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doctor: okay alright so it's been running a little bit high i know we checked your hemoglobin a1c last time and it was about seven . seven . i think and we had talked about you know improving your diet and improving some exercise but is this blood sugar been high and low or high and normal when you're especially in the...
D2N149
15
[ "Personal History" ]
[ "Subjective" ]
okay alright so it's been running a little bit high i know we checked your hemoglobin a1c last time and it was about seven . seven . i think and we had talked about you know improving your diet and improving some exercise but is this blood sugar been high and low or high and normal when you're especially in the last th...
3,800
doctor: okay alright and how is your blood pressure been at home since you've been taking since these episodes that you've been sick are you taking norvasc patient: yes i am but i keep them on some days because my blood pressure has been running somewhat on the low side
D2N149
16
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
okay alright and how is your blood pressure been at home since you've been taking since these episodes that you've been sick are you taking norvasc
3,801
doctor: okay alright and right now it's about a hundred and twenty over seventy what how low does it go in the more when you check it patient: well there are sometimes in the lower nineties
D2N149
17
[ "Personal History" ]
[ "Subjective" ]
okay alright and right now it's about a hundred and twenty over seventy what how low does it go in the more when you check it
3,802
doctor: okay alright well let me let me examine you here in a second and we'll think about you know what we need to do especially with your coughing and your shortness of breath okay so nita i'm i'm examining you now let's pretend i did my exam i'm just gon na verbalize some of my findings so i can put it into my chart...
D2N149
18
[ "Physical Examination", "Discussion", "Diagnostic Testing", "Reassessment", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
okay alright well let me let me examine you here in a second and we'll think about you know what we need to do especially with your coughing and your shortness of breath okay so nita i'm i'm examining you now let's pretend i did my exam i'm just gon na verbalize some of my findings so i can put it into my chart okay an...
3,803
doctor: alright for the second problem for the diabetes since your blood sugar is running a little bit high once you get over this i'm blood sugars running a little bit high once we get you over this hump of the shortness of breath and get this diagnosed i'm gon na go ahead and order another hemoglobin a1c today we wil...
D2N149
19
[ "Discussion", "Follow-up", "Medication", "Diagnostic Testing", "Reassessment" ]
[ "Assessment", "Plan" ]
alright for the second problem for the diabetes since your blood sugar is running a little bit high once you get over this i'm blood sugars running a little bit high once we get you over this hump of the shortness of breath and get this diagnosed i'm gon na go ahead and order another hemoglobin a1c today we will probab...
3,804
doctor: for the high blood pressure definitely hold off on the norvasc for right now let's figure out what's going what's causing this episode of shortness of breath i want some blood testing done and and once we have that under better control we can reassess your blood pressure so right now hold the norvasc and then w...
D2N149
20
[ "Follow-up", "Medication", "Diagnostic Testing", "Reassessment" ]
[ "Assessment", "Plan" ]
for the high blood pressure definitely hold off on the norvasc for right now let's figure out what's going what's causing this episode of shortness of breath i want some blood testing done and and once we have that under better control we can reassess your blood pressure so right now hold the norvasc and then we'll hav...
