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DATEXIS
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aci_bench_intent_annotated

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doctor: okay , great . and for the knee , i think you're doing great with that . you know , continue with your physical exercise , with your physical therapy , uh , uh , with your normal exercise regimen . uh , if you have any issues with that , certainly give us a call . patient: okay .
D2N175
18
[ "Reassessment", "Follow-up", "Other Treatments" ]
[ "Assessment", "Plan" ]
okay , great . and for the knee , i think you're doing great with that . you know , continue with your physical exercise , with your physical therapy , uh , uh , with your normal exercise regimen . uh , if you have any issues with that , certainly give us a call .
4,400
doctor: all right . any other questions ? patient: no , that's it .
D2N175
19
[ "Discussion" ]
[ "Plan" ]
all right . any other questions ?
4,401
doctor: okay . hey , dragon , finalize the note .
D2N175
20
[ "Chitchat" ]
[ "Null" ]
doctor: okay . hey , dragon , finalize the note .
4,402
doctor: hi , alexander . how are you ? patient: i'm doing really well . thank you .
D2N176
0
[ "Greetings" ]
[ "Subjective" ]
hi , alexander . how are you ?
4,403
doctor: so , i know the nurse told you a little bit about dax . i'd like to tell dax about you . okay ? patient: sure .
D2N176
1
[ "Chitchat" ]
[ "Null" ]
so , i know the nurse told you a little bit about dax . i'd like to tell dax about you . okay ?
4,404
doctor: so , alexander is a 62-year-old male , with a past medical history significant for reflux , who presents for follow-up of his chronic problems . so , alexander , what's being going on ? patient: well , i am so thankful you put me on that medicine for my , my reflux .
D2N176
2
[ "Therapeutic History", "Personal History" ]
[ "Subjective" ]
so , alexander is a 62-year-old male , with a past medical history significant for reflux , who presents for follow-up of his chronic problems . so , alexander , what's being going on ?
4,405
doctor: the protonix ? patient: the protonix . that , i had , w- made an amazing change in my life .
D2N176
3
[ "Drug History" ]
[ "Subjective" ]
the protonix ?
4,406
doctor: okay , great . i'm glad to hear that . i know you were having a lot of discomfort there before , so that's good . okay . and how are you doing , kind of , managing your diet ? i know , you know , you have to do some lifestyle modifications , like cutting back on caffeine and spicy foods and alcohol . how are you doing with that ? patient: i'm doing really well . i moved over from caffeine , over to green tea .
D2N176
5
[ "Acute Symptoms", "Drug History" ]
[ "Subjective" ]
okay , great . i'm glad to hear that . i know you were having a lot of discomfort there before , so that's good . okay . and how are you doing , kind of , managing your diet ? i know , you know , you have to do some lifestyle modifications , like cutting back on caffeine and spicy foods and alcohol . how are you doing with that ?
4,407
doctor: all right . good . i'm glad to hear that . great . all right . patient: uh , i think getting that , rid of that reflux , really helped my attitude improve .
D2N176
7
[ "Acute Symptoms" ]
[ "Subjective" ]
all right . good . i'm glad to hear that . great . all right .
4,408
doctor: okay . okay . and you have a , a good support system at home ? i know you have a big- patient: yeah .
D2N176
9
[ "Other Socials" ]
[ "Subjective" ]
okay . okay . and you have a , a good support system at home ? i know you have a big-
4,409
doctor: . family . patient: yes . yes . all my kids call and check on me every day .
D2N176
10
[ "Other Socials" ]
[ "Subjective" ]
. family .
4,410
doctor: okay . great . i'm glad to hear that . now , i know you did a review of systems sheet when you checked in . patient: yes .
D2N176
11
[ "Chitchat" ]
[ "Null" ]
okay . great . i'm glad to hear that . now , i know you did a review of systems sheet when you checked in .
4,411
doctor: i , are you having any symptoms ? any chest pain , shortness of breath , belly pain , of , nausea or vomiting ? anything like that ? patient: no . no symptoms at all .
