[
{
"consultation_id": "day1_consultation10",
"dialogue": "[Doctor] hello can you hear me ok?\n[Patient] Hello. Hi.\n[Doctor] Right excellent, before I go any further, can I confirm your name and your age please?\n[Patient] Yeah I can hear you, hi.\n[Patient] Sure, um, I'm Amanda Jackson and I'm nineteen years old.\n[Doctor] Nineteen years old OK Amanda, and how can I help you this afternoon?\n[Patient] Um, so it's being going on for a few days now. Um, it's not happened before and I'm bit worried. I've uh it quite hurts when I kind of pee.\n[Doctor] \n[Patient] Um, and yeah it's like I'm going to the toilet a lot more, um. And it's really, like I can't, like go to uni properly. I'm just like constantly looking for the toilet.\n[Doctor] \n[Patient] Um, and it kind of hurts sometimes when I'm, like in at the bottom of my tummy as well.\n[Doctor] Right OK. I'm sorry to hear there's a lot going on there and I can, see why it's affecting you. Um, so you mentioned it's been going on for last three days, mainly the burning pain when you pass urine. Um, you said you're going to the toilet more often as well, that right?\n[Patient] Uh, yeah it's been going on for a little bit longer than three days I think actually, maybe just under a week. Um.\n[Doctor] Ohh and a week, sorry my . OK, uh.\n[Patient] Sorry no I didn't explain it properly before, um yeah no I it's been going on for about just under a week.\n[Doctor] \n[Patient] Um, and yeah I notice a sort of burning, stinging, when I when I go to the toilet, yeah.\n[Doctor] Are you noticing any, anything in your urine, predominantly blood or um, discolouration of urine?\n[Patient] Um, I think, well today I noticed, um, that it was like a bit pink. The, the urine.\n[Doctor] \n[Doctor] OK, uh of any kind of frank blood? I mean red blood at all, in your urine? \n[Patient] Yeah, I think just today .\n[Patient] Um, I think it was probably but I don't know it was pink so.\n[Doctor] OK. Um, fine we'll we'll have to definitely explore that in a little bit or detail later on. Um, you also mentioned some tummy pain as well, can you tell me a bit more about that pain?\n[Patient] Yeah it's kind of at the bottom of my tummy, um, uh mainly when I go to the loo, I think that's when it's worse.\n[Doctor] OK. Um, can you describe it crampy pain? Is it more of a burning pain?\n[Patient] Um, I wouldn't describe it as crampy I don't think it's like a period pain, it's a bit different, it's, it's hard to say, an achey pain I suppose.\n[Doctor] OK.\n[Doctor] An aching pain, OK. And does the pain move anywhere else? Does it move towards your back? Towards your sides?\n[Patient] No, no, no.\n[Doctor] OK, all right. Um, any other symptoms? Nausea? Vomiting?\n[Patient] No, no nausea vomiting.\n[Doctor] OK. Any temperatures or fevers?\n[Patient] Um no, no not that I've noticed.\n[Doctor] OK, all right. And how are your bowels at the moment? Are your bowels working OK?\n[Patient] Uh I, I usually have a bit of problems with my bowels anyway, so I don't think it's any, different, from what it usually is.\n[Doctor] OK, and when, when when you say you have problems, what kind of problems do you normally have?\n[Patient] Um, I think I have, um, IBS, um, so I just kinda pass, uh, my bowels like quite, quite a lot.\n[Doctor] Right.\n[Patient] Um, and sometimes it's quite, it's quite variable like sometimes it's a bit softer, sometimes it's a bit, sorry if it's a bit disgusting but like, sometimes it's a bit uh harder and kind of hard to predict.\n[Doctor] OK, all right but, and you've noticed no new symptoms? No, no, no new symptoms in your bowels?\n[Patient] Like, yeah OK.\n[Doctor] Uh. OK, all right. Um, and Amanda sometimes we have to ask quite sensitive questions as you can imagine. Um, uh, can I ask? Are you currently uh, are you currently sexually active? At the moment?\n[Patient] No, no, not \n[Patient] Uh uh yeah um, I have a, a long-term, um, boyfriend.\n[Doctor] OK, and um, have you noticed any other discharge from down below? So, from from the front passage?\n[Patient] Hmm no I don't think so. Nothing unusual.\n[Doctor] OK. Have you, do you use any form of contraception?\n[Patient] Uh yeah, uh I'm um on the pill.\n[Doctor] The pill. What kind of pill is it? Is it combined pill or the mini-pill?\n[Patient] Uh, combined pill.\n[Doctor] OK, fine. Um, when was the last time you had um, unprotected sex? If you don't want me asking.\n[Patient] Um, uh, I mean, mean unprotected as in like no, no condoms or anything?\n[Doctor] Yeah, exactly.\n[Patient] Um, I, I guess 'cause, um, I don't really use condoms with my boyfriend, like. I dunno we've just kind of agreed, uh, so um I guess, a week ago, two weeks ago , quite quite .\n[Doctor] Yep, a week ago, OK all right. What I'm trying get at is whether um, uh there's any chance you could be pregnant at all. Uh, I know you're on the pill, but um we're we, nonetheless we do have to ask. Um when was your last, when was your last period?\n[Patient] \n[Patient] \n[Patient] Um, two weeks ago.\n[Doctor] Two weeks ago OK, all right. Just something for us, to bear in mind, if your symptoms don't get any better OK, um. Fine, in terms of your general health otherwise at the moment are you, uh eating and drinking OK?\n[Patient] Uh, yeah, yeah eating drinking OK. Um, I did have one kinda concern I dunno \n[Doctor] \n[Patient] So I I smoked, uh this is quite bad, but I smoked weed for the first time. Uh, like a week and a half ago, I I just wondered whether it's related at all, probably not but I just thought I'd get some advice from you.\n[Doctor] Sure, well thanks for sharing with me. Um, so, I, I don't think it's is related to your symptoms, I think it probably just pure pure coincidence, um.\n[Patient] Sure OK.\n[Patient] Sure.\n[Doctor] But, uh, you know I do strongly advise you to you know, um, make it a regular habit if you can. Um, just for your, just for your general health moving forwards, OK?\n[Patient] OK.\n[Doctor] Um, fine. Moving on, in terms of your health otherwise, do you have any other medical conditions , apart from the IBS, is there anything else I should be aware of?\n[Patient] Sure .\n[Patient] No, nope.\n[Doctor] No, OK great. And what about any medications that you take on a regular basis, apart from the, um, combined pill?\n[Patient] Apart from the pill, um, I take, um, something for the IBS as well. Um it begins with an M, it's pretty hard to pronounce like something , maybe.\n[Doctor] was it, yeah OK.\n[Patient] Yeah, yeah that's it. Yeah, yeah that's right.\n[Doctor] OK, and is that for the cramps, the crampy pain?\n[Patient] Yeah, yeah.\n[Doctor] Yeah OK, and do you have any allergy to any medications?\n[Patient] Um, yeah I think there was an antibiotic, um, called Clindamycin mycin .\n[Doctor] OK, OK, OK.\n[Patient] Then I took like something and yeah that, that didn't, go too well, with me.\n[Doctor] Ritib, OK sure, I'll make a note of that. Um, in terms of family history, any history of problems with the bladder or the kidneys?\n[Patient] No, no.\n[Doctor] No, or generally anything else, good. And socially, tell me a bit more about your home situation, who's at home with you?\n[Patient] Um, so I am living in halls at the moment, uh at uni um, so uh, uh, I'm just living with a flatmate I suppose, um.\n[Doctor] \n[Patient] But my family, uh, live kind of outside of London not too far away. Um, so yeah the my family are fine and I see them now and then. Uh, yeah things I think, I think they're OK generally.\n[Doctor] Very good.\n[Doctor] Great, and what are you studying at university?\n[Patient] I'm studying, uh, English.\n[Doctor] English, OK good, and how are you enjoying your course?\n[Patient] Yeah, yeah it's it's going well thanks. Just kind of started a few months ago, a few months ago and yeah I, I really enjoy it. Yeah, yeah it's really fun.\n[Doctor] Good.\n[Doctor] Very good, very good, good. Um, in terms of smoking and alcohol, do you, do you participate in either?\n[Patient] Uh, as I admitted before I tried weed for the first time, uh, but, uh, I don't smoke. Uh ,I drink occasionally, um, kind of socially, um, with friends .\n[Doctor] O K OK, what, what's made you have your first joint last week? Was \n[Patient] Um, I it was just a party,.Um, there were other people doing it, um.\n[Doctor] OK.\n[Patient] I kind of was a little bit tipsy so, probably wasn't thinking quite straight. Um, but yeah I, I completely agree it's not something I wanna get into on a regular basis.\n[Doctor] \n[Doctor] Sure, uh, and obviously as your doctor I'm here to look after you so yeah I I would strongly recommend you, you know, to avoid if you can. Great, um, fine so, at this stage I wouldn't normally examine you, but I think based on your story I think, um, you know, uh, I'm reassured.\n[Patient] Sure.\n[Doctor] But the fact that I, I I think it's, um, probably just a simple what we'd say a UTI or a cystitis, bladder infection.\n[Patient] OK.\n[Doctor] Uh, you know you haven't got any other symptoms that, suggest to me that there's anything to worry about, so things like fevers and back pain. Um, would be more worrying for me to hear. Um, so it's something we can treat quite readily with antibiotics. Um, so we've got a choice of two antibiotics something called Trimethoprim or, Nitrofurantoin which is a three day course.\n[Patient] \n[Patient] \n[Patient] Mm-hmm.\n[Patient] Mm-hmm.\n[Doctor] And normally they're usually quite effective, um, for your symptoms. It's probably worth giving us a urine sample today as well if you can, so we can send it off to the lab.\n[Patient] \n[Doctor] And see exactly what's going on there. Um, start the antibiotics, make sure you're well hydrated, drink plenty of fluids.\n[Patient] OK.\n[Patient] \n[Doctor] Um, if you are having some pain, simple Paracetamol, um, would probably be advisable.\n[Patient] Yeah.\n[Doctor] Um, we'll see what the urine sample shows. Um, and if it is indeed positive, we'll know which antibiotics are the right ones.\n[Patient] OK.\n[Doctor] Um, but if things still are still not getting any better next week come back and see me, and we can have another look again.\n[Patient] OK, OK uh great. Um, with, with the urine sample, um, uh, how do I go about doing that, do you know? Is it through the app?\n[Doctor] So if I'll give yeah no it's a well uh so yeah good question, so I will give you I will organise uh for you to come in, and drop off a sample at one of our practices, um which we can test there and then, at the urine and send it off to the lab uh we can back in touch with you with the results.\n[Patient] OK.\n[Patient] OK perfect. Great.\n[Doctor] OK, do bear in mind those symptoms I mentioned about the fever and the back pain and vomiting. If you have any of those give me a call, OK?\n[Patient] Either back pain, vomiting, great OK. Yeah, I'll watch out for those.\n[Doctor] All right, OK. Have a good day. Thank you, bye bye.\n[Patient] OK, great thank you. You too, have a good day, bye bye.",
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"text": " hello can you hear me ok?",
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"text": "Hello. Hi.",
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"text": " Right excellent, before I go any further, can I confirm your name and your age please?",
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"text": "Sure, um, I'm Amanda Jackson and I'm nineteen years old.",
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"text": "Um, so it's being going on for a few days now. Um, it's not happened before and I'm bit worried. I've uh it quite hurts when I kind of pee.",
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"text": "Um, and yeah it's like I'm going to the toilet a lot more, um. And it's really, like I can't, like go to uni properly. I'm just like constantly looking for the toilet.",
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"text": "Um, and it kind of hurts sometimes when I'm, like in at the bottom of my tummy as well.",
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"text": "Right OK. I'm sorry to hear there's a lot going on there and I can, see why it's affecting you. Um, so you mentioned it's been going on for last three days, mainly the burning pain when you pass urine. Um, you said you're going to the toilet more often as well, that right?",
"speaker": "Doctor"
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"text": "Uh, yeah it's been going on for a little bit longer than three days I think actually, maybe just under a week. Um.",
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"text": "Sorry no I didn't explain it properly before, um yeah no I it's been going on for about just under a week.",
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"text": "Um, and yeah I notice a sort of burning, stinging, when I when I go to the toilet, yeah.",
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"text": " Are you noticing any, anything in your urine, predominantly blood or um, discolouration of urine?",
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"text": "Um, I think, well today I noticed, um, that it was like a bit pink. The, the urine.",
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"text": " OK. Um, fine we'll we'll have to definitely explore that in a little bit or detail later on. Um, you also mentioned some tummy pain as well, can you tell me a bit more about that pain?",
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"text": "Yeah it's kind of at the bottom of my tummy, um, uh mainly when I go to the loo, I think that's when it's worse.",
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"text": "OK. Um, can you describe it crampy pain? Is it more of a burning pain?",
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"text": "Um, I wouldn't describe it as crampy I don't think it's like a period pain, it's a bit different, it's, it's hard to say, an achey pain I suppose.",
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"text": " OK, all right. Um, any other symptoms? Nausea? Vomiting?",
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"text": "No, no nausea vomiting.",
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"text": "Um no, no not that I've noticed.",
"speaker": "Patient"
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"text": "OK, all right. And how are your bowels at the moment? Are your bowels working OK?",
"speaker": "Doctor"
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"text": "Uh I, I usually have a bit of problems with my bowels anyway, so I don't think it's any, different, from what it usually is.",
"speaker": "Patient"
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{
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"text": "OK, and when, when when you say you have problems, what kind of problems do you normally have?",
"speaker": "Doctor"
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"text": "Um, I think I have, um, IBS, um, so I just kinda pass, uh, my bowels like quite, quite a lot.",
"speaker": "Patient"
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"text": "Right.",
"speaker": "Doctor"
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"text": "Um, and sometimes it's quite, it's quite variable like sometimes it's a bit softer, sometimes it's a bit, sorry if it's a bit disgusting but like, sometimes it's a bit uh harder and kind of hard to predict.",
"speaker": "Patient"
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"text": " OK, all right but, and you've noticed no new symptoms? No, no, no new symptoms in your bowels?",
"speaker": "Doctor"
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"text": "Like, yeah OK.",
"speaker": "Patient"
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"text": "Uh. OK, all right. Um, and Amanda sometimes we have to ask quite sensitive questions as you can imagine. Um, uh, can I ask? Are you currently uh, are you currently sexually active? At the moment?",
"speaker": "Doctor"
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"text": "No, no, not ",
"speaker": "Patient"
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"text": "Uh uh yeah um, I have a, a long-term, um, boyfriend.",
"speaker": "Patient"
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"text": "OK, and um, have you noticed any other discharge from down below? So, from from the front passage?",
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"text": "Hmm no I don't think so. Nothing unusual.",
"speaker": "Patient"
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"text": " OK. Have you, do you use any form of contraception?",
"speaker": "Doctor"
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"text": "Uh yeah, uh I'm um on the pill.",
"speaker": "Patient"
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"text": "The pill. What kind of pill is it? Is it combined pill or the mini-pill?",
"speaker": "Doctor"
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"text": "Uh, combined pill.",
"speaker": "Patient"
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"text": "OK, fine. Um, when was the last time you had um, unprotected sex? If you don't want me asking.",
"speaker": "Doctor"
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"text": "Um, uh, I mean, mean unprotected as in like no, no condoms or anything?",
"speaker": "Patient"
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"text": "Yeah, exactly.",
"speaker": "Doctor"
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"text": "Um, I, I guess 'cause, um, I don't really use condoms with my boyfriend, like. I dunno we've just kind of agreed, uh, so um I guess, a week ago, two weeks ago , quite quite .",
"speaker": "Patient"
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"text": "Yep, a week ago, OK all right. What I'm trying get at is whether um, uh there's any chance you could be pregnant at all. Uh, I know you're on the pill, but um we're we, nonetheless we do have to ask. Um when was your last, when was your last period?",
"speaker": "Doctor"
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"text": "Um, two weeks ago.",
"speaker": "Patient"
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"text": "Two weeks ago OK, all right. Just something for us, to bear in mind, if your symptoms don't get any better OK, um. Fine, in terms of your general health otherwise at the moment are you, uh eating and drinking OK?",
"speaker": "Doctor"
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"text": "Uh, yeah, yeah eating drinking OK. Um, I did have one kinda concern I dunno ",
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"text": "So I I smoked, uh this is quite bad, but I smoked weed for the first time. Uh, like a week and a half ago, I I just wondered whether it's related at all, probably not but I just thought I'd get some advice from you.",
"speaker": "Patient"
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{
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"text": " Sure, well thanks for sharing with me. Um, so, I, I don't think it's is related to your symptoms, I think it probably just pure pure coincidence, um.",
"speaker": "Doctor"
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"text": "Sure OK.",
"speaker": "Patient"
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"text": "Sure.",
"speaker": "Patient"
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"text": "But, uh, you know I do strongly advise you to you know, um, make it a regular habit if you can. Um, just for your, just for your general health moving forwards, OK?",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "Um, fine. Moving on, in terms of your health otherwise, do you have any other medical conditions , apart from the IBS, is there anything else I should be aware of?",
"speaker": "Doctor"
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"start": 350.59223,
"end": 351.97223,
"text": "Sure .",
"speaker": "Patient"
},
{
"start": 359.54728,
"end": 360.82229,
"text": "No, nope.",
"speaker": "Patient"
},
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"start": 360.01111,
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"text": "No, OK great. And what about any medications that you take on a regular basis, apart from the, um, combined pill?",
"speaker": "Doctor"
},
{
"start": 368.01733,
"end": 377.85741,
"text": "Apart from the pill, um, I take, um, something for the IBS as well. Um it begins with an M, it's pretty hard to pronounce like something , maybe.",
"speaker": "Patient"
},
{
"start": 375.1975,
"end": 379.33548,
"text": " was it, yeah OK.",
"speaker": "Doctor"
},
{
"start": 378.79741,
"end": 381.04742,
"text": "Yeah, yeah that's it. Yeah, yeah that's right.",
"speaker": "Patient"
},
{
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"end": 383.53551,
"text": "OK, and is that for the cramps, the crampy pain?",
"speaker": "Doctor"
},
{
"start": 384.04243,
"end": 385.38243,
"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 384.53551,
"end": 387.80451,
"text": "Yeah OK, and do you have any allergy to any medications?",
"speaker": "Doctor"
},
{
"start": 389.00246,
"end": 396.81751,
"text": "Um, yeah I think there was an antibiotic, um, called Clindamycin mycin .",
"speaker": "Patient"
},
{
"start": 394.51494,
"end": 397.78393,
"text": " OK, OK, OK.",
"speaker": "Doctor"
},
{
"start": 396.81751,
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"text": "Then I took like something and yeah that, that didn't, go too well, with me.",
"speaker": "Patient"
},
{
"start": 401.9495,
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"text": "Ritib, OK sure, I'll make a note of that. Um, in terms of family history, any history of problems with the bladder or the kidneys?",
"speaker": "Doctor"
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"text": "No, no.",
"speaker": "Patient"
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"start": 412.37031,
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"text": "No, or generally anything else, good. And socially, tell me a bit more about your home situation, who's at home with you?",
"speaker": "Doctor"
},
{
"start": 419.98766,
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"text": "Um, so I am living in halls at the moment, uh at uni um, so uh, uh, I'm just living with a flatmate I suppose, um.",
"speaker": "Patient"
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{
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"speaker": "Doctor"
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"text": "But my family, uh, live kind of outside of London not too far away. Um, so yeah the my family are fine and I see them now and then. Uh, yeah things I think, I think they're OK generally.",
"speaker": "Patient"
},
{
"start": 436.41887,
"end": 438.35682,
"text": " Very good.",
"speaker": "Doctor"
},
{
"start": 440.14304,
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"text": "Great, and what are you studying at university?",
"speaker": "Doctor"
},
{
"start": 442.94282,
"end": 444.99283,
"text": "I'm studying, uh, English.",
"speaker": "Patient"
},
{
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"text": "English, OK good, and how are you enjoying your course?",
"speaker": "Doctor"
},
{
"start": 448.40285,
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"text": "Yeah, yeah it's it's going well thanks. Just kind of started a few months ago, a few months ago and yeah I, I really enjoy it. Yeah, yeah it's really fun.",
"speaker": "Patient"
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"start": 450.69485,
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"text": "Good.",
"speaker": "Doctor"
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"text": "Very good, very good, good. Um, in terms of smoking and alcohol, do you, do you participate in either?",
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},
{
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"text": "Uh, as I admitted before I tried weed for the first time, uh, but, uh, I don't smoke. Uh ,I drink occasionally, um, kind of socially, um, with friends .",
"speaker": "Patient"
},
{
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"text": " O K OK, what, what's made you have your first joint last week? Was ",
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"text": "Um, I it was just a party,.Um, there were other people doing it, um.",
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"text": "OK.",
"speaker": "Doctor"
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"text": "I kind of was a little bit tipsy so, probably wasn't thinking quite straight. Um, but yeah I, I completely agree it's not something I wanna get into on a regular basis.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "Sure, uh, and obviously as your doctor I'm here to look after you so yeah I I would strongly recommend you, you know, to avoid if you can. Great, um, fine so, at this stage I wouldn't normally examine you, but I think based on your story I think, um, you know, uh, I'm reassured.",
"speaker": "Doctor"
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{
"start": 499.1732,
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"text": "Sure.",
"speaker": "Patient"
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{
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"text": "But the fact that I, I I think it's, um, probably just a simple what we'd say a UTI or a cystitis, bladder infection.",
"speaker": "Doctor"
},
{
"start": 515.54832,
"end": 517.22832,
"text": " OK.",
"speaker": "Patient"
},
{
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"text": "Uh, you know you haven't got any other symptoms that, suggest to me that there's anything to worry about, so things like fevers and back pain. Um, would be more worrying for me to hear. Um, so it's something we can treat quite readily with antibiotics. Um, so we've got a choice of two antibiotics something called Trimethoprim or, Nitrofurantoin which is a three day course.",
"speaker": "Doctor"
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"text": "Mm-hmm.",
"speaker": "Patient"
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"end": 537.82842,
"text": "Mm-hmm.",
"speaker": "Patient"
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{
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"text": "And normally they're usually quite effective, um, for your symptoms. It's probably worth giving us a urine sample today as well if you can, so we can send it off to the lab.",
"speaker": "Doctor"
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{
"start": 543.13846,
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"speaker": "Patient"
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{
"start": 546.02012,
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"text": "And see exactly what's going on there. Um, start the antibiotics, make sure you're well hydrated, drink plenty of fluids.",
"speaker": "Doctor"
},
{
"start": 546.82847,
"end": 547.42847,
"text": "OK.",
"speaker": "Patient"
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"start": 549.84848,
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"speaker": "Patient"
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{
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"text": "Um, if you are having some pain, simple Paracetamol, um, would probably be advisable.",
"speaker": "Doctor"
},
{
"start": 554.6435,
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"text": "Yeah.",
"speaker": "Patient"
},
{
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"text": "Um, we'll see what the urine sample shows. Um, and if it is indeed positive, we'll know which antibiotics are the right ones.",
"speaker": "Doctor"
},
{
"start": 560.10353,
"end": 560.69853,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 568.28937,
"end": 574.53772,
"text": "Um, but if things still are still not getting any better next week come back and see me, and we can have another look again.",
"speaker": "Doctor"
},
{
"start": 575.29864,
"end": 584.4437,
"text": "OK, OK uh great. Um, with, with the urine sample, um, uh, how do I go about doing that, do you know? Is it through the app?",
"speaker": "Patient"
},
{
"start": 582.61368,
"end": 600.14495,
"text": "So if I'll give yeah no it's a well uh so yeah good question, so I will give you I will organise uh for you to come in, and drop off a sample at one of our practices, um which we can test there and then, at the urine and send it off to the lab uh we can back in touch with you with the results.",
"speaker": "Doctor"
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{
"start": 596.79379,
"end": 597.79379,
"text": "OK.",
"speaker": "Patient"
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{
"start": 601.02881,
"end": 602.89882,
"text": "OK perfect. Great.",
"speaker": "Patient"
},
{
"start": 602.0691,
"end": 608.40022,
"text": "OK, do bear in mind those symptoms I mentioned about the fever and the back pain and vomiting. If you have any of those give me a call, OK?",
"speaker": "Doctor"
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{
"start": 609.30386,
"end": 612.42888,
"text": "Either back pain, vomiting, great OK. Yeah, I'll watch out for those.",
"speaker": "Patient"
},
{
"start": 611.47611,
"end": 616.42099,
"text": "All right, OK. Have a good day. Thank you, bye bye.",
"speaker": "Doctor"
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"start": 613.83388,
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"text": "OK, great thank you. You too, have a good day, bye bye.",
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"doctor_utterances": " hello can you hear me ok? Right excellent, before I go any further, can I confirm your name and your age please? Nineteen years old OK Amanda, and how can I help you this afternoon? Right OK. I'm sorry to hear there's a lot going on there and I can, see why it's affecting you. Um, so you mentioned it's been going on for last three days, mainly the burning pain when you pass urine. Um, you said you're going to the toilet more often as well, that right? Ohh and a week, sorry my . OK, uh. Are you noticing any, anything in your urine, predominantly blood or um, discolouration of urine? OK, uh of any kind of frank blood? I mean red blood at all, in your urine? OK. Um, fine we'll we'll have to definitely explore that in a little bit or detail later on. Um, you also mentioned some tummy pain as well, can you tell me a bit more about that pain? OK. Um, can you describe it crampy pain? Is it more of a burning pain? OK. An aching pain, OK. And does the pain move anywhere else? Does it move towards your back? Towards your sides? OK, all right. Um, any other symptoms? Nausea? Vomiting? OK. Any temperatures or fevers? OK, all right. And how are your bowels at the moment? Are your bowels working OK? OK, and when, when when you say you have problems, what kind of problems do you normally have? Right. OK, all right but, and you've noticed no new symptoms? No, no, no new symptoms in your bowels? Uh. OK, all right. Um, and Amanda sometimes we have to ask quite sensitive questions as you can imagine. Um, uh, can I ask? Are you currently uh, are you currently sexually active? At the moment? OK, and um, have you noticed any other discharge from down below? So, from from the front passage? OK. Have you, do you use any form of contraception? The pill. What kind of pill is it? Is it combined pill or the mini-pill? OK, fine. Um, when was the last time you had um, unprotected sex? If you don't want me asking. Yeah, exactly. Yep, a week ago, OK all right. What I'm trying get at is whether um, uh there's any chance you could be pregnant at all. Uh, I know you're on the pill, but um we're we, nonetheless we do have to ask. Um when was your last, when was your last period? Two weeks ago OK, all right. Just something for us, to bear in mind, if your symptoms don't get any better OK, um. Fine, in terms of your general health otherwise at the moment are you, uh eating and drinking OK? Sure, well thanks for sharing with me. Um, so, I, I don't think it's is related to your symptoms, I think it probably just pure pure coincidence, um. But, uh, you know I do strongly advise you to you know, um, make it a regular habit if you can. Um, just for your, just for your general health moving forwards, OK? Um, fine. Moving on, in terms of your health otherwise, do you have any other medical conditions , apart from the IBS, is there anything else I should be aware of? No, OK great. And what about any medications that you take on a regular basis, apart from the, um, combined pill? was it, yeah OK. OK, and is that for the cramps, the crampy pain? Yeah OK, and do you have any allergy to any medications? OK, OK, OK. Ritib, OK sure, I'll make a note of that. Um, in terms of family history, any history of problems with the bladder or the kidneys? No, or generally anything else, good. And socially, tell me a bit more about your home situation, who's at home with you? Very good. Great, and what are you studying at university? English, OK good, and how are you enjoying your course? Good. Very good, very good, good. Um, in terms of smoking and alcohol, do you, do you participate in either? O K OK, what, what's made you have your first joint last week? Was OK. Sure, uh, and obviously as your doctor I'm here to look after you so yeah I I would strongly recommend you, you know, to avoid if you can. Great, um, fine so, at this stage I wouldn't normally examine you, but I think based on your story I think, um, you know, uh, I'm reassured. But the fact that I, I I think it's, um, probably just a simple what we'd say a UTI or a cystitis, bladder infection. Uh, you know you haven't got any other symptoms that, suggest to me that there's anything to worry about, so things like fevers and back pain. Um, would be more worrying for me to hear. Um, so it's something we can treat quite readily with antibiotics. Um, so we've got a choice of two antibiotics something called Trimethoprim or, Nitrofurantoin which is a three day course. And normally they're usually quite effective, um, for your symptoms. It's probably worth giving us a urine sample today as well if you can, so we can send it off to the lab. And see exactly what's going on there. Um, start the antibiotics, make sure you're well hydrated, drink plenty of fluids. Um, if you are having some pain, simple Paracetamol, um, would probably be advisable. Um, we'll see what the urine sample shows. Um, and if it is indeed positive, we'll know which antibiotics are the right ones. Um, but if things still are still not getting any better next week come back and see me, and we can have another look again. So if I'll give yeah no it's a well uh so yeah good question, so I will give you I will organise uh for you to come in, and drop off a sample at one of our practices, um which we can test there and then, at the urine and send it off to the lab uh we can back in touch with you with the results. OK, do bear in mind those symptoms I mentioned about the fever and the back pain and vomiting. If you have any of those give me a call, OK? All right, OK. Have a good day. Thank you, bye bye.",
"patient_utterances": "Hello. Hi. Yeah I can hear you, hi. Sure, um, I'm Amanda Jackson and I'm nineteen years old. Um, so it's being going on for a few days now. Um, it's not happened before and I'm bit worried. I've uh it quite hurts when I kind of pee. Um, and yeah it's like I'm going to the toilet a lot more, um. And it's really, like I can't, like go to uni properly. I'm just like constantly looking for the toilet. Um, and it kind of hurts sometimes when I'm, like in at the bottom of my tummy as well. Uh, yeah it's been going on for a little bit longer than three days I think actually, maybe just under a week. Um. Sorry no I didn't explain it properly before, um yeah no I it's been going on for about just under a week. Um, and yeah I notice a sort of burning, stinging, when I when I go to the toilet, yeah. Um, I think, well today I noticed, um, that it was like a bit pink. The, the urine. Yeah, I think just today . Um, I think it was probably but I don't know it was pink so. Yeah it's kind of at the bottom of my tummy, um, uh mainly when I go to the loo, I think that's when it's worse. Um, I wouldn't describe it as crampy I don't think it's like a period pain, it's a bit different, it's, it's hard to say, an achey pain I suppose. No, no, no. No, no nausea vomiting. Um no, no not that I've noticed. Uh I, I usually have a bit of problems with my bowels anyway, so I don't think it's any, different, from what it usually is. Um, I think I have, um, IBS, um, so I just kinda pass, uh, my bowels like quite, quite a lot. Um, and sometimes it's quite, it's quite variable like sometimes it's a bit softer, sometimes it's a bit, sorry if it's a bit disgusting but like, sometimes it's a bit uh harder and kind of hard to predict. Like, yeah OK. No, no, not Uh uh yeah um, I have a, a long-term, um, boyfriend. Hmm no I don't think so. Nothing unusual. Uh yeah, uh I'm um on the pill. Uh, combined pill. Um, uh, I mean, mean unprotected as in like no, no condoms or anything? Um, I, I guess 'cause, um, I don't really use condoms with my boyfriend, like. I dunno we've just kind of agreed, uh, so um I guess, a week ago, two weeks ago , quite quite . Um, two weeks ago. Uh, yeah, yeah eating drinking OK. Um, I did have one kinda concern I dunno So I I smoked, uh this is quite bad, but I smoked weed for the first time. Uh, like a week and a half ago, I I just wondered whether it's related at all, probably not but I just thought I'd get some advice from you. Sure OK. Sure. OK. Sure . No, nope. Apart from the pill, um, I take, um, something for the IBS as well. Um it begins with an M, it's pretty hard to pronounce like something , maybe. Yeah, yeah that's it. Yeah, yeah that's right. Yeah, yeah. Um, yeah I think there was an antibiotic, um, called Clindamycin mycin . Then I took like something and yeah that, that didn't, go too well, with me. No, no. Um, so I am living in halls at the moment, uh at uni um, so uh, uh, I'm just living with a flatmate I suppose, um. But my family, uh, live kind of outside of London not too far away. Um, so yeah the my family are fine and I see them now and then. Uh, yeah things I think, I think they're OK generally. I'm studying, uh, English. Yeah, yeah it's it's going well thanks. Just kind of started a few months ago, a few months ago and yeah I, I really enjoy it. Yeah, yeah it's really fun. Uh, as I admitted before I tried weed for the first time, uh, but, uh, I don't smoke. Uh ,I drink occasionally, um, kind of socially, um, with friends . Um, I it was just a party,.Um, there were other people doing it, um. I kind of was a little bit tipsy so, probably wasn't thinking quite straight. Um, but yeah I, I completely agree it's not something I wanna get into on a regular basis. Sure. OK. Mm-hmm. Mm-hmm. OK. Yeah. OK. OK, OK uh great. Um, with, with the urine sample, um, uh, how do I go about doing that, do you know? Is it through the app? OK. OK perfect. Great. Either back pain, vomiting, great OK. Yeah, I'll watch out for those. OK, great thank you. You too, have a good day, bye bye.",
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"reference_note": "{\"day\": 1, \"consultation\": 10, \"presenting_complaint\": \"It hurts when I pee\", \"note\": \"1/52 hx of dysuria, frequency and suprapubic pain. Noticed urine today was pink, nil frank haematuria. \\nSuprapubic pain on PU - aching pain, nil radiating \\nNil nausea/vomiting \\nNil fevers \\nNil new bowel sx \\nCurrently sexually active - long-term partner. Nil PV discharge. LMP 2/52 \\nE+D well \\n\\nPMH: IBS\\nDH: COCP, mebeverine \\nAllergic to clindamycin \\nFH: nil\\nSH: lives in student halls, nil smoking, social EtOH\\n\\nImp: UTI\\n\\nPlan:\\n1.\\tUrine dip and MSU\\n2.\\tStart abx - nitrofurantoin abx for 3/7 \\n3.\\tPush fluids \\n4.\\tSimple analgesia\\n5.\\tReview in 1/52 INB, or earlier if worsening sx (fever, back pain, vomiting)\\n\", \"highlights\": [\"dysuria\", \"frequency\", \"suprapubic pain\", \"IBS\", \"UTI\"]}",
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"dialogue": "[Doctor] Uh no, it is, yes. Hello?\n[Patient] Hi.\n[Doctor] Can you hear me OK? Great. Hello there. Um, before I go any further, can I confirm you name and your age please?\n[Patient] Yes. So, my name is Robert.\n[Doctor] Robert?\n[Patient] Yep.\n[Doctor] OK.\n[Patient] Um, I'm forty eight.\n[Doctor] OK. Great.\n[Patient] \n[Doctor] Excellent. And how can I help you this afternoon, sir?\n[Patient] Right, so, uh, I've been having, uh, diarrhoea, for like, let's say past three days, more or less.\n[Doctor] OK, well I'm sorry to hear that. Uh can you tell me a bit more about your diarrhoea?\n[Patient] Yeah, so it's been a, very bad diarrhoea, so it keeps me like, I keep going back and forth, to, to the toilet very often.\n[Doctor] Right.\n[Patient] Um, yeah it started like three days ago.\n[Doctor] Mm-hmm.\n[Patient] And uh, uh, so it started with vomiting, so I vomited a couple of times. Uh, but then, that went away, and, uh, yeah it's just diarrhoea now.\n[Doctor] OK. And you mentioned you've been um going to the toilet very often. How many times are you going a day?\n[Patient] Yeah, around, five to six times a day.\n[Doctor] OK. And uh uh can you tell me, I know it's not nice to talk about, but is it quite watery, your stools, loose?\n[Patient] Yes, it's definitely, definitely watery, uh, loose stools, yeah.\n[Doctor] OK.\n[Doctor] K. Any blood in your stools?\n[Patient] No, not that I could see.\n[Doctor] OK. And uh uh uh with the diarrhea have you noticed any other symptoms, like tummy pain?\n[Patient] Uh, not, not really, no. Uh, but I, I, I feel like, um, I can't, really drink too much, so I feel very dehydrated.\n[Doctor] \n[Doctor] OK. When you say you can't drink too much, why is that?\n[Patient] Uh, yeah because, really I, uh I, um, I'm like, I feel like I don't drink enough, like I'm, I'm drink, I'm trying to drink, but then I just go to the loo, and I like, I, uh I, I, I do everything and I feel dehydrated again.\n[Doctor] OK, alright. Um have you managed to eat anything, solids?\n[Patient] Uh, not much, not much. So just a little bit, but I don't feel, um, I don't really feel like, uh, I have appetite.\n[Doctor] OK. You . OK. Um with your um, the vomiting has now stopped. Is that right? You said\n[Patient] Yes, yes.\n[Doctor] OK, alright. Have you had any other symptoms, like fever or temperature?\n[Patient] Uh, so, not, really I , I feel a little bit warm, um, probably at, at the beginning I was feeling I had a bit of temperature, but now I feel, I feel kind of fine.\n[Doctor] OK. \n[Patient] I feel very weak though.\n[Doctor] OK. Alright. Any headaches or muscle pains?\n[Patient] Not, not really, no.\n[Doctor] OK, alright. And you mentioned three days ago. What were you doing when the symptoms started? Are you aware of any triggers?\n[Patient] , not that I, I remember, what was I doing, I, I was at home I was working, on my computer and. Yeah, just felt, like some nausea and I had to, to vomit, and then I had some diarrhoea, straight after that.\n[Doctor] Yeah. Did you have any takeaway food, or any dodgy restaurant food?\n[Patient] Uh, not that I remember, no.\n[Doctor] OK. Have you been around anyone unwell, with diarrhea recently, last week or so?\n[Patient] Hmm, not that I know, not that I.\n[Doctor] OK. OK. Um, right. So moving on, um are you otherwise fit and well?\n[Patient] Yeah, yeah, .\n[Doctor] Uh OK. And do you take any regular medications?\n[Patient] Um, so I, I do suffer of asthma. So, I do have my inhalers, uh, that I you know, I need, I use infrequently, let's say only when I have, uh, a bit of .\n[Doctor] Is that, is that inhaler?\n[Patient] Sorry?\n[Doctor] Is that the blue inhaler? Blue inhaler. OK, alright. Any other medications that you take?\n[Patient] Yes it is, yeah.\n[Patient] Uh, no, nothing.\n[Doctor] OK. Do you have any allergies to medications?\n[Patient] Um, not that I know of.\n[Doctor] OK. And any family history of any medical problems?\n[Patient] Um, so, my father has, high uh, well used to have high blood pressure. He actually, so he actually died, of, bowel cancer, like ten years ago.\n[Doctor] OK. Sorry to hear that. Um, OK. And uh what about your mother?\n[Patient] Ohh yes, so uh, probably is worth mentioning uh, she has diabetes.\n[Doctor] Diabetes. Do you know if that's type one or type two?\n[Patient] Uh, it's type two.\n[Doctor] OK. Alright. Fine. And um, just a little bit more about your life in general, sir. Um who, who's at home with you? Who lives at home with you?\n[Patient] Sorry?\n[Doctor] Who lives at home with you, sir?\n[Patient] Ohh I, I live alone.\n[Doctor] You live alone, OK. Are you currently working at the moment?\n[Patient] Uh, well I haven't been able to work in the past few days, but yes , like given, uh, my uh.\n[Doctor] What's your employment? What do you do for work?\n[Patient] I'm a software engineer.\n[Doctor] . OK, alright. Have you taken time off work recently?\n[Patient] Uh, yes, yes I have, uh. Uh, these last three days I've been feeling, really unwell, so I couldn't work.\n[Doctor] OK, alright. And just the last couple of questions with, regarding your smoking and alcohol. Do you do either of those?\n[Patient] Uh, not really, I drink infrequently, like socially let's say, and I don't smoke.\n[Doctor] OK, alright. Um fine. uh Robert um having listened to your story, I think you're probably suffering from what we call gastroenteritis, uh which essentially is just a, a tummy bug. It's an infection of your, your tummy. Um and normally lasts about three to five days, and gets better.\n[Patient] OK.\n[Patient] All right.\n[Doctor] the things you can do to really help yourself get better soon, um are you can drink plenty of fluids. Really try and flush the toxins out of your body.\n[Patient] OK.\n[Doctor] Uh you can get things from the pharmacy, which is called Dioralyte, which can help replenish any uh minerals and vitamins you may have lost. Uh, it's called Dioralyte. Um it's, it's a, it's a type of fluid replacement drink.\n[Patient] I'm sorry, what's the name of that?\n[Patient] \n[Doctor] Um, you can take some Paracetamol if you're feeling feverish and weak.\n[Patient] All right.\n[Doctor] I would probably advise you to continue taking time off work for next day or two, until you get better. normally you have to be diarrhea-free for about twenty four to forty eight hours, before you return back to work.\n[Patient] OK.\n[Doctor] Um, let's see how the next few days go. And if you're still not better next week, I want you to come back and see me. And we can have another look at your symptoms, OK?\n[Patient] That sounds good, that sounds good. Uh, thanks so much.\n[Doctor] Thanks. do you have any questions for me, or?\n[Patient] Um, no I think that's fine. Uh, yeah I'll, I'll try to , and drink , drink plenty of fluid and I hope it go away. Uh, if it doesn't I'll uh, I'll call, I'll call back. Is that OK?\n[Doctor] \n[Doctor] I really hope you get better soon.\n[Patient] Thanks a lot. Thanks so much, for your time.\n[Doctor] OK. Bye bye.\n[Patient] OK. Bye.",
