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|---|---|---|---|
okay so you think it's been going on longer okay alright now how about have you had any burning when you urinate at all
|
[
"Vegetative History"
] |
[
"Subjective"
] | 700
|
i'm good .
|
[
"Chitchat"
] |
[
"Null"
] | 701
|
that we had too much , yeah .
|
[
"Discussion",
"Medication"
] |
[
"Plan"
] | 702
|
diane is a 28 year old female with a past medical history , significant for , depression and hypertension who presents for emergency room follow-up . so diane what's going on ? i heard that your- your blood pressure was really high in the emergency room . what happened ?
|
[
"Personal History"
] |
[
"Subjective"
] | 703
|
it's nice to meet you . i'm dr. miller .
|
[
"Chitchat"
] |
[
"Null"
] | 704
|
nausea or vomiting , changes in bowel movements ?
|
[
"Vegetative History"
] |
[
"Subjective"
] | 705
|
sure now for your next problem of your hypertension i wan na go ahead and order a lipid panel on you and i think i do wan na increase i do wan na increase the lisinopril to forty milligrams once a day just to get your blood pressure under better control and we'll see how you do on the forty milligrams once a day for your third problem of your diabetes let's go ahead and order a hemoglobin a1c and just to make sure that we do n't have to make any adjustments to your metformin how does that sound
|
[
"Medication",
"Diagnostic Testing",
"Reassessment"
] |
[
"Assessment",
"Plan"
] | 706
|
uh , lastly for your third problem for your hypertension i'm gon na go ahead and order an echocardiogram just to recheck it . just that heart murmur . and i'm going to go ahead and keep the lisinopril at 20 milligrams a day . do you have any questions ?
|
[
"Reassessment",
"Discussion",
"Diagnostic Testing",
"Medication"
] |
[
"Assessment",
"Plan"
] | 707
|
and so in order to reduce the size of the breast , we have to take out both the fat and the glands . so it just depends on how much is left , whether you can breastfeed in the future . and then also , the breast will change over time . if you , um , gain weight , they will get larger , things like that .
|
[
"Discussion",
"Other Treatments"
] |
[
"Plan"
] | 708
|
okay . all right . and in terms of your depression , how are you , how are you doing ?
|
[
"Personal History"
] |
[
"Subjective"
] | 709
|
okay and when you when you got it would you have any trauma to your foot or it just just did it pop up all of a sudden
|
[
"Personal History"
] |
[
"Subjective"
] | 710
|
okay . i do feel stool in your lower colon , which would coincide with constipation , but i also feel a slight enlargement of your liver here on the upper right side . have you had any lab work done recently ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 711
|
okay have you ever taken any daily medications for your asthma an inhaler or singulair or anything like that
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 712
|
for your blood sugar check are you checking that or not really
|
[
"Personal History"
] |
[
"Subjective"
] | 713
|
okay okay good good you know it's hard to stay away from the sugary foods sometimes i i enjoy ice cream regularly okay so let's do physical exam as long as you are here so i'm just gon na listen to your heart your heart sounds normal no murmurs or gallops listen to your lungs quick if you can take a deep breath lungs are clear that's good news let's take a look at that knee right knee looks like it definitely has some swelling i'm gon na do some maneuvers here does it hurt when i push you on the inside of the knee
|
[
"Physical Examination"
] |
[
"Objective"
] | 714
|
okay yeah so like that your brother does n't either
|
[
"Family History"
] |
[
"Subjective"
] | 715
|
okay great so if you do n't have any other questions i'm gon na have the nurse check you out and get all that scheduled and i'm gon na see you in about three weeks
|
[
"Chitchat"
] |
[
"Null"
] | 716
|
okay well first of all i i agree with you the weather has kinda been all over the place been hot and been cold and and and now it seems like we've had a week of pretty chilly weather hopefully that changes pretty soon so tell me a little bit about when when your back pain started and and and what happened there
|
[
"Personal History"
] |
[
"Subjective"
] | 717
|
sure we can do that and so okay but you are still taking that twenty milligrams per day correct
|
[
"Personal History"
] |
[
"Subjective"
] | 718
|
well do n't , do n't get crazy with the pickle juice because all of the salt in it .
