DATEXIS/med_intent_classification · Datasets at Hugging Face

text stringlengths 6 3.62k	intents listlengths 1 9	sections listlengths 1 4	__index_level_0__ int64 0 3.89k
alright did we use proper lifting technique do you wonder	[ "Acute Symptoms" ]	[ "Subjective" ]	1,700
everything's okay ?	[ "Personal History" ]	[ "Subjective" ]	1,701
okay , and where are you hurting ? can you show me ?	[ "Acute Symptoms" ]	[ "Subjective" ]	1,702
okay , good . are you doing the blood pressure checks at home ?	[ "Personal History" ]	[ "Subjective" ]	1,703
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 .	[ "Discussion", "Follow-up" ]	[ "Plan" ]	1,704
a deep achy pain okay what kind of activities makes the pain feel worse	[ "Acute Symptoms" ]	[ "Subjective" ]	1,705
all right . and anything make it better or worse ?	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	1,706
you're welcome	[ "Chitchat" ]	[ "Null" ]	1,707
okay . all right , well , let's go ahead to a physical exam , okay ?	[ "Physical Examination" ]	[ "Objective" ]	1,708
okay alright and are you able to bend it	[ "Acute Symptoms" ]	[ "Subjective" ]	1,709
no chest pain are you having any belly pain	[ "Acute Symptoms" ]	[ "Subjective" ]	1,710
all right . so it's your right elbow ?	[ "Acute Symptoms" ]	[ "Subjective" ]	1,711
doctor: okay . hey , dragon , finalize the note .	[ "Chitchat" ]	[ "Null" ]	1,712
okay . 'cause we do n't wan na end up in the hospitaltoo	[ "Chitchat" ]	[ "Null" ]	1,713
okay . all right .and then in terms of your blood pressure , how are you doing ?	[ "Personal History" ]	[ "Subjective" ]	1,714
uh , i do see that . like i said , the only way to really fix that is to cut it out .	[ "Discussion", "Other Treatments" ]	[ "Plan" ]	1,715
okay alright well let's go ahead i wan na just do a quick physical exam now i'm gon na be calling out some of my findings and i'm gon na let you know what that means when i'm done okay so looking here first at your vital signs your vital signs look pretty good you do have a low-grade fever of about a hundred . four right now but otherwise your blood pressure is pretty good it's about one thirty two over eighty and your heart rate is eighty four now that looks pretty good so i'm just gon na go ahead and examine you so on your facial exam i'm gon na just press on your face here does this hurt	[ "Physical Examination" ]	[ "Objective" ]	1,716
your diabetes is n't going so low right now so stay away from the strawberries because that's a lot of sugar you'll need that	[ "Discussion", "Other Treatments" ]	[ "Plan" ]	1,717
you take that once daily and that's gon na help decrease the occurrences of your asthma	[ "Discussion", "Medication" ]	[ "Plan" ]	1,718
welcome to the gi specialty clinic .	[ "Chitchat" ]	[ "Null" ]	1,719
and you're going to have to take off work . um , if your symptoms worsen , i want you to call me .	[ "Follow-up", "Other Treatments" ]	[ "Plan" ]	1,720
okay and have you been able to walk on it at all	[ "Acute Symptoms" ]	[ "Subjective" ]	1,721
hi logan . how are you ?	[ "Greetings" ]	[ "Subjective" ]	1,722
i see . okay . well then do what feels good . if you do notice that you're starting to get dry , then reduce to once per day .	[ "Discussion", "Medication" ]	[ "Plan" ]	1,723
okay alright well that that sounds good so today is thursday so what do you have for the weekend	[ "Other Socials" ]	[ "Subjective" ]	1,724
okay . so , um , on my physical exam , your lungs are clear . your heart is , is regular . you do have a grade two systolic ejection murmur . we've had that before , so nothing new-	[ "Physical Examination" ]	[ "Objective" ]	1,725
my goodness . wow . i am so sorry to hear that , um , but thank you so much for ... you know , all of these bits and pieces really help knit up a story together for ashley so we can get her the best care .	[ "Chitchat" ]	[ "Null" ]	1,726
if you need some , uh , just let me know .	[ "Chitchat" ]	[ "Null" ]	1,727
okay . and how about when you bend the knee like this ?	[ "Physical Examination" ]	[ "Objective" ]	1,728
once the rash stops , you can stop the tacrolimus ointment . um , continue doxycycline another week and then stop . but you can keep using the wash and the metro cream .	[ "Medication" ]	[ "Plan" ]	1,729
and it looks like your kidney function is also very good . so i'm , i'm very happy about that .	[ "Lab Examination" ]	[ "Objective" ]	1,730