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"text": "Uh no, it is, yes. Hello?",
"speaker": "Doctor"
},
{
"start": 3.7183,
"end": 4.39436,
"text": "Hi.",
"speaker": "Patient"
},
{
"start": 4.85484,
"end": 11.06993,
"text": "Can you hear me OK? Great. Hello there. Um, before I go any further, can I confirm you name and your age please?",
"speaker": "Doctor"
},
{
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"text": "Yes. So, my name is Robert.",
"speaker": "Patient"
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{
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"text": "Robert?",
"speaker": "Doctor"
},
{
"start": 15.74636,
"end": 16.36867,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 16.42379,
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 17.32297,
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"text": "Um, I'm forty eight.",
"speaker": "Patient"
},
{
"start": 20.199,
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"text": "OK. Great.",
"speaker": "Doctor"
},
{
"start": 21.59382,
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"text": "",
"speaker": "Patient"
},
{
"start": 22.81191,
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"text": "Excellent. And how can I help you this afternoon, sir?",
"speaker": "Doctor"
},
{
"start": 25.98968,
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"text": "Right, so, uh, I've been having, uh, diarrhoea, for like, let's say past three days, more or less.",
"speaker": "Patient"
},
{
"start": 34.60874,
"end": 40.12569,
"text": "OK, well I'm sorry to hear that. Uh can you tell me a bit more about your diarrhoea?",
"speaker": "Doctor"
},
{
"start": 40.21357,
"end": 49.97817,
"text": "Yeah, so it's been a, very bad diarrhoea, so it keeps me like, I keep going back and forth, to, to the toilet very often.",
"speaker": "Patient"
},
{
"start": 49.74998,
"end": 50.28449,
"text": "Right.",
"speaker": "Doctor"
},
{
"start": 49.97817,
"end": 54.41291,
"text": "Um, yeah it started like three days ago.",
"speaker": "Patient"
},
{
"start": 53.91205,
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"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 54.41291,
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"text": "And uh, uh, so it started with vomiting, so I vomited a couple of times. Uh, but then, that went away, and, uh, yeah it's just diarrhoea now.",
"speaker": "Patient"
},
{
"start": 66.54731,
"end": 73.26534,
"text": "OK. And you mentioned you've been um going to the toilet very often. How many times are you going a day?",
"speaker": "Doctor"
},
{
"start": 73.40671,
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"text": "Yeah, around, five to six times a day.",
"speaker": "Patient"
},
{
"start": 77.03798,
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"text": "OK. And uh uh can you tell me, I know it's not nice to talk about, but is it quite watery, your stools, loose?",
"speaker": "Doctor"
},
{
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"text": "Yes, it's definitely, definitely watery, uh, loose stools, yeah.",
"speaker": "Patient"
},
{
"start": 86.24233,
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 91.27461,
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"text": "K. Any blood in your stools?",
"speaker": "Doctor"
},
{
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"text": "No, not that I could see.",
"speaker": "Patient"
},
{
"start": 95.66954,
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"text": "OK. And uh uh uh with the diarrhea have you noticed any other symptoms, like tummy pain?",
"speaker": "Doctor"
},
{
"start": 102.03885,
"end": 113.09846,
"text": "Uh, not, not really, no. Uh, but I, I, I feel like, um, I can't, really drink too much, so I feel very dehydrated.",
"speaker": "Patient"
},
{
"start": 105.18327,
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"text": "",
"speaker": "Doctor"
},
{
"start": 113.51127,
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"text": "OK. When you say you can't drink too much, why is that?",
"speaker": "Doctor"
},
{
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"text": "Uh, yeah because, really I, uh I, um, I'm like, I feel like I don't drink enough, like I'm, I'm drink, I'm trying to drink, but then I just go to the loo, and I like, I, uh I, I, I do everything and I feel dehydrated again.",
"speaker": "Patient"
},
{
"start": 133.93612,
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"text": "OK, alright. Um have you managed to eat anything, solids?",
"speaker": "Doctor"
},
{
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"text": "Uh, not much, not much. So just a little bit, but I don't feel, um, I don't really feel like, uh, I have appetite.",
"speaker": "Patient"
},
{
"start": 151.52702,
"end": 160.67224,
"text": "OK. You . OK. Um with your um, the vomiting has now stopped. Is that right? You said",
"speaker": "Doctor"
},
{
"start": 160.44903,
"end": 161.84487,
"text": "Yes, yes.",
"speaker": "Patient"
},
{
"start": 160.67224,
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"text": " OK, alright. Have you had any other symptoms, like fever or temperature?",
"speaker": "Doctor"
},
{
"start": 166.6574,
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"text": "Uh, so, not, really I , I feel a little bit warm, um, probably at, at the beginning I was feeling I had a bit of temperature, but now I feel, I feel kind of fine.",
"speaker": "Patient"
},
{
"start": 181.72201,
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"text": "OK. ",
"speaker": "Doctor"
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{
"start": 182.29334,
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"text": "I feel very weak though.",
"speaker": "Patient"
},
{
"start": 184.0594,
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"text": " OK. Alright. Any headaches or muscle pains?",
"speaker": "Doctor"
},
{
"start": 188.05341,
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"text": "Not, not really, no.",
"speaker": "Patient"
},
{
"start": 190.6461,
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"text": "OK, alright. And you mentioned three days ago. What were you doing when the symptoms started? Are you aware of any triggers?",
"speaker": "Doctor"
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{
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"text": ", not that I, I remember, what was I doing, I, I was at home I was working, on my computer and. Yeah, just felt, like some nausea and I had to, to vomit, and then I had some diarrhoea, straight after that.",
"speaker": "Patient"
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{
"start": 213.80078,
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"text": "Yeah. Did you have any takeaway food, or any dodgy restaurant food?",
"speaker": "Doctor"
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{
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"text": "Uh, not that I remember, no.",
"speaker": "Patient"
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{
"start": 221.7103,
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"text": "OK. Have you been around anyone unwell, with diarrhea recently, last week or so?",
"speaker": "Doctor"
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{
"start": 228.15787,
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"text": "Hmm, not that I know, not that I.",
"speaker": "Patient"
},
{
"start": 230.02705,
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"text": "OK. OK. Um, right. So moving on, um are you otherwise fit and well?",
"speaker": "Doctor"
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{
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"text": "Yeah, yeah, .",
"speaker": "Patient"
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{
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"text": "Um, so I, I do suffer of asthma. So, I do have my inhalers, uh, that I you know, I need, I use infrequently, let's say only when I have, uh, a bit of .",
"speaker": "Patient"
},
{
"start": 256.47979,
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"text": "Is that, is that inhaler?",
"speaker": "Doctor"
},
{
"start": 259.28309,
"end": 259.88726,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 259.92066,
"end": 266.56586,
"text": "Is that the blue inhaler? Blue inhaler. OK, alright. Any other medications that you take?",
"speaker": "Doctor"
},
{
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"text": "Yes it is, yeah.",
"speaker": "Patient"
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{
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"text": "Uh, no, nothing.",
"speaker": "Patient"
},
{
"start": 268.73253,
"end": 271.6734,
"text": "OK. Do you have any allergies to medications?",
"speaker": "Doctor"
},
{
"start": 271.96966,
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"text": "Um, not that I know of.",
"speaker": "Patient"
},
{
"start": 274.36158,
"end": 279.01752,
"text": "OK. And any family history of any medical problems?",
"speaker": "Doctor"
},
{
"start": 279.5332,
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"text": "Um, so, my father has, high uh, well used to have high blood pressure. He actually, so he actually died, of, bowel cancer, like ten years ago.",
"speaker": "Patient"
},
{
"start": 292.31232,
"end": 298.36172,
"text": "OK. Sorry to hear that. Um, OK. And uh what about your mother?",
"speaker": "Doctor"
},
{
"start": 297.45001,
"end": 304.31018,
"text": "Ohh yes, so uh, probably is worth mentioning uh, she has diabetes.",
"speaker": "Patient"
},
{
"start": 304.48541,
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"text": "Diabetes. Do you know if that's type one or type two?",
"speaker": "Doctor"
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{
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"text": "Uh, it's type two.",
"speaker": "Patient"
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{
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"text": "OK. Alright. Fine. And um, just a little bit more about your life in general, sir. Um who, who's at home with you? Who lives at home with you?",
"speaker": "Doctor"
},
{
"start": 322.42666,
"end": 323.01416,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 323.13719,
"end": 324.46114,
"text": "Who lives at home with you, sir?",
"speaker": "Doctor"
},
{
"start": 325.05437,
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"text": "Ohh I, I live alone.",
"speaker": "Patient"
},
{
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"text": "You live alone, OK. Are you currently working at the moment?",
"speaker": "Doctor"
},
{
"start": 330.23198,
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"text": "Uh, well I haven't been able to work in the past few days, but yes , like given, uh, my uh.",
"speaker": "Patient"
},
{
"start": 336.65758,
"end": 338.99093,
"text": "What's your employment? What do you do for work?",
"speaker": "Doctor"
},
{
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"text": "I'm a software engineer.",
"speaker": "Patient"
},
{
"start": 340.74899,
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"text": ". OK, alright. Have you taken time off work recently?",
"speaker": "Doctor"
},
{
"start": 347.05451,
"end": 355.10815,
"text": "Uh, yes, yes I have, uh. Uh, these last three days I've been feeling, really unwell, so I couldn't work.",
"speaker": "Patient"
},
{
"start": 355.20468,
"end": 362.02867,
"text": "OK, alright. And just the last couple of questions with, regarding your smoking and alcohol. Do you do either of those?",
"speaker": "Doctor"
},
{
"start": 362.86713,
"end": 369.22135,
"text": "Uh, not really, I drink infrequently, like socially let's say, and I don't smoke.",
"speaker": "Patient"
},
{
"start": 369.21639,
"end": 392.50194,
"text": "OK, alright. Um fine. uh Robert um having listened to your story, I think you're probably suffering from what we call gastroenteritis, uh which essentially is just a, a tummy bug. It's an infection of your, your tummy. Um and normally lasts about three to five days, and gets better.",
"speaker": "Doctor"
},
{
"start": 382.57562,
"end": 383.32562,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 393.30487,
"end": 394.30487,
"text": "All right.",
"speaker": "Patient"
},
{
"start": 393.56826,
"end": 402.98977,
"text": " the things you can do to really help yourself get better soon, um are you can drink plenty of fluids. Really try and flush the toxins out of your body.",
"speaker": "Doctor"
},
{
"start": 403.45077,
"end": 404.24244,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 403.54829,
"end": 420.3838,
"text": "Uh you can get things from the pharmacy, which is called Dioralyte, which can help replenish any uh minerals and vitamins you may have lost. Uh, it's called Dioralyte. Um it's, it's a, it's a type of fluid replacement drink.",
"speaker": "Doctor"
},
{
"start": 411.82583,
"end": 413.47167,
"text": "I'm sorry, what's the name of that?",
"speaker": "Patient"
},
{
"start": 416.93002,
"end": 417.40918,
"text": "",
"speaker": "Patient"
},
{
"start": 420.3838,
"end": 424.80318,
"text": "Um, you can take some Paracetamol if you're feeling feverish and weak.",
"speaker": "Doctor"
},
{
"start": 420.82587,
"end": 421.3467,
"text": "All right.",
"speaker": "Patient"
},
{
"start": 424.80318,
"end": 436.67958,
"text": "I would probably advise you to continue taking time off work for next day or two, until you get better. normally you have to be diarrhea-free for about twenty four to forty eight hours, before you return back to work.",
"speaker": "Doctor"
},
{
"start": 430.4926,
"end": 431.4926,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 436.67958,
"end": 445.92156,
"text": "Um, let's see how the next few days go. And if you're still not better next week, I want you to come back and see me. And we can have another look at your symptoms, OK?",
"speaker": "Doctor"
},
{
"start": 446.53439,
"end": 449.86973,
"text": "That sounds good, that sounds good. Uh, thanks so much.",
"speaker": "Patient"
},
{
"start": 448.31405,
"end": 451.42696,
"text": "Thanks. do you have any questions for me, or?",
"speaker": "Doctor"
},
{
"start": 451.57609,
"end": 463.81031,
"text": "Um, no I think that's fine. Uh, yeah I'll, I'll try to , and drink , drink plenty of fluid and I hope it go away. Uh, if it doesn't I'll uh, I'll call, I'll call back. Is that OK?",
"speaker": "Patient"
},
{
"start": 460.4539,
"end": 460.98077,
"text": "",
"speaker": "Doctor"
},
{
"start": 462.9754,
"end": 465.20659,
"text": " I really hope you get better soon.",
"speaker": "Doctor"
},
{
"start": 465.86786,
"end": 468.01371,
"text": "Thanks a lot. Thanks so much, for your time.",
"speaker": "Patient"
},
{
"start": 466.72273,
"end": 469.01843,
"text": " OK. Bye bye.",
"speaker": "Doctor"
},
{
"start": 469.32621,
"end": 470.32621,
"text": "OK. Bye.",
"speaker": "Patient"
}
],
"doctor_utterances": "Uh no, it is, yes. Hello? Can you hear me OK? Great. Hello there. Um, before I go any further, can I confirm you name and your age please? Robert? OK. OK. Great. Excellent. And how can I help you this afternoon, sir? OK, well I'm sorry to hear that. Uh can you tell me a bit more about your diarrhoea? Right. Mm-hmm. OK. And you mentioned you've been um going to the toilet very often. How many times are you going a day? OK. And uh uh can you tell me, I know it's not nice to talk about, but is it quite watery, your stools, loose? OK. K. Any blood in your stools? OK. And uh uh uh with the diarrhea have you noticed any other symptoms, like tummy pain? OK. When you say you can't drink too much, why is that? OK, alright. Um have you managed to eat anything, solids? OK. You . OK. Um with your um, the vomiting has now stopped. Is that right? You said OK, alright. Have you had any other symptoms, like fever or temperature? OK. OK. Alright. Any headaches or muscle pains? OK, alright. And you mentioned three days ago. What were you doing when the symptoms started? Are you aware of any triggers? Yeah. Did you have any takeaway food, or any dodgy restaurant food? OK. Have you been around anyone unwell, with diarrhea recently, last week or so? OK. OK. Um, right. So moving on, um are you otherwise fit and well? Uh OK. And do you take any regular medications? Is that, is that inhaler? Is that the blue inhaler? Blue inhaler. OK, alright. Any other medications that you take? OK. Do you have any allergies to medications? OK. And any family history of any medical problems? OK. Sorry to hear that. Um, OK. And uh what about your mother? Diabetes. Do you know if that's type one or type two? OK. Alright. Fine. And um, just a little bit more about your life in general, sir. Um who, who's at home with you? Who lives at home with you? Who lives at home with you, sir? You live alone, OK. Are you currently working at the moment? What's your employment? What do you do for work? . OK, alright. Have you taken time off work recently? OK, alright. And just the last couple of questions with, regarding your smoking and alcohol. Do you do either of those? OK, alright. Um fine. uh Robert um having listened to your story, I think you're probably suffering from what we call gastroenteritis, uh which essentially is just a, a tummy bug. It's an infection of your, your tummy. Um and normally lasts about three to five days, and gets better. the things you can do to really help yourself get better soon, um are you can drink plenty of fluids. Really try and flush the toxins out of your body. Uh you can get things from the pharmacy, which is called Dioralyte, which can help replenish any uh minerals and vitamins you may have lost. Uh, it's called Dioralyte. Um it's, it's a, it's a type of fluid replacement drink. Um, you can take some Paracetamol if you're feeling feverish and weak. I would probably advise you to continue taking time off work for next day or two, until you get better. normally you have to be diarrhea-free for about twenty four to forty eight hours, before you return back to work. Um, let's see how the next few days go. And if you're still not better next week, I want you to come back and see me. And we can have another look at your symptoms, OK? Thanks. do you have any questions for me, or? I really hope you get better soon. OK. Bye bye.",
"patient_utterances": "Hi. Yes. So, my name is Robert. Yep. Um, I'm forty eight. Right, so, uh, I've been having, uh, diarrhoea, for like, let's say past three days, more or less. Yeah, so it's been a, very bad diarrhoea, so it keeps me like, I keep going back and forth, to, to the toilet very often. Um, yeah it started like three days ago. And uh, uh, so it started with vomiting, so I vomited a couple of times. Uh, but then, that went away, and, uh, yeah it's just diarrhoea now. Yeah, around, five to six times a day. Yes, it's definitely, definitely watery, uh, loose stools, yeah. No, not that I could see. Uh, not, not really, no. Uh, but I, I, I feel like, um, I can't, really drink too much, so I feel very dehydrated. Uh, yeah because, really I, uh I, um, I'm like, I feel like I don't drink enough, like I'm, I'm drink, I'm trying to drink, but then I just go to the loo, and I like, I, uh I, I, I do everything and I feel dehydrated again. Uh, not much, not much. So just a little bit, but I don't feel, um, I don't really feel like, uh, I have appetite. Yes, yes. Uh, so, not, really I , I feel a little bit warm, um, probably at, at the beginning I was feeling I had a bit of temperature, but now I feel, I feel kind of fine. I feel very weak though. Not, not really, no. , not that I, I remember, what was I doing, I, I was at home I was working, on my computer and. Yeah, just felt, like some nausea and I had to, to vomit, and then I had some diarrhoea, straight after that. Uh, not that I remember, no. Hmm, not that I know, not that I. Yeah, yeah, . Um, so I, I do suffer of asthma. So, I do have my inhalers, uh, that I you know, I need, I use infrequently, let's say only when I have, uh, a bit of . Sorry? Yes it is, yeah. Uh, no, nothing. Um, not that I know of. Um, so, my father has, high uh, well used to have high blood pressure. He actually, so he actually died, of, bowel cancer, like ten years ago. Ohh yes, so uh, probably is worth mentioning uh, she has diabetes. Uh, it's type two. Sorry? Ohh I, I live alone. Uh, well I haven't been able to work in the past few days, but yes , like given, uh, my uh. I'm a software engineer. Uh, yes, yes I have, uh. Uh, these last three days I've been feeling, really unwell, so I couldn't work. Uh, not really, I drink infrequently, like socially let's say, and I don't smoke. OK. All right. OK. I'm sorry, what's the name of that? All right. OK. That sounds good, that sounds good. Uh, thanks so much. Um, no I think that's fine. Uh, yeah I'll, I'll try to , and drink , drink plenty of fluid and I hope it go away. Uh, if it doesn't I'll uh, I'll call, I'll call back. Is that OK? Thanks a lot. Thanks so much, for your time. OK. Bye.",
"num_turns": 96,
"reference_note": "{\"day\": 1, \"consultation\": 12, \"presenting_complaint\": \"I've been having really bad diarrhoea for the last 3 days\", \"note\": \"3/7 hx ago developed vomiting. Has now developed diarrhea - 5-6x/day. Watery/loose stools. No blood in stools. No abdo pain. \\nReduced oral intake. Not drinking sufficient fluids. Feels dehydrated. Appetite reduced. \\nNo fever/temp, but feels warm. Feels weak. No headaches/muscle pain. \\nUnaware of triggers. No unwell contacts \\n\\nPMH: asthma \\nDH: salbutamol PRN \\nNKDA\\nFH: father - HTN, died of bowel Ca. mother - diabetes Type 2\\nSH: lives alone , software engineer. Nil smoking, social EtOH\\n\\nImp: gastroenteritis \\n\\nPlan:\\n1.\\tSupportive mx - rest, fluids\\n2.\\tOTC diarolyte \\n3.\\tRegular paracetamol\\n4.\\tReview in 3-5d INB, or earlier if worsening sx (diarrhea, vomiting, abdo pain, reduced oral intake)\\n\", \"highlights\": [\"vomiting\", \"diarrhea\", \"No fever/temp\", \"gastroenteritis\"]}",
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"consultation_id": "day2_consultation02",
"dialogue": "[Doctor] Hi there. Good morning.\n[Patient] Hello, good morning.\n[Doctor] Um, I'm Doctor Deen Mirza from GP at Hand. Nice to see you.\n[Patient] Nice to see you.\n[Doctor] OK. Before we start your appointment, could you please tell me your first name and your date of birth.\n[Patient] Yes. Uh, my name is John Smith. And I was born on the fifth of April, uh, nineteen seventy three.\n[Doctor] OK, that's great. Thank you for that. Um, are you in a private place where you're OK to speak freely?\n[Patient] Yes. .\n[Doctor] OK, OK, great. OK, so um, tell me a bit about what's been happening? You said you mentioned in the notes that you've got a problem with your elbow.\n[Patient] Yeah. Um, I just noticed this like about a week ago, or something? Um, have like a weird swelling on, on, on my elbow. I noticed that when I was in the shower. Uh, It's not painful at all, or like, I I feel fine. But it's just, just a bit, a bit weird, to see that. Um, it's, it's slightly warm. Um, and I, I, cannot feel like this, little bit fluid in inside, or, uh, um?\n[Doctor] Sure.\n[Doctor] Sure, sure. , and .\n[Patient] So, I, I like to know what's going on with .\n[Doctor] , and so, did you say it was the left elbow or the right elbow?\n[Patient] Um, it's the, the left elbow.\n[Doctor] Left elbow, OK. , and have you banged that elbow? Do you have any kind of injury?\n[Patient] No, not really. Um, not that I know of. I haven't noticed anything. I can actually like move it normally. Um, it's just, I , I can just see that. It feels a bit strange, a bit\n[Doctor] Sure, OK. , and um, , in terms of your job, do you do anything physical?\n[Patient] Not really. No, I just, you know sit at a desk. Um, yeah.\n[Doctor] Right. OK. , and um, has this happened before?\n[Patient] No, no I haven't noticed that before. Um, I don't have any like history of, of seeing this. I don't remember .\n[Doctor] Sure, OK. Uh, and can I um, can I just double-check? Has anyone in your family, got any, kind of rheumatology, diseases, like rheumatoid arthritis, or lupus or anything like that?\n[Patient] Um, no, well I, I do, well I think, I think I have something like uh, osteoarthritis. Um, Uh, uh, it sometimes kind of hurts, uh, my joints. But uh, in my family, I'm not sure.\n[Doctor] OK.\n[Patient] . No.\n[Doctor] Sure. , so you know you said you think you've got , uh, osteoarthritis. Has anyone ever told you that? Have you ever seen a doctor who's confirmed that, and told you you've got osteoarthritis?\n[Patient] Um, yes. Yes, a few years ago.\n[Doctor] OK. , was that a GP or a specialist or, was it, a physiotherapist?\n[Patient] a a GP. Um, yeah.\n[Doctor] GP, OK, all right. Um, look can I just, uh, sorry can I just double-check how old you are please?\n[Patient] I'm uh, fifty three.\n[Doctor] Fifty three, OK. Fantastic. All right. Um, and, do you have any other illnesses at all?\n[Patient] Um, Well not, not really, no. Um, I'm, I'm allergic to, to peanuts. Um, but that's, that's pretty much all I uh, have to say about my medical history, yeah.\n[Doctor] Right, OK. . OK. Uh, are you, are, are you allergic to any medication?\n[Patient] Uh, no. Not that I know of.\n[Doctor] No. Sure. , and um, do you um, are you on any medication on a regular basis?\n[Patient] Uh, no.\n[Doctor] No, OK. And are you normally fit and well? Mobile and active?\n[Patient] yeah. I do, I do, I do some sports. I run regularly, like two, three times a week. Um, yeah, no, I'm, think I'm healthy.\n[Doctor] OK, good, good, glad to hear. Well done that's , it's good that you're doing that on a regular basis. OK. Um, and um, uh, can I, is it possible for me to have a look at your elbow, now?\n[Patient] Uh, yeah, sure.\n[Doctor] OK, good, bear with me one second.\n[Doctor] Right, OK. And if you can just raise your elbow up a little bit like that, a bit higher, so I can just see the underside. OK, fantastic, all right. And then, just, bring it round to this side, , I can see other side. OK, fantastic. All right. And if you can just touch the tip of your elbow with your fingers. There's, , is it, is it hot, compared to the surrounding skin, the adjacent skin?\n[Patient] Yeah.\n[Patient] It's a bit warm, yes.\n[Doctor] It's a bit warmer. OK. Um, and um, is it very tender when you're pressing on that nerve? Is it, if you, if you give it a press, does it hurt you at all?\n[Patient] On the, on the tip of the elbow, it's, it's OK, just like, next to it like where the, the swelling is, it's a bit, yeah it feels weird.\n[Doctor] OK. All right. Um, well, um, I noticed the skin was a bit dry, , on the tip of the elbow. Do you, do you have dry skin anywhere else on the body?\n[Patient] Uh, no not really. I have skin really dry now.\n[Doctor] , do you , do you suffer from eczema at all?\n[Patient] No.\n[Doctor] No. Alright. OK. So um, what I think we should do, with regards to your elbow problem OK. Is um, I think, it would be worthwhile. , this seems like uh, what we call the Bursitis. OK. So, that's an inflammation of one of the fluid sacs around the joint. Um, what I think we should do is, I think you should be on some anti-inflammatory medication, in the, in the first instance.\n[Patient] OK.\n[Doctor] And, as well as that, what I would like to do, is to get some blood tests done, to check for other types of uh, causes of joint swelling. K?\n[Patient] Alright.\n[Doctor] So, um, what we're going to do is, we're going to arrange some, um, blood test forms to be sent out to your house. And, there'll be instructions within that pack, about where to go to get those blood tests done. And, that will involve you, um, having some tests done to check for inflammatory markers, infection, rheumatological antibodies.\n[Patient] \n[Doctor] So we'll do a full screen, and also check for things like Gout as well, OK. Um.\n[Patient] OK.\n[Doctor] The time frame for that, will be um, the results will come back to us after about five or six days. Um.\n[Patient] K . O\n[Doctor] From now, but it may take time for the form to come out to you. And if you get the form get the blood tests done straight away, by the time that we're expecting result back, you know one or two days after that, we're looking maybe six days. And, what I would suggest, is, we can arrange a follow-up appointment for you, in one of our clinics, where we can have a look at your joint, feel it, we can review the blood test.\n[Patient] OK.\n[Doctor] Uh, we can um, get a gauge as to, uh, what's going on. Now in terms of your joint right now, It doesn't look like, to me that's something called, excuse me, septic arthritis. So, we're worried sometimes that someone might have an acutely infected joint.\n[Patient] Mm-hmm.\n[Doctor] Um, and uh, your, your joint doesn't look like that.\n[Patient] Yeah.\n[Doctor] However, if your, the elbow was to become very red, very painful, uh, and the redness was to spread or become uh, you know more intense. Then you need to get on the phone or get, have a video appointment , with one of us as soon as possible.\n[Patient] OK.\n[Doctor] 'Cause that would be an emergency. That would require more immediate assessment, more immediate treatment. OK?\n[Patient] do you, do you think it's something dangerous? Like something, like could I die from that, or is it, is it\n[Doctor] No. I, I don't think this is anything dangerous. don't need to worry. OK? What I'm doing, is I'm just outlining the worst case scenario if things were to, to develop. K? So, , this, this is not the case right now. Right now, it looks quite straightforward.\n[Patient] OK.\n[Patient] Yeah, OK, I see.\n[Doctor] It's nothing , sinister or life-threatening. Um, what I'm doing is I'm just saying, in case things worsen, these are the things that we'd be looking out for, and this is what we have to do. But you don't have that now, thankfully, and I don't think you're going to have it.\n[Patient] OK.\n[Doctor] But I'm just saying, the what if scenario. Is that OK?\n[Patient] Yeah that, that sounds good. Thank you.\n[Doctor] All right. Did you have any questions that you wanted to ask me?\n[Patient] Um, well just yeah I just wanted to know about this. Um, yeah it feels a bit better now . Uh, but yeah, no that's it. Thank you.\n[Doctor] OK, all right. Um. OK. So, I, I would take Ibuprofen regularly, OK. You can get that , over the counter. Um, that's four hundred milligrams, two times a day. And you should take, take that after food, not on an empty stomach. If you get any heartburn, stop taking it. OK.\n[Patient] OK.\n[Patient] Sure. thanks. Bye.\n[Doctor] All right. So, what I wanna do is, I'll get the forms sent out to you. And, um, we are going to arrange a, a follow-up appointment. Maybe within a um, actually you know, the follow-up appointment doesn't have to be face-to-face, if it's more convenient for you do, to do it over the phone, we can do that over the phone, uh, over video. We can do that as well, that's, that's your call. But you contact us, , after you've had the blood test done, and we can review things then, OK.\n[Patient] OK.\n[Patient] OK, yeah that sounds good. I, I'll do that. And if I see that it's getting worse, I'll probably ask for a physical appointment.\n[Doctor] Sure, sure that's a good idea. All right then, OK. Um, take care then. So , look just leave that with me, I'll sort all those bits and pieces out, and then we'll get them sent out to you, and then we'll, we'll um, review you after the tests, things goes well, OK.\n[Patient] \n[Patient] Thank you. Alright. Sounds\n[Doctor] All right then. Take care then, all the best. Bye bye.\n[Patient] Bye.",
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"text": "Yeah. Um, I just noticed this like about a week ago, or something? Um, have like a weird swelling on, on, on my elbow. I noticed that when I was in the shower. Uh, It's not painful at all, or like, I I feel fine. But it's just, just a bit, a bit weird, to see that. Um, it's, it's slightly warm. Um, and I, I, cannot feel like this, little bit fluid in inside, or, uh, um?",
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"text": ", and so, did you say it was the left elbow or the right elbow?",
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"text": "Left elbow, OK. , and have you banged that elbow? Do you have any kind of injury?",
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"text": "No, not really. Um, not that I know of. I haven't noticed anything. I can actually like move it normally. Um, it's just, I , I can just see that. It feels a bit strange, a bit",
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"text": "Sure, OK. , and um, , in terms of your job, do you do anything physical?",
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"text": "Not really. No, I just, you know sit at a desk. Um, yeah.",
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"text": "Right. OK. , and um, has this happened before?",
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"text": "Sure, OK. Uh, and can I um, can I just double-check? Has anyone in your family, got any, kind of rheumatology, diseases, like rheumatoid arthritis, or lupus or anything like that?",
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"text": "Um, no, well I, I do, well I think, I think I have something like uh, osteoarthritis. Um, Uh, uh, it sometimes kind of hurts, uh, my joints. But uh, in my family, I'm not sure.",
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"text": "Sure. , so you know you said you think you've got , uh, osteoarthritis. Has anyone ever told you that? Have you ever seen a doctor who's confirmed that, and told you you've got osteoarthritis?",
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"text": "Um, yes. Yes, a few years ago.",
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"text": " a a GP. Um, yeah.",
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"text": "GP, OK, all right. Um, look can I just, uh, sorry can I just double-check how old you are please?",
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"text": "Um, Well not, not really, no. Um, I'm, I'm allergic to, to peanuts. Um, but that's, that's pretty much all I uh, have to say about my medical history, yeah.",
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"text": "Right, OK. . OK. Uh, are you, are, are you allergic to any medication?",
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"text": "Uh, no. Not that I know of.",
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"text": "No. Sure. , and um, do you um, are you on any medication on a regular basis?",
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"text": "No, OK. And are you normally fit and well? Mobile and active?",
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"text": " yeah. I do, I do, I do some sports. I run regularly, like two, three times a week. Um, yeah, no, I'm, think I'm healthy.",
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"text": "OK, good, good, glad to hear. Well done that's , it's good that you're doing that on a regular basis. OK. Um, and um, uh, can I, is it possible for me to have a look at your elbow, now?",
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"text": "Uh, yeah, sure.",
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"text": "Right, OK. And if you can just raise your elbow up a little bit like that, a bit higher, so I can just see the underside. OK, fantastic, all right. And then, just, bring it round to this side, , I can see other side. OK, fantastic. All right. And if you can just touch the tip of your elbow with your fingers. There's, , is it, is it hot, compared to the surrounding skin, the adjacent skin?",
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"text": "It's a bit warm, yes.",
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"text": "It's a bit warmer. OK. Um, and um, is it very tender when you're pressing on that nerve? Is it, if you, if you give it a press, does it hurt you at all?",
"speaker": "Doctor"
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"text": "On the, on the tip of the elbow, it's, it's OK, just like, next to it like where the, the swelling is, it's a bit, yeah it feels weird.",
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"text": "OK. All right. Um, well, um, I noticed the skin was a bit dry, , on the tip of the elbow. Do you, do you have dry skin anywhere else on the body?",
"speaker": "Doctor"
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"text": "Uh, no not really. I have skin really dry now.",
"speaker": "Patient"
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"text": ", do you , do you suffer from eczema at all?",
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"text": "No. Alright. OK. So um, what I think we should do, with regards to your elbow problem OK. Is um, I think, it would be worthwhile. , this seems like uh, what we call the Bursitis. OK. So, that's an inflammation of one of the fluid sacs around the joint. Um, what I think we should do is, I think you should be on some anti-inflammatory medication, in the, in the first instance.",
"speaker": "Doctor"
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"text": "OK.",
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"text": "And, as well as that, what I would like to do, is to get some blood tests done, to check for other types of uh, causes of joint swelling. K?",
"speaker": "Doctor"
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"text": "Alright.",
"speaker": "Patient"
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"text": "So, um, what we're going to do is, we're going to arrange some, um, blood test forms to be sent out to your house. And, there'll be instructions within that pack, about where to go to get those blood tests done. And, that will involve you, um, having some tests done to check for inflammatory markers, infection, rheumatological antibodies.",
"speaker": "Doctor"
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"speaker": "Patient"
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"text": "So we'll do a full screen, and also check for things like Gout as well, OK. Um.",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "The time frame for that, will be um, the results will come back to us after about five or six days. Um.",
"speaker": "Doctor"
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"text": "K . O",
"speaker": "Patient"
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"text": "From now, but it may take time for the form to come out to you. And if you get the form get the blood tests done straight away, by the time that we're expecting result back, you know one or two days after that, we're looking maybe six days. And, what I would suggest, is, we can arrange a follow-up appointment for you, in one of our clinics, where we can have a look at your joint, feel it, we can review the blood test.",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "Uh, we can um, get a gauge as to, uh, what's going on. Now in terms of your joint right now, It doesn't look like, to me that's something called, excuse me, septic arthritis. So, we're worried sometimes that someone might have an acutely infected joint.",
"speaker": "Doctor"
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"text": "Mm-hmm.",
"speaker": "Patient"
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"text": "Um, and uh, your, your joint doesn't look like that.",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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"text": "However, if your, the elbow was to become very red, very painful, uh, and the redness was to spread or become uh, you know more intense. Then you need to get on the phone or get, have a video appointment , with one of us as soon as possible.",
"speaker": "Doctor"
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{
"start": 421.88882,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 422.10516,
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"text": "'Cause that would be an emergency. That would require more immediate assessment, more immediate treatment. OK?",
"speaker": "Doctor"
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{
"start": 427.46858,
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"text": " do you, do you think it's something dangerous? Like something, like could I die from that, or is it, is it",
"speaker": "Patient"
},
{
"start": 435.19274,
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"text": "No. I, I don't think this is anything dangerous. don't need to worry. OK? What I'm doing, is I'm just outlining the worst case scenario if things were to, to develop. K? So, , this, this is not the case right now. Right now, it looks quite straightforward.",
"speaker": "Doctor"
},
{
"start": 438.16435,
"end": 439.16435,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 444.42527,
"end": 445.84557,
"text": "Yeah, OK, I see.",
"speaker": "Patient"
},
{
"start": 449.7719,
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"text": "It's nothing , sinister or life-threatening. Um, what I'm doing is I'm just saying, in case things worsen, these are the things that we'd be looking out for, and this is what we have to do. But you don't have that now, thankfully, and I don't think you're going to have it.",
"speaker": "Doctor"
},
{
"start": 457.41093,
"end": 458.41093,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 461.87092,
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"text": "But I'm just saying, the what if scenario. Is that OK?",
"speaker": "Doctor"
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"text": "Yeah that, that sounds good. Thank you.",
"speaker": "Patient"
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"text": "All right. Did you have any questions that you wanted to ask me?",
"speaker": "Doctor"
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"text": "Um, well just yeah I just wanted to know about this. Um, yeah it feels a bit better now . Uh, but yeah, no that's it. Thank you.",
"speaker": "Patient"
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"text": "OK, all right. Um. OK. So, I, I would take Ibuprofen regularly, OK. You can get that , over the counter. Um, that's four hundred milligrams, two times a day. And you should take, take that after food, not on an empty stomach. If you get any heartburn, stop taking it. OK.",
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"text": "Sure. thanks. Bye.",
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"text": "All right. So, what I wanna do is, I'll get the forms sent out to you. And, um, we are going to arrange a, a follow-up appointment. Maybe within a um, actually you know, the follow-up appointment doesn't have to be face-to-face, if it's more convenient for you do, to do it over the phone, we can do that over the phone, uh, over video. We can do that as well, that's, that's your call. But you contact us, , after you've had the blood test done, and we can review things then, OK.",
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"text": "OK, yeah that sounds good. I, I'll do that. And if I see that it's getting worse, I'll probably ask for a physical appointment.",
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"text": "Sure, sure that's a good idea. All right then, OK. Um, take care then. So , look just leave that with me, I'll sort all those bits and pieces out, and then we'll get them sent out to you, and then we'll, we'll um, review you after the tests, things goes well, OK.",
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"text": "Thank you. Alright. Sounds",
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"text": "All right then. Take care then, all the best. Bye bye.",
