text stringlengths 14 3.73k | encounter_id stringclasses 207
values | text_id int64 0 69 | intents listlengths 1 9 | sections listlengths 1 4 | doc_only stringlengths 6 3.62k | __index_level_0__ int64 0 5.29k |
|---|---|---|---|---|---|---|
doctor: okay . so on exam you've got some tenderness over your lateral epicondyle . uh , you have some swelling there and some redness . uh , you have some pain with flexion , extension of your elbow as well . uh , and you have some pain on the dorsal aspect of your- of your forearm as well . okay ? so let's look at your x-rays . hey dragon , show me the x-rays . all right . your x-ray of your elbow-it looks like , i mean , the bones are lined up properly . there's no fracture- . it , uh , there's a little bit of swelling there on the lateral elbow but i do n't see any fracture , so that's good . so , looking at the x-ray and looking at your exam , uh , my diagnosis here would be lateral epicondylitis , and this is basically inflammation of this area where this tendon in- inserts . and probably that happened when you were moving those boxes . so we'll try some motrin , uh , about 800 milligrams every six hours . uh , i'll give you a sling for comfort , just so you can use it if- if it's causing a lot of pain . patient: hmm . | D2N019 | 19 | [
"Physical Examination",
"Radiology Examination",
"Acute Assessment",
"Discussion",
"Medication",
"Other Treatments"
] | [
"Objective",
"Assessment",
"Plan"
] | okay . so on exam you've got some tenderness over your lateral epicondyle . uh , you have some swelling there and some redness . uh , you have some pain with flexion , extension of your elbow as well . uh , and you have some pain on the dorsal aspect of your- of your forearm as well . okay ? so let's look at your x-rays . hey dragon , show me the x-rays . all right . your x-ray of your elbow-it looks like , i mean , the bones are lined up properly . there's no fracture- . it , uh , there's a little bit of swelling there on the lateral elbow but i do n't see any fracture , so that's good . so , looking at the x-ray and looking at your exam , uh , my diagnosis here would be lateral epicondylitis , and this is basically inflammation of this area where this tendon in- inserts . and probably that happened when you were moving those boxes . so we'll try some motrin , uh , about 800 milligrams every six hours . uh , i'll give you a sling for comfort , just so you can use it if- if it's causing a lot of pain . | 500 |
doctor: and it should get better , uh , in about , you know , in a couple of days it should be improved . and if it does n't get better , give us a call and we'll see you some time next week . okay ? so we'll give you a sling , we'll give you the motrin , i'll give you about , uh , 30 , uh , uh , 30 , uh , uh , medications for that . uh , do you have any questions ? patient: no , no . thank you . | D2N019 | 20 | [
"Discussion",
"Follow-up"
] | [
"Plan"
] | and it should get better , uh , in about , you know , in a couple of days it should be improved . and if it does n't get better , give us a call and we'll see you some time next week . okay ? so we'll give you a sling , we'll give you the motrin , i'll give you about , uh , 30 , uh , uh , 30 , uh , uh , medications for that . uh , do you have any questions ? | 501 |
doctor: hey dragon , order the medications and the procedures . all right , why do n't you come with me and we'll get you signed out ? patient: okay , sounds good . | D2N019 | 21 | [
"Chitchat"
] | [
"Null"
] | hey dragon , order the medications and the procedures . all right , why do n't you come with me and we'll get you signed out ? | 502 |
doctor: hey dragon , finalize the report . | D2N019 | 22 | [
"Chitchat"
] | [
"Null"
] | doctor: hey dragon , finalize the report . | 503 |
doctor: hi , vincent . how are you ? patient: i'm good . how about you ? | D2N020 | 0 | [
"Greetings"
] | [
"Subjective"
] | hi , vincent . how are you ? | 504 |
doctor: i'm good . so le- are you ready to get started ? patient: i am . | D2N020 | 1 | [
"Chitchat"
] | [
"Null"
] | i'm good . so le- are you ready to get started ? | 505 |
doctor: okay . vincent is a 56-year-old male here with abnormal lab findings . so , i've heard you were in the er , vincent , and they found that you had a low hemoglobin . patient: yup . | D2N020 | 2 | [
"Personal History"
] | [
"Subjective"
] | okay . vincent is a 56-year-old male here with abnormal lab findings . so , i've heard you were in the er , vincent , and they found that you had a low hemoglobin . | 506 |
doctor: were you having some dizziness and some lightheadedness ? patient: i was very lightheaded . i- i do n't know . very lightheaded . | D2N020 | 3 | [
"Personal History",
"Vegetative History"
] | [
"Subjective"
] | were you having some dizziness and some lightheadedness ? | 507 |
doctor: okay . and have you noticed bleeding from anywhere ? patient: i have not . i have n't hurt myself in quite a while . maybe a slight nick from a knife while chopping some onions , but nothing more than that . | D2N020 | 4 | [
"Personal History"
] | [
"Subjective"
] | okay . and have you noticed bleeding from anywhere ? | 508 |
doctor: but no blood in your stools or- patient: no . | D2N020 | 5 | [
"Vegetative History"
] | [
"Subjective"
] | but no blood in your stools or- | 509 |
doctor: . anything like that ? patient: no . | D2N020 | 6 | [
"Vegetative History"
] | [
"Subjective"
] | . anything like that ? | 510 |
doctor: okay . and any type of weight loss or decreased appetite or night sweats ? coughs ? patient: uh , s- slightly decreased appetite , but i wish i had some weight loss . | D2N020 | 7 | [
"Vegetative History"
] | [
"Subjective"
] | okay . and any type of weight loss or decreased appetite or night sweats ? coughs ? | 511 |
