DATEXIS/aci_bench_intent_annotated · Datasets at Hugging Face

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doctor: okay alright patient: but sometimes it gets to an eleven	D2N067	13	[ "Acute Symptoms" ]	[ "Subjective" ]	okay alright	1,700
doctor: okay what would do you know if you are doing something that would cause it to be an eleven are you back on your ski's patient: no i ca n't ski	D2N067	14	[ "Acute Symptoms" ]	[ "Subjective" ]	okay what would do you know if you are doing something that would cause it to be an eleven are you back on your ski's	1,701
doctor: okay does it hurt more when you walk for longer periods of time patient: yes	D2N067	16	[ "Acute Symptoms" ]	[ "Subjective" ]	okay does it hurt more when you walk for longer periods of time	1,702
doctor: okay how long does the pain last patient: for as long as my walk is and i do n't sometimes i walk five minutes kinda depends on the wind	D2N067	17	[ "Acute Symptoms" ]	[ "Subjective" ]	okay how long does the pain last	1,703
doctor: okay alright patient: sometimes i walk there is	D2N067	18	[ "Acute Symptoms" ]	[ "Subjective" ]	okay alright	1,704
doctor: okay alright have you done anything to help with the pain patient: well i wear a brace and i have used a lot of thc cream on it	D2N067	19	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	okay alright have you done anything to help with the pain	1,705
doctor: okay alright thc cream is an interesting choice but do you think that's been helpful patient: yes	D2N067	20	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	okay alright thc cream is an interesting choice but do you think that's been helpful	1,706
doctor: alright have you taken patient: reasons	D2N067	21	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	alright have you taken	1,707
doctor: not a problem have you taken any medications patient: no just gummies	D2N067	22	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	not a problem have you taken any medications	1,708
doctor: okay like vitamins or more thc patient: kind of like thc gummies	D2N067	23	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	okay like vitamins or more thc	1,709
doctor: thc gummies patient: my grandma gave them to me	D2N067	24	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	thc gummies	1,710
doctor: thc gummies from grandma that's an excellent grandmother that you have okay have you noticed any swelling stiffness tenderness patient: yeah i i get a lot of swelling and it really is it's very stiff in the morning until i get walking	D2N067	25	[ "Acute Symptoms" ]	[ "Subjective" ]	thc gummies from grandma that's an excellent grandmother that you have okay have you noticed any swelling stiffness tenderness	1,711
doctor: okay alright and then have you had any hospitalizations or surgeries in the past patient: well i had surgery on my right knee before	D2N067	26	[ "Personal History" ]	[ "Subjective" ]	okay alright and then have you had any hospitalizations or surgeries in the past	1,712
doctor: okay so you've had surgery before alright do you remember what kind of surgery patient: i do n't know they told me they reconstructed the whole thing i was fourteen i was a really good gymnast back then really good	D2N067	27	[ "Personal History" ]	[ "Subjective" ]	okay so you've had surgery before alright do you remember what kind of surgery	1,713
doctor: okay okay okay how so do you have any other exercises that i might wan na know about outside of intense gym and ski events patient: no i think that's about it	D2N067	31	[ "Other Socials" ]	[ "Subjective" ]	okay okay okay how so do you have any other exercises that i might wan na know about outside of intense gym and ski events	1,714
doctor: okay and how frequently do you normally ski patient: i ski probably three times a week	D2N067	32	[ "Other Socials" ]	[ "Subjective" ]	okay and how frequently do you normally ski	1,715
doctor: okay and then are you on any medications at this time other than the thc patient: no	D2N067	33	[ "Therapeutic History" ]	[ "Subjective" ]	okay and then are you on any medications at this time other than the thc	1,716
doctor: okay alright what patient: nothing no	D2N067	34	[ "Chitchat" ]	[ "Null" ]	okay alright what	1,717
doctor: okay alright not a problem so if you do n't mind i'm gon na go ahead and start my examination i'm just gon na call it out for the sake of being able to document it appropriately and you or just just let me know if you want me to explain anything further so with your knee i know that you said it hurts on the right inside a lot right so when i press on the inside of your knee does that hurt patient: yes	D2N067	35	[ "Physical Examination" ]	[ "Objective" ]	okay alright not a problem so if you do n't mind i'm gon na go ahead and start my examination i'm just gon na call it out for the sake of being able to document it appropriately and you or just just let me know if you want me to explain anything further so with your knee i know that you said it hurts on the right inside a lot right so when i press on the inside of your knee does that hurt	1,718
doctor: okay and when i press on the outside of your left of your right knee sorry does that hurt patient: no	D2N067	36	[ "Physical Examination" ]	[ "Objective" ]	okay and when i press on the outside of your left of your right knee sorry does that hurt	1,719
doctor: okay alright so when i move your your kneecap does that hurt patient: no it kinda makes a shooting pain down to my ankle though	D2N067	37	[ "Physical Examination" ]	[ "Objective" ]	okay alright so when i move your your kneecap does that hurt	1,720
doctor: okay so does the pain radiate frequently patient: no	D2N067	39	[ "Physical Examination" ]	[ "Objective" ]	okay so does the pain radiate frequently	1,721
doctor: okay alright on your skin exam i do appreciate some mild swelling and bruising that's really interesting since it's been two weeks with your knee are you able to bend it patient: yes	D2N067	41	[ "Physical Examination" ]	[ "Objective" ]	okay alright on your skin exam i do appreciate some mild swelling and bruising that's really interesting since it's been two weeks with your knee are you able to bend it	1,722
doctor: okay and then when you walked in on your gait i think i think i did appreciate a slight limp are you i i i i think you are you are protecting one of your knees does that sound familiar patient: yeah i waddle pretty pretty good now	D2N067	42	[ "Physical Examination" ]	[ "Objective" ]	okay and then when you walked in on your gait i think i think i did appreciate a slight limp are you i i i i think you are you are protecting one of your knees does that sound familiar	1,723
doctor: okay alright and when you move your knee away from your body you're bending like your you're pulling it towards me does that hurt patient: yes	D2N067	43	[ "Physical Examination" ]	[ "Objective" ]	okay alright and when you move your knee away from your body you're bending like your you're pulling it towards me does that hurt	1,724
doctor: okay and then when you pull your knee back towards you does that hurt patient: no	D2N067	44	[ "Physical Examination" ]	[ "Objective" ]	okay and then when you pull your knee back towards you does that hurt	1,725
doctor: alright so pain on dorsiflexion but not on plantar flexion plantar flexion okay alright so what we are gon na do right now i think i'm gon na look at your x-rays but when i when i look at the results of your x-ray i do not appreciate any fracture what i am noticing is the development of a little bit of arthritis and that could explain like why you say that your joints hurt a bit more during like windy weather and what not so this is what we're gon na do for my assessment and plan right the first thing is i think you have a strain of your posterior cruciate ligament what that means is what that will mean for you though is that we are gon na continue to brace your right knee that's gon na hopefully take off some of the stress that you might be putting on it especially since you're limping i am going to recommend you for physical therapy i think it would be an i think it's a good idea to maybe start three times a week to get your strength back into your knee i would recommend not skiing or doing any gymnastics for now and i think that physical therapy will really help considering the injury that you had when you were fourteen i'm gon na prescribe you some medications i do n't necessarily recommend consuming gummies at the same time but the medications i'm gon na give you are gon na be meloxicam fifteen milligrams you're gon na take that once a day that will help with like the swelling and the bruising i'm also gon na prescribe you just like a higher strength nsaid so ibuprofen eight hundred milligrams a day you can take that twice a day as needed for your left knee i think you are i think you just kind of like strength a little bit but like not enough to necessarily require any kind of like medication or bracing i think you just take it easy on your body i know that you're like very active from what i hear and i i think that that's really exciting but i think you might need to listen to your body and give yourself a bit of a break