hey , dragon . order an autoimmune panel . for your next problem , the coronary artery disease , i think you're doing really well , your ekg looks good , your vital signs look good .	[ "Discussion", "Diagnostic Testing" ]	[ "Plan" ]	1,731
. blood pressure go up . let's look at the readings . hey dragon ? show me the blood pressure readings . yeah ... yeah you know they do run a little bit on the high side , so we'll have to address that as well .	[ "Physical Examination" ]	[ "Objective" ]	1,732
we'll definitely get those tests	[ "Chitchat" ]	[ "Null" ]	1,733
okay . well , salt does have a tendency to make your body hold on to water , reducing your salt intake could help with some of the swelling . you can also prop your feet up any time you get a chance , especially at night . and have you talked to your private care doctor about this at all ?	[ "Discussion", "Other Treatments" ]	[ "Plan" ]	1,734
okay are you still getting that numbing and tingling periodically in your feet or is that completely gone	[ "Acute Symptoms" ]	[ "Subjective" ]	1,735
hey gregory good to see you today so take a look at my notes and i see that you're here you've had a nonhealing foot ulcer so can you tell me how you're doing how long have you had it what's going on with it	[ "Personal History", "Greetings" ]	[ "Subjective" ]	1,736
it has okay alright and any other symptoms like a cough or shortness of breath or dizziness or anything like that	[ "Personal History", "Vegetative History" ]	[ "Subjective" ]	1,737
okay so do you think you would be able to get that under control by yourself or would you do you think you would need help with that maybe a dietitian be able to help you out	[ "Discussion", "Other Treatments" ]	[ "Plan" ]	1,738
okay okay and when does that numbness and tingling do you get a lot of pain with it first let me ask that question	[ "Acute Symptoms", "Vegetative History" ]	[ "Subjective" ]	1,739
um , so this happened , what ? like 12 hours ago now ?	[ "Acute Symptoms" ]	[ "Subjective" ]	1,740
are you having any side effects from the medications at all ?	[ "Therapeutic History" ]	[ "Subjective" ]	1,741
okay , all right . and then for your last problem your hypertension , you know , again i , i , i think it's out of control . but we'll see , i think , you know , i'd like to see you take the lisinopril as directed , okay ? uh , i want you to record your blood pressures within the patient , you know , take your blood pressure every day . record them to me for like , about a week , so i have to see if we have to add another agent , okay ? 'cause we need to get that under better control for your heart failure to be more successful , okay ?	[ "Discussion", "Medication" ]	[ "Assessment", "Plan" ]	1,742
but i have n't seen a lot of data on the impact on cholesterol . regardless , we will take it .	[ "Lab Examination" ]	[ "Objective" ]	1,743
what what happened to your ankle	[ "Acute Symptoms" ]	[ "Subjective" ]	1,744
so have you had any let's get back to the exam here have you had a recent mri of your brain i saw one from a few years ago but as doctor white said anything about getting a more a recent mri	[ "Personal History" ]	[ "Subjective" ]	1,745
yeah . so i was reading about this syndrome that i actually have never heard of .	[ "Chitchat" ]	[ "Null" ]	1,746
wow okay and do you know if there was any direct or associated trauma that you can think of over the past three weeks like did you fall or hit your shoulder or anything	[ "Acute Symptoms" ]	[ "Subjective" ]	1,747
okay . great . let's do the exam . all right , so your physical exam looks pretty normal other than you've got kind of these mild wheezes in all your lung fields . and so i think you do have copd from your pulmonary function tests , your x-ray , and that . so i'm gon na diagnose you with copd . chronic obstructive pulmonary disease . it means you're not able to exhale appropriately .	[ "Physical Examination", "Acute Assessment" ]	[ "Objective", "Assessment" ]	1,748
it actually will help with both .	[ "Discussion", "Medication" ]	[ "Plan" ]	1,749
i hope you do n't either one of the things that we get concerned about with an anti-inflammatory like that is that it can irritate the stomach so if you do start to notice that you're getting heartburn or pain right there	[ "Discussion" ]	[ "Plan" ]	1,750
okay have you taken anything for the pain	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	1,751