doctor: um , okay . and how about any abdominal pain ? fever , chills ? patient: uh , none of that . | D2N020 | 8 | [
"Vegetative History"
] | [
"Subjective"
] | um , okay . and how about any abdominal pain ? fever , chills ? | 512 |
doctor: okay . all right . um , any nausea or vomiting ? patient: not really . yeah . maybe a bit of nausea . | D2N020 | 9 | [
"Vegetative History"
] | [
"Subjective"
] | okay . all right . um , any nausea or vomiting ? | 513 |
doctor: okay . all right . um , well , how are you doing in terms of your knee replacement . i know you had that done last year . that's going okay ? patient: mm , it seems okay . yeah . | D2N020 | 11 | [
"Personal History"
] | [
"Subjective"
] | okay . all right . um , well , how are you doing in terms of your knee replacement . i know you had that done last year . that's going okay ? | 514 |
doctor: okay . you're walking around without a problem ? patient: yup , yup . just not good enough to run yet , but everything else works just fine . | D2N020 | 12 | [
"Personal History"
] | [
"Subjective"
] | okay . you're walking around without a problem ? | 515 |
doctor: all right .um , and i know a few years ago , you had , had that scare with the possible lung cancer , but then they did the biopsy and , and you've been fine . patient: yup , yup . all good . | D2N020 | 13 | [
"Personal History"
] | [
"Subjective"
] | all right .um , and i know a few years ago , you had , had that scare with the possible lung cancer , but then they did the biopsy and , and you've been fine . | 516 |
doctor: turned out to be benign . patient: yup . | D2N020 | 14 | [
"Personal History"
] | [
"Subjective"
] | turned out to be benign . | 517 |
doctor: okay . great . all right . well , let's go ahead and do a quick physical exam . so looking at you , you do n't appear in any distress . your heart is regular . your lungs sound nice and clear . you have some tenderness to the right lower quadrant to palpation of your abdomen . your lower extremities have no edema . um , all right . well , let's go ahead and look at your labs , okay ? patient: yup . | D2N020 | 15 | [
"Physical Examination"
] | [
"Objective"
] | okay . great . all right . well , let's go ahead and do a quick physical exam . so looking at you , you do n't appear in any distress . your heart is regular . your lungs sound nice and clear . you have some tenderness to the right lower quadrant to palpation of your abdomen . your lower extremities have no edema . um , all right . well , let's go ahead and look at your labs , okay ? | 518 |
doctor: hey , dragon , show me the hemoglobin . yeah , so your hemoglobin is 8.2 , which is quite low for somebody of your height and weight , so we'll have to look into that a , a little bit further . i know that they did the endoscopy in the emergency room . hey , dragon , show me the endoscope results . good . so it looks like you had some gastritis , which is just inflammation of your stomach and they also found a slight polyp , which i know that they biopsied and the results are pending at this time . um , so , you may have had some bleeding from the gastritis . it's not usual for people to have bleeding from that . um , okay , well , hey , dragon , show me the anemia panel . okay . anyway , okay . well , vincent , i think , you know , in terms of , my impression of you is that you've had this newfound anemia and for that , i think that we should go ahead and put you on protonix , 40 milligrams , once a day to help with the gastritis . does that sound okay to you ? patient: it does . you're the doctor . i do n't know what it is . | D2N020 | 16 | [
"Reassessment",
"Radiology Examination",
"Lab Examination",
"Medication"
] | [
"Objective",
"Assessment",
"Plan"
] | hey , dragon , show me the hemoglobin . yeah , so your hemoglobin is 8.2 , which is quite low for somebody of your height and weight , so we'll have to look into that a , a little bit further . i know that they did the endoscopy in the emergency room . hey , dragon , show me the endoscope results . good . so it looks like you had some gastritis , which is just inflammation of your stomach and they also found a slight polyp , which i know that they biopsied and the results are pending at this time . um , so , you may have had some bleeding from the gastritis . it's not usual for people to have bleeding from that . um , okay , well , hey , dragon , show me the anemia panel . okay . anyway , okay . well , vincent , i think , you know , in terms of , my impression of you is that you've had this newfound anemia and for that , i think that we should go ahead and put you on protonix , 40 milligrams , once a day to help with the gastritis . does that sound okay to you ? | 519 |
doctor: so that's just , uh , what we call a proton pump inhibitor which , uh , helps decrease the amount of acid secreted within your stomach . patient: got it . makes sense . | D2N020 | 17 | [
"Discussion"
] | [
"Plan"
] | so that's just , uh , what we call a proton pump inhibitor which , uh , helps decrease the amount of acid secreted within your stomach . | 520 |
doctor: hey , hey , dragon , order protonix , 40 milligrams , once a day . and i'd like you to try to cut down on your caffeine 'cause that can also irritate your stomach . try not to take any ibuprofen and try to cut down on any alcohol intake , okay ? patient: yup , yup . the coffee's the hard part . | D2N020 | 18 | [
"Other Treatments",
"Medication",
"Drug History"
] | [
"Plan"
] | hey , hey , dragon , order protonix , 40 milligrams , once a day . and i'd like you to try to cut down on your caffeine 'cause that can also irritate your stomach . try not to take any ibuprofen and try to cut down on any alcohol intake , okay ? | 521 |
