really high temperature, if he has any neurological symptoms, like seizures or. If he's feeling weak, dizzy if he has any fainting spells, please do take him to the ER and. And so for now I'll just wait for those covid swaps to come back. How does that sound? P: Yeah, sounds good. D: OK great yeah, yeah no worries and. I I should have mentioned if it was just the cough or if he was just short of breath or something like that and he didn't have the fever, we would add other things like asthma to the list of things he could be worked up for, but um right now it sounds like it sounds like an infection. P: OK yeah, that's good to know. D: Alright, sounds great. Have a good day. P: You too thanks.
dataset\resampled_file\RES0100.wav	D: How may I help you today? P: Umm, yeah so I just came in today with, I've been having a few symptoms for the last I would say 5 days. So I've had, it started with a sore throat just five days ago, kind of just very irritating sore throat sensation that's kind of gotten worse over the last few days. And then I started getting a fever four days ago and it has been going on for the last couple of days as well. And the highest temperature I measured on myself was 38.8 degrees Celsius and yeah, so that, that's, that's my main concern right now. D: OK and, since the sore throat started 5 days ago has it been getting better, worse or staying the same? P: I would say it's getting worse. I have some pain with swallowing food as well as, like now, even when I'm talking a little, I'm getting some pain as well. D: OK, have you been able to maintain your appetite? P: I do feel like I've lost a bit of my appetite over the last three to four days. D: OK, and have you noticed any changes to your voice? P: Uhm, I don't think so, not yet, I, but I think, like the way it's hurting right now, I feel like it's coming. D: Alright, so have you notice any like neck swelling? P: Yeah, now that you mention it, I, I do have like these two lumps on the right side of my neck, like kind of right below the jaw. D: OK. Are they painful? P: Uhm, not, not really. Like when I'm pressing on them they don't really hurt, but I definitely have two lumps. D: I see, OK. We'll, certainly look into that on the physical exam. OK, and uh, and you mentioned that you've also been really tired over these last few days? P: Yeah, I've, I haven't really had much of an appetite, kind of just, I've skipped work, just trying to take it easy like just napping the whole day, as much as I can. D: OK, and so you've been experiencing fatigue. Have you had any, any headaches? P: No headaches, no. D: Alright, how about any eye redness or runny nose, or? P: Uh no, no runny nose, or, so I, I don't have headaches, but I, I, I think I was having some body aches just yesterday. D: OK, so any particular area that, that's aching? P: Uhm, not really. It's kind of just like a general, like I don't know if it was, it was because I was lying around the whole day, but just kind of a general pain throughout the body. D: OK. And have you been experiencing any difficulties, or sorry, have you been experiencing any cough? P: No, not really. D: OK, how about any shortness of breath or trouble breathing? P: No. D: OK, have you had any wheezing? P: No wheezing. D: Alright, and how about any chest pain? P: No, no, no chest pain. D: Have you had any heart palpitations or, or feeling like your heart's racing? P: No. D: OK, uhm, and, maybe you had any lightheadedness or, or dizziness? P: Uh, no, not really. D: Have you had any abdominal pain? P: Uhm, actually, yeah, yesterday when I was, uhm, like when I was having the body pain, I also noticed a little bit of abdominal pain just, like on the upper, I would say upper left side. D: OK, and, and how would you describe this pain and how long has it been going on for? P: Just since yesterday. It's, it's not really like, I would say it's more of a discomfort than a pain, but I definitely do feel like like something's just not right in that area. D: I see, is there anything that you do that, that makes that, that feeling worse, or make, that make it better? P: Yeah, like I, I try not to lie on that side. I have to go on to the other side. D: Alright, did you notice this in the last couple of days as well? P: Yeah, that, that just started yesterday. D: OK. Have you had any nausea or vomiting? P: No. D: How about any diarrhea? P: No. D: Alright, and have you had any fevers or, or sorry, yeah, you mentioned you had a fever of 38.2. And have you had any chills? P: Uhm, no chills, well, yeah, I would say a couple nights ago I might have had some chills, but mainly it's just been, I've been feeling more hot and I have been kind of getting like night sweats. D: OK, you've been having night sweats this week or have they been going on longer? P: No, just, just this week. D: Alright, have you had any changes to your weight over the last several months? P: No, it's been pretty steady. D: Alright, and the fever this week, has it been there the whole time, or has it come and gone? P: It kind of comes and goes. I've probably taken temperatures like every day. But I would say it's definitely, for the last few days it's been more of a fever, like the nightsweats sensation. Before it was a bit fine, like, but the highest temperatures have been in the last few days. D: OK, have you noticed any skin changes or rashes? P: Uhm, just like, I, I don't know, like I don't think there are any changes, but I did notice some, like kind of just pink, pink spots on my arm the other day. D: OK, well uh, were they itchy? P: No, they weren't really itchy. Just like a couple I would say like raised, not raised spots, just like flat, kind of pinkish spots. D: OK, and has that, has that spread anywhere or has it gone away? P: No, hasn't really started spreading yet, I just noticed it on, on my arm, and I, I don't think it has really spread at all. D: OK, this is on, on one arm? P: Yeah. D: OK. And you've had some body aches, uh, have you had any joint pains? P: No join pains, no. D: OK, and are you currently sexually active? P: Yes. D: Alright, and could you tell me a little bit about your partners or, or partner and I, and I was wondering if you use condoms? P: Yeah, so I, I just have one partner right now, my fiance, and we Uh, I actually like have in an IUD, so like we, we don't use condoms, but like we're pretty honest and safe with each other. I fully trust him, like he doesn't have any partners or anything like that and I only have, I don't have any other partners as well. D: OK, have you had a sexually transmitted infection before? P: No, never. D: OK, any concerns currently? Any vaginal discharge or itchiness or, or pain? P: No, nothing like that. D: OK, and have you been pregnant before? P: No, I haven't no. D: OK. And have you been diagnosed with any medical conditions before? P: Uhm, just uh, I have had just eczema in the past, but that, that's fairly stable. It's been treated, I don't really have it anymore. D: OK, do you take any medications regularly? P: Currently, no, no. D: Any allergies to medications? P: No. D: Alright, uhm, and any hospitalizations or surgeries in the past? P: No. D: OK. And could you tell me a little bit about your living situation currently, like, who you live with, and, and where? P: Yeah, so I'm just living with my fiance and that's, we're living in like a small apartment. And right now we're not really seeing anyone else really during the pandemic. D: OK, so have you been around anybody who's been sick? P: I just had to go into work like one day last week just to grab some of my stuff, but didn't really come into contact with anyone. My fiance does go to his work like a couple, like three or four times during the week, so I don't know if he got into contact with anyone, It's, it's hard to say. D: Has he been sick at all? Like any, any cough, sore throat, anything, like that? P: He did have a sore throat last week, but it kind of just went away on its own in a couple of days and compared to me, like, his was nothing really. D: OK, uh. And have you traveled anywhere? P: No. D: And do you smoke cigarettes? P: No. D: How about do you smoke marijuana or use any cannabis products? P: Uh, probably smoke marijuana, just maybe once or twice a month. D: OK, so it sounds like socially? P: Yeah. D: Do you use any other recreational drugs? P: No, nothing else. D: OK. And do you drink alcohol? P: Yeah, I, Probably have some red wine every other day, I would say. D: OK, and this is like one glass or two? P: Yeah, no, It's just like a normal glass of wine. Maybe, like we probably go through like a bottle between both of us, like every two weeks, maybe. D: OK. And in the family, has there been anybody who's had any cancers? P: No, no, no cancer is in the family. D: OK, how about any genetic diseases or anything congenital that runs in the family? P: Not that I know of. D: OK. So that was everything that I wanted to ask about on history, and so next we'll go ahead and get vitals and do a physical exam. But did you have anything else that maybe I forgot to ask about, or any other symptoms maybe? P: No, I don't think so. Do you think it can be covid at all? D: Uhm, so covid does present in a variety of non specific ways and so it certainly could be on the differential for causing a sore throat and abdominal pain and as well as a fever. However, it could be caused by other things as well. Uhm, currently your constellation of symptoms, with the enlarged lymph nodes in the neck, sore throat, it sounds like you may have uhm, an inflamed spleen as well, which could all be signs and symptoms of something called EBV or, or mono. And it sounds like you might have had an exposure, like your husband or fiance rather may have had this last week with the sore throat. All that being said, today we'll do the monospot test to check for that as well as some blood work. And we will do a covid swab as well, just in case. P: OK, that sounds good. Thank you. D: Thank you.
dataset\resampled_file\RES0028.wav	D: Can you just tell me what brings you in here today? P: Yeah, my chest is really hurting. D: OK, and where where does it hurt exactly? P: It's hard to say the exact location, but more on the left side of my chest. D: OK, and is it like what kind of pain is it? Is it like a dull aching pain, or is it as sharp or stabbing pain? P: The pain is. It's stabbing, but also it feels really really tight in my chest. D: OK, and if you're to rate it on a scale of zero to 10, zero being the least amount of pain you felt in your life and 10 being the worst, how much would you rate it? P: I think at 6. D: Six, OK. And when did it start? P: It started this morning just right after I got out of bed. D: OK, so you weren't doing anything like you weren't doing any activities, you just woke up from sleep? P: Yeah I got outta bed. I was just trying to get dressed and all of a sudden I got this tightness and and stabbing pain on the left side of my chest. D: OK, approximately how many hours ago was that? P: I I would say about. Six hours ago. D: OK, and has it been as a pain getting worse at all? P: Uh, it's it's getting worse. D: It's getting worse, OK. And have you had any similar sort of pain in the past before? P: Um nothing like this before. D: No, OK. And is the pain going anywhere else or is it just staying in your chest? P: The pain is just in my chest. D: OK. And does anything that you do make it feel better? P: Sitting up tends to make it feel a bit better. D: OK, and does anything you do make it get, make the pain get worse? P: It gets worse every time I breathe in. D: OK, and what kind of pain do you get when you breathe in? P: It's a sharp stabbing pain. D: OK and apart from the pain, are you having any other symptoms like a cough or shortness of breath and anything like that? P: Yeah, with the pain, I'm having a hard time breathing. D: OK. OK, I just have a few other questions. Uh, have you recently had any kind of trauma or injury to your chest at all? P: Um no. D: OK, have you traveled at all recently? P: I was in in Italy for the past three weeks actually, just got back last night. D: OK. And have you been experiencing any kind of nausea or vomiting, or fever or chills? P: No. No nausea or vomiting. I did take my temperature, no. Sorry I did not take my temperature, but I've been having chills the last few days. D: OK, uh, and uh, yeah, just curious have you been having any kind of swelling at all in your feet or ankles? P: Ah, my legs felt a bit swollen on the way back on the airplane, but they tend to swell so I didn't think anything of it. D: OK so they have swollen up before but you saw them swollen this time as well? P: Yeah. D: OK. And have you been feeling at all fatigued at all? P: I've been really tired with all of the traveling, so I think maybe I'm just jet lagged. D: OK, have you noticed that all your heart racing, like any palpitations? P: Yeah, since this morning it's felt like my heart is is racing. D: OK, have you noticed any skin changes at all? Any rashes? P: No rashes. D: OK, have you noticed any cough, coughing at all? P: I've had a cough since last week, but it feels much worse today. D: OK, and has there been any kind of green slimy mucus in your cough at all? P: No, it's been a dry cough. D: Dry cough, OK. and have you noticed at all coughing up blood? P: No blood. D: OK. And have you recently had any infections in the last month? P: Yeah, a couple of weeks ago I had a runny nose and sore throat and a little bit of a headache but. I feel better from that now. D: OK, and to just go away by itself, or did you have to take any medications? P: It just went away on its own D: OK. Have you been feeling any kind of dizziness at all? P: I have a little bit of yeah, um dizziness when I when the pain gets really bad. D: OK, and I know you mentioned some swelling in your legs and your ankles, but have has any of your legs been hurting at all? P: My left leg hurts really bad right now, but my entire body has been achy these past few days. D: OK, and then you're right, like do you know where it hurts? P: Um. I think just like in the calf. D: In the calf, OK. OK, and do you have any past medical history any like hypertension that like diabetes? So any conditions that you've been diagnosed with? P: No, I I'm healthy. D: OK, any allergies to medications? P: No allergies. D: OK, do you take any birth control or multi vitamins? P: Yeah, I take a daily birth control pill and also a daily multi vitamin. D: OK, and how long have you been on the birth control pill? P: Um, for two years. D: OK, any hospitalizations recently? P: Um none that I can think of. D: Any ill Contacts? P: No. D: Any surgeries in the past? P: No surgeries. D: OK, in your family, has anyone had any conditions like has anyone passed away from a heart attack any cancers, anything like that? P: No cancer, but my mother died of a heart attack when she was 43. And my grandma also had a heart attack when she when she was younger. I wanna say in her 50s but I don't exactly remember how old. D: And currently right now, where do you live? Do you live in like a house, apartment? P: Yeah, I live in an apartment by myself. D: OK, and do you currently work? P: Yeah, I'm in charge of um a retail store as a manager there. D: OK and do drink? P: Sometimes on weekends or if I'm socializing with friends, but not very often. D: OK, and do you use any recreational drugs like marijuana? P: Never. D: OK, and do you smoke? P: Yes, I smoke about 2 packs of cigarettes per day. And I've been smoking since I was 12. D: OK. Alright and in terms of your daily routine like do you get any exercise? P: Uh, not really. Life's a bit too busy and hectic right now right now, unfortunately. D: OK. And how about your diet like what is your regular diet look like? P: A lot of fast food. I know I could work on that, but again, with the busy lifestyle we tend to eat a lot of fried foods and fatty foods. I know I could do better. D: OK. Great thank you.
dataset\resampled_file\RES0162.wav	D: What brings you in today? P: Hi, I am just coming in because for the last couple of months but I've been having this, these coughing fits. Are there like when I'm going to the gym or even at home, like during the weekends when we're vacuuming and cleaning the house. D: When did this start? P: Um, I would say started, uh probably 3 months back, but it's gotten worse, so like before I used to like just have some irritation in my throat and cough a little, but now, I would say probably every other day I'm having these episodes where I can't stop coughing when I'm exercising. D: Hmm, um and is this cough a dry cough, or do you bring up some mucus? P: It's usually, it's usually a dry cough and sometimes I do bring up like this light material, but usually it's mostly a dry cough. D: You never notice any blood, right? P: No, no blood. D: OK and uhm, it started about three months ago, I guess before that did you ever have a problem when you would exercise or when you were vacuuming or cleaning, has this been a problem that has occurred for years and that's just something that you that got worse and now it's come to your attention? Or was it just very new and sudden, three months ago? P: Um, it's fairly new. I've never really had this issue before although I have been like so like after the new year in the winter I, I, I wasn't much of the person who ran or exercised a lot. But I, I kind of needed a new goal to become more fit and active. So I notice that, I don't know, maybe that's why like, it is something new that I've been trying, but yeah, it's not been an issue before. D: OK, and other than the the cough, have you noticed any other symptoms like a sore throat or itchy eyes? Itchy nose? Stuffy nose or runny nose? Anything like that? P: No, none of those, but I did it, initially I used to get just an irritation in my throat. But now it's just more of a cough. D: OK. Do you have, do you get any pain in your chest at all? P: Uh, when I'm usually it goes away in 10-15 minutes but when I'm coughing a lot I do get some tightness. D: OK. Do you ever feel like you're short of breath when you're coughing or otherwise? P: I do find that it's harder to take a breath at those times. D: Ok. Uhm and how long do these last for? Episodes last for? P: Probably, uh 15 to 20 minutes and yeah, it's it's mainly just after I like often times over the last few weeks I've had to just stop doing what I'm doing, like exercising and just come home and rest. D: Do you feel like your hearts beating really fast when that happens or you're sweating? P: Yeah, yeah, I I feel like it's usually, I don't know if it's because of the exercise, but I have like a Fitbit and it's my my heart rate is much faster. D: Uhm, OK. Alright. Have you had any other symptoms so anything, any pain in your belly or any nausea or vomiting? P: No, nothing like that. D: Any changes in your bowel movements or any urinary symptoms? P: Nope. D: Any headaches or fevers or chills? P: No, nothing like that. D: Unintentional weight loss? P: No. D: Any night sweats? P: No. D: Muscle aches, joint pain? P: No. D: Have you been diagnosed with any medical conditions? P: No, I've I've been very healthy. D: Uhm, you mentioned that you started going to the gym more often earlier this year, and that is when you sort of notice some of these symptoms? Is there anything else that changed in your life? Any big changes that you think could be related to this? P: Um no, not really, I've I've been really, umm, I moved back to my parents' home just for a bit right now. D: Ok. P: Now, while the University has closed down, and by that I've lived there all my life before, so I don't know if that had anything to do with it. D: Do you feel like they may have put new curtains or or like there's old carpets or new a new pet, or something that could have caused some irritation for you? P: No, but I have noticed that when I when we vacuum. I, I do get some of those symptoms as well. Just more of an irritation mores than the cough. D: OK. OK, and do you feel that you're particularly anxious when these episodes are occurring? Do you have any new stressors in life? P: Uh, no, not really. D: Any medical conditions that run in the family? P: Uhm, I don't think so. Not that I know of. D: OK, and I guess a little bit more about you. So have you had in the past when you were younger, did you have a rash like eczema or did you have allergic rhinitis where you would sneeze and, to feel ill when you were outside or at certain times of the year? Anything like that? P: I didn't have a, I didn't have any like exam or rashes, but I do generally have umm, get allergies during the spring time when I go outside. D: Do you take any medications for that? P: I just take Reactine usually during the spring. D: Do you have any other allergies? To food or medications? P: No, not that I know. D: And other than Reactine, do you take any medications, including over the counter meds? P: No. D: Nothing else? OK. And. In your family, you said no one has asthma or allergic rhinitis or eczema or anything like that, right? P: Not asthma, my dad also gets those allergies and irritations just like me. D: Uhm, OK. And you mentioned that you're staying with your at your parents place. Are you uh, are you doing things from home? Are you like doing school from home or working from home? P: Yeah, I'm not currently working, just studying from home. D: OK, and have you had contact with anyone who might have been sick? P: No. D: Traveled anywhere outside the province, recently? P: No. D: OK, and do you smoke or have you ever smoked? P: No, never smoked. D: Marijuana? P: No. D: Any recreational drugs? P: Nope. D: Uh, do you drink alcohol or have you ever had alcohol in the past? P: Yeah, alcohol I've had like at University, but generally, maybe just on the weekends. Not anything regular. D: Alright. OK, well, uh, those are all the questions I had for you. We will do a physical exam now and I'll go talk to my attending and we'll uh come talk to you right after. I guess before before I do So what exactly are you hoping to get out of today's visit? P: I just wanted to like I really do you want to become fit and it's just these symptoms are stopping me and kind of affecting my daily routine, so I just wanted to know what I can do to stop like having these symptoms. D: Have you ever tried any puffers? P: No, I haven't. D: No, ok. Right, yeah, let's talk a little bit. P: OK.
dataset\resampled_file\MSK0026.wav	D: How may I help you? P: I'm I'm here because my right knee is very painful. It looks kind of swollen and it's it's also a little bit warm so I'm just worried, I'm worried about it and I was wondering if you could look at it. D: Yeah, certainly, um. So where are you feeling the the pain exactly? P: So it's where, so right in the middle of my knee. So just below the bone that, the big knee bone. D: OK, so like underneath the kneecap, like below that? P: Yeah just just a little bit below. D: OK, so slightly below the Patella. Sounds like somewhere in the region of the tibial through tuberosity. P: Right. D: OK, and when did this pain start? P: It started about two weeks ago. D: OK, two weeks ago when the pain started, was there any trauma or could you remember any movement that that caused the pain? P: Nothing like that, but I recently found out that I had some osteoarthritis on my left knee, so I was trying to put more pressure on my right knee one whenever I was doing like gardening work um and I think something something may have happened when I was doing that, something maybe, maybe I put too much strain on it. D: OK, I see an. Alright, like are you doing a lot of kneeling on on or during the gardening work? P: I am. D: OK. Um, and. How long has the pain been going on for, has it been constant over these two weeks? P: Yes, it has been. D: OK, and how would you describe the pain, is it sharp, burning, achy? P: I would say mostly achy, but it can be sharp. D: OK, and do you feel the pain radiate anywhere else? P: No, just it's pretty local. D: OK, have you tried anything to make the pain better? P: I tried some topical like what are those like ice and fire gels. Those seem to help temporarily, but the pain comes back. D: OK. And. Have you tried, has anything made the pain worse? P: I guess like when I kneel down on it, it gets painful or If I touch it or palpate it, I guess painful if I'm I'm flexing my knee too much that hurts as well. Kind of keeping it straight and not touching it makes it feel better. D: OK, and. What would you say the severity of the pain is with 10 being the worst pain you've ever felt and one being the least pain? P: I give it about a 6. D: OK, and have you had a pain like this in your right knee before? P: No, nothing like this and I have osteoarthritis in my left knee but it feels different. D: OK, and um. OK, and have you had any fevers or chills? P: Uhm, no. D: OK, and how about any night sweats? P: No. D: OK, and have you had any unexpected weight loss over the last several months? P: No. D: Have you had any headaches? P: No. D: Have you had any changes to your senses like vision or hearing? P: No D: Any changes to your sense of smell or taste? P: No. D: OK, have you had any sore throat or cough? P: No. D: Alright, have you had any shortness of breath? P: No. D: Have you had any wheezing? P: No. D: Have you had any chest pain? P: No. D: Had any lightheadedness or dizziness? P: Um no. D: Have you had any heart palpitations? P: No. D: OK um an have you had any nausea or vomiting? P: No. D: Have you had any abdominal pain? P: No. D: Have you had any diarrhea or constipation, or blood in the stool? P: No. D: Have you had any pain with urination or frequency with urination? P: No. D: OK, and have you had any like muscle aches or joint pains anywhere else? P: No. D: OK, and have you had any neurological symptoms such as numbness or or tingling or reduced sensation? P: No. D: OK, and how is your energy been recently have you had any fatigue? P: No, not really. It's been the same. D: OK, and in the past have you been diagnosed with any medical conditions? P: Uhm I have Class 2 obesity. And then also arthritis in my left knee. As well as high blood pressure. D: I see and. Do you take any medications? P: Currently I'm on Ramipril and I take some ibuprofen sometimes for the osteoarthritis in my left knee. D: OK and, do you have any allergies to medications? P: No. D: Have you had any surgeries before? P: Nope. D: Or have you had any hospitalizations for any reason? P: No. D: OK. And. Have you been pregnant in the past? P: Um I I have one, one child, she was born through c-section. D: And are you currently sexually active? P: I am. D: OK, could you tell me about your partner or partners? P: Yeah, so just with my husband of 10 years. D: OK, any concerns for a sexually transmitted infection like vaginal discharge or or pain or itchiness? P: No. D: OK. And could you tell me a little bit about your living situation currently, like who you're living with an whereabouts? P: Um I live in downtown London I live in a house with my husband and my daughter. D: OK. And have you been around anybody who's been sick recently? P: No. D: And have you traveled anywhere recently? P: No. D: OK, are you currently working right now? P: I yes I am. D: OK, well then what what do you do? P: I work as a full time gardener for a landscaping company. D: OK, I see. So you're spending a lot of time doing kind of like repetitive kneeling type movements to do your job? P: Yes, that's right. D: OK And do you smoke cigarettes? P: I don't. D: Alright, and do you drink alcohol? P: I'll have a glass of wine every other night. D: OK, and do you use any recreational drugs? P: No, I don't. D: Have you used anything like that in the in the past. P: No D: like IV drugs, no, OK. And in the family or is there a history of any musculoskeletal or neurological conditions? P: No. D: OK. So next I just wanted to do the physical exam portion and ask you to have a look at the knee first and let me know if the if you're having any swelling, redness or warmth to the knee compared to the other side. P: Sure. D: Sorry so you are having, having swelling, warmth and redness to the right knee? P: Yes. D: OK and are you having pain to like palpation is there a specific spot you can press on that causes a sharp pain? P: Um so just below that kneecap area there is some swelling there and when I press down on that swollen area, it causes a bit of pain. D: OK. And are you able to fully bend, bend and straighten the knee? P: I can do that, but when I bend my knee it really hurts. D: OK. And are you able to walk normally or do you have a limp? P: Um I can walk normally, it just hurts. D: OK. So that was a everything that I wanted to ask today on the history and and physical. Was there anything? That you maybe I forgot about you wanted to add? P: No, I don't think so. D: OK, so right now it's sounding like this could possibly be a knee Bursitis. Or Prepatellar, or sorry, infra patellar bursitis or a prepatellar bursistis which are the kind of the more common types. One thing to make sure that we rule out would be a septic Bursitis. Although you're not having any fevers or chills so that makes it a little bit less likely. P: Mmmm D: But if your symptoms are getting worse and you're developing a fever, it's becoming even more painful then certainly will have to rule out infection. And as well if things are not improving, potentially a structural disease and any, such as a meniscal injury, or like a ligamental injury from all of the like kneeling and and repetitive movements. But right now I think it's mostly sounding like a knee bursitis. P: OK. D: OK, and treatment for that will be activity modification as well as using things like as um NSAIDS and icing to help with um the inflammation. P: OK, that sounds good, thank you.
dataset\resampled_file\RES0047.wav	D: What brings you in? P: Yeah, so I've had this chest tightness and and been short of breath and bringing up sputum with this uh cough. D: OK, so um lets start with the cough. When did that start? P: So I've had a cough now for a few years, um but over this past uh three days it's gotten quite a bit worse. D:: OK, for the past three days, three three years. OK. P: Yeah. D: Um are there any triggers for your cough? P: Uh, yeah, if I'm doing, um, like if I'm really active like if I run to catch the bus or uh or if I'm shovelling snow, maybe I can make, become short of breath, but um not if I'm just walking around the block or anything like that. D: OK, and what caused this cough initially three years ago? Do you know? P: Uh yeah, I think um I think it's just a smokers cough. I think that my family doctor told me I had like chronic bronchitis before. D: OK, OK. How often were you coughing before it got worse recently? P: Uh I would usually cough every day, but the cough would be, usually just in the morning, I I'd get up um, there, I would cough up some sputum and and then maybe, and then I'd usually be OK. D: OK, um and does anything make your cough better? Like do you take any over the counter cough syrup? P: Um yeah, I've tried some over the counter uh cough syrups in the past, but it hasn't helped. D: OK, OK, and if you were to talk about the quality of your cough, is it is it barky? Does it sound harsh? What does it sound like? P: Uh yeah, I would say it sounds pretty harsh. You can kind of, it sounds like there's um mucus moving around, I guess with with the cough in my chest, I can I can kind of feel it D: OK, OK and you mentioned that you're producing a lot of sputum with your cough. What colour is that sputum? P: Greenish D: Green, OK. Any blood? P: No blood. D: No blood, OK. And you mentioned, you've never produced sputum with the cough, especially not green sputum in the past three years, right? P: I would bring up sputum, but it's usually clear and white. D: OK, OK, and do you have any wheeziness associated with this cough? P: Uh, yes I do D: Yes, OK. And you mentioned you were short of breath. Were you short of breath prior to your cough or did that start um when when this cough got worse? P: I think the shortness of breath has gotten a bit worse over the um last few days uh as the cough has gotten worse. D: OK, OK. And if you were to rate the severity of your symptoms, of how you're feeling, 1 to 10, 10 being the worst, where would you put yourself at? P: Uh I would say an 8, it's been really tough, it's been getting really difficult to um breathe. D: OK, yeah. And have you ever experienced anything to this severity in the past? P: No, I haven't had uh this difficulty breathing before. D: OK. OK. Um do you have any chest pain? P: Uh, my chest is, it feels tight. D: OK. Uh it feels tight, OK, does that, does it hurt though? P: Uh no, no, it doesn't really hurt. It's just uncomfortable. D: OK. And do you think it's tight because of the coughing or um the shortness of breath? P: Yeah, I kind of feel it um with the coughing. D: OK and have you noticed any swelling in your limbs? P: Uh yeah, maybe a little bit in my in my feet, more than usual. D: OK, and do you feel like your heart's racing? P: Uh, no. D: No, OK. Any dizziness or fainting spells? P: Uh I haven't had anything like that. D: OK. Um any changes to your vision or hearing? P: No. D: No, um, do you have a stuffy nose or runny nose? P: No. D: Um how about a sore throat? P: No. D: No, any changes to your smell or taste? P: No. D: Um any fevers or chills? P: No, I've felt OK. D: OK, any weight loss? P: Um yeah, maybe I mean over the last few years I've um lost a few pounds, but maybe maybe 10 pounds over the last last couple of years D: Last couple of years, OK. Was it intentional weight loss or unintentional? P: Unintentional. D: OK, um alright, and any changes to your hair, nails or skin, like rashes? P: No, I haven't noticed anything like that. D: OK, and how are your bowel movements? Everything normal there? P: Yeah, that's been normal. D: OK, everything normal with regards to your urine? P: Yeah, that's been normal. D: OK. Any confusion or memory loss? P: No. D: No, OK. Any fatigue? P: Yeah, I've been feeling well, really tired these last three days. D: Yeah, OK. Any joint pains or muscle aches? P: No. D: No, OK um and are you otherwise healthy? P: Um, well, I use uh these inhalers um and I think I've been told I have COPD before. D: OK, Um other than your COPD, do you have any other longstanding medical conditions like high blood pressure, diabetes, anything like that? P: Um yeah I have uh high blood pressure and um I had my gallbladder taken out uh a few years ago. D: OK. OK, any other surgeries or hospitalizations? P: Uh I had an ACL repair like when I was a teenager. D: OK, and besides the inhalers, are you on any other medication? P: Yeah, there's one for blood pressure um and I take vitamin D, um and that's it. D: OK, which one, which um medication are you on for the blood pressure? P: Uh amlodipine. D: Amlodipine, OK. When did you start taking that? P: About uh seven years ago. D: OK, and then for your uh COPD, which inhalers are you on? P: Uh, there's one that's for, um, like short acting. And then there's one that I use everyday, uh Spiriva, I think. D: OK, yeah. And how long have you been on these inhalers? P: Uh it's been a couple of years for well, for the the short one that I I use for rescue therapies been for like a long time, but Spiriva's been the last several years. D: OK, OK, and do you find that your inhalers are helping? P: Yeah. They um, I definitely notice a difference when I, if I miss a dose or something. D: Yeah, OK. And um, do you have any allergies? P: Uh no, I don't think so. D: No, OK. How about um immunizations, are you up to date? P: Yeah, I believe so. D: OK. And in terms of family history, uh are there any lung conditions or heart conditions that run in the family? P: Um, uh no. D: No, OK. Um do you currently smoke? P: Uh I do, yes. I've been trying to quit, I um I smoke about a pack of cigarettes per day now. I used to smoke like 2 packs per day. D: OK, well it's it's good that you've cut down, um if you need any additional help cutting down we have resources that we can refer you to. P: Yeah, that would be great. D: Yeah, um how much, for how long have you been smoking? Like how many years? P: Uh well, I started when I was a teenager, so probably like 35. D: OK. Um and do you do any marijuana? P: Uh no. D: No, OK, OK, um how about alcohol? Do you drink alcohol? P: Yeah, a few beers on the weekend. D: OK. Um and then where do you live currently? P: I live in an apartment by myself. D: OK. Um and any reasons to think that there are any old carpets, mold, or um asbestos or anything like that that could be exacerbating your symptoms? P: Uh I mean I do have a carpet in the bedroom so, but I mean that that's the only carpet in the apartment. D: OK. Um and do you live with anyone? P: No, it's it's just me and my dog. D: OK. Uh have you, have you been around any sick contacts recently? P: Um maybe, I mean I I usually will see uh, a couple of friends, we'll meet up to grab some coffee in the morning in the morning um but I feel like they have been uh OK. D: Yeah OK, how about um travel, have you traveled anywhere recently? P: No. D: No, OK. OK, well I think those were all the questions that I had for you. Did you have any questions or concerns or anything that I missed that you wanted to discuss? P: Um no, I just wanted to, um, yeah, come in because it's been really difficult to breathe. D: Yeah, so OK, well we'll do a physical exam on you um to try to understand um how bad your COPD exacerbation is. Um we'll also try to get an um oxygen saturation on you, and we do want that reading to be between 88 to 92%. If it is less than that um and we think you have a mild exacerbation, we'll just suggest that you use your short acting beta agonist puffer um more often, and then if you, if we think you have moderate, um moderate exacerbation we'll also prescribe uh antibiotics and or steroids to go along with the short acting beta agonist. And if it is severe, or if it becomes severe, um please do seek out aid um in the ER and they'll try, they'll probably put you on um uh some sort of, um oxy like um some sort of supplemental oxygen, whether it's BiPAP or CPAP. Um and again they'll continue giving you your bronchodilators and steroids, as well as antibiotics to um make sure that you don't have any bad complications of uh pneumonia. Um and it does sound like it is a COPD exacerbation at this point, but if you develop any other symptoms like um fevers, or any symptoms that overlap with uh viral viral illnesses, we'll we'll we'll work you up for that, we'll do, I think we will still do a covid swab on you just to make sure you don't have that, uh but we'll start with um working you up for COPD. How does that sound? P: That sounds great. Thank you. D: Alright. Take care.