mm-hmm	[ "Acute Symptoms" ]	[ "Subjective" ]	1,752
no yeah detroit is a hockey town yeah the red wings okay well i'm gon na go ahead and i'll send my nurse in and go ahead and get you discharged and like i said i'd like to see you back here in seven to ten days after that first physical therapy appointment i've got a great phenomenal office staff you just call in once that gets scheduled they will get you in to that next available appointment so take care and i will talk to you later	[ "Follow-up", "Referral" ]	[ "Plan" ]	1,753
good . okay let me take a peek in your nose . all right , good . you can put your mask back on .	[ "Physical Examination" ]	[ "Objective" ]	1,754
okay . have you ever had an upper endoscopy ?	[ "Personal History" ]	[ "Subjective" ]	1,755
okay . hey , dragon , order lisinopril , 10 milligrams daily . do you have any questions ?	[ "Discussion", "Medication" ]	[ "Plan" ]	1,756
okay i you know i'm i'm just thinking you know i need to get some new shoes for some of it my activities i love the i wish i could play basketball but i do a lot of bike riding so i'm always looking for anything that's gon na help me on the bike do you does your family have supplies like that	[ "Chitchat" ]	[ "Null" ]	1,757
any other symptoms , you know , chest pain , shortness of breath , abdominal pain , nausea or vomiting ?	[ "Vegetative History" ]	[ "Subjective" ]	1,758
okay alright so okay so now i i wan na go ahead and do my physical exam i'm gon na call out some of my findings just to make sure that i'm documenting everything and if you have any questions about what it is that i'm saying please feel free to ask okay	[ "Chitchat" ]	[ "Null" ]	1,759
so what part of your elbow would you say hurts	[ "Acute Symptoms" ]	[ "Subjective" ]	1,760
okay that's good so the tylenol really does help you that that's a good thing	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	1,761
you're going to hear me describe things in detail or repeat things as i go to reference later for my notes .	[ "Chitchat" ]	[ "Null" ]	1,762
okay . so , no vision problems .	[ "Personal History" ]	[ "Subjective" ]	1,763
any questions	[ "Discussion" ]	[ "Plan" ]	1,764
you know , let's see how we do over the next couple weeks , and again , we'll refer you to physical therapy if we need to , okay ?	[ "Follow-up" ]	[ "Plan" ]	1,765
okay . so i've found the cream form . we could try ointment form .	[ "Discussion", "Medication" ]	[ "Plan" ]	1,766
okay and i know it got real bad about a month ago that's what the report here from the pcp said but can you tell me exactly where the pain is in your lower back can you kinda point to where that's at	[ "Acute Symptoms" ]	[ "Subjective" ]	1,767
doctor: right trigger finger injection template . attempted to inject one cc of celestone with f- , a half a cc of lidocaine . however , the patient had a dramatic and violent painful reaction to the introduction of the needle , with contortions of the hand , and with dangerously withdrawing the hand with concerns for secondary needle stick . needle was withdrawn . the patient was counseled as to the importance of attempting to get some therapeutic steroid in the flexor tendon sheath . we attempted a second time for a similar injection using the same technique with one cc of celestone and half a cc of lidocaine . a small parma- , uh , palmar vein bled a scant amount , which was cleaned up and band-aid applied . reassured on multiple occasions that no harm was done to his finger . recommended icing in it this evening , and taking ibuprofen .	[ "Medication", "Discussion" ]	[ "Plan" ]	1,768
okay , so in physical exam your heart has a slight three out of six systolic ejection murmur , which we've heard before . your lungs are nice and clear , uh , i do n't appreciate any carotid bruits , and- and you have no lower extremity edema , you have healed , uh , surgical scars on your- on your , uh , right wrist . um , so let's go ahead , i wan na look at some of your results , okay ?	[ "Physical Examination" ]	[ "Objective" ]	1,769
mm-hmm okay alright and are you able to lift up your shoulder so that your shoulder touches your ear at all	[ "Acute Symptoms" ]	[ "Subjective" ]	1,770
right , does that make sense ?	[ "Chitchat" ]	[ "Null" ]	1,771