doctor: yeah . it always is . how about one , one , one eight-ounce cup a day ? okay ? patient: sure . | D2N020 | 19 | [
"Discussion",
"Other Treatments"
] | [
"Plan"
] | yeah . it always is . how about one , one , one eight-ounce cup a day ? okay ? | 522 |
doctor: um , and we'll go ahead and we'll see you in a couple weeks , okay ? patient: sure thing . | D2N020 | 20 | [
"Follow-up"
] | [
"Plan"
] | um , and we'll go ahead and we'll see you in a couple weeks , okay ? | 523 |
doctor: i'm going through , uh , i'll also order another , uh , cbc on you . hey , dragon , order a complete blood count . all right . the nurse will be in soon . it's , you know , settle all that . i'll see you soon . patient: see you . | D2N020 | 21 | [
"Diagnostic Testing"
] | [
"Plan"
] | i'm going through , uh , i'll also order another , uh , cbc on you . hey , dragon , order a complete blood count . all right . the nurse will be in soon . it's , you know , settle all that . i'll see you soon . | 524 |
doctor: hey , dragon , finalize the note . | D2N020 | 22 | [
"Chitchat"
] | [
"Null"
] | doctor: hey , dragon , finalize the note . | 525 |
doctor: next patient is christine hernandez , uh , date of birth is january 13th , 1982 . hey , miss christine , how are you doing today ? patient: i'm good , thanks . how are you ? | D2N021 | 0 | [
"Greetings"
] | [
"Subjective"
] | next patient is christine hernandez , uh , date of birth is january 13th , 1982 . hey , miss christine , how are you doing today ? | 526 |
doctor: i'm pretty good . so it looks like you've completed the covid vaccine , that's great . patient: yes , i did . | D2N021 | 1 | [
"Therapeutic History"
] | [
"Subjective"
] | i'm pretty good . so it looks like you've completed the covid vaccine , that's great . | 527 |
doctor: anything new since your last visit ? patient: no , i did all the tests that you had recommended me to take . i have n't been able to take the thyroid medicine , the one that you prescribed , as i'm still taking my old one . um , the price was a little high on the new one . | D2N021 | 2 | [
"Personal History"
] | [
"Subjective"
] | anything new since your last visit ? | 528 |
doctor: okay , so did ... did you try the coupon that i gave you ? patient: i did not try the coupon , uh , there was a charge of $ 75 . | D2N021 | 3 | [
"Therapeutic History",
"Other Socials"
] | [
"Subjective"
] | okay , so did ... did you try the coupon that i gave you ? | 529 |
doctor: okay , well , next time that ... that coupon should help , and it should only be about $ 3 . patient: okay , um ... i do n't have it , do you happen to have another one you can give me ? | D2N021 | 4 | [
"Discussion"
] | [
"Plan"
] | okay , well , next time that ... that coupon should help , and it should only be about $ 3 . | 530 |
doctor: yep , right here . patient: wonderful , thank you so much , and ... and then the gel , they are charging me $ 100 for it . so , i do n't know if this is because it's a ... it's wal-mart , or if i should try somewhere else , or ... maybe you know how or where i can get it cheaper . | D2N021 | 5 | [
"Other Socials"
] | [
"Subjective"
] | yep , right here . | 531 |
doctor: yeah , let's try something else , um ... sometimes it can be cheaper if we just prescribe you the individual ingredients of a medication , rather than the , the combined medication itself . patient: that would be great . | D2N021 | 6 | [
"Discussion",
"Medication"
] | [
"Plan"
] | yeah , let's try something else , um ... sometimes it can be cheaper if we just prescribe you the individual ingredients of a medication , rather than the , the combined medication itself . | 532 |
doctor: so , that's clindamycin gel and benzoyl peroxide , uh , maybe by doing them separately , they could be a lot cheaper . so , that we can do . the unithroid , with the discount code , should only be about $ 9 for 90 days . patient: okay , that would be great . yeah , they were charging me $ 75 , and i just could n't pay that . | D2N021 | 7 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so , that's clindamycin gel and benzoyl peroxide , uh , maybe by doing them separately , they could be a lot cheaper . so , that we can do . the unithroid , with the discount code , should only be about $ 9 for 90 days . | 533 |
doctor: maybe we'll try different pharmacy , as well . patient: okay . so , do you think that my weight gain could have been the birth control that i was taking before that caused it ? | D2N021 | 8 | [
"Medication",
"Discussion"
] | [
"Plan"
] | maybe we'll try different pharmacy , as well . | 534 |
doctor: maybe . i do n't really see an endocrine cause for it , at least , so i would need to see the , the hyperandrogynism or high testosterone . or , a high dhea , to cause acne , or hair growth , or any of that stuff . but , the numbers are n't showing up out of range . patient: okay . | D2N021 | 9 | [
"Discussion",
"Medication"
] | [
"Plan"
] | maybe . i do n't really see an endocrine cause for it , at least , so i would need to see the , the hyperandrogynism or high testosterone . or , a high dhea , to cause acne , or hair growth , or any of that stuff . but , the numbers are n't showing up out of range . | 535 |
doctor: i really do n't see any endocrine cause for it , like i said . your growth hormone was fine , but we definitely want to and need to treat it . um , i do n't know if we talked about maybe a little weight loss study . patient: you mentioned the weight loss study , and you mentioned that i have some meal plans , um , that you had given me . i still have those , too . | D2N021 | 10 | [
"Discussion",
"Medication"
] | [
"Plan"
] | i really do n't see any endocrine cause for it , like i said . your growth hormone was fine , but we definitely want to and need to treat it . um , i do n't know if we talked about maybe a little weight loss study . | 536 |