D2N176
12
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
i , are you having any symptoms ? any chest pain , shortness of breath , belly pain , of , nausea or vomiting ? anything like that ?
4,412
doctor: okay , great . um , well , let me go ahead . i wan na do a quick physical exam . hey , dragon . show me the vital signs . so , your vital signs here in the office look really good . so , you're doing a great job managing your , your blood pressure . your heart rate's nice and low . i'm gon na go ahead and take a listen to your heart and lungs . patient: okay .
D2N176
13
[ "Physical Examination" ]
[ "Objective" ]
okay , great . um , well , let me go ahead . i wan na do a quick physical exam . hey , dragon . show me the vital signs . so , your vital signs here in the office look really good . so , you're doing a great job managing your , your blood pressure . your heart rate's nice and low . i'm gon na go ahead and take a listen to your heart and lungs .
4,413
doctor: and i'll let you know what i find . okay ? patient: okay .
D2N176
14
[ "Chitchat" ]
[ "Null" ]
and i'll let you know what i find . okay ?
4,414
doctor: okay . good . all right . so , on physical examination , i , i do n't hear any carotid bruits in your neck , which is really good . you know , your heart exam , i do hear a slight 2/6 systolic ejection murmur , which i've heard in the past , so that's stable . uh , your lungs are nice and clear , and you do have , you know , 1+ pitting edema bilaterally in your lower extremities . patient: okay .so , what does that mean ?
D2N176
15
[ "Physical Examination", "Acute Assessment" ]
[ "Objective", "Assessment" ]
okay . good . all right . so , on physical examination , i , i do n't hear any carotid bruits in your neck , which is really good . you know , your heart exam , i do hear a slight 2/6 systolic ejection murmur , which i've heard in the past , so that's stable . uh , your lungs are nice and clear , and you do have , you know , 1+ pitting edema bilaterally in your lower extremities .
4,415
doctor: you know , i , i think , you know , you're doing a ... it sounds like a doing a good job watching your diet . you could ... you just are retaining a little bit of fluid , maybe just from standing all day . patient: okay .
D2N176
16
[ "Acute Assessment" ]
[ "Assessment" ]
you know , i , i think , you know , you're doing a ... it sounds like a doing a good job watching your diet . you could ... you just are retaining a little bit of fluid , maybe just from standing all day .
4,416
doctor: okay ? let's take a look at some of your results . okay ? patient: okay .
D2N176
17
[ "Chitchat" ]
[ "Null" ]
okay ? let's take a look at some of your results . okay ?
4,417
doctor: hey , dragon . show me the endoscope results . so , this was the endoscopy that you had last year when you were having all that pain . it just showed that you had had some mild gastritis . so , it's good to hear that that , you know , protonix is helping you a lot . okay ? patient: okay . okay .
D2N176
18
[ "Acute Assessment", "Lab Examination" ]
[ "Objective", "Assessment" ]
hey , dragon . show me the endoscope results . so , this was the endoscopy that you had last year when you were having all that pain . it just showed that you had had some mild gastritis . so , it's good to hear that that , you know , protonix is helping you a lot . okay ?
4,418
doctor: that sounds great . all right . so , let's talk just a little bit about , you know , my assessment and my plan for you . for your reflux , i want you to continue on the protonix 40 mg a day , and continue with those lifestyle modifications with the dietary stuff- patient: okay .
D2N176
19
[ "Reassessment", "Discussion", "Other Treatments", "Medication" ]
[ "Assessment", "Plan" ]
that sounds great . all right . so , let's talk just a little bit about , you know , my assessment and my plan for you . for your reflux , i want you to continue on the protonix 40 mg a day , and continue with those lifestyle modifications with the dietary stuff-
4,419
doctor: . okay ? do you have any questions ? patient: no questions .
D2N176
20
[ "Chitchat" ]
[ "Null" ]
. okay ? do you have any questions ?
4,420
doctor: okay . all right . well , the nurse is gon na come in soon , and she's gon na check you , get you checked out . okay ? patient: okay . thank you .