you'll be able to do like several workouts when you go to when you go to physical therapy but you know let the yeah let your therapist be your guide about like what you should and should not be putting your body through does that make sense patient: yes	D2N067	45	[ "Physical Examination", "Medication", "Radiology Examination", "Diagnostic Testing", "Acute Assessment" ]	[ "Objective", "Assessment", "Plan" ]	alright so pain on dorsiflexion but not on plantar flexion plantar flexion okay alright so what we are gon na do right now i think i'm gon na look at your x-rays but when i when i look at the results of your x-ray i do not appreciate any fracture what i am noticing is the development of a little bit of arthritis and that could explain like why you say that your joints hurt a bit more during like windy weather and what not so this is what we're gon na do for my assessment and plan right the first thing is i think you have a strain of your posterior cruciate ligament what that means is what that will mean for you though is that we are gon na continue to brace your right knee that's gon na hopefully take off some of the stress that you might be putting on it especially since you're limping i am going to recommend you for physical therapy i think it would be an i think it's a good idea to maybe start three times a week to get your strength back into your knee i would recommend not skiing or doing any gymnastics for now and i think that physical therapy will really help considering the injury that you had when you were fourteen i'm gon na prescribe you some medications i do n't necessarily recommend consuming gummies at the same time but the medications i'm gon na give you are gon na be meloxicam fifteen milligrams you're gon na take that once a day that will help with like the swelling and the bruising i'm also gon na prescribe you just like a higher strength nsaid so ibuprofen eight hundred milligrams a day you can take that twice a day as needed for your left knee i think you are i think you just kind of like strength a little bit but like not enough to necessarily require any kind of like medication or bracing i think you just take it easy on your body i know that you're like very active from what i hear and i i think that that's really exciting but i think you might need to listen to your body and give yourself a bit of a break you'll be able to do like several workouts when you go to when you go to physical therapy but you know let the yeah let your therapist be your guide about like what you should and should not be putting your body through does that make sense	1,726
doctor: alright do you have any questions right now patient: no thank you so much	D2N067	46	[ "Discussion" ]	[ "Plan" ]	alright do you have any questions right now	1,727
doctor: no problem	D2N067	47	[ "Chitchat" ]	[ "Null" ]	doctor: no problem	1,728
doctor: hi , brian . how are you ? patient: hi , good to see you .	D2N068	0	[ "Greetings" ]	[ "Subjective" ]	hi , brian . how are you ?	1,729
doctor: it's good to see you too . so , i know the nurse told you a little bit about dax . patient: mm-hmm .	D2N068	1	[ "Chitchat" ]	[ "Null" ]	it's good to see you too . so , i know the nurse told you a little bit about dax .	1,730
doctor: i'd like to tell dax about you , okay ? patient: sure .	D2N068	2	[ "Chitchat" ]	[ "Null" ]	i'd like to tell dax about you , okay ?	1,731
doctor: so , brian is a 58 year old male with a past medical history significant for congestive heart failure and hypertension , who presents today for follow-up of his chronic problems . so , brian , it's been a little while i've seen you . patient: mm-hmm .	D2N068	3	[ "Personal History" ]	[ "Subjective" ]	so , brian is a 58 year old male with a past medical history significant for congestive heart failure and hypertension , who presents today for follow-up of his chronic problems . so , brian , it's been a little while i've seen you .	1,732
doctor: whats , what's going on ? patient: i , i just feel out of sorts lately . i do n't know if it's the change in the seasons or if we're just doing a lot of projects around the house and , and some , some construction on our own . i'm just feeling out of it . lack of , uh , energy . i'm just so tired and fatigued , and i feel kinda ... i feel lightheaded every once in a while .	D2N068	4	[ "Acute Symptoms" ]	[ "Subjective" ]	whats , what's going on ?	1,733
doctor: okay . all right . um , how long has that been going on for ? patient: uh , probably since labor day , so about five weeks or so .	D2N068	5	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . all right . um , how long has that been going on for ?	1,734
doctor: okay . and , have you noticed any , like , symptoms of weight gain , like , like swollen legs , or , you know , your belly feels bloated and things like that ? patient: i feel , i feel bloated every once in a while .	D2N068	6	[ "Vegetative History" ]	[ "Subjective" ]	okay . and , have you noticed any , like , symptoms of weight gain , like , like swollen legs , or , you know , your belly feels bloated and things like that ?	1,735
doctor: okay . all right . um , and , are you taking your , your medications ? patient: uh , yes , i am .	D2N068	7	[ "Therapeutic History" ]	[ "Subjective" ]	okay . all right . um , and , are you taking your , your medications ?	1,736
doctor: okay . and , how about your diet ? are you watching your diet ? patient: uh , it's been a little bit of a struggle . we began construction on our kitchen over labor day weekend , and it was ... hard to cook or prepare meals so we ate out a lot, and not always the best food out. it , it , it kind of reeked havoc , uh , so it's been maybe off a little bit .	D2N068	8	[ "Personal History" ]	[ "Subjective" ]	okay . and , how about your diet ? are you watching your diet ?	1,737
doctor: okay . all right . and , how about , you know , other symptoms , like , have you had a fever or chills ? patient: no .	D2N068	9	[ "Vegetative History" ]	[ "Subjective" ]	okay . all right . and , how about , you know , other symptoms , like , have you had a fever or chills ?	1,738
doctor: okay , and any problems breathing ? do you feel short of breath ? patient: uh , just when i'm doing doing the projects . again , not even lifting anything really heavy , it's just that if i'm ex- exerting any energy , i , i kinda feel it at that point .	D2N068	10	[ "Acute Symptoms" ]	[ "Subjective" ]	okay , and any problems breathing ? do you feel short of breath ?	1,739
doctor: okay . do you have any chest pain ? patient: slight cramps . that seems to go away after about , maybe about an hour or so after i first feel it .	D2N068	11	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . do you have any chest pain ?	1,740
doctor: okay , and how about a cough ? patient: a , a slight cough , and again , i'm not sure if it's just the change of seasons and i'm getting a cold .	D2N068	12	[ "Acute Symptoms" ]	[ "Subjective" ]	okay , and how about a cough ?	1,741
doctor: mm-hmm . okay . all right . well , you know , for the most part , how , you know , before all of this- patient: mm-hmm .	D2N068	13	[ "Chitchat" ]	[ "Null" ]	mm-hmm . okay . all right . well , you know , for the most part , how , you know , before all of this-	1,742
doctor: . how were you doing with your heart failure ? i know that we've kinda talked about you being able to watch your healthy food intake and that's been kind of a struggle in the past . patient: i , i , i've actually been pretty good about that ever since . the , the , the last year , it's been a little chaotic , but i wanted to make sure i stayed on top of that .	D2N068	14	[ "Personal History" ]	[ "Subjective" ]	. how were you doing with your heart failure ? i know that we've kinda talked about you being able to watch your healthy food intake and that's been kind of a struggle in the past .	1,743
doctor: okay . all right . are you excited for halloween ? patient: uh , ca n't wait .	D2N068	15	[ "Chitchat" ]	[ "Null" ]	okay . all right . are you excited for halloween ?	1,744
doctor: all right , yeah , right . patient: yeah .	D2N068	17	[ "Chitchat" ]	[ "Null" ]	all right , yeah , right .	1,745
doctor: and , so , lastly , for your high blood pressure , how are you doing with that ? have , are , did you buy the blood pressure cuff like i asked ? patient: yeah , i , i did , and we do mon- , i , i monitor it regularly . my wife makes sure i stay on top of that , but it's been pretty good .	D2N068	18	[ "Personal History" ]	[ "Subjective" ]	and , so , lastly , for your high blood pressure , how are you doing with that ? have , are , did you buy the blood pressure cuff like i asked ?	1,746
doctor: okay . all right . well , i know you did the review of systems sheet when you checked in , and you were endorsing this fatigue- patient: mm-hmm .	D2N068	19	[ "Acute Symptoms", "Vegetative History" ]	[ "Subjective" ]	okay . all right . well , i know you did the review of systems sheet when you checked in , and you were endorsing this fatigue-	1,747
doctor: . and a little dizziness and we just talked a lot about a lot of other symptoms . patient: mm-hmm .	D2N068	20	[ "Acute Symptoms", "Vegetative History" ]	[ "Subjective" ]	. and a little dizziness and we just talked a lot about a lot of other symptoms .	1,748