3,805
doctor: any other questions or anything we know if we need to talk about today patient: no i'm good
D2N149
21
[ "Discussion" ]
[ "Plan" ]
any other questions or anything we know if we need to talk about today
3,806
doctor: sounds good we'll get you signed out here in a second
D2N149
22
[ "Chitchat" ]
[ "Null" ]
doctor: sounds good we'll get you signed out here in a second
3,807
doctor: alright scott so so i understand that you you had some right knee injury can you tell me a little bit about what happened patient: yeah i was trying to go out and play some pickup soccer games over the weekend and went to go plank kick the ball and and just felt a pop in my right knee
D2N150
0
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
alright scott so so i understand that you you had some right knee injury can you tell me a little bit about what happened
3,808
doctor: okay and and how long ago did that happen patient: about three days ago
D2N150
1
[ "Acute Symptoms" ]
[ "Subjective" ]
okay and and how long ago did that happen
3,809
doctor: three days okay and when did you notice any swelling anything like that patient: it it's swollen some some of that swelling has gone down
D2N150
2
[ "Vegetative History" ]
[ "Subjective" ]
three days okay and when did you notice any swelling anything like that
3,810
doctor: okay alright and then so how's the pain with your knee on a scale of one to ten one being the least pain ten being the worst pain how's how's it been ranging patient: it's somewhere between six and seven right now it's about four or five with some of the swelling going down
D2N150
4
[ "Acute Symptoms" ]
[ "Subjective" ]
okay alright and then so how's the pain with your knee on a scale of one to ten one being the least pain ten being the worst pain how's how's it been ranging
3,811
doctor: okay alright and did you take anything at all to relieve the pain patient: anti-inflammatories
D2N150
5
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
okay alright and did you take anything at all to relieve the pain
3,812
doctor: okay alrighty and did that help patient: yeah the ibuprofen helped a little bit but i'm on it pretty on a pretty regular basis right now
D2N150
6
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
okay alrighty and did that help
3,813
doctor: gotcha okay now tell me are you able to bend or straighten your leg ever since then patient: i can bend it but it hurts towards the end of the motion and i can straighten it but it does n't it feels like i have to help get it straightened
D2N150
7
[ "Acute Symptoms" ]
[ "Subjective" ]
gotcha okay now tell me are you able to bend or straighten your leg ever since then
3,814
doctor: okay alright and then how about you able to bear any weight on it or walk on it at all patient: i can still bear weight on it but it feels just really loose it it does n't feel normal
D2N150
8
[ "Acute Symptoms" ]
[ "Subjective" ]
okay alright and then how about you able to bear any weight on it or walk on it at all
3,815
doctor: gotcha okay alright well let's go ahead and take a look at your knee here real quick before i take a look at your knee here i'm gon na do a physical exam and in terms of your gait here i did notice that you do have a marked limp on your looks like it's your right leg upon ambulation so let me go ahead and take ...
D2N150
9
[ "Physical Examination" ]
[ "Objective" ]
gotcha okay alright well let's go ahead and take a look at your knee here real quick before i take a look at your knee here i'm gon na do a physical exam and in terms of your gait here i did notice that you do have a marked limp on your looks like it's your right leg upon ambulation so let me go ahead and take a look a...
3,816
doctor: yep okay so you definitely feeling some a little bit of pain to palpation at the medial joint line now i'm gon na have you lie on your back and also i'm gon na do some maneuvering here of your leg i'm gon na do a real quick test on you here okay alright how does that feel patient: just feels just feels loose it...
D2N150
10
[ "Physical Examination" ]
[ "Objective" ]
yep okay so you definitely feeling some a little bit of pain to palpation at the medial joint line now i'm gon na have you lie on your back and also i'm gon na do some maneuvering here of your leg i'm gon na do a real quick test on you here okay alright how does that feel
3,817
doctor: okay sorry about that alright so you're definitely having some difficulty with some passive range of motion here and you're lacking a few degrees of terminal extension to about a hundred and fifteen degrees as well as lacking about maybe twenty to thirty degrees of terminal flexion on the secondary secondary to...
D2N150
11
[ "Physical Examination", "Discussion", "Medication", "Other Treatments", "Diagnostic Testing", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
okay sorry about that alright so you're definitely having some difficulty with some passive range of motion here and you're lacking a few degrees of terminal extension to about a hundred and fifteen degrees as well as lacking about maybe twenty to thirty degrees of terminal flexion on the secondary secondary to the pai...
3,818
doctor: yeah definitely so yeah so you you can limit the activities for sure in terms of your work activities i know if you sit too long sometimes it can be painful because you do need to move that leg a little bit so it does n't lock up so i i would like for you to you know do do some slight activities not enough to s...
D2N150
12
[ "Discussion", "Referral" ]
[ "Plan" ]
yeah definitely so yeah so you you can limit the activities for sure in terms of your work activities i know if you sit too long sometimes it can be painful because you do need to move that leg a little bit so it does n't lock up so i i would like for you to you know do do some slight activities not enough to stress yo...
