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doctor: techniques are fun so tell me do you do you have any history at all of you know hypercholesterol serol anemia on the like at a early age any other you know family members that that you remember that may have that problem patient: well i do n't really think so i do n't really talk to my parents too much
D2N163
11
[ "Family History" ]
[ "Subjective" ]
techniques are fun so tell me do you do you have any history at all of you know hypercholesterol serol anemia on the like at a early age any other you know family members that that you remember that may have that problem
4,100
doctor: okay alright okay we'll we'll we'll we'll take a look at that okay now tell me have you had any issues you know with growing growing up bones are feeling okay you feel like you're growing okay patient: i i guess so i mean when i met with my doctor i they talked about making health goals and making sure that tha...
D2N163
15
[ "Personal History" ]
[ "Subjective" ]
okay alright okay we'll we'll we'll we'll take a look at that okay now tell me have you had any issues you know with growing growing up bones are feeling okay you feel like you're growing okay
4,101
doctor: yeah okay well you know we can get you there too you know we can work on that so we we'll take we'll talk more about some tips to help achieve those goals okay patient: okay
D2N163
17
[ "Chitchat" ]
[ "Null" ]
yeah okay well you know we can get you there too you know we can work on that so we we'll take we'll talk more about some tips to help achieve those goals okay
4,102
doctor: okay and tell me does anyone at home smoke patient: well when i used to live with my parents they did but i live on my own now
D2N163
18
[ "Vegetative History" ]
[ "Subjective" ]
okay and tell me does anyone at home smoke
4,103
doctor: okay you know if your friends come over if they smoke too or what okay patient: nope
D2N163
20
[ "Vegetative History" ]
[ "Subjective" ]
okay you know if your friends come over if they smoke too or what okay
4,104
doctor: okay now tell me is there any history at all of like maybe heart disease or sudden death you know like early early in those your family's years patient: well come to think of it i did have my my grandparents told me that that i had a cousin that died and and he was only like forty four or forty five
D2N163
22
[ "Family History" ]
[ "Subjective" ]
okay now tell me is there any history at all of like maybe heart disease or sudden death you know like early early in those your family's years
4,105
doctor: okay well i'm sorry to hear that okay so that's that's helpful information though okay let's go ahead and do physical exam on you there julie i'm gon na go ahead and take a look at your vital signs looks like your blood pressure looks good so that's good now on your heart exam i do n't appreciate any murmur rub...
D2N163
24
[ "Physical Examination", "Referral", "Other Treatments", "Diagnostic Testing", "Reassessment" ]
[ "Objective", "Assessment", "Plan" ]
okay well i'm sorry to hear that okay so that's that's helpful information though okay let's go ahead and do physical exam on you there julie i'm gon na go ahead and take a look at your vital signs looks like your blood pressure looks good so that's good now on your heart exam i do n't appreciate any murmur rubs or gal...
4,106
doctor: alright now i do want you to continue to be active and exercise so that's great especially that you know your bike riding so you keep that up that's a great thing and you're doing well with that so keep that up for you okay and then i wan na follow up with another cholesterol level in three to six months after ...
D2N163
25
[ "Follow-up", "Other Treatments" ]
[ "Plan" ]
alright now i do want you to continue to be active and exercise so that's great especially that you know your bike riding so you keep that up that's a great thing and you're doing well with that so keep that up for you okay and then i wan na follow up with another cholesterol level in three to six months after you've m...
4,107
doctor: okay good well take care julie i'll talk to you soon patient: alright thanks document
D2N163
26
[ "Chitchat" ]
[ "Null" ]
okay good well take care julie i'll talk to you soon
4,108
doctor: thank you bye
D2N163
27
[ "Chitchat" ]
[ "Null" ]
doctor: thank you bye
4,109
doctor: so elizabeth is a 53 -year-old female today complaining of chest pain and she has a past medical history of diabetes and high blood pressure so elizabeth tell me what's going on with your with your chest pain patient: i do n't know every time i start walking i'm just having this kind of pressure and chest pain ...
