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doctor: the good news is injection given over time can slow the rate of the vision decline and maybe even stop it however i also have to let you know that there could be a situation where you may still note a small amount of vision loss but this is your best chance of maintaining that vision for as long as you can so i... | D2N203 | 14 | [
"Discussion",
"Medication"
] | [
"Plan"
] | the good news is injection given over time can slow the rate of the vision decline and maybe even stop it however i also have to let you know that there could be a situation where you may still note a small amount of vision loss but this is your best chance of maintaining that vision for as long as you can so i know i ... | 5,200 |
doctor: okay i think it's gon na be our best plan to help slow this disease process patient: okay | D2N203 | 15 | [
"Chitchat"
] | [
"Null"
] | okay i think it's gon na be our best plan to help slow this disease process | 5,201 |
doctor: alright so i'm gon na have the nurse come in and get you prepped and we're gon na go ahead and do the first injection today patient: okay okay | D2N203 | 16 | [
"Medication"
] | [
"Plan"
] | alright so i'm gon na have the nurse come in and get you prepped and we're gon na go ahead and do the first injection today | 5,202 |
doctor: sounds good i'll be back in a couple of minutes patient: okay thank you very much | D2N203 | 17 | [
"Chitchat"
] | [
"Null"
] | sounds good i'll be back in a couple of minutes | 5,203 |
doctor: thank you | D2N203 | 18 | [
"Chitchat"
] | [
"Null"
] | doctor: thank you | 5,204 |
doctor: okay well hi joe i understand you've hurt your knee how how are you doing patient: i'm doing okay this feels you know definitely feels like it's swollen and kinda hurts me a little bit | D2N204 | 0 | [
"Acute Symptoms",
"Greetings"
] | [
"Subjective"
] | okay well hi joe i understand you've hurt your knee how how are you doing | 5,205 |
doctor: so what did you do what happened patient: i was i was skiing with some with some friends and i was going down it was snowing pretty hard and i could n't really see as as the two paths kind of come came together and i the front end of the skis i kind of dug into the snow and i ended up basically doing a cart whe... | D2N204 | 1 | [
"Acute Symptoms"
] | [
"Subjective"
] | so what did you do what happened | 5,206 |
doctor: yeah that sounds painful and so when did this occur patient: it it occurred over the weekend on saturday | D2N204 | 2 | [
"Acute Symptoms"
] | [
"Subjective"
] | yeah that sounds painful and so when did this occur | 5,207 |
doctor: and have you been able to to walk at all at all or no patient: a a little bit but it's definitely swollen and it's definitely painful | D2N204 | 3 | [
"Acute Symptoms"
] | [
"Subjective"
] | and have you been able to to walk at all at all or no | 5,208 |
doctor: okay so what all have you been doing for the pain patient: just like taking some you know advil and then just icing you know icing on and off you know a little heat here and there just you know trying to comfort but that's about it | D2N204 | 4 | [
"Acute Symptoms",
"Therapeutic History"
] | [
"Subjective"
] | okay so what all have you been doing for the pain | 5,209 |
doctor: have you ever had any type of injury to your knee before and it is this the left or right knee patient: it's the right knee no it's the first time i've had any knee injuries | D2N204 | 5 | [
"Personal History"
] | [
"Subjective"
] | have you ever had any type of injury to your knee before and it is this the left or right knee | 5,210 |
doctor: okay alright let's see take anything for it okay well let's see let's just do a quick physical exam here so so your now your vitals those look alright your no fever you're at ninety seven . nine your heart rate is sixty four sounds healthy respirations are sixteen blood pressure is one ten over seventy four you... | D2N204 | 6 | [
"Physical Examination"
] | [
"Objective"
] | okay alright let's see take anything for it okay well let's see let's just do a quick physical exam here so so your now your vitals those look alright your no fever you're at ninety seven . nine your heart rate is sixty four sounds healthy respirations are sixteen blood pressure is one ten over seventy four your o2 sat... | 5,211 |
doctor: okay positive pain to palpation and let's bring your leg out are you having pain when with flexion or extension patient: a little bit no not not crazy real pain but there is definitely some pain there | D2N204 | 7 | [
"Physical Examination"
] | [
"Objective"
] | okay positive pain to palpation and let's bring your leg out are you having pain when with flexion or extension | 5,212 |