doctor: have you tried to make any changes in the diet since the last time we spoke ? patient: i've been trying to get better . i will start back at the gym in july , because of my contract , i had to put a hold on it until then . | D2N021 | 11 | [
"Personal History"
] | [
"Subjective"
] | have you tried to make any changes in the diet since the last time we spoke ? | 537 |
doctor: okay , good . patient: and then my cousin was telling me to ask you about cla , because it's supposed to help your metabolism . is that okay to take ? | D2N021 | 13 | [
"Discussion",
"Medication"
] | [
"Plan"
] | okay , good . | 538 |
doctor: um , i'm not sure . what is c , cla ? patient: i'm not sure what it is , either . | D2N021 | 14 | [
"Discussion",
"Medication"
] | [
"Plan"
] | um , i'm not sure . what is c , cla ? | 539 |
doctor: okay , well , i'm unfamiliar with it , so ... patient: okay . i also have a coworker who has a thyroid issue too , and she suggested to try chromium for weight loss . | D2N021 | 15 | [
"Discussion"
] | [
"Subjective",
"Plan"
] | okay , well , i'm unfamiliar with it , so ... | 540 |
doctor: so , that likely will not help too much . you can try either , if you really want to , but then ... it will not accept you into the weight loss study if you try those two . patient: okay . | D2N021 | 16 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so , that likely will not help too much . you can try either , if you really want to , but then ... it will not accept you into the weight loss study if you try those two . | 541 |
doctor: chromium is just a supplement and it wo n't help that much . patient: it wo n't , okay , thank you . | D2N021 | 17 | [
"Discussion",
"Medication"
] | [
"Plan"
] | chromium is just a supplement and it wo n't help that much . | 542 |
doctor: it wo n't hurt ... okay , i should n't say that it wo n't hurt , but , it also wo n't help that much . so , it's up to you . patient: okay . and so , my cousin also suggested amino acids , and that i might find them in certain foods , i guess , for my workout . | D2N021 | 18 | [
"Discussion",
"Medication"
] | [
"Plan"
] | it wo n't hurt ... okay , i should n't say that it wo n't hurt , but , it also wo n't help that much . so , it's up to you . | 543 |
doctor: yeah . amino acids are fine , they wo n't , wo n't really help with weight loss either , but it might help , uh , you replenish , and just kind of , feel hydrated . patient: okay . are they proteins ? um , my cousin said she had lost some weight , and has been working out every day , but she does n't work , so ... i do n't know . | D2N021 | 19 | [
"Discussion"
] | [
"Plan"
] | yeah . amino acids are fine , they wo n't , wo n't really help with weight loss either , but it might help , uh , you replenish , and just kind of , feel hydrated . | 544 |
doctor: yes , amino acids are what make up the protein , which is in any food you eat , with any protein . so , meats , dairy , nuts , any of that sort of thing . patient: okay , thank you . got it . | D2N021 | 20 | [
"Discussion"
] | [
"Plan"
] | yes , amino acids are what make up the protein , which is in any food you eat , with any protein . so , meats , dairy , nuts , any of that sort of thing . | 545 |
doctor: all right . um , are you allergic to any medications ? patient: no , not that i know of . | D2N021 | 21 | [
"Personal History"
] | [
"Subjective"
] | all right . um , are you allergic to any medications ? | 546 |
doctor: okay . is your s- skin pretty sensitive ? patient: yes . | D2N021 | 22 | [
"Personal History"
] | [
"Subjective"
] | okay . is your s- skin pretty sensitive ? | 547 |
doctor: all right . patient: um , yeah , my size , i will start getting rashes , with different products . | D2N021 | 23 | [
"Personal History"
] | [
"Subjective"
] | all right . | 548 |
doctor: and have you ever tried clindamycin topical , as an antibiotic for your acne ? patient: no , i've never tried anything for it . | D2N021 | 24 | [
"Personal History",
"Therapeutic History"
] | [
"Subjective"
] | and have you ever tried clindamycin topical , as an antibiotic for your acne ? | 549 |
doctor: okay . we might give you some of that . patient: okay . and i also want to mention that my feet do swell up a lot . | D2N021 | 25 | [
"Medication"
] | [
"Plan"
] | okay . we might give you some of that . | 550 |
doctor: okay . i'm ... let me take a look at that for just a moment . um , any constipation ? patient: yes , i also do have that problem . | D2N021 | 26 | [
"Vegetative History"
] | [
"Subjective"
] | okay . i'm ... let me take a look at that for just a moment . um , any constipation ? | 551 |
doctor: all right . mira- miralax will definitely help with that . patient: okay , yes , my doctor did also recommend that . | D2N021 | 27 | [
"Medication"
] | [
"Plan"
] | all right . mira- miralax will definitely help with that . | 552 |
doctor: great . all right , let's do an exam real quick . please have a seat on this table and i'll listen to your lungs and heart . patient: okay . | D2N021 | 28 | [
"Physical Examination"
] | [
"Objective"
] | great . all right , let's do an exam real quick . please have a seat on this table and i'll listen to your lungs and heart . | 553 |
doctor: all right , deep breath . all right , again . patient: okay . | D2N021 | 29 | [
"Physical Examination"
] | [
"Objective"
] | all right , deep breath . all right , again . | 554 |
doctor: all right , sounds good . patient: great . | D2N021 | 30 | [
"Physical Examination"
] | [
"Objective"
] | all right , sounds good . | 555 |
doctor: let me take a look at your feet and ankles . patient: okay . | D2N021 | 31 | [
"Physical Examination"
] | [
"Objective"
] | let me take a look at your feet and ankles . | 556 |