D2N164
0
[ "Acute Symptoms", "Personal History", "Greetings" ]
[ "Subjective" ]
so elizabeth is a 53 -year-old female today complaining of chest pain and she has a past medical history of diabetes and high blood pressure so elizabeth tell me what's going on with your with your chest pain
4,110
doctor: okay are you having it now or is it gone right now patient: right now it's not there
D2N164
1
[ "Acute Symptoms" ]
[ "Subjective" ]
okay are you having it now or is it gone right now
4,111
doctor: okay and how long have you been having this patient: probably maybe three months
D2N164
2
[ "Acute Symptoms" ]
[ "Subjective" ]
okay and how long have you been having this
4,112
doctor: okay and what seemed to bring it on anything exacerbated or relieve it patient: it mainly happens when i'm walking i like to try and walk but lately i just have n't been able to keep up with it because i'm having this pain
D2N164
3
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
okay and what seemed to bring it on anything exacerbated or relieve it
4,113
doctor: alright and well how would you describe this pain it's like a dull pain sharp pain stabbing pain how would you describe it patient: i would say it's dull it's kinda like a pressure
D2N164
4
[ "Acute Symptoms" ]
[ "Subjective" ]
alright and well how would you describe this pain it's like a dull pain sharp pain stabbing pain how would you describe it
4,114
doctor: okay and does it go anywhere or radiate any place patient: no
D2N164
5
[ "Acute Symptoms" ]
[ "Subjective" ]
okay and does it go anywhere or radiate any place
4,115
doctor: okay alright but no chest pain right now no shortness of breath no sweats or clamminess or anything like that right now patient: nothing right now
D2N164
6
[ "Vegetative History" ]
[ "Subjective" ]
okay alright but no chest pain right now no shortness of breath no sweats or clamminess or anything like that right now
4,116
doctor: okay alright well certainly you know i looked at your ekg that did we did in the office when you came in the ekg i do n't see any signs of a heart attack or anything like that so i'm you know we should definitely talk about the plan for this chest pain in a few minutes but right now the good news is i do n't se...
D2N164
7
[ "Personal History", "Therapeutic History", "Lab Examination" ]
[ "Subjective", "Objective" ]
okay alright well certainly you know i looked at your ekg that did we did in the office when you came in the ekg i do n't see any signs of a heart attack or anything like that so i'm you know we should definitely talk about the plan for this chest pain in a few minutes but right now the good news is i do n't see any si...
4,117
doctor: yeah i i am addicted to diet coke myself so i i hear you on that one and we had checked your hemoglobin a1c last time it was you know seven . which is pretty good it's not you know it could be better but it's not it's not bad and we talked about sending you to ophthalmology also for an eye exam have you seen op...
D2N164
8
[ "Personal History" ]
[ "Subjective" ]
yeah i i am addicted to diet coke myself so i i hear you on that one and we had checked your hemoglobin a1c last time it was you know seven . which is pretty good it's not you know it could be better but it's not it's not bad and we talked about sending you to ophthalmology also for an eye exam have you seen ophthalmol...
4,118
doctor: okay got it and any nausea vomiting or diarrhea or anything like that with your diabetes or any side effects from your medications the metformin patient: no
D2N164
9
[ "Personal History", "Vegetative History" ]
[ "Subjective" ]
okay got it and any nausea vomiting or diarrhea or anything like that with your diabetes or any side effects from your medications the metformin
4,119
doctor: okay alright good and i saw also there was a record in your i was looking at your record before previously before i walked in you also had we've been checking your blood pressure but but i think you've been into several other clinicians and they had documented high blood pressure have you noticed any findings w...
D2N164
10
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
okay alright good and i saw also there was a record in your i was looking at your record before previously before i walked in you also had we've been checking your blood pressure but but i think you've been into several other clinicians and they had documented high blood pressure have you noticed any findings with that...
4,120
doctor: well i think the last time you were in the clinic and one of the clinics said the referrals the your blood pressure was elevated so they had mentioned that i noticed a trend in your blood pressure it's been running on a little bit on the high side we have n't really diagnosed you with that yet but i think we ar...
D2N164
11
[ "Personal History" ]
[ "Subjective" ]
well i think the last time you were in the clinic and one of the clinics said the referrals the your blood pressure was elevated so they had mentioned that i noticed a trend in your blood pressure it's been running on a little bit on the high side we have n't really diagnosed you with that yet but i think we are someth...