D2N176
21
[ "Chitchat" ]
[ "Null" ]
okay . all right . well , the nurse is gon na come in soon , and she's gon na check you , get you checked out . okay ?
4,421
doctor: hey , dragon . finalize the note .
D2N176
22
[ "Chitchat" ]
[ "Null" ]
doctor: hey , dragon . finalize the note .
4,422
doctor: hi bruce , how are you ? patient: hey , good to see you .
D2N177
0
[ "Greetings" ]
[ "Subjective" ]
hi bruce , how are you ?
4,423
doctor: good to see you as well . uh , so i know the nurse told you a little bit about dax . patient: mm-hmm .
D2N177
1
[ "Chitchat" ]
[ "Null" ]
good to see you as well . uh , so i know the nurse told you a little bit about dax .
4,424
doctor: i'd like to tell dax about you- patient: sure .
D2N177
2
[ "Chitchat" ]
[ "Null" ]
i'd like to tell dax about you-
4,425
doctor: okay ? so bruce is a 60 year old male , with a past medical history , significant for depression , type two diabetes and hypertension , who presents for followup of his chronic problems . so , bruce , i saw you a couple months ago- patient: mm-hmm .
D2N177
3
[ "Personal History" ]
[ "Subjective" ]
okay ? so bruce is a 60 year old male , with a past medical history , significant for depression , type two diabetes and hypertension , who presents for followup of his chronic problems . so , bruce , i saw you a couple months ago-
4,426
doctor: how are- how are you doing ? patient: it's been a crazy year and a half and i think the uh the anxiety , the pressure of getting ready for thanksgiving was really starting to wear on me .
D2N177
4
[ "Acute Symptoms" ]
[ "Subjective" ]
how are- how are you doing ?
4,427
doctor: okay . did you have a nice holiday ? patient: i , i did but it was uh , it was great to see everybody after about two years but it was just a lot of work . i , i did but it was uh , it was great to see everybody after about two years but it was just a lot of work .
D2N177
5
[ "Acute Symptoms" ]
[ "Subjective" ]
okay . did you have a nice holiday ?
4,428
doctor: yeah . yeah . and what do you have to look forward for like , the new year and that type of thing . are you- more gatherings like that ? patient: um planning to take a vacation . so hopefully somewhere nice and warm .
D2N177
6
[ "Acute Symptoms" ]
[ "Subjective" ]
yeah . yeah . and what do you have to look forward for like , the new year and that type of thing . are you- more gatherings like that ?
4,429
doctor: okay . all right . um , well how are you doing in terms of your depression . i know that we've kind of talked about this in the past . patient: mm-hmm .
D2N177
7
[ "Acute Symptoms" ]
[ "Subjective" ]
okay . all right . um , well how are you doing in terms of your depression . i know that we've kind of talked about this in the past .
4,430
doctor: and we have n't put you on medication because you're on other meds and you- you have n't really wanted to do that , so what strategies are you using ? patient: yeah . over the summer we tried something new . i started going for long walks outside every morning. the weather was so nice and all the plants were in full bloom that i loved to start my day that way. on the weekends, it even encouraged me to do a little in the yard myself which was a nice way to be active and get some sun. but with the seasons changing and it getting so cold out, i have not been able to keep doing it and need to find something new to do. . i'm not ready yet to try any meds , so i think i'd like to look into some alternative options .
D2N177
8
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
and we have n't put you on medication because you're on other meds and you- you have n't really wanted to do that , so what strategies are you using ?
4,431
doctor: okay . so yeah . so we can talk about some therapy and that type of thing . patient: sure .
D2N177
9
[ "Other Treatments" ]
[ "Plan" ]
okay . so yeah . so we can talk about some therapy and that type of thing .
4,432
doctor: all right . and no ... you do n't wan na harm yourself or others ? patient: no .
D2N177
10
[ "Acute Symptoms" ]
[ "Subjective" ]
all right . and no ... you do n't wan na harm yourself or others ?
4,433
doctor: any thoughts like that . patient: no .
