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|---|---|---|---|
you want to carry share sure yeah we can switch
|
[
"Chitchat"
] |
[
"Null"
] | 500
|
and how have those numbers been
|
[
"Personal History"
] |
[
"Subjective"
] | 501
|
okay . is her twin a boy or a girl ?
|
[
"Family History"
] |
[
"Subjective"
] | 502
|
okay . all right . and , uh , are you ... did they see a reason , as to why it was elevated ?
|
[
"Personal History"
] |
[
"Subjective"
] | 503
|
okay , and for social history can you tell me what you do for work ?
|
[
"Other Socials"
] |
[
"Subjective"
] | 504
|
okay and do you feel any sort of tightness in the back of your neck or in your shoulders or you know you said it's in the back of your head primarily any discomfort anywhere else
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 505
|
you take it everyday okay do you notice that you're urinating any less recently
|
[
"Vegetative History"
] |
[
"Subjective"
] | 506
|
yeah well i guess you're gon na have to watch that
|
[
"Discussion"
] |
[
"Plan"
] | 507
|
hi frank how are you i heard the medical assistant told me that you're having some shortness of breath
|
[
"Acute Symptoms",
"Greetings"
] |
[
"Subjective"
] | 508
|
thc gummies from grandma that's an excellent grandmother that you have okay have you noticed any swelling stiffness tenderness
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 509
|
yeah , you're welcome . let me know if you have any questions .
|
[
"Discussion"
] |
[
"Plan"
] | 510
|
but i would consider you as someone that would make me a little bit concerned . i have had healthy people die from covid .
|
[
"Discussion"
] |
[
"Plan"
] | 511
|
do you have any questions , hannah ?
|
[
"Discussion"
] |
[
"Plan"
] | 512
|
all right . it all looks good . go ahead and sit up . so , in terms of getting that pressure down , you're on three meds that are maxed out and your blood pressure is still not down . and , the question is what do we need to do to get your- to get it down . uh , your potassium one week ago was 4.0 . uh , has it been redone since in the last week ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 513
|
i'm gon na give him the same medicine as his sister , and just hang onto it , um , just to watch and see . if this was a monday and we had a whole week to watch , i would say to just call us if things got worse , um , but since , um , if it's gon na be the weekend , and things might worsen tonight or tomorrow night , i'd rather you have just what you need on hand .
|
[
"Follow-up",
"Medication"
] |
[
"Plan"
] | 514
|
okay . so , maybe it's a couple times a month you feel this way ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 515
|
okay alright well let's go ahead and refer you to physical therapy if you're still having pain then we might have to consider an mri
|
[
"Discussion",
"Diagnostic Testing",
"Referral"
] |
[
"Plan"
] | 516
|
alright now do you have that pain when you lay on your back as well or just on your left side
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 517
|
okay . all right . and is it one knee versus the other ? or both equally ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 518
|
uh , but keep working hard on , on pt in the meantime though .
|
[
"Discussion",
"Referral"
] |
[
"Plan"
] | 519
|
hmmm sure i'll prescribe demerol
|
[
"Discussion"
] |
[
"Plan"
] | 520
|
okay and when does it does it happen every time you eat
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 521
|
okay and everything's working out well with the protonix ?
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 522
|
so your blood sugar is a little bit high , it was 169 today but that kind of depends on what you ate and you were n't fasting for the blood check so i might have to repeat that test for pre-op , but i do n't think we need to do it today .
|
[
"Lab Examination"
] |
[
"Objective"
] | 523
|
i'm doing pretty good hey i see here in the nurse's notes it looks like you hurt your left ankle can you tell me a little bit more about that
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 524
|
okay . and any tingling or numbness ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 525
|
yeah it should help with the healing of your elbow it's just a procedure we'll stick a needle in your elbow
|
[
"Discussion",
"Other Treatments"
] |
[
"Plan"
] | 526
|
okay alright so i'll see you again soon okay
|
[
"Chitchat"
] |
[
"Null"
] | 527
|
so tell me what brings you in today .