doctor: all right , they look okay right now , certainly let your doctor know about this if it gets any worse or reoccurs . patient: okay , i will do that . | D2N021 | 32 | [
"Physical Examination",
"Follow-up"
] | [
"Objective",
"Plan"
] | all right , they look okay right now , certainly let your doctor know about this if it gets any worse or reoccurs . | 557 |
doctor: now , let's go over your lab work . so , when you took that pill , the dexamethasone test , you passed , which means you do n't have cushing's syndrome . on that test , at least . the salivary cortisol , though , unless you did one wrong ... two of them were completely normal and one was abnormal , so , we might need to repeat that in the future . patient: okay , that's okay . | D2N021 | 33 | [
"Lab Examination"
] | [
"Objective"
] | now , let's go over your lab work . so , when you took that pill , the dexamethasone test , you passed , which means you do n't have cushing's syndrome . on that test , at least . the salivary cortisol , though , unless you did one wrong ... two of them were completely normal and one was abnormal , so , we might need to repeat that in the future . | 558 |
doctor: all right , so , your cholesterol was quite high . the total cholesterol was 222 . the good cholesterol was about 44 . the bad was 153 , and it should be less than 100 . the non-hdl was about 178 , and it should be less than 130 . the good cholesterol should be over 50 , and it was 44 . so , your screen for diabetes is ... was fine . you do have a vitamin d deficiency , and , i do n't know if we started the vitamin d yet , or not . patient: yes , we did . i- i do need to take one today , though . | D2N021 | 34 | [
"Lab Examination"
] | [
"Objective"
] | all right , so , your cholesterol was quite high . the total cholesterol was 222 . the good cholesterol was about 44 . the bad was 153 , and it should be less than 100 . the non-hdl was about 178 , and it should be less than 130 . the good cholesterol should be over 50 , and it was 44 . so , your screen for diabetes is ... was fine . you do have a vitamin d deficiency , and , i do n't know if we started the vitamin d yet , or not . | 559 |
doctor: okay . so , i also checked a lot of other pituitary hormones , iron levels ... everything else seemed to be pretty good , and in decent range . patient: okay , that sounds great . so , i wanted to also show you my liver enzymes , um , because i have n't come back since then ... but i was also happy , because one of them was back to normal . | D2N021 | 35 | [
"Lab Examination"
] | [
"Objective"
] | okay . so , i also checked a lot of other pituitary hormones , iron levels ... everything else seemed to be pretty good , and in decent range . | 560 |
doctor: okay , great . let's see them . patient: okay . so , the one that's 30 , that was almost 200 not so long ago . | D2N021 | 36 | [
"Lab Examination"
] | [
"Objective"
] | okay , great . let's see them . | 561 |
doctor: yeah , your alt was about 128 . patient: okay , and , and back in october was 254 . | D2N021 | 37 | [
"Personal History",
"Lab Examination"
] | [
"Subjective",
"Objective"
] | yeah , your alt was about 128 . | 562 |
doctor: yeah , this is much better . patient: okay , great . and then it dropped in january , and then it dropped a little more in march , since i stopped taking the medicine in december . | D2N021 | 38 | [
"Personal History"
] | [
"Subjective",
"Objective"
] | yeah , this is much better . | 563 |
doctor: okay , that's good . so ... i'm proud of you with the course of your labs , so before i forget , i'm going to , uh , just put your labs into the computer today , and i wo n't be checking your vitamin d level for some time . patient: okay . so , with the thyroid , and the low vitamin d , does that always happen together ? | D2N021 | 39 | [
"Discussion"
] | [
"Plan"
] | okay , that's good . so ... i'm proud of you with the course of your labs , so before i forget , i'm going to , uh , just put your labs into the computer today , and i wo n't be checking your vitamin d level for some time . | 564 |
doctor: um , i do have a lot of people that have thyroid , thyroid issues and they have vitamin d deficiency . patient: okay . | D2N021 | 40 | [
"Discussion"
] | [
"Plan"
] | um , i do have a lot of people that have thyroid , thyroid issues and they have vitamin d deficiency . | 565 |
doctor: this is what i'm , um , i'm going to do . i'm going to put , print out your prescriptions , so you can shop around at the pharmacies and see if you can find better prices . patient: okay , that way i can go ask them and try cvs . | D2N021 | 41 | [
"Discussion",
"Medication"
] | [
"Plan"
] | this is what i'm , um , i'm going to do . i'm going to put , print out your prescriptions , so you can shop around at the pharmacies and see if you can find better prices . | 566 |
doctor: yeah , that sounds like a plan . patient: okay , good . so , the weight loss study that you mentioned , when does that start ? or , how does that work ? | D2N021 | 42 | [
"Discussion"
] | [
"Plan"
] | yeah , that sounds like a plan . | 567 |
doctor: so , we are about to start , as we just got approval last week , and we are just waiting on our paperwork so we can get started . patient: okay , and what's involved with that ? | D2N021 | 43 | [
"Discussion"
] | [
"Plan"
] | so , we are about to start , as we just got approval last week , and we are just waiting on our paperwork so we can get started . | 568 |
