Transcript
Started: Mar 25, 2020 | Total Time:59 min
 |
Hi Dr. Douglas, My name is Danielle. I will be your provider today
|
Greet |
 |
Hello.
|
|
|
What is the reason for you visit today?
|
Question |
|
I’m here because I’ve got an awful cough, a fever, and my chest feels like I’ve been kicked by a horse. I’m sure this is some kind of upper respiratory infection. I was hoping it would go away on its own, but it hasn’t, so my husband Jeffrey convinced me to come in. As amusing as it is for Jeffrey to serve me my meals, this has gone on long enough. I need to feel better.
|
|
|
I’m sorry to hear that you are so uncomfortable from your symptoms. Your frequent cough sounds like it’s aggravating your already uncomfortable chest pain. You have done a great job toughing it out so far, and we’ll find a treatment plan to help you feel better.
|
Empathize |
|
Thank you.
|
|
|
When did your symptoms start?
|
Question |
|
Most of my symptoms started three days ago. I developed this nasty cough, and my nose has been all stuffed up. That’s also when the chest pain started, and when I began to feel exhausted. The fever set in last night. That was the last straw, so Jeffrey brought me in.
|
|
|
How often do the symptoms occur?
|
Question |
|
Most of my symptoms — the hacking cough, chest pain, fatigue, achiness, stuffy nose — started three days ago. The fever started yesterday. None of it has let up since.
|
|
|
Where is your pain?
|
Question |
|
Most of the chest pain is located in the lower right part of my chest. Aside from that, I have some general aches and muscle soreness; this is mostly a deep, dull sort of ache, but it feels more severe when I cough.
|
|
|
I’m sorry to hear that you’re in constant pain, and that your cough makes your pain worse. I will work on finding a therapy that will give you some relief.
|
Empathize |
|
I appreciate your saying that.
|
|
|
Are you coughing up any mucous?
|
Question |
|
I’m coughing up rust-colored sputum.
|
|
|
Are there any factors that make your symptoms worse? (Clarified to Does anything make your symptoms worse?.)
|
Question |
|
Coughing makes this chest pain much worse. Deep breathing also seems to aggravate it, or talking too much. I also can’t move around too much . . . I’ve been staying in bed because any kind of activity makes my pain worse and leaves me exhausted. (Clarified to if anything makes my symptoms worse.)
|
|
|
What helps relieve your symptoms
|
Question |
|
Rest has helped me feel a little better. Exerting myself in any way just makes me feel worse. Jeffrey has also been bringing me hot tea and soup. We’ve also kept my humidifier going. Other than that, I tried taking aspirin to help with my fever and chest pain, but that didn’t give me much relief.
|
|
|
how bad is the pain?
|
Question |
|
I think that this cough is pretty severe. It brings my chest pain up from a 2 out of 10 to a 5 out of 10.
|
|
|
sorry to hear that
|
Empathize |
|
Well, that’s very nice.
|
|
|
Lets talk about your past medical history (Clarified to What is your past medical history?.)
|
Question |
|
I have hypertension and chronic kidney disease. stage 2. (Clarified to what health problems I have had.)
|
|
|
how long have you had the conditions? (Clarified to How long have you had your preexisting health problems?.)
|
Question |
|
I was diagnosed with stage 2 chronic kidney disease 9 years ago, when I had some blood work done for my hypertension. I don’t know how long I had it before that, but I was diagnosed with hypertension 14 years ago, so it could have been a long time. (Clarified to how long I have had my preexisting health problems.)
|
|
|
any recent hospitalizations?
|
Question |
|
I have not been hospitalized recently.
|
|
|
do you have any allergies
|
Question |
|
No, I don’t have allergies.
|
|
|
Are you up to date on vaccines?
|
Question |
|
Let me think . . . I had a flu shot about three months ago. Other than that, it’s been quite a while since I’ve needed any vaccines. I had a pneumococcal vaccine 12 years ago.
|
|
|
You are due for a pneumococcal vaccine, which you should receive again in your adulthood five to ten years after your first shot. These vaccines protect against the bacteria that most commonly cause pneumonia.
|
Educate |
|
Alright.
|
|
|
What medications do you take?
|
Question |
|
I take two prescription medications; a trandolapril/verapamil combo and chlorothiazide. I also take two supplements, vitamin D and calcium. And for the last three days I’ve been taking aspirin.
|
|
|
tell me about the trandolapril/verapamil
|
Question |
|
I take my trandolapril/verapamil once a day for my stage 2 chronic kidney disease and hypertension.