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 528
|
you can stop the ibuprofen .
|
[
"Discussion",
"Medication"
] |
[
"Plan"
] | 529
|
20 to 30 miles on a road bike ?
|
[
"Personal History"
] |
[
"Subjective"
] | 530
|
great . so mister i would like to do a physical exam if that's okay with you
|
[
"Physical Examination"
] |
[
"Objective"
] | 531
|
all right-y . and any difficulties with your pregnancy with her or during delivery ?
|
[
"Family History"
] |
[
"Subjective"
] | 532
|
okay now have you had any other symptoms like fever chills drainage from the wound or anything along those lines
|
[
"Vegetative History"
] |
[
"Subjective"
] | 533
|
okay , so the nurse will come in and she'll go over all that stuff with you .
|
[
"Chitchat"
] |
[
"Null"
] | 534
|
okay so for your diabetes it's gon na be very important to get your diabetes under control in order to get the wound to heal so we might even go ahead and get a diabetic consult so that we can go over some some maybe some ways you can modify your diet without a being too much but maybe that can bring down your hemoglobin a1c into a little bit better level okay
|
[
"Referral",
"Other Treatments"
] |
[
"Plan"
] | 535
|
okay and i'm gon na move it around so when i look at the knee there is no redness there's no swelling i can appreciate a a small amount of effusion and that means that there's a little bit of fluid under the knee or in that knee's joint space and there is there is several reasons that could be now when i push on your knee does it hurt more on the inside or does it hurt more on the outside here
|
[
"Physical Examination"
] |
[
"Objective"
] | 536
|
okay so have you ever hurt your left foot before
|
[
"Personal History"
] |
[
"Subjective"
] | 537
|
just the knees . and have you noticed any swelling of your knees , or any redness of your knees ?
|
[
"Vegetative History"
] |
[
"Subjective"
] | 538
|
okay . anything else i should be aware of or that we should be checking ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 539
|
all right . so , i'm gon na take a look at your ankles and feet . i'm just gon na look for some swelling .
|
[
"Physical Examination"
] |
[
"Objective"
] | 540
|
and how many months have you been participating in weight watchers ?
|
[
"Other Socials",
"Vegetative History"
] |
[
"Subjective"
] | 541
|
it's usually pretty well tolerated have you ever had any trouble with your stomach
|
[
"Personal History"
] |
[
"Subjective"
] | 542
|
um , and your abdomen also feels a little tender . you have some tenderness of the palpation of the right lower quadrant , but other than that , your heart sounds nice and clear and your lungs are clear as well . so let's go ahead and take a look at some of your results , okay ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 543
|
yeah we'll probably do a fasting blood sugar we'll we'll order the hemoglobin a1c that should n't be actually matter because that checks long term but if we need your blood sugar may be elevated today i i would n't be surprised alright and i forgot to examine your back by the way so on your back exam you do have some tenderness in the paraspinal areas of your back in the in the lower back mostly no midline tenderness you have good reflexes so i think this is all muscular pain right now for your back pain i'm gon na go ahead and put you on some naprosyn and some flexeril which is a muscle relaxer i'm gon na give you some exercises you can do to help you get off the couch it'll also help your blood sugar and why do n't we have you if that does n't work the the pain medicine and the physical we can start physical therapy and see if that helps okay
|
[
"Discussion",
"Medication",
"Diagnostic Testing"
] |
[
"Plan"
] | 544
|
good . okay . so , you know , the last time we spoke , you know , you were trying to think of some new strategies to manage your depression . you did n't wan na go on medication because you're already on a bunch of meds .
|
[
"Personal History",
"Therapeutic History"
] |
[
"Subjective"
] | 545
|
wow that's pretty bad does it keep you up at night
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 546
|
yeah , okay .
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 547
|
doctor: alright
|
[
"Chitchat"
] |
[
"Null"
] | 548
|
well a a pill box or maybe setting an alarm on your phone might really help
|
[
"Discussion",
"Medication"
] |
[
"Subjective",
"Plan"
] | 549
|
yeah . it always is . how about one , one , one eight-ounce cup a day ? okay ?
|
[
"Discussion",
"Other Treatments"
] |
[
"Plan"
] | 550
|
okay , great . why do n't you come with me , we'll get the tech to put the cast on .
|
[
"Chitchat"
] |
[
"Null"
] | 551
|
okay . any weight loss ?