dataset\resampled_file\RES0069.wav	D: Would you mind by starting to tell me what brought you in? P: Yeah, absolutely. Uhm, I don't know, I've just been feeling a little feverish, uhm, and I also have a, a bit of a sore throat. D: OK, when... P: I just came in, I just came in to see what's going on, cause I was worried, you know, with covid going on, uhm, going everywhere. D: Certainly, when did the, the sore throat start? P: Last night actually. D: OK. P: Yeah. D: And uhm, have you had any, uhm, problems with swallowing, like food or liquids? P: No, I don't think so. I just had breakfast this morning and no problems there. D: OK, uh, any like, changes that, uhm, other symptoms that you've been having with the sore throat? P: Yeah, I'm just feeling a little feverish. D: OK, and when did that start? P: This morning. D: OK, did you take your temperature? P: No, I don't have a thermometer at home. D: OK, and have you had any, any cough? P: No. D: OK, how about any, like red eyes or runny nose? P: No, neither of those. D: OK, have you had a headache? P: No. D: OK, uh, and have you had any shortness of breath? P: I don't think so. D: OK, and how about any loss of taste or loss of smell? P: Yeah, I don't, uh, yes, I said I was eating breakfast this morning, but it just tasted really bland. D: OK, so maybe loss of taste, so you feel like your nose is really or that you're really congested? P: I guess yeah, now that I think about it. D: OK, uh, and how has your appetite been? P: It's alright. D: OK, and so you haven't had any cough or shortness of breath, but have you noticed any wheezing? P: No. D: OK. And have you had any chest pain? P: No. D: Have you felt as though your hearts's been racing at all or, or beating out of your chest? P: No. D: OK, have you been dizzy or lightheaded? P: No. D: OK. Have you had any nausea or vomiting? P: No. D: Any abdominal pain? P: No. D: Have you had any diarrhea or constipation? P: Uhm, I'm often constipated but nothing new there. D: OK, have you had any urinary problems? P: No. D: Alright, and then how about any muscle aches or, or body aches? P: Sort of, like I just, I found it really hard to get out of bed this morning. D: OK. How has your energy been? Have you been, like really fatigued? P: Yeah. D: OK, and when did, uh, you said the muscle ache started this morning, uhm, how, when did the fatigue start? P: I'd say this morning as well, yesterday was just like a little tickle in my throat and I thought it would just go away you know, and I woke up this morning and I just felt horrible. And the sore throat was just worse and I felt feverish and tired and I felt really crappy. D: OK, yeah, and have you had any symptoms like this before? P: Well yeah, I usually get a cold once a year in the fall. It does feel similar to that. D: OK. P: But I still wanted to be careful and come in, just in case. D: yeah, certainly. Have you had, have you been diagnosed with any medical conditions before? P: I have migraines. D: OK, and are you taking any medications regularly? P: No, no, I'm not. It's not bad. I sometimes just take like, Advil whenever my headache's coming on. D: OK. Any allergies? P: Uh, nope. D: OK. And do you smoke cigarettes? P: I smoke, uh, two or three a day. D: OK, and have you tried to quit? P: No. D: OK, if at any point this is something that you wanted to talk about, we, we certainly could later. P: sure. D: Do you drink alcohol? P: Uhm, a glass at night with dinner. D: OK, and do you use any other recreational drugs? P: No, no, no, nothing like that. D: OK, have you in the past? P: No. D: OK, and have you been around anybody who's been sick recently? P: Uhm, oh, my, like my little granddaughter had, uhm, you know, they're always having a runny nose, right, the little ones. D: Mhm. P: But no, nothing, nothing else. I've just been at home for the most part. D: OK, have you traveled traveled anywhere? P: No. D: OK, and, uh, does your granddaughter go to daycare? Or is she in school? P: She, she does go to daycare, yeah. D: OK, and has there been anybody else around that, that's been sick that you're living with, or you see often? P: No, that's about it. D: OK, I, I think, I don't think I asked this, but have you had any surgeries before? P: I had cataract surgery done. D: OK, and the left, right eye or right eye? P: Both actually, it runs in my family. We get it pretty early on. D: OK, and are there any other conditions that run in your family like heart conditions or cancer? P: Diabetes. D: Diabetes, OK. And who had diabetes? P: Lets see, my mom, my sister, my brother, yeah, yeah. D: OK. And just to, get to know you a little bit better as well. I was wondering if you could tell me a little bit about your living situation? P: Sure, yeah, I live with uh, I live with my son and daughter and my grandson. D: OK, uhm, and, uhm, OK, yeah, I think that's all I wanted to ask about today. Was there anything else that you wanted to tell me or maybe that I forgot to ask about? P: Uh no, I don't think so. Do you think I have covid? D: It's, it's certainly possible. It will be something we test for. P: Sure. D: Although the symptoms that you're experiencing, with feeling or having a fever, sore throat, and not feeling well with the muscle aches and fatigue, uhm, its relatively non-specific, so as you mentioned, it could be something like the common cold, that you've experienced in the past, so we can't rule that out either at this time, but we will do some investigations including a nasal swab for covid and kind of go from there. P: OK, sounds good. D: All right, we'll get that started. P: Great.
dataset\resampled_file\MSK0007.wav	D: How may I help you? P: Hi, yes I've had this pain in my left elbow for a couple of weeks now and it's not getting any better so. I'm just here to kind of figure out what it is. D: OK alright are you feeling this pain on the lateral side of the elbow, on the or on the medial side of the elbow? P: It's on the medial side. D: OK and sorry, when did this pain exactly start? P: So it's been on going for like the past three months. But it's gotten worse over the last, I'd say three weeks. D: OK, and. Has the pain been getting worse, any better? P: Oh the pains been getting worse. D: Yeah, OK. Was there any triggers or precipitating events to the pain, such as like a fall or any types of trauma to the elbow? P: No, no, not that I can think of. D: Have you had any pain or injury to the elbow in the past? P: No. D: Could you describe the character of the pain. Is it sharp, achey or dull? P: It's usually achey, but it can be sharp. D: OK. Does the pain radiate anywhere? P: No, it's pretty. It's pretty much in that one area. D: OK, just on the medial side of the left elbow? P: Yeah. D: OK, and is there anything that you've done to help make the pain go away, or any alleviating factors? P: I am taking some NSAIDs that helps with the pain temporarily. D: OK. And uh. Are there any factors that make the pain worse? P: Um when I. I. I guess when I like extend my elbow out it gets worse. D: OK, so it's a movement OK, and straightening the elbow? P: Yeah. D: OK, I mean, what is the severity of the pain on a scale of 1 to 10, with 10 being the worst pain you've ever felt. P: I'd say about 5. D: OK. And um. So did you have any other symptoms associated with the elbow pain? P: Um no, um not really I. I'm otherwise pretty healthy. D: OK, so have you had any fevers or chills? P: No. D: Have you had any night sweats P: No D: Or any any weight loss? P: No. D: OK, have you had any any headaches? P: No. D: Any sensory changes like changes to your vision or or hearing or even your smell or taste? P: No. D: OK, have you had any eye redness or eye discharge or your ear pain? P: No. D: OK. Have you had a runny nose or sore throat? P: No. D: Have you had a cough or shortness of breath? P: No. D: Have you had any wheezing? P: No. D: OK. Have you had any chest pain? P: No. D: Any lightheadedness or dizziness? P: No. D: Have you had any heart palpitations? P: No. D: OK, and have you had any nausea or vomiting? P: No. D: Have you had any abdominal pain? P: No. D: Any diarrhea or constipation. P: No. D: Have you had any urinary problems? P: No. D: OK. Have you had any skin rashes? P: No, no. D: OK, have you had any numbness or tingling? P: No. D: And how about any muscle weakness? P: No. D: OK, and any joint pains anywhere else? P: No. D: OK, and any changes to your memory or or any confusion? P: No. D: OK, and have you had any fatigue? P: No. D: OK and, have you had any changes to your appetite? P: No. D: OK. Are an have you been diagnosed with any medical conditions in the past? P: No. D: OK, so do you take any medications, either prescribed or over the counter? P: Um no, I just take some multivitamins. D: OK, and do you have any allergies to medications? P: Um no. D: OK, and have you had any hospitalizations or prior surgeries? P: I I had a fracture when I was younger. It was in my humerus bone on the right side. D: OK, so it's the to the fracture was on the other arm? P: Yes. D: OK, and did that heal OK? P: Yes. D: Alright then. Can you tell me about your living situation? Currently, like whereabouts and who you're living with? P: I live with my partner of five years. We live in an apartment together. D: OK, and are you working currently? P: I am. D: And what do you do? P: I work on the assembly line for Chrysler. D : OK, uh, and uh. Do you do repetitive tasks at work? P: I do. D: OK, yeah, do you notice this, uh pain after, more so after a shift or after after a long day? P: Yes, definitely. D: OK, and what types of hobbies do you have, like do you play golf or tennis or or any kind of like, sports I guess? P: Yeah, I used to play golf before this pain in my arm and my elbow, so I haven't played it in the past like six months. D: OK, um OK and um do you smoke cigarettes? P: I don't. D: And do you drink alcohol? P: Um I'll have a glass of wine every other day. D: OK, and how about the use of any recreational drugs like cannabis or or anything else? P: I'll smoke a joint once a week. D: OK, alright and. Is there any family history of any heart or lung problems? P: No. D: Any musculoskeletal or neurological diseases? P: Um no. D: OK, I got any autoimmune diseases like thyroid disease or diabetes? P: No. D: OK, um and so next I wanted to walk through a physical exam, so when you look at the elbow yourself, do you see any swelling or redness? P: No. D: OK, does it look like there is any muscle atrophy either in the forearm or the biceps or triceps? P: No. D: OK, and how about any misalignment or joint deformity? P: No, I don't see any of that. D: OK, and are there any scars? P: No. D: OK, and when you press on the medial part of the the elbow, do you feel pain? P: I do. D: How about over the olecranon or the, yea any pain over the olecranon? P: Um a little bit. D: OK, and is there any pain over the lateral part of the elbow? P: No. D: OK, an any pain over the forearm, or biceps, or triceps muscles? P: No. D: OK, and does the joint feel like it's hot? P: No. D: OK, and any pain with shoulder or elbow movements? P: No. D: OK. P: Actually, sorry with the elbow when I straighten it out all the way it hurts a little bit. D: OK, when are you straightening it out all the way OK, But no pain with shoulder movements and full range of motion? P: No, no pain with shoulder. D: OK. And how about pain with pronation and supination? P: With pronation it hurts. D: OK, at the medial side? P: Yes. D: OK and how about with wrist. So with resisted uh, yeah, wrist flexion? P: Wrist flexion yeah. That hurts too. D: OK, and then how about if you passively extend your your wrist as far down as as you can go? P: Down uh yes. That hurts too. D: OK. And is there any numbness or tingling anywhere? P: No, no, no numbness or tingling. D: OK. OK, so that was everything that I wanted to ask about today. Was there anything else that you wanted to mention? P: No, that was that. What do you think I have and how can I fix it? D: Yeah, so it. It's certainly it it sounds like with the medial aspect of your elbow having pain there over the last several months and some of the physical exam maneuvers, such as like passive wrist extension, resisted wrist flexion as well as pronation and the point tenderness over the medial elbow this could be a medial epicondylitis or a tendinopathy in that area. And so this is typically treated with activity modification, so this could be trying to avoid repetitive movements that that cause pain. And using medications such as Advil and Tylenol and doing strengthening and stretching exercises, which you can learn from a physiotherapist or or on your own as well. And also other things that that the medial side of the elbow that it could be is an ulnar ligament injury. Um or yeah, or the other thing to be considering is and ulnar ligament injury and so if the pain isn't going away, then we might consider an ultrasound or something to look at the structures there. P: OK, that sounds great. Thank you.
dataset\resampled_file\RES0073.wav	D: Would you mind by starting with what brought you in? P: Yeah, so over the last week I've just been feeling some symptoms. It kind of first started with, like a runny nose. That was around like 5 days ago and then it turned into just a lot of congestion, like around my nose and like my throat. And now over the last two days I've been just feeling so much pressure around my nose and around my jaw so I've been getting a lot of pain there as well. D: OK, is your nose still running? P: Yeah, I'm still getting some discharge and I also feel like I'm getting some dripping at the back of my throat too, especially when I wake up. D: OK, and could you describe the discharge? Is it clear, yellow, greenish? P: Uh, it's fairly clear and sometimes, like a bit white, but like, it's not like green or yellow. D: OK, uh, and have you felt that it's difficult to breathe in through either of your nostrils, like it's obstructed? P: Yeah, so at night sometimes I have to like turn because one side of my nose gets difficult to breathe from and then it kind of balances out on the other side. So yeah, I do have some obstruction. D: OK, and have you had any changes to your sense of smell? P: Yeah, so just in the last three days when the congestion got really bad I started losing the ability to smell. D: OK, have you had any changes to your sense of taste? P: No, taste is fine. D: OK, and have you had any cough or sore throat? P: Uh, no. No cough or sore throat. D: OK, and the symptoms have gone on for five days. Have you had a period of time where you got better and then got sick again? P: I did kind of have a runny nose last week as well, so probably like 8 days ago but then the runny nose discontinued a little bit but really got worse 5 days ago, but all these other symptoms just happened in the last few days. D: OK, and you have pain. Do you feel it in your jaw or do you feel it in the in the front of your nose? P: Yes, I would say mainly over the cheeks. It can kind of go near the front of my teeth as well, so like I would say like mostly around the cheeks, jaws and up to the front of my teeth. D: OK, And do you grind your teeth at all at night? or have you had, TMJ issues before? P: No nothing like that. I think it's not so much on and around my teeth, it's more so just to right below my nose, above my teeth and just around my cheeks. D: OK, so no pain in your mouth or anything like that? P: No, not inside my mouth. D: OK, have you had any fevers or chills? P: Uhm, I Don't think I've had a fever. I did feel some chills over the last few days, but just very brief episodes. D: OK, and over the last few weeks have you had any weight loss? P: No. D: OK, and you said you didn't have a cough or a sore throat, but have you had any wheezing? P: No wheezing. D: How about any shortness of breath? P: Uh, not shortness of breath. Just sometimes when my nose gets like really congested, I just turn into like a mouth breather, but that's about it. D: I see, OK, and have you had any chest pain? P: No, no chest pain. D: Alright, and any lightheadedness or feeling dizzy? P: No. D: OK, have you had any nausea or vomiting? P: Nope. D: Any abdominal pain? P: No. D: Have you had any diarrhea? P: Sorry, what was that? D: Have you had any diarrhea? P: No diarrhea. D: OK, and have you had any urinary problems? P: Uh, no. D: And have you had any rashes or skin changes? P: No, not that I know. D: OK, then how about any muscle aches or joint aches? P: Uh, no. D: OK, and have you had any muscle weakness? P: No. D: And how has your energy been? Any fatigue? P: Uhm, it's been mainly OK, just maybe sometimes difficult to get to sleep with all the all the congestion, but I don't think my energy has been affected too much, no. D: OK, and, uh, sorry to go back to this, I don't think I asked. Did you notice any discharge from your eyes or any eye redness? P: Not discharge, but yeah, maybe a little bit of redness. D: OK, have your eyes been itchy? P: Uhm Yeah, a little bit. I would say they have been a bit itchy. D: OK, alright then, do you have any medical conditions that you see a physician for regularly? P: Uh, just uhm, its called dyslipidemia. D: OK, I see, and any medications you take for that? P: Just like a Statin medication. D: OK, do you take any other medications? over the counter? prescribed? P: No, other than that I take multivitamins. D: OK, and do you have any allergies to medications or like environmental allergies that might be getting worse? P: Uh, no, not that I know. D: OK, so you don't experience any symptoms like this when the seasons change? P: I don't think so. I have had this happen to me, Uh, I would say like once before. It happened like two years ago. It was pretty similar. D: OK, uhm, and what was done at that time? P: At that time it kind of just went away on it's own. It got better. I feel it's definitely worse this time. But at that time I didn't even go to the doctor, it kind of just went away. D: OK, I see. Any recent hospitalizations? P: No hospitalizations. D: Any surgeries? P: Nope. D: Alright, and could you tell me where abouts you're living currently and who you're living with? P: Yeah, so I'm currently living in an apartment by myself, just outside of London. D: OK, and anybody that you've been around who's had any symptoms? P: Uh, no, not that I know of. D: OK, so no sick Contacts. And have you traveled anywhere out of the city or province? P: No, I've tried to stay home, besides going to work. I just work at the grocery store. Besides that, no, nowhere else. D: OK, and any of your coworkers have any symptoms? Or any coworkers being off sick? P: No, we're pretty careful right now with the pandemic. D: I see, yeah, that's great. OK, and do you smoke cigarettes? P: No, I quit just a couple of years ago. D: Oh, that's great. It's not easy to quit, so that's awesome. And do you drink alcohol? P: Just maybe like red wine a couple of times a week. D: I see, OK, and do you use any recreational drugs? P: Uh, just, in a month, maybe once or twice, I smoke a joint. D: OK, uh, and anybody in the family have any lung or heart conditions? P: No, not that I know of. D: Alright, and how about any cancer in the family? P: Uh, no, no cancers. D: OK, I think I that was everything I wanted to ask about today. Was there any other symptoms or anything else that you wanted to make sure I knew about today? P: No, I think that's all. I just didn't know if I needed any, like, medications or if I needed to get tested. I just wanted to make sure. D: Yeah, so well, certainly check your temperature to see if you have a fever. And if you do and it's high enough, that will increase the chance that you have a bacterial sinusitis, and if so, with some of your symptoms, including the discharge, obstruction, loss of smell, and facial pain, that all fits the picture for it and also you had a period where you felt a little bit better and then worse again. So that might require antibiotics, but we will check your temperature and go from there. P: Alright, sounds good, thank you so much. D: Thank you.
dataset\resampled_file\MSK0025.wav	D: What brings you in here today? P: So my back has been killing me it's been hurting for the past two months, but recently it's gotten worse. I'd say over the past week or two weeks it's gotten really bad and no over the counter medication is helping with the pain. It's I'm finding it hard to walk. I can't feel anything in the groin area and I'm having so many bladder accidents. D: OK, and so this pain started two months ago, but it's progressed to like these other symptoms as well? P: Yes, that's right. D: Where did the pain start? D: Uh, it started in my lower back. D: Started your lower back OK and does the pain, how would you describe the pain, is it like aching. sharp? P: It's sharp. D: OK and did anything happened prior to the pain, any injuries at all that you experienced? P: Two months ago I was in a motor vehicle accident um an I think my back started hurting then but they did some imaging it's and turned out like one of the discs there was a slip in a disc or something, but at that point the pain was just achey and I don't really have any in any of these other issues. But over the past two weeks it's gotten sharp and I'm having all these other symptoms. D: OK, um and. So you're having the set like what's called, some numbness in your groin. Is that unilateral, like on one side or both sides? P: Uhm, it seems like it's both sides. D: OK, and. So and then you're also having the urinary incontinence. How long is that been going on for? P: The past week. D: OK, and what about the numbness in your groin area? P: That's been going on for the past week as well. D: OK, and OK, and how would you describe your pain right now on a scale of 1 to 10, 10 being the worst pain you've felt? P: Um I would say it's like an 8 or 9. D: Eight or nine OK, and does it get worse with any, any motions at all? P: I think it's worse with um, I don't know like, it's worse with anything, anytime, anytime I tried to move it, it hurts. D: OK, so you just improved with rest complete rest. P: Yeah. D: OK. Does it travel in, does the pain travel anywhere else, does it shoot down your legs at all? P: Yeah, so it does shoot down my legs and I'm having a hard time walking because of that. D: Is it both legs or just one? P: It's mostly on my right, but the left one isn't the same as it used to be either. D: OK P: Yeah, I'm having a hard time like getting up from a chair and things like that. D: OK, and anything that you've tried that has helped relieve some of your symptoms. P: I've tried like over the counter counter and ibuprofen. I've tried some topical analgesics and nothing seems to be working. D: OK. And. Have you experienced any trauma? So you mentioned you had a car accident rate two months ago? P: Yes, that was. Yeah, that was two months ago. D: OK and then. Were you in the hospital, admitted to the hospital for for a while, or how, what happened in your treatment? P: Yeah, I was. I was taken to the ER. They did like a full work up on me. The only thing on my back that they found was a slipped disc and then they said that should that shouldn't cause me too much pain. But if I was having any of these symptoms that I'm having now I should go back, or see a doctor at least. And and otherwise I was fine like I didn't lose a lot of blood or I didn't need any surgical interventions at that point. D: OK, I see. And have you been having any other symptoms or any any pain in any other joints or muscles? P: Uhm, No, no, nothing like that. D: OK, any fevers or chills. P: No. D: Any night sweats? P: No rashes or skin changes. P: No. D: Any kind of chest pain short of, ah sorry shortness of breath? P: Um no. D: Any cough or cold like symptoms? P: No. D: Uhm, any so you have some urinary incontinence, any fecal incontinence? P: No. D: OK, how's an any recent changes in your weight? P: No. D: Have you been sick at all recently? P: No. D: OK, any tingling sensation either in your back or shooting down your legs? P: No. D: Any burning sensation? P: Little bit of burning sensation. D: Yeah OK do you have any numbness in your lower limbs or just numbness around the groin? P: Just numbness around the groin area but my lower limbs do seem weak. D: OK so you have muscle weakness. Is it just one like that's ah weak or both legs? P: So both like seem weak but the right more than the left. D: OK, I see. Uhm, and does this weakness seem to get worse, or is it around the same as it was when it started? P: It's it's it feels like it's getting worse. D: OK, do you have any past medical conditions you have been diagnosed with? P: I had hypothyroid, so I've been taking Synthroid for that. D: OK, any other medications? P: No. D: OK, any allergies to any medications? P: No. D: OK. Any hospitalizations or previous surgeries? P: No. D: Any family history of any musculoskeletal or rheumatologic conditions? P: Um no. D: OK. Currently, do you work? P: I do. I work from home right now, I'm a teacher. D: OK, uh. And do you, did you do any work previously that required heavy lifting or strenuous activities regarding your back at all. P: Um no no, nothing like that. D: And what's your home and living situation like right now? P: I live at home with two of my children. D: OK. And are you able to do things at home that you were before look like, or do you need some extra help from it, your family members, or extra help from other workers. Anything like that? P: Yeah, my family's definitely been helping me out a lot over these past few weeks because. Yeah, like I said, like I'm having some weakness in my legs. I can't move around as much because I'm in so much pain. Um and then like there are all these like bladder accidents so. Yeah, they've been helping me out with everyday things. D: OK, I see. And currently, do you smoke? P: No. D: OK, do you drink alcohol? P: No. D: And any recreational drugs like marijuana? P: No. D: OK. I'm just getting at you to do a few things on just just as part of the physical examination. P: Sure. D: Are you able to bend down or extend your back at all, or is it too painful? P: Yeah, I can't do that. It's too painful. D: Do you notice any kind of redness, swelling in and around your back? P: Um not that I can tell. D: OK, and how about if you press down on the your lower back, does it hurt? P: Yeah, that hurts. D: OK. And are you experiencing the numbness right now and in your groin area? P: I am. D: Are you able to raise your legs when in a lying position with straight legs, knees not bending at all, they are able to raise without any pain? P: No, I can't do that. It's yeah, it's too painful. D: I see, alright, so those are all the questions I had for you so it seems. It's great, it's good that you came to the emergency Department. Do you have any questions at all? P: No, just like how can I fix this? D: Yeah, so based on your symptoms, it's something that's pretty urgent. It's seems like you may be having something called cauda Equina syndrome that may be caused by your back pain and that's why you're feeling that groin would be called saddle anesthesia and then the urinary incontinence. So this may be from the injury that you had with the car accident. And it may be due to some compression of what we call like compression of the nerves in the area which might be giving you some of these symptoms. So the first thing we do need to do is get an MRI of your lower back just to make sure there's nothing going on like for example, like any masses in the area or any kind of abscesses that might be. We may be worried about just to make sure. Well, just to see what's going on in there that's causing these symptoms. And then based on what we find, uh, we will, we will target like the cause of the symptoms, like for example if it's an infect infection that's causing this, you might need to be admitted and require antibiotics. If there is any masses causing it, you may require surgery. For example if it's mainly related to your back it is something that we will have to treat with with an admission so it's good that you came in here today. Do you have any other questions or concerns? P: No, that was it. Thank you so much for your help. D: You're welcome and will get back to you shortly.
dataset\resampled_file\RES0014.wav	D: What brings you in today? P: This afternoon, I'm just here because I've been experiencing some breathlessness as well as a bit of cough. D: OK, when did it start? P: So I think it's a it started around three months ago and I believe it's just been getting worse. D: OK. Um, how often are you experiencing the shortness of breath? P: I feel it like a lot of the time, especially outside when I'm in the cold or at at night when I go outside at night, my chest feels a little tight too at the same time. D: OK, and how long does it last? P: I would say it lasts up to an hour every time I'm out in the cold and then once I come back in. So I'd say it lasts at least one hour. D: OK, does anything else make it worse, like dust? You know, laying down anything like that? P: Sometimes when I'm near dust, sometimes when I'm running during gym class, increased activity does make it worse. D: OK, OK. And if you were to describe the quality of your breathing difficulties, is it more like a burning kind of feeling? Is it like you can't catch your breath? What does it feel like? P: I think it's more just a I can't catch my breath and it feels like my my throat is just kind of like closing off and I can't take deep breaths. D: OK, yeah, that's scary. And one to 10, 10 being the worst, how bad is your shortness of breath? P: It can get up to I would say like an 8 at times. It can get pretty scary. And sometimes, like I feel like heaviness in my chest too when it happens. D: Yeah, and the coughing, has it been going on for as long as your breathlessness? P: I would say around the same same time frame like 3 months, but I'm not always coughing. It comes and goes. D: OK, and for your coughing, is it kind of like the same triggers, the cold, dust, things like that? P: Yeah, I would say so. D: And do you ever have do you ever cough up blood? P: No, I don't. It's mostly just a dry cough. I don't cough up anything. D: OK so no sputum or phlegm, no? OK, do you ever feel wheezy? P: I I I do hear like a like a weird sound when I breathe out sometimes, I I think it might be wheeziness. D: OK, OK. Do you have a sore throat? P: Uh, no I don't have a sore throat, no. D: No? Um, how about a runny nose or stuffy nose? P: No, nothing like that. D: Any changes in your smell? P: No, no changes in my smell, no. D: OK. How about hearing? P: Uh, no hearing is fine. D: OK and like no pus or liquid's coming out of your ear or anything like that, right? P: No. D: No ear pain? P: No. D: OK, and how about your vision, everything OK there? P: Yeah, everything is OK. D: OK, any fevers? P: I don't know about a fever, I haven't checked, but some nights I do, especially in the last week I have woken up feeling a bit chilly. I haven't really checked. D: OK, so you woke up feeling chilly, any night sweats? P: Uh no. D: OK, any weight loss? P: No no. D: How about changes in your skin? Like have you noticed a rash anywhere? P: Uh, not that I've really noticed no, no rashes. D: OK and any chest pain at all? P: No, just sometimes when I I'm coughing a lot I feel a little bit of just tension and heaviness in there. But that's just when I'm like really coughing a lot. D: Yeah OK, and any any feelings like your heart's racing? P: Nope. D: No? OK. And how about swelling? Have you noticed swelling anywhere in your body? P: No, nothing like that. D: No? OK um, OK, how about um, does your shortness of breath get worse when you're falling asleep? P: No, nothing like that. I think it's mainly just worse if I go out in the cold or I'm like running around, doing more activities. D: Does it ever wake you up at night? P: No never. D: OK and any nausea or vomiting? P: No, no nausea or vomitting. D: OK, how about changes in your in your bowel movement? P: No, bowel movements are normal. D: How about in terms of urinating, any changes there? P: No no. D: OK any headaches? P: No. D: No? Any dizziness or fainting spells? P: No. D: Confusion, memory loss? P: No, nothing like that. D: OK, good are you otherwise healthy? P: Yeah, I don't have any other condition, I I do remember my doctors saying I have hay fever before, but that's about it. D: When was that? P: I think that was like more than three years ago. D: OK, um, any recent surgeries? P: No. D: No? Are you on any medications? P: I just take some Tylenol sometimes for the like Tylenol cold, sometimes for the symptoms. I don't think it has really helped. D: No? OK, do you have any allergies? Not just to medications, but to anything else? P: Uh just like hay fever but nothing, nothing else that I can think of, no. D: OK. Um, are you up to date with all your immunizations? P: As far as I know, yeah everything's up to date. D: OK, any family history of lung conditions? P: Uh, don't think so. My sister, I think she they were saying she might have asthma and she also has eczema. No one else in the family has any other conditions. D: Not not even like heart conditions, cancer? P: No, uh no, not that I know. D: OK, OK, have you been in contact with anyone who's been sick recently? P: No. D: No, OK, and any travel recently? P: No, I've been here in Ontario. D: OK, and where do you live? P: So I currently live in London, but I just recently moved into a new flat around two months ago. D: Two months ago, OK. Um, is it more is it an older flat? P: Uh, no, it's fairly new. But one thing I did notice, I don't know if this has anything to do with it, but my flatmate actually smokes. Sometimes that can really irritate and make me cough more sometimes at night. D: Yeah, any any pets? P: Oh no, I don't have any pets. D: OK and and do you smoke? P: No, I don't smoke, no. D: OK. And do you smoke marijuana? P: Nope, never tried marijuana. D: OK, any recreational drugs? P: No, I don't smoke marijuana or cigarettes. D: OK, how about alcohol? Do you drink alcohol? P: Um, just like, maybe sometimes at parties, but very rarely. Maybe I would say once a month. D: OK, OK. Um, and is there anything that you wanted to discuss today that I missed? P: Uh, so no, I think that that was all like just the shortness of breath was scaring me a lot. But yeah, just the coughing, but other than that I just want to know what's going on. D: OK, yeah, and you mentioned you are otherwise healthy so you don't have any history of asthma or anything like that, right? P: No, no ones ever told me that, but my sister has asthma, so I was wondering, maybe? D: Um, have you ever experienced shortness of breath when you were younger with like exercise? P: Uh, not really. Just maybe like the normal amount. Like if I'm running around too much, I feel shortness of breath, but I think it just got worse over the last few months. D: OK and then have you ever had any imaging done in the past like a chest X-Ray or investigations like a pulmonary function test? P: No, I don't recall having any of that done. D: OK alright well those are all the questions I had for you. If you didn't have anything else to add, I guess we will conclude by saying that what you have, we have a differential diagnosis for this. Um, it sounds like what you have is asthma. Since your symptoms started three months ago when you moved into a flat with your friends, and it seems like this smoking and cold is triggering that and so we'll work you up with a pulmonary function test to start and we'll see if bronchodilators will help with your symptoms. And if it doesn't, we'll also rule out other things like pneumonia or like allergic rhinitis. How does that sound? P: Yeah, that sounds good. D: OK, sounds great. Well, we'll see you soon then. P: Alright, thank you. D: Take care. P: You too.
dataset\resampled_file\RES0009.wav	D: To start, could you tell me a little bit about what brought you in today? P: Really I just don't I I don't feel quite right like I've had this pain in my chest for five days now and I've been just feeling kind of out of breath. D: Oh OK, um where are you feeling this pain? P: Um, it's it's kind of um. On the left side of my chest and it's just like a tiny. It's like a lingering sharp pain. I don't really feel it anywhere else. It's just kind of there all the time right now. I I've never had anything like this before. D: OK, so you're not feeling the pain radiate any to any other locations. You're just feeling it sort of in the one spot on the left side? P: Yeah, yeah, exactly. D: OK, and since this pain started 5 days ago, has it gotten any better, any worse, or stayed the same? P: Like when I when it started I was just I was just like sitting on my couch. Um and now it's harder if I'm, it's worse if I'm walking around, like if I walk just down the street to get the mail. But otherwise it's kind of kind of just there, like I took some Tylenol and Advil, and they maybe take the edge off a little bit, but it's always there. And it's worse when I, when I take a deep breath then I really feel it. D: OK, so it's worse. Is the pain worse when you're walking as well? Like out to get the mail? P: It's I don't the the pain is, but I I'm not I can't catch my breath when I'm doing that. D: OK, and how far could you usually walk, or um? P: Oh yeah, usually walk before I go for long walks like every day, like probably like 5 kilometers or something. D: OK, so prior to this happening you were feeling well? P: Yeah, totally. I've not ever had any problems with my heart or lungs or anything. I thought it was maybe just like a chest infection. But I I don't know anymore. D: OK, so you've had that, the difficulties breathing and the pain. And have you had any other symptoms? P: Mmm I think it's just those those, the two things that I said. D: OK, so have you been experiencing any fevers or chills? P: No. Nothing like that. D: OK, how about any nausea or vomiting? P: No. D: OK, and um, how is your energy been? Have you experienced any like significant fatigue? P: Um. Not. Well, I mean, I've been doing less stuff because it's harder to breathe like I'm getting kind of like I can't catch my breath. So I guess maybe maybe a little bit like fatigue. D: I see OK, but feeling fine energy-wise prior to the two 5 days ago? P: Yeah, totally. D: OK, uh and, have you been having any night sweats? P: Uh, no, no I haven't. D: OK, how about any unusual headaches? P: No. D: Alright, and have you felt as though your heart is racing or beating out of your chest at all? P: No, no, it's just that like sharp that sharp pain. D: OK, have you had any episodes of lightheadedness or feeling like you, you might might faint? P: No, no, just the difficulty breathing that scares to me, but it hasn't been like that. D: OK, have you had a cough? P: No, no, that's the thing, that it seems weird, right? D: OK, um sometimes things can be associated with a cough so we'll absolutely look into what the causes of your symptoms are today. But you haven't brought up any any blood or any sputum? P: No no. D: OK, and have you had any wheezing with your with your breath? P: I don't know. I don't think so. D: Alright, and how about any abdominal pain? P: No, I mean the pain is like, yeah, it's in my chest. Yeah, that's not in my it's not in my belly at all. D: OK, and have you had any urinary problems? P: No, I mean so I had. I had a I had a hysterectomy. Weeks ago, maybe like maybe like a month ago now, um? So after that it was, you know, feeling a little. Like I was kind of not drinking as much and that so I wasn't peeing as much then, but I think it's normal now. D: OK um. And how have you recovered since the hysterectomy? Were you like bedbound for quite awhile afterwards or were you up an active? P: Really, it was not really long that I may be a few days, I wasn't. I wasn't walking as much, but I thought it was like back to my normal self. D: OK, well that's good. I'm glad that you recovered from that surgery quickly. And what was the surgery for? P: Uh, I uh. I mean I, I'm done having kids and I, uh, I had. I was just having really heavy periods still so, uh, and you know a lot of pain there, so hat's why I had hysterectomy. D: OK, um, and have you had any bowel problems? P: No no. D: OK, how about any skin changes or or rashes? P: No. D: OK, how about any joint pains or or leg pains or muscle pains? P: Uh, no, I don't think so. D: OK. Um, so in regards to past health, any previous medical diagnosis? P: Uh, no. Just like I had the hysterectomy but I I don't like take any medications I don't have like high blood pressure or anything. D: OK so no prescription medications or over the counter medications you take regularly like supplements or? P: No, just just to those like the Advil and the Tylenol I was taking for the pain. D: OK. And any other surgeries besides the hysterectomy? P: Uh, like I have my wisdom teeth out when I was like a teenager. That's it though. D: OK, then, how about any allergies? P: None. D: OK, and are your immunizations up to date? P: I think so, um. Yeah, yeah I don't. Yeah, I don't think, I didn't get anything that was supposed to. D: OK, well, that's good. And, uh, has anybody in your family experienced anything like this before? P: My mom had a heart attack when she was like in her 70s. Uh. Other than that, I don't. I don't know. I don't think so. D: OK, any, um, cancers in the family or or bleeding disorders or coagulations disorders? P: Um, no, I don't think so. D: OK, so I haven't heard of anybody in the family having like a blood clot, or or a thrombosis anywhere? P: I think my mom's like cousin, but not no one like not like my parents or anything. D: OK, um, so the next few questions I just wanted to ask about your personal and kind of lifestyle habits a little bit. But first, could you tell me about your living situation? P: Uh, yeah I live. Um, like I said like I'm done having kids but I have 2 two kids. They're teenagers. I live um, with them and my husband and, uh. We live not far from here. D: OK, and what do you do for work? P: Um, Im an accountant. D: OK, and do you drink alcohol? P: Um maybe a glass of wine on like the weekends but? Not other than no. D: OK and do you smoke cigarettes? P: I do, I'm trying to stop. I smoke maybe like. I don't know like 5 per day or something at this point. D: OK, but it sounds like you've been working on cutting down which is great. Um and have you used any other recreational drugs? P: Um, no, no. I mean, when I was like younger I sometimes like would use marijuana, but I haven't really recently. D: OK, and have you been any been on any like long trips recently? P: No I wish. D: Fair enough, vacation would be great. Um, OK so. But that was all the questions that I wanted to ask on on history, were going to run some investigations. I am concerned that you might have a pulmonary embolism, and so we're going to do some lab work and imaging to investigate that. P: OK I yeah. Is that scary? Is that bad? D: It can vary from being mild to severe, and so that's what we want to get. Some of the imaging and lab work to see well to first confirm if that's what you actually have, and if so, offer the right treatment. P: OK thanks doctor. D: Welcome will get that started.