4,121
doctor: it certainly could be contributing to that it certainly could be a factor that we need to look at so patient: someone had told me before
D2N164
12
[ "Personal History" ]
[ "Subjective" ]
it certainly could be contributing to that it certainly could be a factor that we need to look at so
4,122
doctor: yeah me too but we we can we can definitely you know get you started on some monitoring devices for that and also maybe start you on some some diet control things that we can do to help with the blood pressure and maybe start you on some blood pressure medications if we need to okay patient: okay sounds good
D2N164
13
[ "Discussion", "Medication", "Other Treatments" ]
[ "Plan" ]
yeah me too but we we can we can definitely you know get you started on some monitoring devices for that and also maybe start you on some some diet control things that we can do to help with the blood pressure and maybe start you on some blood pressure medications if we need to okay
4,123
doctor: so let me examine you elizabeth for a second for the because we're running out of time here for a second so i'm gon na go ahead and do my exam we got ta just did my magical exam and i'm gon na go ahead and verbalize some of my findings just so i can get it documented in my note okay and i'll explain things as w...
D2N164
14
[ "Physical Examination", "Discussion", "Referral", "Medication", "Diagnostic Testing", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
so let me examine you elizabeth for a second for the because we're running out of time here for a second so i'm gon na go ahead and do my exam we got ta just did my magical exam and i'm gon na go ahead and verbalize some of my findings just so i can get it documented in my note okay and i'll explain things as we go alo...
4,124
doctor: yeah if you if you stop walking the chest pain goes away you do n't have to take the pill but if you are walking or you stop and the chest pain does not go away i would take the pill and see if it goes away if it does not patient: how long like how long do i wait to see if it goes away
D2N164
15
[ "Discussion", "Medication" ]
[ "Plan" ]
yeah if you if you stop walking the chest pain goes away you do n't have to take the pill but if you are walking or you stop and the chest pain does not go away i would take the pill and see if it goes away if it does not
4,125
doctor: about five minutes so you can take it up to three pills every five minutes and if it does n't go away then i would you know go to the hospital and get this checked out because i worry about with this chest pain that you're having making sure it does n't lead to a heart attack those chest pain could be a you kno...
D2N164
16
[ "Discussion", "Medication" ]
[ "Plan" ]
about five minutes so you can take it up to three pills every five minutes and if it does n't go away then i would you know go to the hospital and get this checked out because i worry about with this chest pain that you're having making sure it does n't lead to a heart attack those chest pain could be a you know a a a ...
4,126
doctor: alright patient: mm-hmm
D2N164
17
[ "Chitchat" ]
[ "Null" ]
alright
4,127
doctor: and for the second problem the diabetes you know i think you're doing fairly well continue with your eye ophthalmology appointment you have for your eye exam for the diabetic retinopathy continue the metformin five hundred milligrams twice a day i'm gon na order another hemoglobin a1c today and i'm gon na have ...
D2N164
18
[ "Discussion", "Follow-up", "Medication", "Other Treatments", "Reassessment" ]
[ "Assessment", "Plan" ]
and for the second problem the diabetes you know i think you're doing fairly well continue with your eye ophthalmology appointment you have for your eye exam for the diabetic retinopathy continue the metformin five hundred milligrams twice a day i'm gon na order another hemoglobin a1c today and i'm gon na have you come...
4,128
doctor: okay and for the third diagnosis the high blood pressure you you do have a trend i've noticed in your chart that your blood pressure's been running a little bit high several other people have documented as well i'm gon na go ahead and start you on some hydrochlorothiazide it's a pretty low dose medication to he...
D2N164
19
[ "Medication", "Reassessment" ]
[ "Assessment", "Plan" ]
okay and for the third diagnosis the high blood pressure you you do have a trend i've noticed in your chart that your blood pressure's been running a little bit high several other people have documented as well i'm gon na go ahead and start you on some hydrochlorothiazide it's a pretty low dose medication to help you w...
4,129
doctor: yeah it can cause sometimes it can cause a little bit of make you go to the bathroom a little bit more often in the evening but generally most people do n't have a whole lot of side effects i'll give you a handout of the side effects but sometimes you can have a cross reaction with some other medications like s...