3,819
doctor: alright i do want you to i know you are i know you actually jog often so i want you to just slow that down for a bit no jogging for a while until we get you know results of your mri till we figure out what we what we are gon na be doing okay patient: okay
D2N150
13
[ "Discussion" ]
[ "Plan" ]
alright i do want you to i know you are i know you actually jog often so i want you to just slow that down for a bit no jogging for a while until we get you know results of your mri till we figure out what we what we are gon na be doing okay
3,820
doctor: alright and how's your dog you has it been jogging with you before this incident patient: how's just how's my dog or how is my job
D2N150
14
[ "Chitchat" ]
[ "Null" ]
alright and how's your dog you has it been jogging with you before this incident
3,821
doctor: your your dog patient: my my my dog is okay
D2N150
15
[ "Chitchat" ]
[ "Null" ]
your your dog
3,822
doctor: very good alright well i'm gon na go ahead and have the nurse take you to the scheduler to get your mri and i'll get back with you as soon as we get the results of that patient: okay sounds good thank you
D2N150
17
[ "Chitchat" ]
[ "Null" ]
very good alright well i'm gon na go ahead and have the nurse take you to the scheduler to get your mri and i'll get back with you as soon as we get the results of that
3,823
doctor: thank you
D2N150
18
[ "Chitchat" ]
[ "Null" ]
doctor: thank you
3,824
doctor: alright teresa i see here in your chart that you seem to be experiencing some elbow pain could you tell me where it hurts patient: yeah so it's hurting on the inside of my elbow
D2N151
0
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
alright teresa i see here in your chart that you seem to be experiencing some elbow pain could you tell me where it hurts
3,825
doctor: mm-hmm patient: and when i i i've been doing some pottery i've been creating you know i have a pottery wheel and i've been i love my pottery and for my son's birthday i've been making a a ceramic bowl and i'm gon na paint it and i have to do some real full decorations but i've really been working on it a lot an...
D2N151
1
[ "Acute Symptoms" ]
[ "Subjective" ]
mm-hmm
3,826
doctor: i am so sorry so i mean that's really cool that you do parttery it's something that i've wanted to pick up you know but i do n't know that i have those skills yet does the pain radiate down your arm or up your shoulder or anything patient: yeah it does down my arm and along that inside of my arm
D2N151
2
[ "Acute Symptoms" ]
[ "Subjective" ]
i am so sorry so i mean that's really cool that you do parttery it's something that i've wanted to pick up you know but i do n't know that i have those skills yet does the pain radiate down your arm or up your shoulder or anything
3,827
doctor: okay so the medial aspect okay have you did you hit it on anything patient: no not that i recall
D2N151
3
[ "Acute Symptoms" ]
[ "Subjective" ]
okay so the medial aspect okay have you did you hit it on anything
3,828
doctor: okay and have you ever injured your elbow before patient: no i have n't
D2N151
4
[ "Personal History" ]
[ "Subjective" ]
okay and have you ever injured your elbow before
3,829
doctor: okay alright so on a on a scale of one to ten with ten being your arm is actively being sought off by a chainsaw how bad is the pain patient: well i'd say it's about a seven
D2N151
5
[ "Acute Symptoms" ]
[ "Subjective" ]
okay alright so on a on a scale of one to ten with ten being your arm is actively being sought off by a chainsaw how bad is the pain
3,830
doctor: wow that's pretty bad does it keep you up at night patient: yes it really does it's you know if i roll over and it it it just wakes me up
D2N151
6
[ "Acute Symptoms" ]
[ "Subjective" ]
wow that's pretty bad does it keep you up at night
3,831
doctor: okay have you done anything to relieve the pain patient: well i have been taking some ibuprofen but that is n't really helping
D2N151
7
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
okay have you done anything to relieve the pain
3,832
doctor: okay and have you tried anything like ice or heat or anything else patient: i tried a little bit of ice at first
D2N151
8
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
okay and have you tried anything like ice or heat or anything else
3,833
doctor: mm-hmm patient: but and it's just it's been hurting for about four days now
D2N151
9
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
mm-hmm
3,834
doctor: okay okay so it's probably it do you think it's getting worse patient: well it's just not getting better
D2N151
11
[ "Acute Symptoms" ]
[ "Subjective" ]
okay okay so it's probably it do you think it's getting worse
3,835
doctor: okay no i understand okay so i know that you also have like a history of hypertension and that we have you on ten milligrams of lisinopril have you been checking your blood pressures regularly patient: yeah you know what i remember too i mean they they have been pretty good one teens to one thirties
D2N151
12
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
okay no i understand okay so i know that you also have like a history of hypertension and that we have you on ten milligrams of lisinopril have you been checking your blood pressures regularly
3,836
doctor: okay alright and okay do you think that you've been good about taking your medications do you usually take them everyday patient: yeah pretty much i i i you know set an alarm for that lisinopril
D2N151
13
[ "Therapeutic History" ]
[ "Subjective" ]
okay alright and okay do you think that you've been good about taking your medications do you usually take them everyday
3,837
doctor: awesome that's great alright and so i see that you also we are treating you for diabetes as well and that we have you on five hundred milligrams of metformin twice a day how about that have you been taking that regularly patient: well sometimes i forget i mean having a medication twice a day you know sometimes ...