you may wan na check that but okay so that's good but i what i'd like you to do with that is i'd like you to keep a record of them for me for my next visit with you so let's talk a little bit about your diet tell me how how is your diet what what are the what kind of foods do you like what do you eat normally	[ "Personal History" ]	[ "Subjective" ]	1,772
pain with palpation to the left side around the l5 how about on the right side	[ "Physical Examination" ]	[ "Objective" ]	1,773
alright so any other questions	[ "Discussion" ]	[ "Plan" ]	1,774
yeah . you can certainly take them , you know , all at the same time , as long , as yeah , they're all one scale . you can take them all at the same time . just set an alarm-	[ "Discussion", "Medication" ]	[ "Plan" ]	1,775
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 .	[ "Discussion", "Medication" ]	[ "Plan" ]	1,776
is that what it looked like ?	[ "Acute Symptoms" ]	[ "Subjective" ]	1,777
ah , big family then . that's nice .	[ "Chitchat" ]	[ "Null" ]	1,778
below your your sternum you would need to stop taking the medicine and give me a call	[ "Discussion" ]	[ "Plan" ]	1,779
okay . um , and , and are you having any pain in your sinuses ? or , any post nasal drip ?	[ "Acute Symptoms" ]	[ "Subjective" ]	1,780
okay alright and how is positioning for you does any sitting in any particular position hurt more or hurt less	[ "Acute Symptoms" ]	[ "Subjective" ]	1,781
that's it ? and is it still painful ?	[ "Acute Symptoms" ]	[ "Subjective" ]	1,782
. family .	[ "Other Socials" ]	[ "Subjective" ]	1,783
hey diana it's good to see you in here so i see that you injured your wrist could you tell me a bit about what happened	[ "Acute Symptoms", "Greetings" ]	[ "Subjective" ]	1,784
yep yep agreed agreed and so well listen we'll we'll hopefully get you feeling better here and get you back out on the court and out on the course and we'll talk about that but let's let me ask you about your diabetes a little bit a little bit here so how have your blood sugars been running mark have they been what in the low one hundreds two hundreds where are they	[ "Personal History" ]	[ "Subjective" ]	1,785
i mean , out of known risks associated with medications , topicals are usually safer and preferable to oral medications . with that being said , doxycycline is low risk .	[ "Discussion", "Medication" ]	[ "Plan" ]	1,786
okay and did it was it swollen afterwards or is it looks a little bit swollen right now	[ "Acute Symptoms" ]	[ "Subjective" ]	1,787
when you say , " wipe your face in the morning , " do you use a product or just water ?	[ "Therapeutic History" ]	[ "Subjective" ]	1,788
okay and so does the pain move anywhere like your upper back your shoulder	[ "Acute Symptoms" ]	[ "Subjective" ]	1,789
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 .	[ "Personal History" ]	[ "Subjective" ]	1,790
all right . so the patient is alert and cooperative , appears stated age . all right . i'm going to listen to your heart and lungs . and lungs are clear to auscultation bilaterally . heart regular rate and rhythm . all right , so if you could just lay back for me , and i'll examine your abdomen .	[ "Physical Examination" ]	[ "Objective" ]	1,791
okay , and are you taking any medications for that ?	[ "Therapeutic History" ]	[ "Subjective" ]	1,792
okay okay and so so dad how often are you seeing the twitch on karen	[ "Acute Symptoms" ]	[ "Subjective" ]	1,793
okay alright alright so looking at your vital signs here in the office you know they look really good your you you do n't have any temperature your blood pressure is good it's about one seventeen over fifty six	[ "Physical Examination" ]	[ "Objective" ]	1,794
okay , so she has pain- to palpation of the olecranon bursa and pain with pronation and supination . and when you flex- and when you bend it and straighten it , does that hurt ?	[ "Physical Examination" ]	[ "Objective" ]	1,795
any dizziness	[ "Vegetative History" ]	[ "Subjective" ]	1,796
okay and i know this sounds like a weird question but i do need to know do you experience any loss of control of your bladder or bowels	[ "Vegetative History" ]	[ "Subjective" ]	1,797
okay so were you ever told in the past that you have hepatitis c	[ "Personal History" ]	[ "Subjective" ]	1,798
all right i'll have you take this to the front and i'm gon na say four months re-check for asthma and we'll repeat the spirometer- spirometry at that time .	[ "Follow-up", "Diagnostic Testing" ]	[ "Plan" ]	1,799