dataset\resampled_file\RES0088.wav	D: Uh, what brings you in here today? P: Yeah, so my daughter, she's had this hoarse voice for the past like two or three days. It doesn't seem to be getting better. In fact, it's getting worse and she just doesn't sound like herself anymore and she's not speaking as much. D: OK, and when did this start? P: OK, so she had a cough like four days ago, and she's still coughing a little bit, but not as much as she was before, but it's more her voice that I'm concerned about. It sounds very hoarse and harsh. D: OK, and so how many days has she had the hoarse voice for? P: I'd say about two or three days now. D: Two or three days, OK. And when she was coughing, you mentioned like previously was she coughing up any sputum or was it more of a dry cough? P: It was more of a dry cough D: And the cough has pretty much resolved by now? P: Yeah, she still gets them once in a while, but yeah, it's pretty much gone. D: OK, and when she was coughing, did she at all bring up any kind of blood or any green or yellowish material? P: No D: No, OK. Did she have any fevers at all, recently? P: Uh, no, no fevers. D: OK. And does she have any kind of, uh, along with a hoarse voice, does she have any pain with talking? P: Yes, I think so. D: OK, and does she have any pain with swallowing any foods or liquids? P: She's eating and drinking ok, but I suspect there is some pain. D: OK, So how long has she, so she has a sore throat, how long has she had that for? P: The sore throat? Uhm I would say for the past two or three days as well. D: OK, and was there anything that, so she had kind of like a cough previously, but anything else, anyone sick around her, or anything you think might have precipitated some of her symptoms? P: No, not that I know of. I don't think she's had any contacts with sick people recently. D: OK. Are there any, have you tried any medications over the counter, that has helped her? P: Uhm, not over the counter medications, but like I tried to get her to like gargle with like salt water and all that kind of stuff, but that didn't seem to help. D: OK. And have her symptoms been just constant or do they come and go? P: They've been pretty constant. D: OK, and you think her symptoms are getting worse? P: Uh, no, they've been pretty consistent, but maybe the harsh voice is getting worse. D: OK. And other than the symptoms that you've mentioned, has she had any kind of shortness of breath, wheezing, chest pain or anything like that? P: No, nothing like that. D: OK, and no fevers, right? P: No D: OK. Has she traveled at all recently outside of the country or outside of the province? P: No, no, nothing like that. D: OK, and any headaches at all? P: Uhm, no. D: No, any nausea or vomiting? P: Uh, no, nothing like that. D: OK, any runny nose or congestion? P: No. D: No, OK. And have you had a chance to at all, look into her mouth and throat? And if you have, have you noticed any kind of redness, swelling? P: I haven't looked in there too much, like, just an inspection the other day, it looked a little bit red, but I didn't see any discharge. D: OK, and have you noticed any kind of swelling around her neck, ears, like, around her lymph nodes? P: Uhm, I haven't actually taken a look there. D: OK, we can do that. Other than those symptoms, has she been experiencing any kind of like fatigue or have you notice her being just very tired? P: Um, she has seemed a little bit more tired than usual. D: OK, and right now is she going to school or is right now all like virtual? Is she at home? P: Uhm, she's at home right now. D: OK, and does she have any symptoms of, any chest pain at all? P: No chest pain. D: OK, any changes in her bowel movements, any Constipation, diarrhea? P: No. D: OK, any urinary problems? P: No. D: OK, has she been able to sleep well or does she wake up a lot more at night? P: Uhm, she's been able to sleep well, yeah D: OK, how about her appetite? P: Its been pretty normal. She's not eating as much as she used to, but she's still eating and drinking ok. D: OK, and have you noticed any kind of weight changes at all recently has she lost any weight? P: No D: OK, and, has she had any loss of taste, of smell or sorry, loss of sense of taste or smell at all. P: Uh, no. D: Any muscle aches or anything like that? P: Uh, no, nothing like that. D: OK, any exposure to fumes, dust, animals or Pets at Home? P: Uh, no, nothing like that. D: OK, has this happened at all in the past? P: Uhm, no. D: No, OK. Does she have any medical conditions at all that she's been diagnosed with in the past? P: Uhm, no, nothing like that. D: Any like asthma or any other conditions? P: No. D: OK, any allergies that you know of? P: I know she has seasonal allergies, but that's about it. D: OK, and does she take any medications at all on a daily basis? P: Uh, no, she just takes multi vitamins. D: OK, and currently or previously has she had any surgeries or hospitalizations? P: No. D: No, OK. Are there any family history of any lung or heart conditions? P: Uh, no. D: Any cancers? P: There's some colon cancer on her dad side of the family. D: OK, and is there any, so do you remember who the person is and also like when they got diagnosed with the colon cancer? P: So it was her uncle. He was diagnosed when he was forty five. D: OK, other than that, were there any developmental challenges at all while she was growing up? Did she, was she meeting her milestones? Any concerns at all? p: No concerns, she was meeting all her milestones from what I remember. D: OK, and uh, in terms of her pregnancy, were there any, or your pregnancy with her, were there any complications at all either during the pregnancy or after she was born? P No, no complications. D: And right now, where does she live, and who does she live with? P: she's at home with myself, my husband and she has one younger sibling. D: OK and, is everyone at home well, does anyone have any of these symptoms? P: No, OK. D: Right, so, and in terms of the home environment, does anyone smoke in the house? P: No. D: No OK, alright so I think that's all the questions I had right now. Do you have any questions or concerns? P: No, no questions, but uhm, actually, what do you think she has and how can we treat her? D: Yeah, so it seems like that the hoarseness of voice and the sore throat and her symptoms mostly align with what's called laryngitis, and this is usually caused by like just a viral respiratory infection. The hoarseness of voice will usually last more than a week and up to like ten days and it should resolve on its own. But we'll definitely take a better look and do a proper physical examination, see if I see any kind of swelling, redness, or any like white streaks or exudates around her pharynx as well. So after we take a look, we'll see what we can do. It doesn't seem like, it can also be a bacterial infection, in which case we would need to give her antibiotics, but usually it's a viral infection that should go away on its own. So we would just kind of wait and see and potentially just give her voice some rest during this period, and just go on from there. Do you have any other questions or concerns? P: Uh no, that sounds great, thank you. D: You're welcome and yeah, we'll, just do a full examination and then go from there. P: OK, sounds great thanks. D: You're welcome. Take care. P: You too.
dataset\resampled_file\RES0072.wav	D: So what brings you in here? P: Yeah, I've had this sore throat. It started, really, yesterday and I've been having problems with eating and drinking. D: OK, so it just started yesterday. Has it occurred before? P: Not this painful before. D: OK, are you were having any trouble swallowing just solids or liquids as well? P: It hurts to swallow both. When I have something really cold it helps, I mean, it's easier to drink, but it still hurts. D: OK, and are you having any other symptoms besides the sore throat? P: Yeah, I've been nauseous and I vomited a couple of times. D: OK, just within the last day? P: Yeah, this is over the last day. I vomited three times yesterday and once today. D: OK, and uh, what was the color of the vomit? Was it just food that you had eaten? Or was it green? Can you describe it a little bit? P: Yeah, so the first two times it was more of what, like, the food that I had eaten and then the last two times it's been more yellowish green, cause I haven't really eaten much since yesterday afternoon. D: OK, and did you notice any blood in it at all? P: No blood. D: OK, and do you have any idea what caused the nausea or vomiting? Was it after eating? Or, like, were there any triggers? P: I think the first time was associated with like, after eating, but I'm not sure about the other ones. D: OK, and with your sore throat, are you having any kind of like a gag reflex or anything like that? P: Yeah, maybe a little bit, maybe that's what prompted it. D: OK. And has your sore throat been just constant or does it come come and go? P: It's been pretty constant, yeah. D: And how much would you rate the pain out of 1 to 10? 1 being the least pain you've felt in your life, 10 being the worst. P: Uh, I would say, uh, a 6, it's pretty painful. D: OK, um, have you noticed any kind of like swelling around your neck? Or any redness in your throat? P: Yeah, I felt my neck this morning in the front of it, it does feel swollen. D: OK. And are you coughing at all? P: No, I haven't had a cough. D: OK, so no cough but are you producing any sputum or yellow material? P: No, nothing like that. D: OK, are you coughing up any blood at all? P: No. D: Is there anything that makes it better or worse that you have tried? P: Just cold drinks. D: OK. And, uh. So you've also had nausea and vomiting. Are you having any kind of diarrhea or Constipation? P: No, but I've had a sore stomach. D: OK, and did that also start yesterday? P: Yeah, it's just been, like, fairly generalized. Feels sore. D: OK, so not in any particular area, just kind of all over your stomach? P: Yeah, like, I mean, I guess sort of like in the center, more so, but I can't really put one finger on the spot. D: OK, and is it constant or does it come and go? P: It kind of comes and goes. D: OK, and uh, is it associated with eating food at all, or does it get better when you defecate? P: I haven't noticed anything like that, maybe it's worse after vomiting, those few times. D: I see OK, yeah. So yeah, sometimes with the vomiting you can also get some some discomfort. So no diarrhea or Constipation though, right? P: No. D: Uh, so are you having any other symptoms like shortness of breath or chest pain, or like a runny nose? Any any of those symptoms? P: No, nothing like that. I've just had a headache as well, but it's pretty mild. D: OK, have you tried any medications at all, over the counter? P: yeah, I took a Tylenol cause I started feeling a little bit hot as well, to help me sleep last night D: OK, have you been having any fevers or chills? P: Yeah, I felt hot but no chills. D: And did you manage to get like a temperature at all? P: No. D: OK, we can do that here today. So you just felt like a bit hot last night? P: Yeah, last night I felt pretty hot, sweaty. D: OK, have you been in contact with anyone who's been sick, or any recent travel at all? P: I mean, not that I can think of. D: OK, uhm, so I'm just going to list a few symptoms just let me know if you have any of them. Do you, do you feel fatigued? P: No. D: Do you feel that you have any kind of swelling in your extremities, or any rashes or skin changes? P: No, I haven't noticed anything like that. D: OK, any changes in your urinary pattern? P: No. D: OK, any changes in your sleep or appetite? P: No. D: OK, any significant weight loss over the last month? P: No, my weight has been the same. D: OK, and have you, before this all started, have you had any like, Congestion, runny nose, or any other cold like symptoms? P: No, I've felt well otherwise. D: OK. Uhm, do you have any past medical conditions like asthma Or anything else? P: Uh, no. D: OK, so you're healthy? P: Yes. D: OK, do you have any allergies? P: No, I don't. D: OK, are you currently taking any medications regularly? P: No. D: Any previous hospitalizations or surgeries? P: No. D: Any family history of any lung conditions or heart conditions or any cancers? P: No, nothing like that. D: OK, and currently do you work? P: No, I'm just going to school. D: OK, and so, currently where do you live and Who do you live with? P: Yeah, so we live in a house with my parents and younger brother and we've been both back at school now Part time and doing some of it at home online as well. D: OK, so anyone at all that you notice at school that was sick around you? P: No, not that I am aware of. D: OK. So yeah, this is just a question that we ask everyone. Do you drink alcohol or smoke cigarettes or use any recreational drugs? P: Uh, no. D: Ok, so those are all the questions I had to ask you. Anything that I may have missed or anything you want to tell me? P: No, that's everything that's been happening over the last couple of days. D: OK. Alright, so yeah it seems that, from your age and some of your symptoms we will definitely do a testing for strep throat. It seems that you meet that criteria. And we also want to make sure that, since you're having other symptoms as well, just to do a covid test, just in case. We'll take your temperature as well, and we might give you some antibiotics as well to treat you and relieve some of those symptoms. So yeah, just hang tight, we'll get the swab done for you for the Covid test, as well as strep throat and then we'll go from there. P: Great, thank you. D: You're welcome, take care.
dataset\resampled_file\RES0064.wav	D: What brings you in? P: My child has been having a sore throat and chills yesterday as well. D: OK, so you mentioned the sore throat started three to four days ago and the chills started yesterday. And is he having any issues swallowing food or fluids? P: Yeah, it seems like appetite's gone down, like a lot of pain in his throat, especially when swallowing solid foods. D: Have you taken a look into his throat? Is it red? Do you see any yellow streaking white stuff, anything like that? P: I definitely did take a look yesterday and definitely saw a lot of redness. I don't know if I saw any white or yellow streaks, but definitely looks very red in there. D: OK, do his tonsils look enlarged? P: Uh, everything looks swollen in there, I don't know what's what, but it does look very angry in there. D: OK, OK. And has he had a stuffy nose or runny nose? P: No, not really, no. D: Any loss of taste or smell? P: No, nothing like that. D: OK, how about changes in vision or hearing? Any changes in her nails or skin like rashes? P: No, no rashes. D: OK. Have you taken his temperature at home? P: No, I think he might have had a fever yesterday, but we didn't really take a temperature. D: OK. And, any fatigue or exhaustion? P: Energy's pretty much the same, just really complaining a lot about the throat. D: OK, OK, have you noticed any swelling in in the neck area? P: Uhm, I think there might be like a few lumps near his neck, so I don't know if that's swelling, but definitely there is. There's a few that I felt over the last few days. D: OK, coughing? P: No, hasn't been coughing at all D: OK, um, and how about shortness of breath or wheezing? P: No, nothing like that. D: Chest pain? P: No. D: Feeling like his heart is racing? P: No. D: Swelling in his limbs? P: No. I haven't noticed anything like that. D: OK, dizziness or fainting spells? P: No. D: Headaches? P: He was complaining of a headache a few days ago, but it kind of went away on its own. D: OK. So the headache's gone completely now. P: Yeah, yeah. D: OK. Have any confusion or memory loss? P: No, not that I know. D: Joint pain or muscle aches? P: No. D: OK, how about his bowel movements? Have those been normal? P Yeah, they've been normal. No diarrhea or constipation. D: OK, how about in nausea or vomiting? P: No, no, he hasn't told me anything about that. D: Any appetite changes? P: Yeah, just with the trouble swallowing I'm trying to make sure that he gets like liquids because over the last few days he can't tolerate like solid foods at all. D: Yeah, how about a weight loss over the past few weeks? P: No, not really. t's just been over the last few days that he hasn't been eating like himself. D: OK. Alright and has he been healthy otherwise? P: Yeah, otherwise he's a very healthy child. We have rarely gone to a doctor for him before, so yeah, nothing. Nothing else with him. D: OK, have you tried anything for his sore throat? Anything over the counter? P: We did try, uh, like Tylenol cold. It helped with this headache, but it didn't really help with his sore throat D: OK, and has he ever experienced anything like this in the past? P: No, not that I know of. D: OK. Any hospitalizations or surgeries in the past? P: No. D: Any medications that he's on? P: No, no medication. D: OK, is he up to date with all his immunizations? P: Yeah, all his immunizations are up to date. D: OK, any allergies? P: No, not that I know. D: OK, family history of lung conditions or heart conditions? P: No, no lung or heart conditions. His father does have diabetes though. D: OK, how old was he when he was diagnosed with diabetes? P: I think probably in his late 30s with type 2 diabetes. D: Type 2, OK and then any sick contacts recently that he may have had? P: I don't think at home at least, uh, but maybe at school, like you never know who they are in contact with, so I'm wondering if he just picked it up somewhere from school. D: OK. P: Yeah, yeah, they're all wearing masks right now, but I don't know if he picked something something up from his classmates. D: Yeah for sure. OK, and then any travel to anywhere recently? P: No, we've been at home, haven't left even to go to like a different city, have been in London the whole time. D: OK, yeah, and who does he live with at home? P: So he lives with myself and his dad. D: Any siblings? P: No, he's an only child. D: OK, any reason to believe you have old carpets, mold, asbestos, anything that could be triggering his symptoms? P: You know we don't have any pets. We don't have any like old carpets, it's a fairly new apartment, so I don't think any of that should be an issue. D: Okay, well, I think those are all the questions that I had for him. Anything that you wanted to add or anything that I missed today? P: Uh, no, I think those are everything I wanted to talk about but I just was wondering if he needs to get tested or like if there's anything we can do today for him. D: Yeah, so he does seem to be checking off some of the criteria for strep throat. So just to make sure, because he does have a score of right now at least three or four, or maybe even five, definitely over four, we can prescribe him some antibiotics. But we will do a rapid strep test first in the clinic here today just to rule out in or rule that out. If it comes back positive and I guess even if it isn't positive because he checked off a lot of the boxes for strep throat, we will give him a prescription for penicillin or amoxicillin for 10 days. And then you can take that if his symptoms don't go away in a day or two. Because his symptoms also overlap with COVID, we will. do a swab for that as well and you should hear back within 24 to 48 hours and then you should isolate for 14 days. Does that sound good? P: Yeah, that sounds good. D: OK, great thank you. P: Thank you.
dataset\resampled_file\MSK0050.wav	D: How may I help you? P: Um I'm here because I've had some numbness in my right hand and uh doesn't seem to be going going away, so I thought I should get it checked out by you. D: Yeah, certainly so, so when did this exactly start? P: Um so it's been pretty gradual, I would say over the past month or two months um is when I first noticed it, but the numbness is definitely worse now than it was at the start. D: OK, and uh where is this um the pain and numbness, where are you feeling it exactly? P: Um it's particular, it's the worst on my thumb and index finger. D: OK, do you feel it on your ring finger or uh, or sorry or your middle finger? P: Um there is a little bit on my middle and ring finger, but it's like it's very very mild. D: OK. Uh, and uh, like how long, is, are the symptoms constant or or are they intermittent? P: Um I would say it's somewhat constant, but it's worse when um when I'm trying to like hold the steering wheel or using my phone, or you know, reading a book. D: OK, I see, and um is there anything that you do uh at those times, to try to help get the symptoms to go away? P: Um I guess I like shake out my hand um or yeah, try to put pressure on those numb, numb areas. D: OK, does flicking the the wrist or anything like that, does it help? P: Uh maybe slightly. D: OK. And uh like how would you describe the the pains in your hand, like dull, achy, sharp? P: I would say the pain is more like a tingling sensation. Um so I guess the tingling is is like a sharp feeling, um I wouldn't call it so much pain as I would just like tingling and numbness. D: OK. OK, and uh is is there anything, so you mentioned sort of the driving and using your phone, are there any other activities that make it worse? P: Recently I found it's hard for me to hold things um in my right hand, so like if I'm trying to open up a jar um like it's hard for me to hold it, and sometimes I find uh like it'll just fall out of my hand. D: OK, so you're like dropping items and stuff? P: Mhmm, yes. D: OK, and do you feel any, uh, like the numbness or tingling, does it radiate anywhere? Like to your forearm or up into your like upper arm or shoulder? P: Uh no, I don't think so. No. D: OK. And do you have any neck pain? P: No. D: OK, and have you had any trauma or injuries to your wrist or hand? P: No, nothing that I can think of. D: Alright. Um and, have you had any weight loss recently? P: No. D: How about any fevers or chills? P: No. D: Have you had any night sweats? P: No. D: OK, have you had any changes to vision or hearing? P: No. D: How about other senses like any changes to your sense of smell or sense of taste? P: No. D: Alright, have you had a runny nose or felt congested? P: Uh no. D: Alright, have you had a sore throat or a cough, perhaps? P: No. D: Alright, have you had any shortness of breath? P: No. D: Have you had any chest pain or feeling like you're uh like feeling like you have heart palpitations? P: No. D: OK. Have you had any lightheadedness or dizziness? P: Uh no. D: Alright, and have you had any nausea or vomiting? P: No. D: How about any abdominal pain? P: No. D: Alright, how about any urinary problems? P: Uh no. D: Have you had any changes to your bowel movements like diarrhea, constipation? P: No. D: OK, and have you had any changes to your hair or nails? P: No. D: And any skin rashes or um anything like that? P: No. D: Alright, and uh have you had any other pains in your joints or any joint swelling? P: No. D: OK. Uh, and have you been diagnosed with any medical conditions before? P: No, not that I can think of, yeah no, when I was younger I had like childhood asthma but nothing since. D: OK, do you use any inhalers now? P: No, not for a long time. D: OK, do you take any other medications? P: No. D: OK, um and how about, do you have any allergies? P: No. D: OK, and have you had any surgeries or hospitalizations? P: Uh no. D: OK. Um and, uh, could you tell me a little bit about uh where you're living and who you're living with? P: So um I live with my boyfriend and we live in a rented basement apartment downtown. D: OK. Um and are you working currently, or are you in school? P: Um I am a grad student. D: OK, excellent, and um do you smoke cigarettes? P: I don't. D: OK, and uh do you drink alcohol? P: Um I'll have a glass of wine once a week. D: Alright. Um and do you use any recreational drugs? P: Uh no. D: OK. And in the family, uh, are there any, is there a history of like hypothyroidism or other autoimmune conditions? P: Um there's rheumatoid arthritis in the family, but that's about it. D: OK, um but you don't have any other joint swelling or pains, right? P: No. D: OK. Uh, and so next I would like to just um uh do a physical exam, and for the first part I'll ask you to just have a look at the hand and wrist and, are you seeing any swelling, erythema or redness or like any muscle wasting or or atrophy? P: Um so, in my right hand, um I guess the you know the fleshy part of your thumb just above your wrist, um that seems to be um I guess atrophied compared to my left hand. D: OK so, OK, so the muscle bulk is um reduced there. P: Mhmm. D: OK, and are you feeling any temperature changes, like does the, any areas of the hand or wrist feel warm or hot? P: Um no. D: Alright. Um and are there any areas if you uh palpate that cause pain, like over the wrist or any of the joints? P: No pain. Um yeah, no pain. D: Alright, um and, are you able to uh flex and extend your wrist? P: Uh yeah I can do that. D: Alright, and and how about making a fist and and then also extending your fingers back out? P: That hurts, or like that causes the tingling. D: OK, um are there any any issues with like moving your elbow or your shoulder? P: No. D: OK, and if you take your opposite hand, um with just your uh kind of pointer finger and middle finger and just really tap, um right near the wrist crease called the Tinel's test, you tap there. Do you feel any reproduction of symptoms? P: Yeah, that that causes the tingling. D: OK, so you're positive Tinel's test, and um if you kind of place your wrist so that um like the backs of your hands are facing each other so that your wrists are flexed downwards and your um, your wrists are flexed and your fingers are pointing towards the ground and you just hold that position for a period of time. Um do you feel any pain? P: Uh I guess a little bit of tingling. D: OK, so that would be a positive Phalen's test as well. Um and range of motion of the neck, do you have any problems with that or any pain there? P: No. D: OK. Um I think that was everything I wanted to ask about and check on the exam. Did you have any questions for me? P: Um no, no questions. Thank you so much. D: Alright, you're welcome, yeah, so it sounds like this could be uh carpal tunnel syndrome and uh so we we may depending on uh kind of like nerve studies to confirm the diagnosis, and um things that you can do in the meantime would be to use like a splint or um yeah, try to use like nighttime splints and activity modification as well. P: OK, yeah, that sounds good.
dataset\resampled_file\RES0193.wav	D: What brings you here today? P: Hi, I bring you my son today because I've noticed he's had been having this cough sometimes he’ll have it at night and and, he'll have some wheezing and difficulties breathing as well. D: OK, and when did this all start? P: So I I've been noticing it over the last several months. It's been happening um a couple of times per week where he'll get this cough and that at night time and yeah so over the last several months. D: OK, and what did it start with coughing or like the shortness of breath? What would it kind of start with? P: Are more the, uh, the coughing, yeah, he just get it at night time and then sometimes he would get it um like it at at school as well. Or even if you went over to one of us, his friends houses, sometimes he would come home and or afterwards he would have a cough and wheeze and and be short of breath. D: OK, and so is it. Usually after he's worked himself up and like exercise or like just been really active? P: Yeah, that definitely. I noticed that after those times for for sure. D: OK, and are these like the coughing? Is it wet or dry? P: It's it's a dry cough. D: Dry cough OK, so no yellow green material or blood coughed up/ P: No, nothing like that. Uh coughed up. D: OK, and you're saying you also hear wheezing, right? P: Yeah, I'll hear a wheeze. He has this like high pitched whistling sound when he exhales. D: OK, and has he at all had this happen before? Or is this the first time this is happening? P: Um like when he was really younG I think like two he had like bronchiolitis or something like that. I think it was called you had a cough and um like a wheeze at that time, but I think it was because of a like an infection or viral a viral illness. D: I see. Um has he had any uh sore throat, runny nose, cold like symptoms at all recently? P: No, he hasn't had anything like that. D: OK, OK, so his symptoms mainly occur when he's very active um, so they kind of come and go, and have you tried it at all anything that has helped with the symptoms? P: No, I haven't tried anything. D: OK, any kind of dizziness, changes in his behavior at all from being very irritable to very fatigued? Anything like that? P: No, nothing like that. D: OK, um any fevers or chills? P: No. D: OK, any recent travel or contact with someone who's been sick. P: No. D: OK, any nausea or vomiting P: No. D: OK, any changes in his bowel movements? P: No, he hasn't had any diarrhea, so no diarrhea, no constipation. D: OK, and um any changes in his appetite at all? P: Um no he's been eating and growing well. D: OK any changes in his weight? P: Yeah yeah, he's been gaining weight uh over the last over the last little while. I think he's been gaining weight appropriately. D: OK, um do you find that his symptoms get worse in any particular season like the winter or anything like that? P: Um. I yeah. I mean sometimes I guess like in the in the fall or when the seasons change she does get like itchy eyes and like a runny nose. I think he does have maybe some environmental allergies. D: OK, OK, and at home or at school any exposure to like fumes, dust or animals? P: Um no animals at at home, but the friends house he goes over to sometimes they have um a cat there. D: OK and does does he get those symptoms at his friends house? P: Yeah, sometimes he'll come, he'll um he'll have a bit of a cough and you can hear a wheeze sometimes that after, it goes away uhh relatively quickly we like within 30 to 60 minutes and, but um yeah. D: OK. Any past medical conditions that he's been diagnosed with? P: No, he just had that yeah the episode of I think bronchiolitis when he was young, but that was it. D: OK, any um medications that he has to take regularly? P: No. D: No, any allergies, training medications? P: Uhm, no. D: No, or any allergies to any environmental or food factors. P: Uhm, no, I don't think so. D: OK, have you had any rashes at all previously? P: Uhm. No, yeah he hasn't had any rashes. D: OK. And um. Any hospitalizations or surgeries? P: Uh nope. D: OK. And any family history of any heart lung conditions? Any history of asthma at all? P: Um yeah, his mom has a has asthma um and she uses a an inhaler like daily for it. D: OK has, when did um the mom get diagnosed with asthma? Was it during childhood? P: Yeah, she was younger. Um ever since I've known her, she said she's had she's had asthma. It hasn't had any like real I guess exacerbations that that I've noticed or been able to control her symptoms with with um inhalers. D: And um for him, how many times would you say he's having these episodes in an average week now? P: Uh I would say 2. D: 2 and is he getting Any of these symptoms at night time, like him waking up? P: He is yeah it's it. It is happening at night. D: OK, and then as he missed any days of school due to this? P: Yeah um. He's missed a couple of days in the past month because uh he just didn't sleep well and then not feeling good the next day. So um yeah, he has. D: OK. Yeah, so and any issues with the mother's pregnancy with him at all? P: No, she's healthy and the delivery was at term with a normal body weight or birth weight rather and he he was healthy when he was born. D: So no prolonged stay in the ICU or hospital after that? P: No, he was able to go home, luckily. D: OK, and afterwards has he been meeting all his milestones like his motor gross motor, fine motor, social skills and growth and all of those have been meeting them well. P: He has, yeah yeah. He's been meeting all of his milestones and growing well. D: OK, and um any at all issues from the school in terms of learning difficulties or anything like that? P: No, he's been doing well uh in school. D: OK, that's good. Um does he have any siblings? P: Um no, he's a it it's just him. He's our only child D: And what's the home situation like? Who does he live with? P: So it's myself and my wife, which his mom, and so it's just us three and we live in a um in a house. D: OK. Uh, and anyone in the household uh? Does anyone smoke at all? P: No, there aren't any smokers in the home. D: OK, and any new carpets or any dust running or mold or anything like that in the house? P: That there is a carpet and in the basement that, he uses that as his playroom, sometimes D: OK. OK. Yeah, so those are all the questions I had. Do you have any questions at all? P: Yeah, I was just wondering like if this could be maybe asthma as well? D: Yeah, so definitely. That's something that's at the top of our head right now, especially due to his age and the symptoms that he's been having after exertion in particular. And the family history of asthma as well. So definitely that's something that we want to investigate. So what we'll do for him is first, we'll do like a full physical examination. Listen to his alongs. And just assess his breathing and then afterwards we will order some tests for him, so he's six years old, right? P: He is yes. D: OK, so we'll see if we can do something called a pulmonary function test. Sometimes it depends on the child if they're able to follow instructions, and so that test requires a completely breathing out and following some instructions during the test. So since he's six, he might be able to do that. We we can try that. And then afterwards we'll see if he requires anything like an allergy testing or we will we might need to help manage his symptoms with a puffer, for example, like Ventilin and an inhaled Cortico steroid, but those are just some discussions will have in the near future after we've done all these investigations. P: OK, great, thank you. D: You're welcome alright, take care P: Bye.