D2N177
11
[ "Acute Symptoms" ]
[ "Subjective" ]
any thoughts like that .
4,434
doctor: no , okay . and then in terms of your diabetes , how are you doing , you know especially with the holidays managing your- your sugar intake and that type of thing ? patient: uh , got through halloween okay . did n't stick to the diet too much through the thanksgiving week but it's a little bit better . so i've been trying to really monitor it .
D2N177
12
[ "Personal History" ]
[ "Subjective" ]
no , okay . and then in terms of your diabetes , how are you doing , you know especially with the holidays managing your- your sugar intake and that type of thing ?
4,435
doctor: okay . and are you ... you're still taking the metformin , correct ? patient: yes .
D2N177
13
[ "Therapeutic History" ]
[ "Subjective" ]
okay . and are you ... you're still taking the metformin , correct ?
4,436
doctor: okay . all right . and then in terms of your high blood pressure , did you buy the blood pressure cuff that i recommended ? patient: yes .
D2N177
14
[ "Therapeutic History" ]
[ "Subjective" ]
okay . all right . and then in terms of your high blood pressure , did you buy the blood pressure cuff that i recommended ?
4,437
doctor: okay . and how have they been running . i have n't received any you know notes from you in the portal . patient: nothing out of the ordinary . it's been pretty moderate .
D2N177
15
[ "Acute Symptoms" ]
[ "Subjective" ]
okay . and how have they been running . i have n't received any you know notes from you in the portal .
4,438
doctor: it's been pretty good . and you're still taking the lisinopril , no problems with that ? patient: mm-hmm . correct .
D2N177
16
[ "Therapeutic History" ]
[ "Subjective" ]
it's been pretty good . and you're still taking the lisinopril , no problems with that ?
4,439
doctor: okay . all right . i know you did a review of system sheet when you checked in . patient: mm-hmm .
D2N177
17
[ "Chitchat" ]
[ "Null" ]
okay . all right . i know you did a review of system sheet when you checked in .
4,440
doctor: um , do you have any symptoms . chest pain , shortness of breath , belly pain- patient: no .
D2N177
18
[ "Acute Symptoms" ]
[ "Subjective" ]
um , do you have any symptoms . chest pain , shortness of breath , belly pain-
4,441
doctor: blood in your stool . patient: no .
D2N177
19
[ "Acute Symptoms" ]
[ "Subjective" ]
blood in your stool .
4,442
doctor: weight loss . anything like that ? patient: no .
D2N177
20
[ "Vegetative History" ]
[ "Subjective" ]
weight loss . anything like that ?
4,443
doctor: okay . all right . i wan na go ahead and do a quick physical exam . patient: mm-hmm .
D2N177
21
[ "Physical Examination" ]
[ "Objective" ]
okay . all right . i wan na go ahead and do a quick physical exam .
4,444
doctor: hey dragon . show me the vital signs . so here in the office . i agree . your blood pressure looks good . uh , i think you're doing a good job with that so keep up the good work . i'm gon na go ahead and take a listen to your heart and lungs , i'll let you know what i find . patient: sure .
D2N177
22
[ "Physical Examination" ]
[ "Objective" ]
hey dragon . show me the vital signs . so here in the office . i agree . your blood pressure looks good . uh , i think you're doing a good job with that so keep up the good work . i'm gon na go ahead and take a listen to your heart and lungs , i'll let you know what i find .
4,445
doctor: all right . so on physical examination , everything looks pretty good , so on your neck exam , i do n't appreciate any carotid bruits . on your heart exam i do appreciate a slight two out of six systolic ejection murmur heard at the left base , which we've heard in the past . patient: mm-hmm .
D2N177
23
[ "Acute Assessment" ]
[ "Assessment" ]
all right . so on physical examination , everything looks pretty good , so on your neck exam , i do n't appreciate any carotid bruits . on your heart exam i do appreciate a slight two out of six systolic ejection murmur heard at the left base , which we've heard in the past .
