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|---|---|---|---|---|---|---|
doctor: any recent travel or contact or exposure to the coronavirus ? patient: nope . | D2N142 | 19 | [
"Other Socials"
] | [
"Subjective"
] | any recent travel or contact or exposure to the coronavirus ? | 3,600 |
doctor: have you received your coronavirus vaccine ? patient: yes , on february 9th . | D2N142 | 20 | [
"Therapeutic History"
] | [
"Subjective"
] | have you received your coronavirus vaccine ? | 3,601 |
doctor: okay , great . all right well i'm just going to look at your ankles and feet , i'm looking for any signs of swelling . patient: okay . | D2N142 | 21 | [
"Physical Examination"
] | [
"Objective"
] | okay , great . all right well i'm just going to look at your ankles and feet , i'm looking for any signs of swelling . | 3,602 |
doctor: all right , well everything looks good . you can go ahead and sit up miss taylor . all right , so the good news is everything is looking okay . i think we both agree if you were able to stop drinking your blood pressure would cease to be an issue for you . patient: yeah i agree with that . | D2N142 | 22 | [
"Discussion",
"Other Treatments",
"Reassessment"
] | [
"Assessment",
"Plan"
] | all right , well everything looks good . you can go ahead and sit up miss taylor . all right , so the good news is everything is looking okay . i think we both agree if you were able to stop drinking your blood pressure would cease to be an issue for you . | 3,603 |
doctor: so let us discuss the potential medicine to help you with that . what it does is it blocks some of the brain receptors that alcohol stimulates and it tricks the brain into thinking it does not need alcohol , thereby cutting down the urges . patient: the urge to drink or the constant thinking about it ? | D2N142 | 23 | [
"Discussion"
] | [
"Plan"
] | so let us discuss the potential medicine to help you with that . what it does is it blocks some of the brain receptors that alcohol stimulates and it tricks the brain into thinking it does not need alcohol , thereby cutting down the urges . | 3,604 |
doctor: it actually will help with both . patient: okay . so is it like a one-time thing ? | D2N142 | 24 | [
"Discussion",
"Medication"
] | [
"Plan"
] | it actually will help with both . | 3,605 |
doctor: generally the shot is given about once a month , it can also be given as a daily pill , but the shot does tend to work a bit better . patient: yeah i've taken things like this in the past and if it is a pill , i know i wo n't take it . with a shot , it's not like you can un-take it . | D2N142 | 25 | [
"Discussion",
"Medication"
] | [
"Plan"
] | generally the shot is given about once a month , it can also be given as a daily pill , but the shot does tend to work a bit better . | 3,606 |
doctor: yeah that's true . and the shot has been shown to work , it is more just a matter of getting you in to get your shot a month later with the nurse . patient: yeah , sure , sure . | D2N142 | 26 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah that's true . and the shot has been shown to work , it is more just a matter of getting you in to get your shot a month later with the nurse . | 3,607 |
doctor: okay , so it's called naltrexone . i think the other name might be vivitrol . like i've said , the research on it is pretty good . patient: i think i may have taken the naltrexone before . | D2N142 | 27 | [
"Discussion",
"Medication"
] | [
"Plan"
] | okay , so it's called naltrexone . i think the other name might be vivitrol . like i've said , the research on it is pretty good . | 3,608 |
doctor: okay , yeah , maybe you have . patient: yeah , if it was available in a pill form then i'm almost certain i've tried it b- before . | D2N142 | 28 | [
"Discussion",
"Medication"
] | [
"Plan"
] | okay , yeah , maybe you have . | 3,609 |
doctor: okay . if this sounds good though , we can go ahead get you started with the shot . i am looking and it looks like we have you coming back in on may 17th for your first shot , does that sound good ? patient: yeah , yeah , that sounds great . are there any possible side effects ? | D2N142 | 29 | [
"Discussion",
"Follow-up",
"Medication"
] | [
"Plan"
] | okay . if this sounds good though , we can go ahead get you started with the shot . i am looking and it looks like we have you coming back in on may 17th for your first shot , does that sound good ? | 3,610 |
doctor: yeah , some people will experience some nausea , headache , dizziness , anxi- anxiety , tiredness and trouble sleeping , but generally the side effects are mild and should go away within a few days . patient: okay . | D2N142 | 30 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah , some people will experience some nausea , headache , dizziness , anxi- anxiety , tiredness and trouble sleeping , but generally the side effects are mild and should go away within a few days . | 3,611 |