D2N164
20
[ "Discussion", "Medication" ]
[ "Plan" ]
yeah it can cause sometimes it can cause a little bit of make you go to the bathroom a little bit more often in the evening but generally most people do n't have a whole lot of side effects i'll give you a handout of the side effects but sometimes you can have a cross reaction with some other medications like sulfa med...
4,130
doctor: alright any other questions we got patient: that's it
D2N164
21
[ "Discussion" ]
[ "Plan" ]
alright any other questions we got
4,131
doctor: alright well great seeing you thanks for coming in today patient: thank you appreciate it
D2N164
22
[ "Chitchat" ]
[ "Null" ]
alright well great seeing you thanks for coming in today
4,132
doctor: hey sophia how are you doing today patient: i've been better my primary care doctor wanted me to see you because of this knee pain that i've been having for about six months now
D2N165
0
[ "Greetings" ]
[ "Null" ]
hey sophia how are you doing today
4,133
doctor: okay do you remember what caused the pain initially patient: you know i really ca n't recall any specific event that caused the pain
D2N165
1
[ "Acute Symptoms" ]
[ "Subjective" ]
okay do you remember what caused the pain initially
4,134
doctor: alright well can can you describe the pain for me patient: yeah so it's it's like a deep achy pain that it i feel like it's behind my kneecaps and sometimes i can even hear like what seems like like some creaking in my knees
D2N165
2
[ "Acute Symptoms" ]
[ "Subjective" ]
alright well can can you describe the pain for me
4,135
doctor: hmmm alright now tell me what what type of activities makes that pain worse patient: so i feel like the pain gets worse anytime i'm like getting from like a seated position to standing so i i work from home so i'm at my desk a lot so anytime i get up i have some pain or after watching tv or even like going up a...
D2N165
3
[ "Acute Symptoms" ]
[ "Subjective" ]
hmmm alright now tell me what what type of activities makes that pain worse
4,136
doctor: hmmm okay and does anything make the pain feel better patient: usually after i rest it for some time it does help with the pain
D2N165
4
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
hmmm okay and does anything make the pain feel better
4,137
doctor: okay now you did mention earlier that you have tried some things in the past can you tell me what they were patient: yeah so when it first started hurting i was putting ice on it and i even got like some ace bandage like wrapping from the pharmacy i do take ibuprofen or aleve sometimes but i try to avoid really...
D2N165
5
[ "Therapeutic History" ]
[ "Subjective" ]
okay now you did mention earlier that you have tried some things in the past can you tell me what they were
4,138
doctor: okay and and tell me what is your day like patient: well i try to be as active as i can i actually love to run and i would run like five to six miles a day but now i i mean honestly i ca n't even get to half a mile and my leg will start hurting my knee will start hurting
D2N165
6
[ "Other Socials" ]
[ "Subjective" ]
okay and and tell me what is your day like
4,139
doctor: okay that's definitely a decrease in your mileage there where have you been running lately like do you run outside or on a treadmill or patient: yeah i i you know i will do the treadmill during the winter but i just love being outdoors and running
D2N165
7
[ "Other Socials" ]
[ "Subjective" ]
okay that's definitely a decrease in your mileage there where have you been running lately like do you run outside or on a treadmill or
4,140
doctor: yeah yeah there are some really nice senior routes here in boston is n't there like patient: there are
D2N165
8
[ "Chitchat" ]
[ "Null" ]
yeah yeah there are some really nice senior routes here in boston is n't there like
4,141
doctor: so many knee places there's some right by the harbor that i've i've done some runs there before too it's pretty nice well i mean the boston marathon what can you say right patient: right exactly exactly no it's very nice
D2N165
9
[ "Chitchat" ]
[ "Null" ]
so many knee places there's some right by the harbor that i've i've done some runs there before too it's pretty nice well i mean the boston marathon what can you say right
4,142
doctor: well okay well hopefully that we get you feeling better so you can start running again more than . five miles but tell me though have you noticed any swelling or redness in your knees patient: no not really
D2N165
10
[ "Vegetative History" ]
[ "Subjective" ]
well okay well hopefully that we get you feeling better so you can start running again more than . five miles but tell me though have you noticed any swelling or redness in your knees
4,143
doctor: okay and have you ever injured your knees before patient: no i've been pretty good i actually have never broken a bone actually no i'm gon na change that actually i did break my arm when i was in sixth grade but nothing since then
D2N165
11
[ "Personal History" ]
[ "Subjective" ]
okay and have you ever injured your knees before
4,144
doctor: okay and it's just your arm right not not your knee patient: right
D2N165
13
[ "Acute Symptoms" ]
[ "Subjective" ]
okay and it's just your arm right not not your knee
4,145
doctor: okay well alright well let's go ahead and do a quick physical exam on you here let me look at your vital signs okay i reviewed your vitals they they overall they look good take a listen to your heart real quick alright and your heart exam i hear regular rate and rhythm with no murmurs and on your musculoskeleta...