|
[
"Chitchat"
] |
[
"Null"
] | 719
|
i'd like to tell dax about you , okay ?
|
[
"Chitchat"
] |
[
"Null"
] | 720
|
alright so hey it's nice to see you jack i know you've been experiencing some neck pain could you tell me what happened
|
[
"Acute Symptoms",
"Greetings"
] |
[
"Subjective"
] | 721
|
okay now the other thing
|
[
"Discussion",
"Other Treatments"
] |
[
"Plan"
] | 722
|
my gosh the the pang ones are on fire you know they beat up on new york seven to two i mean the hockey's just an amazing sport i i just do you guy do you do a lot of hockey down there in town here
|
[
"Chitchat"
] |
[
"Null"
] | 723
|
and then i will get you a referral to physical therapy something that you can do close to home or close to work and then maybe i could see you back here in maybe four to six weeks and recheck this
|
[
"Discussion",
"Follow-up",
"Referral"
] |
[
"Plan"
] | 724
|
have you ever had any type of injury to that knee i mean did you fall or bump it against something or
|
[
"Personal History"
] |
[
"Subjective"
] | 725
|
that's okay i i it's gon na help me isolate like what's what exactly is going on so please do n't feel embarrassed to answer the questions do you have any weakness
|
[
"Vegetative History"
] |
[
"Subjective"
] | 726
|
hey dragon , order the medications and the procedures . all right , why do n't you come with me and we'll get you signed out ?
|
[
"Chitchat"
] |
[
"Null"
] | 727
|
okay . have you- ... go ahead .
|
[
"Personal History",
"Vegetative History"
] |
[
"Subjective"
] | 728
|
okay now let's talk just briefly about your pain so if you have n't taken anything at all or have you been taking anything at all let's start with that have you been taking anything for the pain
|
[
"Acute Symptoms",
"Therapeutic History"
] |
[
"Subjective"
] | 729
|
okay . and it seems like it's worse at night ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 730
|
hey good to see you philip so i see here you're coming in you had some right elbow pain also you have a past medical history of hypertension diabetes we are gon na check up on those as well so can you tell me what happened to your elbow
|
[
"Acute Symptoms",
"Personal History",
"Greetings"
] |
[
"Subjective"
] | 731
|
hey , dragon , show me the vital signs . so , here in the office today , your vital signs look great . your blood pressure is fine . your heart rates r- right where it should be , which is good , okay ? i'm just gon na do a quick exam . and i'll let you know what , what i find , okay ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 732
|
okay , and that's the 250/50 dose , correct ?
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 733
|
okay , that's good . and your masked face , though , it does look thinner .
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 734
|
no belly pain
|
[
"Vegetative History"
] |
[
"Subjective"
] | 735
|
mm-hmm
|
[
"Vegetative History"
] |
[
"Subjective"
] | 736
|
okay alright
|
[
"Vegetative History"
] |
[
"Subjective"
] | 737
|
okay , so you got my letter last time on the results . your sugars are not very well controlled .
|
[
"Personal History"
] |
[
"Subjective"
] | 738
|
and is it hurt- ... tender right around that area ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 739
|
okay . did you have a nice holiday ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 740
|
okay and what have you taken for the pain
|
[
"Acute Symptoms",
"Therapeutic History"
] |
[
"Subjective"
] | 741
|
okay . and if you stay still , do you feel better ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 742
|
okay alright and so do do you go to the trampoline park often
|
[
"Other Socials"
] |
[
"Subjective"
] | 743
|
mm-hmm .
|
[
"Personal History"
] |
[
"Subjective"
] | 744
|
okay great thanks so carolyn tell me about your headache and headache or headaches when did when did they start and and what symptoms are you having
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 745
|
so let's just go ahead and we'll- we're going to go over , you know , my assessment and my plan for you . so for your first problem , your back pain . you know , i think you have a lumbar strain from the lifting . so , let's go ahead . we can prescribe you some meloxicam 15 mg once a day .
|
[
"Acute Assessment",
"Medication"
] |
[
"Assessment",
"Plan"
] | 746
|
and are you also taking the full dose of the hydrochlorothiazide ? do you have any , um , chest tightness or pressure or any shortness of breath ?