doctor: any other symptoms i might be missing ? nausea or vomiting , diarrhea ? patient: no .	D2N068	21	[ "Acute Symptoms", "Vegetative History" ]	[ "Subjective" ]	any other symptoms i might be missing ? nausea or vomiting , diarrhea ?	1,749
doctor: anything like that ? patient: no .	D2N068	22	[ "Vegetative History" ]	[ "Subjective" ]	anything like that ?	1,750
doctor: okay . all right . well , i just want to go ahead and do a quick physical exam . patient: mm-hmm .	D2N068	23	[ "Physical Examination" ]	[ "Objective" ]	okay . all right . well , i just want to go ahead and do a quick physical exam .	1,751
doctor: hey , dragon ? show me the vital signs . so , looking at your vital signs here in the office , everything looks good . you know , your blood pressure and your heart rate and your oxygenation all look really good . patient: mm-hmm .	D2N068	24	[ "Physical Examination" ]	[ "Objective" ]	hey , dragon ? show me the vital signs . so , looking at your vital signs here in the office , everything looks good . you know , your blood pressure and your heart rate and your oxygenation all look really good .	1,752
doctor: so , i'm gon na just take a listen to a few things and check some things out , and i'll let you know what i find , okay ? patient: perfect .	D2N068	25	[ "Physical Examination" ]	[ "Objective" ]	so , i'm gon na just take a listen to a few things and check some things out , and i'll let you know what i find , okay ?	1,753
doctor: okay . so , on your physical examination , you know , i do appreciate some jugular venous distention to- patient: mm-hmm .	D2N068	26	[ "Physical Examination" ]	[ "Objective" ]	okay . so , on your physical examination , you know , i do appreciate some jugular venous distention to-	1,754
doctor: to about eight centimeters . on your heart exam , i do appreciate a three out of six systolic ejection murmur , which we've heard in the past . and , on your lung exam , i do appreciate some fine crackles at the bases bilaterally , and your lower extremities have , you know , 1+ pitting edema . so , what does all that mean ? that means i think you're retaining a little bit of fluid . patient: mm-hmm .	D2N068	27	[ "Physical Examination" ]	[ "Objective" ]	to about eight centimeters . on your heart exam , i do appreciate a three out of six systolic ejection murmur , which we've heard in the past . and , on your lung exam , i do appreciate some fine crackles at the bases bilaterally , and your lower extremities have , you know , 1+ pitting edema . so , what does all that mean ? that means i think you're retaining a little bit of fluid .	1,755
doctor: okay ? i wan na just go ahead and look at some of your results , okay ? patient: sure .	D2N068	28	[ "Chitchat" ]	[ "Null" ]	okay ? i wan na just go ahead and look at some of your results , okay ?	1,756
doctor: hey , dragon ? show me the chest x-ray . so , looking here at the results of your chest x-ray , it does look like you have a little bit of fluid in your lungs there , and that can be just from , um , your heart failure , okay ? hey , dragon ? show me the echocardiogram . so , this is the echocardiogram that we did about four months ago , and this shows that the pumping function of your heart is a little bit reduced at 45 % , and it also shows that leaky valve , the mitral regurgitation that , that you have , okay ? um , so , let me just go over and talk about , a little bit , my assessment and my plan for you . patient: mm-hmm .	D2N068	29	[ "Lab Examination" ]	[ "Objective" ]	hey , dragon ? show me the chest x-ray . so , looking here at the results of your chest x-ray , it does look like you have a little bit of fluid in your lungs there , and that can be just from , um , your heart failure , okay ? hey , dragon ? show me the echocardiogram . so , this is the echocardiogram that we did about four months ago , and this shows that the pumping function of your heart is a little bit reduced at 45 % , and it also shows that leaky valve , the mitral regurgitation that , that you have , okay ? um , so , let me just go over and talk about , a little bit , my assessment and my plan for you .	1,757
doctor: okay ? so , for your first problem , your congestive heart failure , i think you're retaining fluid , and i wan na go ahead and increase your lasix to 80 mg once a day . patient: mm-hmm .	D2N068	30	[ "Medication", "Reassessment" ]	[ "Assessment", "Plan" ]	okay ? so , for your first problem , your congestive heart failure , i think you're retaining fluid , and i wan na go ahead and increase your lasix to 80 mg once a day .	1,758
doctor: i want you to weigh yourself every day . i want you to call me if you're gaining more weight . patient: mm-hmm .	D2N068	31	[ "Follow-up", "Other Treatments" ]	[ "Plan" ]	i want you to weigh yourself every day . i want you to call me if you're gaining more weight .	1,759
doctor: and , i certainly want you to call me if you have any other symptoms of shortness of breath , and i wan na go ahead and order another echocardiogram , okay ? patient: sure .	D2N068	32	[ "Follow-up", "Diagnostic Testing" ]	[ "Plan" ]	and , i certainly want you to call me if you have any other symptoms of shortness of breath , and i wan na go ahead and order another echocardiogram , okay ?	1,760
doctor: hey , dragon ? order an echocardiogram .lastly , for your high blood pressure , it looks like you're managing it well at this time , okay ? so , i wan na go ahead and continue with the lisinopril 20 mg a day . i want you to continue to record your blood pressures at home , and report them to me in the patient portal if you see they're getting elevated , okay ? patient: mm-hmm .	D2N068	33	[ "Reassessment", "Diagnostic Testing", "Medication" ]	[ "Assessment", "Plan" ]	hey , dragon ? order an echocardiogram .lastly , for your high blood pressure , it looks like you're managing it well at this time , okay ? so , i wan na go ahead and continue with the lisinopril 20 mg a day . i want you to continue to record your blood pressures at home , and report them to me in the patient portal if you see they're getting elevated , okay ?	1,761
doctor: does that sound like a plan ? patient: that sounds fine .	D2N068	34	[ "Chitchat" ]	[ "Null" ]	does that sound like a plan ?	1,762
doctor: okay . um , i'm gon na be in touch with you after we get your test results , and we'll go from there , okay ? patient: sure .	D2N068	35	[ "Chitchat" ]	[ "Null" ]	okay . um , i'm gon na be in touch with you after we get your test results , and we'll go from there , okay ?	1,763
doctor: all right . hey , dragon , finalize the note .	D2N068	36	[ "Chitchat" ]	[ "Null" ]	doctor: all right . hey , dragon , finalize the note .	1,764
doctor: hi , ms. thompson . i'm dr. moore . how are you ? patient: hi , dr. moore .	D2N069	0	[ "Greetings" ]	[ "Subjective" ]	hi , ms. thompson . i'm dr. moore . how are you ?	1,765
doctor: all right , hey , dragon , ms. thompson is a 43 year old female here for right knee pain . so tell me what happened with your knee ? patient: well , i was , um , trying to change a light bulb , and i was up on a ladder and i kinda had a little bit of a stumble and kinda twisted my knee as i was trying to catch my fall .	D2N069	2	[ "Acute Symptoms" ]	[ "Subjective" ]	all right , hey , dragon , ms. thompson is a 43 year old female here for right knee pain . so tell me what happened with your knee ?	1,766
doctor: okay . and did you injure yourself any place else ? patient: no , no . it just seems to be the knee .	D2N069	3	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . and did you injure yourself any place else ?	1,767
doctor: all right . and when did this happen ? patient: it was yesterday .	D2N069	4	[ "Acute Symptoms" ]	[ "Subjective" ]	all right . and when did this happen ?	1,768
doctor: all right . and , uh , where does it hurt mostly ? patient: it hurts like in , in , in the inside of my knee .	D2N069	5	[ "Acute Symptoms" ]	[ "Subjective" ]	all right . and , uh , where does it hurt mostly ?	1,769
doctor: all right . and anything make it better or worse ? patient: i have been putting ice on it , uh , and i've been taking ibuprofen , but it does n't seem to help much .	D2N069	7	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	all right . and anything make it better or worse ?	1,770
doctor: okay . so it sounds like you fell a couple days ago , and you've hurt something inside of your right knee . patient: mm-hmm .	D2N069	8	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . so it sounds like you fell a couple days ago , and you've hurt something inside of your right knee .	1,771
doctor: and you've been taking a little bit of ice , uh , putting some ice on it , and has n't really helped and some ibuprofen . is that right ? patient: that's right . yeah .	D2N069	9	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	and you've been taking a little bit of ice , uh , putting some ice on it , and has n't really helped and some ibuprofen . is that right ?	1,772