D2N151
14
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
awesome that's great alright and so i see that you also we are treating you for diabetes as well and that we have you on five hundred milligrams of metformin twice a day how about that have you been taking that regularly
3,838
doctor: okay alright so when you say a sweet tooth what are we talking about there patient: i love to bak also besides my ceramics i'm really big and baking and i like to make cakes and and take them to you know parties and get togethers you know family get togethers and i like to make senna rules too i've been doing t...
D2N151
16
[ "Vegetative History" ]
[ "Subjective" ]
okay alright so when you say a sweet tooth what are we talking about there
3,839
doctor: okay cinnamon rolls can be kind of hard like do you for your cakes do you do you use fondant you know to like do any of the decorations patient: no i i mine are just pretty basic they're not overly fancy
D2N151
17
[ "Vegetative History" ]
[ "Subjective" ]
okay cinnamon rolls can be kind of hard like do you for your cakes do you do you use fondant you know to like do any of the decorations
3,840
doctor: so you know it's good patient: yeah
D2N151
20
[ "Vegetative History" ]
[ "Subjective" ]
so you know it's good
3,841
doctor: alright well so i totally understand like baking and like the excitement of being able to give those to your family but we maybe wan na start cutting down on eating and taste testing ourselves is do you think that's something we could manage patient: yeah i know i need to get better on it i probably could use m...
D2N151
21
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
alright well so i totally understand like baking and like the excitement of being able to give those to your family but we maybe wan na start cutting down on eating and taste testing ourselves is do you think that's something we could manage
3,842
doctor: mm-hmm yeah that sounds like a patient: had some friends tell me something about that
D2N151
22
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
mm-hmm yeah that sounds like a
3,843
doctor: yeah that sounds like a great idea and i think if that's something that we can maybe discuss to get you in contact with someone who can offer you someone with a degree that can offer you some really good advice you know i do n't wan na as much as it's really helpful to have friends i do wan na be able to give y...
D2N151
23
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
yeah that sounds like a great idea and i think if that's something that we can maybe discuss to get you in contact with someone who can offer you someone with a degree that can offer you some really good advice you know i do n't wan na as much as it's really helpful to have friends i do wan na be able to give you like ...
3,844
doctor: a hundred percent yeah you know like i one of the things that i struggle with is like are eggs good for you or bad for you you know like with cholesterol i feel like it changes every other year or something like that so you're right there may be some pieces of information that we do need to update and and you k...
D2N151
24
[ "Discussion", "Physical Examination", "Other Treatments" ]
[ "Objective", "Plan" ]
a hundred percent yeah you know like i one of the things that i struggle with is like are eggs good for you or bad for you you know like with cholesterol i feel like it changes every other year or something like that so you're right there may be some pieces of information that we do need to update and and you know over...
3,845
doctor: yeah that's uh uh that's a really good question so our big and favorite one is gon na be your blood pressure right so you're right like we are seeing some some definite improvement today it was one twenty over seventy and honestly that's a great place to be so that tells me that your medication is working and t...
D2N151
25
[ "Physical Examination" ]
[ "Objective" ]
yeah that's uh uh that's a really good question so our big and favorite one is gon na be your blood pressure right so you're right like we are seeing some some definite improvement today it was one twenty over seventy and honestly that's a great place to be so that tells me that your medication is working and that mayb...
3,846
doctor: mm-hmm i do wan na say that like looking at your the weight we do see like maybe a five pound increase from the last time that you were here but that's completely normal right to be able like to fluctuate you know give or take five pounds so i'm not i'm not i'm not like seriously worried about it but if we do c...