alright did we use proper lifting technique do you wonder

[ "Acute Symptoms" ]

[ "Subjective" ]

1,700

everything's okay ?

[ "Personal History" ]

[ "Subjective" ]

1,701

okay , and where are you hurting ? can you show me ?

[ "Acute Symptoms" ]

[ "Subjective" ]

1,702

okay , good . are you doing the blood pressure checks at home ?

[ "Personal History" ]

[ "Subjective" ]

1,703

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 .

[ "Discussion", "Follow-up" ]

[ "Plan" ]

1,704

a deep achy pain okay what kind of activities makes the pain feel worse

[ "Acute Symptoms" ]

[ "Subjective" ]

1,705

all right . and anything make it better or worse ?

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

1,706

you're welcome

[ "Chitchat" ]

[ "Null" ]

1,707

okay . all right , well , let's go ahead to a physical exam , okay ?

[ "Physical Examination" ]

[ "Objective" ]

1,708

okay alright and are you able to bend it

[ "Acute Symptoms" ]

[ "Subjective" ]

1,709

no chest pain are you having any belly pain

[ "Acute Symptoms" ]

[ "Subjective" ]

1,710

all right . so it's your right elbow ?

[ "Acute Symptoms" ]

[ "Subjective" ]

1,711

doctor: okay . hey , dragon , finalize the note .

[ "Chitchat" ]

[ "Null" ]

1,712

okay . 'cause we do n't wan na end up in the hospitaltoo

[ "Chitchat" ]

[ "Null" ]

1,713

okay . all right .and then in terms of your blood pressure , how are you doing ?

[ "Personal History" ]

[ "Subjective" ]

1,714

uh , i do see that . like i said , the only way to really fix that is to cut it out .

[ "Discussion", "Other Treatments" ]

[ "Plan" ]

1,715

okay alright well let's go ahead i wan na just do a quick physical exam now i'm gon na be calling out some of my findings and i'm gon na let you know what that means when i'm done okay so looking here first at your vital signs your vital signs look pretty good you do have a low-grade fever of about a hundred . four right now but otherwise your blood pressure is pretty good it's about one thirty two over eighty and your heart rate is eighty four now that looks pretty good so i'm just gon na go ahead and examine you so on your facial exam i'm gon na just press on your face here does this hurt

[ "Physical Examination" ]

[ "Objective" ]

1,716

your diabetes is n't going so low right now so stay away from the strawberries because that's a lot of sugar you'll need that

[ "Discussion", "Other Treatments" ]

[ "Plan" ]

1,717

you take that once daily and that's gon na help decrease the occurrences of your asthma

[ "Discussion", "Medication" ]

[ "Plan" ]

1,718

welcome to the gi specialty clinic .

[ "Chitchat" ]

[ "Null" ]

1,719

and you're going to have to take off work . um , if your symptoms worsen , i want you to call me .

[ "Follow-up", "Other Treatments" ]

[ "Plan" ]

1,720

okay and have you been able to walk on it at all

[ "Acute Symptoms" ]

[ "Subjective" ]

1,721

hi logan . how are you ?

[ "Greetings" ]

[ "Subjective" ]

1,722

i see . okay . well then do what feels good . if you do notice that you're starting to get dry , then reduce to once per day .

[ "Discussion", "Medication" ]

[ "Plan" ]

1,723

okay alright well that that sounds good so today is thursday so what do you have for the weekend

[ "Other Socials" ]

[ "Subjective" ]

1,724

okay . so , um , on my physical exam , your lungs are clear . your heart is , is regular . you do have a grade two systolic ejection murmur . we've had that before , so nothing new-

[ "Physical Examination" ]

[ "Objective" ]

1,725

my goodness . wow . i am so sorry to hear that , um , but thank you so much for ... you know , all of these bits and pieces really help knit up a story together for ashley so we can get her the best care .

[ "Chitchat" ]

[ "Null" ]

1,726

if you need some , uh , just let me know .

[ "Chitchat" ]

[ "Null" ]

1,727

okay . and how about when you bend the knee like this ?

[ "Physical Examination" ]

[ "Objective" ]

1,728

once the rash stops , you can stop the tacrolimus ointment . um , continue doxycycline another week and then stop . but you can keep using the wash and the metro cream .