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"doctor_utterances": "Hi there. Good morning. Um, I'm Doctor Deen Mirza from GP at Hand. Nice to see you. OK. Before we start your appointment, could you please tell me your first name and your date of birth. OK, that's great. Thank you for that. Um, are you in a private place where you're OK to speak freely? OK, OK, great. OK, so um, tell me a bit about what's been happening? You said you mentioned in the notes that you've got a problem with your elbow. Sure. Sure, sure. , and . , and so, did you say it was the left elbow or the right elbow? Left elbow, OK. , and have you banged that elbow? Do you have any kind of injury? Sure, OK. , and um, , in terms of your job, do you do anything physical? Right. OK. , and um, has this happened before? Sure, OK. Uh, and can I um, can I just double-check? Has anyone in your family, got any, kind of rheumatology, diseases, like rheumatoid arthritis, or lupus or anything like that? OK. Sure. , so you know you said you think you've got , uh, osteoarthritis. Has anyone ever told you that? Have you ever seen a doctor who's confirmed that, and told you you've got osteoarthritis? OK. , was that a GP or a specialist or, was it, a physiotherapist? GP, OK, all right. Um, look can I just, uh, sorry can I just double-check how old you are please? Fifty three, OK. Fantastic. All right. Um, and, do you have any other illnesses at all? Right, OK. . OK. Uh, are you, are, are you allergic to any medication? No. Sure. , and um, do you um, are you on any medication on a regular basis? No, OK. And are you normally fit and well? Mobile and active? OK, good, good, glad to hear. Well done that's , it's good that you're doing that on a regular basis. OK. Um, and um, uh, can I, is it possible for me to have a look at your elbow, now? OK, good, bear with me one second. Right, OK. And if you can just raise your elbow up a little bit like that, a bit higher, so I can just see the underside. OK, fantastic, all right. And then, just, bring it round to this side, , I can see other side. OK, fantastic. All right. And if you can just touch the tip of your elbow with your fingers. There's, , is it, is it hot, compared to the surrounding skin, the adjacent skin? It's a bit warmer. OK. Um, and um, is it very tender when you're pressing on that nerve? Is it, if you, if you give it a press, does it hurt you at all? OK. All right. Um, well, um, I noticed the skin was a bit dry, , on the tip of the elbow. Do you, do you have dry skin anywhere else on the body? , do you , do you suffer from eczema at all? No. Alright. OK. So um, what I think we should do, with regards to your elbow problem OK. Is um, I think, it would be worthwhile. , this seems like uh, what we call the Bursitis. OK. So, that's an inflammation of one of the fluid sacs around the joint. Um, what I think we should do is, I think you should be on some anti-inflammatory medication, in the, in the first instance. And, as well as that, what I would like to do, is to get some blood tests done, to check for other types of uh, causes of joint swelling. K? So, um, what we're going to do is, we're going to arrange some, um, blood test forms to be sent out to your house. And, there'll be instructions within that pack, about where to go to get those blood tests done. And, that will involve you, um, having some tests done to check for inflammatory markers, infection, rheumatological antibodies. So we'll do a full screen, and also check for things like Gout as well, OK. Um. The time frame for that, will be um, the results will come back to us after about five or six days. Um. From now, but it may take time for the form to come out to you. And if you get the form get the blood tests done straight away, by the time that we're expecting result back, you know one or two days after that, we're looking maybe six days. And, what I would suggest, is, we can arrange a follow-up appointment for you, in one of our clinics, where we can have a look at your joint, feel it, we can review the blood test. Uh, we can um, get a gauge as to, uh, what's going on. Now in terms of your joint right now, It doesn't look like, to me that's something called, excuse me, septic arthritis. So, we're worried sometimes that someone might have an acutely infected joint. Um, and uh, your, your joint doesn't look like that. However, if your, the elbow was to become very red, very painful, uh, and the redness was to spread or become uh, you know more intense. Then you need to get on the phone or get, have a video appointment , with one of us as soon as possible. 'Cause that would be an emergency. That would require more immediate assessment, more immediate treatment. OK? No. I, I don't think this is anything dangerous. don't need to worry. OK? What I'm doing, is I'm just outlining the worst case scenario if things were to, to develop. K? So, , this, this is not the case right now. Right now, it looks quite straightforward. It's nothing , sinister or life-threatening. Um, what I'm doing is I'm just saying, in case things worsen, these are the things that we'd be looking out for, and this is what we have to do. But you don't have that now, thankfully, and I don't think you're going to have it. But I'm just saying, the what if scenario. Is that OK? All right. Did you have any questions that you wanted to ask me? OK, all right. Um. OK. So, I, I would take Ibuprofen regularly, OK. You can get that , over the counter. Um, that's four hundred milligrams, two times a day. And you should take, take that after food, not on an empty stomach. If you get any heartburn, stop taking it. OK. All right. So, what I wanna do is, I'll get the forms sent out to you. And, um, we are going to arrange a, a follow-up appointment. Maybe within a um, actually you know, the follow-up appointment doesn't have to be face-to-face, if it's more convenient for you do, to do it over the phone, we can do that over the phone, uh, over video. We can do that as well, that's, that's your call. But you contact us, , after you've had the blood test done, and we can review things then, OK. Sure, sure that's a good idea. All right then, OK. Um, take care then. So , look just leave that with me, I'll sort all those bits and pieces out, and then we'll get them sent out to you, and then we'll, we'll um, review you after the tests, things goes well, OK. All right then. Take care then, all the best. Bye bye.",
"patient_utterances": "Hello, good morning. Nice to see you. Yes. Uh, my name is John Smith. And I was born on the fifth of April, uh, nineteen seventy three. Yes. . Yeah. Um, I just noticed this like about a week ago, or something? Um, have like a weird swelling on, on, on my elbow. I noticed that when I was in the shower. Uh, It's not painful at all, or like, I I feel fine. But it's just, just a bit, a bit weird, to see that. Um, it's, it's slightly warm. Um, and I, I, cannot feel like this, little bit fluid in inside, or, uh, um? So, I, I like to know what's going on with . Um, it's the, the left elbow. No, not really. Um, not that I know of. I haven't noticed anything. I can actually like move it normally. Um, it's just, I , I can just see that. It feels a bit strange, a bit Not really. No, I just, you know sit at a desk. Um, yeah. No, no I haven't noticed that before. Um, I don't have any like history of, of seeing this. I don't remember . Um, no, well I, I do, well I think, I think I have something like uh, osteoarthritis. Um, Uh, uh, it sometimes kind of hurts, uh, my joints. But uh, in my family, I'm not sure. . No. Um, yes. Yes, a few years ago. a a GP. Um, yeah. I'm uh, fifty three. Um, Well not, not really, no. Um, I'm, I'm allergic to, to peanuts. Um, but that's, that's pretty much all I uh, have to say about my medical history, yeah. Uh, no. Not that I know of. Uh, no. yeah. I do, I do, I do some sports. I run regularly, like two, three times a week. Um, yeah, no, I'm, think I'm healthy. Uh, yeah, sure. Yeah. It's a bit warm, yes. On the, on the tip of the elbow, it's, it's OK, just like, next to it like where the, the swelling is, it's a bit, yeah it feels weird. Uh, no not really. I have skin really dry now. No. OK. Alright. OK. K . O OK. Mm-hmm. Yeah. OK. do you, do you think it's something dangerous? Like something, like could I die from that, or is it, is it OK. Yeah, OK, I see. OK. Yeah that, that sounds good. Thank you. Um, well just yeah I just wanted to know about this. Um, yeah it feels a bit better now . Uh, but yeah, no that's it. Thank you. OK. Sure. thanks. Bye. OK. OK, yeah that sounds good. I, I'll do that. And if I see that it's getting worse, I'll probably ask for a physical appointment. Thank you. Alright. Sounds Bye.",
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"reference_note": "{\"day\": 2, \"consultation\": 2, \"presenting_complaint\": \"I have a strange swelling on my elbow\", \"note\": \"Hx: 1 week history of spontaneous elbow swelling left. Not painful. No trauma. \\nNo FH of rheumatological disease- NB pt says he has been old he has OA previously by doctors- ? need to confirm this\\nWorks in a desk job\\nNot happened before\\nOtherwise well- \\nPMHx: nil of note\\nFH: nil of note\\nDH: not on any medication, allergic to peanuts\\nSH: exercises regularly, active\\nEx: looks well, not in pain. Mild erythema and minimal swelling (if any) around olecranon process left elbow\\nImp: possible bursitis\\nPlan: for NSAIDs- usual advice re SE\\nFor rheum bloods: esr, crp, fbc, rheum factor and urate\\nReview thereafter in person/ via video\\nTo contact us back in interim if any deterioration/concerns- pt warned re symptoms of septic arthritis\\n\", \"highlights\": [\"elbow swelling\", \"No trauma\", \"allergic to peanuts\", \"looks well\", \"possible bursitis\", \"for NSAIDs\", \"bloods\"]}",
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"dialogue": "[Doctor] Hi there. Good morning. I'm Doctor from GP at Hand. Nice to see you.\n[Patient] Hi.\n[Doctor] OK. So, um, before we start your appointment. Could I confirm your full name and date of birth please?\n[Patient] Yeah, it's John Smith, and I am thirty two years old.\n[Doctor] Sorry, I didn't catch your date of birth.\n[Patient] I'm thirty two years old.\n[Doctor] Thirty two years old, OK. Could you tell me the first line of your address, and your postcode please?\n[Patient] It's four Park Avenue, and it's AB one CB two.\n[Doctor] That's great, thank you so much for that. Are you in a private place where you're OK to speak at the moment?\n[Patient] Yes.\n[Doctor] OK. So how can I help you today? You've been having some problems with your asthma. Is that right?\n[Patient] Sorry, say that .\n[Doctor] How can I help you today?\n[Patient] So, um, I've been experiencing very weird symptoms, over the past month or so. And I don't know what's causing them. I have googled it and, um, nothing's coming up, so I thought I'd come and speak to you about it.\n[Doctor] OK.\n[Doctor] OK. So, tell me a bit more about these weird symptoms you've been having.\n[Patient] So, it started with, feeling very tired, but for a couple of days, and then I get back to normal.\n[Doctor] \n[Patient] And then I started losing feeling, in my hands and arms. I get a weird sensation like, uh, I guess, pins and needles.\n[Doctor] Right again, the connection's not so great. You've been getting pins and needles in the hand. Is that right?\n[Patient] And.\n[Patient] Yeah, that's correct.\n[Doctor] OK. Is that the right or left hand?\n[Patient] My right hand.\n[Doctor] Is it always the right?\n[Patient] Yes.\n[Doctor] OK. Um, we've lost video now, maybe is there a, a, a button you can press?\n[Doctor] OK. Are you happy for us to carry on without the video? I can't see you at the moment.\n[Patient] Yes, that's fine.\n[Doctor] All right. Um, so, you've been having these pins and needles, and episodes of numbness, in the right hand. Is it just the hand, or does it go up the arm as well?\n[Patient] Uh, the pins and needles are in the hand, but I feel like my arm is getting weaker, but it only lasts few days and then goes back to normal. So, it's very weird.\n[Doctor] Right, OK. Um, is there any involvement of your leg at all?\n[Patient] Uh, my, colleague said, I'm walking slightly differently to normal. And again, it's only for three days, or three or four days.\n[Doctor] OK. You, you said you've been having weird symptoms for about a month.\n[Patient] Yes.\n[Doctor] , so, what has been happening from the beginning of the month? What else has been happening?\n[Patient] Um, I generally feel tired, and weak. And, sometimes I feel nauseous, and I don't feel like I want to do anything.\n[Doctor] Right, OK. Um, and, um.\n[Doctor] You know, , your colleague said you've, you've not been walking normally.\n[Patient] Yes.\n[Doctor] Do you feel anything different, on either side, in terms of your legs? Can , have you noticed anything different?\n[Patient] Yeah, so, at the same time I get my arm symptoms, my leg feels weaker.\n[Doctor] Right, OK. And. You know you, the abnormal gait. Has that been present, outside of these episodes?\n[Patient] No, it has not. So normally, I'm, fit and well actually.\n[Doctor] Right, .\n[Doctor] All right, OK. Um, and, these, these episodes. How often have they been happening?\n[Patient] They have been getting more regular. So at the start, it would be maybe once a week, uh, to every once , once a month, but now it's getting uh, uh, a couple of times a day.\n[Doctor] Right, OK. And, how long have these episodes been going on for? When, when did it all start? Was it a month ago?\n[Patient] , probably a month and a half, maybe two months.\n[Doctor] Right, OK. OK. And, along with these symptoms, of the weakness and numbness. Do you have any other symptoms at the same time? Like swallowing, or difficulty speaking, or vision problems?\n[Patient] So, recently I've noticed, I can't hold my cup of coffee. And when I, do drink coffee, it's slightly harder to drink. And that's only been in the last couple of days, I guess.\n[Doctor] Right. Is that during these episodes, or outside of these episodes?\n[Patient] Only during the episodes.\n[Doctor] OK. Do you have any difficulty swallowing at all?\n[Patient] Not currently, no.\n[Doctor] . During the episodes, do you have any difficulty swallowing?\n[Patient] I, I, I feel like there's something in my throat.\n[Doctor] OK. What about, um, difficulty speaking during these episodes? Any, any issues with that at all?\n[Patient] No, I can speak fine.\n[Doctor] OK. And any visual problems during these episodes?\n[Patient] I, I don't think so, but I wear glasses.\n[Doctor] OK, all right. Now um, can I just ask? , has, uh, is there any history of stroke, or mini-strokes in your family?\n[Patient] Uh, yes. My, father has had a, operation to the side of his neck, to reduce the risk of stroke.\n[Doctor] Right, OK. Um, and, uh, how about yourself? Have you had any history of, mini-strokes or anything like that, along those lines? I know you're quite young.\n[Patient] No, so after my, dad had his operation, I was required to be checked, and my cholesterol , was fine.\n[Doctor] Good, excellent. So you had a, a blood test done. And did they check for diabetes as well?\n[Patient] Yeah. They checked my diabetes, my blood pressure and my, cholesterol, and the doctor said it was all OK.\n[Doctor] Fantastic, OK. Now, do you have any other illnesses at all?\n[Patient] No.\n[Doctor] No. Are you on any medication?\n[Patient] I take an aspirin, seventy five milligrams, once a day, but that's, because of something I read on the internet.\n[Doctor] OK. So, so, why is that? Why do you take that?\n[Patient] I think it's, meant to reduce your risk of stroke and heart attack.\n[Doctor] OK. Do, have you ever told a doctor before, your GP, that you're on Aspirin?\n[Patient] Yes I took, I started to , taking it after my, father had his operation, but that wasn't the doctor telling me.\n[Doctor] OK. Uh, and, has any GP ever spoken to you about, the risks of Aspirin, and whether you should be on it? Or have you not , told the , the GP in the past?\n[Patient] No, I haven't.\n[Doctor] You haven't, OK. Um, all right. Um. Now, um, in terms of your uh, your kind of social situation. Um, are you working at the moment?\n[Patient] Yes, I am.\n[Doctor] , what do you work as?\n[Patient] Uh, I'm, uh, I'm actually a doctor.\n[Doctor] You're a , a, a medical doctor?\n[Patient] Yes.\n[Doctor] OK. Uh, which, specialty are you in?\n[Patient] I work in, uh, plastic surgery.\n[Doctor] Plastic surgery, OK, great. And, um, do you, have any, um, allergies to any medication at all?\n[Patient] I'm allergic to penicillin only.\n[Doctor] OK. And, um, are you, um, living alone?\n[Patient] No, I live with my wife.\n[Doctor] Right, OK. Um, fantastic. Uh , do you smoke at all?\n[Patient] No, I don't.\n[Doctor] Right, OK. Um, that's fine. Now, obviously you're a, you're a medic yourself. Did you have any thoughts as to what might be going on?\n[Patient] Uh, I've actually, got no idea.\n[Doctor] Right, OK. Um, well the, the way you're describing these episodes. They make me concerned about, mini-strokes or TIAs, , transient ischemic attacks. Um.\n[Patient] OK.\n[Doctor] And so, that's something quite urgent. And given that you've got a family history of um, stroke. Um, even though you're quite young, I think um, it's something that we need to exclude. So, what I'm probably going to do, uh, in fact what I am going to do, is I'm going to, refer you to a stroke, a TIA clinic. Um, now just to double-check. Do you have the symptoms right now?\n[Patient] No, I'm perfectly fine at the moment.\n[Doctor] OK. So, so, what I'm gonna do, is I'm uh, I'm gonna refer you to a, a mini-stroke clinic, or a TIA clinic. Um, I send that referral off now, and then you can attend them, they, they'll usually, call you in within the next one to two days, OK. Because it's something relatively urgent. Now, today it's Wednesday, so we've got a few days , before the weekend. So, um, uh, basically the deadline should be, Thursday, Friday. We're expecting you to be seen by the time, that's the kind of turnaround we're, we're looking at. And in that clinic, they'll be doing a number of things. Um, they'll be checking, they'll be doing a ultrasound of the, carotid arteries, like your, your father had. Um, and, they'll be doing a, maybe a, they might do a scan of your brain as well, to check if there's any signs of a bleed there. But, um, they'll be doing a range of tests in a short time frame, in order to exclude whether, you have um, any illness. OK, whether you have got any kind of stroke or, mini-stroke.\n[Patient] Sure.\n[Doctor] Now, if your symptoms return and they persist, they're prolonged. Then um, you may need to attend A and E. OK, because um, our presumptive, working diagnosis is, mini-stroke or TIA, OK. And if, a mini-stroke is prolonged then uh, then we end up thinking that this might be a stroke and in that case, that becomes even more of an emergency. So, we're not talking about waiting one or two days, we want you to go to hospital in that instance, as soon as possible, OK.\n[Patient] Sure.\n[Doctor] Now if , things happen again, feel free to contact us, we can assess you over the phone, we can give you direction and guidance over the phone. That's, that's, that's not a problem, you know, you, you've got easy access to us. OK. So, um, this is the plan going forward. Um, I'm going to, um, do that referral. You should hear back from the hospital, relatively soon. The hospital, you can actually ring them, on um, uh, the PALS number, and then there's also the TIA clinic number. I'm going to leave that number in the notes for this consultation, OK. So you'll have all the information you need, to chase this appointment.\n[Patient] OK.\n[Doctor] And um, if you want, you can ring them, either today or tomorrow morning. , today in the afternoon, wait uh, one or two hours. Or tomorrow morning just to find out when they got time to slot you in. And, just to make sure they've got you in the system, that they've got in the books, and they're going to be calling you in, OK.\n[Patient] \n[Doctor] , this isn't, a, an immediate emergency that you need to rush down to A and E. But it's something quite urgent we need to, deal with in a short space of time, OK. So if there's, if there's any delay that, transpires for example, you can't make the appointment or, you know, they, you don't get called. , you, you get, get in contact back, back with us, OK.\n[Patient] \n[Doctor] All right. Did you have any questions at all?\n[Patient] No, I think that covers, most of it.\n[Doctor] OK, great. So just bear with me a few minutes, and then I'll send that uh, all through and then you should, um, you should be able to help, you should have the information at your hands to, in order to take things further, OK.\n[Patient] , thank you.\n[Doctor] All the best. Take care now. Bye bye.\n[Patient] ",
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{
"start": 87.4101,
"end": 88.7288,
"text": "My right hand.",
"speaker": "Patient"
},
{
"start": 89.0885,
"end": 90.46019,
"text": "Is it always the right?",
"speaker": "Doctor"
},
{
"start": 89.87399,
"end": 91.45214,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 92.45299,
"end": 98.35945,
"text": "OK. Um, we've lost video now, maybe is there a, a, a button you can press?",
"speaker": "Doctor"
},
{
"start": 100.79829,
"end": 105.64001,
"text": "OK. Are you happy for us to carry on without the video? I can't see you at the moment.",
"speaker": "Doctor"
},
{
"start": 105.45936,
"end": 106.57402,
"text": "Yes, that's fine.",
"speaker": "Patient"
},
{
"start": 106.9558,
"end": 116.96604,
"text": "All right. Um, so, you've been having these pins and needles, and episodes of numbness, in the right hand. Is it just the hand, or does it go up the arm as well?",
"speaker": "Doctor"
},
{
"start": 117.58919,
"end": 126.90309,
"text": "Uh, the pins and needles are in the hand, but I feel like my arm is getting weaker, but it only lasts few days and then goes back to normal. So, it's very weird.",
"speaker": "Patient"
},
{
"start": 127.69122,
"end": 131.22992,
"text": "Right, OK. Um, is there any involvement of your leg at all?",
"speaker": "Doctor"
},
{
"start": 131.85589,
"end": 139.85777,
"text": "Uh, my, colleague said, I'm walking slightly differently to normal. And again, it's only for three days, or three or four days.",
"speaker": "Patient"
},
{
"start": 140.97084,
"end": 144.57605,
"text": "OK. You, you said you've been having weird symptoms for about a month.",
"speaker": "Doctor"
},
{
"start": 145.28581,
"end": 145.8501,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 146.08409,
"end": 149.29818,
"text": ", so, what has been happening from the beginning of the month? What else has been happening?",
"speaker": "Doctor"
},
{
"start": 150.50672,
"end": 158.01242,
"text": "Um, I generally feel tired, and weak. And, sometimes I feel nauseous, and I don't feel like I want to do anything.",
"speaker": "Patient"
},
{
"start": 159.6702,
"end": 163.92507,
"text": "Right, OK. Um, and, um.",
"speaker": "Doctor"
},
{
"start": 165.85723,
"end": 169.42176,
"text": "You know, , your colleague said you've, you've not been walking normally.",
"speaker": "Doctor"
},
{
"start": 169.63218,
"end": 170.25361,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 170.363,
"end": 175.69017,
"text": "Do you feel anything different, on either side, in terms of your legs? Can , have you noticed anything different?",
"speaker": "Doctor"
},
{
"start": 176.46716,
"end": 181.35478,
"text": "Yeah, so, at the same time I get my arm symptoms, my leg feels weaker.",
"speaker": "Patient"
},
{
"start": 182.69729,
"end": 190.93218,
"text": "Right, OK. And. You know you, the abnormal gait. Has that been present, outside of these episodes?",
"speaker": "Doctor"
},
{
"start": 191.84109,
"end": 195.67031,
"text": "No, it has not. So normally, I'm, fit and well actually.",
"speaker": "Patient"
},
{
"start": 193.48797,
"end": 194.15715,
"text": "Right, .",
"speaker": "Doctor"
},
{
"start": 196.07298,
"end": 202.84323,
"text": "All right, OK. Um, and, these, these episodes. How often have they been happening?",
"speaker": "Doctor"
},
{
"start": 204.17689,
"end": 214.82082,
"text": "They have been getting more regular. So at the start, it would be maybe once a week, uh, to every once , once a month, but now it's getting uh, uh, a couple of times a day.",
"speaker": "Patient"
},
{
"start": 216.09028,
"end": 222.22241,
"text": "Right, OK. And, how long have these episodes been going on for? When, when did it all start? Was it a month ago?",
"speaker": "Doctor"
},
{
"start": 220.6694,
"end": 223.69678,
"text": ", probably a month and a half, maybe two months.",
"speaker": "Patient"
},
{
"start": 223.9758,
"end": 236.32217,
"text": "Right, OK. OK. And, along with these symptoms, of the weakness and numbness. Do you have any other symptoms at the same time? Like swallowing, or difficulty speaking, or vision problems?",
"speaker": "Doctor"
},
{
"start": 236.73168,
"end": 249.43872,
"text": "So, recently I've noticed, I can't hold my cup of coffee. And when I, do drink coffee, it's slightly harder to drink. And that's only been in the last couple of days, I guess.",
"speaker": "Patient"
},
{
"start": 250.84822,
"end": 254.56763,
"text": "Right. Is that during these episodes, or outside of these episodes?",
"speaker": "Doctor"
},
{
"start": 254.60062,
"end": 256.14856,
"text": "Only during the episodes.",
"speaker": "Patient"
},
{
"start": 256.38777,
"end": 260.02086,
"text": "OK. Do you have any difficulty swallowing at all?",
"speaker": "Doctor"
},
{
"start": 260.08405,
"end": 261.29696,
"text": "Not currently, no.",
"speaker": "Patient"
},
{
"start": 261.3426,
"end": 263.7822,
"text": ". During the episodes, do you have any difficulty swallowing?",
"speaker": "Doctor"
},
{
"start": 264.10135,
"end": 266.6572,
"text": "I, I, I feel like there's something in my throat.",
"speaker": "Patient"
},
{
"start": 267.52444,
"end": 272.98486,
"text": "OK. What about, um, difficulty speaking during these episodes? Any, any issues with that at all?",
"speaker": "Doctor"
},
{
"start": 273.29961,
"end": 274.67318,
"text": "No, I can speak fine.",
"speaker": "Patient"
},
{
"start": 275.30053,
"end": 278.33709,
"text": "OK. And any visual problems during these episodes?",
"speaker": "Doctor"
},
{
"start": 278.6391,
"end": 280.75181,
"text": "I, I don't think so, but I wear glasses.",
"speaker": "Patient"
},
{
"start": 281.07837,
"end": 288.89329,
"text": "OK, all right. Now um, can I just ask? , has, uh, is there any history of stroke, or mini-strokes in your family?",
"speaker": "Doctor"
},
{
"start": 289.95701,
"end": 299.26445,
"text": "Uh, yes. My, father has had a, operation to the side of his neck, to reduce the risk of stroke.",
"speaker": "Patient"
},
{
"start": 299.79308,
"end": 310.14346,
"text": "Right, OK. Um, and, uh, how about yourself? Have you had any history of, mini-strokes or anything like that, along those lines? I know you're quite young.",
"speaker": "Doctor"
},
{
"start": 310.54048,
"end": 317.61634,
"text": "No, so after my, dad had his operation, I was required to be checked, and my cholesterol , was fine.",
"speaker": "Patient"
},
{
"start": 318.84895,
"end": 324.63911,
"text": "Good, excellent. So you had a, a blood test done. And did they check for diabetes as well?",
"speaker": "Doctor"
},
{
"start": 322.8662,
"end": 332.04559,
"text": "Yeah. They checked my diabetes, my blood pressure and my, cholesterol, and the doctor said it was all OK.",
"speaker": "Patient"
},
{
"start": 331.89836,
"end": 335.71949,
"text": "Fantastic, OK. Now, do you have any other illnesses at all?",
"speaker": "Doctor"
},
{
"start": 335.82619,
"end": 336.49047,
"text": "No.",
"speaker": "Patient"
},
{
"start": 336.70448,
"end": 338.35752,
"text": "No. Are you on any medication?",
"speaker": "Doctor"
},
{
"start": 339.05015,
"end": 344.42906,
"text": "I take an aspirin, seventy five milligrams, once a day, but that's, because of something I read on the internet.",
"speaker": "Patient"
},
{
"start": 345.82042,
"end": 348.50982,
"text": "OK. So, so, why is that? Why do you take that?",
"speaker": "Doctor"
},
{
"start": 349.06905,
"end": 352.8513,
"text": "I think it's, meant to reduce your risk of stroke and heart attack.",
"speaker": "Patient"
},
{
"start": 354.05489,
"end": 357.94864,
"text": "OK. Do, have you ever told a doctor before, your GP, that you're on Aspirin?",
"speaker": "Doctor"
},
{
"start": 358.30234,
"end": 363.56471,
"text": "Yes I took, I started to , taking it after my, father had his operation, but that wasn't the doctor telling me.",
"speaker": "Patient"
},
{
"start": 364.24451,
"end": 372.26515,
"text": "OK. Uh, and, has any GP ever spoken to you about, the risks of Aspirin, and whether you should be on it? Or have you not , told the , the GP in the past?",
"speaker": "Doctor"
},
{
"start": 372.27022,
"end": 373.44731,
"text": "No, I haven't.",
"speaker": "Patient"
},
{
"start": 373.5673,
"end": 385.0967,
"text": "You haven't, OK. Um, all right. Um. Now, um, in terms of your uh, your kind of social situation. Um, are you working at the moment?",
"speaker": "Doctor"
},
{
"start": 385.38498,
"end": 386.37929,
"text": "Yes, I am.",
"speaker": "Patient"
},
{
"start": 386.52626,
"end": 387.69486,
"text": ", what do you work as?",
"speaker": "Doctor"
},
{
"start": 388.17714,
"end": 389.79973,
"text": "Uh, I'm, uh, I'm actually a doctor.",
"speaker": "Patient"
},
{
"start": 390.18948,
"end": 392.02319,
"text": "You're a , a, a medical doctor?",
"speaker": "Doctor"
},
{
"start": 391.85736,
"end": 392.65735,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 392.93202,
"end": 395.34822,
"text": "OK. Uh, which, specialty are you in?",
"speaker": "Doctor"
},
{
"start": 396.36418,
"end": 398.47033,
"text": "I work in, uh, plastic surgery.",
"speaker": "Patient"
},
{
"start": 398.71793,
"end": 404.98096,
"text": "Plastic surgery, OK, great. And, um, do you, have any, um, allergies to any medication at all?",
"speaker": "Doctor"
},
{
"start": 405.96928,
"end": 408.13366,
"text": "I'm allergic to penicillin only.",
"speaker": "Patient"
},
{
"start": 408.37296,
"end": 412.66791,
"text": "OK. And, um, are you, um, living alone?",
"speaker": "Doctor"
},
{
"start": 413.10495,
"end": 414.35768,
"text": "No, I live with my wife.",
"speaker": "Patient"
},
{
"start": 414.68949,
"end": 419.80459,
"text": "Right, OK. Um, fantastic. Uh , do you smoke at all?",
"speaker": "Doctor"
},
{
"start": 420.5635,
"end": 421.41712,
"text": "No, I don't.",
"speaker": "Patient"
},
{
"start": 422.14271,
"end": 430.55276,
"text": "Right, OK. Um, that's fine. Now, obviously you're a, you're a medic yourself. Did you have any thoughts as to what might be going on?",
"speaker": "Doctor"
},
{
"start": 431.64031,
"end": 434.21564,
"text": "Uh, I've actually, got no idea.",
"speaker": "Patient"
},
{
"start": 434.7326,
"end": 446.76854,
"text": "Right, OK. Um, well the, the way you're describing these episodes. They make me concerned about, mini-strokes or TIAs, , transient ischemic attacks. Um.",
"speaker": "Doctor"
},
{
"start": 446.32854,
"end": 446.84282,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 446.76854,
"end": 468.2289,
"text": "And so, that's something quite urgent. And given that you've got a family history of um, stroke. Um, even though you're quite young, I think um, it's something that we need to exclude. So, what I'm probably going to do, uh, in fact what I am going to do, is I'm going to, refer you to a stroke, a TIA clinic. Um, now just to double-check. Do you have the symptoms right now?",
"speaker": "Doctor"
},
{
"start": 468.60592,
"end": 470.3112,
"text": "No, I'm perfectly fine at the moment.",
"speaker": "Patient"
},
{
"start": 470.27925,
"end": 522.90873,
"text": "OK. So, so, what I'm gonna do, is I'm uh, I'm gonna refer you to a, a mini-stroke clinic, or a TIA clinic. Um, I send that referral off now, and then you can attend them, they, they'll usually, call you in within the next one to two days, OK. Because it's something relatively urgent. Now, today it's Wednesday, so we've got a few days , before the weekend. So, um, uh, basically the deadline should be, Thursday, Friday. We're expecting you to be seen by the time, that's the kind of turnaround we're, we're looking at. And in that clinic, they'll be doing a number of things. Um, they'll be checking, they'll be doing a ultrasound of the, carotid arteries, like your, your father had. Um, and, they'll be doing a, maybe a, they might do a scan of your brain as well, to check if there's any signs of a bleed there. But, um, they'll be doing a range of tests in a short time frame, in order to exclude whether, you have um, any illness. OK, whether you have got any kind of stroke or, mini-stroke.",
"speaker": "Doctor"
},
{
"start": 519.547,
"end": 520.32635,
"text": "Sure.",
"speaker": "Patient"
},
{
"start": 522.90873,
"end": 551.18689,
"text": "Now, if your symptoms return and they persist, they're prolonged. Then um, you may need to attend A and E. OK, because um, our presumptive, working diagnosis is, mini-stroke or TIA, OK. And if, a mini-stroke is prolonged then uh, then we end up thinking that this might be a stroke and in that case, that becomes even more of an emergency. So, we're not talking about waiting one or two days, we want you to go to hospital in that instance, as soon as possible, OK.",
"speaker": "Doctor"
},
{
"start": 550.94993,
"end": 551.44278,
"text": "Sure.",
"speaker": "Patient"
},
{
"start": 551.18689,
"end": 584.86545,
"text": "Now if , things happen again, feel free to contact us, we can assess you over the phone, we can give you direction and guidance over the phone. That's, that's, that's not a problem, you know, you, you've got easy access to us. OK. So, um, this is the plan going forward. Um, I'm going to, um, do that referral. You should hear back from the hospital, relatively soon. The hospital, you can actually ring them, on um, uh, the PALS number, and then there's also the TIA clinic number. I'm going to leave that number in the notes for this consultation, OK. So you'll have all the information you need, to chase this appointment.",
"speaker": "Doctor"
},
{
"start": 578.70308,
"end": 579.27451,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 584.86545,
"end": 598.48747,
"text": "And um, if you want, you can ring them, either today or tomorrow morning. , today in the afternoon, wait uh, one or two hours. Or tomorrow morning just to find out when they got time to slot you in. And, just to make sure they've got you in the system, that they've got in the books, and they're going to be calling you in, OK.",
"speaker": "Doctor"
},
{
"start": 598.46767,
"end": 599.39213,
"text": "",
"speaker": "Patient"
},
{
"start": 598.48747,
"end": 617.37638,
"text": ", this isn't, a, an immediate emergency that you need to rush down to A and E. But it's something quite urgent we need to, deal with in a short space of time, OK. So if there's, if there's any delay that, transpires for example, you can't make the appointment or, you know, they, you don't get called. , you, you get, get in contact back, back with us, OK.",
"speaker": "Doctor"
},
{
"start": 617.45918,
"end": 618.03775,
"text": "",
"speaker": "Patient"
},
{
"start": 618.315,
"end": 620.45867,
"text": "All right. Did you have any questions at all?",
"speaker": "Doctor"
},
{
"start": 620.85281,
"end": 622.69516,
"text": "No, I think that covers, most of it.",
"speaker": "Patient"
},
{
"start": 623.05633,
"end": 631.66522,
"text": "OK, great. So just bear with me a few minutes, and then I'll send that uh, all through and then you should, um, you should be able to help, you should have the information at your hands to, in order to take things further, OK.",
"speaker": "Doctor"
},
{
"start": 631.82717,
"end": 632.73432,
"text": ", thank you.",
"speaker": "Patient"
},
{
"start": 632.76074,
"end": 634.50894,
"text": "All the best. Take care now. Bye bye.",
"speaker": "Doctor"
},
{
"start": 634.11308,
"end": 634.55593,
"text": "",
"speaker": "Patient"
}
],
"doctor_utterances": "Hi there. Good morning. I'm Doctor from GP at Hand. Nice to see you. OK. So, um, before we start your appointment. Could I confirm your full name and date of birth please? Sorry, I didn't catch your date of birth. Thirty two years old, OK. Could you tell me the first line of your address, and your postcode please? That's great, thank you so much for that. Are you in a private place where you're OK to speak at the moment? OK. So how can I help you today? You've been having some problems with your asthma. Is that right? How can I help you today? OK. OK. So, tell me a bit more about these weird symptoms you've been having. Right again, the connection's not so great. You've been getting pins and needles in the hand. Is that right? OK. Is that the right or left hand? Is it always the right? OK. Um, we've lost video now, maybe is there a, a, a button you can press? OK. Are you happy for us to carry on without the video? I can't see you at the moment. All right. Um, so, you've been having these pins and needles, and episodes of numbness, in the right hand. Is it just the hand, or does it go up the arm as well? Right, OK. Um, is there any involvement of your leg at all? OK. You, you said you've been having weird symptoms for about a month. , so, what has been happening from the beginning of the month? What else has been happening? Right, OK. Um, and, um. You know, , your colleague said you've, you've not been walking normally. Do you feel anything different, on either side, in terms of your legs? Can , have you noticed anything different? Right, OK. And. You know you, the abnormal gait. Has that been present, outside of these episodes? Right, . All right, OK. Um, and, these, these episodes. How often have they been happening? Right, OK. And, how long have these episodes been going on for? When, when did it all start? Was it a month ago? Right, OK. OK. And, along with these symptoms, of the weakness and numbness. Do you have any other symptoms at the same time? Like swallowing, or difficulty speaking, or vision problems? Right. Is that during these episodes, or outside of these episodes? OK. Do you have any difficulty swallowing at all? . During the episodes, do you have any difficulty swallowing? OK. What about, um, difficulty speaking during these episodes? Any, any issues with that at all? OK. And any visual problems during these episodes? OK, all right. Now um, can I just ask? , has, uh, is there any history of stroke, or mini-strokes in your family? Right, OK. Um, and, uh, how about yourself? Have you had any history of, mini-strokes or anything like that, along those lines? I know you're quite young. Good, excellent. So you had a, a blood test done. And did they check for diabetes as well? Fantastic, OK. Now, do you have any other illnesses at all? No. Are you on any medication? OK. So, so, why is that? Why do you take that? OK. Do, have you ever told a doctor before, your GP, that you're on Aspirin? OK. Uh, and, has any GP ever spoken to you about, the risks of Aspirin, and whether you should be on it? Or have you not , told the , the GP in the past? You haven't, OK. Um, all right. Um. Now, um, in terms of your uh, your kind of social situation. Um, are you working at the moment? , what do you work as? You're a , a, a medical doctor? OK. Uh, which, specialty are you in? Plastic surgery, OK, great. And, um, do you, have any, um, allergies to any medication at all? OK. And, um, are you, um, living alone? Right, OK. Um, fantastic. Uh , do you smoke at all? Right, OK. Um, that's fine. Now, obviously you're a, you're a medic yourself. Did you have any thoughts as to what might be going on? Right, OK. Um, well the, the way you're describing these episodes. They make me concerned about, mini-strokes or TIAs, , transient ischemic attacks. Um. And so, that's something quite urgent. And given that you've got a family history of um, stroke. Um, even though you're quite young, I think um, it's something that we need to exclude. So, what I'm probably going to do, uh, in fact what I am going to do, is I'm going to, refer you to a stroke, a TIA clinic. Um, now just to double-check. Do you have the symptoms right now? OK. So, so, what I'm gonna do, is I'm uh, I'm gonna refer you to a, a mini-stroke clinic, or a TIA clinic. Um, I send that referral off now, and then you can attend them, they, they'll usually, call you in within the next one to two days, OK. Because it's something relatively urgent. Now, today it's Wednesday, so we've got a few days , before the weekend. So, um, uh, basically the deadline should be, Thursday, Friday. We're expecting you to be seen by the time, that's the kind of turnaround we're, we're looking at. And in that clinic, they'll be doing a number of things. Um, they'll be checking, they'll be doing a ultrasound of the, carotid arteries, like your, your father had. Um, and, they'll be doing a, maybe a, they might do a scan of your brain as well, to check if there's any signs of a bleed there. But, um, they'll be doing a range of tests in a short time frame, in order to exclude whether, you have um, any illness. OK, whether you have got any kind of stroke or, mini-stroke. Now, if your symptoms return and they persist, they're prolonged. Then um, you may need to attend A and E. OK, because um, our presumptive, working diagnosis is, mini-stroke or TIA, OK. And if, a mini-stroke is prolonged then uh, then we end up thinking that this might be a stroke and in that case, that becomes even more of an emergency. So, we're not talking about waiting one or two days, we want you to go to hospital in that instance, as soon as possible, OK. Now if , things happen again, feel free to contact us, we can assess you over the phone, we can give you direction and guidance over the phone. That's, that's, that's not a problem, you know, you, you've got easy access to us. OK. So, um, this is the plan going forward. Um, I'm going to, um, do that referral. You should hear back from the hospital, relatively soon. The hospital, you can actually ring them, on um, uh, the PALS number, and then there's also the TIA clinic number. I'm going to leave that number in the notes for this consultation, OK. So you'll have all the information you need, to chase this appointment. And um, if you want, you can ring them, either today or tomorrow morning. , today in the afternoon, wait uh, one or two hours. Or tomorrow morning just to find out when they got time to slot you in. And, just to make sure they've got you in the system, that they've got in the books, and they're going to be calling you in, OK. , this isn't, a, an immediate emergency that you need to rush down to A and E. But it's something quite urgent we need to, deal with in a short space of time, OK. So if there's, if there's any delay that, transpires for example, you can't make the appointment or, you know, they, you don't get called. , you, you get, get in contact back, back with us, OK. All right. Did you have any questions at all? OK, great. So just bear with me a few minutes, and then I'll send that uh, all through and then you should, um, you should be able to help, you should have the information at your hands to, in order to take things further, OK. All the best. Take care now. Bye bye.",
"patient_utterances": "Hi. Yeah, it's John Smith, and I am thirty two years old. I'm thirty two years old. It's four Park Avenue, and it's AB one CB two. Yes. Sorry, say that . So, um, I've been experiencing very weird symptoms, over the past month or so. And I don't know what's causing them. I have googled it and, um, nothing's coming up, so I thought I'd come and speak to you about it. So, it started with, feeling very tired, but for a couple of days, and then I get back to normal. And then I started losing feeling, in my hands and arms. I get a weird sensation like, uh, I guess, pins and needles. And. Yeah, that's correct. My right hand. Yes. Yes, that's fine. Uh, the pins and needles are in the hand, but I feel like my arm is getting weaker, but it only lasts few days and then goes back to normal. So, it's very weird. Uh, my, colleague said, I'm walking slightly differently to normal. And again, it's only for three days, or three or four days. Yes. Um, I generally feel tired, and weak. And, sometimes I feel nauseous, and I don't feel like I want to do anything. Yes. Yeah, so, at the same time I get my arm symptoms, my leg feels weaker. No, it has not. So normally, I'm, fit and well actually. They have been getting more regular. So at the start, it would be maybe once a week, uh, to every once , once a month, but now it's getting uh, uh, a couple of times a day. , probably a month and a half, maybe two months. So, recently I've noticed, I can't hold my cup of coffee. And when I, do drink coffee, it's slightly harder to drink. And that's only been in the last couple of days, I guess. Only during the episodes. Not currently, no. I, I, I feel like there's something in my throat. No, I can speak fine. I, I don't think so, but I wear glasses. Uh, yes. My, father has had a, operation to the side of his neck, to reduce the risk of stroke. No, so after my, dad had his operation, I was required to be checked, and my cholesterol , was fine. Yeah. They checked my diabetes, my blood pressure and my, cholesterol, and the doctor said it was all OK. No. I take an aspirin, seventy five milligrams, once a day, but that's, because of something I read on the internet. I think it's, meant to reduce your risk of stroke and heart attack. Yes I took, I started to , taking it after my, father had his operation, but that wasn't the doctor telling me. No, I haven't. Yes, I am. Uh, I'm, uh, I'm actually a doctor. Yes. I work in, uh, plastic surgery. I'm allergic to penicillin only. No, I live with my wife. No, I don't. Uh, I've actually, got no idea. OK. No, I'm perfectly fine at the moment. Sure. Sure. OK. No, I think that covers, most of it. , thank you. ",