|
[
"Vegetative History"
] |
[
"Subjective"
] | 552
|
hmmm yeah i'm not a big cat person
|
[
"Chitchat"
] |
[
"Null"
] | 553
|
okay so pain on palpation both on the bony process and on the muscle can you move your neck from side to side can you move your neck can you swive it side to side no no alright so i'm i'm seeing i'm seeing some range of movement moderate range of movement that's fine okay i so when can you bend your neck forward that that's your whole body just just the neck are you capable of bending up
|
[
"Physical Examination"
] |
[
"Objective"
] | 554
|
okay well so where does it hurt like in on the inside or the outside or
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 555
|
good morning julie how are you doing this morning
|
[
"Greetings"
] |
[
"Subjective"
] | 556
|
yeah you know be sure you're staying well hydrated you know six to eight glasses of water per day is a good good idea and you you know when when it warms up you're certainly gon na prespire more and lose lose more fluid so so i would i would recommend that you continue to have you know a a standard six to eight glasses of of fluid intake per day but yeah that you know that should do it and if you're feeling particularly dehydrated you might wan na increase that if you have an increased activity level so alright any other questions for me
|
[
"Discussion",
"Other Treatments"
] |
[
"Plan"
] | 557
|
okay . i- i know that we had given you some clobetasol for your scalp . is that- so that's doing okay ?
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 558
|
okay and you said you lift a lot of weights
|
[
"Other Socials"
] |
[
"Subjective"
] | 559
|
okay . all right . well , i wan na go ahead and do a quick physical exam , all right ? hey , dragon , show me the vital signs . so , your vital signs here in the office look quite good .
|
[
"Physical Examination"
] |
[
"Objective"
] | 560
|
you are welcome , have a good rest of your day .
|
[
"Chitchat"
] |
[
"Null"
] | 561
|
. and they showed that . so , how are you doing with that ?
|
[
"Personal History"
] |
[
"Subjective"
] | 562
|
yeah what what are you doing with your basement are you are you doing like a a man cave or
|
[
"Chitchat"
] |
[
"Null"
] | 563
|
yeah those those trails are great there's like five miles of regular flat trails and then there's a bunch of hiking trails that they've opened up as well it's a really great place man you guys need to get out there we'll get you fixed up and we'll get you back out there okay
|
[
"Chitchat"
] |
[
"Null"
] | 564
|
alright so go ahead and do a quick exam on your knee here so when i press here does that hurt
|
[
"Physical Examination"
] |
[
"Objective"
] | 565
|
okay so you are positive for pain to palpation you do note that moderate tenderness of the medial epicondyle now i'm gon na have you turn your wrist as if you're turning a door knob do you have any pain when you do that
|
[
"Physical Examination"
] |
[
"Objective"
] | 566
|
okay . all right , and how are you doing with your psoriasis ?
|
[
"Personal History"
] |
[
"Subjective"
] | 567
|
uh , digoxin ?
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 568
|
okay . but you're not hurting right now ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 569
|
so do you have anything any other questions for me
|
[
"Discussion"
] |
[
"Plan"
] | 570
|
okay . so , i know that we've kind of talked about holding off on medical therapy-
|
[
"Discussion"
] |
[
"Plan"
] | 571
|
yeah and you're it's just you're weak are is it
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 572
|
no it did n't help alright did you hear anything pop or anything like that when
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 573
|
okay alright i'm gon na do a couple of other other maneuvers here for your knee so on your left knee exam i do appreciate some edema you also have some effusion some fluid in the knee you have moderate range of motion so you're able to move it a little bit but not all the way i also see you have some pain on flexion and extension of the knee even negative lachman's test and a negative valgus and varus test as well so all that to say is i do n't think anything is is torn in your knee based on the your physical exam so we did do a x-ray of your left knee and luckily it was normal so there is no fractures no bony abnormalities so everything is good there so let me talk to you little bit about my assessment and plan for your knee okay
|
[
"Physical Examination",
"Radiology Examination"
] |
[
"Objective"
] | 574
|
and throat looks fine no tonsils
|
[
"Acute Assessment"
] |
[
"Assessment"
] | 575
|
you did not okay okay what are you doing for the pain today
|
[
"Acute Symptoms",
"Therapeutic History"
] |
[
"Subjective"
] | 576
|
okay alright but no chest pain right now no shortness of breath no sweats or clamminess or anything like that right now
|
[
"Vegetative History"
] |
[
"Subjective"
] | 577
|
um , any changes in , um , weight gain or anything like that ?