4,446
doctor: your lungs are nice and clear and you do have uh one plus non-pitting edema bilaterally in your lower extremities . so what does all that mean ? it just means i heard a little sound in your heart , which you know is n't anything clinically significant . we had looked into that last year . patient: mm-hmm .
D2N177
24
[ "Acute Assessment" ]
[ "Assessment" ]
your lungs are nice and clear and you do have uh one plus non-pitting edema bilaterally in your lower extremities . so what does all that mean ? it just means i heard a little sound in your heart , which you know is n't anything clinically significant . we had looked into that last year .
4,447
doctor: you do have a little swelling in your legs but that might just be from your your diet recently , okay . patient: sure .
D2N177
25
[ "Acute Assessment" ]
[ "Assessment" ]
you do have a little swelling in your legs but that might just be from your your diet recently , okay .
4,448
doctor: i wan na just take a look at some of your results . hey dragon , show me the ekg . so i just had the nurse do an ekg on you before you came in just to make sure we were n't missing anything . you're in your 60's we have some risk factors . everything looks good . patient: mm-hmm .
D2N177
26
[ "Acute Assessment", "Lab Examination" ]
[ "Objective", "Assessment" ]
i wan na just take a look at some of your results . hey dragon , show me the ekg . so i just had the nurse do an ekg on you before you came in just to make sure we were n't missing anything . you're in your 60's we have some risk factors . everything looks good .
4,449
doctor: there's no evidence that i'm concerned about anything at this time . hey dragon , show me the diabetes logs . so on your diabetic labs , your hemoglobin a1c is elevated . it's at eight . i'd like to see it closer to six . now some of them might be having to do with the holidays that type of thing but i still think that we need to get that under better control . patient: sure .
D2N177
27
[ "Reassessment", "Discussion", "Lab Examination" ]
[ "Objective", "Assessment", "Plan" ]
there's no evidence that i'm concerned about anything at this time . hey dragon , show me the diabetes logs . so on your diabetic labs , your hemoglobin a1c is elevated . it's at eight . i'd like to see it closer to six . now some of them might be having to do with the holidays that type of thing but i still think that we need to get that under better control .
4,450
doctor: so lets talk a little bit about my assessment and plan for you so for your first problem of your depression i'd like to just go ahead and refer you to uh psychiatry not for medications , but just for some talk therapy that type of thing , okay ? patient: that's fine .
D2N177
28
[ "Acute Assessment", "Referral" ]
[ "Assessment", "Plan" ]
so lets talk a little bit about my assessment and plan for you so for your first problem of your depression i'd like to just go ahead and refer you to uh psychiatry not for medications , but just for some talk therapy that type of thing , okay ?
4,451
doctor: um , for your second problem of your type two diabetes i'd like to go ahead and order a hemoglobin a1c in the next couple months . i want to increase the metformin to 1000 milligrams twice a day . and we're gon na go ahead and order a lipid panel , okay . patient: mm-hmm .
D2N177
29
[ "Reassessment", "Diagnostic Testing", "Medication" ]
[ "Assessment", "Plan" ]
um , for your second problem of your type two diabetes i'd like to go ahead and order a hemoglobin a1c in the next couple months . i want to increase the metformin to 1000 milligrams twice a day . and we're gon na go ahead and order a lipid panel , okay .
4,452
doctor: uh , lastly for your third problem for your hypertension i'm gon na go ahead and order an echocardiogram just to recheck it . just that heart murmur . and i'm going to go ahead and keep the lisinopril at 20 milligrams a day . do you have any questions ? patient: no questions .
D2N177
30
[ "Reassessment", "Discussion", "Diagnostic Testing", "Medication" ]
[ "Assessment", "Plan" ]
uh , lastly for your third problem for your hypertension i'm gon na go ahead and order an echocardiogram just to recheck it . just that heart murmur . and i'm going to go ahead and keep the lisinopril at 20 milligrams a day . do you have any questions ?
4,453
doctor: okay the nurse will be in soon , she'll get you checked out , okay ? patient: you got it .
