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med_intent_classification

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okay that sound definitely understandable so you've been in a lot of pain so have you tried to take any medications to alleviate the pain
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
3,200
how are- how are you doing ?
[ "Acute Symptoms" ]
[ "Subjective" ]
3,201
i know that you were endorsing the back pain-
[ "Acute Symptoms" ]
[ "Subjective", "Objective" ]
3,202
i was just reviewing your records from dr. howard and he's referred you because the workup for headaches revealed a mass on your pituitary gland . i did review your mri images and you have a significant mass there . can you tell me about the issues you've been experiencing ?
[ "Acute Symptoms", "Personal History" ]
[ "Subjective" ]
3,203
mm-hmm alright but you know that pepperoni is pretty high in salt on top of a cheesy pizza right
[ "Vegetative History" ]
[ "Subjective" ]
3,204
um , so let's go over some of your results , okay ?
[ "Chitchat" ]
[ "Null" ]
3,205
wow , that's remarkable .
[ "Lab Examination" ]
[ "Objective" ]
3,206
your second problem is your hypertension . that seems to be relatively stable . i want you to stay on your current medication . you're on li- lisinopril 10 mg once a day . just stay right on that medication . no changes at this point . seems to be doing well , okay ?
[ "Discussion", "Medication", "Reassessment" ]
[ "Assessment", "Plan" ]
3,207
good , good . do you have any rash leftover ?
[ "Acute Symptoms" ]
[ "Subjective" ]
3,208
no chest pain ?
[ "Personal History", "Vegetative History" ]
[ "Subjective" ]
3,209
okay alright and how have your blood sugars been doing this time i know you're taking the metformin are you checking your accu-cheks how has that been going
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
3,210
that would be 125 ounces of water a day and you should avoid drinking sugary drinks like mountain dew .
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
3,211
mm-hmm
[ "Discussion" ]
[ "Plan" ]
3,212
i know . scary stuff . but you had a lumpectomy on january 20th , 2020 , which removed the eight millimeter tumor and margins were negative . the pathology confirmed dcis . looks like they also removed 5 lymph nodes , which , thankfully , were negative for malignancy . that's great !
[ "Personal History" ]
[ "Subjective" ]
3,213
how about this way
[ "Physical Examination" ]
[ "Objective" ]
3,214
um , i'm just gon na check out your heart and your lungs .
[ "Physical Examination" ]
[ "Objective" ]
3,215
does that feel the same
[ "Physical Examination" ]
[ "Objective" ]
3,216
mm-hmm okay and then do you have any numbness or tingling associated with the pain
[ "Vegetative History" ]
[ "Subjective" ]
3,217
okay . great . that's good . i'm glad to hear that . okay . and then , in terms of your gout , um , how are you doing with that ? i know you had an episode of gout of your , your right first big toe , um , about two months ago . how are you doing with that ?
[ "Personal History" ]
[ "Subjective" ]
3,218
okay awesome alright so sorry one question did you do you have a history of playing sports
[ "Other Socials" ]
[ "Subjective" ]
3,219
okay can you tell me a little bit more about it how did it start or how did it do you remember injuring yourself
[ "Personal History" ]
[ "Subjective" ]
3,220
okay alright so four days ago you started feeling badly okay now were you having chills
[ "Acute Symptoms" ]
[ "Subjective" ]
3,221
. a couple of weeks ago .
[ "Personal History" ]
[ "Subjective" ]
3,222
yeah yeah you are on a fair amount of medications you know we do have you on those medications because you did have a heart attack about six months ago they put that that stent into your left anterior descending artery and so that's a major artery on the left side of your heart and so we need to keep those stents open and and kinda help your heart heal so it is gon na be very important for you to continue on those medications so you're still taking your aspirin and are you still taking the brilinta
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
3,223
okay so you said you had the pain on the right hand side does it move anywhere or radiate
[ "Personal History" ]
[ "Subjective" ]
3,224
alright so have you noticed any pain when you've been urinating
[ "Vegetative History" ]
[ "Subjective" ]
3,225
okay if i push in on your big toe and move it back and forth does that hurt
[ "Physical Examination" ]
[ "Objective" ]
3,226
okay . and how long have you been considering this ?