doctor: then we can schedule you for a follow-up in june to see how you are doing . patient: all right that sounds good . | D2N142 | 31 | [
"Follow-up"
] | [
"Plan"
] | then we can schedule you for a follow-up in june to see how you are doing . | 3,612 |
doctor: all right great . well otherwise stay with your current medicines , keep checking your blood pressure , and let's see if we can stop the alcohol for good . let us know if you have any questions or any issues come up after you receive the first dose . patient: all right , sounds good , thank you . | D2N142 | 32 | [
"Medication",
"Other Treatments",
"Drug History"
] | [
"Plan"
] | all right great . well otherwise stay with your current medicines , keep checking your blood pressure , and let's see if we can stop the alcohol for good . let us know if you have any questions or any issues come up after you receive the first dose . | 3,613 |
doctor: you are welcome , have a good rest of your day . patient: you too . | D2N142 | 33 | [
"Chitchat"
] | [
"Null"
] | you are welcome , have a good rest of your day . | 3,614 |
doctor: miss taylor is drinking alcohol four to five days per week to excess . no tobacco , no substance abuse , skin is moist , good trigger . on exam she is alert , pleasant , in no acute distress . she is not diabetic , there is no tremor , no cva tenderness , chest clear to percussion and auscultation , unlabored b... | D2N142 | 34 | [
"Drug History",
"Personal History",
"Physical Examination",
"Acute Assessment",
"Reassessment",
"Medication",
"Follow-up",
"Discussion"
] | [
"Subjective",
"Objective",
"Assessment",
"Plan"
] | doctor: miss taylor is drinking alcohol four to five days per week to excess . no tobacco , no substance abuse , skin is moist , good trigger . on exam she is alert , pleasant , in no acute distress . she is not diabetic , there is no tremor , no cva tenderness , chest clear to percussion and auscultation , unlabored b... | 3,615 |
doctor: next patient is grace ross . date of birth 8-23-97 . ms. ross is a new patient . she's here today for a full spectrum std testing . the patient states that she's having symptoms of discomfort , a change in discharge , and odor in her vaginal region . she says that the right side of her vagina is starting to bec... | D2N143 | 0 | [
"Personal History",
"Greetings"
] | [
"Subjective"
] | next patient is grace ross . date of birth 8-23-97 . ms. ross is a new patient . she's here today for a full spectrum std testing . the patient states that she's having symptoms of discomfort , a change in discharge , and odor in her vaginal region . she says that the right side of her vagina is starting to become pain... | 3,616 |
doctor: so , how are you doing today ? i hear that you're here for std testing . is that correct ? patient: yeah . actually , i found out earlier this week , that my boyfriend has been cheating on me , for some time . i'm really worried , that i could have caught something , you know ? | D2N143 | 1 | [
"Acute Symptoms"
] | [
"Subjective"
] | so , how are you doing today ? i hear that you're here for std testing . is that correct ? | 3,617 |
doctor: mm-hmm . patient: i wanted to make sure i do n't have anything . | D2N143 | 2 | [
"Acute Symptoms"
] | [
"Subjective"
] | mm-hmm . | 3,618 |
doctor: yeah . i'm sorry to hear that . of course , we can do that today . um . well , let's see . how do you feel ? do you have any symptoms ? patient: well , um , i started noticing some weird discharge last week . | D2N143 | 3 | [
"Acute Symptoms"
] | [
"Subjective"
] | yeah . i'm sorry to hear that . of course , we can do that today . um . well , let's see . how do you feel ? do you have any symptoms ? | 3,619 |
doctor: mm-hmm . patient: uh , it smells different . it's not the same color , or consistency , as usually , it is . | D2N143 | 4 | [
"Acute Symptoms"
] | [
"Subjective"
] | mm-hmm . | 3,620 |
doctor: right . patient: um . that part did n't even phase me , until i noticed that the right side of my vagina was hurting . just sore , you know , but that has n't gone away . | D2N143 | 5 | [
"Acute Symptoms"
] | [
"Subjective"
] | right . | 3,621 |
doctor: yep . nah , that does sound like a cause for concern . how long have you been with him ? patient: hmm , we've been dating for three years . | D2N143 | 6 | [
"Acute Symptoms"
] | [
"Subjective"
] | yep . nah , that does sound like a cause for concern . how long have you been with him ? | 3,622 |
doctor: mm-hmm . patient: as far as , i can figure , he started cheating on me , i think , about three months ago . | D2N143 | 7 | [
"Acute Symptoms"
] | [
"Subjective"
] | mm-hmm . | 3,623 |
doctor: uh- . um , okay . do you ... have you ever had an irregular pap smear ? patient: well , yeah , i did , but it was back whenever i was 20 or so . it has n't ... and i have n't had one since . | D2N143 | 8 | [