D2N177
31
[ "Chitchat" ]
[ "Null" ]
okay the nurse will be in soon , she'll get you checked out , okay ?
4,454
doctor: hey dragon , finalize the note .
D2N177
32
[ "Chitchat" ]
[ "Null" ]
doctor: hey dragon , finalize the note .
4,455
doctor: okay . maria martin , date of birth 03/05/1946 , has been informed and consents to have this visit recorded . the patient is here for follow-up . hi , maria . how have you been doing ? patient: same i guess . pretty good .
D2N178
0
[ "Greetings" ]
[ "Subjective" ]
okay . maria martin , date of birth 03/05/1946 , has been informed and consents to have this visit recorded . the patient is here for follow-up . hi , maria . how have you been doing ?
4,456
doctor: okay , so you got my letter last time on the results . your sugars are not very well controlled . patient: yeah , i got them .
D2N178
1
[ "Personal History" ]
[ "Subjective" ]
okay , so you got my letter last time on the results . your sugars are not very well controlled .
4,457
doctor: okay . so did you increase your glimepiride ? patient: did i increase it ?
D2N178
2
[ "Therapeutic History" ]
[ "Subjective" ]
okay . so did you increase your glimepiride ?
4,458
doctor: yeah . so we want you to , as the letter said , from the last time , when your a1c was 9.9 , we wanted you to increase it to four milligrams twice a day , so let's start that . patient: okay , sure . so you want me to take two of the pills , now twice a day ?
D2N178
4
[ "Medication" ]
[ "Plan" ]
yeah . so we want you to , as the letter said , from the last time , when your a1c was 9.9 , we wanted you to increase it to four milligrams twice a day , so let's start that .
4,459
doctor: yes . uh , how much of it do you have ? patient: well , i just filled it .
D2N178
5
[ "Discussion", "Medication" ]
[ "Plan" ]
yes . uh , how much of it do you have ?
4,460
doctor: okay , good . so yeah , you can take two of them twice a day , of what you have . the new prescription will be for four milligrams twice a day . patient: okay .
D2N178
6
[ "Discussion", "Medication" ]
[ "Plan" ]
okay , good . so yeah , you can take two of them twice a day , of what you have . the new prescription will be for four milligrams twice a day .
4,461
doctor: great . and are you trying to eat healthier : less sugars , less carbohydrates ? patient: uh , well ...
D2N178
7
[ "Vegetative History" ]
[ "Subjective" ]
great . and are you trying to eat healthier : less sugars , less carbohydrates ?
4,462
doctor: not really ? patient: . well , i have n't had any pasta ; i just do n't really like it , so we do n't have any in the house . we do n't often have bread , and if we do , we buy wheat bread .
D2N178
8
[ "Vegetative History" ]
[ "Subjective" ]
not really ?
4,463
doctor: okay . but even the wheat bread , try to cut down on the number of slices you eat per day . patient: i just usually have two in the morning . i do n't care for sandwiches much ; maybe peanut butter sandwiches once in a while .
D2N178
9
[ "Vegetative History" ]
[ "Subjective" ]
okay . but even the wheat bread , try to cut down on the number of slices you eat per day .
4,464
doctor: well , that's great . patient: i drink club soda .
D2N178
11
[ "Vegetative History" ]
[ "Subjective" ]
well , that's great .
4,465
doctor: okay , that's fine . how about your eye exams ? are they up-to-date ? patient: yep . i just got new glasses .
D2N178
13
[ "Personal History" ]
[ "Subjective" ]
okay , that's fine . how about your eye exams ? are they up-to-date ?
4,466
doctor: okay . who do you go see ? patient: i go to liberty road , the group up there .
D2N178
14
[ "Personal History" ]
[ "Subjective" ]
okay . who do you go see ?
4,467
doctor: okay . the , um , the optimum optometrists , right ? patient: they keep changing doctors each time i go .
D2N178
15
[ "Personal History" ]
[ "Subjective" ]
okay . the , um , the optimum optometrists , right ?