[ "Medication" ]

[ "Plan" ]

1,729

and it looks like your kidney function is also very good . so i'm , i'm very happy about that .

[ "Lab Examination" ]

[ "Objective" ]

1,730

hey , dragon . order an autoimmune panel . for your next problem , the coronary artery disease , i think you're doing really well , your ekg looks good , your vital signs look good .

[ "Discussion", "Diagnostic Testing" ]

[ "Plan" ]

1,731

. blood pressure go up . let's look at the readings . hey dragon ? show me the blood pressure readings . yeah ... yeah you know they do run a little bit on the high side , so we'll have to address that as well .

[ "Physical Examination" ]

[ "Objective" ]

1,732

we'll definitely get those tests

[ "Chitchat" ]

[ "Null" ]

1,733

okay . well , salt does have a tendency to make your body hold on to water , reducing your salt intake could help with some of the swelling . you can also prop your feet up any time you get a chance , especially at night . and have you talked to your private care doctor about this at all ?

[ "Discussion", "Other Treatments" ]

[ "Plan" ]

1,734

okay are you still getting that numbing and tingling periodically in your feet or is that completely gone

[ "Acute Symptoms" ]

[ "Subjective" ]

1,735

hey gregory good to see you today so take a look at my notes and i see that you're here you've had a nonhealing foot ulcer so can you tell me how you're doing how long have you had it what's going on with it

[ "Personal History", "Greetings" ]

[ "Subjective" ]

1,736

it has okay alright and any other symptoms like a cough or shortness of breath or dizziness or anything like that

[ "Personal History", "Vegetative History" ]

[ "Subjective" ]

1,737

okay so do you think you would be able to get that under control by yourself or would you do you think you would need help with that maybe a dietitian be able to help you out

[ "Discussion", "Other Treatments" ]

[ "Plan" ]

1,738

okay okay and when does that numbness and tingling do you get a lot of pain with it first let me ask that question

[ "Acute Symptoms", "Vegetative History" ]

[ "Subjective" ]

1,739

um , so this happened , what ? like 12 hours ago now ?

[ "Acute Symptoms" ]

[ "Subjective" ]

1,740

are you having any side effects from the medications at all ?

[ "Therapeutic History" ]

[ "Subjective" ]

1,741

okay , all right . and then for your last problem your hypertension , you know , again i , i , i think it's out of control . but we'll see , i think , you know , i'd like to see you take the lisinopril as directed , okay ? uh , i want you to record your blood pressures within the patient , you know , take your blood pressure every day . record them to me for like , about a week , so i have to see if we have to add another agent , okay ? 'cause we need to get that under better control for your heart failure to be more successful , okay ?

[ "Discussion", "Medication" ]

[ "Assessment", "Plan" ]

1,742

but i have n't seen a lot of data on the impact on cholesterol . regardless , we will take it .

[ "Lab Examination" ]

[ "Objective" ]

1,743

what what happened to your ankle

[ "Acute Symptoms" ]

[ "Subjective" ]

1,744

so have you had any let's get back to the exam here have you had a recent mri of your brain i saw one from a few years ago but as doctor white said anything about getting a more a recent mri

[ "Personal History" ]

[ "Subjective" ]

1,745

yeah . so i was reading about this syndrome that i actually have never heard of .

[ "Chitchat" ]

[ "Null" ]

1,746

wow okay and do you know if there was any direct or associated trauma that you can think of over the past three weeks like did you fall or hit your shoulder or anything

[ "Acute Symptoms" ]

[ "Subjective" ]

1,747

okay . great . let's do the exam . all right , so your physical exam looks pretty normal other than you've got kind of these mild wheezes in all your lung fields . and so i think you do have copd from your pulmonary function tests , your x-ray , and that . so i'm gon na diagnose you with copd . chronic obstructive pulmonary disease . it means you're not able to exhale appropriately .

[ "Physical Examination", "Acute Assessment" ]

[ "Objective", "Assessment" ]

1,748

it actually will help with both .