doctor: so , it'll involve you receiving a medication which has been used for diabetes treatment , and it works mostly in the gut on satiety , or satiety hormones . um , the most common side effects are going to be nausea , vomiting , diarrhea and constipation . they are s- uh , six arms , to the study . one is a placebo , the other ones are a , various as ... various dosages of the medication , excuse me . um , you would receive an injection once a week . also , keep in mind that most of the weight loss medications are not covered by insurance . patient: okay . | D2N021 | 44 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so , it'll involve you receiving a medication which has been used for diabetes treatment , and it works mostly in the gut on satiety , or satiety hormones . um , the most common side effects are going to be nausea , vomiting , diarrhea and constipation . they are s- uh , six arms , to the study . one is a placebo , the other ones are a , various as ... various dosages of the medication , excuse me . um , you would receive an injection once a week . also , keep in mind that most of the weight loss medications are not covered by insurance . | 569 |
doctor: so , it's a way of getting them , but , the odds of getting one of the arms with the medication that are in your favor , right , might be only one out of five of our hundred patients that we have on the list for the study that will receive the placebo . patient: okay . | D2N021 | 45 | [
"Discussion",
"Medication"
] | [
"Plan"
] | so , it's a way of getting them , but , the odds of getting one of the arms with the medication that are in your favor , right , might be only one out of five of our hundred patients that we have on the list for the study that will receive the placebo . | 570 |
doctor: does that make sense ? patient: yes , it does . | D2N021 | 46 | [
"Chitchat"
] | [
"Null"
] | does that make sense ? | 571 |
doctor: so , we do expect pretty big weight loss , because of what we learn in diabetes study . so , it's a year long , uh , process , and it's an injection once a week . you come in weekly for the first four , five weeks , i believe . and then , after that , it's once a month . you do get a stipend for partici- for participating in the study , and parking is validated , and whatever else that you need for the study . patient: okay , do you know how much the stipend is ? | D2N021 | 47 | [
"Discussion"
] | [
"Plan"
] | so , we do expect pretty big weight loss , because of what we learn in diabetes study . so , it's a year long , uh , process , and it's an injection once a week . you come in weekly for the first four , five weeks , i believe . and then , after that , it's once a month . you do get a stipend for partici- for participating in the study , and parking is validated , and whatever else that you need for the study . | 572 |
doctor: um , i will have to double check for you , and , you do n't have to be my patient , you just have to meet the criteria . so the criteria is a bmi greater than 30 , if you do n't have any other medical condition . or , a bmi greater than 27 , if you do have another medical condition , like your cholesterol . um , a bmi greater than 27 would quali- uh , qualify you . patient: i have a friend who might be interested , and she does have diabetes . | D2N021 | 48 | [
"Discussion"
] | [
"Plan"
] | um , i will have to double check for you , and , you do n't have to be my patient , you just have to meet the criteria . so the criteria is a bmi greater than 30 , if you do n't have any other medical condition . or , a bmi greater than 27 , if you do have another medical condition , like your cholesterol . um , a bmi greater than 27 would quali- uh , qualify you . | 573 |
doctor: if she has d- diabetes , then she wo n't qualify . patient: okay , you ca n't if you ... if you have diabetes , got it . | D2N021 | 49 | [
"Discussion"
] | [
"Plan"
] | if she has d- diabetes , then she wo n't qualify . | 574 |
doctor: correct . yeah , the only thing that , um , they can not have , really , is diabetes . so , either a psychiatric disease , or schizophrenia , bipolar , things like that . patient: okay . | D2N021 | 50 | [
"Discussion"
] | [
"Plan"
] | correct . yeah , the only thing that , um , they can not have , really , is diabetes . so , either a psychiatric disease , or schizophrenia , bipolar , things like that . | 575 |
doctor: but , if they have hypertension , high cholesterol , things like that ... they can definitely sign up . patient: and they can , okay . thank you for explaining that . | D2N021 | 51 | [
"Discussion"
] | [
"Plan"
] | but , if they have hypertension , high cholesterol , things like that ... they can definitely sign up . | 576 |
doctor: of course . so , do you want me to try to get you into that study ? or , would you just like to try , me to prescribe something ? it's kind of up to you . patient: i think i'll just wait for a little bit now . | D2N021 | 52 | [
"Discussion"
] | [
"Plan"
] | of course . so , do you want me to try to get you into that study ? or , would you just like to try , me to prescribe something ? it's kind of up to you . | 577 |
doctor: all right , sounds good . i'll give you the information for the research , it's just in my office . um , it is a different phone number , though . so then , if you're interested , just call us within a month , because i do n't know how long , uh , the , the wait will be . patient: okay , will do . | D2N021 | 53 | [
"Discussion",
"Follow-up"
] | [
"Plan"
] | all right , sounds good . i'll give you the information for the research , it's just in my office . um , it is a different phone number , though . so then , if you're interested , just call us within a month , because i do n't know how long , uh , the , the wait will be . | 578 |
doctor: perfect . so , let me go grab your discount card for the unithroid . um , when you go in to activate it , the instructions are on this card , and then you use your insurance ... then , show them this , and ask how much it'll cost . if it's too expensive , just let me know . patient: i will . thank you so much for your help on that . | D2N021 | 54 | [