[ "Personal History" ]
[ "Subjective" ]
3,227
okay . so , you're avoiding the salty foods like we had talked about ?
[ "Vegetative History" ]
[ "Subjective" ]
3,228
deep breath . squeeze my fingers for me . feel me touch you here ?
[ "Physical Examination" ]
[ "Objective" ]
3,229
all right , well , i will have the nurse set up the injection procedure , and we'll , and i'll be back shortly .
[ "Chitchat" ]
[ "Null" ]
3,230
okay and can you rate that pain for me right now zero being none ten being the worst pain you've ever been in in your life
[ "Acute Symptoms" ]
[ "Subjective" ]
3,231
okay so when you flex your neck when you're touching your chin to your chest does that hurt
[ "Physical Examination" ]
[ "Objective" ]
3,232
good . other than that , i think that's all for me . um , we'll get you set up for the ultrasound , the procedure . do you have any questions for me ?
[ "Diagnostic Testing" ]
[ "Plan" ]
3,233
no fever alright what about any other symptoms like any body aches any sore throat sinus pain
[ "Vegetative History" ]
[ "Subjective" ]
3,234
okay alright that's good so what is your like how what is your activity level right now that i know that you're you know an olympic weightlifter with books what else do you do to like exercise
[ "Other Socials" ]
[ "Subjective" ]
3,235
. there . um , and not clinically relevant at all . um , your extremities are normal , no edema . um , you have put on a c- a , a little bit of weight .
[ "Physical Examination" ]
[ "Objective" ]
3,236
no , okay , all right . well , i'm gon na go ahead and do a quick physical exam , okay ?
[ "Physical Examination" ]
[ "Objective" ]
3,237
okay alright so when you dropped that brick on your foot were you able to get up and keep working or did you have to get off your you know not stop weightbearing and and get off that foot can you tell me a little bit about after the traumatic incident
[ "Acute Symptoms" ]
[ "Subjective" ]
3,238
how are you doing ma'am ?
[ "Chitchat" ]
[ "Null" ]
3,239
yeah you see this frequently but people who are doing data entry spend a lot of time on keyboards or you know some a lotta manufacturing people who do a repetitive procedure again and again will get that type of pain so here is my plan i'd like to put you in a splint and it's it's it's kind of a wrist splint i would like you to wear that at night that will help with that i want you to continue with the ibuprofens but i would like you to go up to six hundred milligrams four times a day and
[ "Medication", "Other Treatments" ]
[ "Plan" ]
3,240
mister jackson is a 45 -year-old male who has a history of diabetes type two and mild intermittent asthma and he is here today with right elbow pain so hey there mark nice to see you again listen sorry you're having some elbow pain let's talk about it but i would like to record this conversation with this cool app that i'm using that's gon na help me focus on you a bit more would that be alright with you
[ "Acute Symptoms", "Personal History", "Greetings" ]
[ "Subjective" ]
3,241
you're welcome . uh , then the zyrtec , do you pick it up over the counter or do get- do you get it as a prescription ?
[ "Discussion", "Medication" ]
[ "Plan" ]
3,242
so sophia i see that you you hurt your knee tell me about what happened
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
3,243
all right . so not really a link there , all right .
[ "Personal History" ]
[ "Subjective" ]
3,244
that sounds good . um , so you can call the office if you have any additional episodes of pain or any other symptoms you're concerned about . if that happens , we'll get you scheduled for an egd to take a look . if not , you can follow up with me ... follow up with me as needed for any other gi complaints .
[ "Follow-up", "Diagnostic Testing" ]
[ "Plan" ]
3,245
great . after the tests are complete , you can return here for a follow-up visit . if you're still having symptoms , we can consider a referral to our hand clinic , possibly for injections or carpal tunnel release se- surgery . you could also refer ... we could also refer you to an orthopedist for the same treatment .