|
|
|
how long have you taken the chlorothiazide?
|
Question |
|
I have taken chlorothiazide for 14 years.
|
|
|
whats is the dosage of your medications?
|
Question |
|
The trandolapril/verapamil combination is 2 milligrams of trandolapril and 180 milligrams of verapamil. The chlorothiazide pill is 500 milligrams. The aspirin is 325 milligrams each pill. As for the supplements: the calcium is 1200 milligrams and the vitamin D is 15 micrograms.
|
|
|
are you compliant with all of your medications? (Clarified to Are you compliant with your medications?.)
|
Question |
|
I never miss doses of my medication. Jeffrey and I are very diligent, and the pillbox keeps track for us. (Clarified to if I am compliant with medication.)
|
|
|
That is great
|
Empathize |
|
Thank you. I appreciate that.
|
|
|
what you taken any antibiotics? (Clarified to Have you taken antibiotics recently?.)
|
Question |
|
I haven’t taken any antibiotics in some time . . . I honestly can’t remember when that would’ve been. (Clarified to if I have taken antibiotics recently.)
|
|
|
Do you drink, smoke, or use illicit substances?
|
Question |
|
I’ve never used any illicit drugs.
|
|
|
do you exercise?
|
Question |
|
I try to stay active by taking a few short walks a week. Jeffrey and I will walk around our neighborhood for about ten minutes. We try to do this two or three times a week. Unfortunately, right now all I can do is rest.
|
|
|
any difficulties with activities of daily living? (Clarified to Do you have trouble performing daily activities?.)
|
Question |
|
I’ve been struggling a little with everything of late, but I am quite capable in general, thank you. [AUDIO COMING SOON] (Clarified to if I have trouble performing daily activities.)
|
|
|
tell me about your diet?
|
Question |
|
In the morning, Jeffrey and I will have a piece of toast with some eggs, or maybe a fresh croissant that he picks up from the bakery around the corner. We normally eat a very light lunch — a sandwich, or some homemade soup — and for dinner we like to go out to eat a few times a week. Normally we get pasta, or a salad.
|
|
|
For people with hypertension and with chronic kidney disease, some foods are healthier and safer than others. It’s important to consider how your health will be affected when making everyday meal choices.
|
Empathize |
|
That’s kind of you to say.
|
|
|
whats your family medical history
|
Question |
|
My parents have both passed away. My mother was fairly healthy, but my father had hypertension. [AUDIO COMING SOON]
|
|
|
just want to follow up on the aspirin (No matching questions found.)
|
Question |
|
How often do you take the aspirin
|
Question |
|
Not normally, but since I got sick three days ago, I have been taking two aspirins three times a day. That’s a 325 milligram pill.
|
|
|
does it help with pain?
|
Educate |
|
I’ll keep that in mind.
|
|
|
does it help with pain (No matching questions found.)
|
Question |
|
does the aspirin relieve your pain
|
Question |
|
It has done a little good, I suppose, both for my chest pain and my fever . . . I suppose it’s hard to tell, though, because I’ve been taking it since my symptoms started, so I haven’t really felt how bad my symptoms are sans aspirin. [AUDIO COMING SOON]
|
|
|
While it’s great that the aspirin has relieved your symptoms, it is not approved for older adults nor for people taking some of your medications. Always ask a healthcare provider before starting a new medication.
|
Educate |
|
I’ll remember that.
|
|
|
Hi, i will educate you on the new prescription
|
Question |
|
I appreciate it.
|
|
|
Take the medication with a full glass of water
|
Question |
|
Shouldn’t be a problem.
|
|
|
Take the full course of medications
|
Question |
|
I’ll be sure to take the whole course.
|
|
|
Be sure to avoid the sun
|
Question |
|
I won’t be leaving my bed much anyway.
|
|
|
Contact your doctor if you experience rapid weight gain
|
Question |
|
Alright then.
|
|
|
call 911 if you show signs of a severe allergic reaction
|
Question |
|
I’ll have Jeffrey call 911 if that happens.
|
|
|
take tylenol for pain and fever
|
Question |
|
Thanks for that.
|
|
|
guaifenesin will help with your cough
|
Question |
|
Good to know.
|
|
|
you should start feeling better in a few days
|
Question |
|
Hmm. Okay.
|
|
|
drink plenty of fluids
|
Question |
|
I can do that. Does tea work?
|
|
|
yes Mrs Douglas
|
Question |
|
That works for me.
|
|
|
THank you
|
Question |
|
Alright. Thank you for all of your help today.
|