doctor: okay , let's review your past history for a second . it looks like , uh , do you have any other past medical history ? patient: uh , afib .	D2N069	10	[ "Personal History" ]	[ "Subjective" ]	okay , let's review your past history for a second . it looks like , uh , do you have any other past medical history ?	1,773
doctor: okay , and are you taking any medications for that ? patient: yeah , i am . um , begins with a d.	D2N069	11	[ "Therapeutic History" ]	[ "Subjective" ]	okay , and are you taking any medications for that ?	1,774
doctor: uh , digoxin ? patient: that's it . yeah , that's it .	D2N069	12	[ "Therapeutic History" ]	[ "Subjective" ]	uh , digoxin ?	1,775
doctor: okay , all right . how about any surgeries in the past ? patient: i have had a nose job .	D2N069	13	[ "Personal History" ]	[ "Subjective" ]	okay , all right . how about any surgeries in the past ?	1,776
doctor: all right . um , let's do your exam , okay ? so is it tender ... where is it mostly tender right now ? patient: right on the inside of my knee . right here .	D2N069	14	[ "Physical Examination" ]	[ "Objective" ]	all right . um , let's do your exam , okay ? so is it tender ... where is it mostly tender right now ?	1,777
doctor: all right , so if i bend your knee forward , does that seem to hurt ? patient: yes , that hurts .	D2N069	15	[ "Physical Examination" ]	[ "Objective" ]	all right , so if i bend your knee forward , does that seem to hurt ?	1,778
doctor: all right , how about if i twist it a little bit that way . patient: that hurts a lot .	D2N069	16	[ "Physical Examination" ]	[ "Objective" ]	all right , how about if i twist it a little bit that way .	1,779
doctor: okay , okay . and how about down here ? do you feel me touch you down here ? patient: yes .	D2N069	17	[ "Physical Examination" ]	[ "Objective" ]	okay , okay . and how about down here ? do you feel me touch you down here ?	1,780
doctor: all right . any other pain down here in your calves ? patient: no .	D2N069	18	[ "Physical Examination" ]	[ "Objective" ]	all right . any other pain down here in your calves ?	1,781
doctor: no , okay . so on exam you do have some tenderness over the medial portion of your knee over the medial meniscus area . uh , there is no , uh , there is a little bit of tenderness when i flex your , uh , when i , uh , uh , do some valgus stressing on your , on your leg . um , you have normal sensation . so let's take a look at your x-rays . patient: okay .	D2N069	19	[ "Physical Examination" ]	[ "Objective" ]	no , okay . so on exam you do have some tenderness over the medial portion of your knee over the medial meniscus area . uh , there is no , uh , there is a little bit of tenderness when i flex your , uh , when i , uh , uh , do some valgus stressing on your , on your leg . um , you have normal sensation . so let's take a look at your x-rays .	1,782
doctor: okay . hey dragon , show me the x-rays . so looking at the x-ray , um , of your left knee , uh , it appears to be there's no fractures there right now . i do n't see any , uh , there's a little bit of , uh , fluid , uh , but there is no , uh , there's no , um , fracture or there's no dislocation . everything else seems to be lined up properly , okay ? patient: okay .	D2N069	20	[ "Radiology Examination" ]	[ "Objective" ]	okay . hey dragon , show me the x-rays . so looking at the x-ray , um , of your left knee , uh , it appears to be there's no fractures there right now . i do n't see any , uh , there's a little bit of , uh , fluid , uh , but there is no , uh , there's no , um , fracture or there's no dislocation . everything else seems to be lined up properly , okay ?	1,783
doctor: so in summary after my exam , uh , looking at your knee , uh , on the x-ray and your exam , you have some tenderness over the medial meniscus , so i think you have probably an acute medial meniscus sprain right now or strain . uh , at this point , my recommendation would be to put you in a knee brace , uh , and we'll go ahead and have you use some crutches temporarily for the next couple days . we'll have you come back in about a week and see how you're doing , and if it's not better , we'll get an mri at that time . patient: okay .	D2N069	21	[ "Follow-up", "Other Treatments", "Acute Assessment" ]	[ "Assessment", "Plan" ]	so in summary after my exam , uh , looking at your knee , uh , on the x-ray and your exam , you have some tenderness over the medial meniscus , so i think you have probably an acute medial meniscus sprain right now or strain . uh , at this point , my recommendation would be to put you in a knee brace , uh , and we'll go ahead and have you use some crutches temporarily for the next couple days . we'll have you come back in about a week and see how you're doing , and if it's not better , we'll get an mri at that time .	1,784
doctor: i'm going to recommend we give you some motrin , 800 milligrams . uh , you can take it about every six hours , uh , with food . uh , and we'll give you about a two week supply . patient: okay .	D2N069	22	[ "Medication" ]	[ "Plan" ]	i'm going to recommend we give you some motrin , 800 milligrams . uh , you can take it about every six hours , uh , with food . uh , and we'll give you about a two week supply .	1,785
doctor: okay . uh , do you have any questions ? patient: no , i think i'm good .	D2N069	23	[ "Discussion" ]	[ "Plan" ]	okay . uh , do you have any questions ?	1,786
doctor: all right . hey , dragon , order the medications and procedures discussed , and finalize the report . okay , come with me and we'll get you checked out .	D2N069	24	[ "Chitchat" ]	[ "Null" ]	doctor: all right . hey , dragon , order the medications and procedures discussed , and finalize the report . okay , come with me and we'll get you checked out .	1,787
doctor: hi logan . how are you ? patient: hey , good to see you .	D2N070	0	[ "Greetings" ]	[ "Subjective" ]	hi logan . how are you ?	1,788
doctor: it's good to see you as well . so i know the nurse told you about dax . patient: mm-hmm .	D2N070	1	[ "Chitchat" ]	[ "Null" ]	it's good to see you as well . so i know the nurse told you about dax .	1,789
doctor: i'd like to tell dax a little bit about you . patient: sure .	D2N070	2	[ "Chitchat" ]	[ "Null" ]	i'd like to tell dax a little bit about you .	1,790
doctor: so logan is a 58 year old male , with a past medical history significant for diabetes type 2 , hypertension , osteoarthritis , who presents today with some back pain . patient: mm-hmm .	D2N070	3	[ "Acute Symptoms", "Personal History" ]	[ "Subjective" ]	so logan is a 58 year old male , with a past medical history significant for diabetes type 2 , hypertension , osteoarthritis , who presents today with some back pain .	1,791
doctor: so logan , what happened to your back ? patient: uh , we were helping my daughter with some heavy equipment and lifted some boxes a little too quickly , and they were a little too heavy .	D2N070	4	[ "Acute Symptoms" ]	[ "Subjective" ]	so logan , what happened to your back ?	1,792
doctor: okay ... and did you strain your back , did something- patient: i thought i heard a pop when i moved and i had to lie down for about an hour before it actually relieved the pain . and then it's been a little stiff ever since . and this was- what , so today's tuesday . this was saturday morning .	D2N070	5	[ "Acute Symptoms" ]	[ "Subjective" ]	okay ... and did you strain your back , did something-	1,793
doctor: okay , all right . and is it your lower back , your upper back ? patient: my lower back .	D2N070	6	[ "Acute Symptoms" ]	[ "Subjective" ]	okay , all right . and is it your lower back , your upper back ?	1,794
doctor: your lower back , okay . and what- what have you taken for the pain ? patient: i took some tylenol , i took some ibuprofen , i used a little bit of icy heat on the spot but it really did n't seem to help .	D2N070	7	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	your lower back , okay . and what- what have you taken for the pain ?	1,795
doctor: okay . and um ... do you have any numbing or tingling in your legs ? patient: uh ... i felt some tingling in my toes on my right foot until about sunday afternoon . and then that seemed to go away .	D2N070	8	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . and um ... do you have any numbing or tingling in your legs ?	1,796
doctor: okay , and is there a position that you feel better in ? patient: uh ... it's really tough to find a comfortable spot sleeping at night . i would- i tend to lie on my right side and that seemed to help a little bit ?	D2N070	9	[ "Acute Symptoms" ]	[ "Subjective" ]	okay , and is there a position that you feel better in ?	1,797
doctor: okay , all right . well , um ... so how are you doing otherwise ? i know that , you know , we have some issues to talk- patient: mm-hmm .	D2N070	10	[ "Personal History" ]	[ "Subjective" ]	okay , all right . well , um ... so how are you doing otherwise ? i know that , you know , we have some issues to talk-	1,798
doctor: . about today . were you able to take any vacations over the summer ? patient: um ... some long weekends , which was great . just kind of- trying to mix it up through the summer . so lots of three day weekends .	D2N070	11	[ "Chitchat" ]	[ "Null" ]	. about today . were you able to take any vacations over the summer ?	1,799