|
[
"Therapeutic History",
"Vegetative History"
] |
[
"Subjective"
] | 747
|
okay and are and do you still have pain down there in your lower back
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 748
|
okay and that's when you get the pain more
|
[
"Personal History"
] |
[
"Subjective"
] | 749
|
wow okay alright so yeah you you definitely have decreased that so that's again good for you on that one so hopefully you keep you keep that up
|
[
"Chitchat"
] |
[
"Null"
] | 750
|
okay and have you had any numbing or tingling in your fingers at all
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 751
|
okay sure any pain with urination or any blood in your urine
|
[
"Vegetative History"
] |
[
"Subjective"
] | 752
|
okay and what do you mean by bigger pieces of food like what's your diet like
|
[
"Personal History"
] |
[
"Subjective"
] | 753
|
any questions ?
|
[
"Discussion"
] |
[
"Plan"
] | 754
|
valgus stress medial collateral ligament intact lateral collateral ligament intact okay so little kind of little laxity posterior drawer let me see the other let me see the other knee
|
[
"Physical Examination"
] |
[
"Objective"
] | 755
|
alright so you are positive for pain with resistance against flexion of that left wrist so i let let's go ahead and review the x-ray that we did of your elbow the good news is i do n't see any fracture or bony abnormality of that right elbow which is good so let's talk a little bit about my assessment and plan for you so for the problem with elbow pain i do believe that this is consistent with medial epicondylitis which is caused by the overuse and potential damage of those tendons that bend that that bend the wrist towards the palm now i want you to rest it i'm gon na order a sling and i want you to wear the sling while you're awake now we're also gon na have you apply ice to the elbow for twenty minutes three times a day and i want you to take ibuprofen that's gon na be six hundred milligrams q.6 h. with food and i want you to take that for a full week now you're not gon na like this part but i want you to hold off for the next couple of weeks on doing any type of pottery work okay alright now what i wan na do is i wan na see you again in a week and i wan na see how you're doing okay
|
[
"Follow-up",
"Medication",
"Other Treatments",
"Radiology Examination",
"Acute Assessment"
] |
[
"Objective",
"Assessment",
"Plan"
] | 756
|
doctor: all right . hey , dragon . finalize the note .
|
[
"Chitchat"
] |
[
"Null"
] | 757
|
hi keith , how are you ?
|
[
"Greetings"
] |
[
"Subjective"
] | 758
|
alright is it the inside or outside of your elbows
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 759
|
alright have you ever had this type of back pain before
|
[
"Personal History"
] |
[
"Subjective"
] | 760
|
and that's about it . do you have any questions for me ?
|
[
"Discussion"
] |
[
"Plan"
] | 761
|
hi teresa what's going on i heard that i heard that you're having a sore throat you're not feeling well
|
[
"Acute Symptoms",
"Greetings"
] |
[
"Subjective"
] | 762
|
has n't really stayed put ?
|
[
"Personal History"
] |
[
"Subjective"
] | 763
|
hi , martha . how are you ?
|
[
"Greetings"
] |
[
"Subjective"
] | 764
|
abdominal pain ?
|
[
"Vegetative History"
] |
[
"Subjective"
] | 765
|
okay . and i know you had the , uh , bypass grafting last year . you're doing okay ?
|
[
"Personal History"
] |
[
"Subjective"
] | 766
|
okay . and any fever or chills ?
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 767
|
yeah definitely so yeah so you you can limit the activities for sure in terms of your work activities i know if you sit too long sometimes it can be painful because you do need to move that leg a little bit so it does n't lock up so i i would like for you to you know do do some slight activities not enough to stress your legs but definitely move move them a little bit every now and then so it does n't lock up on you okay
|
[
"Discussion",
"Referral"
] |
[
"Plan"
] | 768
|
okay any numbness any tingling
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 769
|
um , but i think , um , i think that's been under control . but if it flares up go ahead and , uh , give me a call , okay ?
|
[
"Discussion",
"Follow-up"
] |
[
"Plan"
] | 770
|
and how often do you have a bowel movement when you are constipated ?
|
[
"Personal History",
"Vegetative History"
] |
[
"Subjective"
] | 771
|
you do n't really seem that excited
|
[
"Chitchat"
] |
[
"Null"
] | 772
|
frequently
|
[
"Personal History"
] |
[
"Subjective"
] | 773
|
okay , i see .
|
[
"Family History"
] |
[
"Subjective"
] | 774
|
okay . and , um , so you're still taking the lisinopril ?