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"reference_note": "{\"day\": 2, \"consultation\": 5, \"presenting_complaint\": \"My asthma is not responding to my inhalers\", \"note\": \"(the above consultation reason doesn't correlate with the patient's presentation)\\nHx: episodes of unilateral right hand numbness/ pins and needles, with some right leg weakness and noticeable gait disturbances, ongoing for 1.5 months\\noccurring with increasing frequency- initially once a week, now more often, occurring daily\\n symptoms not present now\\nno dysphagia, no dysphasia\\nno Pmhx of CVA/TIA\\nFather had CVA- appears to have had carotid endarterectomy\\nNon smoker, normal blood tests for diabetes/ cholesterol when checked a few years ago\\nPMHx and FH: otherwise nil of note\\nDH PT IS TAKING Aspirin daily on his own accord due to his FH\\nSH: pt is a medical doctor, plastic surgeon, lives with wife\\nImp: TIAs- despite young age (need to exclude any systemic disease, eg antiphospholipid syndrome, that could be cause)\\nPlan: needs to be seen urgently in TIA clinic- will fax referral now. Pt to contact them via PALS/ clinic no to ensure f/u\\nIf any prolonged symptoms occur- to attend A/E\\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] \n[Patient] Hello.\n[Doctor] Hi there. I'm Doctor Deen Mirza from Babylon. Good morning.\n[Patient] Good morning. Hi, .\n[Doctor] Good morning. . , sorry, , before we start. Could I get your full name and date of birth? Is that possible? Yes, it's, .\n[Patient] Yeah, sure. Um, my name is John Doe. Um, and I am twenty seven years old. Um, so, I was born in nineteen ninety one, um, seventeenth of November.\n[Doctor] That's perfect, thank you for that. Are you, um, John, are you in a private place where you're OK to speak at the moment?\n[Patient] Yeah, yeah.\n[Doctor] , perfect, thank you for that. OK. So, tell me what the problem is. You've been having some difficulty breathing. Is that correct?\n[Patient] , yeah, exactly. I've, I'm , kind of struggling to breathe at the moment. I, I got stung by a wasp, um, recently. Well, I'm not sure whether it's kind of bitten or stung. Um, but I, uh, I'm feeling like slightly anxious that, uh, there's a bit of, I've got a bit of a, a rash on my arm where, i got stung. Um, and, I've, kind of. But yeah, as I say, I've got this difficulty breathing and potentially, um, there's a bit of swelling in my lips. My tongue feels a bit weird.\n[Doctor] Right, OK. So, when did this bee sting or bee bite occur?\n[Patient] Um, it was, just a few minutes ago.\n[Doctor] Right, OK. Um, and, your, your lips don't seem swollen to me right now, but, do they, which. Can you show me with your finger where you feel it's swollen?\n[Patient] Yeah, it's just kind of on the right-hand side. Um, and it, and it's just a bit sore, maybe it hasn't kind of , fully swollen up yet.\n[Doctor] Sure. Sure, OK. Uh, you said you've been having some difficulty breathing.\n[Patient] Yeah.\n[Doctor] Your breathing seems all right to me right now. Um, the reason why I'm, clarifying is, because we have to decide whether this is a, an acute emergency. Whether I need to send you in to hospital straight away.\n[Patient] Yeah.\n[Doctor] Or whether we, more time to ask questions, OK. So um, , do you feel like you've got difficulty breathing right now, this minute, as we speak?\n[Patient] Right.\n[Patient] I, I, I , I don't, feel like it's , like particularly acute, but i'm just kind of a bit anxious that it might get a bit worse. I don't, I just wanted to speak to someone.\n[Doctor] Sure, sure. . Sure. No you, uh, you did the right thing and I, and I can understand it , it is quite anxiety provoking, OK. All right. Can I just double-check? Before we carry on asking other questions. Have you got history of anaphylaxis?\n[Patient] Uh, not that I know of.\n[Doctor] No, OK. Have you ever been given an EpiPen?\n[Patient] Uh, I haven't no.\n[Doctor] No, OK, all right. Let, let's, um, take a step back now. So, in terms of the bee sting, it was a . Did you see a bee or you're, you're just , um, assuming it was a bee?\n[Patient] Um, I, , I, I find it difficult to tell the difference between a bee and a wasp, but um, , yeah it was one of the two.\n[Doctor] . One of the two.\n[Doctor] , OK. And, um, the area of your body that it stung. Where was it? Did you say it was your arm?\n[Patient] Yeah, it was on my arm.\n[Doctor] All right. And you've got a rash there. Can I have a look?\n[Patient] Uh, yeah sure. Um, it's just, just there.\n[Doctor] OK, all right. That looks OK to me right now. , does it look red to you at the moment?\n[Patient] Mm-hmm.\n[Patient] It's, it's slightly red, yeah and, and kind of there's, a bit of a, like a hole there, where I think that the wasp, stung me.\n[Doctor] \n[Doctor] \n[Doctor] Yeah, yeah, yeah. The puncture mark, yeah, OK, all right. Um, now, is, is there any swelling, around that area, that you can see? I, I couldn't see any.\n[Patient] Uh, .\n[Patient] Not particularly. I, I guess it's just a bit kind of blotchy, uh, and a bit of a rash. It doesn't feel like, particularly swollen. Um.\n[Doctor] Sure. OK, all right.Um, now, have you taken any medication? It's probably a , you probably haven't, 'cause it was a few minutes ago. But have you? Is . , not taken , any , antihistamines or anything like that?\n[Patient] \n[Patient] Not at the, not at the moment, no. Nothing, nothing yet.\n[Doctor] OK. , now, um, if I can just go back. Do you have any history of any , any, kind of illnesses at all?\n[Patient] Um, I've, I've had eczema before. Um.\n[Doctor] OK, .\n[Patient] , that's kind of the, the major thing, nothing, nothing really.\n[Doctor] , OK. Have you, got a history of any allergies to anything?\n[Patient] Uh, I'm allergic to penicillin.\n[Doctor] All right, good. Um, and in your family, is there any history of any illnesses, or, any history of any kind of acute reactions?\n[Patient] Um, not that I think is, particularly relevant, no. I don't have, I don't have any.\n[Doctor] \n[Doctor] Right. , and, um, do you have allergies to any kind of, cats, or dogs, or pets, or anything like that?\n[Patient] Uh, not that I know of, I've , yeah, I've been around dogs and cats, .\n[Doctor] Yeah. , and you've got no food allergies as far as you're aware?\n[Patient] No.\n[Doctor] OK.\n[Doctor] Um, can I ask? Do you suffer from anxiety or panic attacks, or anything like that?\n[Patient] Uh, yeah, uh, sometimes, occasionally.\n[Doctor] Right, OK. Have you ever been on medication for that?\n[Patient] Um, no.\n[Doctor] OK.\n[Patient] No.\n[Doctor] Um, great. Now, um, I need to ask a few questions, maybe not directly related to this, but just, it's for, for general information purposes. So, um, , are you working at the moment?\n[Patient] Yes.\n[Doctor] What do you work as?\n[Patient] Uh, I am a, uh, computer scientist.\n[Doctor] OK. And, um, , you living alone?\n[Patient] Yes.\n[Doctor] OK. Do you have any pets at home?\n[Patient] Um, I have a cat, at home.\n[Doctor] A cat. OK, great. What I'd like to do now. If that's OK John? Is, I'd like to have a look inside your mouth, OK. Um, one of the things that, um, we'd be worried about if, someone's going to have an acute allergic reaction. Is to see whether there's any swelling, of the lips, or the tissues inside the mouth, or the.\n[Patient] Yep.\n[Patient] Yeah.\n[Doctor] Soft tissues of the airway. And, um, I can, I've got a fairly good view of your lips, but I'd like maybe if you can, bring your device closer to your mouth, and then put your head back, mouth open wide. Sit somewhere where there's good lighting. And I just wanna have a look inside the throat, if that's OK?\n[Patient] \n[Doctor] Perfect, OK, great. Now, um, um, can, can I just get you to do it again? And, just say ah, this time.\n[Patient] Yup.\n[Patient] Ah.\n[Doctor] OK, fantastic, brilliant. OK. Um. Uh, John. Based on, um, how you look. How you're talking to me, and how you're breathing, and the appearance, and your wrist. Um, I don't feel that you're having , a, an, an, a life-threatening, uh, allergic reaction. Now it's very normal, to have, a rash, when you have some kind of insect bite. It's uh, it's a localised, um, uh, inflammatory reaction, that um, is normal and that , immediate reaction, that redness, and that maybe slight swelling, is usually temporary. What we're worried about, is when someone has, um, compromise of their breathing. So you mentioned, breathing difficulties and you mentioned swelling of your lip. Thankfully I can't see any of that right now.\n[Patient] Right.\n[Doctor] , but that's, the most, urgent and most pressing thing that we'd be watching out for. Given that it hasn't happened, initially, it's unlikely to happen later. OK we, so we have like a , stage one and stage two reaction, for these types of bites. And, usually if you're gonna have the reaction, it will happen straight away. So, , we may be coming out of the danger zone now, it's um. But I'm just going to warn you about what those signs and symptoms are, in case it happens. So for example. You would have, swelling of the lips, difficulty breathing. You might have something called stridor, which is an inspiratory sound that you, when you're trying, trying to breathe. It makes like a rasping sound, like this. OK. . Thankfully, you don't have anything like that right now. It seems to me like this is a localised allergic reaction. However, if anything changes, if anything deteriorates. Either make an appointment with us, or go straight to A and E.\n[Patient] Yeah.\n[Doctor] Um, uh, and in some cases, if it's, if it's, uh, progressing rapidly, it's better to go straight to A and E, rather than to, wait for a booked appointment with us, OK. What I'd like you to do now, is I'd like you to try and take some antihistamines. So you can buy them over the counter. You can get Piriton or Chlorphenamine, and you can take one tablet, four milligrams, um, up to about six times a day. OK.\n[Patient] Yeah.\n[Doctor] Or you can just take a one-a-day one, whichever is your preference, that's, that's absolutely fine, there's no, no issue. That should be enough to control this. Um, if, the redness in your arm spreads, and you, it feels hot, or you, you know, you have signs of any localised infection. We may need to think about other treatments, like an antibiotic. And like I said if anything deteriorates, in terms of your breathing, that's urgent and we need to process that, , action needs to be taken urgently.\n[Patient] Yeah.\n[Doctor] Did you have any other, um, queries or was there anything else that you're worried about?\n[Patient] OK.\n[Patient] Uh, no, I think, I think that kind of, that makes me feel a bit better. I guess, can I get that um, can I get the, uh, so the antihistamine from any shop, or like does it pharmacy?\n[Doctor] Yeah, that's, that's over the, yeah , over the counter. You don't need to, any chemist, will have it, you don't need a prescription for that. Yeah, it's probably cheaper to buy it over the counter actually, than to get it via prescription.\n[Patient] \n[Doctor] OK. Um, now, um, uh, on the basis of what you've told me, I don't think you need any allergy testing. I think this is just a , a straightforward localised reaction to a, an insect bite.\n[Patient] OK.\n[Doctor] However, if it was to happen that, you know, this, you're, you're having these kind of reactions on a regular basis or other, , non-specific rashes. We might need to think about blood testing, I don't think we're at, at that moment yet. OK. So uh, but , that's something to bear in mind in case this, becomes a recurrent pattern.\n[Patient] OK.\n[Patient] OK.\n[Doctor] OK then, so, we'll leave it like that for now, OK. I'm gonna leave a link to some information about anaphylactic reactions, just for you to read about it. I don't want you to panic, but just for you to be aware what symptoms are.\n[Patient] Great.\n[Patient] Yeah.\n[Doctor] If those kind of things happen, get back to us. If you're feeling worried, just have a lower threshold for , having a chat with us, sometimes a chat is all you need to calm things down.\n[Patient] OK, great. Yeah, that makes sense.\n[Doctor] All right then John, OK. Uh, well we'll leave it like that, , come back to us if you have any further issues.\n[Patient] \n[Patient] OK. Thanks. I appreciate your time.\n[Doctor] My pleasure. All right, take care then. All the best.\n[Patient] Bye bye, bye.\n[Doctor] Bye bye.",
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"text": ", yeah, exactly. I've, I'm , kind of struggling to breathe at the moment. I, I got stung by a wasp, um, recently. Well, I'm not sure whether it's kind of bitten or stung. Um, but I, uh, I'm feeling like slightly anxious that, uh, there's a bit of, I've got a bit of a, a rash on my arm where, i got stung. Um, and, I've, kind of. But yeah, as I say, I've got this difficulty breathing and potentially, um, there's a bit of swelling in my lips. My tongue feels a bit weird.",
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"text": "All right, good. Um, and in your family, is there any history of any illnesses, or, any history of any kind of acute reactions?",
"speaker": "Doctor"
},
{
"start": 252.71075,
"end": 259.02882,
"text": "Um, not that I think is, particularly relevant, no. I don't have, I don't have any.",
"speaker": "Patient"
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{
"start": 255.43333,
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"text": "",
"speaker": "Doctor"
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{
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"text": " Right. , and, um, do you have allergies to any kind of, cats, or dogs, or pets, or anything like that?",
"speaker": "Doctor"
},
{
"start": 266.28701,
"end": 270.86966,
"text": "Uh, not that I know of, I've , yeah, I've been around dogs and cats, .",
"speaker": "Patient"
},
{
"start": 268.42666,
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"text": " Yeah. , and you've got no food allergies as far as you're aware?",
"speaker": "Doctor"
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{
"start": 273.51727,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 274.91457,
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 277.11332,
"end": 281.55333,
"text": "Um, can I ask? Do you suffer from anxiety or panic attacks, or anything like that?",
"speaker": "Doctor"
},
{
"start": 282.69243,
"end": 285.58389,
"text": "Uh, yeah, uh, sometimes, occasionally.",
"speaker": "Patient"
},
{
"start": 286.07999,
"end": 288.71332,
"text": "Right, OK. Have you ever been on medication for that?",
"speaker": "Doctor"
},
{
"start": 289.71443,
"end": 290.94283,
"text": "Um, no.",
"speaker": "Patient"
},
{
"start": 292.05332,
"end": 292.38666,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 292.09668,
"end": 292.60764,
"text": "No.",
"speaker": "Patient"
},
{
"start": 293.66666,
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"text": "Um, great. Now, um, I need to ask a few questions, maybe not directly related to this, but just, it's for, for general information purposes. So, um, , are you working at the moment?",
"speaker": "Doctor"
},
{
"start": 304.41031,
"end": 305.086,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 305.28666,
"end": 306.37332,
"text": "What do you work as?",
"speaker": "Doctor"
},
{
"start": 307.20083,
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"text": "Uh, I am a, uh, computer scientist.",
"speaker": "Patient"
},
{
"start": 312.4511,
"end": 315.37332,
"text": "OK. And, um, , you living alone?",
"speaker": "Doctor"
},
{
"start": 315.70771,
"end": 316.52957,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 317.03332,
"end": 318.92666,
"text": "OK. Do you have any pets at home?",
"speaker": "Doctor"
},
{
"start": 319.58057,
"end": 321.60001,
"text": "Um, I have a cat, at home.",
"speaker": "Patient"
},
{
"start": 321.23999,
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"text": "A cat. OK, great. What I'd like to do now. If that's OK John? Is, I'd like to have a look inside your mouth, OK. Um, one of the things that, um, we'd be worried about if, someone's going to have an acute allergic reaction. Is to see whether there's any swelling, of the lips, or the tissues inside the mouth, or the.",
"speaker": "Doctor"
},
{
"start": 328.69646,
"end": 329.18103,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 338.182,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 338.51332,
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"text": "Soft tissues of the airway. And, um, I can, I've got a fairly good view of your lips, but I'd like maybe if you can, bring your device closer to your mouth, and then put your head back, mouth open wide. Sit somewhere where there's good lighting. And I just wanna have a look inside the throat, if that's OK?",
"speaker": "Doctor"
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{
"start": 346.4182,
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"speaker": "Patient"
},
{
"start": 354.85999,
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"text": "Perfect, OK, great. Now, um, um, can, can I just get you to do it again? And, just say ah, this time.",
"speaker": "Doctor"
},
{
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"text": "Yup.",
"speaker": "Patient"
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{
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"text": "Ah.",
"speaker": "Patient"
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{
"start": 364.09332,
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"text": "OK, fantastic, brilliant. OK. Um. Uh, John. Based on, um, how you look. How you're talking to me, and how you're breathing, and the appearance, and your wrist. Um, I don't feel that you're having , a, an, an, a life-threatening, uh, allergic reaction. Now it's very normal, to have, a rash, when you have some kind of insect bite. It's uh, it's a localised, um, uh, inflammatory reaction, that um, is normal and that , immediate reaction, that redness, and that maybe slight swelling, is usually temporary. What we're worried about, is when someone has, um, compromise of their breathing. So you mentioned, breathing difficulties and you mentioned swelling of your lip. Thankfully I can't see any of that right now.",
"speaker": "Doctor"
},
{
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"text": "Right.",
"speaker": "Patient"
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{
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"text": ", but that's, the most, urgent and most pressing thing that we'd be watching out for. Given that it hasn't happened, initially, it's unlikely to happen later. OK we, so we have like a , stage one and stage two reaction, for these types of bites. And, usually if you're gonna have the reaction, it will happen straight away. So, , we may be coming out of the danger zone now, it's um. But I'm just going to warn you about what those signs and symptoms are, in case it happens. So for example. You would have, swelling of the lips, difficulty breathing. You might have something called stridor, which is an inspiratory sound that you, when you're trying, trying to breathe. It makes like a rasping sound, like this. OK. . Thankfully, you don't have anything like that right now. It seems to me like this is a localised allergic reaction. However, if anything changes, if anything deteriorates. Either make an appointment with us, or go straight to A and E.",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "Um, uh, and in some cases, if it's, if it's, uh, progressing rapidly, it's better to go straight to A and E, rather than to, wait for a booked appointment with us, OK. What I'd like you to do now, is I'd like you to try and take some antihistamines. So you can buy them over the counter. You can get Piriton or Chlorphenamine, and you can take one tablet, four milligrams, um, up to about six times a day. OK.",
"speaker": "Doctor"
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{
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"text": "Yeah.",
"speaker": "Patient"
},
{
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"end": 511.37998,
"text": "Or you can just take a one-a-day one, whichever is your preference, that's, that's absolutely fine, there's no, no issue. That should be enough to control this. Um, if, the redness in your arm spreads, and you, it feels hot, or you, you know, you have signs of any localised infection. We may need to think about other treatments, like an antibiotic. And like I said if anything deteriorates, in terms of your breathing, that's urgent and we need to process that, , action needs to be taken urgently.",
"speaker": "Doctor"
},
{
"start": 506.96576,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 512.15554,
"end": 516.71998,
"text": "Did you have any other, um, queries or was there anything else that you're worried about?",
"speaker": "Doctor"
},
{
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 517.02798,
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"text": "Uh, no, I think, I think that kind of, that makes me feel a bit better. I guess, can I get that um, can I get the, uh, so the antihistamine from any shop, or like does it pharmacy?",
"speaker": "Patient"
},
{
"start": 528.11332,
"end": 537.98022,
"text": "Yeah, that's, that's over the, yeah , over the counter. You don't need to, any chemist, will have it, you don't need a prescription for that. Yeah, it's probably cheaper to buy it over the counter actually, than to get it via prescription.",
"speaker": "Doctor"
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{
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{
"start": 537.98022,
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"text": "OK. Um, now, um, uh, on the basis of what you've told me, I don't think you need any allergy testing. I think this is just a , a straightforward localised reaction to a, an insect bite.",
"speaker": "Doctor"
},
{
"start": 538.67082,
"end": 539.27622,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 547.63332,
"end": 563.17776,
"text": "However, if it was to happen that, you know, this, you're, you're having these kind of reactions on a regular basis or other, , non-specific rashes. We might need to think about blood testing, I don't think we're at, at that moment yet. OK. So uh, but , that's something to bear in mind in case this, becomes a recurrent pattern.",
"speaker": "Doctor"
},
{
"start": 559.25388,
"end": 559.83939,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 563.78822,
"end": 564.41512,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 564.0446,
"end": 574.36,
"text": "OK then, so, we'll leave it like that for now, OK. I'm gonna leave a link to some information about anaphylactic reactions, just for you to read about it. I don't want you to panic, but just for you to be aware what symptoms are.",
"speaker": "Doctor"
},
{
"start": 567.04228,
"end": 567.61444,
"text": "Great.",
"speaker": "Patient"
},
{
"start": 572.95308,
"end": 573.45758,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 574.36,
"end": 582.62665,
"text": "If those kind of things happen, get back to us. If you're feeling worried, just have a lower threshold for , having a chat with us, sometimes a chat is all you need to calm things down.",
"speaker": "Doctor"
},
{
"start": 583.39507,
"end": 585.4876,
"text": "OK, great. Yeah, that makes sense.",
"speaker": "Patient"
},
{
"start": 585.60665,
"end": 590.94665,
"text": "All right then John, OK. Uh, well we'll leave it like that, , come back to us if you have any further issues.",
"speaker": "Doctor"
},
{
"start": 588.17159,
"end": 588.60353,
"text": "",
"speaker": "Patient"
},
{
"start": 591.32354,
"end": 593.04029,
"text": "OK. Thanks. I appreciate your time.",
"speaker": "Patient"
},
{
"start": 593.32665,
"end": 595.21331,
"text": "My pleasure. All right, take care then. All the best.",
"speaker": "Doctor"
},
{
"start": 595.83008,
"end": 597.05006,
"text": "Bye bye, bye.",
"speaker": "Patient"
},
{
"start": 596.48665,
"end": 597.00665,
"text": "Bye bye.",
"speaker": "Doctor"
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],
"doctor_utterances": " Hi there. I'm Doctor Deen Mirza from Babylon. Good morning. Good morning. . , sorry, , before we start. Could I get your full name and date of birth? Is that possible? Yes, it's, . That's perfect, thank you for that. Are you, um, John, are you in a private place where you're OK to speak at the moment? , perfect, thank you for that. OK. So, tell me what the problem is. You've been having some difficulty breathing. Is that correct? Right, OK. So, when did this bee sting or bee bite occur? Right, OK. Um, and, your, your lips don't seem swollen to me right now, but, do they, which. Can you show me with your finger where you feel it's swollen? Sure. Sure, OK. Uh, you said you've been having some difficulty breathing. Your breathing seems all right to me right now. Um, the reason why I'm, clarifying is, because we have to decide whether this is a, an acute emergency. Whether I need to send you in to hospital straight away. Or whether we, more time to ask questions, OK. So um, , do you feel like you've got difficulty breathing right now, this minute, as we speak? Sure, sure. . Sure. No you, uh, you did the right thing and I, and I can understand it , it is quite anxiety provoking, OK. All right. Can I just double-check? Before we carry on asking other questions. Have you got history of anaphylaxis? No, OK. Have you ever been given an EpiPen? No, OK, all right. Let, let's, um, take a step back now. So, in terms of the bee sting, it was a . Did you see a bee or you're, you're just , um, assuming it was a bee? . One of the two. , OK. And, um, the area of your body that it stung. Where was it? Did you say it was your arm? All right. And you've got a rash there. Can I have a look? OK, all right. That looks OK to me right now. , does it look red to you at the moment? Yeah, yeah, yeah. The puncture mark, yeah, OK, all right. Um, now, is, is there any swelling, around that area, that you can see? I, I couldn't see any. Sure. OK, all right.Um, now, have you taken any medication? It's probably a , you probably haven't, 'cause it was a few minutes ago. But have you? Is . , not taken , any , antihistamines or anything like that? OK. , now, um, if I can just go back. Do you have any history of any , any, kind of illnesses at all? OK, . , OK. Have you, got a history of any allergies to anything? All right, good. Um, and in your family, is there any history of any illnesses, or, any history of any kind of acute reactions? Right. , and, um, do you have allergies to any kind of, cats, or dogs, or pets, or anything like that? Yeah. , and you've got no food allergies as far as you're aware? OK. Um, can I ask? Do you suffer from anxiety or panic attacks, or anything like that? Right, OK. Have you ever been on medication for that? OK. Um, great. Now, um, I need to ask a few questions, maybe not directly related to this, but just, it's for, for general information purposes. So, um, , are you working at the moment? What do you work as? OK. And, um, , you living alone? OK. Do you have any pets at home? A cat. OK, great. What I'd like to do now. If that's OK John? Is, I'd like to have a look inside your mouth, OK. Um, one of the things that, um, we'd be worried about if, someone's going to have an acute allergic reaction. Is to see whether there's any swelling, of the lips, or the tissues inside the mouth, or the. Soft tissues of the airway. And, um, I can, I've got a fairly good view of your lips, but I'd like maybe if you can, bring your device closer to your mouth, and then put your head back, mouth open wide. Sit somewhere where there's good lighting. And I just wanna have a look inside the throat, if that's OK? Perfect, OK, great. Now, um, um, can, can I just get you to do it again? And, just say ah, this time. OK, fantastic, brilliant. OK. Um. Uh, John. Based on, um, how you look. How you're talking to me, and how you're breathing, and the appearance, and your wrist. Um, I don't feel that you're having , a, an, an, a life-threatening, uh, allergic reaction. Now it's very normal, to have, a rash, when you have some kind of insect bite. It's uh, it's a localised, um, uh, inflammatory reaction, that um, is normal and that , immediate reaction, that redness, and that maybe slight swelling, is usually temporary. What we're worried about, is when someone has, um, compromise of their breathing. So you mentioned, breathing difficulties and you mentioned swelling of your lip. Thankfully I can't see any of that right now. , but that's, the most, urgent and most pressing thing that we'd be watching out for. Given that it hasn't happened, initially, it's unlikely to happen later. OK we, so we have like a , stage one and stage two reaction, for these types of bites. And, usually if you're gonna have the reaction, it will happen straight away. So, , we may be coming out of the danger zone now, it's um. But I'm just going to warn you about what those signs and symptoms are, in case it happens. So for example. You would have, swelling of the lips, difficulty breathing. You might have something called stridor, which is an inspiratory sound that you, when you're trying, trying to breathe. It makes like a rasping sound, like this. OK. . Thankfully, you don't have anything like that right now. It seems to me like this is a localised allergic reaction. However, if anything changes, if anything deteriorates. Either make an appointment with us, or go straight to A and E. Um, uh, and in some cases, if it's, if it's, uh, progressing rapidly, it's better to go straight to A and E, rather than to, wait for a booked appointment with us, OK. What I'd like you to do now, is I'd like you to try and take some antihistamines. So you can buy them over the counter. You can get Piriton or Chlorphenamine, and you can take one tablet, four milligrams, um, up to about six times a day. OK. Or you can just take a one-a-day one, whichever is your preference, that's, that's absolutely fine, there's no, no issue. That should be enough to control this. Um, if, the redness in your arm spreads, and you, it feels hot, or you, you know, you have signs of any localised infection. We may need to think about other treatments, like an antibiotic. And like I said if anything deteriorates, in terms of your breathing, that's urgent and we need to process that, , action needs to be taken urgently. Did you have any other, um, queries or was there anything else that you're worried about? Yeah, that's, that's over the, yeah , over the counter. You don't need to, any chemist, will have it, you don't need a prescription for that. Yeah, it's probably cheaper to buy it over the counter actually, than to get it via prescription. OK. Um, now, um, uh, on the basis of what you've told me, I don't think you need any allergy testing. I think this is just a , a straightforward localised reaction to a, an insect bite. However, if it was to happen that, you know, this, you're, you're having these kind of reactions on a regular basis or other, , non-specific rashes. We might need to think about blood testing, I don't think we're at, at that moment yet. OK. So uh, but , that's something to bear in mind in case this, becomes a recurrent pattern. OK then, so, we'll leave it like that for now, OK. I'm gonna leave a link to some information about anaphylactic reactions, just for you to read about it. I don't want you to panic, but just for you to be aware what symptoms are. If those kind of things happen, get back to us. If you're feeling worried, just have a lower threshold for , having a chat with us, sometimes a chat is all you need to calm things down. All right then John, OK. Uh, well we'll leave it like that, , come back to us if you have any further issues. My pleasure. All right, take care then. All the best. Bye bye.",
"patient_utterances": "Hello. Good morning. Hi, . Yeah, sure. Um, my name is John Doe. Um, and I am twenty seven years old. Um, so, I was born in nineteen ninety one, um, seventeenth of November. Yeah, yeah. , yeah, exactly. I've, I'm , kind of struggling to breathe at the moment. I, I got stung by a wasp, um, recently. Well, I'm not sure whether it's kind of bitten or stung. Um, but I, uh, I'm feeling like slightly anxious that, uh, there's a bit of, I've got a bit of a, a rash on my arm where, i got stung. Um, and, I've, kind of. But yeah, as I say, I've got this difficulty breathing and potentially, um, there's a bit of swelling in my lips. My tongue feels a bit weird. Um, it was, just a few minutes ago. Yeah, it's just kind of on the right-hand side. Um, and it, and it's just a bit sore, maybe it hasn't kind of , fully swollen up yet. Yeah. Yeah. Right. I, I, I , I don't, feel like it's , like particularly acute, but i'm just kind of a bit anxious that it might get a bit worse. I don't, I just wanted to speak to someone. Uh, not that I know of. Uh, I haven't no. Um, I, , I, I find it difficult to tell the difference between a bee and a wasp, but um, , yeah it was one of the two. Yeah, it was on my arm. Uh, yeah sure. Um, it's just, just there. Mm-hmm. It's, it's slightly red, yeah and, and kind of there's, a bit of a, like a hole there, where I think that the wasp, stung me. Uh, . Not particularly. I, I guess it's just a bit kind of blotchy, uh, and a bit of a rash. It doesn't feel like, particularly swollen. Um. Not at the, not at the moment, no. Nothing, nothing yet. Um, I've, I've had eczema before. Um. , that's kind of the, the major thing, nothing, nothing really. Uh, I'm allergic to penicillin. Um, not that I think is, particularly relevant, no. I don't have, I don't have any. Uh, not that I know of, I've , yeah, I've been around dogs and cats, . No. Uh, yeah, uh, sometimes, occasionally. Um, no. No. Yes. Uh, I am a, uh, computer scientist. Yes. Um, I have a cat, at home. Yep. Yeah. Yup. Ah. Right. Yeah. Yeah. Yeah. OK. Uh, no, I think, I think that kind of, that makes me feel a bit better. I guess, can I get that um, can I get the, uh, so the antihistamine from any shop, or like does it pharmacy? OK. OK. OK. Great. Yeah. OK, great. Yeah, that makes sense. OK. Thanks. I appreciate your time. Bye bye, bye.",
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"dialogue": "[Doctor] Hi there, good morning. Or good afternoon, sorry. Hi.\n[Patient] Hello there. Uh, good afternoon. This is Jack.\n[Doctor] Good afternoon. Hi. This, this is Doctor Deen Mirza from GP at Hand.\n[Patient] I do.\n[Doctor] All right. So before we start your appointment, could I please confirm your full name and date of birth?\n[Patient] Yes, uh, my name is Jack Armani.\n[Doctor] That's great, thank you.\n[Patient] And my date of birth is twelve August nineteen fifty eight.\n[Doctor] That's great, thank you for that. Um, are you in a private place where you're OK to speak at the moment?\n[Patient] Yes, I am.\n[Doctor] OK. So, how can I help you today?\n[Patient] I am. So, I woke up, um, this morning, and, um. \n[Patient] Hello?\n[Doctor] Yeah I'm still here, you'll tell . Yeah.\n[Patient] Uh so I'm a bit worried 'cause I woke up this morning, about an hour ago, and I couldn't move my left arm any more.\n[Doctor] OK. Uh, and how's your arm right now?\n[Patient] Um. Well like, I feel no pain but just, uh, can't move it.\n[Doctor] That you still can't move. And, and what time did you wake up? You said it was an hour, you're sure about that?\n[Patient] Yes.\n[Doctor] OK, um. Now, can I just double check? Has this ever happened before?\n[Patient] No. No, uh, it's really the first time.\n[Doctor] OK. And, did you sleep, anything, in an awkward position, or in a different bed, or anything like that last night?\n[Patient] Uh no, uhf, everything as usual.\n[Doctor] OK. Um, and um, is there any discoloration in your hand?\n[Patient] Um, no.\n[Doctor] K, um, does your hand feel cold?\n[Patient] Mmm, no, really the, mmm, the arm feels fine, apart from me not being able to move it.\n[Doctor] OK. And it's to your on your left side. Have you had any symptoms in your left leg at all?\n[Patient] No, but um, I feel a bit of tingling on the left side of my face.\n[Doctor] Right, OK. Um, and how long has that tingling been there for?\n[Patient] Uh, since I woke up. Um, since I started to feel the , since, since the the arm really it stopped moving, so an hour ago.\n[Doctor] OK, um. Now, um, I can't see you. It's, it's telephone appointment. Have you noticed any kind of, um, asymmetry in your face, or did your face expression look different on one side compared to the other, or anything different at all?\n[Patient] Um.\n[Patient] Mmm, no, not really, it's just.\n[Patient] Uh, having like a bit of issues like, uh, I was trying to drink earlier and I'd be bold a bit and and the tingling on, on the left side.\n[Doctor] OK. So, um, you have some difficulties swallowing, is that right?\n[Patient] Um, yeah.\n[Doctor] OK. Any problems with your speech? Is your, is your, is your speech different to how it, um, sounds normally?\n[Patient] Um, yeah it feels a, a bit harder . It's more complicated maybr, maybe um, be more slow. I need to think more about it.\n[Doctor] OK. Is there anyone at home with you? \n[Patient] Uh, no.\n[Doctor] OK. \n[Patient] Is this something I should be worried about?\n[Doctor] Um, well, um, I'm I'm concerned that some of the symptoms you've got may be, um, symptoms of a stroke.\n[Patient] Hmm, wow.\n[Doctor] OK? So, um, that's something that can be dealt with, but it needs to be dealt with as an emergency in a hospital.\n[Patient] Would, should I call , would you be able to call the ambulance for me?\n[Doctor] Yeah I'm, I'm happy to do that. Um, what we need to do is to make sure that they've got access to you when you come. So, um, maybe you could, uh, leave the front door, um, unlocked, sit in the hallway. But I'm gonna arrange one of my colleagues next to me to, um, call an ambulance to your home address now.\n[Patient] OK.\n[Patient] OK. OK. Thank you.\n[Doctor] So that's being done right now, as we speak. Uh, while we're waiting for that, I'm just gonna ask you a few more questions. Is that OK?\n[Patient] Sure.\n[Doctor] OK. Do you have any other illnesses at all?\n[Patient] Um. I have, uh, type two diabetes and, uh, high blood pressure.\n[Doctor] OK. And, um, are you on any medication for that?\n[Patient] Um, I'm taking Metformin losartan and Amlodipine.\n[Doctor] OK. Do you have any, um, uh, allergies to any medication?\n[Patient] Um, only penicillin, I believe.\n[Doctor] OK.\n[Doctor] Um, are there any illnesses in your family at all?\n[Patient] Uh, my dad has got, um, heart disease. But, uh, but don't, I don't know more detail.\n[Doctor] OK, anyone else?\n[Patient] Not really.\n[Doctor] And um, are you normally living alone?\n[Patient] Uh, yes.\n[Doctor] K. Do you smoke at all?\n[Patient] Uh, I used to.\n[Doctor] OK. How much alcohol do you drink?\n[Patient] Uh, I will have a few drinks over the weekend. Um, maybe a, a couple more during the week.\n[Doctor] So, what, what drinks are we talking about?\n[Patient] Uh, uh, beers, uh, like pints.\n[Doctor] OK.\n[Doctor] OK. All right, um. How are you feeling now? Have you got the symptoms right now still, that, um\n[Patient] Yes, yes. The the arm still can't move and I think the speech is getting a bit harder.\n[Doctor] OK, all right. So, the ambulance is on it's way, all right? Um, and what they're going to do is, they'll probably take you down to, um, the local hospital, A and E. And then, they'll they will ring through for the, um, the stroke doctor to assess you, to see whether they can give you any kind of, um Treatment for that OK? So no worry. They're they're on their way, um, and what I'm gonna do is, I'm gonna stay on the line until they reach there. Just to make sure that you're OK.\n[Patient] OK.\n[Patient] OK. Is there anything I should be doing now?\n[Doctor] Um, not at the moment, no, not at the moment, Just, uh, make sure the the front door's open. Sit in the hallway, by the front door so that they've got access if needs be, if for any reason you can't open the front door. OK, um.\n[Patient] OK.\n[Doctor] All right, then so I'll be staying on the line and we'll and we'll wait until the ambulance comes.\n[Patient] OK, I'm gonna go to the door.\n[Doctor] OK then, all right. Thank you.\n[Patient] Thank you.\n[Doctor] K, bye bye.\n[Patient] ",
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"doctor_utterances": "Hi there, good morning. Or good afternoon, sorry. Hi. Good afternoon. Hi. This, this is Doctor Deen Mirza from GP at Hand. All right. So before we start your appointment, could I please confirm your full name and date of birth? That's great, thank you. That's great, thank you for that. Um, are you in a private place where you're OK to speak at the moment? OK. So, how can I help you today? Yeah I'm still here, you'll tell . Yeah. OK. Uh, and how's your arm right now? That you still can't move. And, and what time did you wake up? You said it was an hour, you're sure about that? OK, um. Now, can I just double check? Has this ever happened before? OK. And, did you sleep, anything, in an awkward position, or in a different bed, or anything like that last night? OK. Um, and um, is there any discoloration in your hand? K, um, does your hand feel cold? OK. And it's to your on your left side. Have you had any symptoms in your left leg at all? Right, OK. Um, and how long has that tingling been there for? OK, um. Now, um, I can't see you. It's, it's telephone appointment. Have you noticed any kind of, um, asymmetry in your face, or did your face expression look different on one side compared to the other, or anything different at all? OK. So, um, you have some difficulties swallowing, is that right? OK. Any problems with your speech? Is your, is your, is your speech different to how it, um, sounds normally? OK. Is there anyone at home with you? OK. Um, well, um, I'm I'm concerned that some of the symptoms you've got may be, um, symptoms of a stroke. OK? So, um, that's something that can be dealt with, but it needs to be dealt with as an emergency in a hospital. Yeah I'm, I'm happy to do that. Um, what we need to do is to make sure that they've got access to you when you come. So, um, maybe you could, uh, leave the front door, um, unlocked, sit in the hallway. But I'm gonna arrange one of my colleagues next to me to, um, call an ambulance to your home address now. So that's being done right now, as we speak. Uh, while we're waiting for that, I'm just gonna ask you a few more questions. Is that OK? OK. Do you have any other illnesses at all? OK. And, um, are you on any medication for that? OK. Do you have any, um, uh, allergies to any medication? OK. Um, are there any illnesses in your family at all? OK, anyone else? And um, are you normally living alone? K. Do you smoke at all? OK. How much alcohol do you drink? So, what, what drinks are we talking about? OK. OK. All right, um. How are you feeling now? Have you got the symptoms right now still, that, um OK, all right. So, the ambulance is on it's way, all right? Um, and what they're going to do is, they'll probably take you down to, um, the local hospital, A and E. And then, they'll they will ring through for the, um, the stroke doctor to assess you, to see whether they can give you any kind of, um Treatment for that OK? So no worry. They're they're on their way, um, and what I'm gonna do is, I'm gonna stay on the line until they reach there. Just to make sure that you're OK. Um, not at the moment, no, not at the moment, Just, uh, make sure the the front door's open. Sit in the hallway, by the front door so that they've got access if needs be, if for any reason you can't open the front door. OK, um. All right, then so I'll be staying on the line and we'll and we'll wait until the ambulance comes. OK then, all right. Thank you. K, bye bye.",
"patient_utterances": "Hello there. Uh, good afternoon. This is Jack. I do. Yes, uh, my name is Jack Armani. And my date of birth is twelve August nineteen fifty eight. Yes, I am. I am. So, I woke up, um, this morning, and, um. Hello? Uh so I'm a bit worried 'cause I woke up this morning, about an hour ago, and I couldn't move my left arm any more. Um. Well like, I feel no pain but just, uh, can't move it. Yes. No. No, uh, it's really the first time. Uh no, uhf, everything as usual. Um, no. Mmm, no, really the, mmm, the arm feels fine, apart from me not being able to move it. No, but um, I feel a bit of tingling on the left side of my face. Uh, since I woke up. Um, since I started to feel the , since, since the the arm really it stopped moving, so an hour ago. Um. Mmm, no, not really, it's just. Uh, having like a bit of issues like, uh, I was trying to drink earlier and I'd be bold a bit and and the tingling on, on the left side. Um, yeah. Um, yeah it feels a, a bit harder . It's more complicated maybr, maybe um, be more slow. I need to think more about it. Uh, no. Is this something I should be worried about? Hmm, wow. Would, should I call , would you be able to call the ambulance for me? OK. OK. OK. Thank you. Sure. Um. I have, uh, type two diabetes and, uh, high blood pressure. Um, I'm taking Metformin losartan and Amlodipine. Um, only penicillin, I believe. Uh, my dad has got, um, heart disease. But, uh, but don't, I don't know more detail. Not really. Uh, yes. Uh, I used to. Uh, I will have a few drinks over the weekend. Um, maybe a, a couple more during the week. Uh, uh, beers, uh, like pints. Yes, yes. The the arm still can't move and I think the speech is getting a bit harder. OK. OK. Is there anything I should be doing now? OK. OK, I'm gonna go to the door. Thank you. ",
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"reference_note": "{\"day\": 2, \"consultation\": 9, \"presenting_complaint\": \"I can't move my left arm\", \"note\": \"Hx: Difficulty moving left arm, occurred upon waking this morning\\nFeels no pain, but still can't move it\\nNo previous similar episodes\\nSlept as per normal last night\\nNo discolouration in hand, arm doesn't feel cold\\nSymptoms limited to left arm, not in left leg\\nTingling present on left side of face over the same period (1 hour)\\nPatient has not noticed any facial asymmetry\\nDifficulty swallowing water- dribbled water\\nSpeech seems \\u2018harder' or \\u2018slow'\\nNo-one at home with patient\\nPmhx: T2dm, HTN\\nDH: metformin, losartan, amlodipine\\nAllergic to penicillin\\nFH: father hs \\u2018heart disease'\\nSH: lives alone, ex smoker, mild- moderate alcohol intake.\\nImp: ? CVA\\nLAS called- blue light, pt to keep front door open, will stay on line till LAS arrives and hand over.\\n\", \"highlights\": [\"Difficulty moving left arm\", \"Tingling present on left side of face\", \"Difficulty swallowing water\", \"Speech seems \\u2018harder' or \\u2018slow'\", \"? CVA\", \"LAS called\"]}",