D2N151
27
[ "Physical Examination", "Other Socials" ]
[ "Subjective", "Objective" ]
mm-hmm i do wan na say that like looking at your the weight we do see like maybe a five pound increase from the last time that you were here but that's completely normal right to be able like to fluctuate you know give or take five pounds so i'm not i'm not i'm not like seriously worried about it but if we do come back...
3,847
doctor: mm-hmm patient: so not a whole lot other than that because i'm busy with my pottery or baking so but i do try to get out and walk daily
D2N151
28
[ "Physical Examination", "Other Socials" ]
[ "Subjective", "Objective" ]
mm-hmm
3,848
doctor: okay that's awesome so like how about about how long are your walks patient: well i just walk around the neighborhood there is you know the sidewalks and there is kind of a little bit more of a nature type area that goes across the bridge and so it's probably you know maybe one to two miles a day
D2N151
29
[ "Other Socials" ]
[ "Subjective" ]
okay that's awesome so like how about about how long are your walks
3,849
doctor: wow that's intense i was not expecting that number that's awesome okay alright so maybe this five pounds is muscle we're gon na go for it okay but thank you but that's some really important information but i'm gon na start your physical exam now okay patient: okay
D2N151
30
[ "Physical Examination" ]
[ "Objective" ]
wow that's intense i was not expecting that number that's awesome okay alright so maybe this five pounds is muscle we're gon na go for it okay but thank you but that's some really important information but i'm gon na start your physical exam now okay
3,850
doctor: alright so i know that you said that you are experiencing elbow pain could you tell me is it your left or your right elbow patient: it's my right
D2N151
31
[ "Physical Examination" ]
[ "Objective" ]
alright so i know that you said that you are experiencing elbow pain could you tell me is it your left or your right elbow
3,851
doctor: okay alright right elbow when i touch it does it hurt on the inside patient: yes it does
D2N151
32
[ "Physical Examination" ]
[ "Objective" ]
okay alright right elbow when i touch it does it hurt on the inside
3,852
doctor: okay so moderate tenderness at the medial epicondyle when you turn like when you turn your wrist is if you're trying to open a door knob do you experience pain patient: no not really
D2N151
33
[ "Physical Examination" ]
[ "Objective" ]
okay so moderate tenderness at the medial epicondyle when you turn like when you turn your wrist is if you're trying to open a door knob do you experience pain
3,853
doctor: alright so turning out no pain but when you turn your wrist inwards do you have any pain patient: yeah
D2N151
34
[ "Physical Examination" ]
[ "Objective" ]
alright so turning out no pain but when you turn your wrist inwards do you have any pain
3,854
doctor: okay so pain with resisted pronation of right forearm when you rest your arm on a table with the palm side up alright i want you to raise your hand by bending the wrist do you experiencing any pain patient: yeah that hurts
D2N151
35
[ "Physical Examination" ]
[ "Objective" ]
okay so pain with resisted pronation of right forearm when you rest your arm on a table with the palm side up alright i want you to raise your hand by bending the wrist do you experiencing any pain
3,855
doctor: alright alright so when you are when i'm pressing here and like flexing your wrist are you experiencing any pain patient: yes
D2N151
36
[ "Physical Examination" ]
[ "Objective" ]
alright alright so when you are when i'm pressing here and like flexing your wrist are you experiencing any pain
3,856
doctor: alright pain with flexion and when bending the wrist alright when i listen to you you know i'm just gon na check your heart and lungs everything sounds sounds good no murmur no rub no gallop your lungs are clear bilaterally to bilaterally to auscultation i'm not noticing any rash for your at your elbow i do n't...
D2N151
37
[ "Physical Examination", "Medication", "Other Treatments", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
alright pain with flexion and when bending the wrist alright when i listen to you you know i'm just gon na check your heart and lungs everything sounds sounds good no murmur no rub no gallop your lungs are clear bilaterally to bilaterally to auscultation i'm not noticing any rash for your at your elbow i do n't notice ...
3,857
doctor: absolutely that's awesome and so it'll be like a a movie like coming soon to a shelf near you that's great for your second problem right we have this longstanding diabetes i want to increase your metformin to a thousand milligrams twice a day i know that you're saying you're having a hard time keeping up with t...