doctor: okay pain with flexion and extension and how about the range of motion having full range of motion here patient: yeah pretty much i can get the full range just feels a little tight and will hurt | D2N204 | 8 | [
"Physical Examination"
] | [
"Objective"
] | okay pain with flexion and extension and how about the range of motion having full range of motion here | 5,213 |
doctor: okay alright and for diagnostics so your x-ray so there's no fracture appreciated no bony abnormalities so that looks alright so let me tell you a little bit about my impression and plan with this so you have a knee contusion so for treatment we'll we need to rest that apply ice you know two three times a day f... | D2N204 | 9 | [
"Discussion",
"Medication",
"Radiology Examination",
"Referral",
"Acute Assessment"
] | [
"Objective",
"Assessment",
"Plan"
] | okay alright and for diagnostics so your x-ray so there's no fracture appreciated no bony abnormalities so that looks alright so let me tell you a little bit about my impression and plan with this so you have a knee contusion so for treatment we'll we need to rest that apply ice you know two three times a day for twent... | 5,214 |
doctor: okay let's venture a little bit more because i need five minutes so where so where were you skiing at patient: so i was actually up we actually took a trip up up north and i was in the i'm in mount saint helen and washington so i was just walking in myself going out and stuff but yeah it was it was a good trip ... | D2N204 | 10 | [
"Other Socials"
] | [
"Subjective"
] | okay let's venture a little bit more because i need five minutes so where so where were you skiing at | 5,215 |
doctor: well washington sounds nice i have n't been there but it sounds like it's pretty nice area to be in and they have a lot of maple syrup there do n't they produce a lot of maple syrup patient: they do they do have a lot of maple syrup and it's it's it's interesting that the the winter actually is n't their busies... | D2N204 | 11 | [
"Chitchat"
] | [
"Null"
] | well washington sounds nice i have n't been there but it sounds like it's pretty nice area to be in and they have a lot of maple syrup there do n't they produce a lot of maple syrup | 5,216 |
doctor: that sounds good now i also meant to ask you so when you did this cartwheel through the air did you have any other injuries to any other parts of your body anything else that you're having any issues with patient: my shoulder feels a little bruised | D2N204 | 12 | [
"Personal History"
] | [
"Subjective"
] | that sounds good now i also meant to ask you so when you did this cartwheel through the air did you have any other injuries to any other parts of your body anything else that you're having any issues with | 5,217 |
doctor: okay let's take a quick look yeah i do appreciate a little bit of bruising here are you having any problem raising it up or or with movement with your range of motion patient: once i raise it up though it's a it is a little little tender i can feel it being tender when i raise it up | D2N204 | 14 | [
"Physical Examination"
] | [
"Objective"
] | okay let's take a quick look yeah i do appreciate a little bit of bruising here are you having any problem raising it up or or with movement with your range of motion | 5,218 |
doctor: okay we'll just go ahead and get an x-ray of that right shoulder too just to be sure if you because who knows maybe you might have done something with that as well so we'll go ahead and have my nurse take you to do that and then we'll talk again alright patient: sounds great | D2N204 | 15 | [
"Diagnostic Testing"
] | [
"Plan"
] | okay we'll just go ahead and get an x-ray of that right shoulder too just to be sure if you because who knows maybe you might have done something with that as well so we'll go ahead and have my nurse take you to do that and then we'll talk again alright | 5,219 |
doctor: hey angela how are you patient: i'm good how are you | D2N205 | 0 | [
"Greetings"
] | [
"Subjective"
] | hey angela how are you | 5,220 |
doctor: i'm good so i see we are here you had a recent diagnosis of stage three nonsmol cell lung cancer and so we are following up on your neo adevant chemotherapy so you can you tell me how you're doing today patient: yeah you know i'm i'm doing okay i have a little bit of some shortness of breath that i noticed over... | D2N205 | 1 | [
"Personal History"
] | [
"Subjective"
] | i'm good so i see we are here you had a recent diagnosis of stage three nonsmol cell lung cancer and so we are following up on your neo adevant chemotherapy so you can you tell me how you're doing today | 5,221 |