"Acute Symptoms"
] | [
"Subjective"
] | uh- . um , okay . do you ... have you ever had an irregular pap smear ? | 3,624 |
doctor: okay . and when was your last pap smear ? patient: uh , about six months ago . it came back normal , though . | D2N143 | 9 | [
"Acute Symptoms"
] | [
"Subjective"
] | okay . and when was your last pap smear ? | 3,625 |
doctor: okay . good , okay . well , let's see ... let's take a look at you , and then , we'll get some samples for std testing . okay ? patient: all right . | D2N143 | 10 | [
"Physical Examination"
] | [
"Objective"
] | okay . good , okay . well , let's see ... let's take a look at you , and then , we'll get some samples for std testing . okay ? | 3,626 |
doctor: you'll hear me talk through your exam , so that i can get it all documented . uh- ? use my general physical exam template . pelvic exam demonstrates no external lesions . normal labia majora and labia minora . normal physiological discharge , with normal color and smell . ms. ross , i'm going to touch you , now... | D2N143 | 11 | [
"Physical Examination",
"Discussion",
"Diagnostic Testing",
"Acute Assessment"
] | [
"Objective",
"Assessment",
"Plan"
] | you'll hear me talk through your exam , so that i can get it all documented . uh- ? use my general physical exam template . pelvic exam demonstrates no external lesions . normal labia majora and labia minora . normal physiological discharge , with normal color and smell . ms. ross , i'm going to touch you , now . you'l... | 3,627 |
doctor: of course , my pleasure . and , if everything is normal , i'll see you again , at your next annual checkup . assessment : is screen for std . plan : discussed with patient , and please add that she is high risk due to an abnormal pap smear in the past , and the recent discovery of her sexual partner having mult... | D2N143 | 12 | [
"Discussion",
"Follow-up"
] | [
"Plan"
] | doctor: of course , my pleasure . and , if everything is normal , i'll see you again , at your next annual checkup . assessment : is screen for std . plan : discussed with patient , and please add that she is high risk due to an abnormal pap smear in the past , and the recent discovery of her sexual partner having mult... | 3,628 |
doctor: tyler nelson , date of birth : 3 , 6 , 1949 , mrn , 385729 . he is here today for ongoing management of rheumatoid arthritis . last time he was here , he received a steroid injection in his right knee . hello mr. nelson , how are you ? patient: um , about the same as last time . my knee is still swollen . | D2N144 | 0 | [
"Personal History",
"Greetings",
"Therapeutic History"
] | [
"Subjective"
] | tyler nelson , date of birth : 3 , 6 , 1949 , mrn , 385729 . he is here today for ongoing management of rheumatoid arthritis . last time he was here , he received a steroid injection in his right knee . hello mr. nelson , how are you ? | 3,629 |
doctor: that was your right knee , correct ? i take it the injection did n't help ? patient: it did , maybe for a couple of weeks . | D2N144 | 1 | [
"Personal History",
"Therapeutic History"
] | [
"Subjective"
] | that was your right knee , correct ? i take it the injection did n't help ? | 3,630 |
doctor: that's it ? and is it still painful ? patient: yeah , it's pretty painful , and now the whole leg is getting swollen . | D2N144 | 2 | [
"Acute Symptoms"
] | [
"Subjective"
] | that's it ? and is it still painful ? | 3,631 |
doctor: okay , what would you say your pain level is ? patient: i mean , right now it's about a 3 or so , but , typically on a normal day it's around 6 . | D2N144 | 3 | [
"Acute Symptoms"
] | [
"Subjective"
] | okay , what would you say your pain level is ? | 3,632 |
doctor: okay , and its been swollen like that for how long now ? patient: since i was last here a couple weeks after that . so about , maybe two months now . | D2N144 | 4 | [
"Personal History"
] | [
"Subjective"
] | okay , and its been swollen like that for how long now ? | 3,633 |
doctor: okay , but before it was just the knee ? patient: yeah , the whole thing was n't swollen like this , but i tried to wear compression socks a lot of the time , but it has n't been helping . | D2N144 | 5 | [
"Personal History"
] | [
"Subjective"
] | okay , but before it was just the knee ? | 3,634 |
doctor: okay , okay , so that has n't been working for you ? patient: i mean , it helps to some degree , but it's still swollen , especially around the knee . | D2N144 | 6 | [
"Therapeutic History"
] | [
"Subjective"
] | okay , okay , so that has n't been working for you ? | 3,635 |
doctor: hmm . has it been keeping you from doing things during the day ? patient: well , i slowed down a little bit , and i found a few things too fast . but when it really hurts , is when i've been sitting for a while , and then i have to try and get up . i'm so stiff getting up i have to use a cane to get my bearings... | D2N144 | 7 | [