[ "Discussion", "Medication" ]

[ "Plan" ]

1,749

i hope you do n't either one of the things that we get concerned about with an anti-inflammatory like that is that it can irritate the stomach so if you do start to notice that you're getting heartburn or pain right there

[ "Discussion" ]

[ "Plan" ]

1,750

okay have you taken anything for the pain

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

1,751

mm-hmm

[ "Acute Symptoms" ]

[ "Subjective" ]

1,752

no yeah detroit is a hockey town yeah the red wings okay well i'm gon na go ahead and i'll send my nurse in and go ahead and get you discharged and like i said i'd like to see you back here in seven to ten days after that first physical therapy appointment i've got a great phenomenal office staff you just call in once that gets scheduled they will get you in to that next available appointment so take care and i will talk to you later

[ "Follow-up", "Referral" ]

[ "Plan" ]

1,753

good . okay let me take a peek in your nose . all right , good . you can put your mask back on .

[ "Physical Examination" ]

[ "Objective" ]

1,754

okay . have you ever had an upper endoscopy ?

[ "Personal History" ]

[ "Subjective" ]

1,755

okay . hey , dragon , order lisinopril , 10 milligrams daily . do you have any questions ?

[ "Discussion", "Medication" ]

[ "Plan" ]

1,756

okay i you know i'm i'm just thinking you know i need to get some new shoes for some of it my activities i love the i wish i could play basketball but i do a lot of bike riding so i'm always looking for anything that's gon na help me on the bike do you does your family have supplies like that

[ "Chitchat" ]

[ "Null" ]

1,757

any other symptoms , you know , chest pain , shortness of breath , abdominal pain , nausea or vomiting ?

[ "Vegetative History" ]

[ "Subjective" ]

1,758

okay alright so okay so now i i wan na go ahead and do my physical exam i'm gon na call out some of my findings just to make sure that i'm documenting everything and if you have any questions about what it is that i'm saying please feel free to ask okay

[ "Chitchat" ]

[ "Null" ]

1,759

so what part of your elbow would you say hurts

[ "Acute Symptoms" ]

[ "Subjective" ]

1,760

okay that's good so the tylenol really does help you that that's a good thing

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

1,761

you're going to hear me describe things in detail or repeat things as i go to reference later for my notes .

[ "Chitchat" ]

[ "Null" ]

1,762

okay . so , no vision problems .

[ "Personal History" ]

[ "Subjective" ]

1,763

any questions

[ "Discussion" ]

[ "Plan" ]

1,764

you know , let's see how we do over the next couple weeks , and again , we'll refer you to physical therapy if we need to , okay ?

[ "Follow-up" ]

[ "Plan" ]

1,765

okay . so i've found the cream form . we could try ointment form .

[ "Discussion", "Medication" ]

[ "Plan" ]

1,766

okay and i know it got real bad about a month ago that's what the report here from the pcp said but can you tell me exactly where the pain is in your lower back can you kinda point to where that's at

[ "Acute Symptoms" ]

[ "Subjective" ]

1,767

doctor: right trigger finger injection template . attempted to inject one cc of celestone with f- , a half a cc of lidocaine . however , the patient had a dramatic and violent painful reaction to the introduction of the needle , with contortions of the hand , and with dangerously withdrawing the hand with concerns for secondary needle stick . needle was withdrawn . the patient was counseled as to the importance of attempting to get some therapeutic steroid in the flexor tendon sheath . we attempted a second time for a similar injection using the same technique with one cc of celestone and half a cc of lidocaine . a small parma- , uh , palmar vein bled a scant amount , which was cleaned up and band-aid applied . reassured on multiple occasions that no harm was done to his finger . recommended icing in it this evening , and taking ibuprofen .

[ "Medication", "Discussion" ]

[ "Plan" ]

1,768

okay , so in physical exam your heart has a slight three out of six systolic ejection murmur , which we've heard before . your lungs are nice and clear , uh , i do n't appreciate any carotid bruits , and- and you have no lower extremity edema , you have healed , uh , surgical scars on your- on your , uh , right wrist . um , so let's go ahead , i wan na look at some of your results , okay ?

[ "Physical Examination" ]

[ "Objective" ]

1,769

mm-hmm okay alright and are you able to lift up your shoulder so that your shoulder touches your ear at all

[ "Acute Symptoms" ]

[ "Subjective" ]

1,770

right , does that make sense ?