doctor: okay yeah yeah i mean that's that's definitely understandable it says you had a four point four centimeter left upper lobe nodule in there so it's kinda big but that's understandable and we're doing the chemo to try to reduce that that that tumor that you do have so how often do you normally run with your dogs ... | D2N205 | 2 | [
"Other Socials"
] | [
"Subjective"
] | okay yeah yeah i mean that's that's definitely understandable it says you had a four point four centimeter left upper lobe nodule in there so it's kinda big but that's understandable and we're doing the chemo to try to reduce that that that tumor that you do have so how often do you normally run with your dogs | 5,222 |
doctor: man okay what kind of dog do you have patient: i have a dobrman | D2N205 | 3 | [
"Other Socials"
] | [
"Subjective"
] | man okay what kind of dog do you have | 5,223 |
doctor: yeah they are pretty active that makes sense alright so have you been coughing have you had any phlegm patient: i've been having a dry cough no phlegm | D2N205 | 4 | [
"Vegetative History"
] | [
"Subjective"
] | yeah they are pretty active that makes sense alright so have you been coughing have you had any phlegm | 5,224 |
doctor: okay have you noticed any fever patient: no fever | D2N205 | 5 | [
"Vegetative History"
] | [
"Subjective"
] | okay have you noticed any fever | 5,225 |
doctor: no fever alright what about any other symptoms like any body aches any sore throat sinus pain patient: well i mean now that you mentioned it like every time i swallow it hurts it does n't feel like i have a cold because it hurts down here more in my chest but every time i swallow it it's really painful | D2N205 | 6 | [
"Vegetative History"
] | [
"Subjective"
] | no fever alright what about any other symptoms like any body aches any sore throat sinus pain | 5,226 |
doctor: okay so when you are swallowing i know some of my patients feel this do you feel like the food is getting stuck patient: no the food is not getting stuck it just hurts | D2N205 | 7 | [
"Vegetative History"
] | [
"Subjective"
] | okay so when you are swallowing i know some of my patients feel this do you feel like the food is getting stuck | 5,227 |
doctor: okay what about when you're you're taking liquids are you able to take in both hydrocort liquids patient: i mean i definitely feel like over the weekend i have n't been taking it as much because it hurt so much but i i am able to i am able to drink and i've been taking ensure and things like that i had a milk s... | D2N205 | 8 | [
"Vegetative History"
] | [
"Subjective"
] | okay what about when you're you're taking liquids are you able to take in both hydrocort liquids | 5,228 |
doctor: okay that's that's that's that's good yeah we we definitely want you to to take in as much liquid as possible best especially since you're on the chemotherapy and the radiation just so you wo n't get dehydrated because that will make you feel a lot worse if you are dehydrated okay so on a on a mental emotional ... | D2N205 | 9 | [
"Other Socials"
] | [
"Subjective"
] | okay that's that's that's that's good yeah we we definitely want you to to take in as much liquid as possible best especially since you're on the chemotherapy and the radiation just so you wo n't get dehydrated because that will make you feel a lot worse if you are dehydrated okay so on a on a mental emotional standpoi... | 5,229 |
doctor: okay so how how are you feeling on your chemo see you're on a combination of sysplatin and a topicide you had your last dose a few days ago any nausea any fatigue from that patient: i was a little nauseated and tired but i took the zofran that you prescribed and that seemed to help and you know i i got some res... | D2N205 | 10 | [
"Therapeutic History"
] | [
"Subjective"
] | okay so how how are you feeling on your chemo see you're on a combination of sysplatin and a topicide you had your last dose a few days ago any nausea any fatigue from that | 5,230 |
doctor: okay that's good so let me do a quick physical exam on you just gon na check your vitals here so your vitals are normal your pulse ox is okay so everything's good with that so i'm gon na feel your neck on your neck exam i do n't appreciate any cervical lymphadenopathy no subclavicular adenopathy your heart exam... | D2N205 | 11 | [
"Physical Examination",
"Medication",
"Therapeutic History",
"Radiology Examination",
"Reassessment",
"Other Treatments"
] | [
"Subjective",
"Objective",
"Assessment",
"Plan"
] | okay that's good so let me do a quick physical exam on you just gon na check your vitals here so your vitals are normal your pulse ox is okay so everything's good with that so i'm gon na feel your neck on your neck exam i do n't appreciate any cervical lymphadenopathy no subclavicular adenopathy your heart exam regular... | 5,231 |