"Other Socials"
] | [
"Subjective"
] | hmm . has it been keeping you from doing things during the day ? | 3,636 |
doctor: yeah , i can see , that makes sense . have you been taking your medication regularly ? your on xeljanz right ? patient: yeah , the xr , i think its , uhm , 11 milligrams a day ? yeah , but i'm taking it everyday , and i'm also taking celebrex which i started maybe 2 months ago . | D2N144 | 8 | [
"Therapeutic History"
] | [
"Subjective"
] | yeah , i can see , that makes sense . have you been taking your medication regularly ? your on xeljanz right ? | 3,637 |
doctor: yes , the 200mgs daily . how's that working for you ? patient: pretty good , up until it started swelling again . | D2N144 | 9 | [
"Therapeutic History"
] | [
"Subjective"
] | yes , the 200mgs daily . how's that working for you ? | 3,638 |
doctor: okay , well come sit over here , and if you could take of your socks and shoes , and we'll take a look at your knee . and just to let you know , i have a service now that writes my note about the visit , so you'll hear me call things out and describe what i see fully . patient: okay , gotcha . | D2N144 | 10 | [
"Physical Examination"
] | [
"Objective"
] | okay , well come sit over here , and if you could take of your socks and shoes , and we'll take a look at your knee . and just to let you know , i have a service now that writes my note about the visit , so you'll hear me call things out and describe what i see fully . | 3,639 |
doctor: right , so let's check your leg . can you straighten it , and does it hurt ? patient: yeah , when i try to straighten it all the way it does . | D2N144 | 11 | [
"Physical Examination"
] | [
"Objective"
] | right , so let's check your leg . can you straighten it , and does it hurt ? | 3,640 |
doctor: okay , range of motion slightly diminished . i'm going to press here , okay ? and how about here , hmm , i see some pitting around the knee and ankle . normal capillary refill in the toes . does any of this area hurt ? patient: um , just kinda sore , like an old bruise ? | D2N144 | 12 | [
"Physical Examination"
] | [
"Objective"
] | okay , range of motion slightly diminished . i'm going to press here , okay ? and how about here , hmm , i see some pitting around the knee and ankle . normal capillary refill in the toes . does any of this area hurt ? | 3,641 |
doctor: so , i can feel that the knee is hot , and that means there's something going on , like some inflammation . so we can give you another steroid injection for that . i also want to get an x-ray of that knee , so we can see where all the swelling is coming from . patient: yeah . let's do it . sounds go to me . | D2N144 | 13 | [
"Medication",
"Diagnostic Testing",
"Reassessment"
] | [
"Assessment",
"Plan"
] | so , i can feel that the knee is hot , and that means there's something going on , like some inflammation . so we can give you another steroid injection for that . i also want to get an x-ray of that knee , so we can see where all the swelling is coming from . | 3,642 |
doctor: okay , and did we set up physical therapy for you last time you were here ? patient: yeah , that was some years ago , but that was the other knee . | D2N144 | 14 | [
"Discussion",
"Referral"
] | [
"Plan"
] | okay , and did we set up physical therapy for you last time you were here ? | 3,643 |
doctor: okay . so i think we'll set that up for you now . we'll also do an x-ray on that knee . i can send you for a physical therapy , and if nothing is helping , then we really might need to get a surgery consult to see what we can do with that knee . patient: okay , sounds like a plan . | D2N144 | 15 | [
"Referral",
"Diagnostic Testing",
"Other Treatments"
] | [
"Plan"
] | okay . so i think we'll set that up for you now . we'll also do an x-ray on that knee . i can send you for a physical therapy , and if nothing is helping , then we really might need to get a surgery consult to see what we can do with that knee . | 3,644 |
doctor: all right , so for today we'll go ahead and we'll give you the steroid shot . i'll try to see if i can get a little bit of fluid out before i do give you the injection . there might be no fluid , but i'll see if i can get anything out regardless . patient: okay . and that's a procedure you're going to do right ... | D2N144 | 16 | [
"Medication"
] | [
"Plan"
] | all right , so for today we'll go ahead and we'll give you the steroid shot . i'll try to see if i can get a little bit of fluid out before i do give you the injection . there might be no fluid , but i'll see if i can get anything out regardless . | 3,645 |