D2N165
14
[ "Physical Examination" ]
[ "Objective" ]
okay well alright well let's go ahead and do a quick physical exam on you here let me look at your vital signs okay i reviewed your vitals they they overall they look good take a listen to your heart real quick alright and your heart exam i hear regular rate and rhythm with no murmurs and on your musculoskeletal exam i...
4,146
doctor: alright good your strength is three out of five for abduction of legs bilaterally and the remainder of muscle strength for your lower extremities are five out of five so that's good let me take a look at your knee now on your knee exam there is no overlying erythema that's redness or ecchymosis and that's bruis...
D2N165
15
[ "Physical Examination" ]
[ "Objective" ]
alright good your strength is three out of five for abduction of legs bilaterally and the remainder of muscle strength for your lower extremities are five out of five so that's good let me take a look at your knee now on your knee exam there is no overlying erythema that's redness or ecchymosis and that's bruising or a...
4,147
doctor: sorry so there is tenderness to palpation of the bilateral retinacular retinaculum and there is positive patellar grind test alright and can you are you able to squat for me patient: i can but that hurts
D2N165
16
[ "Physical Examination" ]
[ "Objective" ]
sorry so there is tenderness to palpation of the bilateral retinacular retinaculum and there is positive patellar grind test alright and can you are you able to squat for me
4,148
doctor: okay alright so you're definitely having some knee pain with squatting and i'm just gon na maneuver your leg just a little bit here real quick okay so lachman anterior and posterior drawer and mcmurray tests are all negative bilaterally so that's good there okay now your neuro exam patella and achilles reflexes...
D2N165
17
[ "Discussion", "Medication", "Radiology Examination", "Referral", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
okay alright so you're definitely having some knee pain with squatting and i'm just gon na maneuver your leg just a little bit here real quick okay so lachman anterior and posterior drawer and mcmurray tests are all negative bilaterally so that's good there okay now your neuro exam patella and achilles reflexes are sym...
4,149
doctor: well that is a goal of treatment and to get you back in running again now you will have to take an take it easy from running for now but we will continue to assess your progress with each visit okay patient: okay
D2N165
18
[ "Discussion" ]
[ "Plan" ]
well that is a goal of treatment and to get you back in running again now you will have to take an take it easy from running for now but we will continue to assess your progress with each visit okay
4,150
doctor: alright anything else patient: no i think that's it
D2N165
19
[ "Discussion" ]
[ "Plan" ]
alright anything else
4,151
doctor: okay well very good well i will be following up with you soon and again just take it easy for now from the running okay patient: okay thank you
D2N165
20
[ "Chitchat" ]
[ "Null" ]
okay well very good well i will be following up with you soon and again just take it easy for now from the running okay
4,152
doctor: hey kyle so i see here on your chart that you've been having some back pain could you tell me like how you've been doing what's going on patient: yeah i have this real bad low back pain it started a couple of weeks ago i was lifting something and i just felt a pop and i i do n't know what's going on
D2N166
0
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
hey kyle so i see here on your chart that you've been having some back pain could you tell me like how you've been doing what's going on
4,153
doctor: okay and so you were like moving what what were you moving exactly when you say lifting patient: i was lifting a box of books
D2N166
1
[ "Acute Symptoms" ]
[ "Subjective" ]
okay and so you were like moving what what were you moving exactly when you say lifting
4,154
doctor: alright did we use proper lifting technique do you wonder patient: you know probably not
D2N166
3
[ "Acute Symptoms" ]
[ "Subjective" ]
alright did we use proper lifting technique do you wonder
4,155
doctor: okay alright i'm sorry about that alright can you describe the pain for me patient: yeah i i feel like kind of it's like achy and sharp
D2N166
4
[ "Acute Symptoms" ]
[ "Subjective" ]
okay alright i'm sorry about that alright can you describe the pain for me
4,156
doctor: uh uh and does the pain like radiate anywhere patient: you know it did n't at first but now i'm feeling it's kinda starting to shoot down my left leg