doctor: i mean and and i for you that's that that's for patients that you know who are on them for a a long period of time right you're only gon na be on it for five days that should n't affect you too bad you might feel when you coming off of it after the five days a few muscle aches other than that you should be fine... | D2N205 | 12 | [
"Discussion",
"Medication",
"Other Treatments",
"Reassessment"
] | [
"Assessment",
"Plan"
] | i mean and and i for you that's that that's for patients that you know who are on them for a a long period of time right you're only gon na be on it for five days that should n't affect you too bad you might feel when you coming off of it after the five days a few muscle aches other than that you should be fine you sho... | 5,232 |
doctor: alright so do you have any questions for me patient: no | D2N205 | 13 | [
"Discussion"
] | [
"Plan"
] | alright so do you have any questions for me | 5,233 |
doctor: alright so we will get you those medications those prescriptions and then we will see you back in two weeks patient: okay great thank you | D2N205 | 14 | [
"Follow-up"
] | [
"Plan"
] | alright so we will get you those medications those prescriptions and then we will see you back in two weeks | 5,234 |
doctor: thanks | D2N205 | 15 | [
"Chitchat"
] | [
"Null"
] | doctor: thanks | 5,235 |
doctor: hey joshua good to see you today so take a look at your chart here brenda and i see that you're coming in you you have i think you have a kidney stone so can you tell me what's going on how are you feeling and you're my my patient patient: and i'm your patient yeah | D2N206 | 0 | [
"Acute Symptoms",
"Greetings"
] | [
"Subjective"
] | hey joshua good to see you today so take a look at your chart here brenda and i see that you're coming in you you have i think you have a kidney stone so can you tell me what's going on how are you feeling and you're my my patient | 5,236 |
doctor: okay so is it is it a constant pain or does it come and go for you patient: it comes and goes it depends on how much i've been drinking and you know what sort of activities i've been doing but it's still there | D2N206 | 3 | [
"Acute Symptoms"
] | [
"Subjective"
] | okay so is it is it a constant pain or does it come and go for you | 5,237 |
doctor: alright so have you noticed any pain when you've been urinating patient: not really | D2N206 | 4 | [
"Vegetative History"
] | [
"Subjective"
] | alright so have you noticed any pain when you've been urinating | 5,238 |
doctor: okay have you noticed any blood in your urine patient: no blood i did have an episode where the pain radiated to one of my testicles which was kinda weird but but yeah it it sort of calmed down a little bit in that regards | D2N206 | 5 | [
"Vegetative History"
] | [
"Subjective"
] | okay have you noticed any blood in your urine | 5,239 |
doctor: okay have you taken anything for the pain patient: yeah i've been taking some ibuprofen and that kinda like calms it down a little bit but it persists | D2N206 | 6 | [
"Acute Symptoms",
"Therapeutic History"
] | [
"Subjective"
] | okay have you taken anything for the pain | 5,240 |
doctor: okay and what would you say like your pain score is out of ten patient: it's probably a four out of ten when it gets a little more out of control for the most part it's probably in the order of one or two out of ten | D2N206 | 7 | [
"Acute Symptoms"
] | [
"Subjective"
] | okay and what would you say like your pain score is out of ten | 5,241 |
doctor: okay so it is it's it's it's not too bad patient: it's a new ones yeah but i know it's there it does n't go away | D2N206 | 8 | [
"Acute Symptoms"
] | [
"Subjective"
] | okay so it is it's it's it's not too bad | 5,242 |
doctor: okay yeah yeah a lot of my patients you know have that that minor pain so you patient: i'm a horrible active by the way | D2N206 | 9 | [
"Acute Symptoms"
] | [
"Subjective"
] | okay yeah yeah a lot of my patients you know have that that minor pain so you | 5,243 |
doctor: no yeah that's that's that's totally fine that's totally fine you know i'm just playing the doctor on tv so good good alright so have you had any other symptoms nausea vomiting anything like that patient: no nausea no vomiting i had some i felt like it might have been like chills but no fevers nothing along tho... | D2N206 | 10 | [
"Vegetative History"
] | [
"Subjective"
] | no yeah that's that's that's totally fine that's totally fine you know i'm just playing the doctor on tv so good good alright so have you had any other symptoms nausea vomiting anything like that | 5,244 |
doctor: okay that's good do you know anybody in your family that has had kidney stones in the past patient: yeah all in my family has had kidney stones in the past | D2N206 | 11 | [
"Family History"
] | [
"Subjective"
] | okay that's good do you know anybody in your family that has had kidney stones in the past | 5,245 |