dataset\resampled_file\GAS0007.wav	D: So I understand you have been experiencing some abdominal pain? P: Yeah yeah stomach hurt, started hurting more last couple of days, maybe 3 days ago I think. D: OK, so for three days ago, for the last three days you said it's been hurting more. Did you have pain before that? P: It felt weird, like crampy. I just, I just thought I was constipated, 'cause I've been haven't been able to be able to go to the bathroom as well. I just thought I was kind of bloated a bit, but yeah, about about that time, started to feel a little bit more painful. D: Can you tell me kind of where you're feeling the pain the most? P: Yeah, kinda like near my right hip like lower where my stomach is that kind of right and below my belly button. Sometimes a little bit on the top just below my belly button, but mainly just in that right lower side yeah. D: OK, have you ever had pain like this in the past? P: No, never. D: OK. And for the last three days, has it been pretty constant? Has it been on and off? P: I feel it's been getting worse to be honest. D: Is there anything that you can think of this made it feel better? P: Honestly, just resting flat makes it feel a little bit better, but nothing much, no. D: OK, is there anything that makes it worse? P: Touching it. Also I puked the the other day and that made it definitely feel worse, just that whole contraction in my body was nasty. D: OK, was it just the one time? P: Yeah. D: OK, you had the nausea associated with the pain? P: Mhm, mhm. D: Um, did the pain stay in that same spot or does it move anywhere else? P: It has pretty much stayed in that one spot, yeah. D: Have you noticed any fevers lately? P: Felt a bit hot the other day, didn't take a temperature though. D: OK, OK, and what specifically prompted you to come in today to the emergency department? P: I thought it was just going to get better when it first started. Maybe just a bit of gas, but here we are kind of Thursday now and it's still pretty bad. D: OK, have you been in contact with anyone that's been sick lately? P: Not off the top of my head, no. D: And have you traveled anywhere recently? P: No. D: And I forgot to ask, did you notice any changes to your bowel habits? P: Yeah, yeah. Before it was fairly regular, about once a day. Five days ago, I started getting constipated, it backed up and pretty much the picture I think last time I went to the bathroom was two days ago I think, yeah. D: OK, I'm just gonna ask you some questions about your overall health. You have any chronic conditions that you see your family doctor for, or any other doctor? P: I got diabetes, type 2. D: And has that generally has that been well controlled for you lately? P: Most part, doctor checks my sugars. I'm not too regular on them myself, but last time he changed medications was a couple years back and I've just been on the same ones ever since. D: What medication are you currently taking? P: Metformin? Metformin. D: And have you ever had any surgeries in the past? P: No, I had my teeth pulled as a kid, but no. D: OK, still have your appendix? P: Yeah, yeah, I never had that problem as a kid. D: And do you have any allergies? P: No, sometimes get a little bit congested during the fall, but that's it. D: Do you have any family history of gastrointestinal problems? P: Gas, like no. I think my grandma died of breast cancer fairly early, but no, not not that not that I can think of. D: OK, and just in terms of your lifestyle, do you live here in town? P: Yeah yeah, I live here. D: Living alone or with family? P: No, no, I got family. Me, the wife, got two kids, one of them is college bound now but yeah. D: Nice, and what do you do for work? Or are you retired? P: I'm still working, I am a production overseer, production manager over at Fairbanks. D: OK, you're a big boss. P: It took awhile to get here. D: I'm sure it was very hard work. In general, do you drink alcohol? P: Oh yeah, like, well, plan on drinking on the two four but not regular, special occasions mainly. Hot days, sometimes I'll have a beer or two. D: Sure, and do you smoke cigarettes? P: No. D: Have you ever smoked in the past? P: No. D: Do you cannabis? P: No. D: Any other substances? P: No. D: OK, is there anything else you wanted to bring up today that I didn't ask you about or any other questions that you have? P: No, just hoping to get an answer to whatever is going on. D: OK, well at this point I will do a quick physical exam. We may want to have blood work done, maybe some other tests based on what we find out from there and then we can kind of let you know after that, what the next steps will be. So I'm just going to take this and go over it with the physician that I'm working with and will get back to you shortly. Thanks for chatting with me. P: Thanks doc.
dataset\resampled_file\RES0102.wav	D: What brings you in here today. P: I I've had this cough that's been ongoing and and getting worse, and and now I've been having this like sharp pain in my in my chest. D: OK, and when did the cough first start? P: So yeah, like the cough started, uh, started maybe a couple of weeks ago. D: A couple weeks ago, OK, and has it gotten worse since then, or has it stayed about the same? P: Uh it, it got worse initially, but it's been about the, uh, well, actually yeah, it's been getting worse 'cause now I've I've started to notice blood in the sputum that wasn't there at first. D: OK, and when did you first notice that? P: So I, I first saw some blood, uhm, two days ago. It was a really small amount so I didn't worry too much, but I I brought up blood yesterday and again this morning. It's been just about enough to cover a tissue, so it's not a lot of blood each time, but it's pretty red. D: OK, and before that were you getting any production throughout your coughs for the last few weeks, like were you producing any sputum? P: Uh, no. D: No, OK. Can you just describe your cough currently? Is it more of a wet cough or dry cough? P: Uh it, yeah, it's it's dry mostly with the exception of bringing up some of the blood. D: And is the blood just in like sputum that you're bringing up? Or are you coughing up blood into the tissue, for example? P: Blood is, I'm coughing that up into the tissue. D: OK, and do you remember 2 weeks ago prior to that, were there any factors that might have caused this, like for example, did you travel anywhere or see or was in contact with anyone that was sick? P: No I haven't uh, traveled anywhere. I have been doing volunteering and and things at the homeless shelter here in in town. It's been really cold out. D: OK, uh, and how long have you been volunteering there? P: Uh, I started this winter, so the last three, three or four months. D: OK, and were you in contact with anyone there that was sick or was having similar symptoms at all? P: There are certainly some people around that that had some that would have a cough, or were not feeling very well but, uh, and sometimes I would see people who would even have a hospital gown on, that that that uh came from the hospital. So yeah, there were definitely some people who weren't feeling well. D: OK, and do you know if anyone at the homeless shelter or anywhere else around your surrounding has had tuberculosis? P: No, not that I'm aware of. I haven't heard of that. D: OK, are you having any other symptoms at all besides the the coughing and the blood, like coughing up blood as well? P: Yeah, I've been uh, starting to get like this sharp chest pain as well. I kind of feel it on the left sides and in center I guess kinda more so. D: OK and your chest pain, when did that start? P: So, uh, this started, yeah, 'bout a few days ago as well. It's been within the last week. D: OK, and uh, would you describe it as, so you said it's kind of a sharp pain, does it move around anywhere? P: No, the pain I feel it about in the same spot each time. D: OK, and are you feeling the pain when you're coughing or is it when you're exerting yourself, like when do you feel the pain, and how long does it last? P: I, yeah, I will feel it when I cough. I also feel it uh, if I'm maybe moving around as well. Like changing positions or things like that. It hurts for a few minutes and then it it will kind of settle down. If if I'm, if I stay stationary and sort of lean forward a little bit it will it will start to feel better. D: Sort of feels better? OK, and besides, besides like leaning forward, has anything helped reduce that pain at all? P: Yeah, well if I lie flat, uhm it, it's uh, or sorry. No actually, the pain gets worse if I I lie flat or if I'm if I'm taking a deep breath in. But really, the only thing that helps the pain is if I try to lean forward when I'm sitting down. D: OK, I see, and do you have any pain when breathing in or out? P: I do, yeah it it gets worse if I if I'm taking a deep breath in, and even more so after I after I cough, if I'm trying to catch my breath, I'll feel it then too. D: OK, and uhm, other than these symptoms, do you have any kind of shortness of breath? Do you have any dizziness or increased sweating, any of those symptoms? P: I have been sweating at night, but, uh, yeah that's it. D: And how about any fevers or chills? P: I I have felt a bit hot. That's more so yeah, maybe when I've been having night sweats, but I feel OK now. D: OK, and when you say night sweats, are your sheets and blankets like soaked your pillows? P: Yeah, there there have been a few few nights for sure, but it doesn't happen every night. But over these last several months, it's been weird, I've woken up soaked. D: OK, uh, do you have any other symptoms like a headache or nausea, vomiting? P: No. D: Have you measured a temperature at all? P: Uhm no I haven't. D: OK, we can do that today. Do you have any other symptoms like feeling like pounding your chest, racing heart, anything like that? P: No, nothing like that. D: Have you noticed any swelling in your extremities, like your legs and hands? P: No. D: OK, and do you have any issues with your bowel movements? Any Constipation or diarrhea? P: No. D: Any urinary issues? P: No. D: OK, any issues with your sleep and appetite? P: Uh, no. Sleep's been OK, and I've been eating well, but I have uhm, lost some weight and and I've been more fatigued over the last couple months. D: OK. Before the two weeks or a couple of weeks that you had this, were you sick at all recently? Like with a cold or any flu like symptoms? P: No, I I uh, I guess I've been fatigued over the last couple of months, but I haven't had any flu like symptoms. D: OK, and do you have any exposure to dust, fumes, animals anywhere in your surrounding? P: I do have uh, two cats at home, but I've had them for seven years now and I've been tested for allergies and and I'm clear there. D: OK? Do you live with anyone right now? P: Yeah, I live with my husband and we have three daughters as well. D: OK, and are any of them sick at all or have any similar symptoms. P: Yeah, my my husband's had a cough uh, as well, he hasn't brought up any blood or anything though. But my my daughters have felt OK. D: OK, and do you have any past medical diagnosis like high blood pressure, diabetes, asthma, anything like that? P: Yeah I do have uh, type 2 diabetes, as well as high blood pressure. I've been diagnosed with depression before as well. I do take a few medications for diabetes and blood pressure. I'm not on insulin though. D: OK, and do you know what medications you take? P: I think an ACE inhibitor and, and I think Ramipril and uh, metformin. D: OK, and do you take anything for depression? P: I used to take a a citalopram, but I stopped and and things have been been stable. D: That's good. Any hospitalizations or surgeries in the past? P: I had two C sections for my second daughter and and 3rd. D: OK, any complications at all with those C sections? P: No, everything was was good. D: OK, any other surgeries or hospitalizations? P: No. D: OK, do you have any family history of any lung conditions, heart conditions, any cancers? P: My dad had a stroke when he was in his late 60s, but that's the only thing I can think of. D: OK, and I know you said you volunteer at the homeless shelter, but do you do anything else for work at all? P: Yeah, I've been doing some administrative work from from home because of covid, so with the extra time I've been trying to to do some extra volunteering. D: That's really good. And so besides, so you live with your husband and three kids, does anyone in smoke in the house or do you smoke at all? P: No, I don't. No one smokes in the house. D: OK, does, uh, do you take any recreational drugs like marijuana? P: No. D: And how about alcohol? P: Sometimes I'll have some like red wine with dinner, but that's only on like Christmas or an occasion. D: OK. Yeah, alright so uh other than that, sorry, I think I might have forgotten to ask you a couple questions. So no fainting spells, no shortness of breath, nothing like that? P: No, I haven't had anything like that, just a stern cough. D: OK, and no chest pain on exertion? P: No, it's the chest pain, well, I guess if I'm like moving around a lot, but it's not, it doesn't come on uh, like because of like physical activity. I just feel it like anytime I'm, like when I'm breathing in or even just moving my body around in the chair. D: And any like fatigue or increased tiredness. P: Yeah, I've had some fatigue for sure. D: OK, and have you lost any weight recently? P: Yeah, I I have actually. I'm I'm down 20 pounds. I thought that was great. I I was 200 pounds just two months ago. D: And have you been trying to lose weight or that 20 pounds just went away spontaneously? P: Uh, I mean I I guess I've tried to make changes to my diet here and there because of the diabetes, but I don't really think that it would be enough to lose 20 pounds. D: OK, I see. Yeah so, do you have any questions? Those are all the questions I have. Do you have any questions or concerns? P: No, I was just, I guess just concerned about the the blood in the, in the cough. D: Yeah, so definitely that's something concerning. We want to make sure there was no, so you work at a homeless shelter, where there may be a tuberculosis case, and your symptoms of coughing up blood as well as losing a significant weight recently, and some of the other symptoms that you described as well, point towards uh TB as one of the causes. No lung cancer history right, in your family? P: No. D: OK, uhm so we definitely want to do testing for TB. Will do us a smear today of your sputum and we will, since you have been in contact with your family, we will have to contact a public health if the tests come back positive, and it seems that, we'll also do some other testing. Sometimes with tuberculosis you can get something called pericarditis, and some of the symptoms you are having may point to pericarditis as well, so we might have to do an EKG. We might have to further do an ultrasound, an x-ray, for example. So first we'll just get the TB test done and then if it comes back positive, you will need to isolate, be admitted to the hospital as well, and be on a course of antibiotics. So I know this is a lot to take in. Do you have any questions or concerns at all? P: Not right now. Guess will wait until some of the results come back and yeah, get started. D: Yeah, so we'll just do the TB test first, alright? P: Alright, thank you. D: Welcome, take care.
dataset\resampled_file\RES0182.wav	D: How may I help you? P: Hi, yeah, I'm here because I'm over the past like couple of months I've been losing a lot of weight. Uhm, but I didn't really have any other symptoms, but since like 2 weeks ago I've been coughing up some blood and now I have a fever as well. D: OK, so you mentioned you notice the weight loss first. How much weight have you lost? Or roughly? P: I've lost about 30 pounds in the past, past like 8 months. D: OK. So, and have you been trying to lose weight? P: No. D: OK and, any, like any changes to your diet or exercise? P: No, nothing like that. D: OK, and more recently you started to have a cough. When did that start? P: The cough started two weeks ago. D: OK. And prior to this, did you have a cough? P: No. D: No. And are you bringing bringing up any sputum or phlegm? P: Uh yeah it's yeah, there's sputum for sure and it looks bloody. D: OK. So you're, you're, you're coughing up blood as well. P: Yes, that's right. D: OK, uh, and that's been going going on for the last two weeks too? P: Yes. D: OK. And how much blood have you been bringing up roughly? If you can think of it in like terms of tablespoons or teaspoons. P: Like every time I cough, it's about the size of a teaspoon. D: OK, and are there any triggers for your cough that you can think of? P: Uhm, I don't think so. They just happen throughout the day. D: OK, and have you tried anything for the cough? P: I tried this cough suppressants. I tried like salt water rinses, like just like at home remedies and over the counter products, but nothing is helping. D: OK. And so have you had any like viral infectious type symptoms, such as like eye, eye discharge or red eyes or runny nose or even a sore throat? P: No, nothing like that. D: OK. And, and have you had any any headaches? P: No, no headaches. D: OK. Have you had any, have you had a runny nose? P: No. D: OK, how about any, have you had any loss of smell or, or taste? P: No. D: OK, have you had any shortness of breath? P: Uh, no. D: Have you had any wheezing? P: Uhm, no. No wheezing. D: OK, have you had any chest pain? P: No. D: OK. Have you had any dizziness or fainting? P: Uhm, no, nothing like that. D: Heart palpitations? P: No. D: OK. And have you had any any nausea or vomiting? P: No. D: Have you had any abdominal pain? P: No. D: Have you had any diarrhea or constipation? P: No. D: Have you had any pain with urination or, or frequency? P: Uh, no. D: OK, have you had any rashes? P: No. D: How about muscle aches or body pains? P: Uhm, muscle aches, yeah. Yeah, that's been happening. D: Any particular muscles? Or is it more general? P: It's more general. D: Have, have you been having any bone pain like any in your back or anything like that? P: No. D: OK, and, uh, how has your energy been? P: Ah, pretty low. D: OK, and how is your appetite been? P: Uhm, also pretty low. D: OK. And in the in the past have you been diagnosed with any medical conditions? P: Uhm, no, I've been pretty healthy so far. D: OK. Uhm, so do you take any medications regularly for anything? P: No. D: OK. And do you have any allergies to medications or, or anything environmental? P: Uh, no. D: OK, and have you had any prior hospitalizations or surgeries? P: Uhm, no. D: OK. And, uh, could you tell me a little bit about your living situation currently? Like who you're living with an ah, whereabouts you're living? P: Uhm, I live alone by myself. I live in an apartment downtown. D: OK, and are you working currently or in school or? P: Um, I'm working from home right now. D: OK, have you been around anybody who's been sick? P: No. D: Have you traveled anywhere recently? P: No, not since I moved here. D: OK, when did you move here and where did you move from? P: I moved here a year back from Sri Lanka. D: OK. And, and in Sri Lanka, were any of your family members or people that you spent time around ever diagnosed with tuberculosis? P: I mean, it's pretty common in Sri Lanka. None of my immediate family members were. D: OK. And do you smoke cigarettes? P: No. D: And ah, do you smoke cannabis or use any cannabis products? P: No. D: OK. And do you drink alcohol? P: I don't. D: OK, how about the use of any other recreational drugs? P: Uh, no. D: OK. And uh, any family history of heart or lung problems? P: Heart or lung? Uh, no, not that I know of. D: OK, and how about any cancers in the family? P: No, no cancers. D: I see, alright. Did you have any other questions for me today? I think that was everything I wanted to ask about for now. P: Ah no, what do you like, what do you think I have, and how do you think I should treat it? D: So, uh, yeah, it's sounding like, like it could be tuberculosis based on the kind of timeline of your symptoms and so and cough and hemoptysis and so we'll do a test for that, like an acid fast test of the sputum. Get a chest X Ray. And if it is tuberculosis, it will require a prolonged course of antibiotics, so that I'll be over several months. Umm, and so I we'll get the infectious disease team involved to help kind of guide our management with the appropriate antibiotic choice, if it does come back to be tuberculosis. P: OK. OK, that sounds good, thank you.
dataset\resampled_file\RES0214.wav	D: What brought you in today? P: Hi, um so I've had this terrible fever for the past three days um and just before that I had a stuffy nose um and I had a sore throat, well I still do, um and it's just not going away, so I thought I should just come in and see if I have covid or what it is. D: OK, so if I understand, it started with a stuffy nose? P: Yes. D: OK and that kinda progressed to a fever? P: Yes, that's right. D: OK, have you been feeling any other symptoms aside from the fever? P: No. D: Nothing really, have you had any nausea, any vomiting at all in the last little while? P: No. D: Any pain anywhere else in your body? P: Uh, no. D: OK, do you have any neck stiffness? P: No. D: Any headaches? P: Um no, no headaches. D: OK, and have you been able to eat and drink during this time period? P: Yes. D: Excellent. OK, you've had a cough at all? P: No cough. D: No cough, OK and then how about abdominal pain, any pain in your tummy? P: Um no. D: Nothing like that, what about other changes in your body? Have you noticed any fevers or any rashes, any skin changes? P: Uh no, nothing like that. D: OK. What about any pain in any of your joints and your knees, hips? P: Oh, actually um not in my joints, but I've just, there there has been some muscle ache. D: OK, how long has that been going on for? P: Uh for the past two three days. D: So around the same time that you've had this fever? P: Mhmm. D: OK. P: That's right. D: Now have you had any contact with anyone who's been sick in the last little while? P: Um no, not that I can think of. D: OK, have you had any recent travel anywhere else? P: No, I did go hiking um last weekend, um and it was about 2 hours away, um there were some people on the hiking trail that I passed by, but um other than that, no travel outside the province. D: OK. Does anyone around you or in your immediate circle come down with anything similar recently? P: Um my husband has also been experiencing similar symptoms for the past week. D: OK, how's he doing? P: Uh the same as me. D: OK. And have you had any covid swabs recently? P: No. D: OK, and aside from the weekend hike, have you been mainly self isolating or? P: Uh yeah, just me and my husband at home. D: OK, and do you leave the house for work at all? P: No, I work from home. D: OK, sounds good. So you have some muscle aches, little bit of fever, stuffy nose, sore throat, do you have any difficulty swallowing? P: Uh no, it just hurts. D: OK, so you're still able to swallow food, swallow liquids? P: Yes, that's right. D: It doesn't feel like anything is going down the wrong way or have any coughing after you swallow? P: No. D: OK. And just in terms of coming back to this sore throat, do you feel like you have any swelling around your neck? Does it feel inflamed or swollen? P: No. D: Nothing like that? P: No. D: OK, alright, excellent. So you're eating well, doing well, any changes to your bowel movements recently? P: Uh no, no. D: OK, alright, I'll just kind of go into other things, just in terms of anything else that you might have had in the past, uh have you ever been hospitalized for any reason in your life? P: I had my gallbladder taken out five years ago. D: OK, so that was around when you were 50 years old? P: Uh yes. D: OK. And any other surgeries you've had in your life? P: Uh no. D: No, anything you've had to see a doctor for? P: Um I, in the past couple of years uh just for things like like this I guess um colds, um I'm pre diabetic, so I've been checking my glucose levels, yeah other than that nothing else. D: So no high blood pressure? P: No. D: No cholesterol issues? P: No. D: OK, so it sounds like you've been pretty healthy otherwise. P: Yeah. D: Excellent, OK. Do you have any allergies? To medications or otherwise. P: Penicillin. D: Penicillin, what happens when you take penicillin? P: Um I get a rash. D: OK. Any trouble breathing? P: No. D: And what medications, if any, are you on? P: Um I'm, I just take multivitamins, that's it though. D: And you said you lived with your husband in a house, um in London? P: Um yes, that's right. D: What do you two do for work? P: So I work from home as a digital marketing agent and my husband is a computer programmer. D: OK. And do you smoke? P: No. D: Do you drink alcohol? P: Uh I drink once once in a while. D: OK. And when you drink, how many drinks do you have? P: Um about one or two glasses of wine. D: Got it. Any other recreational drugs, substances? P: Um no, D: So no marijuana, heroin, cocaine? P: I've tried marijuana before, just like edibles, but not, not regularly. D: Understood. And have you ever used IV drugs? P: No. D: OK, and when was your last menstrual period? P: It was um a year ago. D: A year ago? P: Mhmm. D: OK. And then otherwise, so we talked a little bit about recent travel. It sounds like you have the hiking trip last week and you passed some people, but it sounds like your husband also has kind of similar symptoms that you do right now. P: Yeah. D: Sounds good, now we've already talked about kind of past medical issues. Moving on, I think what we'll do next is move on to a physical exam. But before I do that, do you have any questions for me? Anything else you feel I should know? P: No, do you think I have covid? D: It's a possibility. It's always good to rule these things out, so we'll be ordering a covid swab no matter what. Obviously with any presentation where we have someone come in with a fever and sore throat, we want to rule out anything infectious. So it sounds like if your husband got it, and you have it, covid would be our first thing that we want to rule out. So just while we're trying to investigate, work this up further, I want to have you and your husband self isolate. The other question I suppose I should ask is, have you gotten your flu shot this year? P: No, I haven't. D: So it's also a possibility it might be influenza, just the seasonal flu. But until we, I suppose rule out covid, it'd be best just to keep to yourself just in case you are infectious for the meanwhile. P: OK, sure. D: Alright, well I'm going to go talk to the Doctor and I'll be coming back in to see you, OK? P: Alright, great thank you. D: Take care.
dataset\resampled_file\RES0128.wav	D: How can I help you? P: Hi so I brought my 6 year old son in today because yesterday during soccer practice, he he developed this pretty severe cough and he couldn't catch his breath. D: OK, so this happened yesterday, you mentioned? P: Yeah, it happened yesterday afternoon. D: OK, uhm so you mentioned a cough. Is it a harsh barky cough, or is it more like a muffled cough? P: I would say it's more muffled. D: OK, and is it a dry cough or is it bringing up any phlegm? P: Dry D: Dry OK. So no blood in the with the coughing? P: No blood. D: And does he sound wheezy to you? P: He does, yeah, he's still sounding a little bit wheezy now. It's it's better than last night. He was a bit more wheezy last night. D: OK. Uhm how about shorter breath? Does he sound short of breath at all? P: No, that that's gotten a bit better, that resolved about an hour. Like after he stopped playing but he was, he was short of breath yesterday. D: OK, and have you tried anything for his cough, for his shortness of breath or wheezing? P: No, we haven't D: No OK. Does he have a fever at all? P: No, he doesn't mention anything about feeling hot or or or having chills either. D: No OK, and any rashes that you've noticed? P: No D: No, weight loss over the past few weeks? P: No, he's been gaining weight well. D: OK good, has he had a stuffy nose or runny nose? P: Well, sometimes he will get a runny nose. He takes like Reactin or Claritin or some sort of allergy pill for that sometimes, but that's usually like the changing of seasons that will happen more often. D: OK OK. Does he have any allergies? P: Yeah, to mostly environmental triggers. I'm not sure if the specific things are, but I just know it gets worse. Maybe in the spring, springtime? D: OK. And does he have asthma? P: He's never been diagnosed, but he has had uhm or his sister has asthma. D: OK, OK. And has he? Have you noticed any changes in his vision or hearing? P: No. D: No, OK. How about change in his smell or taste? P: No D: No, how about like does he seem like he has any chest pain? P: No, he hasn't mentioned anything like that. D: Any dizziness or fainting spells? P: No D: No, confusion or memory loss? P: No. D: OK, Uhm how about confusion or sorry you said no headaches? P: No headaches. D: No, OK, any joint pains, muscle aches? P: No. D: OK, and how about changes to his bowel movements? P: No, everything's been normal there. D: OK, how about nausea or vomiting? P: Nothing like that. D: OK, OK, so you mentioned he has asthma. He might have asthma. He was never formally diagnosed. Does is he otherwise healthy or does he have any longstanding medical conditions? P: He's been healthy. Yeah, I know he did have like he would get some itchy skin when he was a bit when he was like a baby, but he hasn't needed any creams for that for a long time. D: OK so he might have something like eczema, you think? P: Yeah, yeah I think he did. D: OK, OK and is he on any medications right now? P: No, he doesn't take anything right now. D: OK, Uhm during his mom's pregnancy with him, were there any complications? P: No, she was uhm healthy and he was born at term with a normal weight and able to go home relatively quickly, so there weren't any concerns. D: OK, that's good and was he healthy like after birth? P: Yeah, so he's he's done well. There weren't really any concerns with development or or growth, and he's doing well in school. D: OK, OK, good. How about uhm so was he a full term baby and was it a vaginal delivery? P: Yes. Yes for both D: OK, any complications during the delivery? P: No, D: OK, and he didn't need any hospitalizations like right after birth as an as a newborn? P: No D: No, OK good. Uhm Is he up to date with all his immunizations? P: He is, yeah D: OK. And you mentioned that he may have some seasonal allergies. Any other allergies that you know of? P: Not that I know of. D: No, OK. You mentioned that his sister has asthma. Any other lung conditions or heart conditions that run in the family? P: No, nothing like that. D: No, OK. OK. Uhm and does anyone at home smoke? P: No D: No OK. Any old carpets? Does mold, asbestos, anything like that at home? P: We we took out the carpets and stuff when his sister was diagnosed with asthma, so it's good from that perspective. D: OK, good, and who lives at home with him? P: So it's myself, his mom and then his sister. D: OK, OK, any pets at home? P: He's got a fish. D: A fish, OK. And has he has come into contact with anyone sick recently? P: No, I don't think so. I mean when at school, they've been pretty diligent with I mean covid and everything right now, so I think he's been OK. D: Ok, uhm has he traveled anywhere recently? P: No. D: No, OK. OK, those are all the questions that I had for you today. Did you have any questions of your own for me? P: Yeah, I was just wondering if if my son had asthma as well and if like you need a prescription for inhalers. D: Yeah, so we're gonna since he's never been diagnosed before, we're gonna do some investigations for him just to start so we can do, we can start by doing a pulmonary function test for him to see what his lung activity is like uhm so we'll start there and then we'll also, because you're saying he's short of breath, we'll take his oxygen saturation as well, and maybe even do some like some basic blood work for him, and if it turns out he has asthma, which in this case I do strongly suspect, we'll prescribe him some bronchodilators like a short acting beta agonist as well as an inhaled corticosteroid because his symptoms do seem somewhat severe this time around. And then I should also mention because some of his symptoms overlap with that of COVID, he will also get a covid swab and you should hear back about that in 24 to 48 hours. How does that sound? P: That sounds good, thank you. D: Alright great, thank you.
dataset\resampled_file\MSK0015.wav	D: How may I help you? P: Yeah, so I'm I'm George, the father, my daughter is 5 years old and I noticed just a few days ago that she was walking a little bit funny and kind of having a limp when she came back from school. And since since that then, she's been saying that it just hurts too much to put any weight on on that leg, on the right leg. And since then I've been like carrying her around. It's been very painful for her. So I just wanted to come in and check what might be going on. D: OK and so so. And this, when did this exactly start? P: So just two days ago. D: OK, an um did she have any trauma to her right hip or or to hurt your right leg like a fall or any injuries? P: Sorry um no. Not that I know of at least and she hasn't told me anything like that. She does do some activities, some sports, but I haven't seen her fall anywhere. D: OK. Um. Alright, and uh, has she has she not not been able to walk then? P: Yeah, so I've I've been carrying around for at least like she's missed school too, but been carrying her around for the last 1 1/2 to two days. As soon as I had like ask her to walk she starts kind of a hopping and saying that there's a lot of pain near the top of her leg and by your hips whenever she puts her foot like a foot down. So yeah, she's in pain crying, so I kind of have to carry her. D: OK. And, uh, how has her behaviour been recently like her mood and things like that? P: She's definitely been more just, a bit anxious about the pain. Very scared about putting her foot down and just overall, I think also more irritable crying more because of the pain so but I I guess I understand if there's something going on it must be very painful. D: OK, and. Alright, has she had any fevers or chills? P: Uhm I. Did notice a couple of days ago she felt a bit warm but we didn't really measure her temperature. Over the last few weeks, though, she has had a. Kind of a runny nose and a cough and I think she might have had a fever last week as well so she has been sick recently. D: OK, so it sounds like she might have had a cold last week and did like the runny nose and cough go away? P: Yeah, the runny nose and cough are gone. Fever was gone too, but she did feel a little bit warm yesterday so I'm not sure about that. D: OK, so she's at a a bit warm now still OK. P: Yup. D: Has she had any any headaches? P: No, no headaches. D: Any sensory changes like things to her vision or hearing or taste or smell? P: No. D: OK. Any um sore throat or cough? P: No. D: Alright, any shortness of breath? P: No. D: Any chest pain? P: No. D: Has she had a loss of appetite? P: No. D: OK, and has she had any unexpected weight loss? P: Oh no, nothing like that. D: Any night sweats? P: No. D: Any nausea or vomiting? P: No. D: Any abdominal pain? P: No abdominal pain. D: OK, any diarrhea or constipation or blood in the stool? P: No, nothing like that. D: Alright, and any problems with urination like pain or frequency? P: No, not that she's mentioned, no. D: OK. And any skin rashes or changes? P: No. D: OK, and any muscle aches or body pains or any other pains anywhere else? P: No, it's mainly just her upper right leg and hip. D: OK, I have she had any numbness or tingling? P: No, not that she's mentioned no. D: OK and and, how about a muscle weakness? P: No. D: No OK. And any confusion or or memory loss? P: Um no. D: OK, I'm and in the past has she been diagnosed with any medical conditions? P: She did have this condition with her hips. Dysplasia, like developmental dysplasia of the hip. So when she was born she she was getting like this clicking noise and her, in her hips and so she was in this splint for probably almost two months at the start, like after she was born. D: OK, and did her hips, did like was she able to walk afterwards? P: Yeah, yeah. And we were seeing a specialist, an orthopedic surgeon and they were managing her and after one year they stopped following her. She was well like she was walking, no issues. D: OK, so she's walking around one year. P: Mmm D: Have you had any other concerns about her, either social or physical development? P: No, she's been really great. She's good with people, she's has great social skills. She has grown well, met all her milestones, she's doing really well at school and gets along well with her peers as well. D: OK, excellent. And were there any concerns throughout pregnancy, such as gestational diabetes or hypertension or any exposures to infections? P: No, her mom's pregnancy was perfectly normal. She was born, like she was delivered vaginally at 39 weeks. She was breech at that time, which the doctor said might have to do with her clicking hips. But yeah, but since then or during pregnancy, no other complications. D: OK, that's great. And. Uh, in regards to, you mentioned her hurt hip any other past medical history? P: Um no other than that she's been healthy. D: OK, and does she take any medications regularly over the counter or prescribed? P: No no, no medications. D: OK, any allergies to medications? P: No, not that I know. D: And sorry has she taking anything for the, the pain? P: No, I haven't really given her anything, I didn't know what to give. D: OK all right, we'll talk more about that. Has she had any prior surgeries or hospitalizations? P: No. D: Can you tell me about who she's living with and whereabouts she's living? P: Yeah, so she's currently living at home with me, my wife, and she has an older brother. We live in a small house just near near the city. D: OK, and what do you guys do for work? P: Yeah, so I'm a lawyer and my wife is a music teacher. D: OK, is there anybody who smokes in the home? P: No, none of us smoke. D: OK um, OK, And any family history of heart or lung conditions? P: Uhm, no, no family history our family is pretty healthy. D: OK, how about any family history of any autoimmune conditions such as hypothyroidism? P: No nothing like that. D: OK. And then any musculoskeletal or neurological conditions in the family? P: No. D: OK, so next on um just the exam. Um when you're looking at the right hip are you seeing any swelling, redness? P: Uh, no, not that I see anything. D: No OK, and is there any like muscle atrophy around the hip? P: No, not that I see at all. D: OK and then is there any misalignment or deformity of the joints that you can see? P: No, I can't. Yeah, I don't see anything in the hips or legs that really points out to me. D: OK um and is there any pain to palpation over the hip or or knee? P: Uh, if I if I press on it, I don't think she's in that much pain. It's mainly just when she's trying to walk or put put weight on it. D: OK, and is she able to move the hip in a full range of motion of like flexion, and extension, abduction, adduction? P: Uhm, so she does. She is able to move it if she really tries. But it's mainly just the putting her weight on it and anytime she puts her weight on it is is when it really hurts. D: OK, so more about the weight on it, and is she able to move that her knee with a full range of motion? P: Yeah. D: OK, and any any muscle weakness when testing around the joint? P: No. D: No, OK. So I think that was everything that I wanted to ask on history and check was there anything I maybe forgot about you thought would be more important today, P: No I think that's all just just was wondering what might be going on? D: Yeah, certainly, so a couple of things that it could be. One is that it can be common in this age group is something called transient synovitis. Where, which can happen in the hip where there's some inflammation and it causes some pain following a viral infection. And it sounds like she had a viral infection last week with the cough, fever and and runny nose and her. She was feeling a bit warm and maybe feverish today as well, which could be a sign with the lower kind of slightly elevated temperature, pointing towards transient synovitis, which is a condition that will be self limiting and can use anti- inflammatories to help with the pain such as ibuprofen, but also something that would be important to rule out would be is septic arthritis because it could could lead to damage of the joint, but this will be lower on the differential and then finally something to consider is Legg-Calve-Perthes disease. And, but this would be more of progressive onset, but if she's not getting any better and or if she becomes more sick like develops a really high fever or a red hot swollen joint, then we'd be thinking more along the lines of septic arthritis and we want to reassess. P: OK, sounds good. Thank you so much.