D2N166
6
[ "Acute Symptoms" ]
[ "Subjective" ]
uh uh and does the pain like radiate anywhere
4,157
doctor: okay alright and how is positioning for you does any sitting in any particular position hurt more or hurt less patient: no sitting is usually okay for me
D2N166
7
[ "Acute Symptoms" ]
[ "Subjective" ]
okay alright and how is positioning for you does any sitting in any particular position hurt more or hurt less
4,158
doctor: mm-hmm okay and then do you have any numbness or tingling associated with the pain patient: no
D2N166
8
[ "Vegetative History" ]
[ "Subjective" ]
mm-hmm okay and then do you have any numbness or tingling associated with the pain
4,159
doctor: okay alright any loss of sensation patient: no
D2N166
9
[ "Vegetative History" ]
[ "Subjective" ]
okay alright any loss of sensation
4,160
doctor: okay how yes sir okay how about any weakness patient: no i do n't feel any weakness
D2N166
10
[ "Vegetative History" ]
[ "Subjective" ]
okay how yes sir okay how about any weakness
4,161
doctor: okay and i know this sounds like a weird question but i do need to know do you experience any loss of control of your bladder or bowels patient: no
D2N166
11
[ "Vegetative History" ]
[ "Subjective" ]
okay and i know this sounds like a weird question but i do need to know do you experience any loss of control of your bladder or bowels
4,162
doctor: alright this this is a no judgment zone i there i'm working through some things in my head to make sure that i give you the best care that we need right i'm making a plan as we move along you mentioned that the pain has been getting worse have you done anything or tried anything that's worked in the past patien...
D2N166
12
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
alright this this is a no judgment zone i there i'm working through some things in my head to make sure that i give you the best care that we need right i'm making a plan as we move along you mentioned that the pain has been getting worse have you done anything or tried anything that's worked in the past
4,163
doctor: mm-hmm patient: that that sometimes helps
D2N166
13
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
mm-hmm
4,164
doctor: okay alright and has anyone discussed the option of like just no has anyone discussed surgery with you patient: no this is the first time i'm talking about it
D2N166
14
[ "Personal History" ]
[ "Subjective" ]
okay alright and has anyone discussed the option of like just no has anyone discussed surgery with you
4,165
doctor: okay alright that's good so what is your like how what is your activity level right now that i know that you're you know an olympic weightlifter with books what else do you do to like exercise patient: you know i try to exercise a few times a week but i'm pretty inconsistent i have a sedentary job
D2N166
15
[ "Other Socials" ]
[ "Subjective" ]
okay alright that's good so what is your like how what is your activity level right now that i know that you're you know an olympic weightlifter with books what else do you do to like exercise
4,166
doctor: okay alright and has this like pain started to like affect you like in your job or anything like that patient: not my job but i feel like i do n't want to be as active as i was previously
D2N166
16
[ "Other Socials" ]
[ "Subjective" ]
okay alright and has this like pain started to like affect you like in your job or anything like that
4,167
doctor: alright so do you have any family members that have spine conditions patient: yeah my dad has back pain
D2N166
17
[ "Family History" ]
[ "Subjective" ]
alright so do you have any family members that have spine conditions
4,168
doctor: okay alright and then do you smoke patient: i do n't smoke
D2N166
18
[ "Vegetative History" ]
[ "Subjective" ]
okay alright and then do you smoke
4,169
doctor: okay awesome alright so sorry one question did you do you have a history of playing sports patient: yes
D2N166
19
[ "Other Socials" ]
[ "Subjective" ]
okay awesome alright so sorry one question did you do you have a history of playing sports
4,170
doctor: okay what did you play patient: soccer
D2N166
20
[ "Other Socials" ]
[ "Subjective" ]
okay what did you play
4,171
doctor: okay what position patient: i played midfield
D2N166
21
[ "Other Socials" ]
[ "Subjective" ]
okay what position
4,172
doctor: okay the people who hide in the back that's fine i was centered forward fine no baby do you have a team that you wrote for patient: you know i am a tatnham hotsper fan
D2N166
22
[ "Chitchat" ]