doctor: no well they did n't set you up good did they patient: yeah i i i guess i can blame them but but yeah it's been a it's been an issue with the family for as long as i've been aware of | D2N206 | 12 | [
"Family History"
] | [
"Subjective"
] | no well they did n't set you up good did they | 5,246 |
doctor: okay alright and i'm reading here it looks like you've had them before as well right patient: i have yeah i passed some by myself and i've had to have surgery a couple of times as well | D2N206 | 13 | [
"Personal History"
] | [
"Subjective"
] | okay alright and i'm reading here it looks like you've had them before as well right | 5,247 |
doctor: okay so the ones that you passed by yourself how many days would you say it would take to to pass patient: usually within within a week i manage to to get them out | D2N206 | 14 | [
"Personal History"
] | [
"Subjective"
] | okay so the ones that you passed by yourself how many days would you say it would take to to pass | 5,248 |
doctor: okay alright so you got anything fun plan for the weekend patient: just getting this pain under control | D2N206 | 15 | [
"Other Socials"
] | [
"Subjective"
] | okay alright so you got anything fun plan for the weekend | 5,249 |
doctor: okay well that that sounds like a good plan we can definitely help you out with that alright so i'm gon na do a quick physical exam on you looks like your blood pressure is a little bit elevated and i think that's probably because you're in pain and that's understandable everything else looks fine so on pressin... | D2N206 | 16 | [
"Physical Examination"
] | [
"Objective"
] | okay well that that sounds like a good plan we can definitely help you out with that alright so i'm gon na do a quick physical exam on you looks like your blood pressure is a little bit elevated and i think that's probably because you're in pain and that's understandable everything else looks fine so on pressing on you... | 5,250 |
doctor: alright so press here in the back and your cva does that back here in patient: yeah it's a little tender yeah it's little tender | D2N206 | 17 | [
"Physical Examination"
] | [
"Objective"
] | alright so press here in the back and your cva does that back here in | 5,251 |
doctor: okay so on your physical exam there seems to be no tenderness to palpation of your abdomen there is cva tenderness on your your right side here and that's due to that kidney stone so we did get a a ct scan before you came in so it does show that you have a stone measuring point five centimeters in size located ... | D2N206 | 18 | [
"Physical Examination",
"Discussion",
"Medication",
"Radiology Examination",
"Reassessment"
] | [
"Objective",
"Assessment",
"Plan"
] | okay so on your physical exam there seems to be no tenderness to palpation of your abdomen there is cva tenderness on your your right side here and that's due to that kidney stone so we did get a a ct scan before you came in so it does show that you have a stone measuring point five centimeters in size located on the p... | 5,252 |
doctor: okay so i can prescribe you some tramadol you know that should help fifty milligrams that should help you out if you do have any of that pain if you get any breakthrough pain from that you can take that ibuprofen it should help you you know with everything and hopefully you can get through that weekend i know y... | D2N206 | 19 | [
"Discussion",
"Medication"
] | [
"Plan"
] | okay so i can prescribe you some tramadol you know that should help fifty milligrams that should help you out if you do have any of that pain if you get any breakthrough pain from that you can take that ibuprofen it should help you you know with everything and hopefully you can get through that weekend i know you went ... | 5,253 |
doctor: okay so continue to use the strainer whenever you urinate so hopefully we can catch the stone i'm also gon na order a bmp a urinalysis and urine culture and based on what that shows we can see if we need to put you on any antibiotics i do n't think you have an infection but you know there is that possibility an... | D2N206 | 20 | [
"Follow-up",
"Medication",
"Diagnostic Testing"
] | [
"Plan"
] | okay so continue to use the strainer whenever you urinate so hopefully we can catch the stone i'm also gon na order a bmp a urinalysis and urine culture and based on what that shows we can see if we need to put you on any antibiotics i do n't think you have an infection but you know there is that possibility and then i... | 5,254 |
doctor: what that is okay so do you have any other questions for me patient: no i'm friend | D2N206 | 21 | [
"Discussion"
] | [
"Plan"
] | what that is okay so do you have any other questions for me | 5,255 |