doctor: okay alright patient: but sometimes it gets to an eleven

D2N067

13

[ "Acute Symptoms" ]

[ "Subjective" ]

okay alright

1,700

doctor: okay what would do you know if you are doing something that would cause it to be an eleven are you back on your ski's patient: no i ca n't ski

D2N067

14

[ "Acute Symptoms" ]

[ "Subjective" ]

okay what would do you know if you are doing something that would cause it to be an eleven are you back on your ski's

1,701

doctor: okay does it hurt more when you walk for longer periods of time patient: yes

D2N067

16

[ "Acute Symptoms" ]

[ "Subjective" ]

okay does it hurt more when you walk for longer periods of time

1,702

doctor: okay how long does the pain last patient: for as long as my walk is and i do n't sometimes i walk five minutes kinda depends on the wind

D2N067

17

[ "Acute Symptoms" ]

[ "Subjective" ]

okay how long does the pain last

1,703

doctor: okay alright patient: sometimes i walk there is

D2N067

18

[ "Acute Symptoms" ]

[ "Subjective" ]

okay alright

1,704

doctor: okay alright have you done anything to help with the pain patient: well i wear a brace and i have used a lot of thc cream on it

D2N067

19

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

okay alright have you done anything to help with the pain

1,705

doctor: okay alright thc cream is an interesting choice but do you think that's been helpful patient: yes

D2N067

20

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

okay alright thc cream is an interesting choice but do you think that's been helpful

1,706

doctor: alright have you taken patient: reasons

D2N067

21

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

alright have you taken

1,707

doctor: not a problem have you taken any medications patient: no just gummies

D2N067

22

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

not a problem have you taken any medications

1,708

doctor: okay like vitamins or more thc patient: kind of like thc gummies

D2N067

23

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

okay like vitamins or more thc

1,709

doctor: thc gummies patient: my grandma gave them to me

D2N067

24

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

thc gummies

1,710

doctor: thc gummies from grandma that's an excellent grandmother that you have okay have you noticed any swelling stiffness tenderness patient: yeah i i get a lot of swelling and it really is it's very stiff in the morning until i get walking

D2N067

25

[ "Acute Symptoms" ]

[ "Subjective" ]

thc gummies from grandma that's an excellent grandmother that you have okay have you noticed any swelling stiffness tenderness

1,711

doctor: okay alright and then have you had any hospitalizations or surgeries in the past patient: well i had surgery on my right knee before

D2N067

26

[ "Personal History" ]

[ "Subjective" ]

okay alright and then have you had any hospitalizations or surgeries in the past

1,712

doctor: okay so you've had surgery before alright do you remember what kind of surgery patient: i do n't know they told me they reconstructed the whole thing i was fourteen i was a really good gymnast back then really good

D2N067

27

[ "Personal History" ]

[ "Subjective" ]

okay so you've had surgery before alright do you remember what kind of surgery

1,713

doctor: okay okay okay how so do you have any other exercises that i might wan na know about outside of intense gym and ski events patient: no i think that's about it

D2N067

31

[ "Other Socials" ]

[ "Subjective" ]

okay okay okay how so do you have any other exercises that i might wan na know about outside of intense gym and ski events

1,714

doctor: okay and how frequently do you normally ski patient: i ski probably three times a week

D2N067

32

[ "Other Socials" ]

[ "Subjective" ]

okay and how frequently do you normally ski

1,715

doctor: okay and then are you on any medications at this time other than the thc patient: no

D2N067

33

[ "Therapeutic History" ]

[ "Subjective" ]

okay and then are you on any medications at this time other than the thc

1,716

doctor: okay alright what patient: nothing no

D2N067

34

[ "Chitchat" ]

[ "Null" ]

okay alright what

1,717

doctor: okay alright not a problem so if you do n't mind i'm gon na go ahead and start my examination i'm just gon na call it out for the sake of being able to document it appropriately and you or just just let me know if you want me to explain anything further so with your knee i know that you said it hurts on the right inside a lot right so when i press on the inside of your knee does that hurt patient: yes

D2N067

35

[ "Physical Examination" ]

[ "Objective" ]

okay alright not a problem so if you do n't mind i'm gon na go ahead and start my examination i'm just gon na call it out for the sake of being able to document it appropriately and you or just just let me know if you want me to explain anything further so with your knee i know that you said it hurts on the right inside a lot right so when i press on the inside of your knee does that hurt

1,718

doctor: okay and when i press on the outside of your left of your right knee sorry does that hurt patient: no

D2N067

36

[ "Physical Examination" ]

[ "Objective" ]

okay and when i press on the outside of your left of your right knee sorry does that hurt

1,719

doctor: okay alright so when i move your your kneecap does that hurt patient: no it kinda makes a shooting pain down to my ankle though

D2N067

37

[ "Physical Examination" ]

[ "Objective" ]

okay alright so when i move your your kneecap does that hurt

1,720

doctor: okay so does the pain radiate frequently patient: no

D2N067

39

[ "Physical Examination" ]

[ "Objective" ]

okay so does the pain radiate frequently

1,721

doctor: okay alright on your skin exam i do appreciate some mild swelling and bruising that's really interesting since it's been two weeks with your knee are you able to bend it patient: yes

D2N067

41

[ "Physical Examination" ]

[ "Objective" ]

okay alright on your skin exam i do appreciate some mild swelling and bruising that's really interesting since it's been two weeks with your knee are you able to bend it

1,722

doctor: okay and then when you walked in on your gait i think i think i did appreciate a slight limp are you i i i i think you are you are protecting one of your knees does that sound familiar patient: yeah i waddle pretty pretty good now

D2N067

42

[ "Physical Examination" ]

[ "Objective" ]

okay and then when you walked in on your gait i think i think i did appreciate a slight limp are you i i i i think you are you are protecting one of your knees does that sound familiar

1,723

doctor: okay alright and when you move your knee away from your body you're bending like your you're pulling it towards me does that hurt patient: yes

D2N067

43

[ "Physical Examination" ]

[ "Objective" ]

okay alright and when you move your knee away from your body you're bending like your you're pulling it towards me does that hurt

1,724

doctor: okay and then when you pull your knee back towards you does that hurt patient: no

D2N067

44

[ "Physical Examination" ]

[ "Objective" ]

okay and then when you pull your knee back towards you does that hurt

1,725

doctor: alright so pain on dorsiflexion but not on plantar flexion plantar flexion okay alright so what we are gon na do right now i think i'm gon na look at your x-rays but when i when i look at the results of your x-ray i do not appreciate any fracture what i am noticing is the development of a little bit of arthritis and that could explain like why you say that your joints hurt a bit more during like windy weather and what not so this is what we're gon na do for my assessment and plan right the first thing is i think you have a strain of your posterior cruciate ligament what that means is what that will mean for you though is that we are gon na continue to brace your right knee that's gon na hopefully take off some of the stress that you might be putting on it especially since you're limping i am going to recommend you for physical therapy i think it would be an i think it's a good idea to maybe start three times a week to get your strength back into your knee i would recommend not skiing or doing any gymnastics for now and i think that physical therapy will really help considering the injury that you had when you were fourteen i'm gon na prescribe you some medications i do n't necessarily recommend consuming gummies at the same time but the medications i'm gon na give you are gon na be meloxicam fifteen milligrams you're gon na take that once a day that will help with like the swelling and the bruising i'm also gon na prescribe you just like a higher strength nsaid so ibuprofen eight hundred milligrams a day you can take that twice a day as needed for your left knee i think you are i think you just kind of like strength a little bit but like not enough to necessarily require any kind of like medication or bracing i think you just take it easy on your body i know that you're like very active from what i hear and i i think that that's really exciting but i think you might need to listen to your body and give yourself a bit of a break you'll be able to do like several workouts when you go to when you go to physical therapy but you know let the yeah let your therapist be your guide about like what you should and should not be putting your body through does that make sense patient: yes

D2N067

45

[ "Physical Examination", "Medication", "Radiology Examination", "Diagnostic Testing", "Acute Assessment" ]