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"dialogue": "[Patient] Hi.\n[Doctor] Hello. Hi, I'm Doctor Jacob and welcome to Babylon. Hello. Hi. So, um, just before we start, is it all right if you could confirm your name for me please? And your date of birth?\n[Patient] \n[Patient] Sure, my name is Mary Smith.\n[Patient] My date of birth is August sixteen, nineteen seventy six.\n[Doctor] And your email address for me, please.\n[Patient] My email address is Mary dot Smith at gmail dot com.\n[Doctor] That's correct. And just to confirm, that you're in a secure location, and we can have a confidential conversation.\n[Patient] Absolutely.\n[Doctor] Right. So you've mentioned that you have some pain in your jaw. Is that correct?\n[Patient] Um, well. I think that's just, like, the first thing that I typed, but, uh, uh, it wasn't really what I, you know, I just typed it and then I clicked submit, so, that was uh, um. I mean it's part of the problem but I would say that, more of a problem for me, is that I can't quite move my left arm. I mean, I can move it but it's it's numb, and then I also feel some, like tingling in my fingertips.\n[Doctor] OK, so numbness in the left arm, yeah? How long has it been going on for?\n[Patient] Yes, yes.\n[Patient] So, I've started taking this boxing class. I've been taking this boxing class for a few weeks, and I feel like maybe, um\n[Doctor] Mm hmm.\n[Patient] It's probably been, I'd say, for at least two weeks, and it's kind of gotten worse. Like,in the beginning, I just kind of felt a little bit of a tingling.\n[Doctor] Mm-hmm.\n[Patient] and then it's gotten, it's gotten worse since then. Then the numbing kind of started I can feel it both in my, uh, um, you know a little bit in my elbow, and then in my arm, as well as in my hand\n[Doctor] Mm-hmm.\n[Patient] And now because it hasn't gotten better, I tried to get a massage, it's not better. Or, you know, try to take warm baths. It's not better, so I figured I'd call you and, and just figure out what's going on.\n[Doctor] Right. So, have you mentioned that message and a warm bath, any medications that you've taken so far?\n[Patient] Uh, well it's. You know it's, it's numb and I, I kind of looked at stuff online, um, but you know I, I do take Ibuprofen because my muscles were sore, a little bit, and I've been taking this boxing class.\n[Doctor] Uh huh.\n[Doctor] \n[Patient] So, you know, I kind of hurt like my knuckles on my right hand. So that's been a little bit painful, so I've just kind of taken ibuprofen for that.\n[Doctor] OK.\n[Patient] But, like I said, I mean, I tried massage, I tried some hot baths, and that didn't help with this numbness thing.\n[Doctor] Mmm.\n[Doctor] Sure.\n[Patient] I'm just kind of getting a little worried.\n[Doctor] Of course. So you just mentioned that your pain is from elbow downwards, is that, you know, the tingling, numbness elbow . Not from your shoulder?\n[Patient] \n[Patient] And, um, well it's kind of funny, you know sometimes I will feel it in my shoulder. Like if I try to, if I try to like you know move like in boxing and stuff, I will even like, uh, um, maybe feel a little bit of, a little bit of pain. Uh, but I would say, if i'm just like resting if I'm sitting like, right now, I can feel like it's numb, and I, I actually feel, tingling right now, not in all of my fingers, just in some.\n[Doctor] Yeah. So, which fingers do you feel numb?\n[Patient] OK, so it's my second, third, and fourth finger.\n[Doctor] Uh huh. Second, third and fourth finger. And is it your palm side or, you know, the back of your hand side which is numb, or both?\n[Patient] No. It's, it's the, it's this side. So, the front side.\n[Doctor] It's the front side. OK, right. And have you been dropping things at all? Like, you know, when you try to hold onto things, like a glass or something, have dropping it?\n[Patient] Yes. So not so much with the glass, but I will say, um, well I play a little bit of a piano and so I just noticed it's been kind of harder to get the notes.\n[Doctor] Mm-hmm.\n[Patient] I can, I can grasp, I can grasp a a glass but because I use my right hand most of the time, you know, I'm not left handed so, it's kind of hard for me to.\n[Doctor] \n[Doctor] So So you would say this in mind weakness, mind. So just to get my facts right. So you would say it's definitely weakness rather than because of the pain, you can't hold it. That's two different things. So you know sometimes you can't hold it because it's hurting you .\n[Patient] Yes.\n[Patient] Yeah.\n[Patient] No, no, it's not hurting, it's not hurting, it's, like, numb, I can't feel it, right? Well, yeah.\n[Doctor] OK. Fine. So, you're definitely having some sort some form of weakness, OK. Edward, any neck pain at all?\n[Patient] Yes, absolutely.\n[Patient] No, not, no, nothing .\n[Doctor] neck pain and all? OK, right, OK. So, just a bit more of a background because I don't have much information on the system. Um, do you have any past, uh, medical history that you'd like to share?\n[Patient] Mm hmm.\n[Patient] Well, I guess because of this. You know, I'm not sure if it's boxing. I also had a really bad cold, like a month ago.\n[Doctor] Mm-hmm.\n[Patient] I mean, I was out, you know, drinking with, uh, friends, um, one of our co-workers just had his three year anniversary and We kinda went crazy and we were like out partying until, you know, late hours, and I just got uncharacteristically drunk for me. And then after that, I was sick for probably good like two weeks. I was at home. I think I must have had some kind of like a flu or something.\n[Doctor] what\n[Doctor] Mm-hmm.\n[Patient] So it's that. And then, I'd say another weird thing that happened to me a few weeks ago, is like, I all of a sudden just couldn't see from the, uh, from my left eye. Like, I, I lost some, like a little bit of a field of vision Uh, and, but that, that just lasted not very long. I mean, that just lasted maybe for, I don't know, twenty, twenty minutes?\n[Doctor] OK.\n[Patient] Uh, and I kind of thought, I don't know maybe it was the the cold you know and the virus and all that so\n[Doctor] Mm-hmm.\n[Patient] I, I guess that's what I can, you know, that's the last thing I can remember, but in general, I'm, I'm pretty healthy. You know, I work out, uh, , and I, I don't really have any medical problems.\n[Doctor] Yeah.\n[Doctor] Do you have any headaches at all, from the, in the recent past?\n[Patient] Um, sometimes I get headaches but I think they're just tired headaches. You know sometimes I'll get kind of Tired but I think that's probably because I work too much. Or, you know because like I'll go for a workout and then I'll really just exhaust myself and then I just kind of feel this fatigue. Uh, or sometimes like this morning for example, I just felt really, fatigued and I couldn't even get myself to the gym. But, you know, since I have this numbness it's kind of like, hard to workout right?\n[Doctor] Hmm.\n[Doctor] Do you wear glasses at all, glasses, contact lenses?\n[Patient] No.\n[Doctor] No, so no glasses . And, you've not experienced anything like a seizure or a fit, anything like that?\n[Patient] What's a seizure?\n[Doctor] Like when you you lose consciousness and you start shaking.\n[Patient] Ohh, no, no, no, no, nothing like that, mmm mmm.\n[Doctor] OK, no fits, yeah, OK. And your weakness is only in your left arm. Legs are walking and all this, normal, yeah?\n[Patient] Right, exactly.\n[Patient] Yeah, yeah, yeah, walking is normal, yeah.\n[Doctor] You mentioned for a while you couldn't see, you know, the outside peripheral vision from your left eye. How long did that episode last for?\n[Patient] You know I think it was only maybe like twenty minutes or so. It's almost like it happened and I thought ohh my God. It's probably I'm still like sick from this, you know virus thing, cold, and so I just kind of slacked it off. And then when I, uh, um, when I woke up it was gone.\n[Doctor] Sure, OK. Um, OK. So is there any regular medications that you're using?\n[Patient] Not really. I just take ibuprofen every once in a while, I take vitamin D. Um, I take some I, I like my my GP really wants me to take iron supplements, but you know, they're just like huge pills so I, I, most of the time I just forget.\n[Doctor] OK.\n[Patient] But, vitamin D I take. And then, sometimes I take Melatonin to help me sleep.\n[Doctor] OK Alright. And any family history you'd like to share? Any significant family history?\n[Patient] I know that my dad has I don't know if it it's hypo, I think it's hypothyroidism.\n[Doctor] Yeah.\n[Patient] Um, and then my, like, he's got he's got some autoimmune stuff going on, like that much I know.\n[Doctor] Mm-hmm.\n[Patient] And then, my mom, my mom, she's actually not in a great shape. She's got diabetes type two. She's got hypertension, um, she's got, gosh, what is it, ohh, yeah, she's got high cholesterol, um, and I think that's it for her. Yeah.\n[Doctor] Yeah, right. Any neurological conditions in the family?\n[Patient] Uh.\n[Doctor] there are related conditions. No, OK, that's fine.\n[Patient] \n[Doctor] OK, so, right. So after, you know, speaking and examining, you know, yourself, I think it's quite important that we do investigate it a bit further. I'm just wondering whether there's something a bit more than just the boxing here. OK, few things that's, made me think other than, just like a boxing injury, is for instance, um, you know, when you said you can't, your vision went, your peripheral vision was not there for about twenty. So, and that with the weakness of the arms, make me think, is there something else going on rather than just an injury?\n[Patient] OK.\n[Patient] \n[Patient] What do you think may be going on?\n[Doctor] sometimes you know you do get things like MS, multiple sclerosis. So people with multiple sclerosis can have, um, visual problems, like what you've experienced and sometimes you know the odd numbness tingling sensations going on. OK?\n[Patient] Ohh!\n[Patient] Ohh my God! Will I be in a wheelchair?\n[Doctor] We, if we capture it a bit early there are treatments for it. OK? I'm not, obviously I'm not suggesting that you do have it, but it is quite important to find out that, whether you have it or not that's the most serious kind of thing that needs to be, uh, dealt with here. Yeah. So, what we can do is I'm going to do an urgent, very urgent neurology referral. Yeah? What they, what that might entail is the brain scan and things like that. Hello?\n[Patient] K, OK.\n[Patient] OK \n[Patient] I see. Yeah yeah yeah! Yeah, I'm here, I'm here.\n[Doctor] I know this might sound a bit of a shock to you, um, but I'm, I think it is more important that we investigate this a bit more seriously.\n[Patient] Yeah.\n[Patient] Alright. Yeah, that makes sense.\n[Doctor] OK. Any questions at all?\n[Patient] Well, what's, OK, so you're gonna do the referral, um, should I be taking any drugs or, um\n[Doctor] No, that's something we can't do. The treatment for it is actually some steroids and things like that, uh, when you have an acute you know, acute reaction or things like that. But, saying that, first we need to firm diagnosis. Yeah. While you're waiting for this to be done, if there's any weakness, uh, you know, if the weakness progresses to your legs, or there's any kind of headaches, vomiting, fits, and your visual symptoms are getting worse and not getting better, then that would be an A and E.\n[Patient] Mm hmm, yes, OK.\n[Patient] OK, got it.\n[Doctor] Alright.\n[Patient] Sounds good! OK, thank you, doctor.\n[Doctor] Yeah. I'm I'm sorry. I, I do appreciate you are a bit worried, but, you know, it's good that we know that you've come and spoken to us today, and hopefully we'll get things sorted and the ball rolling. OK?\n[Patient] Thank you, doctor. Appreciate your time.\n[Doctor] That's OK. You take care.\n[Patient] Thank you. Bye bye!\n[Doctor] Good bye now, bye.",
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"text": "And, um, well it's kind of funny, you know sometimes I will feel it in my shoulder. Like if I try to, if I try to like you know move like in boxing and stuff, I will even like, uh, um, maybe feel a little bit of, a little bit of pain. Uh, but I would say, if i'm just like resting if I'm sitting like, right now, I can feel like it's numb, and I, I actually feel, tingling right now, not in all of my fingers, just in some.",
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"start": 248.98022,
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"text": "Yes.",
"speaker": "Patient"
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{
"start": 252.6788,
"end": 253.27523,
"text": "Yeah.",
"speaker": "Patient"
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{
"start": 260.92499,
"end": 267.3219,
"text": "No, no, it's not hurting, it's not hurting, it's, like, numb, I can't feel it, right? Well, yeah.",
"speaker": "Patient"
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{
"start": 264.62666,
"end": 274.25333,
"text": "OK. Fine. So, you're definitely having some sort some form of weakness, OK. Edward, any neck pain at all?",
"speaker": "Doctor"
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{
"start": 270.89989,
"end": 272.4721,
"text": "Yes, absolutely.",
"speaker": "Patient"
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{
"start": 274.97191,
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"text": "No, not, no, nothing .",
"speaker": "Patient"
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{
"start": 276.77333,
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"text": " neck pain and all? OK, right, OK. So, just a bit more of a background because I don't have much information on the system. Um, do you have any past, uh, medical history that you'd like to share?",
"speaker": "Doctor"
},
{
"start": 284.51915,
"end": 285.18185,
"text": "Mm hmm.",
"speaker": "Patient"
},
{
"start": 291.83173,
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"text": "Well, I guess because of this. You know, I'm not sure if it's boxing. I also had a really bad cold, like a month ago.",
"speaker": "Patient"
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{
"start": 299.27333,
"end": 299.94666,
"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 299.58087,
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"text": "I mean, I was out, you know, drinking with, uh, friends, um, one of our co-workers just had his three year anniversary and We kinda went crazy and we were like out partying until, you know, late hours, and I just got uncharacteristically drunk for me. And then after that, I was sick for probably good like two weeks. I was at home. I think I must have had some kind of like a flu or something.",
"speaker": "Patient"
},
{
"start": 314.15332,
"end": 314.71999,
"text": "what",
"speaker": "Doctor"
},
{
"start": 321.11332,
"end": 321.67332,
"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 321.29814,
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"text": "So it's that. And then, I'd say another weird thing that happened to me a few weeks ago, is like, I all of a sudden just couldn't see from the, uh, from my left eye. Like, I, I lost some, like a little bit of a field of vision Uh, and, but that, that just lasted not very long. I mean, that just lasted maybe for, I don't know, twenty, twenty minutes?",
"speaker": "Patient"
},
{
"start": 335.29999,
"end": 335.85999,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 342.82236,
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"text": "Uh, and I kind of thought, I don't know maybe it was the the cold you know and the virus and all that so",
"speaker": "Patient"
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{
"start": 348.53999,
"end": 349.13999,
"text": "Mm-hmm.",
"speaker": "Doctor"
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{
"start": 349.27088,
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"text": "I, I guess that's what I can, you know, that's the last thing I can remember, but in general, I'm, I'm pretty healthy. You know, I work out, uh, , and I, I don't really have any medical problems.",
"speaker": "Patient"
},
{
"start": 357.06666,
"end": 357.68666,
"text": "Yeah.",
"speaker": "Doctor"
},
{
"start": 360.21332,
"end": 363.63999,
"text": "Do you have any headaches at all, from the, in the recent past?",
"speaker": "Doctor"
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{
"start": 364.51619,
"end": 390.18213,
"text": "Um, sometimes I get headaches but I think they're just tired headaches. You know sometimes I'll get kind of Tired but I think that's probably because I work too much. Or, you know because like I'll go for a workout and then I'll really just exhaust myself and then I just kind of feel this fatigue. Uh, or sometimes like this morning for example, I just felt really, fatigued and I couldn't even get myself to the gym. But, you know, since I have this numbness it's kind of like, hard to workout right?",
"speaker": "Patient"
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{
"start": 379.97332,
"end": 380.63332,
"text": "Hmm.",
"speaker": "Doctor"
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{
"start": 390.49332,
"end": 393.99999,
"text": "Do you wear glasses at all, glasses, contact lenses?",
"speaker": "Doctor"
},
{
"start": 394.50701,
"end": 395.20584,
"text": "No.",
"speaker": "Patient"
},
{
"start": 394.80666,
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"text": "No, so no glasses . And, you've not experienced anything like a seizure or a fit, anything like that?",
"speaker": "Doctor"
},
{
"start": 402.81946,
"end": 403.86162,
"text": "What's a seizure?",
"speaker": "Patient"
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{
"start": 403.95999,
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"text": "Like when you you lose consciousness and you start shaking.",
"speaker": "Doctor"
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{
"start": 408.26481,
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"text": "Ohh, no, no, no, no, nothing like that, mmm mmm.",
"speaker": "Patient"
},
{
"start": 409.13999,
"end": 420.62666,
"text": " OK, no fits, yeah, OK. And your weakness is only in your left arm. Legs are walking and all this, normal, yeah?",
"speaker": "Doctor"
},
{
"start": 416.78808,
"end": 418.09527,
"text": "Right, exactly.",
"speaker": "Patient"
},
{
"start": 420.67941,
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"text": "Yeah, yeah, yeah, walking is normal, yeah.",
"speaker": "Patient"
},
{
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"text": "You mentioned for a while you couldn't see, you know, the outside peripheral vision from your left eye. How long did that episode last for?",
"speaker": "Doctor"
},
{
"start": 432.14809,
"end": 447.38725,
"text": "You know I think it was only maybe like twenty minutes or so. It's almost like it happened and I thought ohh my God. It's probably I'm still like sick from this, you know virus thing, cold, and so I just kind of slacked it off. And then when I, uh, um, when I woke up it was gone.",
"speaker": "Patient"
},
{
"start": 447.83332,
"end": 454.11999,
"text": "Sure, OK. Um, OK. So is there any regular medications that you're using?",
"speaker": "Doctor"
},
{
"start": 455.18759,
"end": 469.52795,
"text": "Not really. I just take ibuprofen every once in a while, I take vitamin D. Um, I take some I, I like my my GP really wants me to take iron supplements, but you know, they're just like huge pills so I, I, most of the time I just forget.",
"speaker": "Patient"
},
{
"start": 469.52665,
"end": 470.08665,
"text": "OK.",
"speaker": "Doctor"
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{
"start": 469.52795,
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"text": "But, vitamin D I take. And then, sometimes I take Melatonin to help me sleep.",
"speaker": "Patient"
},
{
"start": 473.53999,
"end": 484.01999,
"text": "OK Alright. And any family history you'd like to share? Any significant family history?",
"speaker": "Doctor"
},
{
"start": 484.41307,
"end": 492.50653,
"text": "I know that my dad has I don't know if it it's hypo, I think it's hypothyroidism.",
"speaker": "Patient"
},
{
"start": 492.37332,
"end": 493.00665,
"text": "Yeah.",
"speaker": "Doctor"
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{
"start": 492.50653,
"end": 498.26686,
"text": "Um, and then my, like, he's got he's got some autoimmune stuff going on, like that much I know.",
"speaker": "Patient"
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{
"start": 496.87332,
"end": 498.69332,
"text": "Mm-hmm.",
"speaker": "Doctor"
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"start": 498.26686,
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"text": "And then, my mom, my mom, she's actually not in a great shape. She's got diabetes type two. She's got hypertension, um, she's got, gosh, what is it, ohh, yeah, she's got high cholesterol, um, and I think that's it for her. Yeah.",
"speaker": "Patient"
},
{
"start": 518.07999,
"end": 523.07332,
"text": "Yeah, right. Any neurological conditions in the family?",
"speaker": "Doctor"
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{
"start": 524.38454,
"end": 525.42068,
"text": "Uh.",
"speaker": "Patient"
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{
"start": 525.25999,
"end": 528.72862,
"text": "there are related conditions. No, OK, that's fine.",
"speaker": "Doctor"
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"speaker": "Patient"
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{
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"text": "OK, so, right. So after, you know, speaking and examining, you know, yourself, I think it's quite important that we do investigate it a bit further. I'm just wondering whether there's something a bit more than just the boxing here. OK, few things that's, made me think other than, just like a boxing injury, is for instance, um, you know, when you said you can't, your vision went, your peripheral vision was not there for about twenty. So, and that with the weakness of the arms, make me think, is there something else going on rather than just an injury?",
"speaker": "Doctor"
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{
"start": 546.18977,
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"text": "OK.",
"speaker": "Patient"
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"speaker": "Patient"
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{
"start": 565.45893,
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"text": " What do you think may be going on?",
"speaker": "Patient"
},
{
"start": 568.51998,
"end": 588.68665,
"text": " sometimes you know you do get things like MS, multiple sclerosis. So people with multiple sclerosis can have, um, visual problems, like what you've experienced and sometimes you know the odd numbness tingling sensations going on. OK?",
"speaker": "Doctor"
},
{
"start": 574.88595,
"end": 575.62695,
"text": "Ohh!",
"speaker": "Patient"
},
{
"start": 587.96286,
"end": 591.01682,
"text": "Ohh my God! Will I be in a wheelchair?",
"speaker": "Patient"
},
{
"start": 592.08665,
"end": 623.49332,
"text": "We, if we capture it a bit early there are treatments for it. OK? I'm not, obviously I'm not suggesting that you do have it, but it is quite important to find out that, whether you have it or not that's the most serious kind of thing that needs to be, uh, dealt with here. Yeah. So, what we can do is I'm going to do an urgent, very urgent neurology referral. Yeah? What they, what that might entail is the brain scan and things like that. Hello?",
"speaker": "Doctor"
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{
"start": 609.6953,
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"text": "K, OK.",
"speaker": "Patient"
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{
"start": 617.91139,
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"text": "OK ",
"speaker": "Patient"
},
{
"start": 622.88089,
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"text": "I see. Yeah yeah yeah! Yeah, I'm here, I'm here.",
"speaker": "Patient"
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{
"start": 625.76665,
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"text": " I know this might sound a bit of a shock to you, um, but I'm, I think it is more important that we investigate this a bit more seriously.",
"speaker": "Doctor"
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{
"start": 632.01252,
"end": 632.68123,
"text": "Yeah.",
"speaker": "Patient"
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{
"start": 638.16259,
"end": 640.59615,
"text": "Alright. Yeah, that makes sense.",
"speaker": "Patient"
},
{
"start": 640.47998,
"end": 642.82665,
"text": "OK. Any questions at all?",
"speaker": "Doctor"
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{
"start": 643.4152,
"end": 649.6555,
"text": "Well, what's, OK, so you're gonna do the referral, um, should I be taking any drugs or, um",
"speaker": "Patient"
},
{
"start": 648.28665,
"end": 685.60665,
"text": "No, that's something we can't do. The treatment for it is actually some steroids and things like that, uh, when you have an acute you know, acute reaction or things like that. But, saying that, first we need to firm diagnosis. Yeah. While you're waiting for this to be done, if there's any weakness, uh, you know, if the weakness progresses to your legs, or there's any kind of headaches, vomiting, fits, and your visual symptoms are getting worse and not getting better, then that would be an A and E.",
"speaker": "Doctor"
},
{
"start": 664.08151,
"end": 666.50302,
"text": "Mm hmm, yes, OK.",
"speaker": "Patient"
},
{
"start": 686.10909,
"end": 687.72347,
"text": "OK, got it.",
"speaker": "Patient"
},
{
"start": 688.32665,
"end": 689.32665,
"text": "Alright.",
"speaker": "Doctor"
},
{
"start": 688.6271,
"end": 691.70515,
"text": "Sounds good! OK, thank you, doctor.",
"speaker": "Patient"
},
{
"start": 691.62665,
"end": 704.03331,
"text": "Yeah. I'm I'm sorry. I, I do appreciate you are a bit worried, but, you know, it's good that we know that you've come and spoken to us today, and hopefully we'll get things sorted and the ball rolling. OK?",
"speaker": "Doctor"
},
{
"start": 703.42066,
"end": 706.66134,
"text": " Thank you, doctor. Appreciate your time.",
"speaker": "Patient"
},
{
"start": 706.63998,
"end": 708.71331,
"text": "That's OK. You take care.",
"speaker": "Doctor"
},
{
"start": 707.66134,
"end": 709.86626,
"text": "Thank you. Bye bye!",
"speaker": "Patient"
},
{
"start": 709.71998,
"end": 710.93998,
"text": "Good bye now, bye.",
"speaker": "Doctor"
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],
"doctor_utterances": "Hello. Hi, I'm Doctor Jacob and welcome to Babylon. Hello. Hi. So, um, just before we start, is it all right if you could confirm your name for me please? And your date of birth? And your email address for me, please. That's correct. And just to confirm, that you're in a secure location, and we can have a confidential conversation. Right. So you've mentioned that you have some pain in your jaw. Is that correct? OK, so numbness in the left arm, yeah? How long has it been going on for? Mm hmm. Mm-hmm. Mm-hmm. Right. So, have you mentioned that message and a warm bath, any medications that you've taken so far? Uh huh. OK. Mmm. Sure. Of course. So you just mentioned that your pain is from elbow downwards, is that, you know, the tingling, numbness elbow . Not from your shoulder? Yeah. So, which fingers do you feel numb? Uh huh. Second, third and fourth finger. And is it your palm side or, you know, the back of your hand side which is numb, or both? It's the front side. OK, right. And have you been dropping things at all? Like, you know, when you try to hold onto things, like a glass or something, have dropping it? Mm-hmm. So So you would say this in mind weakness, mind. So just to get my facts right. So you would say it's definitely weakness rather than because of the pain, you can't hold it. That's two different things. So you know sometimes you can't hold it because it's hurting you . OK. Fine. So, you're definitely having some sort some form of weakness, OK. Edward, any neck pain at all? neck pain and all? OK, right, OK. So, just a bit more of a background because I don't have much information on the system. Um, do you have any past, uh, medical history that you'd like to share? Mm-hmm. what Mm-hmm. OK. Mm-hmm. Yeah. Do you have any headaches at all, from the, in the recent past? Hmm. Do you wear glasses at all, glasses, contact lenses? No, so no glasses . And, you've not experienced anything like a seizure or a fit, anything like that? Like when you you lose consciousness and you start shaking. OK, no fits, yeah, OK. And your weakness is only in your left arm. Legs are walking and all this, normal, yeah? You mentioned for a while you couldn't see, you know, the outside peripheral vision from your left eye. How long did that episode last for? Sure, OK. Um, OK. So is there any regular medications that you're using? OK. OK Alright. And any family history you'd like to share? Any significant family history? Yeah. Mm-hmm. Yeah, right. Any neurological conditions in the family? there are related conditions. No, OK, that's fine. OK, so, right. So after, you know, speaking and examining, you know, yourself, I think it's quite important that we do investigate it a bit further. I'm just wondering whether there's something a bit more than just the boxing here. OK, few things that's, made me think other than, just like a boxing injury, is for instance, um, you know, when you said you can't, your vision went, your peripheral vision was not there for about twenty. So, and that with the weakness of the arms, make me think, is there something else going on rather than just an injury? sometimes you know you do get things like MS, multiple sclerosis. So people with multiple sclerosis can have, um, visual problems, like what you've experienced and sometimes you know the odd numbness tingling sensations going on. OK? We, if we capture it a bit early there are treatments for it. OK? I'm not, obviously I'm not suggesting that you do have it, but it is quite important to find out that, whether you have it or not that's the most serious kind of thing that needs to be, uh, dealt with here. Yeah. So, what we can do is I'm going to do an urgent, very urgent neurology referral. Yeah? What they, what that might entail is the brain scan and things like that. Hello? I know this might sound a bit of a shock to you, um, but I'm, I think it is more important that we investigate this a bit more seriously. OK. Any questions at all? No, that's something we can't do. The treatment for it is actually some steroids and things like that, uh, when you have an acute you know, acute reaction or things like that. But, saying that, first we need to firm diagnosis. Yeah. While you're waiting for this to be done, if there's any weakness, uh, you know, if the weakness progresses to your legs, or there's any kind of headaches, vomiting, fits, and your visual symptoms are getting worse and not getting better, then that would be an A and E. Alright. Yeah. I'm I'm sorry. I, I do appreciate you are a bit worried, but, you know, it's good that we know that you've come and spoken to us today, and hopefully we'll get things sorted and the ball rolling. OK? That's OK. You take care. Good bye now, bye.",
"patient_utterances": "Hi. Sure, my name is Mary Smith. My date of birth is August sixteen, nineteen seventy six. My email address is Mary dot Smith at gmail dot com. Absolutely. Um, well. I think that's just, like, the first thing that I typed, but, uh, uh, it wasn't really what I, you know, I just typed it and then I clicked submit, so, that was uh, um. I mean it's part of the problem but I would say that, more of a problem for me, is that I can't quite move my left arm. I mean, I can move it but it's it's numb, and then I also feel some, like tingling in my fingertips. Yes, yes. So, I've started taking this boxing class. I've been taking this boxing class for a few weeks, and I feel like maybe, um It's probably been, I'd say, for at least two weeks, and it's kind of gotten worse. Like,in the beginning, I just kind of felt a little bit of a tingling. and then it's gotten, it's gotten worse since then. Then the numbing kind of started I can feel it both in my, uh, um, you know a little bit in my elbow, and then in my arm, as well as in my hand And now because it hasn't gotten better, I tried to get a massage, it's not better. Or, you know, try to take warm baths. It's not better, so I figured I'd call you and, and just figure out what's going on. Uh, well it's. You know it's, it's numb and I, I kind of looked at stuff online, um, but you know I, I do take Ibuprofen because my muscles were sore, a little bit, and I've been taking this boxing class. So, you know, I kind of hurt like my knuckles on my right hand. So that's been a little bit painful, so I've just kind of taken ibuprofen for that. But, like I said, I mean, I tried massage, I tried some hot baths, and that didn't help with this numbness thing. I'm just kind of getting a little worried. And, um, well it's kind of funny, you know sometimes I will feel it in my shoulder. Like if I try to, if I try to like you know move like in boxing and stuff, I will even like, uh, um, maybe feel a little bit of, a little bit of pain. Uh, but I would say, if i'm just like resting if I'm sitting like, right now, I can feel like it's numb, and I, I actually feel, tingling right now, not in all of my fingers, just in some. OK, so it's my second, third, and fourth finger. No. It's, it's the, it's this side. So, the front side. Yes. So not so much with the glass, but I will say, um, well I play a little bit of a piano and so I just noticed it's been kind of harder to get the notes. I can, I can grasp, I can grasp a a glass but because I use my right hand most of the time, you know, I'm not left handed so, it's kind of hard for me to. Yes. Yeah. No, no, it's not hurting, it's not hurting, it's, like, numb, I can't feel it, right? Well, yeah. Yes, absolutely. No, not, no, nothing . Mm hmm. Well, I guess because of this. You know, I'm not sure if it's boxing. I also had a really bad cold, like a month ago. I mean, I was out, you know, drinking with, uh, friends, um, one of our co-workers just had his three year anniversary and We kinda went crazy and we were like out partying until, you know, late hours, and I just got uncharacteristically drunk for me. And then after that, I was sick for probably good like two weeks. I was at home. I think I must have had some kind of like a flu or something. So it's that. And then, I'd say another weird thing that happened to me a few weeks ago, is like, I all of a sudden just couldn't see from the, uh, from my left eye. Like, I, I lost some, like a little bit of a field of vision Uh, and, but that, that just lasted not very long. I mean, that just lasted maybe for, I don't know, twenty, twenty minutes? Uh, and I kind of thought, I don't know maybe it was the the cold you know and the virus and all that so I, I guess that's what I can, you know, that's the last thing I can remember, but in general, I'm, I'm pretty healthy. You know, I work out, uh, , and I, I don't really have any medical problems. Um, sometimes I get headaches but I think they're just tired headaches. You know sometimes I'll get kind of Tired but I think that's probably because I work too much. Or, you know because like I'll go for a workout and then I'll really just exhaust myself and then I just kind of feel this fatigue. Uh, or sometimes like this morning for example, I just felt really, fatigued and I couldn't even get myself to the gym. But, you know, since I have this numbness it's kind of like, hard to workout right? No. What's a seizure? Ohh, no, no, no, no, nothing like that, mmm mmm. Right, exactly. Yeah, yeah, yeah, walking is normal, yeah. You know I think it was only maybe like twenty minutes or so. It's almost like it happened and I thought ohh my God. It's probably I'm still like sick from this, you know virus thing, cold, and so I just kind of slacked it off. And then when I, uh, um, when I woke up it was gone. Not really. I just take ibuprofen every once in a while, I take vitamin D. Um, I take some I, I like my my GP really wants me to take iron supplements, but you know, they're just like huge pills so I, I, most of the time I just forget. But, vitamin D I take. And then, sometimes I take Melatonin to help me sleep. I know that my dad has I don't know if it it's hypo, I think it's hypothyroidism. Um, and then my, like, he's got he's got some autoimmune stuff going on, like that much I know. And then, my mom, my mom, she's actually not in a great shape. She's got diabetes type two. She's got hypertension, um, she's got, gosh, what is it, ohh, yeah, she's got high cholesterol, um, and I think that's it for her. Yeah. Uh. OK. What do you think may be going on? Ohh! Ohh my God! Will I be in a wheelchair? K, OK. OK I see. Yeah yeah yeah! Yeah, I'm here, I'm here. Yeah. Alright. Yeah, that makes sense. Well, what's, OK, so you're gonna do the referral, um, should I be taking any drugs or, um Mm hmm, yes, OK. OK, got it. Sounds good! OK, thank you, doctor. Thank you, doctor. Appreciate your time. Thank you. Bye bye!",
"num_turns": 116,
"reference_note": "{\"day\": 3, \"consultation\": 9, \"presenting_complaint\": \"I have pain in my jaw\", \"note\": \"Numbness of the left arm for 2 weeks \\nMild weakness on holding things and playing the piano \\nNo neck pain \\nVisual disturbace in the left peripheral field lasting 20 minutes 2 weeks ago \\nyou recently started some boxing lessons \\nhad vomiting over a month ago for 2 weeks , started after a party \\nnumbness over the left second, third and fourth finger \\nno fits \\nno weakness elsewhere, gait is normal\\nMedication: ibuprofen, Vitamin D , iron tablets , melatonin\\nFH : Dad - hypothyroidism\\nMOM- diabetes , high cholesterol and high BP\\nPlan : urgent neurology review \\nr/o MS \\nIf there is progressing weakness of the arms and legs, vomiting, visual disturbances, fits you will need to go to A & E\\n\", \"highlights\": [\"Dad - hypothyroidism\", \"MOM- diabetes high cholesterol and high BP\", \"r/o MS\"]}",
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"dialogue": "[Doctor] You have to do it, part of your training as a doctor.\n[Patient] Hello.\n[Doctor] Hi. Hi. Can you hear me?\n[Patient] . Yes, I can hear fine.\n[Doctor] Hi. My name's Doctor Gohill, I'm one of the general practitioners, that works here. Can I check your name and date of birth please?\n[Patient] Uh, I am, uh, Patrick Smith.\n[Doctor] Hi.\n[Patient] Uh, thirty five years old. Um, October, seventh. Uh. ninety , three something.\n[Doctor] Great.\n[Doctor] And Patrick, are you in a, space, that's private and quiet?\n[Patient] Yes.\n[Doctor] Great, and so, we're OK to chat?\n[Patient] Yes, we are.\n[Doctor] OK. So it says here, um, you are feeling hot, and have had severe headaches. Is that correct?\n[Patient] Yeah. It's, it's really affecting my work. Uh, uh, it comes and goes. Uh. Uh, I kind of, feel like, uh, it's, it's hard 'cause I, I , kinda lose my appetite. Also. Uh, one thing that's kinda weird is, I just sometimes also get like some, tingling in my arms.\n[Doctor] OK.\n[Patient] . And, like, especially if, for example when I, come into the elevator, in the morning.\n[Doctor] OK.\n[Patient] I, I can uh, of have, my heart is beating, kinda fast.\n[Doctor] OK. So, those are lots of things. Are they all happening at the same time?\n[Patient] Almost randomly like. Yeah, it's, it's, it's at different , times.\n[Doctor] And, do they all happen at the same time? Or is it one thing one time, and one ?\n[Patient] , one time, one thing at a time.\n[Doctor] OK. So, let's start with the headaches. When they do come, do you have any idea the headache is going to come?\n[Patient] \n[Patient] Uh, not really but, generally during, work times.\n[Doctor] So, it's normally at work?\n[Patient] I'm at work, I'm in a meeting, or on my laptop.\n[Doctor] OK. And, where does the headache sit in your head? Is it the front, or the back?\n[Patient] Um, I can't say, so like, kind of over.\n[Doctor] . OK. And, does it else?\n[Patient] \n[Patient] \n[Doctor] Does it go anywhere else?\n[Patient] , the headache? No, it's mostly in the front, and then yeah, it just kind of stays there.\n[Doctor] And, when you have the headaches, specifically, do you feel sick?\n[Patient] Yeah.\n[Patient] , not, not, not really, but it's like, making it hard. I, yeah, I kind of feel a little bit nauseous maybe. Um.\n[Doctor] OK.\n[Patient] And sometimes I also feel like. Uh, yeah. It's like uh, maybe, probably, breathing or something.\n[Doctor] OK.\n[Patient] No.\n[Doctor] And, do you normally get headaches, before all of this started?\n[Patient] Uh, so. No, I, I feel like my, like, health situation was mostly under control.\n[Doctor] \n[Doctor] OK.\n[Patient] Yeah.\n[Doctor] And then let's.\n[Patient] But it , it started roughly when I changed jobs.\n[Doctor] OK. So, talk to me about your job, what do you do?\n[Patient] I'm a lawyer.\n[Doctor] And, do you work in London at the moment?\n[Patient] Yes.\n[Doctor] So, do you get these headaches on your commute in to work?\n[Patient] Not really. I get it, mostly when I'm, at work.\n[Doctor] OK, and tell me about what you do. Do you sit in front of a computer most of the time? Or do you speak to people?\n[Patient] Like fifty-fifty. I go to meetings and then uh, sit in front of a computer.\n[Doctor] OK.\n[Patient] There's a lot of reading.\n[Doctor] And, these things have happened mostly when you're sitting at your computer?\n[Patient] Um.\n[Patient] , yeah, it happens then, yeah.\n[Doctor] OK, and tell me, what did you do, before being a lawyer?\n[Patient] Uh, no, I was a lawyer at previous job as well.\n[Doctor] OK.\n[Patient] \n[Doctor] So, talk to me about the stress that you're under at the moment. If, uh, ten out of ten is, extremely stressful, and one out of ten is being on vacation. Where would moment?\n[Patient] Think it's, seven, or eight.\n[Doctor] And, is that normal for you?\n[Patient] Yeah, it's like, a law firm, like, there's always pressure.\n[Doctor] OK. So, you mentioned your headaches. You also mentioned your reduced appetite. So, you don't want to eat as much.\n[Patient] Yeah.\n[Doctor] Have you lost weight?\n[Patient] Yes.\n[Doctor] Can you remember how much you've lost?\n[Patient] Five pounds.\n[Doctor] And, is that because you're going to the gym? Or is that unintentional?\n[Patient] It's not intentional, no.\n[Doctor] OK. So, have you noticed your clothes feeling looser?\n[Patient] , not really, ah, no.\n[Doctor] And, have people said, or commented that you've lost weight?\n[Patient] No.\n[Doctor] Great. And, another thing that you also mentioned. Is that you noticed tingling in your hand.\n[Patient] Yeah.\n[Doctor] So, talk to me about that. Is it in one hand? Or both hands?\n[Patient] Both.\n[Doctor] And, do you get that in your legs as well?\n[Patient] No.\n[Doctor] And, what does it feel like, the tingling?\n[Patient] Quick picking, yeah.\n[Doctor] And again, is this the first time you've noticed this?\n[Patient] Yeah.\n[Doctor] OK. And the other two things that I've just, jotted down. Is, you're feeling hot, but you didn't mention that. Is that correct?\n[Patient] Uh, but like. I would say like, I get this like, feeling of, short, like, , short of breath, sometimes.\n[Doctor] OK.\n[Patient] So, like, that could be what, you we're, referring to.\n[Doctor] Yes. So, do you feel short of breath while you're sitting at your desk?\n[Patient] Yeah, no. Yes. Sorry, yeah.\n[Doctor] . OK. And, how about when you're exercising?\n[Patient] No.\n[Doctor] OK. And the last thing is. You mentioned that you noticed your heart beating?\n[Patient] Yeah.\n[Doctor] Again, how often do you get that?\n[Patient] I, I, when I like, it's maybe once a day, uh, maybe more. Uh.\n[Patient] There's one more thing that I, I think I should mention, like, I do have like, some loss of libido at home.\n[Doctor] OK. How long has that been happening for?\n[Patient] Same amount of time really, like, since I changed my job.\n[Doctor] Fine. And, apart from all of these things that you've told me. Do you have any other medical problems?\n[Patient] Uh, well I have, hyperthyroidism.\n[Doctor] OK. And, do you take medications for that?\n[Patient] Thyroxine.\n[Doctor] And, are you remembering to take your medications?\n[Patient] Yes.\n[Doctor] OK. And, do you drink or smoke?\n[Patient] Yes.\n[Doctor] How much do you drink?\n[Patient] Like, once a week, couple of glasses, of wine.\n[Doctor] OK. And, how about smoking?\n[Patient] No.\n[Doctor] And, uh, I need to ask this to all of my patients, but do you do anything else recreational, in terms of drugs?\n[Patient] No.\n[Doctor] OK. So, you've never taken cocaine, or marijuana?\n[Patient] . No.\n[Doctor] OK, thank you. And, are you allergic to anything?\n[Patient] \n[Doctor] Good. So, you've told me lots of things happening to you at the moment, and I can understand, they probably feel quite strange and unusual.\n[Patient] Yeah.\n[Doctor] Um, I think the best course of action is, you come and see, one of our doctors, in the clinic.\n[Patient] Yeah.\n[Doctor] We can give you an examination, and what that means is, we check your heart and your breathing.\n[Patient] Yeah.\n[Doctor] Make sure that those things are functioning correctly.\n[Patient] Yeah.\n[Doctor] And probably do some blood tests, for your thyroxine.\n[Patient] Yep.\n[Doctor] And take it from there. How does that sound?\n[Patient] That sounds, uh, very good. Thank you.\n[Doctor] I think before we give you any medications, we should see you in person.\n[Patient] OK. .\n[Doctor] So, what we're going to do is book an appointment. Or I think you can book an appointment through the app, to come and see us clinic, and see one of my colleagues.\n[Patient] Yep. Yep. Yep.\n[Doctor] I'll let them know what you've told me today, so you won't have to repeat exactly what you've said.\n[Patient] Thank you.\n[Doctor] Great. Do you have any questions?\n[Patient] Right. No, that was it. Thank you very much.\n[Doctor] Thank you very much.\n[Patient] Yep, bye.",
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"text": "Great. And, another thing that you also mentioned. Is that you noticed tingling in your hand.",
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"text": "OK. And the other two things that I've just, jotted down. Is, you're feeling hot, but you didn't mention that. Is that correct?",
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"text": " Uh, but like. I would say like, I get this like, feeling of, short, like, , short of breath, sometimes.",
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"text": "So, like, that could be what, you we're, referring to.",
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"text": "Yes. So, do you feel short of breath while you're sitting at your desk?",
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"text": "Yeah, no. Yes. Sorry, yeah.",
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"text": "OK. And the last thing is. You mentioned that you noticed your heart beating?",
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"speaker": "Patient"
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"text": "Again, how often do you get that?",
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"text": "I, I, when I like, it's maybe once a day, uh, maybe more. Uh.",
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"text": "There's one more thing that I, I think I should mention, like, I do have like, some loss of libido at home.",
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"text": "OK. How long has that been happening for?",
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"text": "Same amount of time really, like, since I changed my job.",
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"text": "Fine. And, apart from all of these things that you've told me. Do you have any other medical problems?",
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"text": "Uh, well I have, hyperthyroidism.",
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"text": "OK. And, do you take medications for that?",
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"text": "And, are you remembering to take your medications?",
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"text": "Yes.",
"speaker": "Patient"
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"text": "OK. And, do you drink or smoke?",
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"text": "Yes.",
"speaker": "Patient"
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"text": "Like, once a week, couple of glasses, of wine.",
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"text": "OK. And, how about smoking?",
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"speaker": "Patient"
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"text": "And, uh, I need to ask this to all of my patients, but do you do anything else recreational, in terms of drugs?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
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"text": "OK. So, you've never taken cocaine, or marijuana?",
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"text": ". No.",
"speaker": "Patient"
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{
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"text": "OK, thank you. And, are you allergic to anything?",
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"speaker": "Patient"
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"text": "Good. So, you've told me lots of things happening to you at the moment, and I can understand, they probably feel quite strange and unusual.",
"speaker": "Doctor"
},
{
"start": 453.27957,
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "Um, I think the best course of action is, you come and see, one of our doctors, in the clinic.",
"speaker": "Doctor"
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{
"start": 459.98673,
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "We can give you an examination, and what that means is, we check your heart and your breathing.",
"speaker": "Doctor"
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{
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "Make sure that those things are functioning correctly.",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "And probably do some blood tests, for your thyroxine.",
"speaker": "Doctor"
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{
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"text": "Yep.",
"speaker": "Patient"
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{