doctor: alright so i'll see you again in two weeks i'll have my nurse come in and bring you that prescription for the tramadol and i think we are all good patient: perfect thank you | D2N206 | 22 | [
"Follow-up"
] | [
"Plan"
] | alright so i'll see you again in two weeks i'll have my nurse come in and bring you that prescription for the tramadol and i think we are all good | 5,256 |
doctor: alright great | D2N206 | 23 | [
"Chitchat"
] | [
"Null"
] | doctor: alright great | 5,257 |
doctor: hi frank how are you i heard the medical assistant told me that you're having some shortness of breath patient: i am i am i am okay i am not great | D2N207 | 0 | [
"Acute Symptoms",
"Greetings"
] | [
"Subjective"
] | hi frank how are you i heard the medical assistant told me that you're having some shortness of breath | 5,258 |
doctor: you are okay you are not great okay well how long have you been having some shortness of breath patient: it's been about a week | D2N207 | 1 | [
"Acute Symptoms"
] | [
"Subjective"
] | you are okay you are not great okay well how long have you been having some shortness of breath | 5,259 |
doctor: it's been about a week okay now have you ever experienced these symptoms before patient: yeah this happened about six months ago and i came in and they changed my lasix dose and i seemed to get better | D2N207 | 2 | [
"Personal History"
] | [
"Subjective"
] | it's been about a week okay now have you ever experienced these symptoms before | 5,260 |
doctor: okay alright so let's talk a little bit about that now i know that you have a history of coronary disease you know you had had a heart attack back in twenty eighteen we put that stent in your right coronary artery i know that the pumping function of your heart was a little low you know that what we call that ej... | D2N207 | 3 | [
"Personal History"
] | [
"Subjective"
] | okay alright so let's talk a little bit about that now i know that you have a history of coronary disease you know you had had a heart attack back in twenty eighteen we put that stent in your right coronary artery i know that the pumping function of your heart was a little low you know that what we call that ejection f... | 5,261 |
doctor: okay alright now have you noticed any swelling in your legs patient: yes definitely | D2N207 | 4 | [
"Vegetative History"
] | [
"Subjective"
] | okay alright now have you noticed any swelling in your legs | 5,262 |
doctor: okay and are you taking the lasix now i know that we had increased it to about forty milligrams once a day are you taking it patient: yeah i take it everyday | D2N207 | 5 | [
"Therapeutic History"
] | [
"Subjective"
] | okay and are you taking the lasix now i know that we had increased it to about forty milligrams once a day are you taking it | 5,263 |
doctor: you take it everyday okay do you notice that you're urinating any less recently patient: no it seems about the same | D2N207 | 6 | [
"Vegetative History"
] | [
"Subjective"
] | you take it everyday okay do you notice that you're urinating any less recently | 5,264 |
doctor: okay alright and do you feel short of breath at rest or is it mostly when you're just walking around patient: walking around stairs in particular walking quickly | D2N207 | 8 | [
"Vegetative History"
] | [
"Subjective"
] | okay alright and do you feel short of breath at rest or is it mostly when you're just walking around | 5,265 |
doctor: okay and how about when you're sleeping at night are you able to lay flat or do you have to sit up a little bit patient: i gone from one pillow to two pillows | D2N207 | 9 | [
"Other Socials"
] | [
"Subjective"
] | okay and how about when you're sleeping at night are you able to lay flat or do you have to sit up a little bit | 5,266 |
doctor: okay alright and do you ever wake up really short of breath does it ever wake you up patient: it did that six months ago it has not done that so far this time | D2N207 | 10 | [
"Vegetative History"
] | [
"Subjective"
] | okay alright and do you ever wake up really short of breath does it ever wake you up | 5,267 |
doctor: okay alright now tell me a little bit about when was the last time you saw your nephrologist patient: about about a month ago | D2N207 | 11 | [
"Personal History"
] | [
"Subjective"
] | okay alright now tell me a little bit about when was the last time you saw your nephrologist | 5,268 |
doctor: okay because as you know you know we we do talk about the fact that you have some kidney dysfunction about stage three so it's gon na be important for you to continue to follow up with your kidney doctor now are you how are you doing staying away from things like motrin and advil i know that you had had some kn... | D2N207 | 12 | [
"Personal History",
"Therapeutic History"
] | [
"Subjective"