"Discussion",
"Medication"
] | [
"Plan"
] | perfect . so , let me go grab your discount card for the unithroid . um , when you go in to activate it , the instructions are on this card , and then you use your insurance ... then , show them this , and ask how much it'll cost . if it's too expensive , just let me know . | 579 |
doctor: you're welcome . then , what i did is , i gave you a topical antibiotic , plus i gave you the benzoyl peroxide . so , the peroxide may bleach your sheets , but , you want to make sure to take it and apply it at night , so you do n't have a reaction from the sun during the day . patient: okay , i can do that . | D2N021 | 55 | [
"Discussion",
"Medication"
] | [
"Plan"
] | you're welcome . then , what i did is , i gave you a topical antibiotic , plus i gave you the benzoyl peroxide . so , the peroxide may bleach your sheets , but , you want to make sure to take it and apply it at night , so you do n't have a reaction from the sun during the day . | 580 |
doctor: but , you do also want to make sure that you do n't mess up your sheets . patient: okay , sounds good . | D2N021 | 56 | [
"Chitchat"
] | [
"Null"
] | but , you do also want to make sure that you do n't mess up your sheets . | 581 |
doctor: um , so , that's that . and then , let's see how you do on the other medications . i think this will , this will get better . in the meantime , a low-carb diet , avoid alcohol and fatty foods , and low chole- cholesterol foods . patient: okay . | D2N021 | 57 | [
"Medication",
"Other Treatments",
"Drug History"
] | [
"Plan"
] | um , so , that's that . and then , let's see how you do on the other medications . i think this will , this will get better . in the meantime , a low-carb diet , avoid alcohol and fatty foods , and low chole- cholesterol foods . | 582 |
doctor: and again , once you finish your dose of vitamin d , for the vitamin d deficiency , you're gon na start with the 2000iu daily , so that you're able to maintain those levels . sound good ? patient: yes , that sounds great . | D2N021 | 58 | [
"Medication"
] | [
"Plan"
] | and again , once you finish your dose of vitamin d , for the vitamin d deficiency , you're gon na start with the 2000iu daily , so that you're able to maintain those levels . sound good ? | 583 |
doctor: i really think your liver enzymes are going to get better once you lose the weight , though . patient: okay , that would be great . | D2N021 | 59 | [
"Discussion",
"Other Treatments"
] | [
"Plan"
] | i really think your liver enzymes are going to get better once you lose the weight , though . | 584 |
doctor: since we stopped your birth control , we can try once called phexxi , which is kind of like a spermicide , basically . patient: okay . | D2N021 | 60 | [
"Discussion",
"Medication"
] | [
"Plan"
] | since we stopped your birth control , we can try once called phexxi , which is kind of like a spermicide , basically . | 585 |
doctor: and you just apply it before intercourse . patient: okay . | D2N021 | 61 | [
"Discussion",
"Medication"
] | [
"Plan"
] | and you just apply it before intercourse . | 586 |
doctor: if you need some , uh , just let me know . patient: okay , i will . i'll let you know . | D2N021 | 62 | [
"Chitchat"
] | [
"Null"
] | if you need some , uh , just let me know . | 587 |
doctor: okay , perfect . so , stay put for me now . i'm going to go see if they have discount samples , and bring you that prescription . and then , i'm going to order the labs for next time . patient: okay , great , thank you so much . | D2N021 | 63 | [
"Discussion",
"Diagnostic Testing"
] | [
"Plan"
] | okay , perfect . so , stay put for me now . i'm going to go see if they have discount samples , and bring you that prescription . and then , i'm going to order the labs for next time . | 588 |
doctor: you're welcome . so , under the plan , under abnormal liver enzymes , they have improved since discontinuation of her birth control . under abnormal weight gain , her dexamethasone suppression test was normal . two out of three salivary cortisol tests were normal , not consistent with cushing's , and therefore we're ruling out cushing's . under her hirsutism , her androgen levels were normal . for the acne vulgaris , the epiduo was not covered , so we'll try benzoyl peroxide with clindamycin , and remove the previous information . on the hyperthyroidism , we'll print out her prescriptions . unithroid should be better priced with the discount card , and we'll repeat levels of everything before next visit . thanks . | D2N021 | 64 | [
"Follow-up",
"Medication",
"Reassessment"
] | [
"Assessment",
"Plan"
] | doctor: you're welcome . so , under the plan , under abnormal liver enzymes , they have improved since discontinuation of her birth control . under abnormal weight gain , her dexamethasone suppression test was normal . two out of three salivary cortisol tests were normal , not consistent with cushing's , and therefore we're ruling out cushing's . under her hirsutism , her androgen levels were normal . for the acne vulgaris , the epiduo was not covered , so we'll try benzoyl peroxide with clindamycin , and remove the previous information . on the hyperthyroidism , we'll print out her prescriptions . unithroid should be better priced with the discount card , and we'll repeat levels of everything before next visit . thanks . | 589 |