4,468
doctor: a new doc each time ? patient: yeah . i got a really nice one i used to see a year ago .
D2N178
16
[ "Personal History" ]
[ "Subjective" ]
a new doc each time ?
4,469
doctor: was that dr. sanchez ? patient: yeah .
D2N178
17
[ "Personal History" ]
[ "Subjective" ]
was that dr. sanchez ?
4,470
doctor: okay . and you saw him not too long ago ? patient: yeah . i just got my prescription from him . well , see , i had the iodine for my eyes .
D2N178
18
[ "Personal History" ]
[ "Subjective" ]
okay . and you saw him not too long ago ?
4,471
doctor: cataracts , yep , okay . patient: so he did that and then i had to wait for a month to get healed up and then he wrote my prescription .
D2N178
19
[ "Personal History" ]
[ "Subjective" ]
cataracts , yep , okay .
4,472
doctor: perfect . and then you've got the high blood pressure . patient: yeah . a couple of weeks ago , it was 116 on the dot .
D2N178
20
[ "Personal History" ]
[ "Subjective" ]
perfect . and then you've got the high blood pressure .
4,473
doctor: okay . well , we will recheck it . you're on a combination of medications . you are on the met- met- uh , metoprolol , 50 milligrams once a day , you're on the lisinopril with hydrochlorothiazide , at 20 , with 25 milligrams once a day , and you're on the amlodipine , 10 milligram once a day . are you taking all of those ? patient: well , yeah .
D2N178
21
[ "Therapeutic History" ]
[ "Subjective" ]
okay . well , we will recheck it . you're on a combination of medications . you are on the met- met- uh , metoprolol , 50 milligrams once a day , you're on the lisinopril with hydrochlorothiazide , at 20 , with 25 milligrams once a day , and you're on the amlodipine , 10 milligram once a day . are you taking all of those ?
4,474
doctor: perfect . and then you've got the high cholesterol and the vascular disease in your legs . you're on atorvastatin . are you tolerating it okay ? patient: yeah , but honestly , my feet feel like hell .
D2N178
22
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
perfect . and then you've got the high cholesterol and the vascular disease in your legs . you're on atorvastatin . are you tolerating it okay ?
4,475
doctor: okay . yeah , the feet i think is what we call peripheral neuropathy . patient: also , i have the pain up to my hip .
D2N178
24
[ "Personal History" ]
[ "Subjective" ]
okay . yeah , the feet i think is what we call peripheral neuropathy .
4,476
doctor: okay . you have pain in the hips and upper legs ? patient: yeah , all of it .
D2N178
25
[ "Acute Symptoms" ]
[ "Subjective" ]
okay . you have pain in the hips and upper legs ?
4,477
doctor: okay . so those do seem relatively stable , right ? and are you trying to get the walking in ? patient: yeah .
D2N178
26
[ "Other Socials" ]
[ "Subjective" ]
okay . so those do seem relatively stable , right ? and are you trying to get the walking in ?
4,478
doctor: okay . and you are smoking still ? patient: yeah , still smoking .
D2N178
27
[ "Drug History" ]
[ "Subjective" ]
okay . and you are smoking still ?
4,479
doctor: not ready to quit ? patient: no , not really .
D2N178
28
[ "Vegetative History" ]
[ "Subjective" ]
not ready to quit ?
4,480
doctor: it's a bad combination . patient: i know . i'll think about it .
D2N178
29
[ "Vegetative History" ]
[ "Subjective" ]
it's a bad combination .
4,481
doctor: okay . now , let's do my review of systems . you're not having any headaches or dizziness ? patient: headaches or dizziness , no .
D2N178
30
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay . now , let's do my review of systems . you're not having any headaches or dizziness ?
4,482
doctor: good , good . and the vision is better with the cataract surgery ? that's been good ? patient: yeah . not happy with this lens ; it's kinda funny . the other one is good .
D2N178
32
[ "Personal History" ]
[ "Subjective" ]
good , good . and the vision is better with the cataract surgery ? that's been good ?