dataset\resampled_file\RES0191.wav	D: How may I help you? P: Hi I'm, I have been having this nasal obstruction and discharge for the past week and it doesn't seem to be going away and it's bothering me so I thought I would get it checked out by you. D: OK, for sure. Uhm, could you describe the discharge? P: Yeah, it's a. It's mostly clear, it doesn't, it doesn't have a color to it. D: OK, so no yellow, green or or red to indicate any blood? P: No. D: OK, and you mentioned, so with the obstruction, have you had difficulties breathing? P: Um a little bit, I just need to, and is mostly at night. I just need to shift to one side or the other to like unblock my airways. D: I see OK and have you been having any pain on your face? Like I like kind of over your cheeks or over your forehead? P: No. D: OK, how about any headaches? P: No headaches. D: All right, have you had any changes or to your sense of smell or any loss of smell? P: Uhm no, maybe a little bit, but no, not really. I can still eat. I can still smell like candles and things like that so, maybe go with no. D: OK. Have you had any changes to your sense of taste? P: No. D: OK. Have you had any eye redness or or any eye pain? P: No. D: Any ear pain or ear discharge? P: No. D: Any changes to the vision or hearing? P: Uh, no. D: OK, have you had a sore throat? P: No. D: Have you had a cough? P: No. D: Have you had any shortness of breath P: Uh, no. D: Have you had any wheezing? P: No. D: OK. And have you coughed up any blood? P: No. D: OK, and have you had any chest pain? P: No. D: Have you had any lightheadedness or dizziness? P: Uh, no. D: Have you felt like your hearts beating really fast or racing? P: No. D: OK, have you had any fevers or chills? P: No. D: Have you had a night sweats? P: No. D: Have you had any unexpected weight loss? P: No. D: OK, have you had any loss of appetite? P: Uh, nope. D: OK, have you had any nausea or vomiting? P: No. D: Have you had any abdominal pain? P: No. D: Have you had any diarrhea or constipation? P: No. D: Have you had any painful urination or urinary frequency? P: No. D: OK, have you had any skin rashes? P: No. D: Have you had any muscle aches or joint pains? P: No. D: Have you had any memory loss or confusion? P: No. D: OK, and how has your energy been? Have you had fatigue or malaise? P: No, nothing like that. D: OK. Uhm, and have you had any sneezing? P: No. D: OK. Uhm, and, uh, are you healthy? Or, or have you been diagnosed with any medical conditions in the past? P: No, I'm actually pretty healthy. D: OK. Have you had any prior surgeries or hospitalizations? P: Nope. D: OK, and any allergies like to any medications or any seasonal allergies? Like do you get symptoms like this that change throughout the year? P: No. D: OK and sorry, no allergies to medications as well? P: No allergies to medications. D: OK, and do you take any medications regularly, either prescribed or over the counter? P: No, I don't take any medications. D: OK, and can you tell me about where you're living currently and who you're living with? P: Uhm, I live by myself right now. I live in an apartment downtown. D: OK, and are you, got working right now or are you going to school or both? P: I'm working right now, but I'm working from home. D: OK, uh, have you been around anybody who's been sick? P: No one personally, but I do go to the grocery store and the bank and all the essential things. D: I see, OK. Uhm, and have you have you traveled anywhere recently? P: No, I haven't. D: OK. Are you in a relationship? P: I am. D: Are you sexually active? P: I am. D: OK, could you tell me a little bit about your partner or, or partners? P: Uhm yeah, so we've been together for the past five years. And yeah, he's the only sexual partner I have. D: OK, and do you use condoms or birth control? P: Birth control. D: OK. Uhm, and any concern for a sexually transmitted infection? P: No. D: OK and you smoke cigarettes? P: I don't. D: Do you smoke cannabis or use cannabis products? P: Uh, nope. D: OK, how about the use of any recreational drugs? P: No. D: OK, do you drink alcohol? P: I do, I'll have like a glass of wine every day. D: OK. And in the family, are there any heart conditions or lung conditions that run in the family? P: No. D: How about things like diabetes or or high blood pressure? P: Uhm, I don't think so. D: OK, and uh, are there any cancers in the family? P: Uhm, there's colon cancer in the family. D: OK, and who was that and how old were they? P: Uhm, my grandfather, he was 55. D: OK. Uhm, alright, and so that was everything that I wanted to ask today on history. Was there anything else that I was maybe forgetting? P: Uh, no, I think that was it. D: OK, so with the prominent symptoms of being nasal discharge and obstruction without fever and without, like changes to smell and also without pain, it's most likely a viral rhinosinusitis. Uhm, however, this could have symptoms that overlap with, with COVID, and so we will still end up doing a swab even though the most likely diagnosis is going to be a viral acute rhinosinusitis. P: OK. D: Do you have any other questions? P: No thank you or yeah, thank you. D: Thank you.
dataset\resampled_file\RES0129.wav	D: What brings you in? P: I just bringing my son in today because he's had this cough that's been going on for a few days now and for these past two days, I've noticed that he's been just tugging at his ear more as well. D: OK, so you said the runny nose started two days ago? P: Yeah, yeah he had a cough yeah cough and runny nose started about yeah 2-3 days ago D: Okay, the runny nose, what color is the discharge? P: Pretty clear and watery D: OK, and the coughing is it dry, or is it bringing up any phlegm? P: It's been dry. D: It's been dry OK. And does it sound harsh? P: Not really, D: No? P: I don't know. It sounds kinda like a typical cough. D: OK, has he lost his sense of taste or smell? P: He's been a bit more irritable and not eating as much but I'm not sure. D: OK, how about changes in his vision or hearing? P: No D: OK. Any fevers? P: Uhm, I don't think so. But he, we haven't checked and he's been, yeah, as I said, kinda, a little bit irritable. D: OK, any weight loss recently? P: Uhm no, he's been gaining weight. Actually, sorry, I think it. Yeah, he has had a fever. The fever. Yeah the fever started like yesterday. D: Oh OK, did you take his temperature? P: Yeah, my my wife just texted me and told me that she checked it, checked it and said it was over 38. D: Oh OK. Yeah, we'll definitely take a temperature here as well just to make sure. Has he had any rashes? P: No, D: No rashes OK. And how about shortness of breath or wheezing? P: No, I haven't heard that. D: No, OK. And then have you actually taken a look into his ears? P: No, I haven't. He has just been tugging at the right one. D: Is he itching it at all? P: Uh yeah, I guess just kind of like really rubbing it around the outside and pulling on the lobe a little bit. D: OK, any discharge? Oh sorry go ahead P: Sorry I'm just gonna say yeah he's been kind of fussy and pointing at it and no discharge from the ear. D: No discharge, OK. Does it look swollen? P: No, the outside of the ear looks normal. D: OK, OK, and how have his bowel movements been? P: That's been normal, . D: Normal. Any changes in his urine? P: No, it's been normal. D: Nausea or vomiting? P: Nope. D: uhm headaches? P: No, I don't think so. D: OK, how about dizziness or fainting spells? P: No. D: No, any confusion or memory loss? P: No, I don't think so. D: No OK, is he an otherwise healthy child? P: Yeah, he he is. I mean he, uhm about six months ago he had uhm croup I think but he recovered quickly from that and he didn't need to be hospitalized or anything. D: OK, and his mother's pregnancy with him, was it complicated in any way? P: She had gestational diabetes, but it was diet controlled and she's healthy now from that perspective. D: OK, OK, that's good. Uhm and then was he born at term? P: He was yeah he was born over like 38 weeks I think D: Oh OK, good and was it a C-section or a vaginal delivery? P: Uhh vaginal. D: OK, any complications during the delivery? P: Uhh no. D: No, OK, how about uhm after birth? Was he hospitalized for any reason? P: No, he wasn't. He was able to go home. D: OK, that's good. Uhm and has he been developing normally in terms of his motor movements, like behavior wise, social wise, like is he on par with his peers in terms of milestones? P: Yeah he is. Yeah, everything's been normal that way and he's been growing well too. D: OK, good. growing while gaining weight well, OK, is he on any medications? P: No, he's not. D: OK. Is he up to date with all his immunizations? P: He is, yeah, we've been following along with with that. D: OK, does he have any allergies? P: I don't think so. D: No, Ok. Any family history of lung or heart conditions? P: Uh, no. D: No OK. Does anyone at home smoke? P: Uhm I do but not like in the house or anything like that, usually just well, it will always be either outside or when I'm at work. D: OK OK, any old carpet, dust, mold, asbestos, anything like that in your home? P: No. D: No. OK. Who does he live with? P: So yeah, he lives with me. It's just me and my wife. D: OK. Any pets at home? P: We have a a dog. D: OK. Has he been in contact with anyone sick recently? P: Uh. Not that I can think of. D: OK is he in like daycare? P: No, no my wife's been, been looking looking after him at home. She's the primary caregiver, well while I'm at work. D: OK, any trouble recently? P: No no. D: No, OK. Well, those are all the questions that I had for you today. Did you have any questions of your own? P: Uhh no, just was wondering what what might be going on? D: Yeah, for sure, so right now it sounds like a viral picture. It sounds like he has a cold and possibly an ear infection. I'd have to take a look into his ear to be able to tell more uhm because some of his symptoms overlap with those of covid we'll probably do a swab and you should hear back in about 24 to 48 hours. Uhm and so after I take a look into his ears, we can do one of a couple of things, so if his tympanic membrane looks like it's been perforated, or if there's pus in there, then we'll prescribe him a 10 day course of antibiotics, and if I see like middle ear effusion or his tympanic membranes bulging, and he seems really sick like he has a high fever, what she does, I will again prescribe him 10 days of antibiotics. And if he has a middle ear effusion or a bulging tympanic membrane, just one of those two, and he doesn't seem to be too sick, we can reassess him in 24 to 48 hours. Uhm An antibiotic that we usually prescribe is amoxicillin. Uhh how does that sound? P: That sounds really good. Thank you. D: OK, no worries. Take care.
dataset\resampled_file\RES0211.wav	D: So what brings you to the clinic today? P: Hi so I just like for I don't know like three or four days I’ve been having this really dry cough and my throat feels really scratchy. I just feel kinda crappy overall. And my head’s pounding D: Your heads pounding. You have a headache right now? P: Yeah, little bit. I just kind of feel just icky. D: OK, and you say I've been feeling that for three to four days now. P: Yeah, yeah exactly D: What did you first notice? P: I first noticed that my throat was kind of scratchy and then I started coughing, but it's really like dry. D: OK, so you haven't been bringing anything up with it? P: No, D: Any flem? P: no nothing. D: OK, you haven't been noticing been running a temperature at home. Have you hot fevers? P: I have felt really hot. D: You felt hot at home, OK, P: yeah, D: You noticed any night sweats by night sweats. I mean you wake up sheets are soaked. P: I honestly I felt hot like all the time like yeah yeah night. I feel hot but during the day too I'm just like I'm I'm like hey I'm wearing like just shorts and like a tank top and I just still feel really hot. D: OK. You notice, skin changes anything in your arms or legs it looks weird? New rashes? P: I don't. I don't think so. I haven't really been looking, but you know. D: No worries and then aside from that, any nausea? Any vomiting? P: No, not that. No, nothing like that. D: Any diarrhea? P: No no. D: Any aches in your joints anywhere? P: No. I mean, I'm I'm tired, but I don't think they're not like hurting. D: OK, so aside that aside from kind of this dry cough feeling hot that otherwise you're feeling OK. You don't have any other real concerns aside from that. P: Yeah, just like I just feel crappy like. Yeah, I really. I don't think I know that's not like a a real like way to say. D: Oh no, no, it's perfectly valid. We called that Malays in general. Just feeling a little bit off. Alright so this is going to talk about you for a little bit, but first, we'll get to that later. So any issues that you've seen a doctor for before? P: I have I have allergies. Usually in like the spring in the fall. D: Do you have any allergies to any medications? P: No, no nothing like that. It's just like I get, really bad allergies like I I've seen an allergist and some years I've gotten allergy shots. But like not every year. Otherwise, I'll take like Claritin. This isn't like this is maybe around like this is just before they normally start, so I don't really have them right now. D: OK. P: Probably like in a few weeks they'd be really bad. D: Now do any of these allergies can't make it difficult to breathe or you feel like your face is swelling up? P: Uh. Like it feels like a little bit like plugged up an like what's that called like post nasal drip? But I don't really feel like I can't breathe. D: It's just like a little stuffy. P: Yeah, yeah, exactly. D: And these shots at the allergist gave you, how often would you get those? P: Those are the ones that I'd have like once. Usually like once a week for a little while, like in the winter before. D: OK, so you don't carry an EpiPen with you. P: No, no, they said it's not like one of those allergies and it's just like it's just like the seasonal ones. But they're just bad. D: OK, sounds good. So you've seen an allergist. Any other doctors that you've seen in your life? P: My family doctor. I don’t really go very often. D: OK, has there been any health issues that you've had in the past? P: No, like I've been really healthy. It's just like the allergies and. D: OK, any surgeries in your life? P: Uh, no, no. D: No. Are you takin any medications right now? P: I take. Claritin for allergies but I haven't like right now. I just have it with me just in case. I take birth control. D: What type of birth control do you take? P: Deyo D: OK and you take that regularly? P: Yeah, it's just like the pill. It's like the one that goes for three months. D: OK, so you don't have an IUD now you just take the oral contraception? P: Yeah yeah, just the pill got it. D: Got it. OK and then so you never had asthma in your life? P: No. D: OK, any family history of asthma? P: Like my cousin. D: OK, what about your parents, brothers, sisters? P: No, nothing like that. D: Do you know what eczema is? P: Like, I've heard of it. D: OK, anyone in the family have it? P: No. Like the only thing, like my dad has allergies too. Same kind as me. D: OK . Dad has allergies. OK, mother and father still alive? P: Yeah. D: Healthy? P: Yeah. D: OK good, do you live with them right now? P: Yeah, yeah, like I'm in high school. D: OK so you live in a house with both your parents. OK any brothers sisters? P: Yeah I have a little brother. D: How old’s he? P: Like 14 now. D: Has anyone in the family been sick recently? P: I think my brother we had like a cold a few weeks ago D: He had a cold. P: Yeah. D: OK. P: But like we are doing our school from home now so. D: Got it. P: My mom works from home and my dad just works like on the farm so. So no one's been like seeing anyone or going anywhere to get sick. D: OK, so sorry, do you live on a farm? P: Yeah, D: OK, in London? P: Like just outside. D: OK. Any travel or anywhere recently? P: No, like I just just came here. But like I don't really leave the house D: So last last two weeks you haven't left the country? P: No. D: Nothing like that. P: I wish. D: You keep any animals on the farm? P: We have like a dog, but it's not like an animal farm D: Got it. OK, another questions, are you sexually active? P: Uh no. D: But you're taking the birth control? OK, so when was your last menstrual period? P: Like like I just got done like a week ago. P: A week ago. And you haven't been sexually active since then. P: No. D: OK. So chances of being pregnant very low. P: Oh Oh yeah yeah, it's been like a year. D: Got it got it alright, do you smoke? Cigarettes? P: No. D: Do you drink alcohol? P: Like before Covid, when I saw my friends like sometimes a little bit but like not really anymore. D: OK, how much would you drink when you went out? P: Oh like, I mean, our parents would sometimes let us have like a couple coolers, but like that, was it? D: Got it. Any other drugs? Marijuana, cocaine? P: Like I tried marijuana once at a party like a couple years ago, but like I had, I never did it again. D: Got it so none of the harder drugs, cocaine, heroin? P: No. D: And I gotta ask this question for everyone. Have you ever injected drugs or anything into your arm or your body? P: No. D: OK. Alright, thanks Jessica. So just to summarize, you kind of had a three to four day dry cough with a little bit of fever, some headache, and just in terms was quickly reviewing then. So you have been bringing anything up. No one in contact with these recently been sick. You don't have asthma, your not taking any medications aside from Claritin, and your little brother might have been sick about two weeks ago with kind of a common cold and we're hoping to get out of this visit is just kind of next steps and where to go from here, correct? P: Yeah, like, I just want to know if I have to like take medicine or something. D: OK. Alright perfect Thank you very much. You have any more questions? P: No, I don't know. I don't have any more questions. I just like I can go home soon like lay down. D: Sounds good, thanks Jessica.
dataset\resampled_file\RES0045.wav	D: What brings you in? P: I've had a cough that started like 4 days ago, um and it's just been getting worse, so I I wanted to come in. D: OK yeah, it's good that you've come in. Um, so the cough started four days ago, has it been constant since? P: Yes it has. D: OK, and how often are you coughing? P: I um, I'd say a few times an hour now. Uh when it first started, it was a bit more intermittent, but now it's happening um all day long and throughout the night as well, it interrupted my sleep last night. D: Oh OK, um is it a dry cough or are you producing sputum? P: It's it's mostly dry. D: OK, so no sputum, no blood? P: No blood. D: OK. Um do you find that there are any triggers to your, to this cough, like um, environmental triggers, like the cold weather, um any old carpets at home, or um you know a particular time of the day, or exertion, anything like that? P: No, interestingly, nothing like that seems to really make it worse. It's just been um kinda coughing all day. D: OK, and um has anything made it better? Have you tried anything for this cough? P: Uh I tried um drinking some uh like tea and some other cough syrups and it didn't didn't help. D: OK, um how about, ah, OK. And if you were to describe the quality of this cough, would you say it's it's, it sounds barky, it sounds harsh, um how would you describe it? P: Uh harsh. D: Harsh, OK. And if you were to rate your symptoms 1 to 10, 10 being the worst, how bad is it? P: Uh, 6. D: Six, OK. And and have you found that your symptoms are getting worse, staying the same, or getting better over the past four days? P: Getting worse. D: Getting worse, OK. And have you ever experienced anything like this in the past? P: Uh no. D: No, do you feel wheezy at all? P: No, I haven't heard any any wheezes. D: OK, how about uh shortness of breath? P: Yeah, I've definitely noticed some difficulty breathing, um yeah. D: OK, and uh, when when did, when did your shortness of breath start? P: Right around the same time as the cough or maybe shortly after, um yeah, shortly after. D: Shortly after, OK. Do you find that there are any triggers for shortness of breath, like exertion? P: Yeah, yeah exertion. Um as well as like the cough itself, I'm finding that I'm coughing so much throughout the day that I'm having a hard time catching up and catching my breath afterwards. D: Yeah, for sure. Um OK, and any chest pain? P: No chest pain. D: OK. Um How about feeling like your heart's racing? P: No, nothing like that. D: No, any swelling in your legs or arms? P: No. D: OK. Do you ever feel like you have uh pain in your calves after walking um a few blocks? P: No. D: No, any fainting spells or dizziness? P: Uh, no. D: No, um have you had a sore throat? P: No. D: No, any changes in your vision or hearing? P: No. D: Runny nose or stuffy nose? P: Not, no, but I've definitely, I feel like I've maybe noticed a change in my smell. D: OK, how so? P: I just uh, I feel like I haven't been able to smell as well. D: Um when did you notice that? P: The, really, these last like 2 days. D: OK, and any changes in your taste? P: Uh I haven't really I, I thought, well, I wasn't really able to taste my food, but I thought that was because I couldn't, I wasn't smelling, um so I thought that was just going to go away, but the symptoms have gotten worse. D: Yeah, and have you had a fever or chills in the past few days? P: Uh yeah, I've had a fever um or I felt hot anyway. D: Did you take your temperature? P: I haven't checked it, but um like I've been feeling pretty sweaty from how hot I've been. D: OK um so we'll take your temperature today and we'll let you know. Um have you noticed any weight loss over the past few weeks? P: No. D: No weight loss, how about fatigue or muscle aches? P: Uh maybe these past couple of days, yeah. D: OK um, any changes to your hair, nails, or skin, like rashes? P: No, I haven't noticed anything like that. D: OK. Um any changes to your bowel habits? P: Uh, no. D: No, any nausea or vomiting? P: Um, no, no. D: No, OK. Any abdominal pains? P: No. D: Any changes to your urine? P: No. D: Uh confusion or memory loss? P: No. D: OK, and would you say that you are an otherwise healthy person? P: Yeah, yeah, that's why, these symptoms um really surprised me. D: Yeah, um so you've never been hospitalized or needed surgery in the past? P: No, I haven't needed to, I haven't seen a doctor in a few years. D: OK, um, are you on any medications? P: Uh nope, just uh take a multivitamin and uh, and that's about it. D: OK, um, OK, um any allergies? P: Uh yeah, I'm allergic to um cats. D: Cats, OK. And have you been around any cats recently? P: No. D: No, OK. How about immunizations? Are you up to date? P: Yeah I am. D: OK. Um any family history of lung conditions or heart conditions? P: Uh, no. D: How about cancers? P: Nothing like that. D: OK, and do you smoke? P: No. D: Um how about marijuana? P: Uh sometimes I'll have a joint with friends or something like that on the weekend, but um yeah, so maybe once a week. D: Once a week, OK. Um, how about alcohol, do you drink any alcohol? P: Uh, no D: No, OK. Um and where do you live right now? P: I live in a house um with my wife and uh 3 kids. D: OK. Is anyone else sick at home? P: Uh everybody's been well. D: OK, um any reason to believe that you've been around any sick contacts recently? P: Um possibly, um I mean, I'm in sales, so meeting with clients all day, um maybe one of them were sick. D: Yeah, yeah for sure. Um, any travel recently? P: Uh no travel, all the meetings have been in the city. D: OK, OK good. So those were all the questions that I had for you today. Did you have any questions of your own or anything that you wanted to discuss today that I missed? P: Um no, that, I was just worried about uh Covid. D: Yeah, so that's definitely top on the list right now for things that we have to rule you out for. Um so we'll take a swab today, we'll send it off um for those PCR results, you should hear back in 24 to 48 hours. Uh in the meantime, you should isolate for 14 days, and that includes from family members when possible, and public health will get in touch with you if those results are positive and so they can they can do some contact tracing. If it's not Covid, it could be another viral illness that's going around, and I guess the best therapy for that is staying hydrated, um getting good sleep, and eating nutritious foods. Uh but if your symptoms get worse, like you're running a really high fever, um you're having neurological symptoms like you know seizures or fainting spells, um or if you're having difficulty breathing, um you should come back to the ER. So how does that sound? P: Yeah, it's really informative. Thank you. D: Alright, take care. P: Thank you.
dataset\resampled_file\RES0141.wav	D: How can I uh, help you today? P: Hi, so I just came in today because I've been just been feeling um, like my head's just been hurting for the past three or four days and I also felt really cold throughout the day for the last few days as well, so, um, I did end up checking my temperature just yesterday afternoon and it was um, 38.7 degrees celsius. D: Okay, um. Tell me about the headache, where exactly is it? P: Yeah so it's kind of just throughout like the front of my forehead and it kind of goes to the side into my temple. D: And what does it feel like? P: It feels like a constant aching. I've had uh, migraines before, but they like, it's not like the pulsating sensation that I usually get with them. D: I see. Uh, okay, and how severe is the pain, if you had to rate it from 1 to 10? P: Um, more than like severe. It's definitely less severe than my migraines, but it, it's just constant. It's, it's just been there for the last four days and I would say probably a 6 out of 10. D: Did you do anything for the pain? Did you take any medications? Anything that makes it better? P: Yeah, I took a Tylenol, I took um, Advil. It helps for like a few hours and then it just comes back. D: And anything that makes the pain worse? P: Um, I definitely think just, if I rest, it's better if, but if I'm like, like I can't, I can't concentrate on work or like anything. D: Okay. Um, and other than the, um, the fever and headaches, have you um, had any um, cough? P: No, no cough. D: Runny nose or congestion? P: No. D: Sore throat? P: No, not really. D: Changes in your sense of smell? P: Uh, I do actually feel like I, like I am losing my smell today. D: And sense of taste? P: I just had breakfast today so um, breakfast was okay. I didn't, uh, but yeah, definitely sense of smell. D: Okay, and any difficulties breathing? P: No. D: Okay, any chest pain? P: No. D: Um, do you feel like your heart is racing? P: No. D: Any diarrhea or constipation? P: No. D: Nausea or vomiting? P: No. D: Pain in your belly? P: No. D: Any muscle aches or joint pains? P: Uh, no, nothing like that. D: Okay, um, do you feel like your neck is stiff? P: No. D: Any numbness or tingling in your arms or fingers, or toes? P: No. D: Any um, night sweats or weight loss, unintentional? P: No, I've only been gaining weight. D: Okay. Any fluid in your, any sort of, swelling in your legs? P: No, nothing like that really. D: Okay, um, any medical conditions that you've been diagnosed with? P: Yes, so I have uh, type 2 diabetes. I was just recently started on metformin medication. D: When were you started on metformin? P: So I think around uh, it's been around two months. D: Okay, how is that going for you? Are you tolerating it okay? P: Yeah I've, I've been tolerating it well. It's just they, they said like I'm kind of just on the edge of the diabetes, like my level, so they just want to act, um, proactively. D: Yeah, that's good. Um, any other medical conditions? P: No, that's, that's all. D: Any medications other than metformin that you take? Anything over the counter? P: Um, so I do take, when my migraines get bad, like I do take, I have taken naproxen before. D: Okay. Surgeries? P: Uh, no surgeries. D: Hospitalizations? P: Uh no. D: Okay, any allergies to medications, foods, or any environmental allergies? P: Not to any medications, but I do have an allergy to peanuts. D: Okay, what happens? P: I do get like a, an anaphylactic reaction. D: Okay, okay. Um, and any um, family history of any medical conditions? P: Uh, so on my dad's side, they like all, like all the men seem to have diabetes, so it's good that I'm starting on the medication. Um on my mom's side, they're pretty healthy. I don't think my mom has any medical conditions. D: Okay, good. Um, and do you currently live alone or do you live with other people? P: Yeah, so I live with my wife, I live with my two kids, a son and daughter. D: And um, have you or any of them had any exposures to anyone who could possibly be sick? P: Um just, uh, so my wife is a school teacher, um, and they did have in-person. Just uh, she's a high school teacher, and they had some they have in-person classes. So yeah, I don't know, but she's been feeling well. My kids are feeling well too. D: Okay, and have you traveled anywhere outside the province? P: No. D: Okay, and do you currently smoke or did you ever smoke in the past? P: No, I've never smoked. I do smoke marijuana just, maybe once or twice a month with some friends. D: Okay, any recreational drugs? P: Sorry, no. D: Um, any alcohol? P: Yeah, I probably drink um, a couple of beers during the weekend. D: Okay, got it. Um, alright. Well, given your symptoms, um, we would like to do a COVID swab, just in, or request a COVID swab to be done through public health, um, just to, just to rule it out. Your symptoms do sound like, or overlap with some of the symptoms that are seen in patients who do have COVID. It could be that you have um, just um, just I guess like your headache and fever. Um, I'll also like do a physical exam to see there's nothing else going on. But in the meantime, I, I'd like you to self isolate and stay away from the rest of your family members as well, um, at least until the results are out. And then when the results are out, if it's positive, you'll receive more guidelines from public health as to what you need to do. P: Okay, sounds good, um, and I work from home, so I don't need to. D: Oh that's good. Okay, so you work from home. P: Alright. D: Good. P: Thank you.
dataset\resampled_file\MSK0001.wav	D: And what brings you to the emergency department today? P: Low back pain. D: OK, and where exactly is uh is the back pain? P: So the pain's just right in the in the lower back. D: Just in the lower back, OK. And when did this pain start? P: It started yesterday, I was unloading groceries from my pickup truck when it suddenly started. D: OK, so, and, did you kind of make any kind of movement? Or did you pick up something really heavy? P: I'm not sure. I just noticed the pain after um after that. D: OK, and what kind of pain are you experiencing? Is it like a dull cramping pain or is it more like a sharp or stabbing pain? P: It feels like it's stabbing just right in my lower back. D: OK. And, um, on a scale of 1 to 10, uh 1 being like the least pain that you felt in your life, 10 being the worst, how much would you rate this pain? P: If I'm sitting, uh completely still like like I am right now, it's a 2 out of 10. D: OK. Um and when does it get worse? P: Uh anytime I I move or bend my back or uh even cough it it worsens the pain significantly. D: OK, and has this pain changed at all since yesterday? P: No, it's been this same awful pain this whole time. D: OK and have have you ever had this kind of pain before? P: I've had back pain uh over the years, but nothing like this before. D: OK. And does it, does the pain go anywhere or does it just stay in the lower back? P: I also feel the pain uh into my right leg. D: OK, and is it the same kind of aching or like stabbing pain that goes into your right leg? Or is it uh just like an aching pain? P: Uh it's it's a, uh, an aching pain. D: OK. And do you have any other symptoms besides the pain? Like are you experiencing any kind of weakness or any kind of, any other changes in your health? P: Uh no it's just the uh the low back pain. D: OK, and have you ever uh experienced any kind of trauma to your back? Like something has hit you or you've fall down, anything like that? P: No, I can't remember any injuries like that in the past. D: OK, any uh fevers or chills or night sweats? P: Um no fever, uh no chills, no night sweats. D: OK, any uh symptoms of feeling very tired, fatigued, anything like that? P: Uh no, I've been OK recently. D: OK. Any changes to your skin at all? Uh I mean, any rashes? P: No. D: OK, any pain in your joints at all? P: Uh just the back pain. D: OK. Uh any new coughs or any um symptoms and runny nose or anything like that? P: Uh no. D: Any changes in your um bowel movements at all like diarrhea, constipation or anything? P: Nothing like that, been regular. D: OK, how about, uh, any urinary problems? P: Uh no, nothing to report there. D: OK, and how has your appetite been? P: Uh appetite's been normal. D: Any significant weight loss or weight gain recently? P: No, the weight's been about the same. D: OK, any recent infections that you know of? P: No, I've been feeling well otherwise. D: OK. Any uh tingling sensation or numbness uh in your back or lower limbs, in your legs? P: Uh no numbness or tingling. D: OK. Any muscle weakness at all? P: Uh no muscle weakness. D: OK, have you been uh having any uh kind of erectile dysfunction? P: Uh no concerns with uh erectile dysfunction. D: OK, and any issues with uh incontinence, like uh having accidents at all, at night or during the day? P: Uh no, I haven't had any problems with bowel or bladder incontinence. D: OK, alright, and in terms of your past medical history, have you have you been diagnosed with any conditions like high blood pressure, diabetes? P: Uh type 2 diabetes. D: OK, and do you take any medications for it? P: Uh I, um insulin for diabetes. D: OK, and any other medications at all? P: Uh just been taking Tylenol for the the back pain. D: And has that worked for you at all? Or has it not made a difference? P: Uh maybe it's taking the edge off a little bit, but it hasn't done too much uh to help the pain. D: OK, any allergies? P: Uh nope. D: OK. Any previous surgeries? P: Uh I had hemorrhoids removed three years ago. D: OK. Um any hospitalizations before? P: Uh no, it was just day surgery, D: OK, any family history of any um conditions uh or like any cancers? P: Uh my father had prostate cancer. D: OK. And currently right now, uh do you work? P: Uh I'm a retired school teacher. D: OK, and where do you live? P: I live alone um in a in a house uh not too far from here, actually. D: OK. And do you do you drink at all? P: Um occasionally uh maybe I'll have a glass of red wine on the weekend or something like that, but uh not too often. D: OK, and do you smoke? P: Uh, I've smoked um yeah, I smoke a pack of cigarettes uh per day. D: OK, and for how long have you smoked uh cigarettes for? P: Uh about 40 years. D: 40 years, OK. And, uh, do you use any kind of recreational drugs? P: Uh never. D: OK, and how is your diet like on like a regular basis? P: I feel like it's uh pretty normal, mostly home cooked meals with some variety, vegetable, vegetables, other meats, and fish. I would say it's pretty balanced. D: OK, alright, I just have a few more questions for you. Um are you currently sexually active? P: Yes, I am. D: OK and who are you sexually active with, any new partners at all? P: Uh no new partners, um just my girlfriend, uh. D: And, uh, how many, I'm sorry, go ahead. P: Um just my my girlfriend recently. D: OK, and have you been sexually active with more than one partner in the past, past year? P: Uh yes, I have, um um two women over the past year. D: OK, and um do you use any kind of protection? P: Yes, always use uh condoms. D: OK. Alright, so now I'm just going to get the patient's vitals.