D2N151
38
[ "Follow-up", "Referral", "Medication", "Diagnostic Testing", "Reassessment" ]
[ "Assessment", "Plan" ]
absolutely that's awesome and so it'll be like a a movie like coming soon to a shelf near you that's great for your second problem right we have this longstanding diabetes i want to increase your metformin to a thousand milligrams twice a day i know that you're saying you're having a hard time keeping up with that so i...
3,858
doctor: your x-ray honestly looks great in that i do n't see any kind of fracture or bony abnormality so that's what makes me think that this is like a tendon related thing right so in reviewing your x-ray like it it does support the the the assessment and plan that i have given you i patient: okay
D2N151
39
[ "Discussion", "Radiology Examination" ]
[ "Objective", "Plan" ]
your x-ray honestly looks great in that i do n't see any kind of fracture or bony abnormality so that's what makes me think that this is like a tendon related thing right so in reviewing your x-ray like it it does support the the the assessment and plan that i have given you i
3,859
doctor: yeah absolutely i do think for your your primary problem the elbow that we might wan na get put you in some physical rehab if the problem is taking a little longer to heal but we'll discuss that at your next visit here okay patient: okay
D2N151
41
[ "Discussion", "Referral" ]
[ "Plan" ]
yeah absolutely i do think for your your primary problem the elbow that we might wan na get put you in some physical rehab if the problem is taking a little longer to heal but we'll discuss that at your next visit here okay
3,860
doctor: alright no problem any other questions patient: nope
D2N151
42
[ "Discussion" ]
[ "Plan" ]
alright no problem any other questions
3,861
doctor: alright thank you for keeping me accountable
D2N151
43
[ "Chitchat" ]
[ "Null" ]
doctor: alright thank you for keeping me accountable
3,862
doctor: good morning noah tell me a little bit about why you are here today patient: hi document i'm i'm just had you know the back pain you know and i've i've had it for you know about a week and
D2N152
0
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
good morning noah tell me a little bit about why you are here today
3,863
doctor: okay can you tell me a little bit more about it how did it start or how did it do you remember injuring yourself patient: no not really i mean i was just like you know i guess i one day i mean i just twisted you know on my left and maybe i mean i might have picked something up
D2N152
2
[ "Personal History" ]
[ "Subjective" ]
okay can you tell me a little bit more about it how did it start or how did it do you remember injuring yourself
3,864
doctor: okay and is it anywhere in specific is it in the middle of the back across the whole low back or on one side or the other patient: i think it's more towards you know right in the middle maybe on the lower side and nothing on the you know i mean it sometimes it goes back you know maybe having troubles with the l...
D2N152
5
[ "Personal History" ]
[ "Subjective" ]
okay and is it anywhere in specific is it in the middle of the back across the whole low back or on one side or the other
3,865
doctor: okay and that's when you get the pain more patient: maybe located in the center but it goes across to the little back and i on the left side
D2N152
6
[ "Personal History" ]
[ "Subjective" ]
okay and that's when you get the pain more
3,866
doctor: i also heard you say you know if you twist suddenly that makes it worse is that correct patient: it makes it worse it makes it worse i mean yeah
D2N152
7
[ "Personal History" ]
[ "Subjective" ]
i also heard you say you know if you twist suddenly that makes it worse is that correct
3,867
doctor: now you know i was looking at your records and i know you have that history of diabetes and i have n't seen you a while for a follow-up for that how you've been feeling patient: i mean been okay i mean i take my meds
D2N152
8
[ "Personal History" ]
[ "Subjective" ]
now you know i was looking at your records and i know you have that history of diabetes and i have n't seen you a while for a follow-up for that how you've been feeling
3,868
doctor: okay so you're on patient: mm-hmm
D2N152
10
[ "Therapeutic History" ]
[ "Subjective" ]
okay so you're on
3,869
doctor: yeah i think i think you're on that metformin twice a day patient: yeah
D2N152
11
[ "Therapeutic History" ]
[ "Subjective" ]
yeah i think i think you're on that metformin twice a day
3,870
doctor: yeah okay patient: yes
D2N152
12
[ "Chitchat" ]
[ "Null" ]
yeah okay
3,871
doctor: do you test your blood sugar at home in the mornings patient: yeah i mean i try to
D2N152
13
[ "Personal History" ]
[ "Subjective" ]
do you test your blood sugar at home in the mornings
3,872