] | okay because as you know you know we we do talk about the fact that you have some kidney dysfunction about stage three so it's gon na be important for you to continue to follow up with your kidney doctor now are you how are you doing staying away from things like motrin and advil i know that you had had some knee pain ... | 5,269 |
doctor: okay now are you able to take tylenol do you not feel any relief from tylenol when you take it patient: yeah tylenol's lovely it just is not very effective | D2N207 | 13 | [
"Therapeutic History"
] | [
"Subjective"
] | okay now are you able to take tylenol do you not feel any relief from tylenol when you take it | 5,270 |
doctor: okay alright yeah because i think we really want you to stay away from that those anti-inflammatories because that can make your kidney function worse and obviously you know we do n't wan na see you go on dialysis or anything like that so we'll have patient: mean neither | D2N207 | 14 | [
"Therapeutic History"
] | [
"Subjective"
] | okay alright yeah because i think we really want you to stay away from that those anti-inflammatories because that can make your kidney function worse and obviously you know we do n't wan na see you go on dialysis or anything like that so we'll have | 5,271 |
doctor: right so we'll have to you know really work on that now tell me a little bit about are you watching the potassium and stuff in your diet patient: nobody's really talked to me about that so | D2N207 | 15 | [
"Personal History"
] | [
"Subjective"
] | right so we'll have to you know really work on that now tell me a little bit about are you watching the potassium and stuff in your diet | 5,272 |
doctor: okay yeah so you want patient: i did n't know what high potassium foods are | D2N207 | 16 | [
"Vegetative History"
] | [
"Subjective"
] | okay yeah so you want | 5,273 |
doctor: okay i'm sorry i've never talked to you about that in the past i that's my fault so yeah so you wan na make sure you stay away from things like bananas oranges you know potatoes have lots of potassium that type of thing and so you know because with your kidney function you know that can cause your potassium lev... | D2N207 | 17 | [
"Vegetative History"
] | [
"Subjective"
] | okay i'm sorry i've never talked to you about that in the past i that's my fault so yeah so you wan na make sure you stay away from things like bananas oranges you know potatoes have lots of potassium that type of thing and so you know because with your kidney function you know that can cause your potassium levels to g... | 5,274 |
doctor: what's that patient: is there anything left is there anything left over that i ca n't eat | D2N207 | 18 | [
"Vegetative History"
] | [
"Subjective"
] | what's that | 5,275 |
doctor: so yeah you can eat you know how about this how about we give you a a referral to a dietitian and they can help you with that patient: sounds good | D2N207 | 19 | [
"Referral",
"Other Treatments"
] | [
"Plan"
] | so yeah you can eat you know how about this how about we give you a a referral to a dietitian and they can help you with that | 5,276 |
doctor: now are you watching the nba playoff should i or should i not bring that up i is that a sensitive subject i mean i'm a self expand and and we did sweep the nuts so patient: yeah well i mean that's fan and i could n't sleep last night but you know | D2N207 | 20 | [
"Chitchat"
] | [
"Null"
] | now are you watching the nba playoff should i or should i not bring that up i is that a sensitive subject i mean i'm a self expand and and we did sweep the nuts so | 5,277 |
doctor: okay well maybe we should n't talk about patient: kinda used to it you know where they where the favorite to win and then like that | D2N207 | 21 | [
"Chitchat"
] | [
"Null"
] | okay well maybe we should n't talk about | 5,278 |
doctor: yeah i know i i i will say i think jason tatum and jaylen brown paid played phenomenally so i do think that they help with the cell fix over the edge so but that's all we'll talk about that what's that patient: i said yeah too bad they did | D2N207 | 22 | [
"Chitchat"
] | [
"Null"
] | yeah i know i i i will say i think jason tatum and jaylen brown paid played phenomenally so i do think that they help with the cell fix over the edge so but that's all we'll talk about that what's that | 5,279 |
doctor: yeah alright well i wan na just go ahead and do a quick physical exam on you okay so you know looking at your vital signs here in the office you know your your blood pressure is about one thirty five over eighty so it's it's not too bad and maybe like to see it a little bit lower i'm just gon na be calling out ... | D2N207 | 23 | [
"Physical Examination",
"Medication",
"Other Treatments",
"Acute Assessment"
] | [
"Objective",