doctor: yep . once we're done talking here , and as far as the edema in your legs , uh , we'll take an x-ray to look for the cause , but there is a lot you can do as well . the compression socks are a good start . um , and also , do you eat a lot of salt ? patient: i mean , um , i mean i love my salty snacks . | D2N144 | 17 | [
"Discussion",
"Medication",
"Other Treatments",
"Diagnostic Testing"
] | [
"Plan"
] | yep . once we're done talking here , and as far as the edema in your legs , uh , we'll take an x-ray to look for the cause , but there is a lot you can do as well . the compression socks are a good start . um , and also , do you eat a lot of salt ? | 3,646 |
doctor: okay . well , salt does have a tendency to make your body hold on to water , reducing your salt intake could help with some of the swelling . you can also prop your feet up any time you get a chance , especially at night . and have you talked to your private care doctor about this at all ? patient: no , i figur... | D2N144 | 18 | [
"Discussion",
"Other Treatments"
] | [
"Plan"
] | okay . well , salt does have a tendency to make your body hold on to water , reducing your salt intake could help with some of the swelling . you can also prop your feet up any time you get a chance , especially at night . and have you talked to your private care doctor about this at all ? | 3,647 |
doctor: okay . so i think , try some of those things out first , and if it does n't help , definitely make an appointment with them , also , as you know , xeljanz is a high-risk medication , so we need to check your cmp levels every couple of months . so this time your levels are good , but do make sure to make an appo... | D2N144 | 19 | [
"Discussion",
"Medication",
"Diagnostic Testing"
] | [
"Plan"
] | okay . so i think , try some of those things out first , and if it does n't help , definitely make an appointment with them , also , as you know , xeljanz is a high-risk medication , so we need to check your cmp levels every couple of months . so this time your levels are good , but do make sure to make an appointment ... | 3,648 |
doctor: yes , of course . well let me go ahead and get supplies and we'll get to work on your knee . fluid aspiration and steroid injection procedure . the risks , benefits , and alternatives were explained . the risks of steroid injection were explained , including , but not limited to : hypopigmentation , soft tissue... | D2N144 | 20 | [
"Discussion",
"Follow-up",
"Medication"
] | [
"Plan"
] | doctor: yes , of course . well let me go ahead and get supplies and we'll get to work on your knee . fluid aspiration and steroid injection procedure . the risks , benefits , and alternatives were explained . the risks of steroid injection were explained , including , but not limited to : hypopigmentation , soft tissue... | 3,649 |
doctor: uh , mrn49282721 . patient's name is jacqueline miller . use last visit exam where appropriate . hi , how are you doing , jacqueline ? patient: i'm pretty . good . how are you ? | D2N145 | 0 | [
"Greetings"
] | [
"Subjective"
] | uh , mrn49282721 . patient's name is jacqueline miller . use last visit exam where appropriate . hi , how are you doing , jacqueline ? | 3,650 |
doctor: good as well . so it sounds like we're , um , under good control right now . patient: yes . it's doing much better . | D2N145 | 1 | [
"Personal History"
] | [
"Subjective"
] | good as well . so it sounds like we're , um , under good control right now . | 3,651 |
doctor: good , good . do you have any rash leftover ? patient: yeah , i have a- a small bit leftover . i started using , uh , doxycycline only one a day because i think the pharmacist said if it's getting better , to just limit it to once a day . | D2N145 | 2 | [
"Acute Symptoms"
] | [
"Subjective"
] | good , good . do you have any rash leftover ? | 3,652 |
doctor: okay , that sounds good . patient: but i was taking it twice a day and i did notice a lotta improvement . | D2N145 | 3 | [
"Personal History"
] | [
"Subjective"
] | okay , that sounds good . | 3,653 |
doctor: i see . um , are you breastfeeding at this time ? patient: no , i'm not right now . | D2N145 | 5 | [
"Vegetative History"
] | [
"Subjective"
] | i see . um , are you breastfeeding at this time ? | 3,654 |
doctor: okay , good . so you- you should not be breastfeeding while you're on that medication . patient: yeah , actually i stopped breastfeeding and then asked for the doxycycline at that time . | D2N145 | 6 | [
"Vegetative History"
] | [
"Subjective"
] | okay , good . so you- you should not be breastfeeding while you're on that medication . | 3,655 |
doctor: okay . even with the doxycycline , you can keep using the elidel . patient: okay . and i did n't take the elidel because when i read about it i got worried . so i wanted to just try the doxycycline and see . | D2N145 | 7 | [
"Vegetative History"
] | [
"Subjective"
] | okay . even with the doxycycline , you can keep using the elidel . | 3,656 |