[ "Objective", "Assessment", "Plan" ]

alright so pain on dorsiflexion but not on plantar flexion plantar flexion okay alright so what we are gon na do right now i think i'm gon na look at your x-rays but when i when i look at the results of your x-ray i do not appreciate any fracture what i am noticing is the development of a little bit of arthritis and that could explain like why you say that your joints hurt a bit more during like windy weather and what not so this is what we're gon na do for my assessment and plan right the first thing is i think you have a strain of your posterior cruciate ligament what that means is what that will mean for you though is that we are gon na continue to brace your right knee that's gon na hopefully take off some of the stress that you might be putting on it especially since you're limping i am going to recommend you for physical therapy i think it would be an i think it's a good idea to maybe start three times a week to get your strength back into your knee i would recommend not skiing or doing any gymnastics for now and i think that physical therapy will really help considering the injury that you had when you were fourteen i'm gon na prescribe you some medications i do n't necessarily recommend consuming gummies at the same time but the medications i'm gon na give you are gon na be meloxicam fifteen milligrams you're gon na take that once a day that will help with like the swelling and the bruising i'm also gon na prescribe you just like a higher strength nsaid so ibuprofen eight hundred milligrams a day you can take that twice a day as needed for your left knee i think you are i think you just kind of like strength a little bit but like not enough to necessarily require any kind of like medication or bracing i think you just take it easy on your body i know that you're like very active from what i hear and i i think that that's really exciting but i think you might need to listen to your body and give yourself a bit of a break you'll be able to do like several workouts when you go to when you go to physical therapy but you know let the yeah let your therapist be your guide about like what you should and should not be putting your body through does that make sense

1,726

doctor: alright do you have any questions right now patient: no thank you so much

D2N067

46

[ "Discussion" ]

[ "Plan" ]

alright do you have any questions right now

1,727

doctor: no problem

D2N067

47

[ "Chitchat" ]

[ "Null" ]

doctor: no problem

1,728

doctor: hi , brian . how are you ? patient: hi , good to see you .

D2N068

0

[ "Greetings" ]

[ "Subjective" ]

hi , brian . how are you ?

1,729

doctor: it's good to see you too . so , i know the nurse told you a little bit about dax . patient: mm-hmm .

D2N068

1

[ "Chitchat" ]

[ "Null" ]

it's good to see you too . so , i know the nurse told you a little bit about dax .

1,730

doctor: i'd like to tell dax about you , okay ? patient: sure .

D2N068

2

[ "Chitchat" ]

[ "Null" ]

i'd like to tell dax about you , okay ?

1,731

doctor: so , brian is a 58 year old male with a past medical history significant for congestive heart failure and hypertension , who presents today for follow-up of his chronic problems . so , brian , it's been a little while i've seen you . patient: mm-hmm .

D2N068

3

[ "Personal History" ]

[ "Subjective" ]

so , brian is a 58 year old male with a past medical history significant for congestive heart failure and hypertension , who presents today for follow-up of his chronic problems . so , brian , it's been a little while i've seen you .

1,732

doctor: whats , what's going on ? patient: i , i just feel out of sorts lately . i do n't know if it's the change in the seasons or if we're just doing a lot of projects around the house and , and some , some construction on our own . i'm just feeling out of it . lack of , uh , energy . i'm just so tired and fatigued , and i feel kinda ... i feel lightheaded every once in a while .

D2N068

4

[ "Acute Symptoms" ]

[ "Subjective" ]

whats , what's going on ?

1,733

doctor: okay . all right . um , how long has that been going on for ? patient: uh , probably since labor day , so about five weeks or so .

D2N068

5

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . all right . um , how long has that been going on for ?

1,734

doctor: okay . and , have you noticed any , like , symptoms of weight gain , like , like swollen legs , or , you know , your belly feels bloated and things like that ? patient: i feel , i feel bloated every once in a while .

D2N068

6

[ "Vegetative History" ]

[ "Subjective" ]

okay . and , have you noticed any , like , symptoms of weight gain , like , like swollen legs , or , you know , your belly feels bloated and things like that ?

1,735

doctor: okay . all right . um , and , are you taking your , your medications ? patient: uh , yes , i am .

D2N068

7

[ "Therapeutic History" ]

[ "Subjective" ]

okay . all right . um , and , are you taking your , your medications ?

1,736

doctor: okay . and , how about your diet ? are you watching your diet ? patient: uh , it's been a little bit of a struggle . we began construction on our kitchen over labor day weekend , and it was ... hard to cook or prepare meals so we ate out a lot, and not always the best food out. it , it , it kind of reeked havoc , uh , so it's been maybe off a little bit .

D2N068

8

[ "Personal History" ]

[ "Subjective" ]

okay . and , how about your diet ? are you watching your diet ?

1,737

doctor: okay . all right . and , how about , you know , other symptoms , like , have you had a fever or chills ? patient: no .

D2N068

9

[ "Vegetative History" ]

[ "Subjective" ]

okay . all right . and , how about , you know , other symptoms , like , have you had a fever or chills ?

1,738

doctor: okay , and any problems breathing ? do you feel short of breath ? patient: uh , just when i'm doing doing the projects . again , not even lifting anything really heavy , it's just that if i'm ex- exerting any energy , i , i kinda feel it at that point .

D2N068

10

[ "Acute Symptoms" ]

[ "Subjective" ]

okay , and any problems breathing ? do you feel short of breath ?

1,739

doctor: okay . do you have any chest pain ? patient: slight cramps . that seems to go away after about , maybe about an hour or so after i first feel it .

D2N068

11

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . do you have any chest pain ?

1,740

doctor: okay , and how about a cough ? patient: a , a slight cough , and again , i'm not sure if it's just the change of seasons and i'm getting a cold .

D2N068

12

[ "Acute Symptoms" ]

[ "Subjective" ]

okay , and how about a cough ?

1,741

doctor: mm-hmm . okay . all right . well , you know , for the most part , how , you know , before all of this- patient: mm-hmm .

D2N068

13

[ "Chitchat" ]

[ "Null" ]

mm-hmm . okay . all right . well , you know , for the most part , how , you know , before all of this-

1,742

doctor: . how were you doing with your heart failure ? i know that we've kinda talked about you being able to watch your healthy food intake and that's been kind of a struggle in the past . patient: i , i , i've actually been pretty good about that ever since . the , the , the last year , it's been a little chaotic , but i wanted to make sure i stayed on top of that .

D2N068

14

[ "Personal History" ]

[ "Subjective" ]

. how were you doing with your heart failure ? i know that we've kinda talked about you being able to watch your healthy food intake and that's been kind of a struggle in the past .

1,743

doctor: okay . all right . are you excited for halloween ? patient: uh , ca n't wait .

D2N068

15

[ "Chitchat" ]

[ "Null" ]

okay . all right . are you excited for halloween ?

1,744

doctor: all right , yeah , right . patient: yeah .

D2N068

17

[ "Chitchat" ]

[ "Null" ]

all right , yeah , right .

1,745

doctor: and , so , lastly , for your high blood pressure , how are you doing with that ? have , are , did you buy the blood pressure cuff like i asked ? patient: yeah , i , i did , and we do mon- , i , i monitor it regularly . my wife makes sure i stay on top of that , but it's been pretty good .

D2N068

18

[ "Personal History" ]

[ "Subjective" ]

and , so , lastly , for your high blood pressure , how are you doing with that ? have , are , did you buy the blood pressure cuff like i asked ?

1,746

doctor: okay . all right . well , i know you did the review of systems sheet when you checked in , and you were endorsing this fatigue- patient: mm-hmm .

D2N068

19

[ "Acute Symptoms", "Vegetative History" ]

[ "Subjective" ]

okay . all right . well , i know you did the review of systems sheet when you checked in , and you were endorsing this fatigue-

1,747

doctor: . and a little dizziness and we just talked a lot about a lot of other symptoms . patient: mm-hmm .

D2N068

20

[ "Acute Symptoms", "Vegetative History" ]

[ "Subjective" ]

. and a little dizziness and we just talked a lot about a lot of other symptoms .

1,748

doctor: any other symptoms i might be missing ? nausea or vomiting , diarrhea ? patient: no .

D2N068

21

[ "Acute Symptoms", "Vegetative History" ]

[ "Subjective" ]

any other symptoms i might be missing ? nausea or vomiting , diarrhea ?

1,749

doctor: anything like that ? patient: no .

D2N068

22

[ "Vegetative History" ]

[ "Subjective" ]

anything like that ?

1,750

doctor: okay . all right . well , i just want to go ahead and do a quick physical exam . patient: mm-hmm .