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"text": "And take it from there. How does that sound?",
"speaker": "Doctor"
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{
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"text": "That sounds, uh, very good. Thank you.",
"speaker": "Patient"
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{
"start": 477.34704,
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"text": "I think before we give you any medications, we should see you in person.",
"speaker": "Doctor"
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{
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"text": "OK. .",
"speaker": "Patient"
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{
"start": 482.10122,
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"text": "So, what we're going to do is book an appointment. Or I think you can book an appointment through the app, to come and see us clinic, and see one of my colleagues.",
"speaker": "Doctor"
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{
"start": 487.20257,
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"text": "Yep. Yep. Yep.",
"speaker": "Patient"
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{
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"text": "I'll let them know what you've told me today, so you won't have to repeat exactly what you've said.",
"speaker": "Doctor"
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{
"start": 495.44663,
"end": 496.16022,
"text": "Thank you.",
"speaker": "Patient"
},
{
"start": 496.46942,
"end": 499.10972,
"text": "Great. Do you have any questions?",
"speaker": "Doctor"
},
{
"start": 497.3037,
"end": 500.70923,
"text": "Right. No, that was it. Thank you very much.",
"speaker": "Patient"
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{
"start": 500.62035,
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"text": "Thank you very much.",
"speaker": "Doctor"
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{
"start": 501.70726,
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"text": "Yep, bye.",
"speaker": "Patient"
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"doctor_utterances": "You have to do it, part of your training as a doctor. Hi. Hi. Can you hear me? Hi. My name's Doctor Gohill, I'm one of the general practitioners, that works here. Can I check your name and date of birth please? Hi. Great. And Patrick, are you in a, space, that's private and quiet? Great, and so, we're OK to chat? OK. So it says here, um, you are feeling hot, and have had severe headaches. Is that correct? OK. OK. OK. So, those are lots of things. Are they all happening at the same time? And, do they all happen at the same time? Or is it one thing one time, and one ? OK. So, let's start with the headaches. When they do come, do you have any idea the headache is going to come? So, it's normally at work? OK. And, where does the headache sit in your head? Is it the front, or the back? . OK. And, does it else? Does it go anywhere else? And, when you have the headaches, specifically, do you feel sick? OK. OK. And, do you normally get headaches, before all of this started? OK. And then let's. OK. So, talk to me about your job, what do you do? And, do you work in London at the moment? So, do you get these headaches on your commute in to work? OK, and tell me about what you do. Do you sit in front of a computer most of the time? Or do you speak to people? OK. And, these things have happened mostly when you're sitting at your computer? OK, and tell me, what did you do, before being a lawyer? OK. So, talk to me about the stress that you're under at the moment. If, uh, ten out of ten is, extremely stressful, and one out of ten is being on vacation. Where would moment? And, is that normal for you? OK. So, you mentioned your headaches. You also mentioned your reduced appetite. So, you don't want to eat as much. Have you lost weight? Can you remember how much you've lost? And, is that because you're going to the gym? Or is that unintentional? OK. So, have you noticed your clothes feeling looser? And, have people said, or commented that you've lost weight? Great. And, another thing that you also mentioned. Is that you noticed tingling in your hand. So, talk to me about that. Is it in one hand? Or both hands? And, do you get that in your legs as well? And, what does it feel like, the tingling? And again, is this the first time you've noticed this? OK. And the other two things that I've just, jotted down. Is, you're feeling hot, but you didn't mention that. Is that correct? OK. Yes. So, do you feel short of breath while you're sitting at your desk? . OK. And, how about when you're exercising? OK. And the last thing is. You mentioned that you noticed your heart beating? Again, how often do you get that? OK. How long has that been happening for? Fine. And, apart from all of these things that you've told me. Do you have any other medical problems? OK. And, do you take medications for that? And, are you remembering to take your medications? OK. And, do you drink or smoke? How much do you drink? OK. And, how about smoking? And, uh, I need to ask this to all of my patients, but do you do anything else recreational, in terms of drugs? OK. So, you've never taken cocaine, or marijuana? OK, thank you. And, are you allergic to anything? Good. So, you've told me lots of things happening to you at the moment, and I can understand, they probably feel quite strange and unusual. Um, I think the best course of action is, you come and see, one of our doctors, in the clinic. We can give you an examination, and what that means is, we check your heart and your breathing. Make sure that those things are functioning correctly. And probably do some blood tests, for your thyroxine. And take it from there. How does that sound? I think before we give you any medications, we should see you in person. So, what we're going to do is book an appointment. Or I think you can book an appointment through the app, to come and see us clinic, and see one of my colleagues. I'll let them know what you've told me today, so you won't have to repeat exactly what you've said. Great. Do you have any questions? Thank you very much.",
"patient_utterances": "Hello. . Yes, I can hear fine. Uh, I am, uh, Patrick Smith. Uh, thirty five years old. Um, October, seventh. Uh. ninety , three something. Yes. Yes, we are. Yeah. It's, it's really affecting my work. Uh, uh, it comes and goes. Uh. Uh, I kind of, feel like, uh, it's, it's hard 'cause I, I , kinda lose my appetite. Also. Uh, one thing that's kinda weird is, I just sometimes also get like some, tingling in my arms. . And, like, especially if, for example when I, come into the elevator, in the morning. I, I can uh, of have, my heart is beating, kinda fast. Almost randomly like. Yeah, it's, it's, it's at different , times. , one time, one thing at a time. Uh, not really but, generally during, work times. I'm at work, I'm in a meeting, or on my laptop. Um, I can't say, so like, kind of over. , the headache? No, it's mostly in the front, and then yeah, it just kind of stays there. Yeah. , not, not, not really, but it's like, making it hard. I, yeah, I kind of feel a little bit nauseous maybe. Um. And sometimes I also feel like. Uh, yeah. It's like uh, maybe, probably, breathing or something. No. Uh, so. No, I, I feel like my, like, health situation was mostly under control. Yeah. But it , it started roughly when I changed jobs. I'm a lawyer. Yes. Not really. I get it, mostly when I'm, at work. Like fifty-fifty. I go to meetings and then uh, sit in front of a computer. There's a lot of reading. Um. , yeah, it happens then, yeah. Uh, no, I was a lawyer at previous job as well. Think it's, seven, or eight. Yeah, it's like, a law firm, like, there's always pressure. Yeah. Yes. Five pounds. It's not intentional, no. , not really, ah, no. No. Yeah. Both. No. Quick picking, yeah. Yeah. Uh, but like. I would say like, I get this like, feeling of, short, like, , short of breath, sometimes. So, like, that could be what, you we're, referring to. Yeah, no. Yes. Sorry, yeah. No. Yeah. I, I, when I like, it's maybe once a day, uh, maybe more. Uh. There's one more thing that I, I think I should mention, like, I do have like, some loss of libido at home. Same amount of time really, like, since I changed my job. Uh, well I have, hyperthyroidism. Thyroxine. Yes. Yes. Like, once a week, couple of glasses, of wine. No. No. . No. Yeah. Yeah. Yeah. Yeah. Yep. That sounds, uh, very good. Thank you. OK. . Yep. Yep. Yep. Thank you. Right. No, that was it. Thank you very much. Yep, bye.",
"num_turns": 147,
"reference_note": "{\"day\": 4, \"consultation\": 2, \"presenting_complaint\": \"I'm feeling hot and have severe headaches\", \"note\": \"PC. Headaches, loss of appetite, tingling, feel hot, palpitations, acute onset, at random times of the day while at work (lawyer)\\n\\nHPC: \\nPC started when started new job (lawer, high stress, works in front of a computer)\\nHeadaches:\\n-\\tNo pre aura, \\n-\\tFrontal\\n-\\tNo radiation\\n-\\tSome nausea no vomiting,\\n-\\tNo pmhx of headache.\\n\\nReduced appetite, with unintentional weight loss, loss of 5lbs \\nPins and needles in both arms, no radiation to legs, maintains motor and sense, no loss of function\\nFevers with headaches \\nPalpitations with mild SOBOE and SOBAR.\\n\\n\\nSymptoms occur at random times of the day while at work, with no pre-symptoms, sometimes together, sometimes individually.\\n\\nPMHx , hypothyroid. \\n\\nDHx allergies - nil\\nThyroxine. \\n\\nSHx lawer , stressful job.\\n\\nDDx ??hypothyroid?\\n\\nPlans : requires further examination and blood tests.\\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] Ohh, hello.\n[Patient] \n[Doctor] Hello. I'm Doctor Geraghty. Ohh, sorry. . Can I take your, full name, date of birth, and, your home address please?\n[Patient] Uh, yeah it's uh, . Um, and, five, um, Kings Place.\n[Doctor] \n[Doctor] And are you in a, uh, and your date of birth?\n[Patient] Uh, it's the twentieth, of the fourth, nineteen ninety.\n[Doctor] \n[Doctor] OK. And are you in a private place you can have a confidential consultation today?\n[Patient] Yes, I am.\n[Doctor] What can I do for you today?\n[Patient] Um, I've got a really bad headache, had it for about a day now.\n[Doctor] OK, and can you just tell me about, how it started? What were you doing when it came on?\n[Patient] Um, yeah, just ever since yesterday morning, since I woke up really. Um, just yeah, kind of throbbing headache, haven't really wanted to leave the house much since then.\n[Doctor] OK, and whereabouts in your head is the pain?\n[Patient] Uh, mainly on the left side.\n[Doctor] OK. What does it feel like?\n[Patient] Um, it just, kind of feels like it's throbbing, it's quite intense, sort of comes and goes. Um, yeah, quite sensitive to light, um, but yeah, quite painful.\n[Doctor] K and . When, when you say it comes and goes, does it completely go away?\n[Patient] Uh, just kind of fades, so it's still there a little bit but, it kind of gets more or less, severe.\n[Doctor] OK. And any, any other symptoms that you've had, any problems with your eyes, or your eyesight?\n[Patient] Uh, no, not at all.\n[Doctor] Any abnormal smells or tastes?\n[Patient] No.\n[Doctor] Any, any nausea, vomiting?\n[Patient] Uh, no, no, been feeling fine actually.\n[Doctor] And have you been eating and drinking OK?\n[Patient] Yeah, yeah, .\n[Doctor] OK. And, normally, do you get any headaches?\n[Patient] Uh, no not really, it's not something I've, ever had before.\n[Doctor] OK. And, has it occurred at a particular term in your menstrual cycle?\n[Patient] Um, no, not particularly, and my period was about a week ago.\n[Doctor] \n[Doctor] Right, OK. And how we're you the before it came on? Have you had any other symptoms, like feeling feverish, , runny nose, sore ears?\n[Patient] No, not really any sort of, cold symptoms, I seemed OK the day before.\n[Doctor] OK. And, at the moment, how are you feeling?\n[Patient] Um, it's still pretty bad. Um, yeah, still the kind of throbbing, yeah.\n[Doctor] Have you had any changes in your skin?\n[Patient] No, skin feeling fine.\n[Doctor] Have you checked your temperature at all? Have you got a thermometer at home?\n[Patient] Um, I haven't. Um, I don't feel like I'm feverish, but I haven't checked.\n[Doctor] And any problems with weakness, tingling, numbness in your arms or legs?\n[Patient] No, not at all.\n[Doctor] And what have you been doing since it came on? Have you been able to go to work, or have you been at home?\n[Patient] Um, taken some painkillers, mainly been at home. Um, yeah just kind of, kind of seems to be worse, when I'm in a light room or like sunlight. So I've kind of just been staying in as much as possible.\n[Doctor] OK. Does it get worse with any position that you're on? Is it worse when you lie flat, or when you bend forward?\n[Patient] Um, no, think I've generally been lying down, seems to be better that way.\n[Doctor] \n[Doctor] Any problems if you cough or sneeze?\n[Patient] Uh, no, but I haven't really got a cough or anything.\n[Doctor] OK. And can you just tell me a bit about, your medical history in the past? Have you had any significant medical problems? Any hospital admissions, operations, something like that?\n[Patient] Uh, no, not recently, nothing.\n[Doctor] Do you take any medication?\n[Patient] Uh, no, just contraception.\n[Doctor] And which contraception do you take?\n[Patient] Uh, Microgynon, pill.\n[Doctor] When did you start that one?\n[Patient] Uh, about six years ago.\n[Doctor] Do you get any side effects from it?\n[Patient] Um, not really, um, no, not too much.\n[Doctor] OK. And, anyone in your family had any medical problems?\n[Patient] Uh, my mum had, uh, high blood pressure, and she's got a history of migraines. Um, but it's not really affected me before.\n[Doctor] OK. And have you had your blood pressure checked recently?\n[Patient] Uh, I haven't actually, no.\n[Doctor] Have you had it checked, when you've had the , repeat prescription done?\n[Patient] Yeah, yeah, so uh, probably about six months ago.\n[Doctor] Do you know if there's been any problems with it?\n[Patient] Um, it's always been fine I think.\n[Doctor] OK. Um, and whereabouts, whereabouts do you live at the moment? You've given me your, address. Do, who do you live with at home?\n[Patient] Uh, just with housemates, um, just friends.\n[Doctor] OK. And do you drink much alcohol day-to-day?\n[Patient] Um, I'd say a normal amount, um, probably, you know, a few drinks at the weekend.\n[Doctor] OK. And do you smoke?\n[Patient] No.\n[Doctor] Do you take any other drugs of any sort?\n[Patient] No.\n[Doctor] Um. So, , what, what tablets did you say you've been taking already? Yeah.\n[Patient] Sorry?\n[Doctor] What tablets have you been taking already, for it?\n[Patient] Uh, just Paracetamol. Um, I'm allergic to Aspirin, so I haven't been taking that.\n[Doctor] What happens when you get a, when you take Aspirin?\n[Patient] Um, I just feel really sick.\n[Doctor] OK. And have you ever, taken any, non-steroidal anti-inflammatories, like Ibuprofen, Naproxen, anything like that?\n[Patient] Um, I have in the past, I haven't been taking it, last few days.\n[Doctor] OK. Um, so, this headache is new to you, and you've, you've not had regular headaches before?\n[Patient] Yeah.\n[Doctor] What I would, suggest is, taking, uh, um, some anti-inflammatories, along with the Paracetamol.\n[Patient] OK.\n[Doctor] Um, as a. Uh, you said you're eating OK?\n[Patient] Yeah, yeah, fine.\n[Doctor] I mean it, from the sounds of it, it does, sound quite like a migraine, but obviously if you had no history of that, in the past. Um, and is anything changed recently, or any, anything you've done recently might've, triggered it?\n[Patient] Uh, not that I can think of, um, may have been a bit stressed out at work, that kind of thing, but .\n[Doctor] Yeah. Um, well that would be the first thing to do, is to take some anti-inflammatories along with the Paracetamol. Make sure you're really well hydrated. Um, and, see how that goes, and if it, if it isn't settling, or it's getting worse, or you get any other change in your headache. Um, or you're unwell with it, with a high temperature, then we would certainly need to speak to you. Straight away about that. The other thing is if you, if you're getting persistent, um, headaches, or headaches associated with your menstrual cycle, or certain things seem to trigger these headaches. Then, it, it would be worth, having a further discussion about it, to see whether we can, work out if we can help the, that longer-term.\n[Patient] OK, brilliant, thank you.\n[Doctor] Um, I would, try and arrange to get your blood pressure checked, if you haven't had it checked for a while. Uh, and, thing to do is to have a thermometer at home, so you can make sure that your temperature's OK.\n[Patient] OK, sure.\n[Patient] Yep.\n[Doctor] If you have a raised temperature or, your headache's just getting worse, or you develop any rashes or anything like that. Then we'd need to speak to you straight away.\n[Patient] Yep, OK, that's brilliant. OK, so I'll take some Ibuprofen and I'll um, hopefully, be a bit better in a day or two then, so yeah.\n[Doctor] OK, so, have you got any other questions?\n[Patient] Uh, no, that was it today.\n[Doctor] OK. OK then, we'll, we'll, we'll, um, speak to you again.\n[Patient] OK, brilliant. Thanks so much.\n[Doctor] , very much. Bye.\n[Patient] Bye.",
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{
"start": 102.85679,
"end": 105.08986,
"text": "And have you been eating and drinking OK?",
"speaker": "Doctor"
},
{
"start": 105.30035,
"end": 107.24493,
"text": "Yeah, yeah, .",
"speaker": "Patient"
},
{
"start": 107.11993,
"end": 111.12744,
"text": "OK. And, normally, do you get any headaches?",
"speaker": "Doctor"
},
{
"start": 111.14467,
"end": 115.21886,
"text": "Uh, no not really, it's not something I've, ever had before.",
"speaker": "Patient"
},
{
"start": 115.12742,
"end": 121.11236,
"text": "OK. And, has it occurred at a particular term in your menstrual cycle?",
"speaker": "Doctor"
},
{
"start": 121.97865,
"end": 126.80709,
"text": "Um, no, not particularly, and my period was about a week ago.",
"speaker": "Patient"
},
{
"start": 122.99205,
"end": 123.59356,
"text": "",
"speaker": "Doctor"
},
{
"start": 126.90182,
"end": 137.57094,
"text": "Right, OK. And how we're you the before it came on? Have you had any other symptoms, like feeling feverish, , runny nose, sore ears?",
"speaker": "Doctor"
},
{
"start": 137.62687,
"end": 142.1696,
"text": "No, not really any sort of, cold symptoms, I seemed OK the day before.",
"speaker": "Patient"
},
{
"start": 142.10476,
"end": 145.57843,
"text": "OK. And, at the moment, how are you feeling?",
"speaker": "Doctor"
},
{
"start": 145.64773,
"end": 150.75311,
"text": "Um, it's still pretty bad. Um, yeah, still the kind of throbbing, yeah.",
"speaker": "Patient"
},
{
"start": 150.96939,
"end": 153.84156,
"text": "Have you had any changes in your skin?",
"speaker": "Doctor"
},
{
"start": 154.28276,
"end": 156.18403,
"text": "No, skin feeling fine.",
"speaker": "Patient"
},
{
"start": 156.022,
"end": 159.4656,
"text": "Have you checked your temperature at all? Have you got a thermometer at home?",
"speaker": "Doctor"
},
{
"start": 159.42671,
"end": 164.20307,
"text": "Um, I haven't. Um, I don't feel like I'm feverish, but I haven't checked.",
"speaker": "Patient"
},
{
"start": 164.19491,
"end": 168.87158,
"text": "And any problems with weakness, tingling, numbness in your arms or legs?",
"speaker": "Doctor"
},
{
"start": 169.17229,
"end": 170.51815,
"text": "No, not at all.",
"speaker": "Patient"
},
{
"start": 170.58586,
"end": 175.27005,
"text": "And what have you been doing since it came on? Have you been able to go to work, or have you been at home?",
"speaker": "Doctor"
},
{
"start": 173.35273,
"end": 186.92841,
"text": " Um, taken some painkillers, mainly been at home. Um, yeah just kind of, kind of seems to be worse, when I'm in a light room or like sunlight. So I've kind of just been staying in as much as possible.",
"speaker": "Patient"
},
{
"start": 186.5106,
"end": 193.05945,
"text": "OK. Does it get worse with any position that you're on? Is it worse when you lie flat, or when you bend forward?",
"speaker": "Doctor"
},
{
"start": 193.26354,
"end": 198.23143,
"text": "Um, no, think I've generally been lying down, seems to be better that way.",
"speaker": "Patient"
},
{
"start": 194.57824,
"end": 195.30757,
"text": "",
"speaker": "Doctor"
},
{
"start": 198.24374,
"end": 200.97672,
"text": "Any problems if you cough or sneeze?",
"speaker": "Doctor"
},
{
"start": 201.2248,
"end": 204.11952,
"text": "Uh, no, but I haven't really got a cough or anything.",
"speaker": "Patient"
},
{
"start": 204.63836,
"end": 214.51802,
"text": "OK. And can you just tell me a bit about, your medical history in the past? Have you had any significant medical problems? Any hospital admissions, operations, something like that?",
"speaker": "Doctor"
},
{
"start": 214.83443,
"end": 217.0894,
"text": "Uh, no, not recently, nothing.",
"speaker": "Patient"
},
{
"start": 217.11951,
"end": 218.97665,
"text": "Do you take any medication?",
"speaker": "Doctor"
},
{
"start": 219.29992,
"end": 221.17961,
"text": "Uh, no, just contraception.",
"speaker": "Patient"
},
{
"start": 222.00672,
"end": 224.05935,
"text": "And which contraception do you take?",
"speaker": "Doctor"
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{
"start": 224.19464,
"end": 226.31493,
"text": "Uh, Microgynon, pill.",
"speaker": "Patient"
},
{
"start": 225.63077,
"end": 227.42776,
"text": "When did you start that one?",
"speaker": "Doctor"
},
{
"start": 227.76606,
"end": 229.64575,
"text": "Uh, about six years ago.",
"speaker": "Patient"
},
{
"start": 229.66084,
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"text": "Do you get any side effects from it?",
"speaker": "Doctor"
},
{
"start": 231.93146,
"end": 236.14197,
"text": "Um, not really, um, no, not too much.",
"speaker": "Patient"
},
{
"start": 236.08939,
"end": 240.39764,
"text": "OK. And, anyone in your family had any medical problems?",
"speaker": "Doctor"
},
{
"start": 240.69835,
"end": 247.87877,
"text": "Uh, my mum had, uh, high blood pressure, and she's got a history of migraines. Um, but it's not really affected me before.",
"speaker": "Patient"
},
{
"start": 245.84875,
"end": 250.88633,
"text": "OK. And have you had your blood pressure checked recently?",
"speaker": "Doctor"
},
{
"start": 251.10432,
"end": 252.86259,
"text": "Uh, I haven't actually, no.",
"speaker": "Patient"
},
{
"start": 252.98407,
"end": 257.60059,
"text": "Have you had it checked, when you've had the , repeat prescription done?",
"speaker": "Doctor"
},
{
"start": 257.38249,
"end": 259.96895,
"text": "Yeah, yeah, so uh, probably about six months ago.",
"speaker": "Patient"
},
{
"start": 259.67437,
"end": 262.01793,
"text": "Do you know if there's been any problems with it?",
"speaker": "Doctor"
},
{
"start": 262.11932,
"end": 264.08038,
"text": "Um, it's always been fine I think.",
"speaker": "Patient"
},
{
"start": 263.89381,
"end": 270.66822,
"text": "OK. Um, and whereabouts, whereabouts do you live at the moment? You've given me your, address. Do, who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 271.03759,
"end": 274.25338,
"text": "Uh, just with housemates, um, just friends.",
"speaker": "Patient"
},
{
"start": 273.81858,
"end": 276.53256,
"text": "OK. And do you drink much alcohol day-to-day?",
"speaker": "Doctor"
},
{
"start": 276.68441,
"end": 281.56129,
"text": "Um, I'd say a normal amount, um, probably, you know, a few drinks at the weekend.",
"speaker": "Patient"
},
{
"start": 281.80351,
"end": 283.07419,
"text": "OK. And do you smoke?",
"speaker": "Doctor"
},
{
"start": 283.52526,
"end": 284.24707,
"text": "No.",
"speaker": "Patient"
},
{
"start": 284.25805,
"end": 286.45764,
"text": "Do you take any other drugs of any sort?",
"speaker": "Doctor"
},
{
"start": 286.623,
"end": 287.35232,
"text": "No.",
"speaker": "Patient"
},
{
"start": 287.67568,
"end": 293.35236,
"text": "Um. So, , what, what tablets did you say you've been taking already? Yeah.",
"speaker": "Doctor"
},
{
"start": 293.86357,
"end": 294.60042,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 294.36429,
"end": 296.87837,
"text": "What tablets have you been taking already, for it?",
"speaker": "Doctor"
},
{
"start": 296.90868,
"end": 301.02897,
"text": "Uh, just Paracetamol. Um, I'm allergic to Aspirin, so I haven't been taking that.",
"speaker": "Patient"
},
{
"start": 300.38853,
"end": 303.26592,
"text": "What happens when you get a, when you take Aspirin?",
"speaker": "Doctor"
},
{
"start": 303.60039,
"end": 305.42745,
"text": "Um, I just feel really sick.",
"speaker": "Patient"
},
{
"start": 305.60997,
"end": 313.03591,
"text": "OK. And have you ever, taken any, non-steroidal anti-inflammatories, like Ibuprofen, Naproxen, anything like that?",
"speaker": "Doctor"
},
{
"start": 312.97629,
"end": 316.60786,
"text": "Um, I have in the past, I haven't been taking it, last few days.",
"speaker": "Patient"
},
{
"start": 317.04401,
"end": 324.05361,
"text": "OK. Um, so, this headache is new to you, and you've, you've not had regular headaches before?",
"speaker": "Doctor"
},
{
"start": 324.75068,
"end": 325.5176,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 325.76267,
"end": 334.16805,
"text": "What I would, suggest is, taking, uh, um, some anti-inflammatories, along with the Paracetamol.",
"speaker": "Doctor"
},
{
"start": 334.98372,
"end": 335.7356,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 335.70419,
"end": 339.26959,
"text": "Um, as a. Uh, you said you're eating OK?",
"speaker": "Doctor"
},
{
"start": 339.18672,
"end": 340.43484,
"text": "Yeah, yeah, fine.",
"speaker": "Patient"
},
{
"start": 340.12212,
"end": 354.79955,
"text": "I mean it, from the sounds of it, it does, sound quite like a migraine, but obviously if you had no history of that, in the past. Um, and is anything changed recently, or any, anything you've done recently might've, triggered it?",
"speaker": "Doctor"
},
{
"start": 355.31447,
"end": 360.48738,
"text": "Uh, not that I can think of, um, may have been a bit stressed out at work, that kind of thing, but .",
"speaker": "Patient"
},
{
"start": 357.54009,
"end": 407.35942,
"text": " Yeah. Um, well that would be the first thing to do, is to take some anti-inflammatories along with the Paracetamol. Make sure you're really well hydrated. Um, and, see how that goes, and if it, if it isn't settling, or it's getting worse, or you get any other change in your headache. Um, or you're unwell with it, with a high temperature, then we would certainly need to speak to you. Straight away about that. The other thing is if you, if you're getting persistent, um, headaches, or headaches associated with your menstrual cycle, or certain things seem to trigger these headaches. Then, it, it would be worth, having a further discussion about it, to see whether we can, work out if we can help the, that longer-term.",
"speaker": "Doctor"
},
{
"start": 408.01346,
"end": 409.90068,
"text": "OK, brilliant, thank you.",
"speaker": "Patient"
},
{
"start": 409.62257,
"end": 421.60307,
"text": "Um, I would, try and arrange to get your blood pressure checked, if you haven't had it checked for a while. Uh, and, thing to do is to have a thermometer at home, so you can make sure that your temperature's OK.",
"speaker": "Doctor"
},
{
"start": 415.78035,
"end": 417.12621,
"text": "OK, sure.",
"speaker": "Patient"
},
{
"start": 421.90063,
"end": 422.50214,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 423.02101,
"end": 430.56885,
"text": "If you have a raised temperature or, your headache's just getting worse, or you develop any rashes or anything like that. Then we'd need to speak to you straight away.",
"speaker": "Doctor"
},
{
"start": 431.81037,
"end": 437.68252,
"text": "Yep, OK, that's brilliant. OK, so I'll take some Ibuprofen and I'll um, hopefully, be a bit better in a day or two then, so yeah.",
"speaker": "Patient"
},
{
"start": 438.00039,
"end": 440.97582,
"text": "OK, so, have you got any other questions?",
"speaker": "Doctor"
},
{
"start": 441.20131,
"end": 442.7577,
"text": "Uh, no, that was it today.",
"speaker": "Patient"
},
{
"start": 443.3292,
"end": 448.9291,
"text": "OK. OK then, we'll, we'll, we'll, um, speak to you again.",
"speaker": "Doctor"
},
{
"start": 449.51707,
"end": 451.08097,
"text": "OK, brilliant. Thanks so much.",
"speaker": "Patient"
},
{
"start": 450.06174,
"end": 452.11866,
"text": ", very much. Bye.",
"speaker": "Doctor"
},
{
"start": 452.20127,
"end": 452.86293,
"text": "Bye.",
"speaker": "Patient"
}
],
"doctor_utterances": "Ohh, hello. Hello. I'm Doctor Geraghty. Ohh, sorry. . Can I take your, full name, date of birth, and, your home address please? And are you in a, uh, and your date of birth? OK. And are you in a private place you can have a confidential consultation today? What can I do for you today? OK, and can you just tell me about, how it started? What were you doing when it came on? OK, and whereabouts in your head is the pain? OK. What does it feel like? K and . When, when you say it comes and goes, does it completely go away? OK. And any, any other symptoms that you've had, any problems with your eyes, or your eyesight? Any abnormal smells or tastes? Any, any nausea, vomiting? And have you been eating and drinking OK? OK. And, normally, do you get any headaches? OK. And, has it occurred at a particular term in your menstrual cycle? Right, OK. And how we're you the before it came on? Have you had any other symptoms, like feeling feverish, , runny nose, sore ears? OK. And, at the moment, how are you feeling? Have you had any changes in your skin? Have you checked your temperature at all? Have you got a thermometer at home? And any problems with weakness, tingling, numbness in your arms or legs? And what have you been doing since it came on? Have you been able to go to work, or have you been at home? OK. Does it get worse with any position that you're on? Is it worse when you lie flat, or when you bend forward? Any problems if you cough or sneeze? OK. And can you just tell me a bit about, your medical history in the past? Have you had any significant medical problems? Any hospital admissions, operations, something like that? Do you take any medication? And which contraception do you take? When did you start that one? Do you get any side effects from it? OK. And, anyone in your family had any medical problems? OK. And have you had your blood pressure checked recently? Have you had it checked, when you've had the , repeat prescription done? Do you know if there's been any problems with it? OK. Um, and whereabouts, whereabouts do you live at the moment? You've given me your, address. Do, who do you live with at home? OK. And do you drink much alcohol day-to-day? OK. And do you smoke? Do you take any other drugs of any sort? Um. So, , what, what tablets did you say you've been taking already? Yeah. What tablets have you been taking already, for it? What happens when you get a, when you take Aspirin? OK. And have you ever, taken any, non-steroidal anti-inflammatories, like Ibuprofen, Naproxen, anything like that? OK. Um, so, this headache is new to you, and you've, you've not had regular headaches before? What I would, suggest is, taking, uh, um, some anti-inflammatories, along with the Paracetamol. Um, as a. Uh, you said you're eating OK? I mean it, from the sounds of it, it does, sound quite like a migraine, but obviously if you had no history of that, in the past. Um, and is anything changed recently, or any, anything you've done recently might've, triggered it? Yeah. Um, well that would be the first thing to do, is to take some anti-inflammatories along with the Paracetamol. Make sure you're really well hydrated. Um, and, see how that goes, and if it, if it isn't settling, or it's getting worse, or you get any other change in your headache. Um, or you're unwell with it, with a high temperature, then we would certainly need to speak to you. Straight away about that. The other thing is if you, if you're getting persistent, um, headaches, or headaches associated with your menstrual cycle, or certain things seem to trigger these headaches. Then, it, it would be worth, having a further discussion about it, to see whether we can, work out if we can help the, that longer-term. Um, I would, try and arrange to get your blood pressure checked, if you haven't had it checked for a while. Uh, and, thing to do is to have a thermometer at home, so you can make sure that your temperature's OK. If you have a raised temperature or, your headache's just getting worse, or you develop any rashes or anything like that. Then we'd need to speak to you straight away. OK, so, have you got any other questions? OK. OK then, we'll, we'll, we'll, um, speak to you again. , very much. Bye.",
"patient_utterances": " Uh, yeah it's uh, . Um, and, five, um, Kings Place. Uh, it's the twentieth, of the fourth, nineteen ninety. Yes, I am. Um, I've got a really bad headache, had it for about a day now. Um, yeah, just ever since yesterday morning, since I woke up really. Um, just yeah, kind of throbbing headache, haven't really wanted to leave the house much since then. Uh, mainly on the left side. Um, it just, kind of feels like it's throbbing, it's quite intense, sort of comes and goes. Um, yeah, quite sensitive to light, um, but yeah, quite painful. Uh, just kind of fades, so it's still there a little bit but, it kind of gets more or less, severe. Uh, no, not at all. No. Uh, no, no, been feeling fine actually. Yeah, yeah, . Uh, no not really, it's not something I've, ever had before. Um, no, not particularly, and my period was about a week ago. No, not really any sort of, cold symptoms, I seemed OK the day before. Um, it's still pretty bad. Um, yeah, still the kind of throbbing, yeah. No, skin feeling fine. Um, I haven't. Um, I don't feel like I'm feverish, but I haven't checked. No, not at all. Um, taken some painkillers, mainly been at home. Um, yeah just kind of, kind of seems to be worse, when I'm in a light room or like sunlight. So I've kind of just been staying in as much as possible. Um, no, think I've generally been lying down, seems to be better that way. Uh, no, but I haven't really got a cough or anything. Uh, no, not recently, nothing. Uh, no, just contraception. Uh, Microgynon, pill. Uh, about six years ago. Um, not really, um, no, not too much. Uh, my mum had, uh, high blood pressure, and she's got a history of migraines. Um, but it's not really affected me before. Uh, I haven't actually, no. Yeah, yeah, so uh, probably about six months ago. Um, it's always been fine I think. Uh, just with housemates, um, just friends. Um, I'd say a normal amount, um, probably, you know, a few drinks at the weekend. No. No. Sorry? Uh, just Paracetamol. Um, I'm allergic to Aspirin, so I haven't been taking that. Um, I just feel really sick. Um, I have in the past, I haven't been taking it, last few days. Yeah. OK. Yeah, yeah, fine. Uh, not that I can think of, um, may have been a bit stressed out at work, that kind of thing, but . OK, brilliant, thank you. OK, sure. Yep. Yep, OK, that's brilliant. OK, so I'll take some Ibuprofen and I'll um, hopefully, be a bit better in a day or two then, so yeah. Uh, no, that was it today. OK, brilliant. Thanks so much. Bye.",
"num_turns": 105,
"reference_note": "{\"day\": 5, \"consultation\": 1, \"presenting_complaint\": \"I have a headache\", \"note\": \"Left sided headache since yesterday morning. Intermittent. Non positional. Not woken her up. No altered smell/taste. E&D normally. No prodromal illness, no viral symptoms, sore ears/coryzal sx. Doesn't feel feverish but hasn't checked temperature. No N&V. No tingling/numbness/weakness/rash. Worse with light but vision not altered. Taken paracetamol only. Period stopped last week.\\nNo hx headaches.\\nPMH: Nil significant\\nDH: Microgynon - no SEs, BP was normal when checked for last prescription ? when.\\nFH: Mother has hypertension and migraines.\\nSH: Lives with flatmates, alcohol - few glasses wine at weekends, non smoker.\\nSome stress at work recently. \\nImp: ? Tension headache/first episode migraine. No features meningitic illness but is worse with light.\\n Plan: Advised to get BP and temp checked and to call straight back if worsening/persistent headache/fever/rash/new symptoms. Advised to start regular ibuprofen with food. To have a review if regular headaches. \\n\", \"highlights\": [\"Left sided headache\", \"Intermittent\", \"Non positional\", \"Doesn't feel feverish\", \"No tingling/numbness/weakness/rash\", \"Worse with light but vision not altered\"]}",
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"dialogue": "[Doctor] Hi there, it's Doctor Smith from Babylon.\n[Patient] Hi.\n[Doctor] Hi. Can you confirm you name, date of birth and your home address, please?\n[Patient] Uh, Sandra Bullock, uh, twentieth of February, nineteen fifty eight.\n[Doctor] Hello. \n[Doctor] And your home address?\n[Patient] Uh, seven three four, court in St. .\n[Doctor] OK, that's fine. Uh, are you in a private place that you can have a consultation at the moment?\n[Patient] Yeah, yeah, I am.\n[Doctor] OK, what can I do for you today?\n[Patient] Um, well, like five days ago I started having problems like a cough, and my nose is just constantly streaming.\n[Doctor] OK. And, and are you normally fit and well?\n[Patient] Yeah, normally I'm diabetic, but other than that, like, generally pretty good.\n[Doctor] Right, OK. So, just tell me about the last, did you say five days?\n[Patient] Yeah, five days or so ago.\n[Doctor] OK. How about your cough at the moment?\n[Patient] Uh, it's quite bad. It's kind of quite dry, um. I'm coughing maybe every twenty, thirty minutes or so.\n[Doctor] OK, you bringing up any phlegm at all?\n[Patient] No.\n[Doctor] No. Any chest pain?\n[Patient] No. Chest what, sorry?\n[Doctor] Any pain in your chest?\n[Patient] Uh, no.\n[Doctor] Any difficulty breathing, feeling short of breath or any pain when you take a deep breath?\n[Patient] No, that's all fine.\n[Doctor] Have you coughed up any blood or anything like that?\n[Patient] Nope.\n[Doctor] And what about your nose symptoms? Are you front of your sinuses or anything?\n[Patient] Uh, just . Uh, nothing up in here but just constant streaming, like, using a million tissues.\n[Doctor] OK. And any blood coming from the nose?\n[Patient] No, it's pretty green.\n[Doctor] Right, OK. Any other symptoms, like sore ears? Sore throat?\n[Patient] Uh, I I've been feeling really hot, um, I don't know if it's fever as such, but, like, to touch I'm quite hot but sometimes I'm feeling really chilly, needing to be under a blanket, that sort of thing.\n[Doctor] Have you checked your temperature with a thermometer?\n[Patient] Uhh, no, I haven't.\n[Doctor] OK. Um, and are you eating and drinking normally?\n[Patient] Uhh, yes. Um, kind of around when it started, I had some diarrhoea, but I don't know if that was associated. But since then it's all been pretty fine.\n[Doctor] OK. So, you're drinking well, holding down fluids OK?\n[Patient] Yeah.\n[Doctor] And passing water OK?\n[Patient] Yeah, that's fine.\n[Doctor] No vomiting, diarrhoea now?\n[Patient] No.\n[Doctor] OK, that's fine. Um, any rashes that you've noticed?\n[Patient] Rashes? Uhh, no, nothing like that.\n[Doctor] Yeah. Any headaches or change in your vision?\n[Patient] No, um, I've had quite achy muscles, but that's pretty much it.\n[Doctor] OK. And normally, do you have any chest problems?\n[Patient] Uh, no.\n[Doctor] Do you ever get wheezing, short of breath?\n[Patient] Uh, I mean, like, if I do intense exercise, then yes. But not .\n[Doctor] . And, do you regularly have any infections in your chest, or anything that needs treatment, normally?\n[Patient] No, uh, I've got hypertension, um, so I'm on some drugs for that, um, but that's it, really.\n[Doctor] OK. Um, any other medical problems?\n[Patient] Uh, just the hypertension and the diabetes.\n[Doctor] OK, and what type of drugs are you on?\n[Patient] Uh, I think something called metformin, and lisinopril I think is the other one.\n[Doctor] OK, and when did you last have your blood pressure checked?\n[Patient] Uh, ooh, uh, a while ago. Um, .\n[Doctor] Do you know if it, do you know if it's been stable?\n[Patient] Uh, I can't remember.\n[Doctor] OK. And with your blood, with your diabetes, have you had a blood test recently?\n[Patient] Um, yeah. Like. Yeah, it was normal. It was around three weeks ago.\n[Doctor] OK, and do you know what dose of the lisinopril you're taking?\n[Patient] Uh, two hundred.\n[Doctor] OK. Have you been able to pass water normally? Any increase in in frequency that you're passing water or any increased thirst?\n[Patient] Uh, no, not particularly.\n[Doctor] And has your weight been stable?\n[Patient] Yeah.\n[Doctor] What is your weight and height?\n[Patient] Uh, my height is five foot five, and my weight is sixty five kilograms.\n[Doctor] OK. And do you smoke at all?\n[Patient] \n[Doctor] You drink any alcohol?\n[Patient] Yes, the odd cherry.\n[Doctor] OK.Um, who do you live with at home?\n[Patient] Uh, my partner and my dog.\n[Doctor] And do you work?\n[Patient] Uh, yes. I'm an office manager.\n[Doctor] OK. And have you been doing anything yourself to help with the symptoms? Anything that you've bought in the chemist?\n[Patient] Um, uh, a quite a few lemon sips. Um, they seems to be helping.\n[Doctor] Do you, what, what do you mean by quite a few? How many in, in a day do you normally take?\n[Patient] Uh, maybe two or three. Maybe, like, at the start of the day and at the end of the day.\n[Doctor] OK. Have you noticed any improvement in that?\n[Patient] Yeah. It tends to soothe my throat a bit for when I'm going to sleep.\n[Doctor] OK. Um, do you have any allergies to anything?\n[Patient] Uh, I sometimes suffer from some, like, hay fever. But, um, but it's not bad \n[Doctor] Any . Any allergies to any medications at all?\n[Patient] Not that I'm aware of, no.\n[Doctor] OK. So, what you've described to me, it sounds like you, you probably have got an infection in the chest, um, because it's, it, you know, you're obviously getting symptoms of from your nose and your chest. Um, it sounds like you might have a high temperature, it's definitely worth getting a thermometer and checking your temperature.\n[Patient] OK. I can just get one of those at a pharmacy or something?\n[Doctor] Yeah, and most of the time, these infections are caused by viruses, so they do normally settle by themselves. But it can take, you know, a week or two, um, and you can persistently have the cough ongoing longer than that. Um, the important thing to do would be to take your temperature. Um, and if you feel like, if the temperature's ongoing, above thirty seven point five, thirty eight, um, and you keep spiking temperatures and that's not settling down, or your cough's getting worse, you're coughing up lots of nasty phlegm or you cough up any blood or get blood coming out your nose, um, or any shortness of breath, chest pain, then we certainly would need to speak to you again. With the diabetes you are a bit more likely to get a bacterial infection than if you didn't have the diabetes, so it's something we do need to be careful of.\n[Patient] OK.\n[Patient] OK. So, then we would at potentially antibiotics at that time, perhaps?\n[Doctor] Yeah, potentially. If it is, if it's not settling or the temperature's ongoing, getting worse, then we definitely need to talk to you again.\n[Patient] OK.\n[Doctor] Um, have you got any other questions?\n[Patient] Um, no, that's all fine.\n[Doctor] It's fine to carry on what you're doing at the moment, with the lemsip. I wouldn't take, and that, that contains paracetamol so don't take any other paracetamol containing products, um, with that at the same time.\n[Patient] Yeah.\n[Doctor] Um, the cough syrup isn't advisable in the daytime because it's best for your body if you just keep coughing. But if you're kept up all night and you can't sleep at all, then it, it's OK to have a little bit of cough syrup, just to settle that down.\n[Patient] OK. Cool.\n[Doctor] OK? Do you have blood sugar checking equipment? Do you check? No, OK. Well, if you make sure that you have the regular diabetes and blood pressure checkups that your GP has asked you for?\n[Patient] Yep.\n[Patient] I'm not at home.\n[Patient] Yeah.\n[Doctor] OK, great. Alright then, take care. Bye.\n[Patient] Alright. Thanks so much. Bye.",
"turns": [
{
"start": 1.24342,
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"text": "Hi there, it's Doctor Smith from Babylon.",
"speaker": "Doctor"
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{
"start": 3.36485,
"end": 4.0608,
"text": "Hi.",
"speaker": "Patient"
},
{
"start": 4.33552,
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"text": "Hi. Can you confirm you name, date of birth and your home address, please?",
"speaker": "Doctor"
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{
"start": 7.79052,
"end": 13.3513,
"text": "Uh, Sandra Bullock, uh, twentieth of February, nineteen fifty eight.",
"speaker": "Patient"
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{
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"text": "Hello. ",
"speaker": "Doctor"
},
{
"start": 15.28942,
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"text": "And your home address?",
"speaker": "Doctor"
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{
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"text": "Uh, seven three four, court in St. .",
"speaker": "Patient"
},
{
"start": 22.13151,
"end": 26.88148,
"text": "OK, that's fine. Uh, are you in a private place that you can have a consultation at the moment?",
"speaker": "Doctor"
},
{
"start": 27.07422,
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"text": "Yeah, yeah, I am.",
"speaker": "Patient"
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{
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"text": "OK, what can I do for you today?",
"speaker": "Doctor"
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{
"start": 30.93908,
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"text": "Um, well, like five days ago I started having problems like a cough, and my nose is just constantly streaming.",
"speaker": "Patient"
},
{
"start": 37.57222,
"end": 41.51957,
"text": "OK. And, and are you normally fit and well?",
"speaker": "Doctor"
},
{
"start": 42.13498,
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"text": "Yeah, normally I'm diabetic, but other than that, like, generally pretty good.",
"speaker": "Patient"
},
{
"start": 47.50639,
"end": 51.32874,
"text": "Right, OK. So, just tell me about the last, did you say five days?",
"speaker": "Doctor"
},
{
"start": 51.61467,
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"text": "Yeah, five days or so ago.",