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 775
|
okay and and has work been not hard lately you've been busy it sounds like
|
[
"Other Socials"
] |
[
"Subjective"
] | 776
|
and how's your weight been ? any fluctuation ?
|
[
"Vegetative History"
] |
[
"Subjective"
] | 777
|
shortness of breath
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 778
|
okay . watch for low sugars , weak , shaky , sweaty . if that happens , let us know , and i do n't expect it to .
|
[
"Discussion"
] |
[
"Plan"
] | 779
|
does that sound like a plan ?
|
[
"Chitchat"
] |
[
"Null"
] | 780
|
okay let me come around let me lift up the left side if i lift that up does that cause
|
[
"Physical Examination"
] |
[
"Objective"
] | 781
|
that is n't very nice you gon na have to show her that that's not very nice you're gon na have to teach her a lesson
|
[
"Other Socials"
] |
[
"Subjective"
] | 782
|
great and then for your diabetes i wan na go ahead and let's go ahead and increase your your metformin to fifteen hundred milligrams i think all for that too i want you to go ahead and continue taking your blood sugars to make sure as as you normally would to make sure that you know that change in medication is is actually being effective alright do you have any other questions for me at this time
|
[
"Discussion",
"Medication",
"Reassessment"
] |
[
"Assessment",
"Plan"
] | 783
|
um , and doxycycline can give you bad upset stomach or heartburn . um , it will make you sunburn , even if you never sunburn , so you have to protect yourself .
|
[
"Medication"
] |
[
"Plan"
] | 784
|
okay alright now are you a pretty active person you said you were skiing do you do what kind of other activities do you do
|
[
"Other Socials"
] |
[
"Subjective"
] | 785
|
and any surgeries in the past ?
|
[
"Personal History"
] |
[
"Subjective"
] | 786
|
okay . great . i'm glad to hear that . now , i know you did a review of systems sheet when you checked in .
|
[
"Chitchat"
] |
[
"Null"
] | 787
|
doctor: hey , dragon , finalize the note .
|
[
"Chitchat"
] |
[
"Null"
] | 788
|
do you or do you like going to colorado
|
[
"Chitchat"
] |
[
"Null"
] | 789
|
that but yeah go ahead
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 790
|
okay but you're never really pain free is that what i hear you saying
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 791
|
okay , squeeze my finger here . good . can you feel me touch out here ?
|
[
"Physical Examination"
] |
[
"Objective"
] | 792
|
okay got it and how about your blood pressure how has that been running at home are you checking your blood pressures daily still and how how your how how have your blood pressures been
|
[
"Personal History"
] |
[
"Subjective"
] | 793
|
okay . on physical examination everything looks good . you know your lungs are nice and clear . your heart sounds good . you know you do have some weakness of your lower extremities . the right is about 4 out of 5 , the left is about 3 out of 5 . but you reflexes are really good so i'm , i'm encouraged by that . and you do have some , you know , arthritic changes of the right knee .
|
[
"Physical Examination"
] |
[
"Objective"
] | 794
|
okay alright and have you noticed any other joint pain like in your elbows or shoulders or anything like that that since this started
|
[
"Acute Symptoms"
] |
[
"Subjective"
] | 795
|
okay , sure . and , are you right or left-handed ?
|
[
"Personal History"
] |
[
"Subjective"
] | 796
|
it's not very expensive and i can just call it into your pharmacy
|
[
"Chitchat"
] |
[
"Null"
] | 797
|
i love mcdonald's too my favorite is big mac i do n't know about you but i got ta have my big mac with those large fries which you what's your favorite mcdonald's treat there
|
[
"Vegetative History"
] |
[
"Subjective"
] | 798
|
you do n't check it at all okay that's that's okay i i looked at it here we will talk about that in a minute and are you taking the lisinopril i think we have you on twenty milligrams a day
|
[
"Therapeutic History"
] |
[
"Subjective"
] | 799
|
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.