[ "Discussion" ]
[ "Plan" ]
3,246
okay . and is there any family history of gi cancer or liver disease ?
[ "Family History" ]
[ "Subjective" ]
3,247
that is awesome . and how did you do that ?
[ "Personal History" ]
[ "Subjective" ]
3,248
okay alright how long have you been mountain biking
[ "Other Socials" ]
[ "Subjective" ]
3,249
okay hi andrea well i
[ "Greetings" ]
[ "Subjective" ]
3,250
okay now you mentioned earlier that you tried some things in the past what have what are they and did they work at all
[ "Therapeutic History" ]
[ "Subjective" ]
3,251
and do you notice it at other times besides during the night ?
[ "Acute Symptoms" ]
[ "Subjective" ]
3,252
so ideally what we are doing i think this is the best course of action to deal with the deeper problem right of these infections and to kind of like clear up the pneumonia everything seems to hint on so what we're gon na do is treat your current infection we're going to either prevent you from being around hay or make it so that it's safe for you to be with hay and then we're gon na see like what we need to do moving forward does that help
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
3,253
no ? okay . um , and any problems sleeping while laying flat ?
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
3,254
okay . and , it looks like you have a pre- previous surgical history of a colectomy ? what happened there ?
[ "Personal History" ]
[ "Subjective" ]
3,255
yeah so some of those symptoms like any flu like symptoms have you had like any body aches or chills or anything like that
[ "Vegetative History" ]
[ "Subjective" ]
3,256
yeah .
[ "Personal History" ]
[ "Subjective" ]
3,257
okay okay good so ice and rest makes it feel better running and and activity makes it hurt a little bit more is that correct
[ "Acute Symptoms" ]
[ "Subjective" ]
3,258
doctor: thank you
[ "Chitchat" ]
[ "Null" ]
3,259
okay so do you think that's the albuterol inhaler is it do you remember the name like ventolin or
[ "Therapeutic History" ]
[ "Subjective" ]
3,260
no problem bye
[ "Chitchat" ]
[ "Null" ]
3,261
yeah it's nice my wife and i were there this weekend and they just opened two weeks ago so everything's fully stocked and if you guys are doing some renovations you might run down there and you know save big money at home depot
[ "Chitchat" ]
[ "Null" ]
3,262
okay so i will prescribe that for you and then we will see how that goes and if your pain continues we can talk about different surgical options to treat the pain
[ "Discussion", "Medication" ]
[ "Plan" ]
3,263
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 ?
[ "Personal History" ]
[ "Subjective" ]
3,264
okay , well that's good .
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
3,265
okay . and how are you doing with your crestor ? any problems with that ?
[ "Therapeutic History" ]
[ "Subjective" ]
3,266
okay . um , and , you know , i know that you've had a kidney transplant a few years ago .
[ "Personal History" ]
[ "Subjective" ]
3,267
alright well can can you describe the pain for me
[ "Acute Symptoms" ]
[ "Subjective" ]
3,268
and then we'll talk more about the surgery and what it entails . and , um , at this point , who is your insurance provider ?
[ "Other Socials" ]
[ "Subjective" ]
3,269
okay . all right . good . i'm glad to hear that . uh , so , let's go ahead . i wan na just do a quick physical exam , okay ?
[ "Physical Examination" ]
[ "Objective" ]
3,270
like , just , like , reflux into your throat or are you actually vomiting ?
[ "Vegetative History" ]
[ "Subjective" ]
3,271
okay that's understandable alright so for the last issue for the insomnia i'm just gon na have you take ten milligrams of melatonin as needed
[ "Medication", "Reassessment" ]
[ "Assessment", "Plan" ]
3,272
does the ibuprofen work
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
3,273
okay hey did you happen to catch that pittsburgh pang one hockey game last night
[ "Chitchat" ]
[ "Null" ]
3,274
okay good okay perfect now i know that you're from the west coast are you super excited that la one the super bowl or are you more of a san francisco forty nine or span
[ "Chitchat" ]
[ "Null" ]
3,275
okay . good . and are you still on the carvedilol 25 milligrams two times a day for hypertension and lexapro 10 milligrams a day for anxiety ? looks like your allergic to sulfa drugs as well . is that correct ?