"speaker": "Patient"
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{
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"text": "OK. How about your cough at the moment?",
"speaker": "Doctor"
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{
"start": 56.12142,
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"text": "Uh, it's quite bad. It's kind of quite dry, um. I'm coughing maybe every twenty, thirty minutes or so.",
"speaker": "Patient"
},
{
"start": 64.61158,
"end": 66.90104,
"text": "OK, you bringing up any phlegm at all?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
},
{
"start": 69.17077,
"end": 71.29576,
"text": "No. Any chest pain?",
"speaker": "Doctor"
},
{
"start": 70.243,
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"text": "No. Chest what, sorry?",
"speaker": "Patient"
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{
"start": 72.91418,
"end": 74.61154,
"text": "Any pain in your chest?",
"speaker": "Doctor"
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{
"start": 74.84434,
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"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 75.99312,
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"text": "Any difficulty breathing, feeling short of breath or any pain when you take a deep breath?",
"speaker": "Doctor"
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{
"start": 81.41865,
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"text": "No, that's all fine.",
"speaker": "Patient"
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"text": "Have you coughed up any blood or anything like that?",
"speaker": "Doctor"
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"start": 85.55088,
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"text": "Nope.",
"speaker": "Patient"
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{
"start": 86.32202,
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"text": "And what about your nose symptoms? Are you front of your sinuses or anything?",
"speaker": "Doctor"
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{
"start": 89.73495,
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"text": "Uh, just . Uh, nothing up in here but just constant streaming, like, using a million tissues.",
"speaker": "Patient"
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{
"start": 98.86801,
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"text": "OK. And any blood coming from the nose?",
"speaker": "Doctor"
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"text": "No, it's pretty green.",
"speaker": "Patient"
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{
"start": 103.86141,
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"text": "Right, OK. Any other symptoms, like sore ears? Sore throat?",
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"text": "Uh, I I've been feeling really hot, um, I don't know if it's fever as such, but, like, to touch I'm quite hot but sometimes I'm feeling really chilly, needing to be under a blanket, that sort of thing.",
"speaker": "Patient"
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"text": "Have you checked your temperature with a thermometer?",
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"text": "Uhh, no, I haven't.",
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{
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"text": "OK. Um, and are you eating and drinking normally?",
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"text": "Uhh, yes. Um, kind of around when it started, I had some diarrhoea, but I don't know if that was associated. But since then it's all been pretty fine.",
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{
"start": 138.79542,
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"text": "OK. So, you're drinking well, holding down fluids OK?",
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"text": "Yeah.",
"speaker": "Patient"
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{
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"end": 145.49934,
"text": "And passing water OK?",
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"text": "Yeah, that's fine.",
"speaker": "Patient"
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{
"start": 146.63092,
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"text": "No vomiting, diarrhoea now?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
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{
"start": 149.64407,
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"text": "OK, that's fine. Um, any rashes that you've noticed?",
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"text": "Rashes? Uhh, no, nothing like that.",
"speaker": "Patient"
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"text": "Yeah. Any headaches or change in your vision?",
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{
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"text": "No, um, I've had quite achy muscles, but that's pretty much it.",
"speaker": "Patient"
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{
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"text": "OK. And normally, do you have any chest problems?",
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"text": "Uh, no.",
"speaker": "Patient"
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"text": "Do you ever get wheezing, short of breath?",
"speaker": "Doctor"
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"text": "Uh, I mean, like, if I do intense exercise, then yes. But not .",
"speaker": "Patient"
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{
"start": 177.94659,
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"text": ". And, do you regularly have any infections in your chest, or anything that needs treatment, normally?",
"speaker": "Doctor"
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{
"start": 185.91949,
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"text": "No, uh, I've got hypertension, um, so I'm on some drugs for that, um, but that's it, really.",
"speaker": "Patient"
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{
"start": 191.7952,
"end": 195.24255,
"text": "OK. Um, any other medical problems?",
"speaker": "Doctor"
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{
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"text": "Uh, just the hypertension and the diabetes.",
"speaker": "Patient"
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{
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"text": "OK, and what type of drugs are you on?",
"speaker": "Doctor"
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{
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"text": "Uh, I think something called metformin, and lisinopril I think is the other one.",
"speaker": "Patient"
},
{
"start": 209.20961,
"end": 211.70302,
"text": "OK, and when did you last have your blood pressure checked?",
"speaker": "Doctor"
},
{
"start": 213.03144,
"end": 220.50515,
"text": "Uh, ooh, uh, a while ago. Um, .",
"speaker": "Patient"
},
{
"start": 217.95958,
"end": 221.27535,
"text": " Do you know if it, do you know if it's been stable?",
"speaker": "Doctor"
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{
"start": 221.93279,
"end": 223.32753,
"text": "Uh, I can't remember.",
"speaker": "Patient"
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{
"start": 223.24245,
"end": 230.57793,
"text": "OK. And with your blood, with your diabetes, have you had a blood test recently?",
"speaker": "Doctor"
},
{
"start": 231.46572,
"end": 240.33417,
"text": "Um, yeah. Like. Yeah, it was normal. It was around three weeks ago.",
"speaker": "Patient"
},
{
"start": 240.81471,
"end": 244.20285,
"text": "OK, and do you know what dose of the lisinopril you're taking?",
"speaker": "Doctor"
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{
"start": 244.88682,
"end": 247.48551,
"text": "Uh, two hundred.",
"speaker": "Patient"
},
{
"start": 248.36731,
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"text": "OK. Have you been able to pass water normally? Any increase in in frequency that you're passing water or any increased thirst?",
"speaker": "Doctor"
},
{
"start": 257.16976,
"end": 259.63029,
"text": "Uh, no, not particularly.",
"speaker": "Patient"
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{
"start": 259.75542,
"end": 261.87383,
"text": "And has your weight been stable?",
"speaker": "Doctor"
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{
"start": 262.72241,
"end": 263.47241,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 263.47909,
"end": 265.57777,
"text": "What is your weight and height?",
"speaker": "Doctor"
},
{
"start": 265.86057,
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"text": "Uh, my height is five foot five, and my weight is sixty five kilograms.",
"speaker": "Patient"
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{
"start": 272.87378,
"end": 275.57771,
"text": "OK. And do you smoke at all?",
"speaker": "Doctor"
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"start": 275.93298,
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"text": "",
"speaker": "Patient"
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{
"start": 276.65666,
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"text": "You drink any alcohol?",
"speaker": "Doctor"
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{
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"text": "Yes, the odd cherry.",
"speaker": "Patient"
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{
"start": 281.41981,
"end": 284.12376,
"text": "OK.Um, who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 284.51853,
"end": 286.5909,
"text": "Uh, my partner and my dog.",
"speaker": "Patient"
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{
"start": 288.13032,
"end": 289.70926,
"text": "And do you work?",
"speaker": "Doctor"
},
{
"start": 290.27512,
"end": 293.30803,
"text": "Uh, yes. I'm an office manager.",
"speaker": "Patient"
},
{
"start": 293.21582,
"end": 300.99868,
"text": "OK. And have you been doing anything yourself to help with the symptoms? Anything that you've bought in the chemist?",
"speaker": "Doctor"
},
{
"start": 302.01859,
"end": 308.49888,
"text": "Um, uh, a quite a few lemon sips. Um, they seems to be helping.",
"speaker": "Patient"
},
{
"start": 306.97233,
"end": 312.38021,
"text": " Do you, what, what do you mean by quite a few? How many in, in a day do you normally take?",
"speaker": "Doctor"
},
{
"start": 312.7489,
"end": 316.59102,
"text": "Uh, maybe two or three. Maybe, like, at the start of the day and at the end of the day.",
"speaker": "Patient"
},
{
"start": 316.88678,
"end": 319.44598,
"text": "OK. Have you noticed any improvement in that?",
"speaker": "Doctor"
},
{
"start": 320.32129,
"end": 323.71604,
"text": "Yeah. It tends to soothe my throat a bit for when I'm going to sleep.",
"speaker": "Patient"
},
{
"start": 324.46572,
"end": 328.32096,
"text": "OK. Um, do you have any allergies to anything?",
"speaker": "Doctor"
},
{
"start": 329.14369,
"end": 333.64371,
"text": "Uh, I sometimes suffer from some, like, hay fever. But, um, but it's not bad ",
"speaker": "Patient"
},
{
"start": 332.242,
"end": 335.80778,
"text": "Any . Any allergies to any medications at all?",
"speaker": "Doctor"
},
{
"start": 336.05161,
"end": 337.61082,
"text": "Not that I'm aware of, no.",
"speaker": "Patient"
},
{
"start": 337.82752,
"end": 358.21594,
"text": "OK. So, what you've described to me, it sounds like you, you probably have got an infection in the chest, um, because it's, it, you know, you're obviously getting symptoms of from your nose and your chest. Um, it sounds like you might have a high temperature, it's definitely worth getting a thermometer and checking your temperature.",
"speaker": "Doctor"
},
{
"start": 358.49908,
"end": 361.57804,
"text": "OK. I can just get one of those at a pharmacy or something?",
"speaker": "Patient"
},
{
"start": 361.90049,
"end": 419.5849,
"text": "Yeah, and most of the time, these infections are caused by viruses, so they do normally settle by themselves. But it can take, you know, a week or two, um, and you can persistently have the cough ongoing longer than that. Um, the important thing to do would be to take your temperature. Um, and if you feel like, if the temperature's ongoing, above thirty seven point five, thirty eight, um, and you keep spiking temperatures and that's not settling down, or your cough's getting worse, you're coughing up lots of nasty phlegm or you cough up any blood or get blood coming out your nose, um, or any shortness of breath, chest pain, then we certainly would need to speak to you again. With the diabetes you are a bit more likely to get a bacterial infection than if you didn't have the diabetes, so it's something we do need to be careful of.",
"speaker": "Doctor"
},
{
"start": 411.11116,
"end": 411.85458,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 420.62436,
"end": 424.96648,
"text": "OK. So, then we would at potentially antibiotics at that time, perhaps?",
"speaker": "Patient"
},
{
"start": 424.74596,
"end": 430.77279,
"text": "Yeah, potentially. If it is, if it's not settling or the temperature's ongoing, getting worse, then we definitely need to talk to you again.",
"speaker": "Doctor"
},
{
"start": 430.92703,
"end": 431.7165,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 431.77279,
"end": 435.0211,
"text": "Um, have you got any other questions?",
"speaker": "Doctor"
},
{
"start": 435.63757,
"end": 438.04547,
"text": "Um, no, that's all fine.",
"speaker": "Patient"
},
{
"start": 437.95558,
"end": 451.29112,
"text": "It's fine to carry on what you're doing at the moment, with the lemsip. I wouldn't take, and that, that contains paracetamol so don't take any other paracetamol containing products, um, with that at the same time.",
"speaker": "Doctor"
},
{
"start": 445.79295,
"end": 446.33111,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 451.29112,
"end": 464.63848,
"text": "Um, the cough syrup isn't advisable in the daytime because it's best for your body if you just keep coughing. But if you're kept up all night and you can't sleep at all, then it, it's OK to have a little bit of cough syrup, just to settle that down.",
"speaker": "Doctor"
},
{
"start": 465.35481,
"end": 466.5127,
"text": "OK. Cool.",
"speaker": "Patient"
},
{
"start": 467.21566,
"end": 483.1206,
"text": "OK? Do you have blood sugar checking equipment? Do you check? No, OK. Well, if you make sure that you have the regular diabetes and blood pressure checkups that your GP has asked you for?",
"speaker": "Doctor"
},
{
"start": 468.55876,
"end": 469.15744,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 473.11798,
"end": 474.40746,
"text": "I'm not at home.",
"speaker": "Patient"
},
{
"start": 483.42779,
"end": 483.94697,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 484.32126,
"end": 489.23998,
"text": "OK, great. Alright then, take care. Bye.",
"speaker": "Doctor"
},
{
"start": 485.05881,
"end": 489.17998,
"text": " Alright. Thanks so much. Bye.",
"speaker": "Patient"
}
],
"doctor_utterances": "Hi there, it's Doctor Smith from Babylon. Hi. Can you confirm you name, date of birth and your home address, please? Hello. And your home address? OK, that's fine. Uh, are you in a private place that you can have a consultation at the moment? OK, what can I do for you today? OK. And, and are you normally fit and well? Right, OK. So, just tell me about the last, did you say five days? OK. How about your cough at the moment? OK, you bringing up any phlegm at all? No. Any chest pain? Any pain in your chest? Any difficulty breathing, feeling short of breath or any pain when you take a deep breath? Have you coughed up any blood or anything like that? And what about your nose symptoms? Are you front of your sinuses or anything? OK. And any blood coming from the nose? Right, OK. Any other symptoms, like sore ears? Sore throat? Have you checked your temperature with a thermometer? OK. Um, and are you eating and drinking normally? OK. So, you're drinking well, holding down fluids OK? And passing water OK? No vomiting, diarrhoea now? OK, that's fine. Um, any rashes that you've noticed? Yeah. Any headaches or change in your vision? OK. And normally, do you have any chest problems? Do you ever get wheezing, short of breath? . And, do you regularly have any infections in your chest, or anything that needs treatment, normally? OK. Um, any other medical problems? OK, and what type of drugs are you on? OK, and when did you last have your blood pressure checked? Do you know if it, do you know if it's been stable? OK. And with your blood, with your diabetes, have you had a blood test recently? OK, and do you know what dose of the lisinopril you're taking? OK. Have you been able to pass water normally? Any increase in in frequency that you're passing water or any increased thirst? And has your weight been stable? What is your weight and height? OK. And do you smoke at all? You drink any alcohol? OK.Um, who do you live with at home? And do you work? OK. And have you been doing anything yourself to help with the symptoms? Anything that you've bought in the chemist? Do you, what, what do you mean by quite a few? How many in, in a day do you normally take? OK. Have you noticed any improvement in that? OK. Um, do you have any allergies to anything? Any . Any allergies to any medications at all? OK. So, what you've described to me, it sounds like you, you probably have got an infection in the chest, um, because it's, it, you know, you're obviously getting symptoms of from your nose and your chest. Um, it sounds like you might have a high temperature, it's definitely worth getting a thermometer and checking your temperature. Yeah, and most of the time, these infections are caused by viruses, so they do normally settle by themselves. But it can take, you know, a week or two, um, and you can persistently have the cough ongoing longer than that. Um, the important thing to do would be to take your temperature. Um, and if you feel like, if the temperature's ongoing, above thirty seven point five, thirty eight, um, and you keep spiking temperatures and that's not settling down, or your cough's getting worse, you're coughing up lots of nasty phlegm or you cough up any blood or get blood coming out your nose, um, or any shortness of breath, chest pain, then we certainly would need to speak to you again. With the diabetes you are a bit more likely to get a bacterial infection than if you didn't have the diabetes, so it's something we do need to be careful of. Yeah, potentially. If it is, if it's not settling or the temperature's ongoing, getting worse, then we definitely need to talk to you again. Um, have you got any other questions? It's fine to carry on what you're doing at the moment, with the lemsip. I wouldn't take, and that, that contains paracetamol so don't take any other paracetamol containing products, um, with that at the same time. Um, the cough syrup isn't advisable in the daytime because it's best for your body if you just keep coughing. But if you're kept up all night and you can't sleep at all, then it, it's OK to have a little bit of cough syrup, just to settle that down. OK? Do you have blood sugar checking equipment? Do you check? No, OK. Well, if you make sure that you have the regular diabetes and blood pressure checkups that your GP has asked you for? OK, great. Alright then, take care. Bye.",
"patient_utterances": "Hi. Uh, Sandra Bullock, uh, twentieth of February, nineteen fifty eight. Uh, seven three four, court in St. . Yeah, yeah, I am. Um, well, like five days ago I started having problems like a cough, and my nose is just constantly streaming. Yeah, normally I'm diabetic, but other than that, like, generally pretty good. Yeah, five days or so ago. Uh, it's quite bad. It's kind of quite dry, um. I'm coughing maybe every twenty, thirty minutes or so. No. No. Chest what, sorry? Uh, no. No, that's all fine. Nope. Uh, just . Uh, nothing up in here but just constant streaming, like, using a million tissues. No, it's pretty green. Uh, I I've been feeling really hot, um, I don't know if it's fever as such, but, like, to touch I'm quite hot but sometimes I'm feeling really chilly, needing to be under a blanket, that sort of thing. Uhh, no, I haven't. Uhh, yes. Um, kind of around when it started, I had some diarrhoea, but I don't know if that was associated. But since then it's all been pretty fine. Yeah. Yeah, that's fine. No. Rashes? Uhh, no, nothing like that. No, um, I've had quite achy muscles, but that's pretty much it. Uh, no. Uh, I mean, like, if I do intense exercise, then yes. But not . No, uh, I've got hypertension, um, so I'm on some drugs for that, um, but that's it, really. Uh, just the hypertension and the diabetes. Uh, I think something called metformin, and lisinopril I think is the other one. Uh, ooh, uh, a while ago. Um, . Uh, I can't remember. Um, yeah. Like. Yeah, it was normal. It was around three weeks ago. Uh, two hundred. Uh, no, not particularly. Yeah. Uh, my height is five foot five, and my weight is sixty five kilograms. Yes, the odd cherry. Uh, my partner and my dog. Uh, yes. I'm an office manager. Um, uh, a quite a few lemon sips. Um, they seems to be helping. Uh, maybe two or three. Maybe, like, at the start of the day and at the end of the day. Yeah. It tends to soothe my throat a bit for when I'm going to sleep. Uh, I sometimes suffer from some, like, hay fever. But, um, but it's not bad Not that I'm aware of, no. OK. I can just get one of those at a pharmacy or something? OK. OK. So, then we would at potentially antibiotics at that time, perhaps? OK. Um, no, that's all fine. Yeah. OK. Cool. Yep. I'm not at home. Yeah. Alright. Thanks so much. Bye.",
"num_turns": 108,
"reference_note": "{\"day\": 5, \"consultation\": 7, \"presenting_complaint\": \"Cough and a cold\", \"note\": \"PC: Cough and cold.\\nHPC: 4-5 day hx runny nose, dry cough. No sputum/haemoptysis. No epistaxis/sinus pain. Feels hot, hasn't measured temperature. No SOB/inspiratory pain/wheeze. Aches and pains. No vomiting. E&D ok. PUing ok. \\nNo hx chest problems/recurrent chest infections/wt loss.\\nThinks last BP was fine, can't remember when last BP/DM check up was. Doesn't check blood sugars/urine at home. \\nNo increased thirst/urinary freq.\\nTaking 2-3 lemsips a day which eases sx.\\n\\nPMH: Hypertension\\nT2 DM\\n\\nDH: Lisinopril \\nMetformin\\n\\nHeight- 5ft 5in\\nWeight - 65kg\\n\\nSH: Non smoker, odd sherry. Lives with partner and dog. Office manager.\\n\\nImp: Viral bronchitis.\\n\\nPlan: Advised continue lemsips but no other paracetamol containing products. Avoid cough syrup but can take if unable to sleep at night. \\nMay take 1-2 weeks to settle and cough can persist for up to a month but to contact us if symptoms not worse/fever persists - check with thermometer/coughing up phlegm/blood in sputum/nose bleeds.\\n\", \"highlights\": [\"No sputum/haemoptysis\", \"No SOB/inspiratory pain/wheeze\", \"T2 DM\", \"Non smoker\"]}",
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"dialogue": "[Patient] Hello.\n[Doctor] Hi there, it's Doctor Smith from Babylon. Can you confirm your name, date of birth and your address, please?\n[Patient] Uh, date of birth twenty second of december, nineteen ninety. Uh, address, uh, sixteen avenue.\n[Doctor] OK, that's fine. Are you in a private place so you can have a consultation?\n[Patient] Yeah, sure.\n[Doctor] What can I do for you today?\n[Patient] So, um, recently I'm wheezy. Uh, I have feel like kind of short of breath.\n[Doctor] OK, and how long has that been going on for?\n[Patient] Mmm, two, three days. Yeah, quite recently.\n[Doctor] And have you ever had similar symptoms in the past?\n[Patient] Um, I think so. It was a while before, yeah, but I can't remember.\n[Doctor] As, was that as an adult or as a child?\n[Patient] Sorry? Oh, as a , as a adult, yeah.\n[Doctor] How long ago was that?\n[Patient] Sorry?\n[Doctor] How long ago was that, that you had similar symptoms?\n[Patient] I can't remember, sorry.\n[Doctor] And any problems with wheezing when you were a child or any asthma?\n[Patient] Uh, yes, I had asthma. I also had, uh, hay fever and eczema , sorry.\n[Doctor] OK, and when you were a child how bad was your asthma?\n[Patient] Uh, it's quite bad.\n[Doctor] Did you have to take medication?\n[Patient] Yeah, I take the asthma inhaler.\n[Doctor] Do you know which ones you took?\n[Patient] No, I can't remember.\n[Doctor] And did you ever have to go to hospital with it?\n[Patient] Yeah, sometimes.\n[Doctor] Did you ever get severely unwell, have to be on intensive care unit or anything like that?\n[Patient] No, not that bad but still, sometimes, need to go to hospital to check if it goes well.\n[Doctor] Did you have to miss school?\n[Patient] Uh, yeah, occasionally.\n[Doctor] OK. And when do you think it last, when do you think that asthma stopped? At what age did you get to a point where you weren't taking medication anymore?\n[Patient] Mmm.\n[Patient] Few years ago, like, three or four years ago I think? Yeah.\n[Doctor] And so this time, how did it start? Did you have any other symptoms? Any chest pain, temperature, cold symptoms, anything like that?\n[Patient] Yeah, so I have, I have cough and cough a lot, and I have a fever. Um, I also used to walk to work but recently I can't because it's, I, I feel like very short of breath and sometimes I feel like I can't even finish sentence is quite difficult to, to complete the, the the talking sometimes, yeah. Occasionally.\n[Doctor] Right. Have you coughed any phlegm up or anything like that?\n[Patient] No.\n[Doctor] Any, any, um, blood in there when you cough?\n[Patient] No, I don't think so.\n[Doctor] OK. And any chest pain?\n[Patient] No chest pain, no.\n[Doctor] Have you been woken up at night time at all?\n[Patient] No, just daytime working, yeah.\n[Doctor] Have you been able to do any exercise?\n[Patient] No, I can't.\n[Doctor] OK, and do you have a peak flow meter at home, where you measure your breathing?\n[Patient] Sorry?\n[Doctor] You have what's called a peak flow meter, which you breathe into to get a score on your breathing?\n[Patient] No, no.\n[Doctor] And do you normally take any asthma inhalers over the last few years?\n[Patient] Yes, yeah.\n[Doctor] You do? So you said you stopped them three to four years ago?\n[Patient] \n[Patient] Ohh, um, when I had asthma I used to take this inhaler, yeah.\n[Doctor] OK. How about over the last three to four years?\n[Patient] Yeah.\n[Doctor] Have you taken any medication?\n[Patient] Um, I took salbutamol? Salbutamol? Yeah.\n[Doctor] OK, so you, you normally take that do you? Or is that just recently?\n[Patient] Normally, yeah.\n[Doctor] OK, and how often do you normally need it?\n[Patient] Every, every few weeks? I'm not sure.\n[Doctor] OK. What about when you exercise normally, do you have to use medication? Uh, inhalers?\n[Patient] Yeah, yeah, a bit.\n[Doctor] Pardon?\n[Patient] Yeah.\n[Doctor] OK, um, and do you take any other medications?\n[Patient] No, nothing else.\n[Doctor] Any other medical problems?\n[Patient] Uh, I have, uh, hay fever as well.\n[Doctor] OK, do you take anything for that?\n[Patient] No.\n[Doctor] And any allergies to medications?\n[Patient] No, no allergies.\n[Doctor] Do you smoke?\n[Patient] No, I don't smoke.\n[Doctor] Do you drink any alcohol regularly?\n[Patient] Yeah, one glass.\n[Doctor] How often? Have a glass of what?\n[Patient] Today, yeah. Uh, one glass of wine.\n[Doctor] Every, how often did you say?\n[Patient] Every two or three days? Depends, yeah.\n[Doctor] And who do you live with at home?\n[Patient] Yeah.\n[Doctor] Who do you live with at home?\n[Patient] Yeah, .\n[Doctor] Who do you live with, do you live on your own, or do you live with\n[Patient] I live with my partner.\n[Doctor] OK, and what's your job, day-to-day?\n[Patient] Uh, I'm engineer.\n[Doctor] And have you been at work in the last few days?\n[Patient] No I can't because I used to walk walk to work, but recently I, I work from home or sometimes I take sick leave, yeah.\n[Doctor] OK, and when, at the moment, are you, um, feeling short of breath when you're sitting still? Or just when you walk?\n[Patient] No.\n[Patient] Just walk or sometimes, but currently I feel, I feel well.\n[Doctor] Are you able to get up and down the stairs OK?\n[Patient] Yeah.\n[Doctor] Right, OK. Um, and did you say you were finding it hard to complete your sentences?\n[Patient] Yeah, sometimes.\n[Doctor] OK, um.\n[Patient] Yeah, , days, yeah.\n[Doctor] Right, OK. Um, I mean, it sounds like you've had a flare up of your asthma. It could be, um, triggered by, if there's more pollen around, or there may be, you may have a viral infection, causing it to get worse.\n[Patient] Mm-hmm. Mm-hmm.\n[Doctor] Did you say you checked your temperature already?\n[Patient] Yes, I checked, I have fever .\n[Doctor] Was it normal?\n[Patient] Yeah, yeah.\n[Doctor] What was your temperature?\n[Patient] Uh, thirty seven, yeah.\n[Doctor] OK, that's fine. Um, have you got an asthma inhaler at home?\n[Patient] Yeah.\n[Doctor] OK. So what I would suggest is you take it more regularly than you are doing at the moment. Have you got, um, a spacer at home?\n[Patient] Mm-hmm.\n[Patient] Um, do you want to show me how to do it or somehow?\n[Doctor] Um, do you have a spacer at home?\n[Patient] No.\n[Doctor] OK. Um, what I can do is, I can prescribe you a peak flow meter so we can check your breathing level and a spacer to use your inhaler a bit more efficiently, which the pharmacist can show you how you use that when you pick it up.\n[Patient] Yeah, sure.\n[Doctor] Um, and if you increase it so you're taking it two to four puffs, like, every four hours?\n[Patient] Mm-hmm.\n[Doctor] Initially, um, if you get a high temperature or your wheezing is getting worse, you need to call us back straightaway so we can just advise you further with that.\n[Patient] OK.\n[Doctor] And it will be a good idea when you're feeling better if we can arrange just a review, just to see how your asthma is, because we may need to start some other medication for you.\n[Patient] OK, sounds good, yeah.\n[Doctor] You could arrange a review in a week or so, um, but, but before that and if you're, if you're feeling worse.\n[Patient] In a week, right? OK.\n[Doctor] OK, and the other thing to do would be to take a regular antihistamine.\n[Patient] Mm-hmm.\n[Doctor] Which you can get from the pharmacy, I can put a on your notes about what to take.\n[Patient] Yeah.\n[Patient] Yeah, they'll be helpful.\n[Doctor] And then if you, when you get the peak flow meter, if you can take, the pharmacist can show you how to use it, and if you can record a value first thing when you wake up.\n[Patient] Mm-hmm.\n[Doctor] And in the evening over the next week, and then we can discuss that over the phone when we look at the figures and see whether you need to go on another inhaler as well.\n[Patient] Oh, awesome, thank you.\n[Doctor] Have you got any questions?\n[Patient] Um, no, that's fine, yeah, thank you very much.\n[Doctor] Thanks a lot, bye.\n[Patient] ",
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{
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"text": "OK, so you, you normally take that do you? Or is that just recently?",
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"text": "Normally, yeah.",
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{
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"text": "OK, and how often do you normally need it?",
"speaker": "Doctor"
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{
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"text": "Every, every few weeks? I'm not sure.",
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{
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"text": "OK. What about when you exercise normally, do you have to use medication? Uh, inhalers?",
"speaker": "Doctor"
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{
"start": 278.0454,
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"text": " Yeah, yeah, a bit.",
"speaker": "Patient"
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{
"start": 280.91673,
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"text": "Pardon?",
"speaker": "Doctor"
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{
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"text": "Yeah.",
"speaker": "Patient"
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{
"start": 284.36448,
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"text": "OK, um, and do you take any other medications?",
"speaker": "Doctor"
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{
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"text": "No, nothing else.",
"speaker": "Patient"
},
{
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"text": "Any other medical problems?",
"speaker": "Doctor"
},
{
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"text": "Uh, I have, uh, hay fever as well.",
"speaker": "Patient"
},
{
"start": 299.08085,
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"text": "OK, do you take anything for that?",
"speaker": "Doctor"
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{
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"text": "No.",
"speaker": "Patient"
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{
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"text": "And any allergies to medications?",
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"text": "No, no allergies.",
"speaker": "Patient"
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{
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"text": "Do you smoke?",
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{
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"text": "No, I don't smoke.",
"speaker": "Patient"
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{
"start": 312.68528,
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"text": "Do you drink any alcohol regularly?",
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{
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"text": "Yeah, one glass.",
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"text": "How often? Have a glass of what?",
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"text": "Today, yeah. Uh, one glass of wine.",
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"text": "Every, how often did you say?",
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"text": "Every two or three days? Depends, yeah.",
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"text": "And who do you live with at home?",
"speaker": "Doctor"
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"text": "Yeah.",
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"text": "Yeah, .",
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"text": "OK, and what's your job, day-to-day?",
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"text": "OK, and when, at the moment, are you, um, feeling short of breath when you're sitting still? Or just when you walk?",
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"text": "Right, OK. Um, and did you say you were finding it hard to complete your sentences?",
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"text": "Yeah, sometimes.",
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"text": "OK, um.",
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"text": "Yeah, , days, yeah.",
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"text": "Right, OK. Um, I mean, it sounds like you've had a flare up of your asthma. It could be, um, triggered by, if there's more pollen around, or there may be, you may have a viral infection, causing it to get worse.",
"speaker": "Doctor"
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"text": "Mm-hmm. Mm-hmm.",
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"text": "Yes, I checked, I have fever .",
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"text": "Was it normal?",
"speaker": "Doctor"
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{
"start": 419.91091,
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"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 421.28186,
"end": 422.87887,
"text": " What was your temperature?",
"speaker": "Doctor"
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{
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"text": "Uh, thirty seven, yeah.",
"speaker": "Patient"
},
{
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"text": "OK, that's fine. Um, have you got an asthma inhaler at home?",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "OK. So what I would suggest is you take it more regularly than you are doing at the moment. Have you got, um, a spacer at home?",
"speaker": "Doctor"
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"text": "Mm-hmm.",
"speaker": "Patient"
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{
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"text": "Um, do you want to show me how to do it or somehow?",
"speaker": "Patient"
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"text": "Um, do you have a spacer at home?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
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{
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"text": "OK. Um, what I can do is, I can prescribe you a peak flow meter so we can check your breathing level and a spacer to use your inhaler a bit more efficiently, which the pharmacist can show you how you use that when you pick it up.",
"speaker": "Doctor"
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{
"start": 471.76523,
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"text": "Yeah, sure.",
"speaker": "Patient"
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{
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"text": "Um, and if you increase it so you're taking it two to four puffs, like, every four hours?",
"speaker": "Doctor"
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{
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"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 480.46069,
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"text": "Initially, um, if you get a high temperature or your wheezing is getting worse, you need to call us back straightaway so we can just advise you further with that.",
"speaker": "Doctor"
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{
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"text": "OK.",
"speaker": "Patient"
},
{
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"text": "And it will be a good idea when you're feeling better if we can arrange just a review, just to see how your asthma is, because we may need to start some other medication for you.",
"speaker": "Doctor"
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{
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"text": "OK, sounds good, yeah.",
"speaker": "Patient"
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{
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"text": "You could arrange a review in a week or so, um, but, but before that and if you're, if you're feeling worse.",
"speaker": "Doctor"
},
{
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"text": "In a week, right? OK.",
"speaker": "Patient"
},
{
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"text": "OK, and the other thing to do would be to take a regular antihistamine.",
"speaker": "Doctor"
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{
"start": 523.20289,
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"text": "Mm-hmm.",
"speaker": "Patient"
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{
"start": 523.97541,
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"text": "Which you can get from the pharmacy, I can put a on your notes about what to take.",
"speaker": "Doctor"
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{
"start": 526.84873,
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "Yeah, they'll be helpful.",
"speaker": "Patient"
},
{
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"text": "And then if you, when you get the peak flow meter, if you can take, the pharmacist can show you how to use it, and if you can record a value first thing when you wake up.",
"speaker": "Doctor"
},
{
"start": 541.79322,
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"text": "Mm-hmm.",
"speaker": "Patient"
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{
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"text": "And in the evening over the next week, and then we can discuss that over the phone when we look at the figures and see whether you need to go on another inhaler as well.",
"speaker": "Doctor"
},
{
"start": 550.8954,
"end": 552.99419,
"text": "Oh, awesome, thank you.",
"speaker": "Patient"
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{
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"text": "Have you got any questions?",
"speaker": "Doctor"
},
{
"start": 555.29841,
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"text": "Um, no, that's fine, yeah, thank you very much.",
"speaker": "Patient"
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{
"start": 559.35584,
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"text": "Thanks a lot, bye.",
"speaker": "Doctor"
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"doctor_utterances": "Hi there, it's Doctor Smith from Babylon. Can you confirm your name, date of birth and your address, please? OK, that's fine. Are you in a private place so you can have a consultation? What can I do for you today? OK, and how long has that been going on for? And have you ever had similar symptoms in the past? As, was that as an adult or as a child? How long ago was that? How long ago was that, that you had similar symptoms? And any problems with wheezing when you were a child or any asthma? OK, and when you were a child how bad was your asthma? Did you have to take medication? Do you know which ones you took? And did you ever have to go to hospital with it? Did you ever get severely unwell, have to be on intensive care unit or anything like that? Did you have to miss school? OK. And when do you think it last, when do you think that asthma stopped? At what age did you get to a point where you weren't taking medication anymore? And so this time, how did it start? Did you have any other symptoms? Any chest pain, temperature, cold symptoms, anything like that? Right. Have you coughed any phlegm up or anything like that? Any, any, um, blood in there when you cough? OK. And any chest pain? Have you been woken up at night time at all? Have you been able to do any exercise? OK, and do you have a peak flow meter at home, where you measure your breathing? You have what's called a peak flow meter, which you breathe into to get a score on your breathing? And do you normally take any asthma inhalers over the last few years? You do? So you said you stopped them three to four years ago? OK. How about over the last three to four years? Have you taken any medication? OK, so you, you normally take that do you? Or is that just recently? OK, and how often do you normally need it? OK. What about when you exercise normally, do you have to use medication? Uh, inhalers? Pardon? OK, um, and do you take any other medications? Any other medical problems? OK, do you take anything for that? And any allergies to medications? Do you smoke? Do you drink any alcohol regularly? How often? Have a glass of what? Every, how often did you say? And who do you live with at home? Who do you live with at home? Who do you live with, do you live on your own, or do you live with OK, and what's your job, day-to-day? And have you been at work in the last few days? OK, and when, at the moment, are you, um, feeling short of breath when you're sitting still? Or just when you walk? Are you able to get up and down the stairs OK? Right, OK. Um, and did you say you were finding it hard to complete your sentences? OK, um. Right, OK. Um, I mean, it sounds like you've had a flare up of your asthma. It could be, um, triggered by, if there's more pollen around, or there may be, you may have a viral infection, causing it to get worse. Did you say you checked your temperature already? Was it normal? What was your temperature? OK, that's fine. Um, have you got an asthma inhaler at home? OK. So what I would suggest is you take it more regularly than you are doing at the moment. Have you got, um, a spacer at home? Um, do you have a spacer at home? OK. Um, what I can do is, I can prescribe you a peak flow meter so we can check your breathing level and a spacer to use your inhaler a bit more efficiently, which the pharmacist can show you how you use that when you pick it up. Um, and if you increase it so you're taking it two to four puffs, like, every four hours? Initially, um, if you get a high temperature or your wheezing is getting worse, you need to call us back straightaway so we can just advise you further with that. And it will be a good idea when you're feeling better if we can arrange just a review, just to see how your asthma is, because we may need to start some other medication for you. You could arrange a review in a week or so, um, but, but before that and if you're, if you're feeling worse. OK, and the other thing to do would be to take a regular antihistamine. Which you can get from the pharmacy, I can put a on your notes about what to take. And then if you, when you get the peak flow meter, if you can take, the pharmacist can show you how to use it, and if you can record a value first thing when you wake up. And in the evening over the next week, and then we can discuss that over the phone when we look at the figures and see whether you need to go on another inhaler as well. Have you got any questions? Thanks a lot, bye.",