doctor: okay . so we can talk about the elidel . a lot of the things you read about is not actually relevant to the cream or ointment form , but it's about the oral form that's used in really high doses , longterm , after people have a heart transplant or a kidney transplant or something like that . patient: okay . i d... | D2N145 | 8 | [
"Discussion",
"Medication"
] | [
"Plan"
] | okay . so we can talk about the elidel . a lot of the things you read about is not actually relevant to the cream or ointment form , but it's about the oral form that's used in really high doses , longterm , after people have a heart transplant or a kidney transplant or something like that . | 3,657 |
doctor: yeah , and when you suppress the immune system that hard for that long , it can predispose you for developing cancers like hematologic type cancers . it does n't apply to as-needed use of the medicine , a cream or an ointment , okay ? patient: okay . then i can resume taking - taking the doxycycline twice a day... | D2N145 | 9 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah , and when you suppress the immune system that hard for that long , it can predispose you for developing cancers like hematologic type cancers . it does n't apply to as-needed use of the medicine , a cream or an ointment , okay ? | 3,658 |
doctor: so let me clarify . what exactly are you using ? and then we'll look at you and figure out , okay ? so you're using the sulfacetamide wash ? uh , how frequently are you using that one ? patient: twice a day . | D2N145 | 10 | [
"Therapeutic History"
] | [
"Subjective"
] | so let me clarify . what exactly are you using ? and then we'll look at you and figure out , okay ? so you're using the sulfacetamide wash ? uh , how frequently are you using that one ? | 3,659 |
doctor: okay , and that's not drying you out too much ? patient: no , that's fine . | D2N145 | 11 | [
"Therapeutic History"
] | [
"Subjective"
] | okay , and that's not drying you out too much ? | 3,660 |
doctor: okay . and you're using the metro cream ? patient: yes . | D2N145 | 12 | [
"Therapeutic History"
] | [
"Subjective"
] | okay . and you're using the metro cream ? | 3,661 |
doctor: how often are you using that one ? patient: after my face wash , i immediately apply the cream . | D2N145 | 13 | [
"Therapeutic History"
] | [
"Subjective"
] | how often are you using that one ? | 3,662 |
doctor: okay . and then , are you using any other kind of lotions or anything ? patient: no . | D2N145 | 14 | [
"Therapeutic History"
] | [
"Subjective"
] | okay . and then , are you using any other kind of lotions or anything ? | 3,663 |
doctor: so you're not using the cetaphil cleanser ? patient: i'm not . | D2N145 | 15 | [
"Therapeutic History"
] | [
"Subjective"
] | so you're not using the cetaphil cleanser ? | 3,664 |
doctor: okay . and no neutrogena wipes ? patient: no wipes . | D2N145 | 16 | [
"Therapeutic History"
] | [
"Subjective"
] | okay . and no neutrogena wipes ? | 3,665 |
doctor: okay . um , and then what about , um , any lotions that you're using ? patient: i'm not using any lotion right now , just those two . | D2N145 | 17 | [
"Therapeutic History"
] | [
"Subjective"
] | okay . um , and then what about , um , any lotions that you're using ? | 3,666 |
doctor: no lotion , okay . so that may be something else we should add in , a lotion to just help moisturize . but we'll see . patient: okay . | D2N145 | 18 | [
"Therapeutic History"
] | [
"Subjective"
] | no lotion , okay . so that may be something else we should add in , a lotion to just help moisturize . but we'll see . | 3,667 |
doctor: um , and then again , when did you go down to just taking the doxycycline once a day ? patient: that was last week . so the first two weeks , i did twice a day . | D2N145 | 19 | [
"Therapeutic History"
] | [
"Subjective"
] | um , and then again , when did you go down to just taking the doxycycline once a day ? | 3,668 |
doctor: okay . let me take a look at your face here . i'm gon na describe for the transcriptionist what i'm seeing . you're fitzpatrick skin type iv , meaning you're not going to burn , you're going to sun tan , um , essentially , iv to v. and then on bilateral medial cheeks , there are a few really faint erythematous ... | D2N145 | 21 | [
"Physical Examination"
] | [
"Objective"
] | okay . let me take a look at your face here . i'm gon na describe for the transcriptionist what i'm seeing . you're fitzpatrick skin type iv , meaning you're not going to burn , you're going to sun tan , um , essentially , iv to v. and then on bilateral medial cheeks , there are a few really faint erythematous papules ... | 3,669 |
doctor: i think i would go ahead and go back to twice a day , every day , with the doxycycline . patient: okay . | D2N145 | 22 | [
"Discussion",
"Medication"
] | [
"Plan"