|
[
"Personal History"
] |
[
"Subjective"
] | 578
|
okay and what have you taken for the pain
|
[
"Acute Symptoms",
"Therapeutic History"
] |
[
"Subjective"
] | 579
|
hey matthew how're you doing
|
[
"Greetings"
] |
[
"Subjective"
] | 580
|
lastly , once we get your knee surgery , um we , we should think about getting you a colonoscopy . we can do it here locally because you have medicare . do you have private insurance also ?
|
[
"Discussion",
"Diagnostic Testing"
] |
[
"Plan"
] | 581
|
hey , dragon . um , order medications and procedures as discussed . all right .
|
[
"Chitchat"
] |
[
"Null"
] | 582
|
okay well very good well i will be following up with you soon and again just take it easy for now from the running okay
|
[
"Chitchat"
] |
[
"Null"
] | 583
|
okay like a prednisone taper pack that type of thing
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 584
|
all right , well , i'm gon na scoot up closer and just take a quick look at your hand . all right , so , lean over here . all right , so on this exam today , we have a very pleasant , cooperative , healthy male , no distress . his heart rate is regular rate , rhythm , 2+ radial pulse , no swelling or bruise , bruising in the palm over the volar surface of his index finger , normal creases , slightly diminished over the pip of the index finger compared to the middle finger . his index finger rests in a 10-degree pip-flexed , uh , position . all right , is that uncomfortable to correct that , and is it uncomfortable now here ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 585
|
okay alright and then so how's the pain with your knee on a scale of one to ten one being the least pain ten being the worst pain how's how's it been ranging
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 586
|
okay alright and did the ski patrol give you crutches i i see you have them here with you okay alright great and are you otherwise generally healthy
|
[
"Personal History",
"Therapeutic History"
] |
[
"Subjective"
] | 587
|
okay . all right . well , let's talk about your , your kidney transplant . how are-
|
[
"Personal History"
] |
[
"Subjective"
] | 588
|
okay and you might even just keep a log of what your blood pressures are and when it's up think about you know what you've eaten if you've done something different because that may help you to figure out what you need to cut back on or how you might need to change your your eating habits a little bit so
|
[
"Other Treatments"
] |
[
"Plan"
] | 589
|
what about bruising ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 590
|
okay . all right . hey , dragon . i am seeing mrs. anderson , a 44-years-old female , uh , complaining to check the left shoulder pain . um , so how long how has this lasted ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 591
|
yeah . mildly dry skin , no skin breakdown . l- let me know if you can feel this .
|
[
"Physical Examination"
] |
[
"Objective"
] | 592
|
. a couple of , like couple months ago . that's been fine ?
|
[
"Personal History"
] |
[
"Subjective"
] | 593
|
correct , it's not a steroid .
|
[
"Discussion",
"Medication"
] |
[
"Plan"
] | 594
|
that's also good for your kidneys , so everything , everything good ... is good there . your third problem is your depression . been a rough year . some of that's just normal reactive stuff . so i think we'll just keep you where you are at . not going to change the zoloft . do you need a refill on your zoloft ?
|
[
"Reassessment",
"Discussion",
"Medication"
] |
[
"Assessment",
"Plan"
] | 595
|
did it ? yeah , this one is water-soluble , and i think it's fairly low toxicity , but high benefit , and i think decreasing the pain will encourage you to move that finger .
|
[
"Discussion",
"Medication"
] |
[
"Plan"
] | 596
|
okay . great . all right . and then , you know , how about your reflux ? we had placed you on , um , omeprazole , you know , to help with some of those symptoms and i know that you were gon na do some dietary modifications . how are you doing with that ?
|
[
"Personal History",
"Therapeutic History"
] |
[
"Subjective"
] | 597
|
i would recommend calling your primary care and discuss that with him since he follows you for your blood pressure and cholesterol .
|
[
"Discussion"
] |
[
"Plan"
] | 598
|
all right so your ears look good , a little bit of wax on both sides . can i see inside your mouth ? big ahh .
|
[
"Physical Examination"
] |
[
"Objective"
] | 599
|
Subsets and Splits
Filtered ChitChat, Greetings, History
The query filters and retrieves specific records based on their index and intent labels, providing insight into a subset of chatty, greeting, and personal history interactions.