D2N068

23

[ "Physical Examination" ]

[ "Objective" ]

okay . all right . well , i just want to go ahead and do a quick physical exam .

1,751

doctor: hey , dragon ? show me the vital signs . so , looking at your vital signs here in the office , everything looks good . you know , your blood pressure and your heart rate and your oxygenation all look really good . patient: mm-hmm .

D2N068

24

[ "Physical Examination" ]

[ "Objective" ]

hey , dragon ? show me the vital signs . so , looking at your vital signs here in the office , everything looks good . you know , your blood pressure and your heart rate and your oxygenation all look really good .

1,752

doctor: so , i'm gon na just take a listen to a few things and check some things out , and i'll let you know what i find , okay ? patient: perfect .

D2N068

25

[ "Physical Examination" ]

[ "Objective" ]

so , i'm gon na just take a listen to a few things and check some things out , and i'll let you know what i find , okay ?

1,753

doctor: okay . so , on your physical examination , you know , i do appreciate some jugular venous distention to- patient: mm-hmm .

D2N068

26

[ "Physical Examination" ]

[ "Objective" ]

okay . so , on your physical examination , you know , i do appreciate some jugular venous distention to-

1,754

doctor: to about eight centimeters . on your heart exam , i do appreciate a three out of six systolic ejection murmur , which we've heard in the past . and , on your lung exam , i do appreciate some fine crackles at the bases bilaterally , and your lower extremities have , you know , 1+ pitting edema . so , what does all that mean ? that means i think you're retaining a little bit of fluid . patient: mm-hmm .

D2N068

27

[ "Physical Examination" ]

[ "Objective" ]

to about eight centimeters . on your heart exam , i do appreciate a three out of six systolic ejection murmur , which we've heard in the past . and , on your lung exam , i do appreciate some fine crackles at the bases bilaterally , and your lower extremities have , you know , 1+ pitting edema . so , what does all that mean ? that means i think you're retaining a little bit of fluid .

1,755

doctor: okay ? i wan na just go ahead and look at some of your results , okay ? patient: sure .

D2N068

28

[ "Chitchat" ]

[ "Null" ]

okay ? i wan na just go ahead and look at some of your results , okay ?

1,756

doctor: hey , dragon ? show me the chest x-ray . so , looking here at the results of your chest x-ray , it does look like you have a little bit of fluid in your lungs there , and that can be just from , um , your heart failure , okay ? hey , dragon ? show me the echocardiogram . so , this is the echocardiogram that we did about four months ago , and this shows that the pumping function of your heart is a little bit reduced at 45 % , and it also shows that leaky valve , the mitral regurgitation that , that you have , okay ? um , so , let me just go over and talk about , a little bit , my assessment and my plan for you . patient: mm-hmm .

D2N068

29

[ "Lab Examination" ]

[ "Objective" ]

hey , dragon ? show me the chest x-ray . so , looking here at the results of your chest x-ray , it does look like you have a little bit of fluid in your lungs there , and that can be just from , um , your heart failure , okay ? hey , dragon ? show me the echocardiogram . so , this is the echocardiogram that we did about four months ago , and this shows that the pumping function of your heart is a little bit reduced at 45 % , and it also shows that leaky valve , the mitral regurgitation that , that you have , okay ? um , so , let me just go over and talk about , a little bit , my assessment and my plan for you .

1,757

doctor: okay ? so , for your first problem , your congestive heart failure , i think you're retaining fluid , and i wan na go ahead and increase your lasix to 80 mg once a day . patient: mm-hmm .

D2N068

30

[ "Medication", "Reassessment" ]

[ "Assessment", "Plan" ]

okay ? so , for your first problem , your congestive heart failure , i think you're retaining fluid , and i wan na go ahead and increase your lasix to 80 mg once a day .

1,758

doctor: i want you to weigh yourself every day . i want you to call me if you're gaining more weight . patient: mm-hmm .

D2N068

31

[ "Follow-up", "Other Treatments" ]

[ "Plan" ]

i want you to weigh yourself every day . i want you to call me if you're gaining more weight .

1,759

doctor: and , i certainly want you to call me if you have any other symptoms of shortness of breath , and i wan na go ahead and order another echocardiogram , okay ? patient: sure .

D2N068

32

[ "Follow-up", "Diagnostic Testing" ]

[ "Plan" ]

and , i certainly want you to call me if you have any other symptoms of shortness of breath , and i wan na go ahead and order another echocardiogram , okay ?

1,760

doctor: hey , dragon ? order an echocardiogram .lastly , for your high blood pressure , it looks like you're managing it well at this time , okay ? so , i wan na go ahead and continue with the lisinopril 20 mg a day . i want you to continue to record your blood pressures at home , and report them to me in the patient portal if you see they're getting elevated , okay ? patient: mm-hmm .

D2N068

33

[ "Reassessment", "Diagnostic Testing", "Medication" ]

[ "Assessment", "Plan" ]

hey , dragon ? order an echocardiogram .lastly , for your high blood pressure , it looks like you're managing it well at this time , okay ? so , i wan na go ahead and continue with the lisinopril 20 mg a day . i want you to continue to record your blood pressures at home , and report them to me in the patient portal if you see they're getting elevated , okay ?

1,761

doctor: does that sound like a plan ? patient: that sounds fine .

D2N068

34

[ "Chitchat" ]

[ "Null" ]

does that sound like a plan ?

1,762

doctor: okay . um , i'm gon na be in touch with you after we get your test results , and we'll go from there , okay ? patient: sure .

D2N068

35

[ "Chitchat" ]

[ "Null" ]

okay . um , i'm gon na be in touch with you after we get your test results , and we'll go from there , okay ?

1,763

doctor: all right . hey , dragon , finalize the note .

D2N068

36

[ "Chitchat" ]

[ "Null" ]

doctor: all right . hey , dragon , finalize the note .

1,764

doctor: hi , ms. thompson . i'm dr. moore . how are you ? patient: hi , dr. moore .

D2N069

0

[ "Greetings" ]

[ "Subjective" ]

hi , ms. thompson . i'm dr. moore . how are you ?

1,765

doctor: all right , hey , dragon , ms. thompson is a 43 year old female here for right knee pain . so tell me what happened with your knee ? patient: well , i was , um , trying to change a light bulb , and i was up on a ladder and i kinda had a little bit of a stumble and kinda twisted my knee as i was trying to catch my fall .

D2N069

2

[ "Acute Symptoms" ]

[ "Subjective" ]

all right , hey , dragon , ms. thompson is a 43 year old female here for right knee pain . so tell me what happened with your knee ?

1,766

doctor: okay . and did you injure yourself any place else ? patient: no , no . it just seems to be the knee .

D2N069

3

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . and did you injure yourself any place else ?

1,767

doctor: all right . and when did this happen ? patient: it was yesterday .

D2N069

4

[ "Acute Symptoms" ]

[ "Subjective" ]

all right . and when did this happen ?

1,768

doctor: all right . and , uh , where does it hurt mostly ? patient: it hurts like in , in , in the inside of my knee .

D2N069

5

[ "Acute Symptoms" ]

[ "Subjective" ]

all right . and , uh , where does it hurt mostly ?

1,769

doctor: all right . and anything make it better or worse ? patient: i have been putting ice on it , uh , and i've been taking ibuprofen , but it does n't seem to help much .

D2N069

7

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

all right . and anything make it better or worse ?

1,770

doctor: okay . so it sounds like you fell a couple days ago , and you've hurt something inside of your right knee . patient: mm-hmm .

D2N069

8

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . so it sounds like you fell a couple days ago , and you've hurt something inside of your right knee .

1,771

doctor: and you've been taking a little bit of ice , uh , putting some ice on it , and has n't really helped and some ibuprofen . is that right ? patient: that's right . yeah .

D2N069

9

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

and you've been taking a little bit of ice , uh , putting some ice on it , and has n't really helped and some ibuprofen . is that right ?

1,772

doctor: okay , let's review your past history for a second . it looks like , uh , do you have any other past medical history ? patient: uh , afib .

D2N069

10

[ "Personal History" ]

[ "Subjective" ]

okay , let's review your past history for a second . it looks like , uh , do you have any other past medical history ?

1,773

doctor: okay , and are you taking any medications for that ? patient: yeah , i am . um , begins with a d.

D2N069

11

[ "Therapeutic History" ]

[ "Subjective" ]

okay , and are you taking any medications for that ?