] | i think i would go ahead and go back to twice a day , every day , with the doxycycline . | 3,670 |
doctor: uh , but i would pickup the elidel too . patient: okay , i can do that . | D2N145 | 23 | [
"Discussion",
"Medication"
] | [
"Plan"
] | uh , but i would pickup the elidel too . | 3,671 |
doctor: i mean , out of known risks associated with medications , topicals are usually safer and preferable to oral medications . with that being said , doxycycline is low risk . patient: it is ? okay . | D2N145 | 24 | [
"Discussion",
"Medication"
] | [
"Plan"
] | i mean , out of known risks associated with medications , topicals are usually safer and preferable to oral medications . with that being said , doxycycline is low risk . | 3,672 |
doctor: um , and doxycycline can give you bad upset stomach or heartburn . um , it will make you sunburn , even if you never sunburn , so you have to protect yourself . patient: yeah , i mean , i feel sun sensitive whenever i go out , so i am taking all the precautions , with wearing a hat and all of that . | D2N145 | 25 | [
"Medication"
] | [
"Plan"
] | um , and doxycycline can give you bad upset stomach or heartburn . um , it will make you sunburn , even if you never sunburn , so you have to protect yourself . | 3,673 |
doctor: great . i just wanted to make sure you knew about that . patient: yes , i did . thank you . | D2N145 | 26 | [
"Discussion",
"Medication"
] | [
"Plan"
] | great . i just wanted to make sure you knew about that . | 3,674 |
doctor: all right . but i think to help get rid of it sooner rather than later , if insurance will cover the elidel , pick it up and start using it . patient: yeah , i did check . the insurance is not covering it . | D2N145 | 27 | [
"Discussion",
"Medication"
] | [
"Plan"
] | all right . but i think to help get rid of it sooner rather than later , if insurance will cover the elidel , pick it up and start using it . | 3,675 |
doctor: it's not ? okay . well , let's look around really quick because if you use a goodrx coupon , it will be around 30 to $ 40 or something . patient: okay . | D2N145 | 28 | [
"Discussion",
"Medication"
] | [
"Plan"
] | it's not ? okay . well , let's look around really quick because if you use a goodrx coupon , it will be around 30 to $ 40 or something . | 3,676 |
doctor: let's see . patient: so with your coupon , it was around $ 850 or something . | D2N145 | 29 | [
"Discussion",
"Medication"
] | [
"Plan"
] | let's see . | 3,677 |
doctor: ugh , yeah . that's way too much . patient: i agree . and- and because i also looked at the eucrisa that you recommended in my notes , and if it's still ex- if it's still expensive , i could try that instead . | D2N145 | 30 | [
"Discussion",
"Medication"
] | [
"Plan"
] | ugh , yeah . that's way too much . | 3,678 |
doctor: yeah , so it ... actually ... it is actually more expensive . i think the prices fluctuate . patient: okay . | D2N145 | 31 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah , so it ... actually ... it is actually more expensive . i think the prices fluctuate . | 3,679 |
doctor: because now it's showing the cheapest of $ 70 , and when i looked before , it was around 30 to $ 40 . patient: yeah . if it was around $ 200 , i would've picked it up . but it was coming to around $ 850 after insurance . | D2N145 | 32 | [
"Discussion",
"Medication"
] | [
"Plan"
] | because now it's showing the cheapest of $ 70 , and when i looked before , it was around 30 to $ 40 . | 3,680 |
doctor: okay . so i've found the cream form . we could try ointment form . patient: you mean the tacrolimus ? | D2N145 | 33 | [
"Discussion",
"Medication"
] | [
"Plan"
] | okay . so i've found the cream form . we could try ointment form . | 3,681 |
doctor: yeah , mm-hmm . patient: okay . | D2N145 | 34 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah , mm-hmm . | 3,682 |
doctor: so if we send it to pick'n save or metro market ... let's see where else . patient: can you do the metro market ? | D2N145 | 35 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so if we send it to pick'n save or metro market ... let's see where else . | 3,683 |
doctor: yeah . let me put in the prescription and we'll see what we can find . patient: sure . | D2N145 | 36 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah . let me put in the prescription and we'll see what we can find . | 3,684 |
doctor: pharmacy is what i'm trying to say . patient: okay . but it's not a steroid , right ? | D2N145 | 37 | [
"Discussion",
"Medication"
] | [
"Plan"
] | pharmacy is what i'm trying to say . | 3,685 |
doctor: correct , it's not a steroid . patient: okay , good . | D2N145 | 38 | [
"Discussion",
"Medication"
] | [
"Plan"
] | correct , it's not a steroid . | 3,686 |
doctor: it's called a calcineurin inhibitor . it's kinda like a steroid in that it calms inflammation . patient: okay . | D2N145 | 39 | [
"Discussion",
"Medication"