"Assessment",
"Plan"
] | yeah alright well i wan na just go ahead and do a quick physical exam on you okay so you know looking at your vital signs here in the office you know your your blood pressure is about one thirty five over eighty so it's it's not too bad and maybe like to see it a little bit lower i'm just gon na be calling out my physi... | 5,280 |
doctor: how about you start taking the the increased dose in the morning and then we'll see how you do and if necessary i'll have to add a second dose in the afternoon that you can take around four o'clock in the afternoon i do n't want you to take it too late at night because then you will be going to the bathroom all... | D2N207 | 24 | [
"Discussion",
"Medication"
] | [
"Plan"
] | how about you start taking the the increased dose in the morning and then we'll see how you do and if necessary i'll have to add a second dose in the afternoon that you can take around four o'clock in the afternoon i do n't want you to take it too late at night because then you will be going to the bathroom all night o... | 5,281 |
doctor: so i also want to go ahead and order a chest x-ray just to make sure that we are not missing anything else okay for your second problem of your coronary artery disease you know it sounds like you're doing well except for this heart failure exacerbation so i wan na go ahead and order another echocardiogram to ch... | D2N207 | 25 | [
"Discussion",
"Medication",
"Diagnostic Testing",
"Reassessment"
] | [
"Assessment",
"Plan"
] | so i also want to go ahead and order a chest x-ray just to make sure that we are not missing anything else okay for your second problem of your coronary artery disease you know it sounds like you're doing well except for this heart failure exacerbation so i wan na go ahead and order another echocardiogram to check out ... | 5,282 |
doctor: well how long have you been having it how long you've been having that foot pain patient: that's why i took the motrin it lasted you know four five days slowly went away | D2N207 | 26 | [
"Personal History"
] | [
"Subjective"
] | well how long have you been having it how long you've been having that foot pain | 5,283 |
doctor: it was in both of your feet patient: one | D2N207 | 27 | [
"Personal History"
] | [
"Subjective"
] | it was in both of your feet | 5,284 |
doctor: one and where in your foot was was it patient: just in front of the big toe | D2N207 | 28 | [
"Personal History"
] | [
"Subjective"
] | one and where in your foot was was it | 5,285 |
doctor: just in front of the big toe okay have you ever had a history of gout patient: nobody has told me about that | D2N207 | 29 | [
"Personal History"
] | [
"Subjective"
] | just in front of the big toe okay have you ever had a history of gout | 5,286 |
doctor: okay alright well it sounds like it could've been gout you know with your chronic kidneys chronic kidney disease it it's a possibility so for this possible gout flare for your fourth problem of your possible gout flare let's go ahead i wan na just go ahead and order a uric acid just to see and it's something th... | D2N207 | 30 | [
"Discussion",
"Medication",
"Diagnostic Testing",
"Reassessment"
] | [
"Assessment",
"Plan"
] | okay alright well it sounds like it could've been gout you know with your chronic kidneys chronic kidney disease it it's a possibility so for this possible gout flare for your fourth problem of your possible gout flare let's go ahead i wan na just go ahead and order a uric acid just to see and it's something that we ca... | 5,287 |
doctor: okay any other questions patient: just as long as you think i'm gon na get better | D2N207 | 31 | [
"Discussion"
] | [
"Plan"
] | okay any other questions | 5,288 |
doctor: i think you're gon na get better yes i think we're gon na you know i really want you to watch your salt intake and i'm gon na go ahead and order that dietary dietitian referral so that you can get your diet under control but you really have to watch your salt intake i think that that's kind of what this heart f... | D2N207 | 32 | [
"Discussion",
"Referral",
"Other Treatments"
] | [
"Plan"
] | i think you're gon na get better yes i think we're gon na you know i really want you to watch your salt intake and i'm gon na go ahead and order that dietary dietitian referral so that you can get your diet under control but you really have to watch your salt intake i think that that's kind of what this heart failure e... | 5,289 |
doctor: okay anything else patient: yeah no that's good thank you | D2N207 | 33 | [
"Discussion"
] | [
"Plan"
] | okay anything else | 5,290 |
doctor: okay you're welcome bye | D2N207 | 34 | [
"Chitchat"
] | [
"Null"
] | doctor: okay you're welcome bye | 5,291 |
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