doctor: and how have those numbers been patient: they bumped towards i mean bit towards the higher side i mean i must have been
D2N152
15
[ "Personal History" ]
[ "Subjective" ]
and how have those numbers been
3,873
doctor: well if patient: yeah
D2N152
17
[ "Chitchat" ]
[ "Null" ]
well if
3,874
doctor: yeah if i remember right your family do n't they own that that bakery down on the corner of main street and did n't they own that patient: yeah thank you
D2N152
18
[ "Chitchat" ]
[ "Null" ]
yeah if i remember right your family do n't they own that that bakery down on the corner of main street and did n't they own that
3,875
doctor: and how do you do you stay away from those i i got ta be honest i love i love the cakes and donuts they make those are delicious patient: yeah i try to
D2N152
19
[ "Chitchat" ]
[ "Null" ]
and how do you do you stay away from those i i got ta be honest i love i love the cakes and donuts they make those are delicious
3,876
doctor: well let me so we're gon na have to watch that and i'll come back and we'll talk a little bit about the diabetes but let's go ahead and do that i do n't wan na do a a a quick physical exam on you i'm gon na look in your eyes here and so let me quickly look in your ears patient: i see
D2N152
22
[ "Physical Examination" ]
[ "Objective" ]
well let me so we're gon na have to watch that and i'll come back and we'll talk a little bit about the diabetes but let's go ahead and do that i do n't wan na do a a a quick physical exam on you i'm gon na look in your eyes here and so let me quickly look in your ears
3,877
doctor: okay that looks good and any let me let me listen to your lungs okay your lungs are clear and your heart it's a regular rate and rhythm that's all good as we go through that now i want you to sit up here i'm gon na press down your back starting at the top and any pain up top no patient: no
D2N152
23
[ "Physical Examination" ]
[ "Objective" ]
okay that looks good and any let me let me listen to your lungs okay your lungs are clear and your heart it's a regular rate and rhythm that's all good as we go through that now i want you to sit up here i'm gon na press down your back starting at the top and any pain up top no
3,878
doctor: okay and then once i get down here and around that low back i wan na press in the center first does that cause you a lot of pain patient: yeah
D2N152
24
[ "Physical Examination" ]
[ "Objective" ]
okay and then once i get down here and around that low back i wan na press in the center first does that cause you a lot of pain
3,879
doctor: yeah okay patient: yeah that that's the spot
D2N152
25
[ "Chitchat" ]
[ "Null" ]
yeah okay
3,880
doctor: okay and if i come over here to the right no patient: not that much you know
D2N152
26
[ "Physical Examination" ]
[ "Objective" ]
okay and if i come over here to the right no
3,881
doctor: okay so and then on the left hand side if i push down here kind of into your butt patient: yeah
D2N152
27
[ "Physical Examination" ]
[ "Objective" ]
okay so and then on the left hand side if i push down here kind of into your butt
3,882
doctor: yeah okay patient: yeah
D2N152
28
[ "Chitchat" ]
[ "Null" ]
yeah okay
3,883
doctor: lay back on the stretcher for me for a second i'm gon na go ahead and and lift your legs for me or i'm gon na go ahead and lift your legs for you just relax i'm gon na start here on the right side when i lift that right leg up does that cause you significant pain or any pain at all patient: a little a little bi...
D2N152
29
[ "Physical Examination" ]
[ "Objective" ]
lay back on the stretcher for me for a second i'm gon na go ahead and and lift your legs for me or i'm gon na go ahead and lift your legs for you just relax i'm gon na start here on the right side when i lift that right leg up does that cause you significant pain or any pain at all
3,884
doctor: okay let me come around let me lift up the left side if i lift that up does that cause patient: yeah yeah yeah that's that's
D2N152
30
[ "Physical Examination" ]
[ "Objective" ]
okay let me come around let me lift up the left side if i lift that up does that cause
3,885
doctor: i can see that gritts on your face so okay that's good and you know as i look at your lower extremities there is no pain or numbness or tingling in your feet or anything like that patient: hmmm no
D2N152
32
[ "Acute Symptoms", "Physical Examination" ]
[ "Subjective", "Objective" ]
i can see that gritts on your face so okay that's good and you know as i look at your lower extremities there is no pain or numbness or tingling in your feet or anything like that
3,886
doctor: okay okay so lem me talk a little bit about my impression and plan so for that low back pain i believe you have a musculoskeletal low back strain i'm going to order a low back x-ray so we'll order that and get that done as an outpatient i do n't expect to see anything significant but it's gon na tell me how tho...