[ "Null" ]
okay the people who hide in the back that's fine i was centered forward fine no baby do you have a team that you wrote for
4,173
doctor: they have the best colors not going to lie but i i grew up manu so sorry patient: well i wo n't fault you for that
D2N166
23
[ "Chitchat" ]
[ "Null" ]
they have the best colors not going to lie but i i grew up manu so sorry
4,174
doctor: thanks okay so if you do n't mind i'm gon na go ahead and do my physical exam i'm gon na call out my findings just to have them recorded and if you have any questions please feel free to stop me and let me know okay patient: okay
D2N166
24
[ "Physical Examination" ]
[ "Objective" ]
thanks okay so if you do n't mind i'm gon na go ahead and do my physical exam i'm gon na call out my findings just to have them recorded and if you have any questions please feel free to stop me and let me know okay
4,175
doctor: alright so looking at your vitals your blood pressure seems alright we are in like the one thirty over seventy range that's perfectly fine your respiratory rate i have you at an eighteen again pretty normal when i listen here to your heart you have a regular rate and rhythm i do n't appreciate any murmurs rubs ...
D2N166
25
[ "Physical Examination" ]
[ "Objective" ]
alright so looking at your vitals your blood pressure seems alright we are in like the one thirty over seventy range that's perfectly fine your respiratory rate i have you at an eighteen again pretty normal when i listen here to your heart you have a regular rate and rhythm i do n't appreciate any murmurs rubs or gallo...
4,176
doctor: okay so there is midline tenderness at the l4 l5 disk space with right sided lumbar paravertebral tenderness alright so are you able to bend forward patient: yes
D2N166
26
[ "Physical Examination" ]
[ "Objective" ]
okay so there is midline tenderness at the l4 l5 disk space with right sided lumbar paravertebral tenderness alright so are you able to bend forward
4,177
doctor: alright and are you able to bend backward patient: yes
D2N166
27
[ "Physical Examination" ]
[ "Objective" ]
alright and are you able to bend backward
4,178
doctor: alright do either of those actions cause you pain patient: bending forward
D2N166
28
[ "Physical Examination" ]
[ "Objective" ]
alright do either of those actions cause you pain
4,179
doctor: okay so pain with lumbar flexion and so i'm gon na have you lie down and we're gon na do i'm sorry okay and then i see that a supine straight leg test is positive alright so for your neurological exam you said that you are experiencing pain radiating down radiating down your left leg correct patient: yes
D2N166
29
[ "Physical Examination" ]
[ "Objective" ]
okay so pain with lumbar flexion and so i'm gon na have you lie down and we're gon na do i'm sorry okay and then i see that a supine straight leg test is positive alright so for your neurological exam you said that you are experiencing pain radiating down radiating down your left leg correct
4,180
doctor: alright when i touch are there any like decreased sensation patient: no
D2N166
30
[ "Physical Examination" ]
[ "Objective" ]
alright when i touch are there any like decreased sensation
4,181
doctor: okay alright so patella and achilles reflexes are symmetrical alright so i received before you came in here we got an mri and so in reviewing your results it does show a disk desiccation a disk bulge with paracentral disk herniation resulting in moderate right neuroforaminal i do n't like this word neural foram...
D2N166
31
[ "Discussion", "Medication", "Radiology Examination", "Diagnostic Testing", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
okay alright so patella and achilles reflexes are symmetrical alright so i received before you came in here we got an mri and so in reviewing your results it does show a disk desiccation a disk bulge with paracentral disk herniation resulting in moderate right neuroforaminal i do n't like this word neural foraminal ste...
4,182
doctor: yeah i think i have time in my schedule to get it done today just you know i'm here for you right now patient: alright
D2N166
32
[ "Discussion" ]
[ "Plan" ]
yeah i think i have time in my schedule to get it done today just you know i'm here for you right now
4,183
doctor: there are sorry yeah you're right there are risks associated with this kind of injection just like any procedure but we aim to minimize them and my ma when she comes in we will give you some paperwork with explanations and any and hopefully answer most of the questions that you have if after reading that you ha...