[ "Therapeutic History", "Drug History" ]
[ "Subjective" ]
3,276
okay i'm gon na press here on your back is that painful
[ "Physical Examination" ]
[ "Objective" ]
3,277
yeah me too but we we can we can definitely you know get you started on some monitoring devices for that and also maybe start you on some some diet control things that we can do to help with the blood pressure and maybe start you on some blood pressure medications if we need to okay
[ "Discussion", "Medication", "Other Treatments" ]
[ "Plan" ]
3,278
so , james , what happened to your back ?
[ "Acute Symptoms" ]
[ "Subjective" ]
3,279
okay what about your family are are anyone in your family that you know have immune deficiencies
[ "Family History" ]
[ "Subjective" ]
3,280
alright do either of those actions cause you pain
[ "Physical Examination" ]
[ "Objective" ]
3,281
okay yeah i'm a self expand and and we just swept the brooklyn net so i was really excited about that
[ "Chitchat" ]
[ "Null" ]
3,282
alright . just gon na listen to your heart here . no belly pain ?
[ "Physical Examination" ]
[ "Objective" ]
3,283
um , so , french fries are one of my favorite foods , that and fried chicken , so- i give you a lot of credit for staying away from french fries .
[ "Chitchat" ]
[ "Null" ]
3,284
. a little bit .
[ "Radiology Examination" ]
[ "Objective" ]
3,285
okay . do you find that it's done anything for you in the past ?
[ "Therapeutic History" ]
[ "Subjective" ]
3,286
okay so you know looking at your looking at your head and your neck i do n't appreciate any like adenopathy no thyromegaly no no carotid bruit looking at your listening to your heart i do n't appreciate any murmur no rub no gallop your lungs are clear to auscultation bilaterally your lower legs you have palpable pulses no lower edema your shoulders every like your upper extremities i see normal range of movement with your right wrist let's go ahead and focus on it so when i push on the inside here does it hurt
[ "Physical Examination" ]
[ "Objective" ]
3,287
what kind of work do you do
[ "Other Socials" ]
[ "Subjective" ]
3,288
excellent . and do you have any other questions for me ?
[ "Chitchat" ]
[ "Null" ]
3,289
very good alright well i'm gon na go ahead and have the nurse take you to the scheduler to get your mri and i'll get back with you as soon as we get the results of that
[ "Chitchat" ]
[ "Null" ]
3,290
yeah , that does seem like a likely cause of your symptoms . anything seem to make the pain worse ?
[ "Acute Symptoms" ]
[ "Subjective" ]
3,291
so i now i know you're worried about you know what's been happening with your with your you know with your blood cholesterol so can you tell me a little bit more about what's going on
[ "Acute Symptoms" ]
[ "Subjective" ]
3,292
okay have you tried icing
[ "Therapeutic History" ]
[ "Subjective" ]
3,293
okay so medial joint line tenderness
[ "Physical Examination" ]
[ "Objective" ]
3,294
yeah that's a great question here i i'm gon na go ahead and we're gon na for the mri i'll have to get a preapproval from your insurance company i will work on that my my my team in the front office will get that preapproved and then once that's done we'll call you to help schedule that mri
[ "Diagnostic Testing" ]
[ "Plan" ]
3,295
okay . and are you ... you're still taking the metformin , correct ?
[ "Therapeutic History" ]
[ "Subjective" ]
3,296
thank you
[ "Chitchat" ]
[ "Null" ]
3,297
okay . and you saw him not too long ago ?
[ "Personal History" ]
[ "Subjective" ]
3,298
okay and then do you remember any trauma did you hit your arm or elbow or any on anything
[ "Acute Symptoms" ]
[ "Subjective" ]
3,299