dataset\resampled_file\RES0055.wav	D: What brings you in? P: Hi, yes I just came in today because I've been a bit concerned about some breathing difficulties over the last few days. It all started out with like a cough over the last week, but now I'm having trouble breathing as well. D: Oh OK, well I'm sorry to hear that. So you said a cough as well, so the cough at least a week back and the shortness of breath or difficulty breathing, when did that start? P: So yeah, the cough, I usually have a cough. I've had COPD for a long time, but this past week the coughing has been much worse with a lot of more sputum and. Other than that, it started I would say two to three days ago. The cough got worse and then every time I'm moving around I like have to sit down and catch my breath, which is pretty abnormal for me. D: OK yeah, so alright. So let's focus on the cough first. You said it's a wet cough? P: Yes, I am producing a lot of sputum. D: OK, what color is your sputum? P: It's mainly like clear white. D: OK yeah so you don't see yellow pus or anything green or bloody in there? P: No, I don't think so. But there's definitely like a lot more than what I usually produce. D: OK, umm this cough, does it sound harsh, barky or does it sound muffled? P: I would say it's a bit harsh at times. I wouldn't say it's barky or muffled. I do find myself wheezing a little over the last few days as well. D: OK. Do you find you have any chest pain associated with the shortness of breath? P: Oh no, I don't really have any pains. D: OK, and have you ever experienced anything like this before? P: I did a couple of years ago, I had to be admitted because I had some shortness of breath. D: OK. P: But that was, I think, two years ago. D: OK. And when you were admitted two years ago, did they tell you what you had? P: Yeah, they said I had some kind of lung infection at that time, so they gave me some antibiotics while I was in the hospital. D: OK, did they ever say to you that you had anything else like asthma, COPD, any longstanding conditions? P: Yeah so I've had COPD for more than... I guess more than 10 years now so I think it just got a lot worse with the infection. D: OK yeah alright. So this time around, have you had any fevers? P: I've been having a couple of chills but like they would come and go. I didn't really think it was a fever. D: OK, any weight loss? P: No. D: OK, how about changes in your hair or nails like or or skin like rashes? P: Umm, no. D: Any changes in your vision or hearing? P: Nope. D: And how about smell or taste? P: Umm, no. I think they're the same. D: OK. Have a stuffy nose or runny nose? P: I do feel a bit stuffy, but it's not too bad. D: OK. And any swelling in your in your legs or upper limbs? P: No, not that I know. D: How about calf pain? P: Nope. D: Dizziness or fainting spells? P: No. D: Headaches? P: No headaches. D: Memory loss or confusion? P: Nope. D: Changes in your bowel movement or abdominal pain? P: Nope. D: Changes to urinating? P: No, that's all fine D: OK, so besides the COPD, do you have any other longstanding conditions? P: I do have some high blood pressure which I take, I think I take one of these medications called metoprolol. D: OK, and when was the last time you had your blood pressure checked? P: Umm, probably like a month ago and it was pretty good. I've been checking by myself at home too and it hasn't been changing too much. I think the last one I took was probably like 135 / 80. D: Oh, I see. OK, any hospitalizations besides the one that you had for COPD a year back? P: Umm, back when I was a kid I had my tonsils removed. D: OK, are you on any medications besides the metoprolol? P: I do take multivitamins.I think that's yeah, that's about it. D: Do you take any puffers for your COPD? P: Yeah, so I do have three like different puffers I take. I can't remember the name. I do have some puffers I don't take. I've been using them right now. It has been helping with some of my shortness of breath, but I've definitely been having to use them way more than I used to. D: OK. Do you know which puffer you're on? P: Yeah, so I think one of them is called ventolin. OK, and then I think the second one is called the Spiriva. D: OK, sure, Yep. P: So one of them should be a short acting beta agonist. D: Just wanna make sure that you have one with a long acting and then the other one is a long acting beta agonist. OK, good. Alright, are you up to date with all your immunizations? P: Yeah, I think so. D: And are you allergic to anything? P: No, not that I know. D: Any family history of lung conditions? P: Umm, no I don't think so. Yeah, no, I don't think so. D: OK. How about heart conditions? P: Yeah, my father died of a heart attack in his 60s. D: OK. Alright, any cancers? P: My uncle had skin cancer. D: OK. Do you know what type of skin cancer like melanoma, basal cell, squamous cell? P: No, I think it wasn't the bad one. It was like the one they can remove right away. D: Oh I see. OK, OK, that's good.Do you smoke? P: Yeah, I've been smoking for around, I would say the last 20 years. D: OK, how much do you smoke? P: Probably I would say pack a day for the last 20 years. D: Umm, have you ever thought about quitting? P: Yeah I did. I did once and then went back onto it. I definitely do smoke less than before though. OK, but yeah, I don't think I'm ready to quit yet. D: OK, yeah no problem. Do you drink alcohol? P: Umm, yeah, maybe once a week I would have a small Cup of whiskey. D: OK, sure, that's fine. And any other drugs? P: No, no marijuana, no other drugs. D: OK, and where do you live right now? P: Right now I live in a small bungalow in London. D: OK, any reasons to believe there are carpets, dust, mold, asbestos, anything that could be triggering your COPD? P: Umm, I don't think so. Everything is pretty up to date. D: OK, have you had any contact with anyone that's been sick recently? P: No, I've been mostly trying to isolate and like just be in my own home. D: OK, how about travel to anywhere? P: Nope, I've been in Ontario since the beginning of the pandemic. D: Yeah OK, that makes sense. Well, those were all the questions that I had for you today. Did you have any questions of your own? P: Yeah, I was just worried if it can be COVID or if it's just like another infection that I had like before. D: Yeah, so we're definitely going to do a COVID swab on you and those results should take about 24 to 48 hours to come back to you. And in the meantime, because your symptoms do overlap with COVID, you should isolate for 14 days. Public health will be in touch with you if it's positive to do some contact tracing. If it's not COVID, it could be another viral infection that's been going around during this time of year which is likely because you have COPD, since you're already coughing more than you usually are and seeing more sputum. We will reassess to see whether your puffers are working. If we need to add any additional things like inhaled corticosteroids as well as antibiotics and so just keep an eye on your symptoms for now and will also want to do probably a chest X Ray and possibly a pulmonary function test. How does that sound? P: Thank you. D: OK yeah no problem.
dataset\resampled_file\RES0186.wav	D: What brings you in? P: Hi there, I've been having this uhm, cough that's been ongoing for the past two days, and I've started to become short of breath as well. Even with just a little bit of exertion. I've also been feeling feverish and I checked my temperature and it was 38 point, uh, point 5. D: OK, Well that's definitely a fever. Can you tell me a little bit about when the coughing started? P: Yeah, I first noticed it two days ago and it's been kind of just getting a little bit worse over these last two days to the point now where I'm I'm short of breath as well. D: OK, so that's sort of two days ago and then when do the shortness of breath start? P: Uh, the shortness of breath has been within the last day within the last day. D: Within the last day, OK. And the coughing is that I dry cough or is it a wet cough? P: It's a dry cough. D: OK. Uhm so no sputum or blood. P: No sputum or blood in the coughing. D: OK, that's good. And alright any chest pain? P: No, I haven't had any chest pain. D: OK. Any palpitations of your heart? P: No, no heart palpitations. D: OK. And any have you noticed, like a runny nose or a stuffy nose? P: No, I haven't really had a runny nose, no runny nose. D: OK, no runny nose. That's good, and then any changes in your vision or hearing? P: No changes to vision or hearing. D: How about changes to your smell or taste? P: No changes to smell or taste. That's been been normal. D: Been normal, OK, that's good. And how about of, how about weight loss? P: No, I haven't had any, uh, any weight loss. D: OK, that's good, any rashes? P: Uh, no rashes. D: Changes to your bowel movements? P: No, I I haven't had any. No diarrhea. I have had a little bit of uh like belly pain though. D: OK, OK. When did the belly pain start? P: That's just been uh, yeah, within the last day, uh, as well. It just feels a bit uncomfortable kind of all over. D: OK yeah alright uhm and you don't feel gassy or, or bloated? P: No. D: OK. Uhm, and no nausea or vomiting? P: No, I haven't had any. Ah, actually I have been a bit, I've had some nausea as well like that's what I feel like with that with the abdominal pain. D: Mhmm. OK, And any changes in your smell or taste? P: Uhm, so I, actually yeah, with the sense of smell like I haven't been able to smell as well. Now that you ask again, yeah, sorry. D: OK, no worries and any appetite changes? P: Yeah, I haven't. I've had a loss of appetite. D: OK. Alright. Alright, and are you still eating the same or a little bit less? P: A bit less. So I guess I haven't been is hungry. I say similar amount of time just really these last two days. D: Yeah. Have you had any dizziness or fainting spells? P: No, I haven't. D: No. Any memory loss or confusion? P: No. D: No. Joint aches or muscle aches? P: Yeah, I've had like muscle aches. I guess I feel like we've been getting older, but no yeah, I've had muscle aches these last couple of days as well. Kind of generally achy. D: OK. And are you otherwise healthy or do you have any longstanding medical conditions? P: I have diabetes, type 2 diabetes, and I have high blood pressure as well. D: OK. P: Yeah, my weights a bit a bit high. D: OK, uhm and do you take any medications for these things? P: Yeah, so I take metformin and I also take an ACE inhibitor, and that's it. D: OK. Alright, and are you up to date with your immunizations? P: I believe so yes. D: Yeah. OK. And how about allergies? Do you have any? P: No, I don't think no, no allergies. D: OK, any family history of heart or lung conditions? P: Uh, no, nothing like that. D: OK, uhm, alright, any history of like cancers in the family? P: No history of cancer in the family. D: OK. Do you smoke at all? P: No, not I don't smoke. D: You don't smoke, OK. How about recreational drugs? P: No, I don't use anything like that. D: No. OK. Do you drink alcohol? P: Yeah, I'll have like one beer each day so yeah, about yeah, one beer a day. D: One beer a day, OK. And where do you live right now? P: Umm, so I live in a house with with my wife and ah, and our son. D: OK, and anyone at home sick? P: Uh, nobody's been sick at home. D: OK, have you been in contact with anyone who has been sick? P: Uh, I don't think so. I mean, I've been going out to do the essentials and uhm, I I do work out at a factory ah and so I mean, there might have been somebody there, but I'm not sure. D: OK, OK, and have you traveled anywhere recently? P: Uh no travel, just been going to work and doing the essentials and home. D: OK, that's good. And any reasons to believe you have old carpet, mold, asbestos, pets, anything at home that could be making your condition worse? P: I don't believe so. No, we yeah, it's a new a newer home and we've done some renovations. D: OK, that's good. Uhm those are all the questions that I had for you today. Did you have any questions of your own for myself? P: No, I was just worried that maybe I could have Covid. D: Yeah, for sure, so that's kind of top on my list right now to rule out, so we will do a Covid swab and you should hear back in about 24 to 48 hours with those results. In the meantime, you should isolate for for about 14 days and if your symptoms get worse, go to the ER and if you're experiencing things like weakness, seizures like, and you're not getting any better in a couple of weeks, or you feel dehydrated. Otherwise, supportive care at home, keeping yourself hydrated, eating well, sleeping well, all of those will definitely help as well. Does that sound OK? P: Yeah, it does. Thank you. D: OK, yeah, no problem.
dataset\resampled_file\MSK0043.wav	D: What brings you here today? P: I've had this like, pain in my knee. It started within the last few hours and my knee's swollen, it's painful. Um, I can barely move it. D: Okay, were you uh, did you injure yourself at all before the last few hours or anything? Any trauma to um, is it the right knee or the left knee? P: It's the left knee, an no, no trauma uh, or anything like that. I've never hurt this knee before in my life. D: Okay, and has this ever happened to you before? P: Uh. Um, no, nothing in my joints. I've had other infections before, like in my skin, um, like cellulitis, but I, I've never had a knee, knee problem like this before. D: Okay, I see. And have you ever had cellulitis in that area? P: Uh, I, I had it over, kind of my, uh, like over my foot before. D: Okay, and um, where would you describe the pain is? Is it like on the kneecap, is it above the kneecap, below? Where would you describe it? P: I would say it's like my whole knee, it's like uh, I don't know, it looks like it's going to explode. D: Okay, is it like um, so, it's swollen, is it red and warm? P: It is, yeah, it's really red. D: Okay P: And warm as well. D: Okay, and how would you describe the pain? Um, is it like a sharp, stabbing pain, or is it an aching pain? P: It's a, a stabbing pain. D: Okay, and uh, are you mainly having the pain with movement of your knee, or um, when you're pressing on it? P: Uh, I would say both, I can't um, I can't really move it, it'll give me pain. And even pressing on it, it's, it's quite painful. D: Okay. And on a scale of uh, 1 to 10, sorry 0 to 10, with 10 being the worst pain you've felt in your life, how much would you rate this pain? P: Uh, it's a 9. D: A 9, okay. Um, so it just started a few hours ago. Is there anything that makes the pain better or worse? P: Um, I mean just trying to stay as still as possible is all I've been been doing so far, uh because, um, like any type of movement is really bad. D: Okay, and are you able to weight bear, are you able to stand and walk by yourself? P: Uh, I, I was pretty much like hopping on one leg to, to get in here and as soon as I could, I got in a wheelchair, just because it uh, hurts so bad. D: Okay, and um, do you have any pain or symptoms in any other joints or muscles of your body? P: No, just, it's just my left knee. D: Just your left knee, okay. Um, do you have any other symptoms like fevers, chills, nausea or vomiting? P: Um, I have felt uh, uh feverish, yeah. But then, yeah, I, I felt feverish and um, but I haven't had any chills, though. D: Okay, when were you feeling fevers? P: Uh, just like, today, it's kind of, yeah, it started within the last day. D: Okay, and um, did you get a chance to measure your temperature at all? If not, we can do that here. P: Um no, no, I didn't get to uh, I, I didn't check it. D: Okay, and have you been sick at all recently, either with um, any cold-like symptoms uh, or any GI symptoms, like diarrhea, um, constipation, anything like that? P: Uh, no, I haven't had any, anything like that. D: Okay, and have you recently had any um, sexually transmitted diseases, or exposures to uh, ticks or lyme disease? P: Uh, I don't think so. I've been just, in well, in the city. I haven't traveled anywhere, and I uh, I haven't been sexually active for, for quite a while now, so. D: Okay, okay. Uh, have you recently, at all, had um, any procedures done on your knee, like any surgeries or any joint like um, injections or aspirations? P: No, nothing done to my knee. D: Okay. Okay, um, so yeah, we'll take a temperature of your uh, fever, and, so are you able to flex or extend your knee at all, or is it very painful? P: It's really painful. I uh, the movement's really limited. D: Okay, and has the pain been constant since it started a few hours ago. P: Yeah, it's gotten uh, like it's, it's gotten slightly worse. D: Okay, I see. Okay, um, any skin changes or rashes anywhere on your body? P: No, it's just the red knee. D: Okay. Um, any changes in your weight or appetite? P: Uh no, no. I haven't had any changes there. D: Okay, and otherwise, are you having um, any symptoms of uh, dizziness, fainting? P: Uh, no, I haven't had any of those symptoms. D: Okay, any weakness um, in your extremities? P: No, no weakness. D: Okay, um, do you have any past medical conditions that you've been diagnosed with? Any diabetes? High blood pressure? P: Uh, I've been told my, my blood sugar has been like, it hasn't been controlled, so yeah, I think I have diabetes. Um, uh, but that's, that's it. D: Okay, um, do you take anything for medicate, medication for your diabetes? P: Uh, yeah, I, I take metformin and um, and uh, yeah, that, that's all I've been taking, but, I mean, it's really hard for me to uh, like get my medication sometimes and so um, I don't always take it. D: Okay, I see. Um, and do you have any allergies to any medications? P: Uh, not that I, not that I can think of. And, so something that I forgot to mention is uh, like I've had hepatitis in the past as well um, and uh, yeah. D: And do you know hepatitis you've had? P: Um, I've had, it was uh, hepatitis C and uh, I was, um, treated, I was treated for it. D: Okay. Okay, and how long ago was that? P: That was about uh, two years ago. D: Okay, and uh, did they tell you like how it may have been transmitted at all? Was it, uh, sexually? Um, was it through um, use of IV drug use? And did they tell you what the likely cause was? P; Yeah, the, the likely cause was um, I was told it was through IV uh, drug use. I've been using now for uh, for about 10 years. D: Okay, and have you um, and what do you usually use? P: Uh, well like, any, anything that I, that I can usually. But I, I guess like um, various types of opioids are kind of the, the, the main thing that I'll, that I'll use. D: Okay, and have you um, injected uh, drugs recently at all? P: Uh, yeah I, about uh, about two days ago was the last time. D: Okay, okay. And um, do you use any other uh, drugs? Any recreational drugs like marijuana or any, do you inject any other drugs at all? P: Yeah, I'll smoke, uh, smoke marijuana as well and um, like, I'll sometimes like, I'll take uh, pills too like dilaudid is um, is something that I'll, I'll get my hands on, but it can be expensive so, um, just, just whatever is available. D: Okay. Um, have you had uh, when was the last time you had cellulitis? P: Uh, he last time was about six months ago. D: Okay, and were you admitted at all, or were you treated as an outpatient? P: Uh, I was treated as an outpatient for that, and it did clear up. It wasn't the first time that I've, I've had cellulitis and, and um, yeah, so it was treated. D: Okay, have you had any hospitalizations or surgeries in the past? P: Um no, I haven't. D: Okay. Uh, any family history of any conditions um, musculoskeletal or rheumatologic conditions? Uh, any rheumatoid arthritis, anything like that? P: Uh, I don't think so. D: Okay. And currently, right now, um, what is your living situation like? P: Uh, so um, I just live with uh, two of my, um, or actually sorry no, I live with my uh, with my parents and uh, yeah, so it's just both my parents. D: Okay. And, um, do you currently work? P: Uh, I was working until like, I um, yeah about uh, about 15 years ago and now I, like I got injured on the, uh, um at work and I've had like chronic back pain and I don't know, I think that's kind of how this partly all, all started. So I've been at home receiving uh, I'm on disability. D: Okay. And do you smoke cigarettes? P: Uh, I do, yeah I, I, I smoke um, about half a pack uh, to a pack a day. D: Okay, and how long have you been smoking for? P: Uh, so this has been, uh, about 20 years. D: 20 years, okay. And do you drink alcohol? P: Um, sometimes yeah. I'll, I'll have uh, just a few beers, maybe a few beers a week. D: Okay, and yeah, we were just talking about some of uh, like the movement, but you're saying you have pain with any kind of movement at all, right? P: Yeah, it, it's really painful, I just, I try not to move it at all. D: And it's very red and swollen and warm as well? P: Yeah, all of those. D: Any symptoms at all in your hips or ankle? P: No, those feel fine. I can move my hip and ankle okay, and no pain. D: Okay, alright, so those are all the questions I had for you. We'll do like a full physical examination, take a look at your knee, um, and most likely, what this sounds like, is something called septic arthritis. It's uh, it's when there's like an infection that um, can go into your joints and uh, it is a pretty serious issue that we need to um, assess and treat as soon as possible. So the first thing that we will um, need to do, we'll need to do some blood work just to get some inflammation markers and just your uh, CBC, and see if you have um, an infection. However, we'll also need to do a joint aspiration of your of your um, go your knee, and we'll be taking some fluid within your joint called the synovial fluid and assess for um, we'll send in for um, culture, and look for like these crystals, and count. And then based on that, we'll understand um, the infection you have and what kind of infection you have. We will start you on antibiotics right away um, today, and so you will be um, here for a while until we get all those results back. And you may also require um, an admission today as well. P: Okay, uh, thank you. Yeah, that, that sounds good. D: Alright, yeah, so yeah, we'll get all that done for you shortly, and uh, we'll go from there. P: Right, thank you. D: And um, we might also need an x-ray, so just sit tight. We'll, we'll come call you. P: Okay, thank you. D: Alright, you're welcome.
dataset\resampled_file\RES0094.wav	D: Uh, how may I help you? P: I've, uh, had a runny nose over the last few days and I've started to have a sore throat as well. D: Hmm, Uhm, when did this start? P: I would, so the runny nose started, uh, about five days ago and, and the sore throat, uhm, about the same. D: OK. Have you, uh, with the, the runny nose, do you have any, what's the discharge like? P: Uh, it's been kind of watery, it's clear. D: OK. Alright and has your sore throat gotten better or worse over the past five days? P: Uh, it did get a little bit worse initially and since then it's been kind of stable. D: Have you, uhm, had any difficulties swallowing? P: No, it, it is a bit sore, uhm, to swallow so it takes me a little bit longer to eat, but I've been able to still, still eat. D: Have you changed, noticed any changes in your voice? Any hoarseness in your voice? P: No. D: No, OK. And do you have any nasal congestion? Does your nose feel stuffy? P: Yeah it does, yes. D: OK, uhm, any fevers or chills? P: No, I don't think so. D: OK. Any difficulties breathing? P: No. D: Any cough? P: No. D: OK, uhm any, uh, pain in your chest? P: No. D: Any other symptoms, anything related to your belly, say, diarrhea or Constipation or any changes in your urinary, any urinary symptoms? P: No, nothing like that. D: OK, OK, are you feeling fatigued, tired? Have any muscle aches? P: I, I have felt a little bit more drowsy these last few days and, uhm, yeah my, uhm, I have had some muscle aches as well. D: Have you taken anything to help yourself, anything over the counter or any pills? P: I did use, uh, some uhm, like cold medication to help because I was having a headache as well and a lot of I guess just like pressure from the nose stuffiness. D: Did the cold meds help? P: Yeah, it did help a little bit, it did help my nose clear up but it came right back after a few hours. D: And how's your headache now? P: It's not too bad. It's pretty mild, but it's there. D: Uhm, do you usually get headaches of this sort, or is this very different from what you generally experience, if you usually have headaches. P: I don't usually get headaches, but I have felt uhm, a headache like this before though. D: Oh OK, when was that? P: Maybe the last time I was, I was sick. D: Sure. P: Or if I don't get a good night's sleep. School's pretty early in the morning, so sometimes if I'm not sleeping well. D: I see. OK alright, any other symptoms that you've experienced over the past five days that I didn't ask you about? P: No, it's been, yeah mostly the runny nose and sore throat and headache. D: I see. OK, alright, and do you have any medical conditions? P: No, I've been healthy. D: All right, good, any medications that you take on a regular basis? P: Uh, I'll use like Reactine or Claritin sometimes for allergies, but that's it. D: What allergies do you have? P: I have allergies to dust and some environmental things, like pollen or ragweed I think maybe. D: I see. Alright, and, uhm, do you have any family history of any medical conditions? P: Uh, I think my dad has high blood pressure. He takes a medication for that, uhm nothing serious though that I know of. D: OK, alright, and who do you currently live with? P: So I live with both my parents and I have an older sister as well. D: Good, OK, and do you smoke? P: I did try a vape once or twice, but, didn't really like it so, no. D: Alright, what about marijuana? P: Uh, no, I haven't tried that. D: Any recreational drugs? P: No. D: Do you drink alcohol? P: No. D: And have you recently traveled anywhere? P: No, we've been doing classes virtually. D: And any contact with anyone who you think might be sick. P: No. D: OK alright, well sounds like you have a sore throat and runny nose. You've been a little bit drowsy, had some headaches in the past five days, things were getting a little bit worse early on, but it's been a little bit, it's been more stable now. We'll do a physical exam, see, just listen to your chest, have a look inside your mouth and check your temperature and go from there. It sounds like you probably have a viral infection of some sort that should get, hopefully get better over time. We will also get a covid swab done just in case and if things seem to get worse, we can, you can definitely come back. P: OK, great, thank you.
dataset\resampled_file\RES0099.wav	D: Umm, how may I help you? P: So yeah I've been having for the last two days, uh, it just started randomly. I had to miss work, Just a headache started at the beginning and then I noticed the same day, so this was two days ago. A headache started and my body just started aching throughout the day and yesterday I just developed, I think it was a fever, I didn't really get a chance to check, like, but I was very chilly yesterday and now I have this cough as well. D: OK, so just to confirm, so the, the symptoms at first started with a headache and, and fatigue, and that started two days ago? P: Yeah, like with fatigue, like also just the, my muscles were aching. D: OK, and any particular muscles that were achy or is this more of a, uhm, general kind of whole body feeling? P: Just a general whole body feeling. D: OK. Uh, and in terms of the headache, could you describe, uhm, could you describe the headache? P: Yes, it's just kind of like at the front like near my forehead, on, on kind of like both sides more. It just feels like, like pressure in there. D: OK, have you had headaches like this before? P: Uh, no, not really. D: OK. Uhm, is the headache on one side or, or the other or on both sides? P: I think it's like both sides. D: And is the headache like pulsating or is it more, continuous kind of constant pain? P: I think it's more continuous constant. D: Alright, and have you had any sensitivity to light or sound that, that's made the headache a lot worse? P: No, it's, it's kind of just there, it's about the same as when it was when it started. D: OK, have you had any nausea and vomiting associated with that, the headache or anything else? P: Uh, no. D: OK. And so, and then, last question for the headache piece. Does it feel like it was a like kind of sudden onset, worst headache of your life sensation? P: Uh, no, it's still like, like I can still cope with it, like, if I wanted to I would have gone into work. But it was the muscle aches that really started bothering me. D: OK. And so you had a cough as well, when did this start, and is it a dry or wet cough? P: It's a dry cough and it started yesterday, probably in the morning when I woke up. D: OK, and has the cough been getting any better or worse? P: Uhm, since yesterday I would sayit's probably a bit worse now. D: Alright, and it's dry, but have you seen any blood that's come up? P: No, no, no blood. D: And have you had any shortness of breath? P: No. D: OK. And have you had any flu like symptoms or infectious symptoms like a red eyes, runny eyes, runny nose, or a sore throat? P: No, I don't have any of those symptoms. D: OK, you mentioned you felt feverish. Do you feel hot now? P: Not right now, but I did have, last night just, was just very chilly and Uh, I had to just wrap myself up in a couple blankets. D: OK. Did you have any night sweats? P: No, I, I didn't have any night sweats. D: Alright, and have you had any chest pain? P: No, no chest pain. D: Alright, so how about any dizziness or lightheadedness? P: Nope. D: OK. And have you had any wheeze? P: No wheezing. D: OK. Uhm, and have you noticed any swelling to any of your extremities? Like your ankles? P: Uh, no. Nope. D: OK. And have you had any belly pain? P: No belly pain. D: Any urinary problems like pain or, or frequency going to the bathroom? P: No. D: And any diarrhea? P: No diarrhea. D: Alright, and have you noticed any rashes or, or changes to your skin? P: No, not at all. D: Alright, and I don't know, you've had muscle aches, have you had any joint pains? P: Uh, no, no musc, sorry no joint pain. It's mainly just like in, I would say in around my upper back like my upper arms and kind of like my thighs and glutes areas D: OK. And how has your energy been these last couple of days? P: Yesterday I felt a bit drained. I just kind of like stayed in bed the whole day. D: OK, and have you tried any medications for the, for the headache or any of your symptoms so far? P: I, I took a Tylenol. I actually took a couple Tylenols, uh, when the headache and pain started. It did help a bit for a couple hours, but it just kind of came back. D: OK. And in the past, have you been diagnosed with any medical conditions? P: Uhm, Just uh, like I had type 2 diabetes, that's it. D: OK, and are you using medications for your diabetes? P: Yeah, I've been on Metformin. D: OK, have you used insulin before? P: No, no, I've never had to use insulin. It's pretty stable, like my family doctors even considering taking me off the metformin. D: OK, no, that's great. And that reminds me, actually, how has your weight been over the last several months? Have you had any weight changes? P: Not really, like I, I, I think over the last two years I've just been very focused on my fitness, so I feel like I've probably lost around 30 pounds over the last year. Last one to two, yeah, year, but like I, I've been exercising a lot like uhm, gym every day, it's, it's been, it's been a journey. D: no that's great though, good for you. I encourage you to keep that up for sure. OK, and so do you take any other medications, other, over the counter or prescribed? P: Uhm, just a multi vitamins. D: Alright, and do you have any allergies to medications? P: No, not that I know of. D: All right. So have you had any hospitalizations or surgeries? P: No. D: Alright, and uh, anybody in the family have any like lung conditions, heart conditions or diseases that run in the family? P: Uh, my, my son actually just recently was diagnosed with asthma. But I think that he gets that from his mom's side. D: OK. Uhm, you don't have any asthma or problems breathing like that? P: No, nothing like that. D: OK, and right now, so you mentioned your son and wife, is that who you're living with? P: Yeah, it's just us three. D: OK, and uh, any exposures to, to anybody who's been sick, either at home or at work or, or any other activities? P: Uh, unfortunately I do have to, uh, I'm one of the unlucky ones that still has to go into work. And yeah, it's it's hard to say like at work, there are times when we, like at lunch we eat like without a mask. I don't know if, I didn't notice anyone having any symptoms, but like, I don't know if someone, you know, who knows where anyone has been. D: Yeah, so nobody that you're aware of who's been sick though? P: No. D: And everybody at home has been OK? P: Yeah, at home everyone's good. I kind of just distance myself into like one room. D: Mhm. P: Just in case anything goes wrong. D: OK. And have you traveled anywhere? P: No, we've been, we've been at home this whole time. D: OK. And do you smoke cigarettes? P: No, I've never smoked. D: OK, so do you, do you smoke marijuana? P: No. D: Alright and you use any other recreational drugs like cocaine, opioids, heroin? And how, have you used anything like that in the past? P: No. Never. D: OK, uhm, and do you drink alcohol? P: Yeah, well just occasionally, like I would say maybe, maybe some wine, once, uh, like once every couple days. Maybe a beer on the weekend, but that's it. D: Alright. So I think that was all I wanted to ask on history today. Was there anything else that, that you wanted to add before we go on to the exam and? P: Yeah, so I, I, I don't know if I should get a test done, like for covid. Uhm yeah, that's all, just wondering if I, if I can do that here? D: Yeah, so that is something that that is on the differential for what could be causing your symptoms, especially with uhm, starting at having a cough and the nonspecific viral type symptoms with the cough, headache, muscle aches, so certainly could be caused by covid, but there are other reasons for, that could explain these symptoms, such as other types of viral illnesses, and so we will do a PCR swab today, as well as do, well, check your vitals to see if you have a fever now and we'll also maybe send an influenza swab as well, and and do some blood work. But in the meantime, since we're running the covid swab, it will be important to self isolate for the next 14 days and we will let you know what the test results show. But despite, even if they are negative, it will be important to still stay self isolating for the next 14 days. P: OK, I'll do that. That sounds good. D: Alright, thank you.
dataset\resampled_file\RES0020.wav	D: Could you tell me what brought you in today? P: Sure, you know I've been having this chest pain for the since last night. Um, and I'm also having a hard time breathing so thought I should check it out. D: Ok, um and so the chest pain came on last night. Were you doing anything before before it coming on? P: No, I was just about to head to bed and suddenly I felt this crampy pain in my chest. D: Ok, and where is this pain located? P: I'd say like the center of my chest. D: Ok, uh, has the pain been going on constantly since last night? P: Yeah, I would say so. D: Ok, has it changed in character at all? You said it was crampy, but has it felt like anything else? P: Um, no. Just just crampy, yeah. D: I see, did you feel the pain anywhere else, or do you feel it just in the center of your chest? P: Ah yes, center of my chest going up to around my throat area maybe. D: OK, I see and anything that you've done, that's made the pain worse? P: Um, I guess taking in a deep breath. D: Ok, and how about changing positions, does the pain get worse if you lie flat or or if you lean forward? P: No. D: Ok, um, and have you ever had a pain like this in your chest before? P: No. D: Ok, and and has the pain get been getting worse, getting better, staying the same? P: It's been the same. D: Ok, have you taken anything for it, to help with the pain? P: No. D: Ok, and the shortness of breath you mentioned, uh, when did that start? P: Around the same time. D: Ok and, is this trouble breathing like after walking a certain distance or exerting yourself? P: No, it it it, it's just always there. D: Ok, and have you noticed any changes to the sounds of your breathing, like a wheeze or whistling sound? P: Yeah, maybe maybe a slight wheeze. D: Ok, do you think that you're breathing more quickly? P: No. D: Ok um, have you had a cough? P: No cough, no. D: Alright, and so you haven't been bringing up any sputum or or any blood? P: No. D: Ok and, have you had a sore throat? P: No sore throat. D: Alright, so you've had this chest pain since last night and shortness of breath that started around a similar time last night. Have you had any other symptoms? P: Just just some fatigue, some tiredness. D: Alright, and did that start around the same time? P: That started a few days before, like maybe two days before. D: Ok, has there been any change to your sleep or any stressful events happen that might be tiring you out? P: No. D: Ok, and have you had any headaches? P: Nope, no headaches. D: How about any eye symptoms like discharge or or eye pain? P: No, nothing like that. D: Any any redness of your eye? P: Nope. D: Alright, so have you had a runny nose? P: No. D: Alright, and uh have you felt like your heart is racing at all? P: No. D: Ok, have you had a loss of taste or smell? P: Nope. D: And have you had a decrease in your appetite? P: Um, no. D: I see, ok and have you had any changes to your weight in the last several months? P: No. D: Alright and, have you had any diarrhea or constipation? P: No. D: Alright, and how about any nausea or vomiting? P: Uh, none. D: Any abdominal pains? P: No. D: Alright, and how about any confusion or or concerns around memory? P: No. D: Alright, and, any muscle aches or pains? P: Maybe slight muscle aches. D: Have you had any weakness? P: No. D: Ok, and any rashes you noticed anywhere? P: No none. D: Ok, and have you had a fever? P: Um, nope. D: How about any any chills? P: No chills. D: Alright and then any night sweats? P: No. D: Alright, and do you have any medical conditions that you see a physician regularly for? P: No, actually sorry, I have diabetes. D: Ok, is that type 2? P: Type 2. D: Ok, and are you taking any medications for that or is it kind of diet or lifestyle controlled? P: I'm on insulin for that. D: Ok, and you use a sliding scale or do you have a regimen you use? P: Um, I have, so I have like a long acting and short acting, so I just take the long acting before I go to bed and then the short acting before meals. D: I see ok. So that sounds like a great, a great plan. Do you take any other medications? P: Yes, I take some vitamins and you know, like vitamin D and calcium, but that's it. D: Ok, any allergies? P: I'm allergic to penicillin. D: Ok, have you had antibiotics recently for any reason? P: No. D: Ok, and are your immunizations up to date? P: I think so. I think the only thing is I have to see if I'm up to date with my Pneumovax. D: Ok, great yeah I was wondering about that one so we can look into that certainly. And do you know if you've had the Zoster or the Shingles vaccine? P: Yes, I had that one. D: Ok great um, and um next could you I was wondering if you could tell me a little bit about your living situation? P: Sure, I live with my husband. We live in a 3 bedroom townhouse. It's a fairly new home. D: Ok, great. Did you recently move there? P: Yes we did. D: Ok, cool. And so there's no concerns with like old carpets or being exposed to kind of like dust or or molds or anything like that in the home? P: No, nothing like that. D: Ok, and um, has your husband been sick at all? P: No, he's been fine. D: Ok, and do you have any pets in the home? P: We have a cat. D: OK, and do you have any allergies to pets? P: No. D: Alright, um and how do you support yourself financially right now? P: Um, we're both retired, but we have our RESP savings. D: Oh excellent, ok, and for your previous occupation, were you exposed to any chemicals or like asbestos or inhalants that you're aware of? P: Uh no no, nothing like that. D: Ok, and you smoke cigarettes? P: I don't. D: Do you drink alcohol? P: I have maybe a glass or two glasses of wine over the weekends. D: Ok, and do you smoke marijuana or use any cannabis products? P: No, I don't. D: OK, and how about the use of any other recreational drugs? P: No, no, nothing like that. D: Ok and, and has anybody in your family had a heart condition before? P: My mother passed away when she was 80, she had some valvular issues. D: Ok um, uh, ok, and has anybody in the family had a heart attack before? P: No, not that I know of. D: Alright, and, anybody have any lung conditions? P: No. D: Alright, and then any cancer that runs in the family? P: Cancer? No no. D: Ok um, I think that's all I wanted to cover on the the history today. Was there anything else you'd like to tell me that I was, that I maybe didn't ask about? P: Uh no, I think you asked me all those other questions, I'm just wondering what do you like, what do you think I have? D: Yeah, certainly, uh, so it could possibly be something related to the heart. I don't, and sometimes especially people in your age group who have diabetes can have chest pain and symptoms that could be nonspecific. And so we will, we will check that for sure. We'll get an ECG and some lab work with the troponin and also a chest X Ray so that we can investigate for that. And also the chest X Ray could help us look to see if you have something going on in your lungs, like a possible pneumonia or, maybe a viral infection as well, which could include something like COVID-19. So we'll be ordering a PCR nasal swab as well to test for that. And so in the meantime, because we'll be doing that test, it requires self quarantine for 14 days so, if possible, that would mean distancing from your husband in the home as well for that 14 day period, but the results should come back from that test within the next several days. And and sorry, also if it is positive, we will have to notify public health as well so that the appropriate contact tracing can be done. P: Ok, ok well thank you very much. D: Now you're very welcome. We'll get the investigations started now. P: Sure, sounds good.