D2N166
34
[ "Discussion", "Medication" ]
[ "Plan" ]
there are sorry yeah you're right there are risks associated with this kind of injection just like any procedure but we aim to minimize them and my ma when she comes in we will give you some paperwork with explanations and any and hopefully answer most of the questions that you have if after reading that you have any m...
4,184
doctor: alright patient: great
D2N166
35
[ "Chitchat" ]
[ "Null" ]
alright
4,185
doctor: anything else patient: i think that's it
D2N166
36
[ "Discussion" ]
[ "Plan" ]
anything else
4,186
doctor: alright
D2N166
37
[ "Chitchat" ]
[ "Null" ]
doctor: alright
4,187
doctor: angela good to see you today so i'm writing here in my notes that you're you're coming in you had some left knee pain so how did you hurt your knee patient: yeah so i hurt my knee the other day when i was running around with my niece she she is learning how to take off the training wheels for her bike
D2N167
0
[ "Acute Symptoms" ]
[ "Subjective" ]
angela good to see you today so i'm writing here in my notes that you're you're coming in you had some left knee pain so how did you hurt your knee
4,188
doctor: mm-hmm patient: and i fell and i think i twisted my knee in some kind of funky way
D2N167
1
[ "Acute Symptoms" ]
[ "Subjective" ]
mm-hmm
4,189
doctor: okay that that that that's not good how old are your niece patient: she is five and perfect
D2N167
2
[ "Other Socials" ]
[ "Subjective" ]
okay that that that that's not good how old are your niece
4,190
doctor: well that's good that you're trying to help her with the learning how to ride a bike patient: yeah
D2N167
3
[ "Other Socials" ]
[ "Subjective" ]
well that's good that you're trying to help her with the learning how to ride a bike
4,191
doctor: that sounds fun but i'm i'm sad as you hurt your knee doing it so for your knee pain are you are you able to bear weight on that leg the left leg patient: well i've been limping ever since and it really has n't gotten better so i thought it was maybe time to come see you because it happened about a week ago
D2N167
4
[ "Acute Symptoms" ]
[ "Subjective" ]
that sounds fun but i'm i'm sad as you hurt your knee doing it so for your knee pain are you are you able to bear weight on that leg the left leg
4,192
doctor: yeah yeah it's a definitely a good time to come see me so what part of your knee would you say it hurts patient: honestly it's been hurting on both sides more so on the inside than the the outside
D2N167
5
[ "Acute Symptoms" ]
[ "Subjective" ]
yeah yeah it's a definitely a good time to come see me so what part of your knee would you say it hurts
4,193
doctor: so okay so more in the medial aspect less on the lateral okay that makes sense and you said did you hear a pop when you when you twisted it patient: yeah i did
D2N167
6
[ "Acute Symptoms" ]
[ "Subjective" ]
so okay so more in the medial aspect less on the lateral okay that makes sense and you said did you hear a pop when you when you twisted it
4,194
doctor: okay alright so how would you rate your pain with your knee out of out of one to ten patient: it started off as like a four but i think it's getting worse and it's starting like it's it's like a like a throbbing kind of pain yeah
D2N167
7
[ "Acute Symptoms" ]
[ "Subjective" ]
okay alright so how would you rate your pain with your knee out of out of one to ten
4,195
doctor: alright and have you taken anything for the pain patient: yeah so i i had like a ulcer not too long ago so my doctor told me that i could n't take any like kind of advil or ibuprofen
D2N167
8
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
alright and have you taken anything for the pain
4,196
doctor: mm-hmm patient: so i've been taking some tylenol and i wrapped it with kinesiology tape are you familiar with that
D2N167
9
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
mm-hmm
4,197
doctor: yep yeah i'm i'm familiar patient: okay
D2N167
10
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
yep yeah i'm i'm familiar
4,198
doctor: alright and has the has the ibuprofen been helping you at all patient: i ca n't take ibuprofen
D2N167
11
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
alright and has the has the ibuprofen been helping you at all
4,199