doctor: this is philip gutierrez , date of birth 1/12/71 . he is a 50-year-old male here for a second opinion regarding the index finger on the right hand . he had a hyperextension injury of that index finger during a motor vehicle accident in march of this year . he was offered an injection of the a1 polyregion , but did not want any steroid because of the reaction to dexamethasone , which causes his heart to race . he was scheduled to see dr. alice davis , which it does n't appear he did . he had an mri of that finger , because there was concern about a capsular strain plus or minus rupture of , quote , " fds tendon , " end quote . he has been seen at point may orthopedics largely by the physical therapy staff and a pr , pa at that institution . at that practice , an mri was obtained on 4/24/2021 , which showed just focal soft tissue swelling over the right index mcp joint , partial-thickness tear of the right fds , and fluid consistent with tenosynovitis around the fdp and fds tendons . radial and ulnar collateral ligaments of the index mcp joint were intact , as the mcp joint capsule . extensor tendons also deemed intact . his x-rays , four views of the right hand today , show no bony abnormalities , joint congruency throughout all lesser digits on the right hand , no soft tissue shadows of concern , no arthritis . hi , how are you , mr . gutierrez ? patient: i'm good , how about you ? | D2N022 | 0 | [
"Personal History",
"Greetings",
"Radiology Examination"
] | [
"Subjective",
"Objective"
] | this is philip gutierrez , date of birth 1/12/71 . he is a 50-year-old male here for a second opinion regarding the index finger on the right hand . he had a hyperextension injury of that index finger during a motor vehicle accident in march of this year . he was offered an injection of the a1 polyregion , but did not want any steroid because of the reaction to dexamethasone , which causes his heart to race . he was scheduled to see dr. alice davis , which it does n't appear he did . he had an mri of that finger , because there was concern about a capsular strain plus or minus rupture of , quote , " fds tendon , " end quote . he has been seen at point may orthopedics largely by the physical therapy staff and a pr , pa at that institution . at that practice , an mri was obtained on 4/24/2021 , which showed just focal soft tissue swelling over the right index mcp joint , partial-thickness tear of the right fds , and fluid consistent with tenosynovitis around the fdp and fds tendons . radial and ulnar collateral ligaments of the index mcp joint were intact , as the mcp joint capsule . extensor tendons also deemed intact . his x-rays , four views of the right hand today , show no bony abnormalities , joint congruency throughout all lesser digits on the right hand , no soft tissue shadows of concern , no arthritis . hi , how are you , mr . gutierrez ? | 590 |
doctor: well , how can i help you today ? patient: so i was a passenger in , uh , a car that was rear-ended , and we were hit multiple times . i felt two bumps , which slung me forward and caused me to stretch out my right index finger . | D2N022 | 1 | [
"Acute Symptoms"
] | [
"Subjective"
] | well , how can i help you today ? | 591 |
doctor: so hitting the car in front of you all made that finger go backwards ? patient: um , i do n't really know . i just felt , like , it felt like i laid on my finger , and so , i felt like it went back , and it's been hurting since about march . and it's been like that ever , ever since the wreck happened . so i , and i ca n't make a fist , but sometimes the pain's unbearable . and , like , even driving hurts . | D2N022 | 2 | [
"Acute Symptoms"
] | [
"Subjective"
] | so hitting the car in front of you all made that finger go backwards ? | 592 |
doctor: okay , so this was march of this year , so maybe about three months ago ? patient: yeah , and it's still swollen . so i was seeing , uh , an orthopedist , and they sent me to an occupational therapist . and i've been doing therapy with them , and then they sent me to go back and get an mri . so i went and got the mri . uh , then they told me that the mri came back , and it said i had a tear in my finger , but he was n't gon na give me an injection , because the injection was going to make the tear worse . | D2N022 | 3 | [
"Personal History"
] | [
"Subjective"
] | okay , so this was march of this year , so maybe about three months ago ? | 593 |
doctor: mm-hmm . patient: and then , after he got the mri , he said that i have , uh , a tear in my finger , and that he did n't wan na do surgery , but he would do an injection . then i'm thinking that you told me you would n't do an injection in there , and then the oper- , occupational therapy says it's because of the tear . and then , they do n't want me to keep rubbing the thing , and doing things with my hand . so i feel like i'm not getting medical care , really . | D2N022 | 4 | [
"Personal History"
] | [
"Subjective"
] | mm-hmm . | 594 |
doctor: yeah , i see that . patient: so i came to see if you could do anything for this hand , because i am right-handed , and i kinda need that hand . | D2N022 | 5 | [
"Personal History"
] | [
"Subjective"
] | yeah , i see that . | 595 |
doctor: what do you do for a living ? patient: uh , i'm an x-ray tech . | D2N022 | 6 | [
"Other Socials"
] | [
"Subjective"
] | what do you do for a living ? | 596 |
doctor: well , um , so do you have any diabetes or rheumatoid arthritis ? patient: nope . | D2N022 | 7 | [
"Personal History"
] | [
"Subjective"
] | well , um , so do you have any diabetes or rheumatoid arthritis ? | 597 |
doctor: uh , do you take any chronic medications of su- , significance ? patient: uh , i do take a blood pressure pill , and that's it . | D2N022 | 8 | [
"Therapeutic History"
] | [
"Subjective"
] | uh , do you take any chronic medications of su- , significance ? | 598 |
doctor: okay , and it looks like you suffer from itching with the methylprednisolone ? patient: uh , that's correct . | D2N022 | 9 | [
"Therapeutic History",
"Personal History"
] | [
"Subjective"
] | okay , and it looks like you suffer from itching with the methylprednisolone ? | 599 |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.