4,483
doctor: hmm , sometimes they can go in and clean up the eye with laser , but we'll see what they say . patient: okay .
D2N178
33
[ "Personal History" ]
[ "Subjective" ]
hmm , sometimes they can go in and clean up the eye with laser , but we'll see what they say .
4,484
doctor: okay . no shortness of breath or coughing ? patient: i've been coughing here lately because i've been congested .
D2N178
34
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay . no shortness of breath or coughing ?
4,485
doctor: what does it look like when it comes up ? patient: it's relatively clear .
D2N178
35
[ "Vegetative History" ]
[ "Subjective" ]
what does it look like when it comes up ?
4,486
doctor: no fever , chills , no shortness of breath ? patient: no .
D2N178
36
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
no fever , chills , no shortness of breath ?
4,487
doctor: okay . no chest pains or pressure or tightness ? patient: no .
D2N178
37
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay . no chest pains or pressure or tightness ?
4,488
doctor: nausea , vomiting , gi symptoms ? patient: no .
D2N178
38
[ "Vegetative History" ]
[ "Subjective" ]
nausea , vomiting , gi symptoms ?
4,489
doctor: okay . peeing okay ? patient: not good . it's , you know , i'm old ; it takes me a little more time .
D2N178
39
[ "Vegetative History" ]
[ "Subjective" ]
okay . peeing okay ?
4,490
doctor: slower stream but stable ? patient: yes , but i do pee ...
D2N178
40
[ "Vegetative History" ]
[ "Subjective" ]
slower stream but stable ?
4,491
doctor: mm-hmm . how many times do you have to get up at night ? patient: not too bad , just once in a while .
D2N178
42
[ "Vegetative History" ]
[ "Subjective" ]
mm-hmm . how many times do you have to get up at night ?
4,492
doctor: okay . all right , let's have a look at you . patient: okay .
D2N178
44
[ "Physical Examination" ]
[ "Objective" ]
okay . all right , let's have a look at you .
4,493
doctor: physical exam : carotids are normal , pulse is no buits . heart exam : rhythm is regular , normal rate , s1 and s2 are crisp . i do not hear any murmurs today , okay . have you lean forward for me . take some deep breaths , in and out . okay , lungs are clear . i do n't hear any rasps or wheezing today . patient: my coughing got better this morning .
D2N178
45
[ "Physical Examination" ]
[ "Objective" ]
physical exam : carotids are normal , pulse is no buits . heart exam : rhythm is regular , normal rate , s1 and s2 are crisp . i do not hear any murmurs today , okay . have you lean forward for me . take some deep breaths , in and out . okay , lungs are clear . i do n't hear any rasps or wheezing today .
4,494
doctor: you cleared out the lungs ? all right , let me take a look at your feet . patient: okay .
D2N178
46
[ "Physical Examination" ]
[ "Objective" ]
you cleared out the lungs ? all right , let me take a look at your feet .
4,495
doctor: okay . extremities are without edema . pulses are palpable on the dorsalis pedis posterial tibial . she has thickened nails . patient: yeah .
D2N178
47
[ "Physical Examination" ]
[ "Objective" ]
okay . extremities are without edema . pulses are palpable on the dorsalis pedis posterial tibial . she has thickened nails .
4,496
doctor: yeah . mildly dry skin , no skin breakdown . l- let me know if you can feel this . patient: okay . i closed my eyes . yeah , yeah , okay .
D2N178
48
[ "Physical Examination" ]
[ "Objective" ]
yeah . mildly dry skin , no skin breakdown . l- let me know if you can feel this .
4,497
doctor: mildly decreased sensation in the tips of the first and second toes . okay , we're done with your exam . patient: okay .
D2N178
49
[ "Physical Examination" ]
[ "Objective" ]
mildly decreased sensation in the tips of the first and second toes . okay , we're done with your exam .
4,498
doctor: okay . so again , try to keep the feet moisturized . patient: yeah .
D2N178
50
[ "Discussion" ]
[ "Plan" ]
okay . so again , try to keep the feet moisturized .
4,499