1,774

doctor: uh , digoxin ? patient: that's it . yeah , that's it .

D2N069

12

[ "Therapeutic History" ]

[ "Subjective" ]

uh , digoxin ?

1,775

doctor: okay , all right . how about any surgeries in the past ? patient: i have had a nose job .

D2N069

13

[ "Personal History" ]

[ "Subjective" ]

okay , all right . how about any surgeries in the past ?

1,776

doctor: all right . um , let's do your exam , okay ? so is it tender ... where is it mostly tender right now ? patient: right on the inside of my knee . right here .

D2N069

14

[ "Physical Examination" ]

[ "Objective" ]

all right . um , let's do your exam , okay ? so is it tender ... where is it mostly tender right now ?

1,777

doctor: all right , so if i bend your knee forward , does that seem to hurt ? patient: yes , that hurts .

D2N069

15

[ "Physical Examination" ]

[ "Objective" ]

all right , so if i bend your knee forward , does that seem to hurt ?

1,778

doctor: all right , how about if i twist it a little bit that way . patient: that hurts a lot .

D2N069

16

[ "Physical Examination" ]

[ "Objective" ]

all right , how about if i twist it a little bit that way .

1,779

doctor: okay , okay . and how about down here ? do you feel me touch you down here ? patient: yes .

D2N069

17

[ "Physical Examination" ]

[ "Objective" ]

okay , okay . and how about down here ? do you feel me touch you down here ?

1,780

doctor: all right . any other pain down here in your calves ? patient: no .

D2N069

18

[ "Physical Examination" ]

[ "Objective" ]

all right . any other pain down here in your calves ?

1,781

doctor: no , okay . so on exam you do have some tenderness over the medial portion of your knee over the medial meniscus area . uh , there is no , uh , there is a little bit of tenderness when i flex your , uh , when i , uh , uh , do some valgus stressing on your , on your leg . um , you have normal sensation . so let's take a look at your x-rays . patient: okay .

D2N069

19

[ "Physical Examination" ]

[ "Objective" ]

no , okay . so on exam you do have some tenderness over the medial portion of your knee over the medial meniscus area . uh , there is no , uh , there is a little bit of tenderness when i flex your , uh , when i , uh , uh , do some valgus stressing on your , on your leg . um , you have normal sensation . so let's take a look at your x-rays .

1,782

doctor: okay . hey dragon , show me the x-rays . so looking at the x-ray , um , of your left knee , uh , it appears to be there's no fractures there right now . i do n't see any , uh , there's a little bit of , uh , fluid , uh , but there is no , uh , there's no , um , fracture or there's no dislocation . everything else seems to be lined up properly , okay ? patient: okay .

D2N069

20

[ "Radiology Examination" ]

[ "Objective" ]

okay . hey dragon , show me the x-rays . so looking at the x-ray , um , of your left knee , uh , it appears to be there's no fractures there right now . i do n't see any , uh , there's a little bit of , uh , fluid , uh , but there is no , uh , there's no , um , fracture or there's no dislocation . everything else seems to be lined up properly , okay ?

1,783

doctor: so in summary after my exam , uh , looking at your knee , uh , on the x-ray and your exam , you have some tenderness over the medial meniscus , so i think you have probably an acute medial meniscus sprain right now or strain . uh , at this point , my recommendation would be to put you in a knee brace , uh , and we'll go ahead and have you use some crutches temporarily for the next couple days . we'll have you come back in about a week and see how you're doing , and if it's not better , we'll get an mri at that time . patient: okay .

D2N069

21

[ "Follow-up", "Other Treatments", "Acute Assessment" ]

[ "Assessment", "Plan" ]

so in summary after my exam , uh , looking at your knee , uh , on the x-ray and your exam , you have some tenderness over the medial meniscus , so i think you have probably an acute medial meniscus sprain right now or strain . uh , at this point , my recommendation would be to put you in a knee brace , uh , and we'll go ahead and have you use some crutches temporarily for the next couple days . we'll have you come back in about a week and see how you're doing , and if it's not better , we'll get an mri at that time .

1,784

doctor: i'm going to recommend we give you some motrin , 800 milligrams . uh , you can take it about every six hours , uh , with food . uh , and we'll give you about a two week supply . patient: okay .

D2N069

22

[ "Medication" ]

[ "Plan" ]

i'm going to recommend we give you some motrin , 800 milligrams . uh , you can take it about every six hours , uh , with food . uh , and we'll give you about a two week supply .

1,785

doctor: okay . uh , do you have any questions ? patient: no , i think i'm good .

D2N069

23

[ "Discussion" ]

[ "Plan" ]

okay . uh , do you have any questions ?

1,786

doctor: all right . hey , dragon , order the medications and procedures discussed , and finalize the report . okay , come with me and we'll get you checked out .

D2N069

24

[ "Chitchat" ]

[ "Null" ]

doctor: all right . hey , dragon , order the medications and procedures discussed , and finalize the report . okay , come with me and we'll get you checked out .

1,787

doctor: hi logan . how are you ? patient: hey , good to see you .

D2N070

0

[ "Greetings" ]

[ "Subjective" ]

hi logan . how are you ?

1,788

doctor: it's good to see you as well . so i know the nurse told you about dax . patient: mm-hmm .

D2N070

1

[ "Chitchat" ]

[ "Null" ]

it's good to see you as well . so i know the nurse told you about dax .

1,789

doctor: i'd like to tell dax a little bit about you . patient: sure .

D2N070

2

[ "Chitchat" ]

[ "Null" ]

i'd like to tell dax a little bit about you .

1,790

doctor: so logan is a 58 year old male , with a past medical history significant for diabetes type 2 , hypertension , osteoarthritis , who presents today with some back pain . patient: mm-hmm .

D2N070

3

[ "Acute Symptoms", "Personal History" ]

[ "Subjective" ]

so logan is a 58 year old male , with a past medical history significant for diabetes type 2 , hypertension , osteoarthritis , who presents today with some back pain .

1,791

doctor: so logan , what happened to your back ? patient: uh , we were helping my daughter with some heavy equipment and lifted some boxes a little too quickly , and they were a little too heavy .

D2N070

4

[ "Acute Symptoms" ]

[ "Subjective" ]

so logan , what happened to your back ?

1,792

doctor: okay ... and did you strain your back , did something- patient: i thought i heard a pop when i moved and i had to lie down for about an hour before it actually relieved the pain . and then it's been a little stiff ever since . and this was- what , so today's tuesday . this was saturday morning .

D2N070

5

[ "Acute Symptoms" ]

[ "Subjective" ]

okay ... and did you strain your back , did something-

1,793

doctor: okay , all right . and is it your lower back , your upper back ? patient: my lower back .

D2N070

6

[ "Acute Symptoms" ]

[ "Subjective" ]

okay , all right . and is it your lower back , your upper back ?

1,794

doctor: your lower back , okay . and what- what have you taken for the pain ? patient: i took some tylenol , i took some ibuprofen , i used a little bit of icy heat on the spot but it really did n't seem to help .

D2N070

7

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

your lower back , okay . and what- what have you taken for the pain ?

1,795

doctor: okay . and um ... do you have any numbing or tingling in your legs ? patient: uh ... i felt some tingling in my toes on my right foot until about sunday afternoon . and then that seemed to go away .

D2N070

8

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . and um ... do you have any numbing or tingling in your legs ?

1,796

doctor: okay , and is there a position that you feel better in ? patient: uh ... it's really tough to find a comfortable spot sleeping at night . i would- i tend to lie on my right side and that seemed to help a little bit ?

D2N070

9

[ "Acute Symptoms" ]

[ "Subjective" ]

okay , and is there a position that you feel better in ?

1,797

doctor: okay , all right . well , um ... so how are you doing otherwise ? i know that , you know , we have some issues to talk- patient: mm-hmm .

D2N070

10

[ "Personal History" ]

[ "Subjective" ]

okay , all right . well , um ... so how are you doing otherwise ? i know that , you know , we have some issues to talk-

1,798

doctor: . about today . were you able to take any vacations over the summer ? patient: um ... some long weekends , which was great . just kind of- trying to mix it up through the summer . so lots of three day weekends .

D2N070

11

[ "Chitchat" ]

[ "Null" ]

. about today . were you able to take any vacations over the summer ?

1,799