[ "Chitchat" ]

[ "Null" ]

1,771

you may wan na check that but okay so that's good but i what i'd like you to do with that is i'd like you to keep a record of them for me for my next visit with you so let's talk a little bit about your diet tell me how how is your diet what what are the what kind of foods do you like what do you eat normally

[ "Personal History" ]

[ "Subjective" ]

1,772

pain with palpation to the left side around the l5 how about on the right side

[ "Physical Examination" ]

[ "Objective" ]

1,773

alright so any other questions

[ "Discussion" ]

[ "Plan" ]

1,774

yeah . you can certainly take them , you know , all at the same time , as long , as yeah , they're all one scale . you can take them all at the same time . just set an alarm-

[ "Discussion", "Medication" ]

[ "Plan" ]

1,775

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 .

[ "Discussion", "Medication" ]

[ "Plan" ]

1,776

is that what it looked like ?

[ "Acute Symptoms" ]

[ "Subjective" ]

1,777

ah , big family then . that's nice .

[ "Chitchat" ]

[ "Null" ]

1,778

below your your sternum you would need to stop taking the medicine and give me a call

[ "Discussion" ]

[ "Plan" ]

1,779

okay . um , and , and are you having any pain in your sinuses ? or , any post nasal drip ?

[ "Acute Symptoms" ]

[ "Subjective" ]

1,780

okay alright and how is positioning for you does any sitting in any particular position hurt more or hurt less

[ "Acute Symptoms" ]

[ "Subjective" ]

1,781

that's it ? and is it still painful ?

[ "Acute Symptoms" ]

[ "Subjective" ]

1,782

. family .

[ "Other Socials" ]

[ "Subjective" ]

1,783

hey diana it's good to see you in here so i see that you injured your wrist could you tell me a bit about what happened

[ "Acute Symptoms", "Greetings" ]

[ "Subjective" ]

1,784

yep yep agreed agreed and so well listen we'll we'll hopefully get you feeling better here and get you back out on the court and out on the course and we'll talk about that but let's let me ask you about your diabetes a little bit a little bit here so how have your blood sugars been running mark have they been what in the low one hundreds two hundreds where are they

[ "Personal History" ]

[ "Subjective" ]

1,785

i mean , out of known risks associated with medications , topicals are usually safer and preferable to oral medications . with that being said , doxycycline is low risk .

[ "Discussion", "Medication" ]

[ "Plan" ]

1,786

okay and did it was it swollen afterwards or is it looks a little bit swollen right now

[ "Acute Symptoms" ]

[ "Subjective" ]

1,787

when you say , " wipe your face in the morning , " do you use a product or just water ?

[ "Therapeutic History" ]

[ "Subjective" ]

1,788

okay and so does the pain move anywhere like your upper back your shoulder

[ "Acute Symptoms" ]

[ "Subjective" ]

1,789

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 .

[ "Personal History" ]

[ "Subjective" ]

1,790

all right . so the patient is alert and cooperative , appears stated age . all right . i'm going to listen to your heart and lungs . and lungs are clear to auscultation bilaterally . heart regular rate and rhythm . all right , so if you could just lay back for me , and i'll examine your abdomen .

[ "Physical Examination" ]

[ "Objective" ]

1,791

okay , and are you taking any medications for that ?

[ "Therapeutic History" ]

[ "Subjective" ]

1,792

okay okay and so so dad how often are you seeing the twitch on karen

[ "Acute Symptoms" ]

[ "Subjective" ]

1,793

okay alright alright so looking at your vital signs here in the office you know they look really good your you you do n't have any temperature your blood pressure is good it's about one seventeen over fifty six

[ "Physical Examination" ]

[ "Objective" ]

1,794

okay , so she has pain- to palpation of the olecranon bursa and pain with pronation and supination . and when you flex- and when you bend it and straighten it , does that hurt ?

[ "Physical Examination" ]

[ "Objective" ]

1,795

any dizziness

[ "Vegetative History" ]

[ "Subjective" ]

1,796

okay and i know this sounds like a weird question but i do need to know do you experience any loss of control of your bladder or bowels

[ "Vegetative History" ]

[ "Subjective" ]

1,797

okay so were you ever told in the past that you have hepatitis c

[ "Personal History" ]

[ "Subjective" ]

1,798

all right i'll have you take this to the front and i'm gon na say four months re-check for asthma and we'll repeat the spirometer- spirometry at that time .

[ "Follow-up", "Diagnostic Testing" ]

[ "Plan" ]

1,799