] | [
"Plan"
] | it's called a calcineurin inhibitor . it's kinda like a steroid in that it calms inflammation . | 3,687 |
doctor: but it's not a steroid , so do n't use steroids on your face , for sure , as they'll make this kind of rash worse . but also , steroids carry the risk of causing thinning of the skin . patient: all right . | D2N145 | 40 | [
"Discussion",
"Medication"
] | [
"Plan"
] | but it's not a steroid , so do n't use steroids on your face , for sure , as they'll make this kind of rash worse . but also , steroids carry the risk of causing thinning of the skin . | 3,688 |
doctor: these medications do n't cause thinning of the skin and they're not going to cause some other kind of rash . um , the thing to know is that sometimes five to 10 minutes after you put it on , it can cause this weird kind of tingly or needle-like sensation or make it redder or flush . but it should only last a fe... | D2N145 | 41 | [
"Discussion",
"Medication"
] | [
"Plan"
] | these medications do n't cause thinning of the skin and they're not going to cause some other kind of rash . um , the thing to know is that sometimes five to 10 minutes after you put it on , it can cause this weird kind of tingly or needle-like sensation or make it redder or flush . but it should only last a few second... | 3,689 |
doctor: so it only lasts a couple seconds . it does n't mean it's going to happen again . it's nothing bad . it will still work , so keep using it as long as you know you can stand it , okay ? patient: okay , thank you for explaining . | D2N145 | 42 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so it only lasts a couple seconds . it does n't mean it's going to happen again . it's nothing bad . it will still work , so keep using it as long as you know you can stand it , okay ? | 3,690 |
doctor: so i will say , " apply to rash on face twice daily , until resolved . " patient: okay . so only apply to the rash area ? | D2N145 | 43 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so i will say , " apply to rash on face twice daily , until resolved . " | 3,691 |
doctor: yes , and keep using the face wash. patient: okay . | D2N145 | 44 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yes , and keep using the face wash. | 3,692 |
doctor: i think you could just do it once a day . i do n't think you need to do it twice a day , just because i do n't wan na dry your sky out too much , okay ? patient: i never noticed that my face is dry or got thin . i feel so good after using it . | D2N145 | 45 | [
"Discussion",
"Medication"
] | [
"Plan"
] | i think you could just do it once a day . i do n't think you need to do it twice a day , just because i do n't wan na dry your sky out too much , okay ? | 3,693 |
doctor: i understand , but it could get dry and i do n't wan na create other problems for you . patient: all right . i'll just wash once a day with it . but it was feeling very good , like there's this little bit of moisture getting back in . with the other wash , when i would use it twice a day , i was drying out . bu... | D2N145 | 46 | [
"Discussion",
"Medication"
] | [
"Plan"
] | i understand , but it could get dry and i do n't wan na create other problems for you . | 3,694 |
doctor: i see . okay . well then do what feels good . if you do notice that you're starting to get dry , then reduce to once per day . patient: that sounds good . | D2N145 | 47 | [
"Discussion",
"Medication"
] | [
"Plan"
] | i see . okay . well then do what feels good . if you do notice that you're starting to get dry , then reduce to once per day . | 3,695 |
doctor: so to review , um , continue using the same face wash , continue with metro cream , and increase the use of doxycycline to twice a day . patient: okay . | D2N145 | 48 | [
"Medication"
] | [
"Plan"
] | so to review , um , continue using the same face wash , continue with metro cream , and increase the use of doxycycline to twice a day . | 3,696 |
doctor: and then just do it until it's gone , and then do it for once a day for another week before stopping . patient: okay , sounds good . | D2N145 | 49 | [
"Medication"
] | [
"Plan"
] | and then just do it until it's gone , and then do it for once a day for another week before stopping . | 3,697 |
doctor: all right . and i'll rewrite your instructions here . patient: thank you so much . | D2N145 | 50 | [
"Chitchat"
] | [
"Null"
] | all right . and i'll rewrite your instructions here . | 3,698 |
doctor: if there are any other questions or you're getting different instructions , feel free to reach out to me and we'll clarify , okay ? patient: okay . | D2N145 | 51 | [
"Discussion",
"Follow-up"
] | [
"Plan"
] | if there are any other questions or you're getting different instructions , feel free to reach out to me and we'll clarify , okay ? | 3,699 |
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