D2N152
33
[ "Reassessment", "Discussion", "Diagnostic Testing", "Acute Assessment", "Other Treatments", "Referral", "Medication" ]
[ "Assessment", "Plan" ]
okay okay so lem me talk a little bit about my impression and plan so for that low back pain i believe you have a musculoskeletal low back strain i'm going to order a low back x-ray so we'll order that and get that done as an outpatient i do n't expect to see anything significant but it's gon na tell me how those joint...
3,887
doctor: i would yes it's nice for you to go to the bakery but you ca n't have any donuts i'm no i you just really need to watch that intake of of anything that you might get at the at the bakery so just just be careful with those carbohydrates those sweets that you're taking as we go through your day it's occasional oc...
D2N152
34
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
i would yes it's nice for you to go to the bakery but you ca n't have any donuts i'm no i you just really need to watch that intake of of anything that you might get at the at the bakery so just just be careful with those carbohydrates those sweets that you're taking as we go through your day it's occasional occasional...
3,888
doctor: yeah i that's a great question i'm really glad you asked that i would prefer that you're taking your blood pressure every morning the first thing you get up when you get up in the morning that's gon na give me a good idea and so if you can do that the first thing in the morning and keep a record of it you know ...
D2N152
35
[ "Discussion", "Diagnostic Testing" ]
[ "Plan" ]
yeah i that's a great question i'm really glad you asked that i would prefer that you're taking your blood pressure every morning the first thing you get up when you get up in the morning that's gon na give me a good idea and so if you can do that the first thing in the morning and keep a record of it you know i know y...
3,889
doctor: not yet let's let's get the that's a great question i may end up referring you to a a pain doctor for that low back pain but i really would like to start with some of the diagnostics first let's get an x-ray and if there is you know any question of that x-ray and the pain continues i'm gon na go ahead and maybe...
D2N152
36
[ "Discussion", "Diagnostic Testing", "Referral" ]
[ "Plan" ]
not yet let's let's get the that's a great question i may end up referring you to a a pain doctor for that low back pain but i really would like to start with some of the diagnostics first let's get an x-ray and if there is you know any question of that x-ray and the pain continues i'm gon na go ahead and maybe order a...
3,890
doctor: okay thank you i'm gon na send my nursing to see you and we'll get you out the door patient: thank you
D2N152
37
[ "Chitchat" ]
[ "Null" ]
okay thank you i'm gon na send my nursing to see you and we'll get you out the door
3,891
doctor: take care patient: that one is a follow-up mm-hmm
D2N152
38
[ "Chitchat" ]
[ "Null" ]
take care
3,892
doctor: hi gregory how are you i the medical assistant told me that you injured your knee patient: yeah yeah i heard it stepping off a curb
D2N153
0
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
hi gregory how are you i the medical assistant told me that you injured your knee
3,893
doctor: how long ago did that happen patient: about two and a half weeks ago
D2N153
1
[ "Acute Symptoms" ]
[ "Subjective" ]
how long ago did that happen
3,894
doctor: two and a half weeks ago and what what knee is bothering you patient: the right knee the outside of my right knee
D2N153
2
[ "Acute Symptoms" ]
[ "Subjective" ]
two and a half weeks ago and what what knee is bothering you
3,895
doctor: the outside of your right knee patient: yeah
D2N153
3
[ "Acute Symptoms" ]
[ "Subjective" ]
the outside of your right knee
3,896
doctor: okay and did you actually fall down when this happened or patient: no i just sorta turned over my ankle
D2N153
4
[ "Acute Symptoms" ]
[ "Subjective" ]
okay and did you actually fall down when this happened or
3,897
doctor: and no okay so now it clicks when you walk okay does it hurt when you walk patient: no unless i stand on one foot for an extended period of time like leaning my foot up against the wall
D2N153
6
[ "Acute Symptoms" ]
[ "Subjective" ]
and no okay so now it clicks when you walk okay does it hurt when you walk
3,898
doctor: okay and what have you taken for the pain patient: really nothing
D2N153
8
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
okay and what have you taken for the pain
3,899