dataset\resampled_file\MSK0017.wav	D: What brings you in? P: Hi, yeah, so I've had this uh back pain that's been going on now for the last uh two weeks, it's just kind of right in the lower back and it just hasn't gone away. D: OK, um last two weeks you said, is it getting worse? P: Uh no, it's not really getting any worse, uh it's just been uh limiting my abilities at work. D: Right, OK, and what do you do for work? P: So I work um at a butcher shop. D: OK. P: Yeah, and we're like always like carrying heavy things and yeah, it's a lot a lot of like lifting and standing. D: OK. Did anything trigger this back pain two weeks ago? Did you have some sort of injury or trauma to the area? P: No, I can't think of anything uh like specific that happened, but there was one night where um like after work, I was sitting down after dinner and um I got pretty stiff that night. It was pretty sore and kind of ever since then, it's been been sore. D: OK, OK, um and is this a persistent kind of back pain or does it come and go? P: It's um, I can kind of always feel it, but it certainly gets worse if I am moving. So if I'm just kind of sitting at rest, I don't really, yeah, I don't really feel it that much. D: OK, OK, and if you were to describe the quality of this pain, um would you say it's sharp, throbbing, achy, crampy? P: I'd say I get kind of uh, it's a sharp pain. D: Sharp pain, OK. Um does anything make it better or worse? P: Um better would just be uh resting. D: OK. P: Um kind of just lying down, or um yeah, just just trying to uh rest. But um making it worse, yeah, if I'm uh like really any movement um if I'm like bending forward or um kind of like leaning to the side, I start to get um get some pain in the lower back. D: OK, OK. And then 1 to 10, 10 being the worst pain you've ever felt, how bad or uh how severe would you rate it? P: I would say 7. D: A 7, OK. And have you ever had pain like this in the past? P: Uh yeah, I've I've hurt my lower back before like many years ago. Um but it's been OK since then. D: OK. Uh did you get any sort of treatment or management for that pain um back in the day? P: At that time it was just rest and like did some stretching and I took some um anti inflammatories and it went away after a couple of months. D: OK, OK. Um and are you having any sort of like numbness or tingling, anywhere on your body? P: No, nothing like that. D: Alright, how about any muscle weakness? P: Uh no muscle weakness. D: No, OK. Are you still able to walk and do things that you normally would do in a day? P: Uh yeah, I'm able to walk still. D: OK. Um any dizziness or fainting spells? P: Nope, nothing like that. D: OK. Any pain elsewhere on your body? P: No, just just the lower back, yeah. D: OK. Headaches? P: Uh nope. D: OK, weight loss? P: No, I haven't had any weight loss. D: OK. Fevers or chills? P: Nope, no fevers or chills. D: Um rashes? P: Uh no rashes. D: Changes in your vision, hearing, taste or smell? P: No changes like that. D: OK. Any coughing, shortness of breath or wheeziness? P: Um nope, nothing like that. D: Um chest pain or heart palpitations? P: Nope, nothing like that. D: OK. Issues or changes in your bowel movements? P: Uh no changes to bowel movements, no diarrhea and no incontinence or anything like that. D: OK, um and then uh nausea or vomiting? P: Nope, nothing like that. D: OK, how about um changes to your appetite? P: Um nope, I've been eating uh, I've been eating well. D: Changes in your voiding? P: Uh nope, I haven't had any changes to urination. D: OK. Um and then are you otherwise healthy or do you have any longstanding medical conditions? P: Uh I I've had a few sports injuries when I was younger, uh like to my my knee, but that's it, I've been healthy otherwise. D: OK and um those injuries, are they all healed? P: Uh sometimes I'll get um like a little achiness in my knee from from doing like too much activity, but I know when those, when that happens. D: OK. Are you on any medications? P: No, I I don't uh take any medications. D: OK. Are you up to date with all your immunizations? P: I am, yep. D: OK. Um do you have any allergies? P: Uh, no allergies. D: OK, any family history of um muscular or skeletal issues? P: Um no, nothing like that. D: OK, how about um heart or lung diseases? P: Uh, no, no heart or lung diseases. D: OK, uhm how about autoimmune conditions? P: Um nope, nothing like that. D: OK. Cancers? P: Uh no cancers. D: OK. Um and do you smoke? P: Um no, I don't smoke. D: OK and do you consume marijuana? P: Uh sometimes, I'll have like uh edibles, little candy, sometimes at nighttime they they help me uh relax and sleep, but I don't use that very often. D: OK, how often do you use them? P: I would say maybe uh once a week. D: Once a week, OK. Alright um and then, what else did I wanna ask you? Um do you, do you take any recreational drugs? P: No, and I haven't used any before. D: OK, and how about alcohol, do you consume alcohol? P: Yeah I'll have a couple of beers on the weekend, so maybe like two or three. D: OK, uhm and who and where do you live right, who with and where do you live right now? P: Yeah, I live with my wife and our um and our son who's in high school. We live in a in a house. D: OK, OK. Um alright, and any concerns for STI's at all? P: Oh no, I've been with my wife now for a long time and we've been monogamous so no concerns for uh sexually transmitted infection right now. D: OK, how about um sick contacts, have you been in contact with anyone sick recently? P: No, I don't think so. D: OK, any travel recently? P: Uh no, I haven't traveled anywhere. D: OK um and well, let's move on to the physical exam part of this interview. Um so I'm going to get you to stand up from a sitting position. Does that hurt your back? P: Um yeah it does. I I do feel a little bit of a a twinge there. D: OK, and where about specifically? P: Kind of just, yeah, on the lower uh lower right side like more on the, more on the right side. D: More on the right side, OK. Now, if you have a mirror with you, or if you have someone there with you who can um speak to this, does your right side appear more red, swollen, or hot compared to your left side of the lower back? P: Uh no, nothing like that. D: No, OK, and does it seem like it's more atrophied or do you see any deformities or skin changes in that area? P: Uh nope, no deformities or skin changes. D: OK, um alright and I'm gonna get you to um bend down all the way and touch your toes if you can. P: Um yeah I I can get part part way down. D: You can get partway down, does it hurt? P: Um a little bit, I can feel it pulling and stretching, yeah. D: OK. Um alright, and then I'm gonna get you to uh like laterally flex to your right side. So kind of like you're doing an exercise um and you're just like bending towards that side. P: Yeah, that hurts. D: That hurts, OK, how about the other side, the left side? P: Yeah that hurts too. D: OK. Um and now I wanna get you to uh bring your knees up towards the ceiling. Does that hurt? One at a time, like your right right knee and your left knee. P: Uh, not really. D: No, OK, how about when you um flex your knees backwards? P: Nope. D: And kind of point your knees towards the ground. P: No, no pain there. D: OK, so no pain on knee extension or flexion. Um how about when you point your toes to the ceiling? P: Uh no pain there. D: OK so no pain on plantar flexion, how about when you point your uh toes to the ground? P: No pain there. D: OK, so no pain on dorsiflexion, and then sorry I forgot to ask you earlier, do you have any sort of numbness in the groin area? P: No, no numbness in the groin area. D: OK, so no numbness in the groin area, no weakness, no um changes in your bowel or bladder habits, including no incontinence, so uh no red flags? P: Yeah, nothing like that. D: OK, OK, good um and, OK so those are all the questions that I had for you. Did you have any questions for myself? P: Uh, no I was just uh yeah, kind of wondering do I do I need any X Rays or like what what what's going on? D: Yeah, so um what it sounds like right now is that you have something called mechanical back pain. It's pretty common and um it can be anything from your spinal joints to the discs to the vertebrate or soft tissue or muscle. Um and a lot of these can be caused by um hard activity at work, um like carrying heavy things um and then carrying them in like an improper position or something like that. Um and we diagnose that on history and physical exam, um but if after we try some management and treatment plans, it doesn't go away and it persists for more than eight weeks, we do recommend imaging, including an MRI. So uh in terms of management for right now, um modified activity at work, um some short term bed rest, uh very short term though um and bed rest is only really recommended if you have severe back pain and muscle spasms, um and you definitely shouldn't be doing that for more than like 24 to 48 hours, and physical activity can help, um so referral to physical therapy or physiotherapy um can help in rehab and they'll give you some exercises that you can try at home to kind of um strengthen those muscles. And then ice and heating packs um temporarily can help, uh medications like NSAIDs can help as well with the inflammation. Um so we'll try these things out and then we'll continue to follow up. Um yeah, did you have any questions or does that sound like an OK plan? P: Uh that sounds like a good plan. D: OK, sounds good, thank you.
dataset\resampled_file\MSK0006.wav	D: What brings you in? P: I I've had this, uh pain in the right buttock area, it's been really intense, and more recently I'm feeling it like radiate just down my right leg as well. D: OK, and sorry when did you say it started? P: So um it's been going on uh for, well, it's it's gotten really intense in the last uh like 2 days. D: OK, and before that, did you have any pain at all or was it just like sudden? P: Yeah, I do have a bit of pain uh down in my uh in in my buttock area. Um but um it's just gotten really uh, it's gotten more painful over these last couple of days. D: OK. Um and is it a persistent kind of pain? Or does it come and go? P: Um it's uh persistent, it's it it does get worse though, depending on what what I'm doing. D: OK, what uh when does it get worse? P: Um well it it gets it gets worse with walking, with sitting, um really any like any kinds of movements, like if I just gotta kind of stay still and that's the only thing that really helps it. D: OK, um have you tried anything for it? P: Uh yeah, I'm just taking some pain medic medications over the counter for these last couple of days um like Advil and Tylenol, but that's it. D: OK, um and does, is it helping? P: It does, I mean, uh not really, it hasn't really helped much. D: OK. Um alright, and if you were to describe the quality of the pain, would you say it's sharp, dull, achy, throbby? P: Uh it um, kind of like a sharp pain in the in the buttock and um it it um it's kind of like burning uh down the leg. D: OK, OK, so a radicular kind of pain then. Um OK, and if you were to rate the severity of your pain 1 to 10, 10 being the worst pain you've ever felt, what would you rate it? P: 8. D: OK. And does this pain radiate elsewhere, I know you said it starts on your buttocks, kind of goes down your legs, does it go up your back or down into the other leg at all? P: No, I feel it just uh just in the buttock and down the leg. D: OK, uh have you ever experienced this kind of pain before? P: Uhm I have, yeah um I'm a a truck driver, and so I do a lot of uh a lot of sitting and I've had kind of sciatic pain um in the past. D: OK, and have you ever had any like trauma or anything that could have triggered this initially um in the past? P: No, I don't think so, I don't, I haven't really done much, just kind of work and um ueah, I haven't had any trauma to the back or anything like that. D: OK, and are you experiencing any sort of weakness with your legs? P: Uh no no weakness, just um well, yeah, maybe I guess, maybe yeah, maybe a little bit of uh, leg weakness, I've had I've had a little bit of difficulty walking, been limping. D: Oh I see, OK. OK, and just in your right leg, right? P: Yeah. D: Any urinary or um stool incontinence? P No. D: No, OK. Any sexual dysfunction? P: No, I haven't had anything like that. D: OK, um any numbness or tingling? P: Yeah, I've I've had some numbness and tingling down the the right leg. D: OK, how about in the groin area? P: No, it's just kind of down the back of my leg. D: OK, um alright, and otherwise do you have any other symptoms? P: No, it's just been just been, uh, this pain. D: OK, alright. Um and I'll just kind of go through some questions with you. Do you have any joint pains or muscle aches elsewhere? P: No. D: No weight loss? P: No weight loss. D: Fevers or chills? P: No fevers or chills. D: Uh rashes? P: No rashes. D: Changes to your vision, hearing, smell, or taste? P: No. D: Um are you coughing, having shortness of breath, or wheezing? P: No, I haven't been any, having any symptoms like that. D: OK, any chest pain, palpitations, uh or dizziness or fainting spells? P: No, nothing like that. D: Any changes to your bowel movements? P: No diarrhea or constipation. D: And no bleeding in the stool? P: No blood in the stool. D: OK. And then how about nausea or vomiting? P: No, I haven't had any nausea or vomiting. D: OK, changes to your urine? P: Uh no, no changes to the urine. D: OK, and are you otherwise healthy? Do you have any longstanding medical conditions? P: I do have um high blood pressure and uh high cholesterol and I take medications for those, I take amlodipine and um a statin. D: OK, do you have any other medical conditions, are are you on any other medications besides those? P: Just a multivitamin. D: OK, and are you up to date with all your immunizations? P: I am, yes. D: OK, any allergies? P: Uh no, I don't believe so. D: No, uh family history of um musculoskeletal or neurological issues? P: Uh no, nothing like that. D: Uh autoimmune conditions? P: No, nothing like that. D: Cancers? P: No. D: No, OK. And do you smoke? P: Um yeah, I smoke uh about um half a pack of cigarettes per day. D: OK, for how long have you been doing that? P: Uh for uh yeah, about 40 years. D: 40 years, OK, have you ever thought of quitting? P: I have, yeah, I've cut down over the years, um I used to smoke more, it's just the culture with uh, I don't know everybody's driving a truck and smoking. D: OK, yeah, that's hard. If you ever need any resources, we have some that we can refer you to. P: Thank you. D: Yeah, no worries. And do you um consume marijuana? P: No, I don't. D: OK, how about other recreational drugs? P: Uh nope, nothing like that before. D: OK, do you drink alcohol? P: Um yeah, I'll have a beer or two on the weekend, so maybe a couple of drinks per week. D: OK. Um and how about um do uh, sick contacts, have you been in touch with any recently? P: No, I haven't been around anybody who's been sick. D: OK, um any travel recently? P: Uh just for the drop offs that I that I make um driving, I do have to make some pretty um long hauls uh back and forth um, the, yeah. D: OK. Um and where do you currently live? P: So I live in a house with my um with my wife uh yeah and son. D: OK, alright and, OK so now I'm just going to move on to the physical exam part of this um and I'm going to ask you to do a few things, OK? So, well just by looking at your legs, or if you have a mirror um and you can look at your right buttock area, um do you see any swelling or redness? P: Um no, I don't see anything like that. D: OK. And does it feel hot? P: No, it doesn't feel hot. D: OK. And do you see any skin changes? P: No skin changes. D: Um any atrophy or deformity in the area? P: No. D: No, um has your gait changed, like does it, are you limping, hobbling, anything like that? P: Um yeah, I feel like I've been limping a little bit, uh yeah. D: Are you putting more um pressure on the left foot then? P: I am, yeah, yeah, I guess there's like an antalgic gait. D: OK, alright, and then um if you press down on your hipbone, do you feel any pain there? On your right hip bone. P: No, I don't. D: OK, how about when you press down on your buttocks itself? P: Um yeah, there is uh a little bit of tenderness um over the buttock area. D: OK, how about the back of your legs? P: No. D: OK, how about the front um of your legs, thighs? P: No. D: No, OK. Alright, um and then I'm gonna just get you to do a few movements um with me as well. Would you uh OK, so are you sitting down right now? P: Yeah. D: OK. Would you mind standing up from a sitting position? P: Yeah, for sure. D: Does that hurt? P: It uh yeah, that that that causes pain. D: OK, so that causes, so um hip hip extension uh that causes some pain, um and as well as knee extension, so would you mind um kicking your right leg up in front of you all the way up as far as you can go? P: Mhmm, oh yeah. D: Does that hurt? P: It does, yeah. D: OK so right hip flexion um also causes pain, and then would you mind uh folding your knees backwards um and just sort of flexing it? Does that hurt? P: Uh no. D: OK, so no pain at knee flexion. And how about when you point your feet um and toes up towards the ceiling? P: Uhm yeah I I do get some pain with my um, yeah when that's all straightened out, yeah. D: OK, so some pain on um planter flexion of the right foot. And how about if you um point your feet and toes towards the ground? P: No pain there. D: OK, um alright and how about when you uh kick your legs uh to the side and upwards? P: Oh uh no pain with abduction. D: OK so no pain on right hip abduction, and then how about when you bring it back down? P: No. D: OK and no pain on hip adduction. OK, well those are all the questions that I have for you. Do you have any questions for myself? P: Uh just wondering about possibly like what it could be. D: Yeah, um so it sounds um right now like you may have some sort of uh sacral nerve radiculopathy um or or like a lower lumbar, lumbar um radiculopathy, um basically uh that's known as sciatica, uh where your nerve roots can be compressed, causing some of these symptoms. Um and to diagnose these things, usually it's just done by history and physical exam um but if after we try out some management things, it doesn't go away or you're having some red flags, including um numbness in the groin area, bowel or bladder incontinence, then we can look at some um imaging for the for the spine, including MRI. Um and so in terms of management of this, um we can try a couple couple of like conservative approaches first, so that includes taking NSAIDs uh for the pain um and then like activity modification. So if you're sitting down um all the time, um perhaps like taking little breaks, uh stretching out your legs, doing some physio as well um during those breaks can help um, and as well, I'm going to give you a referral for physical therapy and they'll do some exercises with you and um slowly increase those exercises. Um and if those still don't work, we can try um steroids, steroid injections, um as well, we talked about the imaging if it doesn't go away in about 6 to 8 weeks. Does that sound OK? P: Yeah, that sounds good. Thank you. D: OK, yeah no problem.
dataset\resampled_file\RES0120.wav	D: So what brings you in here today? P: Hi, um so I've been very I've been, I haven't been feeling very well for the past four days. I've, I've been having chills. I am feeling short of breath and now my chest hurts. D: Okay, I'm sorry. Um so how long, like can you just tell me what started first and when did this all kind of start? P: So, what started first? So, I would say the shortness of breath started first, um, and then I started having these chills and now it hurts like my chest hurts every time I try to take, try to take a deep breath in. D: And how long is this been going on for? P: Um, it's been going on for the past four days. D: Four days, okay. Um, and do you have any kind of cough at all? P: No cough. D: Okay, so just shortness of breath. And can you describe your shortness of breath a little bit? Is it uh, are you having catching your breath, or would you say you're having trouble taking deep breaths? Or how would you describe it? P: It's mostly when I'm trying to take a deep breath in. D: Okay, and uh, where would you say you're getting the chest pain? P: Um, it's mostly like centre of my chest, like, close to my, like I'd say it's like it feels like, it's not my like, it doesn't feel like it's inside. It feels more like it's pushing up on, on my chest wall. D: Okay, I see. And is it related to you taking deep breaths at all? P: Yes, it's definitely when I take a deep breath in. D: Okay, and what kind of pain is it? Is it like a sharp pain, stabbing pain, aching pain? How would you describe it? P: Um, it's a, it's, it's like a, I don't know. I guess it's a sharp pain when I try to take a deep breath in. D: Okay, um, and does it get relieved with uh, when you when you expire? P: Yeah. D: Okay, and have you had any of these symptoms before in the past? P: Um, nothing like this. D: Okay. Um, would you say like, your symptoms are constant, or do they kind of come and go? P: Um, they're pretty constant. D: Okay. And are they getting worse at all? P: Uh, no it's not getting worse, it was just bad to start with and it's still bad. D: Okay, and um, is there anything that you've tried that helps you with your breathing or relieves your chest pain? Anything that works for you? P: Um I guess sitting forward helps. Time now to take a super deep breath in. D: Okay, and have you had any kind of fevers or chills? P: Uh, yeah, I've, I've had chills for sure. I felt hot. I haven't actually taken my temperature, so I'm not too sure about if I actually have a fever. D: Okay, and when did you feel these chills? P: They've been going on for the past three days. D: Okay. Uh, and do you have any kind of other symptoms, like runny nose, sore throat, anything like that? P: Uh maybe like a slight runny nose, yeah. D: Okay, and do you get short of breath when laying down at all? P: Um, I, no, not no, I wouldn't say so. D: Okay, and do you have to wake up at night to catch your breath at all? P: No, nothing like that. D: Okay, and do you have any kind of swelling in your legs, hands, anywhere? P: No. D: Okay. Have you experienced any kind of um dizziness or fainting episodes? P: Uh, no. D: Okay, do you get any kind of chest pain with any activities? P: No, not really. I guess it's, I get tired with the shortness of breath. D: And do you, um, find that your heart is racing at all? P: Uh no, nothing like that. D: Are you having any night sweats? P: No. D: Um, have you had any sick contacts recently? P: Uh, I guess when I went to the grocery store the other day and there were people coughing around me. D: Okay, and were they wearing masks or were you wearing a mask? P: Yeah, everyone was wearing a mask. D: Okay. Are you um, having any kind of changes in your bowel movements at all? Any constipation or diarrhea? P: No. D: No, okay. Any changes in your appetite at all? P: Uh, no. D: No. Any nausea or vomiting? P: No. D: Okay. Any changes in your urinary pattern? P: No. D: Okay, any changes in your weight recently? Have you lost any significant weight? P: No. D: No, okay. Have you recently had a cold, like cold-like symptoms at all within the last few weeks? P: Um, yeah, I guess the runny nose. Um, I've had on and off for the past like 7 days. D: Okay, now, it hasn't gone away? P: No, it's not that bothersome though. It's more the chills and the shortness of breath, and this chest pain now that is worrying me. D: Okay, and do you have any past medical conditions or diagnoses? P: Um I was diagnosed with diabetes, um high blood pressure and high cholesterol. D: Okay, and when were you diagnosed with diabetes? P: I was diagnosed about 10 years ago. D: Okay. Um, I'm sorry I forgot to ask you this specifically, have you experienced any kind of loss of your sense of taste or smell? P: No. D: No, okay. Um do you take any medications for your medical conditions? P: Um, medications. So I take, so, for the diabetes I take insulin. For the high blood pressure I take ramipril. For the high cholesterol I take rosuvastatin. D: Okay, and do you have any allergies to any medications at all? P: No. D: Okay. Um, any recent surgeries or hospitalizations? Or any reason for why, if like, if you were immobilized at all? P: Um no, I don't think so. D: Okay, any history of hospitalizations or surgeries at all? P: Uh, I had a cholecystectomy about, oh gosh, it's like, 12 years ago. D: Okay, and were there any complications at all? P: No. D: Okay. Um any family history of any lung conditions, heart conditions or cancers? P: No. D: Okay. Um currently, do you work at all? P: No I, no I'm retired. D: Okay, and what's your living situation like? P: I live with my husband, um in a condo. D: Okay. Um and are you, is your husband well? Does he have any symptoms? P: Uh yeah, he's, he's been okay. D: Okay, that's good. Um, any kind of dust or mold, asbestos or any pets in your in your home? P: No, nothing like that. D: Okay. Do you smoke at all? P: Um I used to, but not anymore. D: Okay, and how long did you smoke for and how much would you smoke everyday? P: Uh, so I stopped about 20 years back. I smoked for about 25 years. I smoked about a pack a day. D: I see, um, and do you use any recreational drugs like marijuana? P: Um, I don't, no. D: Okay, and do you drink alcohol at all? P: I, I'll have a glass of wine here and there. D: Okay, and um yeah, so those were kind of, all the questions that I had today. Do you have any concerns or questions? P: Um, yeah like what, do you think I have COVID? D: Yeah so, right now it's definitely something that's on everyone's mind. Um some of these symptoms, um the shortness of breath and fever, definitely can be COVID, and that's something that we are going to test you with, and that's something we test everyone with. Um, but because you're having shortness of breath, uh, we do need to make sure nothing else is going on as well. Uh you can potentially have pneumonia that's not COVID, it can be any other virus or bacteria, so we will get some blood work done, we'll get your temperature and all your vitals taken as well, um and then get a chest x-ray as well. P: Okay. D: And if it turns out at all that you have pneumonia, we'll just reassess and see if you need to stay in the hospital for longer, if you need any antibiotics within the hospital, or you can take them at home. So yeah, we'll do a full physical examination and do all those tests and then go from there. P: Okay, that sounds great. Thank you. D: You're welcome. Um yeah, we'll be there with you shortly. P: Okay, great.
dataset\resampled_file\RES0187.wav	D: What brings you in? P: Hi, I'm just coming in here today because I've been just on wall recently over the last, I would say three to four days. I started getting these like really bad muscle pains all throughout my body and then over the past few days I've also been feeling chilly, so uhm, I wonder if I have a fever and I've also just been having this cough for the last few days as well. D: OK, what started first? P: I think the muscle pain started first and then it was the coughing then since yesterday, I think I might have a fever as well. D: OK. The cough started ,or the muscle aches started first. Was that two days ago, three days ago? P: Almost four days ago now. D: Four days, OK, and the cough started when? P: Cough started three days ago. D: OK, OK. Uhm before the muscle aches started, did you like do anything different in your life, like you know, do a lot of exercise or any other strenuous activities? P: No, I I haven't really changed my routine at all. D: OK, and where specifically like wha, which muscles ache? P: Pretty much like throughout my body, but I would say more so like upper back, my thighs, then my arms, yeah, kind of just all over. D: OK any joint pains as well? P: Uh, no, I don't think so. D: OK. And is it hard for you to walk like use your arms? Do you have any sort of like motor weakness? P: Uhm, it's not, I I can walk and there's no issues, but I I do feel like just overall general weakness. I don't know if that's to do with the pain or just feeling unwell. D: OK, so you're able to do those things. You just feel like maybe you're tired? P: Yeah. D: OK. Any numbness or tingling? P: No. D: No, OK. The cough, is it a dry cough or like productive cough? Are you bringing up phlegm? P: It's a dry cough. D: A dry cough, OK. Uhm, so no sputum or blood, right? P: No. D: OK, and you have a runny nose or stuffy nose? P: Uh, no. D: Sore throat? P: No. D: Shortness of breath? P: No. D: No, OK. Wheeziness? P: No. D: OK, any fevers? P: And I have been feeling chilly over the last few days, just, I have been wearing like multiple layers having to put on an extra blanket so I might have been having a fever. D: OK, but you haven't taken your temperature, right? P: No. D: OK. Any weight loss? P: No. D: Changes in your hair, nails or skin like rashes? P: Not that I've noticed. D: OK. Changes in your vision or hearing? P: No. D: Taste or smell? P: No. D: Chest pain? P: Oh sorry. Now that you mention I, I think taste a little bit today, I realized I was I wasn't really able to taste my breakfast. D: OK. So a little bit of change there? P: Mhmm. D: OK. And any chest pain? P: No. D: OK, any feelings of like feel like feeling like your heart's racing? P: No. D: OK. Uhm, how about uh like calf pain when you do a lot of walking? P: No. D: Fainting or dizziness spells? P: No. D: OK, any changes to your bowel movements? P: Uhm, no. D: OK, and any nausea or vomiting? P: No, no nausea or vomiting. D: OK, uh how about appetite changes? P: Uhm, appetites been the same. D: Any changes in your urine? P: No. D: Headaches? P: No. D: Confusion or memory loss? P: No. D: OK. Uhm, alright so are you otherwise healthy or do you have any longstanding medical conditions? P: Uh no, otherwise I've been pretty well haven't even really had to go to the doctor much in the past few years. D: OK, that's good. And then, any hospitalizations or surgeries in the past? P: No. D: No, OK. And how about medications, are you on any? P: Uh, no medications. D: OK, are you up to date with all your immunizations? P: Yep. D: OK, and how about allergies, do you have any? P: No, not that just like uh, seasonal allergies I sometimes get just itchy eyes and runny nose, sneezing in the springtime. D: OK. And do your current symptoms feel like that? P: No, no. D: No, OK. P: I feel completely different. D: OK, any family history of lung or heart conditions? P: Uhm, think my uncle had a heart attack in his 50s. D: OK. P: And I think my father has high blood pressure. D: OK. OK, any cancers in the family? P: Uh no, not that I know of. D: And then do you smoke? P: Uhm, just socially sometimes when I'm with friends, not-nothing regular. D: OK, and so for the past like two months, how often have you been smoking? P: Probably a couple cigarettes on the weekend. We usually smoke marijuana, so not not too much like tobacco or cigarettes. D: OK. OK. Uhm, do you do any other recreational drugs like marijuana, cocaine? P: Just marijuana, no other drugs. D: OK, do you smoke it or edibles. P: Smoke it. D: OK, and how often do you smoke cannabis? P: Probably just when I'm meeting up with friends. So every weekend I would say. D: Every weekend? P: Yeah. D: OK. And then how about an alcohol, do you drink alcohol? P: Yeah, I drink alcohol probably a couple of drinks every few days. D: OK. OK. And sorry what kind of alcohol do you drink every few days? P: Just mostly beers, maybe whiskey sometimes. D: OK, and how much of that? P: So probably a couple beers. Uhm every few days and then whiskey, maybe a normal glass every few days, so yeah I would say 3 or 4 beers a week and then maybe 2 glasses of whiskey. In a, in an average week. D: OK, OK. Alright, and have you been in touch with or in contact with anyone sick recently? P: No, no one's been sick. Uhm I do meet up with some friends on the weekends. Some of them are from work, some of them are just that that I know outside of work. D: OK. OK, uhm and have any of them been sick or have they all been pretty healthy? P: Uhm, in heard from anyone that's been sick. We we kind of have a rule that if you know if we feel sick then not to, not to show up just because, like you know, when we're when we're drinking and like smoking, we may share like a joint, so it's not like we don't want to get everyone sick if one person is sick. D: Yeah for sure. Uhm, that makes sense. Alright, any travel recently? P: No. D: No, OK. And where do you live right now? P: Right now I just live in an apartment by myself just outside of London. D: OK. Any old carpets, dust, mold, asbestos anything that could make your condition worse? P: No. D: OK, so those are all the questions that I had for you. Did you have any questions of your own for myself? P: Uh no, I don't think so, I just wanted to see what this might be. D: Yeah, for sure. Uhm so, we are going to do a Covid swab on you because a lot of your symptoms do align with those of Covid, so we just want to rule that out first, so you should hear back in about 24 to 48 hours. Uhm, in the meantime you should isolate for two weeks and if it's not Covid, it could be another viral infection that's been going around this time of year. Either way, kind of management plan is the same, so make sure you're hydrated, eat well, sleep well, and if your symptoms become worse, severe or there any red flags like you have neurological symptoms, like seizures or weakness where you can move your limbs, you should seek help from the ER. How does that sound? P: OK. That sounds good. Thank you. D: OK yeah, no problem.