"patient_utterances": "Hello. Uh, date of birth twenty second of december, nineteen ninety. Uh, address, uh, sixteen avenue. Yeah, sure. So, um, recently I'm wheezy. Uh, I have feel like kind of short of breath. Mmm, two, three days. Yeah, quite recently. Um, I think so. It was a while before, yeah, but I can't remember. Sorry? Oh, as a , as a adult, yeah. Sorry? I can't remember, sorry. Uh, yes, I had asthma. I also had, uh, hay fever and eczema , sorry. Uh, it's quite bad. Yeah, I take the asthma inhaler. No, I can't remember. Yeah, sometimes. No, not that bad but still, sometimes, need to go to hospital to check if it goes well. Uh, yeah, occasionally. Mmm. Few years ago, like, three or four years ago I think? Yeah. Yeah, so I have, I have cough and cough a lot, and I have a fever. Um, I also used to walk to work but recently I can't because it's, I, I feel like very short of breath and sometimes I feel like I can't even finish sentence is quite difficult to, to complete the, the the talking sometimes, yeah. Occasionally. No. No, I don't think so. No chest pain, no. No, just daytime working, yeah. No, I can't. Sorry? No, no. Yes, yeah. Ohh, um, when I had asthma I used to take this inhaler, yeah. Yeah. Um, I took salbutamol? Salbutamol? Yeah. Normally, yeah. Every, every few weeks? I'm not sure. Yeah, yeah, a bit. Yeah. No, nothing else. Uh, I have, uh, hay fever as well. No. No, no allergies. No, I don't smoke. Yeah, one glass. Today, yeah. Uh, one glass of wine. Every two or three days? Depends, yeah. Yeah. Yeah, . I live with my partner. Uh, I'm engineer. No I can't because I used to walk walk to work, but recently I, I work from home or sometimes I take sick leave, yeah. No. Just walk or sometimes, but currently I feel, I feel well. Yeah. Yeah, sometimes. Yeah, , days, yeah. Mm-hmm. Mm-hmm. Yes, I checked, I have fever . Yeah, yeah. Uh, thirty seven, yeah. Yeah. Mm-hmm. Um, do you want to show me how to do it or somehow? No. Yeah, sure. Mm-hmm. OK. OK, sounds good, yeah. In a week, right? OK. Mm-hmm. Yeah. Yeah, they'll be helpful. Mm-hmm. Oh, awesome, thank you. Um, no, that's fine, yeah, thank you very much. ",
"num_turns": 140,
"reference_note": "{\"day\": 5, \"consultation\": 8, \"presenting_complaint\": \"I'm wheezy\", \"note\": \"PC: Wheeze\\n\\nHPC: 2-3 hx wheeze. No fever, has checked temp - 37. Cold symptoms. Not coughing up sputum, no haemoptysis/CP. Not night time waking. Not exercising at the moment. Sometimes can't complete sentences but no SOB at rest, no problems walking upstairs. More wheezy walking to work. Doesn't have peak flow meter at home. Has missed a few days of work.\\nHx asthma as a child, took inhalers ? what. Had hospital admissions and missed school. No ITU. Stopped medication 3-4 years ago but sometimes takes salbutamol still every few weeks. Needs salbutamol when exercises.\\n\\nPMH Asthma, Hayfever\\n\\nDH Salbutamol NKDA\\n\\nSH: Non smoker. 1U alcohol every 2-3 days. Lives with partner. Works as engineer.\\n\\nImp: Exacerbation asthma\\n\\nPlan: Continue to monitor temperature and speak to us if spiking temperatures.\\nCollect prescription of peak flow meter and spacer. Pharmacist can advise on usage. Record PEFR twice daily, first on waking and at night. Increase salbutamol with spacer to 2-4 puffs 4hrly and arrange a review with us next week. May need to add in another inhaler. If wheeze not settling/getting worse in meantime if feels unwell for urgent appointment. \\n\", \"highlights\": [\"Wheeze\", \"No fever\", \"Not coughing up sputum\", \"Sometimes can't complete sentences but no SOB at rest\", \"Stopped medication 3-4 years ago but sometimes takes salbutamol still every few weeks\"]}",
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"dialogue": "[Patient] Hi.\n[Doctor] Hi there. It's Doctor Smith from Babylon. Hi Doctor Smith. Hi, can you confirm your name, date of birth, and your home address please?\n[Patient] Hi Doctor Smith.\n[Patient] Yes. My name is Mary Jo. Date of birth is January first, nineteen eighty.\n[Doctor] \n[Patient] And my address is uh, sixty Sloane Avenue, London.\n[Doctor] OK, I, are you in a private place where you can have a consultation today?\n[Patient] Absolutely.\n[Doctor] What can I do for you?\n[Patient] So, a couple of things. I, I, think I may have, overdone my workouts, and now my knees are hurting, and they're clicking a lot, and it's starting to worry me. Um, I can't run very far, um, any more without just feeling, pain in my knees. And then, sometimes I also get this weird tingling in my toes. Um. So yeah, that's, that's it. I'm just concerned and I figured you know I'd call and, see if you can, help me figure out what's going on.\n[Doctor] OK, that's fine. So when do you think it started?\n[Patient] So probably, it's been about two weeks.\n[Doctor] OK. Um, and, any joint problems before that?\n[Patient] You know not, not really. I mean I play a lot of sports. Um, and I had a , like I play some ice hockey, and I had this injury a few months ago. You know I just like, fell on the ice and, and, you know had a, huge bruise but, I think that's about it.\n[Doctor] OK, So, um, at the moment, just tell me about the exercise that you're doing, normally.\n[Patient] So I'm training, well, I'm currently training for a marathon, um, that's gonna happen in, June. And so, I'm trying to run like. I mean right now, I'm actually not even doing such long runs, maybe like seven or eight miles. And so, I started about uh, maybe a month ago.\n[Doctor] \n[Patient] Uh, I've done like, you know, four or five miles, and I've just done like a couple of seven, mile runs. And then uh, uh, and then you know I go to the gym like few times a week and, kinda do my, usual routine.\n[Doctor] \n[Patient] Um, but, yeah, I think the only thing that's really different has, have been, the runs, the longer runs.\n[Doctor] And, have you had, any times when the knee feels like it's giving way underneath you?\n[Patient] Um, well, I, what do you mean by that? I'm not sure what, what that means.\n[Doctor] So, it means if you're, if you're there and uh, you just feel it sort of jolt, like give way, feel unstable underneath you.\n[Patient] Not, not bad, I mean it just kinda starts hurting, you know. Um.\n[Doctor] And does it hurt, uh, how far into the run does it generally hurt?\n[Patient] You know I would say probably starts off like after, uh, maybe, twenty minutes or so. Which is, probably I don't know like somewhere around mile, three maybe, two and a half or three miles.\n[Doctor] OK. Ooh you're fast. Um.\n[Patient] switching my kilometres and miles, I'm not sure, all right.\n[Doctor] Um. And, um, do you have to stop running, or can you run through the pain?\n[Patient] Yeah, that is a good question. So, um, you know the last few times, the last time I actually stopped, I mean I ran a little bit longer, but then I stopped, because it was um, I, I feel like it's getting worse.\n[Doctor] OK.\n[Patient] Um, and, when I start doing my abs, that's, you know when I do my abs. It's kind of requiring me to move my you know, um, to kind of go from the flex position on my knees, and straighten my legs, then I feel all this clicking.\n[Doctor] OK.\n[Patient] And, I think that's also freaked me out, and uh, I just figured you know, something's wrong here.\n[Doctor] Right. And, you said before, it's both knees.\n[Patient] So it's more, um, it's actually my right knee that hurts.\n[Doctor] And, any problems with your left one?\n[Patient] No.\n[Doctor] OK, and, can you just describe in the knee, or show me whereabouts the pain, is happening mainly?\n[Patient] So, ah, you know I, I feel it, it's kind of weird, I feel it in the middle, but I almost feel like maybe it kind of uh, um, moves to the right, to the right of my knee a little bit.\n[Doctor] OK. Have you noticed any tenderness when you press over any areas in the knee?\n[Patient] So, yes, well it's, I have, probably some fluid. I googled it, and you know it says that sometimes fluid accumulates uh, I.\n[Doctor] OK. , does it look swollen to you?\n[Patient] Sorry?\n[Doctor] Does the knee look swollen?\n[Patient] Um, well it did, like, the first time I ran, it was a little bit swollen, but then I just put some like ice on it, and it went away.\n[Doctor] \n[Patient] Um, but, right now, right now it's not swollen, and right now it doesn't hurt, you know. Um, but, it just kind of comes on when uh, um, or you know right now when I flex and extend my leg, it, there's no clicking but, I'll notice it in the gym and then, you know, when I run it'll start hurting.\n[Doctor] OK, and, if you're sitting, still for a while, do you have any problems when you stand up, any locking up of the knee?\n[Patient] No.\n[Doctor] Can't straighten it. Any problems going up and down stairs?\n[Patient] No.\n[Doctor] Any problems just walking normally?\n[Patient] No, none, I don't.\n[Doctor] And intervals of range of movement. Are you able to fully straighten the leg?\n[Patient] Yes.\n[Doctor] And what about fully flex it?\n[Patient] Yes.\n[Doctor] OK. Are you taking any medication for the knee?\n[Patient] Well, um, since you're asking. Um, yes I , I take Ibuprofen, um, and I'll just kinda, use it sometime like uh, um, like sometimes I have some joint issues, but you know, that kind of, is not very frequent. So I'll take Ibuprofen for that. But you know it's nothing like major maybe, like, four hundred milligrams max, something like that. I also sometimes will um, you know, smoke a joint. Um, and, yeah, other than that, that's it.\n[Doctor] OK, and any other joint problems, that you're getting? Any back pains? Small swelling of your, hands, feet, elbows, wrists? Any pain?\n[Patient] No.\n[Patient] Uh, well I have sometimes, you know how sometimes like if you stand for a long time, your feet will kinda, or your legs will swell up. Like I noticed it because of my socks, I'll just kind of, notice this indentation.\n[Doctor] OK.\n[Patient] And then, another weird thing. I've felt this just once, but there was this tingling in my toes, like uh, um, after the run. There was tingling in my toes like on my, you know my right toes, um, so.\n[Doctor] On your right side.\n[Patient] Yes.\n[Doctor] Any change in colour, or temperature of your lower legs?\n[Patient] No.\n[Doctor] Any swelling which stays if you push in, and then you release it, that it stays there?\n[Patient] Well I don't know if I really try that, but I, I will tell you that, what I noticed is like if I, you know when my socks come off, I kind of notice that indentation a little bit, I mean it's not like major, right but, I. Uh, I mean do you mean I just need to like press and see what happens, if it like kind of stays or, .\n[Doctor] Yeah, any, or any pain in the back of the calf or anything like that?\n[Patient] No, no, nothing like that, no.\n[Doctor] Um, and, with your foot, has that gone back to normal now? Do you feel any altered senstation, tingling numbness, anything like that?\n[Patient] No it was just, it was that time, uh, but it was just really weird, because it kind of went on for a while.\n[Doctor] OK.And any pain in the joints of your foot or , on the underside in the arch? Any problems walking round on hard floors?\n[Patient] No.\n[Patient] No.\n[Doctor] OK, have you had, any other medical problems before?\n[Patient] Uh, well, I had uh.\n[Patient] You know what just, kind of your garden variety stuff, right, colds and, uh. I mean I, I do have, I'm far-sighted, and so I had uh, I had Lasik surgery. And then, once I had this really bad UTI, they thought it was kidney stones, and so they had me actually in ER. And if my GP didn't call them, tell them, that you know, they don't need to give me Morphine. Um, that was kind of an awful experience but, uh, other than that, you know, I'm, I'm, I'm pretty good. \n[Doctor] OK, and, do you take any other medications, apart from the ones you told me about?\n[Patient] Well, I'll take uh, I take vitamin D. Uh, I take melatonin. Sometimes, you know, just for cramps, I'll take, like, uh, um, ibuprofen, or actually , uh, I'll take, what am I taking? Aleve. Whatever Aleve is. Think that's maybe um, Acetaminophen, or, I can't remember what class of drugs. You know occasionally, if I'm really having hard times, like I'll, I'll sleeping, I'll take Xanax. Um, but, I prefer Melatonin, it's just sometimes Melatonin doesn't work.\n[Doctor] OK. And, any problems with your stomach, or asthma, indigestion, acid reflux?\n[Patient] No, no, no problems.\n[Doctor] . And, what I would suggest is, definitely carrying on with the ice therapy that you've been using. So, as much as you can, 'cause that really does make a difference to injuries. Brings the healing blood into the area, and it gives it the best chance of, getting better. So, as much as you can, use the ice.\n[Patient] Mm-hmm.\n[Doctor] Um, obviously you're trying to stick to a marathon programme, but. Um, I would, try and ease up on the running, if you can. And if it, if it's painful enough that you're, having to stop running, then it's not a good idea, to do that. Um. It's fine to take the Ibuprofen. Um, I can prescribe you a slightly stronger, anti-inflammatory that you can take regularly instead of the Ibuprofen, but not with the Ibuprofen.\n[Patient] Hmm.\n[Doctor] But make sure that with food. Ultimately we probably need to, examine the knee.\n[Patient] I see.\n[Doctor] Um, so, the best thing I would, suggest, getting a appointment with the physiotherapist first, who can do like a long, assessment, and examination of the knee. And then we can make an assessment as to whether we need to do any, um, imagery to , have a look inside the knee, and see if there's any problem with the, cartilage.\n[Patient] OK.\n[Patient] Well, you know I read, I read some stuff online that, that maybe like my ligaments there's, I think it's like ACL or, or something like that right, and so if that. I mean I'm kind of like freaked out that that may break. So do you think it's that, or?\n[Doctor] Um, it's, it's not really possible to, diagnose that over the , over the video. So we definitely would need to, see you. And, the, a physio is the best point of call, because they'll probably be the most likely initial treatment.\n[Patient] Right.\n[Doctor] But certainly if the appointment time's too long to wait, then we can see, we can see you in our clinic as well.\n[Patient] OK.\n[Patient] OK. Can you, so are you going to send referral for that?\n[Doctor] Yep, we can, we can do a referral before that. If in the meantime you develop like persistant swelling, heat, redness, um, of the knee, or high temperature, feel unwell, or it completely locks up and you can't bend and stretch it.\n[Patient] OK. Great.\n[Doctor] Then, you'd need to see a doctor urgently, so call us back in that, case. .\n[Patient] Mm-hmm.\n[Patient] That sounds good. Thank you yeah. , sure I mean, give me the, stronger medicine, I'll give that a try.\n[Doctor] OK. I'll send it through to your pharmacy for you. OK? Thank you, bye.\n[Patient] OK. Sweet. Thanks so much. OK. Bye, bye.",
"turns": [
{
"start": 0.95302,
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"text": "Hi.",
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{
"start": 1.525,
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"text": "Hi there. It's Doctor Smith from Babylon. Hi Doctor Smith. Hi, can you confirm your name, date of birth, and your home address please?",
"speaker": "Doctor"
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"text": "Hi Doctor Smith.",
"speaker": "Patient"
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"text": "Yes. My name is Mary Jo. Date of birth is January first, nineteen eighty.",
"speaker": "Patient"
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"text": "",
"speaker": "Doctor"
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"text": "And my address is uh, sixty Sloane Avenue, London.",
"speaker": "Patient"
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{
"start": 19.29167,
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"text": "OK, I, are you in a private place where you can have a consultation today?",
"speaker": "Doctor"
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"text": "Absolutely.",
"speaker": "Patient"
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"text": "What can I do for you?",
"speaker": "Doctor"
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{
"start": 26.23945,
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"text": "So, a couple of things. I, I, think I may have, overdone my workouts, and now my knees are hurting, and they're clicking a lot, and it's starting to worry me. Um, I can't run very far, um, any more without just feeling, pain in my knees. And then, sometimes I also get this weird tingling in my toes. Um. So yeah, that's, that's it. I'm just concerned and I figured you know I'd call and, see if you can, help me figure out what's going on.",
"speaker": "Patient"
},
{
"start": 55.35,
"end": 57.85,
"text": "OK, that's fine. So when do you think it started?",
"speaker": "Doctor"
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{
"start": 58.7729,
"end": 61.34707,
"text": "So probably, it's been about two weeks.",
"speaker": "Patient"
},
{
"start": 61.46666,
"end": 66.45,
"text": "OK. Um, and, any joint problems before that?",
"speaker": "Doctor"
},
{
"start": 67.67504,
"end": 83.81265,
"text": "You know not, not really. I mean I play a lot of sports. Um, and I had a , like I play some ice hockey, and I had this injury a few months ago. You know I just like, fell on the ice and, and, you know had a, huge bruise but, I think that's about it.",
"speaker": "Patient"
},
{
"start": 84.13333,
"end": 91.25,
"text": "OK, So, um, at the moment, just tell me about the exercise that you're doing, normally.",
"speaker": "Doctor"
},
{
"start": 91.49948,
"end": 110.38662,
"text": "So I'm training, well, I'm currently training for a marathon, um, that's gonna happen in, June. And so, I'm trying to run like. I mean right now, I'm actually not even doing such long runs, maybe like seven or eight miles. And so, I started about uh, maybe a month ago.",
"speaker": "Patient"
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{
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"text": "",
"speaker": "Doctor"
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{
"start": 110.38662,
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"text": "Uh, I've done like, you know, four or five miles, and I've just done like a couple of seven, mile runs. And then uh, uh, and then you know I go to the gym like few times a week and, kinda do my, usual routine.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "Um, but, yeah, I think the only thing that's really different has, have been, the runs, the longer runs.",
"speaker": "Patient"
},
{
"start": 129.51666,
"end": 135.3,
"text": "And, have you had, any times when the knee feels like it's giving way underneath you?",
"speaker": "Doctor"
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{
"start": 137.3706,
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"text": "Um, well, I, what do you mean by that? I'm not sure what, what that means.",
"speaker": "Patient"
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{
"start": 140.96666,
"end": 148.80833,
"text": "So, it means if you're, if you're there and uh, you just feel it sort of jolt, like give way, feel unstable underneath you.",
"speaker": "Doctor"
},
{
"start": 149.58391,
"end": 153.75207,
"text": "Not, not bad, I mean it just kinda starts hurting, you know. Um.",
"speaker": "Patient"
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{
"start": 152.71666,
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"text": "And does it hurt, uh, how far into the run does it generally hurt?",
"speaker": "Doctor"
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{
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"text": "You know I would say probably starts off like after, uh, maybe, twenty minutes or so. Which is, probably I don't know like somewhere around mile, three maybe, two and a half or three miles.",
"speaker": "Patient"
},
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"start": 171.15,
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"text": "OK. Ooh you're fast. Um.",
"speaker": "Doctor"
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{
"start": 174.03589,
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"text": " switching my kilometres and miles, I'm not sure, all right.",
"speaker": "Patient"
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{
"start": 176.07499,
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"text": " Um. And, um, do you have to stop running, or can you run through the pain?",
"speaker": "Doctor"
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{
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"text": "Yeah, that is a good question. So, um, you know the last few times, the last time I actually stopped, I mean I ran a little bit longer, but then I stopped, because it was um, I, I feel like it's getting worse.",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "Um, and, when I start doing my abs, that's, you know when I do my abs. It's kind of requiring me to move my you know, um, to kind of go from the flex position on my knees, and straighten my legs, then I feel all this clicking.",
"speaker": "Patient"
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{
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"text": "OK.",
"speaker": "Doctor"
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{
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"text": "And, I think that's also freaked me out, and uh, I just figured you know, something's wrong here.",
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{
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"text": "Right. And, you said before, it's both knees.",
"speaker": "Doctor"
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{
"start": 217.90493,
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"text": "So it's more, um, it's actually my right knee that hurts.",
"speaker": "Patient"
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{
"start": 221.39795,
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"text": " And, any problems with your left one?",
"speaker": "Doctor"
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{
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"text": "No.",
"speaker": "Patient"
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{
"start": 227.56603,
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"text": "OK, and, can you just describe in the knee, or show me whereabouts the pain, is happening mainly?",
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{
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"text": "So, ah, you know I, I feel it, it's kind of weird, I feel it in the middle, but I almost feel like maybe it kind of uh, um, moves to the right, to the right of my knee a little bit.",
"speaker": "Patient"
},
{
"start": 244.43163,
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"text": "OK. Have you noticed any tenderness when you press over any areas in the knee?",
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{
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"text": "So, yes, well it's, I have, probably some fluid. I googled it, and you know it says that sometimes fluid accumulates uh, I.",
"speaker": "Patient"
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"text": "OK. , does it look swollen to you?",
"speaker": "Doctor"
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"text": "Sorry?",
"speaker": "Patient"
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"text": "Does the knee look swollen?",
"speaker": "Doctor"
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"text": "Um, well it did, like, the first time I ran, it was a little bit swollen, but then I just put some like ice on it, and it went away.",
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"text": "Um, but, right now, right now it's not swollen, and right now it doesn't hurt, you know. Um, but, it just kind of comes on when uh, um, or you know right now when I flex and extend my leg, it, there's no clicking but, I'll notice it in the gym and then, you know, when I run it'll start hurting.",
"speaker": "Patient"
},
{
"start": 287.52419,
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"text": "OK, and, if you're sitting, still for a while, do you have any problems when you stand up, any locking up of the knee?",
"speaker": "Doctor"
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{
"start": 296.10814,
"end": 296.55781,
"text": "No.",
"speaker": "Patient"
},
{
"start": 296.54102,
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"text": "Can't straighten it. Any problems going up and down stairs?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
},
{
"start": 302.26372,
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"text": "Any problems just walking normally?",
"speaker": "Doctor"
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"start": 304.80447,
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"text": "No, none, I don't.",
"speaker": "Patient"
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{
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"text": "And intervals of range of movement. Are you able to fully straighten the leg?",
"speaker": "Doctor"
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"text": "Yes.",
"speaker": "Patient"
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"text": "And what about fully flex it?",
"speaker": "Doctor"
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"text": "Yes.",
"speaker": "Patient"
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"text": "OK. Are you taking any medication for the knee?",
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"text": "Well, um, since you're asking. Um, yes I , I take Ibuprofen, um, and I'll just kinda, use it sometime like uh, um, like sometimes I have some joint issues, but you know, that kind of, is not very frequent. So I'll take Ibuprofen for that. But you know it's nothing like major maybe, like, four hundred milligrams max, something like that. I also sometimes will um, you know, smoke a joint. Um, and, yeah, other than that, that's it.",
"speaker": "Patient"
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"start": 352.70749,
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"text": "OK, and any other joint problems, that you're getting? Any back pains? Small swelling of your, hands, feet, elbows, wrists? Any pain?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
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"text": "Uh, well I have sometimes, you know how sometimes like if you stand for a long time, your feet will kinda, or your legs will swell up. Like I noticed it because of my socks, I'll just kind of, notice this indentation.",
"speaker": "Patient"
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{
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"text": "OK.",
"speaker": "Doctor"
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"text": "And then, another weird thing. I've felt this just once, but there was this tingling in my toes, like uh, um, after the run. There was tingling in my toes like on my, you know my right toes, um, so.",
"speaker": "Patient"
},
{
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"text": "On your right side.",
"speaker": "Doctor"
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{
"start": 386.77914,
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"text": "Yes.",
"speaker": "Patient"
},
{
"start": 387.65054,
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"text": "Any change in colour, or temperature of your lower legs?",
"speaker": "Doctor"
},
{
"start": 392.34327,
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"text": "No.",
"speaker": "Patient"
},
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"start": 392.91946,
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"text": "Any swelling which stays if you push in, and then you release it, that it stays there?",
"speaker": "Doctor"
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{
"start": 398.9928,
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"text": "Well I don't know if I really try that, but I, I will tell you that, what I noticed is like if I, you know when my socks come off, I kind of notice that indentation a little bit, I mean it's not like major, right but, I. Uh, I mean do you mean I just need to like press and see what happens, if it like kind of stays or, .",
"speaker": "Patient"
},
{
"start": 415.43215,
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"text": "Yeah, any, or any pain in the back of the calf or anything like that?",
"speaker": "Doctor"
},
{
"start": 418.96079,
"end": 420.97421,
"text": "No, no, nothing like that, no.",
"speaker": "Patient"
},
{
"start": 420.65064,
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"text": "Um, and, with your foot, has that gone back to normal now? Do you feel any altered senstation, tingling numbness, anything like that?",
"speaker": "Doctor"
},
{
"start": 429.39705,
"end": 435.43639,
"text": "No it was just, it was that time, uh, but it was just really weird, because it kind of went on for a while.",
"speaker": "Patient"
},
{
"start": 435.72632,
"end": 444.72635,
"text": "OK.And any pain in the joints of your foot or , on the underside in the arch? Any problems walking round on hard floors?",
"speaker": "Doctor"
},
{
"start": 441.8199,
"end": 442.23601,
"text": "No.",
"speaker": "Patient"
},
{
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"end": 445.73937,
"text": "No.",
"speaker": "Patient"
},
{
"start": 446.16333,
"end": 449.39023,
"text": "OK, have you had, any other medical problems before?",
"speaker": "Doctor"
},
{
"start": 450.75244,
"end": 453.11036,
"text": "Uh, well, I had uh.",
"speaker": "Patient"
},
{
"start": 455.05036,
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"text": "You know what just, kind of your garden variety stuff, right, colds and, uh. I mean I, I do have, I'm far-sighted, and so I had uh, I had Lasik surgery. And then, once I had this really bad UTI, they thought it was kidney stones, and so they had me actually in ER. And if my GP didn't call them, tell them, that you know, they don't need to give me Morphine. Um, that was kind of an awful experience but, uh, other than that, you know, I'm, I'm, I'm pretty good. ",
"speaker": "Patient"
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{
"start": 484.54019,
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"text": "OK, and, do you take any other medications, apart from the ones you told me about?",
"speaker": "Doctor"
},
{
"start": 488.5553,
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"text": "Well, I'll take uh, I take vitamin D. Uh, I take melatonin. Sometimes, you know, just for cramps, I'll take, like, uh, um, ibuprofen, or actually , uh, I'll take, what am I taking? Aleve. Whatever Aleve is. Think that's maybe um, Acetaminophen, or, I can't remember what class of drugs. You know occasionally, if I'm really having hard times, like I'll, I'll sleeping, I'll take Xanax. Um, but, I prefer Melatonin, it's just sometimes Melatonin doesn't work.",
"speaker": "Patient"
},
{
"start": 517.90686,
"end": 523.79853,
"text": "OK. And, any problems with your stomach, or asthma, indigestion, acid reflux?",
"speaker": "Doctor"
},
{
"start": 522.64917,
"end": 524.77984,
"text": "No, no, no problems.",
"speaker": "Patient"
},
{
"start": 525.22353,
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"text": ". And, what I would suggest is, definitely carrying on with the ice therapy that you've been using. So, as much as you can, 'cause that really does make a difference to injuries. Brings the healing blood into the area, and it gives it the best chance of, getting better. So, as much as you can, use the ice.",
"speaker": "Doctor"
},
{
"start": 535.8537,
"end": 536.33692,
"text": "Mm-hmm.",
"speaker": "Patient"
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"start": 542.54757,
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"text": "Um, obviously you're trying to stick to a marathon programme, but. Um, I would, try and ease up on the running, if you can. And if it, if it's painful enough that you're, having to stop running, then it's not a good idea, to do that. Um. It's fine to take the Ibuprofen. Um, I can prescribe you a slightly stronger, anti-inflammatory that you can take regularly instead of the Ibuprofen, but not with the Ibuprofen.",
"speaker": "Doctor"
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{
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"text": "Hmm.",
"speaker": "Patient"
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{
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"text": "But make sure that with food. Ultimately we probably need to, examine the knee.",
"speaker": "Doctor"
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"text": "I see.",
"speaker": "Patient"
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{
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"text": "Um, so, the best thing I would, suggest, getting a appointment with the physiotherapist first, who can do like a long, assessment, and examination of the knee. And then we can make an assessment as to whether we need to do any, um, imagery to , have a look inside the knee, and see if there's any problem with the, cartilage.",
"speaker": "Doctor"
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{
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"text": "OK.",
"speaker": "Patient"
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{
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"text": "Well, you know I read, I read some stuff online that, that maybe like my ligaments there's, I think it's like ACL or, or something like that right, and so if that. I mean I'm kind of like freaked out that that may break. So do you think it's that, or?",
"speaker": "Patient"
},
{
"start": 610.04852,
"end": 624.23334,
"text": "Um, it's, it's not really possible to, diagnose that over the , over the video. So we definitely would need to, see you. And, the, a physio is the best point of call, because they'll probably be the most likely initial treatment.",
"speaker": "Doctor"
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{
"start": 616.59888,
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"text": "Right.",
"speaker": "Patient"
},
{
"start": 624.23334,
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"text": "But certainly if the appointment time's too long to wait, then we can see, we can see you in our clinic as well.",
"speaker": "Doctor"
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{
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"text": "OK.",
"speaker": "Patient"
},
{
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"text": "OK. Can you, so are you going to send referral for that?",
"speaker": "Patient"
},
{
"start": 632.79909,
"end": 646.61982,
"text": "Yep, we can, we can do a referral before that. If in the meantime you develop like persistant swelling, heat, redness, um, of the knee, or high temperature, feel unwell, or it completely locks up and you can't bend and stretch it.",
"speaker": "Doctor"
},
{
"start": 634.04951,
"end": 635.12537,
"text": "OK. Great.",
"speaker": "Patient"
},
{
"start": 646.61982,
"end": 653.50203,
"text": "Then, you'd need to see a doctor urgently, so call us back in that, case. .",
"speaker": "Doctor"
},
{
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"end": 647.21639,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 651.91438,
"end": 658.65171,
"text": "That sounds good. Thank you yeah. , sure I mean, give me the, stronger medicine, I'll give that a try.",
"speaker": "Patient"
},
{
"start": 658.48305,
"end": 663.95685,
"text": "OK. I'll send it through to your pharmacy for you. OK? Thank you, bye.",
"speaker": "Doctor"
},
{
"start": 660.95449,
"end": 665.69998,
"text": "OK. Sweet. Thanks so much. OK. Bye, bye.",
"speaker": "Patient"
}
],
"doctor_utterances": "Hi there. It's Doctor Smith from Babylon. Hi Doctor Smith. Hi, can you confirm your name, date of birth, and your home address please? OK, I, are you in a private place where you can have a consultation today? What can I do for you? OK, that's fine. So when do you think it started? OK. Um, and, any joint problems before that? OK, So, um, at the moment, just tell me about the exercise that you're doing, normally. And, have you had, any times when the knee feels like it's giving way underneath you? So, it means if you're, if you're there and uh, you just feel it sort of jolt, like give way, feel unstable underneath you. And does it hurt, uh, how far into the run does it generally hurt? OK. Ooh you're fast. Um. Um. And, um, do you have to stop running, or can you run through the pain? OK. OK. Right. And, you said before, it's both knees. And, any problems with your left one? OK, and, can you just describe in the knee, or show me whereabouts the pain, is happening mainly? OK. Have you noticed any tenderness when you press over any areas in the knee? OK. , does it look swollen to you? Does the knee look swollen? OK, and, if you're sitting, still for a while, do you have any problems when you stand up, any locking up of the knee? Can't straighten it. Any problems going up and down stairs? Any problems just walking normally? And intervals of range of movement. Are you able to fully straighten the leg? And what about fully flex it? OK. Are you taking any medication for the knee? OK, and any other joint problems, that you're getting? Any back pains? Small swelling of your, hands, feet, elbows, wrists? Any pain? OK. On your right side. Any change in colour, or temperature of your lower legs? Any swelling which stays if you push in, and then you release it, that it stays there? Yeah, any, or any pain in the back of the calf or anything like that? Um, and, with your foot, has that gone back to normal now? Do you feel any altered senstation, tingling numbness, anything like that? OK.And any pain in the joints of your foot or , on the underside in the arch? Any problems walking round on hard floors? OK, have you had, any other medical problems before? OK, and, do you take any other medications, apart from the ones you told me about? OK. And, any problems with your stomach, or asthma, indigestion, acid reflux? . And, what I would suggest is, definitely carrying on with the ice therapy that you've been using. So, as much as you can, 'cause that really does make a difference to injuries. Brings the healing blood into the area, and it gives it the best chance of, getting better. So, as much as you can, use the ice. Um, obviously you're trying to stick to a marathon programme, but. Um, I would, try and ease up on the running, if you can. And if it, if it's painful enough that you're, having to stop running, then it's not a good idea, to do that. Um. It's fine to take the Ibuprofen. Um, I can prescribe you a slightly stronger, anti-inflammatory that you can take regularly instead of the Ibuprofen, but not with the Ibuprofen. But make sure that with food. Ultimately we probably need to, examine the knee. Um, so, the best thing I would, suggest, getting a appointment with the physiotherapist first, who can do like a long, assessment, and examination of the knee. And then we can make an assessment as to whether we need to do any, um, imagery to , have a look inside the knee, and see if there's any problem with the, cartilage. Um, it's, it's not really possible to, diagnose that over the , over the video. So we definitely would need to, see you. And, the, a physio is the best point of call, because they'll probably be the most likely initial treatment. But certainly if the appointment time's too long to wait, then we can see, we can see you in our clinic as well. Yep, we can, we can do a referral before that. If in the meantime you develop like persistant swelling, heat, redness, um, of the knee, or high temperature, feel unwell, or it completely locks up and you can't bend and stretch it. Then, you'd need to see a doctor urgently, so call us back in that, case. . OK. I'll send it through to your pharmacy for you. OK? Thank you, bye.",
"patient_utterances": "Hi. Hi Doctor Smith. Yes. My name is Mary Jo. Date of birth is January first, nineteen eighty. And my address is uh, sixty Sloane Avenue, London. Absolutely. So, a couple of things. I, I, think I may have, overdone my workouts, and now my knees are hurting, and they're clicking a lot, and it's starting to worry me. Um, I can't run very far, um, any more without just feeling, pain in my knees. And then, sometimes I also get this weird tingling in my toes. Um. So yeah, that's, that's it. I'm just concerned and I figured you know I'd call and, see if you can, help me figure out what's going on. So probably, it's been about two weeks. You know not, not really. I mean I play a lot of sports. Um, and I had a , like I play some ice hockey, and I had this injury a few months ago. You know I just like, fell on the ice and, and, you know had a, huge bruise but, I think that's about it. So I'm training, well, I'm currently training for a marathon, um, that's gonna happen in, June. And so, I'm trying to run like. I mean right now, I'm actually not even doing such long runs, maybe like seven or eight miles. And so, I started about uh, maybe a month ago. Uh, I've done like, you know, four or five miles, and I've just done like a couple of seven, mile runs. And then uh, uh, and then you know I go to the gym like few times a week and, kinda do my, usual routine. Um, but, yeah, I think the only thing that's really different has, have been, the runs, the longer runs. Um, well, I, what do you mean by that? I'm not sure what, what that means. Not, not bad, I mean it just kinda starts hurting, you know. Um. You know I would say probably starts off like after, uh, maybe, twenty minutes or so. Which is, probably I don't know like somewhere around mile, three maybe, two and a half or three miles. switching my kilometres and miles, I'm not sure, all right. Yeah, that is a good question. So, um, you know the last few times, the last time I actually stopped, I mean I ran a little bit longer, but then I stopped, because it was um, I, I feel like it's getting worse. Um, and, when I start doing my abs, that's, you know when I do my abs. It's kind of requiring me to move my you know, um, to kind of go from the flex position on my knees, and straighten my legs, then I feel all this clicking. And, I think that's also freaked me out, and uh, I just figured you know, something's wrong here. So it's more, um, it's actually my right knee that hurts. No. So, ah, you know I, I feel it, it's kind of weird, I feel it in the middle, but I almost feel like maybe it kind of uh, um, moves to the right, to the right of my knee a little bit. So, yes, well it's, I have, probably some fluid. I googled it, and you know it says that sometimes fluid accumulates uh, I. Sorry? Um, well it did, like, the first time I ran, it was a little bit swollen, but then I just put some like ice on it, and it went away. Um, but, right now, right now it's not swollen, and right now it doesn't hurt, you know. Um, but, it just kind of comes on when uh, um, or you know right now when I flex and extend my leg, it, there's no clicking but, I'll notice it in the gym and then, you know, when I run it'll start hurting. No. No. No, none, I don't. Yes. Yes. Well, um, since you're asking. Um, yes I , I take Ibuprofen, um, and I'll just kinda, use it sometime like uh, um, like sometimes I have some joint issues, but you know, that kind of, is not very frequent. So I'll take Ibuprofen for that. But you know it's nothing like major maybe, like, four hundred milligrams max, something like that. I also sometimes will um, you know, smoke a joint. Um, and, yeah, other than that, that's it. No. Uh, well I have sometimes, you know how sometimes like if you stand for a long time, your feet will kinda, or your legs will swell up. Like I noticed it because of my socks, I'll just kind of, notice this indentation. And then, another weird thing. I've felt this just once, but there was this tingling in my toes, like uh, um, after the run. There was tingling in my toes like on my, you know my right toes, um, so. Yes. No. Well I don't know if I really try that, but I, I will tell you that, what I noticed is like if I, you know when my socks come off, I kind of notice that indentation a little bit, I mean it's not like major, right but, I. Uh, I mean do you mean I just need to like press and see what happens, if it like kind of stays or, . No, no, nothing like that, no. No it was just, it was that time, uh, but it was just really weird, because it kind of went on for a while. No. No. Uh, well, I had uh. You know what just, kind of your garden variety stuff, right, colds and, uh. I mean I, I do have, I'm far-sighted, and so I had uh, I had Lasik surgery. And then, once I had this really bad UTI, they thought it was kidney stones, and so they had me actually in ER. And if my GP didn't call them, tell them, that you know, they don't need to give me Morphine. Um, that was kind of an awful experience but, uh, other than that, you know, I'm, I'm, I'm pretty good. Well, I'll take uh, I take vitamin D. Uh, I take melatonin. Sometimes, you know, just for cramps, I'll take, like, uh, um, ibuprofen, or actually , uh, I'll take, what am I taking? Aleve. Whatever Aleve is. Think that's maybe um, Acetaminophen, or, I can't remember what class of drugs. You know occasionally, if I'm really having hard times, like I'll, I'll sleeping, I'll take Xanax. Um, but, I prefer Melatonin, it's just sometimes Melatonin doesn't work. No, no, no problems. Mm-hmm. Hmm. I see. OK. Well, you know I read, I read some stuff online that, that maybe like my ligaments there's, I think it's like ACL or, or something like that right, and so if that. I mean I'm kind of like freaked out that that may break. So do you think it's that, or? Right. OK. OK. Can you, so are you going to send referral for that? OK. Great. Mm-hmm. That sounds good. Thank you yeah. , sure I mean, give me the, stronger medicine, I'll give that a try. OK. Sweet. Thanks so much. OK. Bye, bye.",
"num_turns": 106,
"reference_note": "{\"day\": 5, \"consultation\": 11, \"presenting_complaint\": \"I have a pouring diarrhea\", \"note\": \"PC: R knee pain\\n\\nHPC: 2/52 R knee pain. Training for marathon. Currently up to 7-8 miles few times a week. Gym few x week. Had to stop running at 20 min point due to pain this week. \\nPain in front of knee and right side. No specific area tenderness. Has noticed puffiness of knee after exercise, used ice and this settled completely. No giving way/locking. No problems going up/downstairs or on normal walking. \\nFROM. \\nGenerally feels pain is getting worse. \\nHas had previous ice hockey injury and bruising afterwards.\\nNo other jt pains, no general unwell/fever.\\nHas had tingling R side forefoot which settled down. Slight ankle swelling, indentation socks. No change in temp/colour.\\nNo problems walking hard floors/pain in sole.\\n\\nPMH: LASIK, ? kidney stones.\\n\\nDHx: Vit D, melatonin, ibuprofen. Xanax sometimes . \\n\\nSH: Has occ joint. \\n\\nPlan: Advised replace ibuprofen with naproxen which I will prescribe. Continue using ice as much as possible and reduce exercise. Do not continue to run with pain. No hx GI sx/asthma. Advise I will refer for physio for assessment and ongoing Rx. If persistent swelling/heat/redness/locking to see Dr asap.\\n\", \"highlights\": [\"Training for marathon\", \"puffiness of knee after exercise\", \"No giving way/locking\", \"FROM\", \"tingling R side forefoot\", \"If persistent swelling/heat/redness/locking to see Dr asap\"]}",
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