dataset\resampled_file\MSK0023.wav	D: What brings you in here today? P: Hi, hi there I've been having this knee pain. It started almost immediately after I was I was playing basketball on the high school team and it was during practice I jumped up for a rebound and I, when I landed I heard a pop of my my left knee and I immediately felt pain. I just went off to the off to the sideline. D: OK, and when did this happen? P: Uh, this happened about. Probably like 6 hours ago. Maybe like a few hours ago. D: OK, OK, I see and since then have you been able to walk at all or have you been just, has it been very difficult? P: At first I was able to kind of limp off the court, but since then I I haven't really been able to walk. It's gotten pretty swollen since then and it looks bruised as well. D: OK, it's swollen and bruised in what kind of pain are you having, is it like sharp or is it aching? P: It's pretty sharp. It feels like there's people just stabbing me in the knee. D: OK. Uhm And um, do you have any, so you're having pain in your knee. Has it gone worse than when it started? P: Um. Yeah, it's yeah it feels a bit more painful than it did earlier. I think maybe the adrenaline was pumping a little bit. But yeah, now it's it's pretty pretty painful. P: OK OK uhm. And how much would you rate the pain out of 10, 10 being the worst pain you've felt in your life? P: Oh, I'd say this is like a 9 or a 10, this is it's really painful. D: OK, are you having pain anywhere else or is it just your left knee? P: Just my left knee. D: OK alright. Are you having other symptoms like fainting, dizziness? P: No, I I haven't had anything like that. D: OK, and are you having any fevers, chills or anything like that? P: No fevers or chills. D: OK. Any kind of numbness or tingling at all? P: No no Mr tingling. D: OK. Is the pain moving anywhere else from your knees? P: Uh, no I just feel like pretty like just right in my in my knee. D: OK, and what kind of motions are hurting you right now the most? P: I would say just like bending my knee, like, yeah, flexing my knee up as well as, like if I try to put any weight on it like I can't walk on it right now, I can't put any weight on my knee right now. And also even straightening it out hurts as well if I'm really flexing the muscle, so just trying to stay pretty immobile right now. D: OK, I see. OK, and in terms of other symptoms, any kind of chest pain, shortness of breath? P: No, nothing like that. D: OK, any rashes or skin changes? P: No, the only skin change that I that I have is the like bruising or looks like you like blood around my knee. D: OK you see is it warm to touch? P: Um. No, no, it's not warm. D: OK. In terms of your past medical history, any conditions you've been diagnosed with in the past? P: No, I've been healthy. D: OK, any medications that you take regularly? P: No, I don't. I don't think anything regularly. D: OK, any allergies to any medications? P: No, I don't. D: OK, any hospitalizations or previous surgeries? P: No, nothing like that. D: OK, and any family history of any musculoskeletal or rheumatologic conditions? P: Um, no no, nothing like that I I I mean I think my dad I had a rotator cuff injury or something like that but I mean he's in his 50s now so I think that happened at work or something I don't know. D: OK. Uhm, OK, and other than that, do you, so are you at school right now? P: I am yeah, I'm in grade grade 10 and playing well playing on the the high school basketball team and that's how I got this injury here. D: And have you had a similar injury at all in the past? P: No, I mean I'm I've I've sprained my ankles in the past, which would go would heal with some rest after a few days I never got those checked out because they're they weren't so bad, but I've never injured my knee before. D: OK and. Currently, right now, what's your living situation like? P: So I live with both of my parents and I also have a younger sibling. A sister, she's 8 years old and we have a dog as well. D: OK, uhm. Alright, and have you experimented at all with any recreational drugs, alcohol, or smoking cigarettes? P: No, nothing like that. I see kids at school um smoking and stuff, but, you know, as an athlete, I try to stay away from that kind of stuff as much as possible. D: OK, no, yeah, that's really that's really good that you're thinking like that. Any issues at school like bullying or do you feel unsafe either at home, around your home environment or at school? P: No, I don't feel unsafe. I mean, I know there's always those kids at school who are mean to others. But I mean, I, I generally feel safe. D: OK, alright so I'm just going to ask a few questions about just the examination part of part of this. Do you, so you mentioned you can't flex your knees at all, can you extend them? P: Yeah it it can, uh, straighten it out all like most of the way, it seems like it's bent a little still maybe from like the swelling and only I can't straighten it out the full way. D: OK, and then you said you noticed like bruising and kind of like there's blood accumulating in that area? P: Yeah exactly yeah, it looks like it. 'cause it's a bit like Brown. I guess I can like see or on my knee I guess like the like a big bruise. D: OK, I see. OK. And. Yeah, so those are kind of like all the questions I had for you. It seems that based on the description of how the injury happened an the mechanism and what you're feeling right now and in terms of the examination, it's possible that you had knee ligament injury. Most likely in this case, the anterior cruciate ligament, but just to make sure we will need to do an MRI of your knee and see which ligament is affected and to what extent. Uh, and usually with the with the depending on what we find on the MRI sometimes it can be just conservative management, but however oftentimes you do require surgery, so it would be. Just a surgery where we put kind of like a scope in into your knee and through the scope we try to fix the ligament. So yeah first, we'll just do the MRI and see to what extent your knee injury is and how how affected the ligaments are, and then we'll go from there. Does that sound OK? P: It does. Yeah yeah, thank you. D: Welcome alright, Take care.
dataset\resampled_file\MSK0021.wav	D: What can I do for you? P: Hi there, yeah I've had this pain in my knee that's been going on for a few weeks now and it hasn't gone away and and so I thought I would get checked out. It's been really impacting my running. I just haven't been able to run as often as I would like to and so that's why I wanted to get this looked at. D: Yeah, for sure. You said it started a couple of weeks ago. Was that two weeks ago, three weeks ago? Or more than that? P: Yeah, I would say maybe it's been going on for the past four weeks, for the past month. D: Past month. OK. And is it a constant type of pain or does it come and go? P: It comes and goes, yeah, and it depends on what I'm doing. D: OK. Uhm, alright and what kind of makes it worse or better? P: So if I'm out while running, what will bug it, but I think like that the main things that hurt are if I'm walking down stairs or if if I'm squatting. I like to lift weights as well, and yeah, I could barely even do body weight now 'cause if I I'm squatting down it causes a lot of pain, it's a sharp pain. D: OK. OK, and if you were to describe the quality of your pain, would you say it's achy, throbbing, dull, sharp, burning? P: Uh, it's a sharp pain. D: Sharp pain, OK. And one to 10, 10 being the worst pain you've ever had. How bad is this pain? P: It's about a 7. D: 7. And have you ever had pain like this in the past? P: Uh, no, I haven't. D: OK, and do you feel like your pains getting worse over the past four weeks? P: Uh, yeah it has gotten, has gotten a bit worse. D: OK, uhm, alright, and do you, are you experiencing any sort of muscle weakness? P: No muscle weakness. D: No, OK. How about numbness or tingling? P: No numbness or tingling. D: Headaches? P: No. D: Confusion or memory loss? P: Nope. D: Any joint pains or muscle aches outside of the area of this left knee? P: No, just, just the left knee. D: And whereabouts on the left knee, is it? P: It's on the anterior aspect. Like on the front of it, but I I could, it feels like the pain is right behind my like right underneath the kneecap. D: Right underneath the knee, OK. P: Yeah. D: OK. Alright and otherwise like have you had any weight loss? P: No, my way it's been the same. D: OK, how about fevers or chills? P: No fevers or chills. D: OK. How about fatigue? P: No fatigue, energy's been good. D: OK. Changes in your hair or nails like rashes? P: No, nothing, nothing like that. D: OK. Changes in your vision, hearing, smell or taste? P: Nope, that's all been normal. D: OK, alright. How about coughing, shortness of breath, or wheezing? P: Uh, no, not not-nothing like that. D: OK, chest pain or heart palpitations? P: Nope. No chest pain or or anything like that. D: OK. Any changes in your bowel movements? P: Nope, I haven't had any diarrhea or any blood. D: OK, any changes in your urination? P: No. D: No, OK. Alright, and are you otherwise healthy or do you have any longstanding medical conditions? P: I do have, ah, asthma, so I I do take a, an inhaler. I have a daily, a daily one that I'll use and then, just a, like rescue one. So like the blue one that I'll use sometimes, but I haven't needed that one for for awhile. I've been pretty good. I don't even need it when I'm going or runs anymore. D: OK, OK that's good. And are you on any medications? P: Yeah, just the just the inhalers and then I took uh, birth control as well. I've been taking that since I was 16 so, yeah, so for like 6 years? 7 years? D: OK alright. And are you, have you been hospitalized or had surgeries in the past? P: No, I haven't had any. D: OK, how about immunizations? Are you up to date? P: I am, yes. D: OK, how about allergies? Do you have any? P: Uh, I, uhm, I don't, no. D: No allergies, OK, good. And any family history of musculoskeletal issues. P: Uh, no, ah, well, I think my grandparents have like osteoarthritis or something like that. They, but, that's it. D: OK. Uhm, how about longer heart conditions? P: No, nothing like that. D: OK. And any autoimmune conditions? P: No, I don't believe so. D: No, OK. How about cancers? P: Uh, no, no cancers in the family. D: OK, And, and do you smoke? P: No, I I try to stay away from that with all the running and stuff that I'm doing. I'm uh, I want to make sure that I'm able to to improve. D: Yeah, for sure. And how about marijuana? Do you consume that in any form? P: No, I don't. D: No, OK, and how about recreational drugs? P: No, I stay away from that stuff too. D: OK, OK, good. And who do you live with and where do you live right now? P: So I live with a couple of roommates at school, just finishing up my undergraduate degree. D: OK, OK. Uhm, have you been in contact with anyone sick recently? P: No, I don't, I don't think so. Everybody's been been healthy. D: OK, OK, and travel anywhere? P: No, we've been at, been at home. D: OK. OK, uhm, alright, so I think those are all the questions that I have for you. Let's move on to the physical exam part of this interview, if that's OK with you. So I'm going to get you to take a look at both your knees and let me know if you see more redness or swelling in your left knee compared to your right. P: Uh, no, I'm not noticing any swelling. D: Do you see any redness? P: No, no redness. D: No, OK. How about any atrophy, deformities, or skin changes in your left knee compared to your right knee? P: No, nothing like that. D: No, OK. I'm gonna get you to press down and palpate on your quadriceps on both knee. Sorry, on both thighs. Do you feel any pain there? P: Uh, no pain there. D: OK, how about when you press down on your knee caps? P: Yeah, I do get some pain when I push on the on the kneecap, uhm, on my left knee. D: OK, how about just below that where your shins start? P: No pain there. D: No pain there, and then how about on the lateral aspects of your knee? P: Ah, no pain there. D: And then the medial aspects of your knee? P: No pain there. D: No pain there. OK, good. When you are palpating, was there a difference in temperature between the left and right knee? Was the left knee a little bit more warm than the right knee? P: No, the temperature feels the same. D: OK, OK, good. So now I'm going to uhm, are you sitting down? P: I am yes. D: OK, so from a sitting position I'm going to get you to stand up uhm, and you let me know if that is painful. P: It is, yeah. D: Yeah, OK. Uhm, and then how about when you bend your knees? P: Uhm, no, no pain with just bending. D: OK, how about when you, uh, when you flex your hips so you can do one leg at a time, does that hurt? P: Oh no, that doesn't hurt. D: OK. And how about squatting down? P: That does hurt. Yeah, squatting hurts. D: Squatting hurts OK. OK and then how about when you point your toes towards the ceiling? P: No pain. D: OK. How about when you point your toes towards the ground? P: No pain. D: No pain. So no pain on dorsiflexion or planter flexion, OK. Do you hear any like popping or crackling sounds in your knees when you climb stairs or when you're standing up after sitting down for a long time? P: Yeah, yeah, sometimes I will hear, uhm, some, some like yeah, crackling sounds. D: OK, alright and yeah, you mentioned that you do a lot of running. Do you do any other sorts of exercises? P: Yeah, I'll do some weight lifting and like cycling as well. I mean, all kinds of different stuff. We just, like staying as active as I can. D: OK, alright yeah, given your young age and the fact that you do a lot of running and a lot of physical activity like cycling and lifting weights, what you have is most likely something called a Patellofemoral syndrome and that is basically a nerve. Uh kind of pain and then in the in the soft tissues and bone around your kneecap. Uhm, and it's basically happens because of overuse, so vigorous physical activities that put repeated stress on your knees, like running and cycling, uhm, can cause that or just like improper sports training techniques. Uhm, we can do a few things that that'll help with the pain. So for a little bit, if you could hold off on the running that would be good. So, in the meantime, while you while you switch to like low impact activities, whether that's like riding a stationary bike or swimming, you can also try something called the RICE method and so that stands for resting, uhm, so avoiding putting any strain on that knee using ice packs for several days, compression, so wrapping your knee in like an elastic bandage, as well as elevating your knees higher than your, then the level of your chest can help. And then with the sharp pain you could also also take ibuprofen for pain management. Uhm, yeah, so we can start there if it doesn't get better we can also order an x-ray just to rule out other things that could have caused this pain in your knee. And if none of those nonsurgical treatments work, oh sorry, I also forgot to mention will also refer you to physiotherapy to help you with the range of motion and strength and endurance. But of those non surgical treatments work we'll also refer you to like am arthroscopy or some sort of surgery that may be able to fix the issue more permanently. Does that sound OK? P: It does, yeah, thank you. D: OK, yeah, no worries.
dataset\resampled_file\GEN0001.wav	D: Hi, what brings you to clinic today? P: Hi, so I feel like I might have a bladder infection. I see a urologist because I've had some issues with like an overactive bladder for awhile. I've had a few bladder infections in the past and this is usually how how they feel. I feel like a little bit of burning when I go to the bathroom and I have to go like a lot right now. But then also sometimes it means that like it gets like this when I have my period and I don't have my period right now, but I you know I I could be getting it, but I also just don't wanna let it go keep going if I do have an infection. I just like rather get it like treated if I do. D: OK understood. When was your last period? P: Um, like 2 weeks ago. D: About two weeks ago, are you fairly regular? P: Like yes and no, it's. I'm I'm not super irregular, but I I sometimes have like basically it's like I alternate sometimes. I my cycles like 4 weeks and sometimes it's more like 5. D: Sorry, just clarify again, you're 30 years old? P: Yeah I'm 30. D: Ok are you on any contraception right now? P: Uh, no, I'm not. D: Ok. Are you sexually active at all? P: No. D: No? Ok. So just in terms of your urinary tract infections, when was your last one? P: I had one like 3 months ago maybe. D: 3 months ago ok, and they prescribed you antibiotics and it went away fairly quickly? P: Yeah yeah it went away like I always I always have an overactive bladder and I always have to go pretty frequently, like every hour, sometimes half hour. But so that's still there, but like it hasn't ever since then, I haven't had any like pain with it. D: Ok, so you still have quite a, you have a, quite a bit of urgency to go? P: Yeah. D: Kind of going more frequently, but I suppose the new thing you're a little bit concerned about is that it, it burns a little bit, it stings a little bit when you do urinate. Am I understanding correctly? P: Exactly like for the past couple days, it's felt like that. D: Ok, has it been getting progressively worse at all? P: Um, maybe a little bit I I feel like now I can recognize it pretty early when it's not too bad to kind of get ahead of it. D: OK understood. And do you have any pain kind of behind your ribs at all? On your back? P: Sorry, can you repeat that? D: You haven't had any pain on your back, middle back kind of close to your ribs, have you? P: Not that I can think of. D: Ok, and have you noticed any changes to the quality of the urine? For example has it looked frothy or smelled bad? P: It maybe looked like a little cloudy. But nothing, nothing else out of the ordinary like I've never had blood in it or anything. D: Understood. Have you noticed any visual changes in the area near the vagina? P: No, not that I can think of. D: Like any lesions, anything like that? Anything concerned for an STI that you're worried about? P: No, and like I haven't had like had a sexual partner in a few years. D: Understood, understood. These are kind of questions that we ask when someone's having a little bit of maybe an issue holding in their urine. Have you ever felt any numbness or inability to feel kind of around your buttocks region? For example, when you wipe with tissue paper, can you feel that well? P: Oh yeah, I can feel everything. D: Ok and no changes to your poops, to your bowel movements? P: No, nothing, pretty normal. D: Ok, and how do you feel otherwise? P: I, I mean, I feel I feel a little tired, felt like a little hot yesterday. I don't have a thermometer so like I didn't take my temperature but, you know, sometimes I feel a little hot like when I've had the infections before. D: OK, you don't have any swelling on your anywhere in your body on your ankles, do you? P: No. D: No? Ok, and then, so no puffiness around your eyes that you've noticed? P: No, nothing like that. D: Any rashes or any changes on your face? P: Like my mom said, I, I I saw my mom earlier and she said I looked like a little flushed but it's not not like a rash or anything. D: No? No markings across the bridge of your nose and your cheeks? P: No. D: Ok, and then in regards otherwise you feel a little flushed, a little tired? Any other medical issues that you have? P: No, just this like overactive bladder thing. D: OK, and have they given you any medications for it? P: We tried a few different ones before, now I get I get Botox injections into the bladder like maybe twice a year. D: Anything else they've used recently? Like any medications you're on right now, I suppose? P: No, nothing no nothing else. Yeah, I guess I have like I have an inhaler but I don't use it all the time like I haven't had to. D: Oh, so you have asthma? P: Yeah, like I honestly don't feel like I have it very much now, but I still have like I still have the inhaler. D: Understood, understood. Anything else, you've taken medications for in the past? P: Oh, I used to take birth control, like the the pill but like I just I don't have a boyfriend right now and I just didn't really feel like I needed it otherwise. D: Understood, understood. And have you had any past surgeries? P: Um, I had my appendix out when I was 24. That's it though. D: Ok got it. And then just in terms of you yourself, do you live in London? P: Yeah yeah I do. D: Ok. What do you do for work? P: I work at a bank. D: Ok, do you have any children? P: No. D: Ok, and in regards to anything so any sick contacts? P: Uh no. D: Any recent travel? P: No. D: Any allergies? P: Like sometimes in the spring I'll get like a little stuffy but... D: Ok, sounds great. P: No like, yeah... D: Nothing to concerning? No drug allergies? P: No, nothing like that. D: Got it, got it. OK, I think what now do next, I'll move to a physical exam. I think we might just do some investigations just in order to get some more information. And then the physician will come in to see you, ok? P: Cool, thank you. D: No problem.
dataset\resampled_file\RES0085.wav	D: What brings you in? P: Yeah, so I just brought my son, went to the hospital. I've just been getting very concerned because he's making like these, like grunting noises for the last day and, like it's it's really worrying me, I don't know if he's like not breathing and I also just did like a temperature on him just this morning and it came up to like like a high 38, so I don't know what's going on, and then he's just very like irritable and just not himself I think. D: OK, so all of this started a day ago, you mentioned? P: Yeah, it started yesterday, but the grunting started today, like, I think he was a bit on the warmer side last night as well, more irritable last night, but the grunting started this morning. D: OK, Uhm, and you mentioned his fever was 38, correct? P: Yeah, I think it was like 38, 7 or something like that. D: OK is he coughing at all? P: Uhm, yeah, I would say with the grunting there is some coughing in between as well. D: OK, and is he bringing up any phlegm? P: Uhm, he's been having some spit ups as well. They're mainly like clear and whitish, but yeah I don't know if he's bringing anything else up. There's no green or yellow material though. D: OK, any blood in there? P: No, I haven't notice any blood. D: Does he sound wheezy? P: Uh no, it's mainly just the grunting. D: OK, OK, does he look swollen to you? P: Uh, swollen as in just, uh, like in his. D: In his, uh, like uh, legs, arms or belly area. P: No, I don't think so. D: No ok, and uh, does he have a runny nose or a stuffy nose? P: No, I don't think so. D: No, OK, how is his feeding? P: Yeah, it's it's been difficult. So right now, like his mom is at home, but she was having difficulty feeding. He's mainly breastfed right now. D: OK. P: And he's not really been feeding too much either. D: OK, and how about like the number of wet diapers he has? P: Just the normal like, that hasn't changed. He has like three or four in a day. D: OK, OK, good. Have you noticed any changes to his bowel movements or urine? P: No, pretty much been the same. D: OK, is he throwing up at all? P: Nope, just some spit ups, I don't know if that's, Just because of the coughing or if they're just spit ups, like, but nothing after eating. D: OK, OK, have you noticed any rashes on him? P: No, no rashes. D: OK, uhm, has he had any fainting spells or seizures? P: Uh, no, I've been really trying to make sure, like, I was worried if he gets blue or something that we would rush to the emergency department, but I haven't noticed anything like that. D: OK, OK good. Has he been in contact with anyone who's been sick recently? P: No, I don't think so. We've been trying to be very careful with the pandemic and everything going on. D: For sure, any travel to anywhere recently? P: No. D: OK, and is he an other-wise healthy baby? P: Yeah, so, uh, healthy but he was born premature at 36 weeks. D: OK. P: And no complications really with the pregnancy or after he was born. But yeah, he was premature. D: OK, and so he didn't need any hospitalizations right after birth, right? P: No, he was fine after birth. D: And no longstanding medical conditions after birth? P: No. D: Has he needed hospitalizations for anything in the past, or surgeries? P: No, nothing like that. D: OK, and is he up to date with all his immunizations? P: Yeah, the two months vaccinations are all up to date. D: OK, good. Medication-wise is he on anything? P: No, no medications. D: OK, any allergies? P: No. D: Any family history of lung conditions or heart conditions? P: No, not that we know of. D: OK, any cancers in the family? P: Nope. D: And who does he live with at home? P: Just me and my wife. D: OK, uhm, in a house, apartment? P: In a house. D: OK, any old carpets, mold, dust, asbestos, pets, anything like that at home? P: No, nothing like that. D: OK, and does anyone at home smoke? P: Nope. D: OK, well, those were all the questions I had for you. Did you have any questions of your own? P: Yeah, no, I was just really worried like, the grunting is just really scaring us. So do you, I was just wondering if you know what it could be. D: Yeah, so the grunting is worrisome. He could have anything from bronchiolitis to pneumonia so what we'll do is, we'll, first get his temperature, we'll get his O2 sat and we will get some imaging done as well to see if it's more in line with bronchiolitis or pneumonia. If it's bronchiolitis, it will be supportive treatment so we can keep him here at the hospital because he is in some distress and we'll keep him hydrated and give him some oxygen. And if it's pneumonia, we'll prescribe him some antibiotics. How does that sound? P: Yeah, and will he need to stay in the hospital at all? D: Yeah so for now, because, if he is in any distress and if he needs oxygen, and IV hydration, he'll need to stay in the hospital until he's better from that standpoint. I should also mention, we should do a covid swab on him as well because his symptoms are in line with covid as well, so we'll have to do that to rule it out. P: OK, yeah, that sounds good, Uh, uh, yeah, thank you so much. D: Yeah, no worries.
dataset\resampled_file\RES0053.wav	P: I was just bringing my son and he's just had cough for the last couple of days. I thought about a day and a half ago, it doesn't feel like a cold. He hasn't been too sick, but I was a little bit worried and I wanted to get him seen to see if there's anything we could do. D: Yeah, for sure. It's a good thing that you brought him in. So the cough, is it consistent? Or does it come and go? P: It seems to be a little bit worse at night. He'll have this cough during the day. Sometimes I'll notice when he's playing. He's had these coughing fits that last for up to a minute but usually recovers from. He hasn't been too active to be honest. He's been a little bit slowed down these last couple of days, but in regards to consistency, I'd say it's a little bit worse at night. D: OK, any other triggers like dust or the cold air? Anything like that? P: I haven't really noticed anything. We've been mainly keeping inside due to covid, right? I think my wife left a window open the other night, and maybe the cough was a little bit better. I'm not sure. It's kind of hard to tell when we sleep. D: Yeah, have you tried anything for it, like have you given him any over the counter cough medications? P: No, we're a little scared to give him anything. He's so young. He's 2 1/2. We haven't been really giving him any medications to be honest. D: OK, good. And if you were to describe the quality of this cough, would you say it's barky? Is it harsh? P: Barky might be a good word to describe it, like he's had colds before his coughs were quiet but this sounds harsh. It sounds like he's really trying to cough hard there. Very violent sometimes. D: OK OK. And has he ever had a cough like this in the past? P: No, never. D: OK, and then in terms of the timeline, is it getting worse? His cough? P: I think it has been to be honest. He was a little ill like he had a runny nose a couple of days ago, maybe two days ago and then the cough started but it only really started getting noticeably different about the night of the first day, about two days ago so. Now it's been more present I suppose,than it was when he just first had it. D: OK, and is it a dry cough or does he bring up sputum? P: Sputum like phlegm,no he doesn't bring anything up really, so dry. D: OK so no blood as well right? P: No blood. D: OK, does he have any shortness of breath with his cough? P: I feel like when he has the coughing fits, he's winded. He's weak after them. Sometimes he cries after them or before the middle can be a trigger for it, but just resting normally, he doesn't seem that out of breath, no. D: OK any wheeziness? P: No, not really. He's able to breathe. I can't really hear him breathing that much. Sometimes at night after a bad cough he'll be really winded. And yeah, it does sound like a little different when he's breathing, but just right now he sounds normal. D: OK, and any reason for you to think he has chest pain? P: He hasn't any sort of chest pain. He says his throat hurts, but I don't think it's his chest. D: Has he had any fevers? P No. D: Any change in his hair, nails or skin like rashes? P: No, no rashes. D: How about weight loss? P: No weight loss, he's a fairly healthy kid. D: And his vision and hearing are normal? P: You know, I haven't gotten him formally assessed yet, but seems to be able to read pretty well from a distance. He's not in school yet, but I haven't noticed anything, and he can hear fine. I think he responds when I call. D: OK, has he had a stuffy or runny nose? P: Yeah yeah, that's kind of how it first started three days ago. Maybe had a runny nose. OK, yeah. D: Does he still have a runny nose? P: Umm, a little bit less now. No, not as much now. D: OK. And his taste, any reason to believe there are any changes there? P: Well, we've been kind of spoiling him a bit, just giving him ice cream. His throat hurts a little bit and he seems to still like it, so it's hard to tell. D: OK, so he has a little bit of a sore throat as well? P: Yeah. D: OK OK, and then any dizziness or fainting spells that you've noticed? P: No fainting or dizzy spells, but he's really gassed after he has like a coughing fit and he doesn't want to stand up, he'll just be sitting down or he wants to be held. D: OK, is he more irritable than usual? P: Yeah after he has a bad coughing fit, he wants to be soothed and he'll be crying, but it's just more of because he's worn out, I believe he's tired. D: Yeah, OK, and then any confusion or memory loss? P: No. D: OK, and then in terms of his bowel movements, have things been normal from that standpoint? P: Oh yeah, process of potty training him, but no, no real changes. D: OK, so no diarrhea, no constipation, no blood in the stool? P: No. D: OK and he's passing gas? P: OK yeah I'd say so. D: Any nausea or vomiting? P: No. We haven't been really feeding him solid meals, it's because he's been sick, we've been trying to give him soup and liquids for the most part because his throat hurts, but he's able to keep them down. So no, no nausea, no vomiting. D: OK, and then how about changes in his appetite? P: Yeah, he's not eating as much but still, we're trying to force food into him to keep his energy up. Most of time he always will be asking for snacks in the afternoon, but now not so much. D: OK. Alright and any anything else that I missed that he's been experiencing over the past few days? P: No, just the cough. D: OK, and then he otherwise healthy? Does he have any longstanding medical conditions? P: No longstanding medical conditions. Yeah, nothing really. We had a little bit of stay in the NICU, just because he was a little bit underweight, but no, nothing really. D: OK. And then his mother's pregnancy with him? Any complications at that point? P: Yeah he's a little pre term. 34 weeks I think. D: OK, was he also underweight too? You mentioned just a little bit. P: Yeah. D: OK, and any complications during the actual delivery? P: Yeah, not that I remember like she started going to labor early, like earlier than we expected. We thought it was just a regular contraction and that it will just resolve but she wound up proceeding when we showed up at the hospital D: OK and then in terms of growth, weight and head circumference, has he been hitting all those milestones for the past 2 1/2 years? P: Yeah, we we bring him to the family doctor every couple of month for his regular checkups and nothing has been brought up to be concerning for his vaccines. He has been doing well. D: OK and then how about other milestones like speech, movement, fine movement, all of that, like have those been normal? Is he on par with his peers? P: Yeah, this is our first kid, but compared to his cousins he seems to be doing well. He's speaking, he's got little sentences, now he has good eye contact. He's a good kid. D: OK, good good. Any hospitalizations or surgeries aside from when he was born? P: No no. D: OK good and is he on any medications? P: No, OK we give him like a flintstone gummy. D: OK, is he up to date with all his immunizations? P: Yeah. D: Any allergies? P: Not that we know of. D: Any family history of lung conditions? P: So my grandfather, so his greatgrandfather I suppose passed away from lung cancer. He was a heavy smoker though. On my mom's side there's some breast cancer. No, nothing really that comes to mind for lungs. D: And any heart conditions? P: No, not that we know of. D: And how about other cancers? P: No, not that I know of. D: OK, how about asthma, eczema or allergies in the family? P: You know, I think my sister is allergic to peas, but she was never sick from them like go to the hospital. I don't think there are any allergies in the family. D: OK, good, has he been in contact with anyone who's been sick recently? P: You know, like 5 days ago we had a playdate with his cousin. And we kind of thought that that's where he got the cold from. Like the runny nose, but it just turned weird, you know. D: OK and how's this cousin doing? P: Last time I talked to Charlotte, Hank seems to be doing well so. D: Alright, and has he traveled to anywhere recently? Have you any of you traveled anywhere recently? P: No, with covid and everything, we have just been keeping to ourselves. D: And with who and where does he live? P: He lives with me and his mother in a house D: OK. Any old carpets or mold or concerns for asbestos? Anything like that at home? P: I don't know when this house is built. I don't think there's any asbestos in it and it's all hardwood. So no. D: OK, good. Anyone at home smoke? P: No, no. D: OK, good. So those were all the questions that I had. Do you have any questions for me? P: No, no that's it, no. D: OK, well, from the sounds of it, he most likely has some sort of viral infection. We will do a COVID swap to rule that out because some symptoms do seem to overlap with COVID and we want to make sure to rule that out. So we'll take a swab. Those PCR results should come back in about 24 to 48 hours. In the meantime, he should isolate for 14 days at home and if it's not COVID, it could be another viral infection like parainfluenza, also known as croup. So for that, for any of these viral infections, actually the best treatment is to stay at home and make sure that he's very well hydrated and eating well. If his symptoms persist for three to five days or more, or if his symptoms worsen, especially if he has like a seizure or urological issues, he should go to the ER and if his symptoms do become worse, we can also prescribe him some steroids or epinephrine just to open up his airways. And if it's really, really bad he might be hospitalised as well. So just keep an eye on on that for now. And if you have any questions or concerns, just give us a call. How does that sound? P: A little scary. Sounds good. OK, I'll just keep an eye on him for the next five days. D: Give us a call if his symptoms are becoming worse or if they're not resolving and we will try to do an assessment on him. Of course we will do a physical exam today and will let you know how severe his symptoms are. Most children will get over their infection on their own and he likely won't need any additional treatments. P: OK, sounds good. D: Alright take care. P: Thank you.
dataset\resampled_file\CAR0001.wav	D: What brought you in today? P: Sure, I'm I'm just having a lot of chest pain and and so I thought I should get it checked out. D: OK, before we start, could you remind me of your gender and age? P: Sure 39, I'm a male. D: OK, and so when did this chest pain start? P: It started last night, but it's becoming sharper. D: OK, and where is this pain located? P: It's located on the left side of my chest. D: OK, and, so how long has it been going on for then if it started last night? P: So I guess it would be a couple of hours now, maybe like 8. D: OK. Has it been constant throughout that time, or uh, or changing? P: I would say it's been pretty constant, yeah. D: OK, and how would you describe the pain? People will use words sometimes like sharp, burning, achy. P: I'd say it's pretty sharp, yeah. D: Sharp OK. Uh, anything that you have done tried since last night that's made the pain better? P: Um not laying down helps. D: OK, so do you find laying down makes the pain worse? P: Yes, definitely. D: OK, do you find that the pain is radiating anywhere? P: No. D: OK, and is there anything else that makes the pain worse besides laying down? P: Not that I've noticed, no. D: OK, so not like taking a deep breath or anything like that? P: Maybe taking a deep breath. Yeah. D: OK. And when the pain started, could you tell me uh, could you think of anything that you were doing at the time? P: I mean, I was moving some furniture around, but, that I've done that before. D: OK, so you didn't feel like you hurt yourself when you were doing that? P: No. D: OK, and in regards to how severe the pain is on a scale of 1 to 10, 10 being the worst pain you've ever felt, how severe would you say the pain is? P: I'd say it's like a seven or eight. It's pretty bad. D: OK, and with the pain, do you have any other associated symptoms? P: I feel a little lightheaded and I'm having some trouble breathing. D: OK. Have you had any loss of consciousness? P: No. D: OK. Uh, have you been experiencing any like racing of the heart? P: Um, a little bit, yeah. D: OK. And have you been sweaty at all? P: Just from the from having issues breathing. D: OK, have you been having issues breathing since the pain started? P: Yes. D: OK. Um recently have you had any periods of time where you like have been immobilized or or, you haven't been like able to move around a lot? P: No no. D: OK. And have you been feeling sick at all? Any infectious symptoms? P: No. D: OK, have you had any nausea or vomiting? P: No. D: Any fevers or chills? P: No. D: OK, how about any abdominal pain? P: No. D: Any urinary problems? P: No. D: Or bowel problems? P: No. D: OK, have you had a cough? P: No. D: OK. You haven't brought up any blood? P: No. D: OK, have you had a wheeze with your difficulty breathing? P: No, not that I've heard. D: OK, any changes to the breath sounds at all like any noisy breathing? P: No. Well, I guess if when I'm really having trouble breathing, yeah. D: OK. Has anything like this ever happened to you before? P: No. D: No, OK. And have you had any night sweats? P: No. D: Alright, and then how about any rashes or skin changes? P: No rashes, but I guess like my neck seems to be a little swollen. D: OK, do you have any neck pain? P: No. D: OK, have you had any like accidents like a car accident or anything where you really jerked your neck? P: No. D: OK. Um any any trauma at all to the chest or or back? P: No. D: OK, so just in regards to past medical history, do you have any prior medical conditions? P: No. D: OK, any recent hospitalizations? P: No. D: OK, any prior surgeries? P: No. D: OK, do you take any medications regularly? Are they prescribed or over the counter? P: No. D: Alright, how about any allergies to medications? P: None. D: Alright, any immunizations or are they up to date? P: They are all up to date. D: Excellent. Alright, and could you tell me a little bit about your living situation currently? P: Sure, I live in an apartment by myself. I, uh, yep, that's about it. D: OK, and how do you support yourself financially? P: I'm an accountant. D: OK, sounds like a pretty stressful job or that it can be. Do you smoke cigarettes? P: I do. D: OK, and how much do you smoke? P: I smoke about a pack a day. D: OK, how long have you been smoking for? P: For the past 10 to 15 years. D: OK, and do you smoke cannabis? P: Uh sometimes. D: Uh, how much marijuana would you smoke per per week? P: Per week, maybe about 5 milligrams. Not that much. D: OK, and do you use any other recreational drugs like cocaine, crystal, meth, opioids? P: No. D: OK. Have you used IV drugs before? P: No. D: OK. And do you drink alcohol? P: I do. D: OK. How much alcohol do you drink each week? P: Uhm about I would say I have like one or two drinks a day, so about 10 drinks a week. D: OK, uh, yeah and um alright, and then briefly, could you tell me a little bit about your like diet and exercise? P: Sure, I try to eat healthy for dinner at least, but most of my lunches are, uh I eat out. And then in terms of exercise, I try to exercise every other day, I run for about half an hour. D; OK, well that's great that you've been working on the the activity and the diet as well. So has anything like this happened in your family before? P: No. D: OK, has anybody in the family had a heart attack before? P: Actually, yes, my father had a heart attack when he was 45. D: OK, and anybody in the family have cholesterol problems? P: I think my father did. D: I see OK, and how about anybody in the family have a stroke? P: No strokes. D: OK, and then any cancers in the family? P: No. D: OK, and is there anything else that you wanted to tell me about today that that I on on history? P: No, I don't think so. I think you asked me everything.

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